JOSE SOARES JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
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- 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.
- The Role of F-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Diagnosis of Left-sided Endocarditis: Native vs Prosthetic Valves Endocarditis(2020) CAMARGO, Raphael Abegao de; BITENCOURT, Marcio Sommer; MENEGHETTI, Jose Claudio; JR, Jose Soares; GONCALVES, Luis Fernando Tonello; BUCHPIGUEL, Carlos Alberto; PAIXAO, Milena Ribeiro; FELICIO, Marilia Francesconi; SOEIRO, Alexandre de Matos; STRABELLI, Tania Mara Varejao; MANSUR, Alfredo Jose; TARASOUTCHI, Flavio; JR, Mucio Tavares de Oliveira; CASTELLI, Jussara Bianchi; GUALANDRO, Danielle Menosi; POCEBON, Lucas Zoboli; BLANKSTEIN, Ron; ALAVI, Abass; MOORE, John Edmund; MILLAR, Beverley Cherie; SICILIANO, Rinaldo FocacciaBackground: F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG-PET/CT) has emerged as a useful diagnostic tool for suspected infective endocarditis (IE) in patients with prosthetic valves or implantable devices. However, there is limited evidence regarding use of F-18-FDG-PET/CT for the diagnosis of native valve endocarditis (NVE). Methods: Between 2014 and 2017, 303 episodes of left-sided suspected IE (188 prosthetic valves/ascending aortic prosthesis and 115 native valves) were studied. F-18-FDG-PET/CT accuracy was determined in the subgroups of patients with NVE and prosthetic valve endocarditis (PVE)/ascending aortic prosthesis infection (AAPI). Associations between inflammatory infiltrate patterns and F-18-FDG-PET/CT uptake were investigated in an exploratory ad hoc histological analysis. Results: Among 188 patients with PVE/AAPI, the sensitivity, specificity, and positive and negative predictive values of F-18-FDG-PET/CT focal uptake were 93%, 90%, 89%, and 94%, respectively, while among 115 patients with NVE, the corresponding values were 22%, 100%, 100%, and 66%. The inclusion of abnormal F-18-FDG cardiac uptake as a major criterion at admission enabled a recategorization of 76% (47/62) of PVE/AAPI cases initially classified as ""possible"" to ""definite"" IE. In the histopathological analysis, a predominance of polymorphonuclear cell inflammatory infiltrate and a reduced extent of fibrosis were observed in the PVE group only. Conclusions: Use of F-18-FDG-PET/CT at the initial presentation of patients with suspected PVE increases the diagnostic capability of the modified Duke criteria. In patients who present with suspected NVE, the use of F-18-FDG-PET/CT is less accurate and could only be considered a complementary diagnostic tool for a specific population of patients with NVE.
- 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.