CESAR HIGA NOMURA

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/65, Hospital das Clínicas, Faculdade de Medicina - Líder

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Agora exibindo 1 - 10 de 21
  • conferenceObject
    USE OF BIOMARKERS AND CARDIAC MAGNETIC RESONANCE FOR DETECTION OF MYOCARDIAL INFARCTION RELATED TO CORONARY REVASCULARIZATION PROCEDURES
    (2014) MELO, Rodrigo Vieira de; OIKAWA, Fernando Teiichi; COSTA, Leandro; REZENDE, Paulo; STRUNZ, Celia; NOMURA, Cesar; MARQUES FILHO, Ismar A.; VILLA, Alexandre; HUEB, Alexandre; HUEB, Whady; KALIL-FILHO, Roberto
  • conferenceObject
    Subclinical Coronary Atherosclerosis in Subjects with Ischemic Stroke caused by Cervicocephalic Atherothrombosis - preliminary results
    (2018) ARAUJO, Ana Luiza; NOMURA, Cesar; SANTOS, Raul; SHU, Edson; OLIVEIRA, Marcelo; MARTIN, Maria; OSHIRO, Carlos; MIRANDA, Maramelia; SILVA, Gisele Sampaio; SILVA, Victor; LEITE, Claudia; CONFORTO, Adriana
  • article 2 Citação(ões) na Scopus
    Long-term prognostic value of late gadolinium enhancement and periprocedural myocardial infarction after uncomplicated revascularization: MASS-V follow-up
    (2022) LINHARES-FILHO, Jaime; HUEB, Whady; LIMA, Eduardo; REZENDE, Paulo; AZEVEDO, Diogo; ROCHITTE, Carlos; NOMURA, Cesar; SERRANO-JUNIOR, Carlos; RAMIRES, Jose; KALIL-FILHO, Roberto
    Aims Cardiac biomarkers elevation is common after revascularization, even in absence of periprocedural myocardial infarction (PMI) detection by imaging methods. Thus, late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) may be useful on PMI diagnosis and prognosis. We sought to evaluate long-term prognostic value of PMI and new LGE after revascularization. Methods and results Two hundred and two patients with multivessel coronary disease and preserved ventricular function who underwent elective revascularization were included, of whom 136 (67.3%) underwent coronary artery bypass grafting and 66 (32.7%) percutaneous coronary intervention. The median follow-up was 5 years (4.8-5.8 years). Cardiac biomarkers measurement and LGE-CMR were performed before and after procedures. The Society for Cardiovascular Angiography and Interventions definition was used to assess PMI. Primary endpoint was composed of death, infarction, additional revascularization, or cardiac hospitalization. Primary endpoint was observed in 29 (14.3%) patients, of whom 13 (14.9%) had PMI and 16 (13.9%) did not (P = 0.93). Thirty-six (17.8%) patients had new LGE. Twenty (12.0%) events occurred in patients without new LGE and 9 (25.2%) in patients with it (P = 0.045). LGE was also associated to increased mortality, with 4 (2.4%) and 4 (11.1%) deaths in subjects without and with it (P = 0.02). LGE was the only independent predictor of primary endpoint and mortality (P = 0.03 and P = 0.02). Median LGE mass was estimated at 4.6 g. Patients with new LGE had a greater biomarkers release (median troponin: 8.9 ng/mL vs. 1.8 ng/mL and median creatine kinase-MB: 38.0 ng/mL vs. 12.3 ng/mL; P < 0.001 in both comparisons). Conclusions New LGE was shown to be better prognostic predictor than biomarker-only PMI definition after uncomplicated revascularization. Furthermore, new LGE was the only independent predictor of cardiovascular events and mortality.
  • conferenceObject
    RESTRICTIVE AND HYPERTROPHIC CARDIOMYOPATHIES AS INDICATION FOR HEART TRANSPLANTATION: CLINICAL OUTCOME IN A SINGLE CENTER
    (2013) TANAKA, Ana Cristina; MIURA, Nana; THOMAZ, Ana Maria; AIELLO, Vera Demarchi; BENEVENUTI, Luiz; TAVARES, Glaucia; NOMURA, Cesar; JATENE, Marcelo Biscegli; AZEKA, Estela
    PURPOSE: The purpose of this study was evaluate the prevalence and outcome of restrictive and hypertrophic cardiomyopathies in a cohort of pediatric heart transplantation. METHOD: To evaluate the prevalence and clinical outcome of children with restrictive and hypertrophic cardiomyopathies submitted heart transplantation. RESULTS: From october 1992 to 2012, 115 patients were submitted heart transplantation. 120 transplants were performed at Heart Institute (InCor) University São Paulo Medical School. Seventeen (14,7%) of these patients hat restrictive cardiomyopathy/hypertrophic cardiomyopathy and have undergone to heart transplantation. The mean age was 10,4 years. Survival was 76,4%. Follow-up period ranged from 26 days to 6,6 years. CONCLUSION: Restrictive and hypertrophic cardiomyopathies can be an indication for heart transplantation a favorable outcome.
  • conferenceObject
    ASSOCIATION BETWEEN ABNORMAL BIOMARKER RELEASE AND MYOCARDIAL EDEMA ASSESSED BY MAGNETIC RESONANCE IMAGING AFTER UNCOMPLICATED REVASCULARIZATION PROCEDURES
    (2020) RIBAS, Fernando Faglioni; HUEB, Whady; REZENDE, Paulo; ROCHITTE, Carlos; NOMURA, Cesar; MORAIS, Thamara; LIMA, Eduardo Gomes; BOROS, Gustavo; CARVALHO, Felipe Pereira Camara; RIBEIRO, Matheus; LINHARES FILHO, Jaime; DALLAZEN, Anderson Roberto; SILVA, Rafael; MOCHA, Mauricio; SERRANO, Carlos; RAMIRES, Jose; KALIL-FILHO, Roberto
  • article 0 Citação(ões) na Scopus
    Motion Correction for Extracellular Volume Fraction Mapping in Cardiac MRI
    (2018) SATO, Tetsuo; KAMIKAWA, Satoshi; NAKAYAMA, Subaru; ICHINOSE, Nobuyasu; KUHARA, Shigehide; KANAYA, Shigehiko; MINATO, Kotaro; NOMURA, Cesar
    Extracellular volume fraction mapping (ECV Map) can provide quantitative measurements of myocardial tissue with amyloid deposition and myocardial edema. ECV measurements have been shown to correlate well with myocardial fibrosis. Pixel-wise ECV Maps are calculated from acquired precontrast and postcontrast T1 Maps calibrated by blood hematocrit. The maps are acquired with ECG triggering and breath holding. However, ECV measurement is not accurate when heart motion occurs because of inconsistent and inadequate breath holding during image acquisition. We present an application of motion-correction algorithm for ECV Maps in cardiac MRI. Our proposed method is based on aligning the position of the heart between precontrast and postcontrast T1 Maps before calculating the ECV Map. The problem with this registration is spatial displacement of the myocardium because of different diaphragm positions. We have developed an automatic approach to detect the displacement before and after contrast injection, and the ECV Map is measured with correction of the myocardium position considering the displacement. We confirmed that our proposed method improves the accuracy of the ECV Map regardless of the size of displacement.
  • conferenceObject
    BIOMARKERS AND CMR WITH LATE GADOLINIUM ENHANCEMENT FOR DIAGNOSIS OF PROCEDURE-RELATED MYOCARDIAL NECROSIS: A PROSPECTIVE TRIAL USING THE THIRD UNIVERSAL DEFINITION OF MYOCARDIAL INFARCTION
    (2013) HUEB, Whady; NOMURA, Cesar; VILLA, Alexandre V.; PARGA, Jose; COSTA, Leandro; MELO, Rodrigo M. V.; OIKAWA, Fernando T. C.; STRUNZ, Celia; REZENDE, Paulo; LIMA, Eduardo; GARZILLO, Cibele L.; RIBEIRO, Expedito E.; HUEB, Alexandre; SERRANO, Carlos; RAMIRES, Jose; KALIL-FILHO, Roberto
    Background: The elevation of cardiac biomarkers after percutaneous or surgical myocardial revascularization procedures is common. However, the correlation between the release and the diagnosis of procedure-related myocardial infarction (Ml) remains unknown. In this study we aim to compare the release of cardiac biomarkers after mechanical interventions with the presence of late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR). Methods: In this prospective study, we evaluated 64 stable multivessel coronary artery disease patients with preserved ventricular function and formal indication to revascularization. The release of troponin and CKMB for diagnosis of procedure-related Ml was defined as the third universal definition of Ml. CMR with LGE was performed in all patients before and after interventions. Measurements of cardiac biomarkers were performed before and after the procedure, every 6 hours until 48h after PCI and 72h after CABG. Results: Of 64 patients, 44 (68.8%) underwent CABG and 20 (31.2%) underwent PCI; 46 (72%) were male, 45 (70%) had 3-vessel disease, 33 (52%) had diabetes and 23 (36%) had class Ill/IV of angina. For CABG patients, injury occurred in 95.5% (troponin) and 25% (CKMB); for PCI patients injury occurred in 70% (troponin) and 5% (CKMB). From the initial 64 patients, 14 (21.9%) had new LGE on post-procedure CMR, 13 after CABG and 1 after PCI. From these 14 patients, 7 (50%) presented elevation of CKMB above the cutoffs and troponin was elevated in all patients. From the 50 patients with no new LGE on CMR, 5 (10%) presented CKMB elevation and 42 (84%) presented troponin elevation above the 99th percentile. Based on current cutoffs, troponin had a sensitivity of 100% and specificity of 16% (positive predictive value of 25% and negative predictive value of 100%). CKMB had a sensitivity of 50% and specificity of 90% (positive predictive value of 58% and negative predictive value of 87%). Conclusion: In this study, cardiac biomarkers had a low accuracy for the diagnosis of procedure-related myocardial infarction based on LGE CMR.
  • conferenceObject
    Safety of Endovascular Therapeutic Hypothermia as an Adjuvant Therapy in Acute ST Segment Elevation Myocardial Infarction
    (2017) DALLAN, Luis A.; RIBEIRO, Marcelo; GIANNETTI, Natali; ROCHITTE, Carlos; NOMURA, Cesar; HAJJAR, Ludhmila; LAGE, Silvia; LIMA, Felipe G.; SOEIRO, Alexandre; NICOLAU, Jose C.; TAVARES, Mucio; NETO, Pedro A. Lemos; TIMERMAN, Sergio; KALIL, Roberto
  • conferenceObject
    T1 MAPPING FOR MYOCARDIAL TISSUE EVALUATION IN PATIENTS WITH ISCHEMIA AND STABLE CORONARY ARTERY DISEASE: MASS V-TRIAL STUDY GROUP
    (2020) RIBEIRO, Matheus; HUEB, Whady; REZENDE, Paulo; ROCHITTE, Carlos; NOMURA, Cesar; MORAIS, Thamara; LIMA, Eduardo Gomes; BOROS, Gustavo; RIBAS, Fernando Faglioni; CARVALHO, Felipe Pereira Camara; CARVALHO, Guilherme; SERRANO, Carlos; RAMIRES, Jose; KALIL-FILHO, Roberto
  • conferenceObject
    Prognostic Value of Combined CT Angiography and Myocardial Perfusion Imaging vs. Invasive Coronary Angiography and Nuclear Stress Perfusion Imaging for Predicting Major Adverse Cardiovascular Events - The CORE320 Multicenter Study
    (2015) CHEN, Marcus Y.; ROCHITTE, Carlos E.; ARBAB-ZADEH, Armin; DEWEY, Marc; GEORGE, Richard T.; MILLER, Julie M.; NIINUMA, Hiroyuki; YOSHIOKA, Kunihiro; KITAGAWA, Kakuya; NAKAMORI, Shiro; LAHAM, Roger; VAVERE, Andrea L.; CERCI, Rodrigo J.; MEHRA, Vishal C.; NOMURA, Cesar; KOFOED, Klaus F.; JINZAKI, Masahiro; KURIBAYASHI, Sachio; ROOS, Albert de; LAULE, Michael; TAN, Swee Yaw; HOE, John; PAUL, Narinder; RYBICKI, Frank J.; BRINKER, Jeffery A.; ARAI, Andrew E.; COX, Christopher; CLOUSE, Melvin E.; CARLI, Marcelo F. Di; LIMA, Joao A.