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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Autor: NOMURA, Cesar Higa ×

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Agora exibindo 1 - 10 de 63
  • article 2 Citação(ões) na Scopus
    Spontaneous subepithelial hemorrhage: the Antopol-Goldman lesion
    (2021) FONSECA, Eduardo Kaiser Ururahy Nunes; TORRES, Roberto Vitor Almeida; SCOPPETTA, Luiz Raphael Pereira Donoso; NOMURA, Cesar Higa
  • article 9 Citação(ões) na Scopus
    Diagnostic Performance of a Machine Learning-Based CT-Derived FFR in Detecting Flow-Limiting Stenosis
    (2021) MORAIS, Thamara Carvalho; ASSUNCAO-JR, Antonildes Nascimento; DANTAS JUNIOR, Roberto Nery; SILVA, Carla Franco Grego da; PAULA, Caroline Bastida de; TORRES, Roberto Almeida; MAGALHAES, Tiago Augusto; NOMURA, Cesar Higa; AVILA, Luiz Francisco Rodrigues de; PARGA FILHO, Jose Rodrigues
    Background: The non-invasive quantification of the fractional flow reserve (FFRCT) using a more recent version of an artificial intelligence-based software and latest generation CT scanner (384 slices) may show high performance to detect coronary ischemia. Objectives: To evaluate the diagnostic performance of FFRCT for the detection of significant coronary artery disease (CAD) in contrast to invasive FFR (iFFR) using previous generation CT scanners (128 and 256-detector rows). Methods: Retrospective study with patients referred to coronary artery CT angiography (CTA) and catheterization (iFFR) procedures. Siemens Somatom Definition Flash (256-detector rows) and AS+ (128-detector rows) CT scanners were used to acquire the images. The FFRCT and the minimal lumen area (MLA) were evaluated using a dedicated software (cFFR version 3.0.0, Siemens Healthineers, Forchheim, Germany). Obstructive CAD was defined as CTA lumen reduction >= 50%, and flow-limiting stenosis as iFFR <= 0.8. All reported P values are two-tailed, and when <0.05, they were considered statistically significant. Results: Ninety-three consecutive patients (152 vessels) were included. There was good agreement between FFRCT and iFFR, with minimal FFRCT overestimation (bias: -0.02; limits of agreement:0.14-0.09). Different CT scanners did not modify the association between FFRCT and FFRi (p for interaction=0.73). The performance of FFRCT was significantly superior compared to the visual classification of coronary stenosis (AUC 0.93vs.0.61, p<0.001) and to MLA (AUC 0.93vs.0.75, p<0.001), reducing the number of false-positive cases. The optimal cut-off point for FFRCT using a Youden index was 0.85 (87% Sensitivity, 86% Specificity, 73% PPV, 94% NPV), with a reduction of false-positives. Conclusion: Machine learning-based FFRCT using previous generation CT scanners (128 and 256-detector rows) shows good diagnostic performance for the detection of CAD, and can be used to reduce the number of invasive procedures.
  • conferenceObject
    Endovascular Therapeutic Hypothermia Is Feasible as an Adjuvant Therapy in Acute ST-Segment Elevation Myocardial Infarction Patients Without Delay in Door-to-Balloon Time
    (2019) DALLAN, Luis; GIANNETTI, Natali; DAE, Michael; POLASTRI, Thatiane; ROCHITTE, Carlos Eduardo; NOMURA, Cesar Higa; HAJJAR, Ludhmila Abrahao; BERNOCHE, Claudia; LAGE, Silvia; LIMA, Felipe; NICOLAU, Jose Carlos; TAVARES JR., Mucio; RIBEIRO, Expedito; KALIL JR., Roberto; LEMOS, Pedro A.; TIMERMAN, Sergio
  • article 17 Citação(ões) na Scopus
    Brazilian Cardio-oncology Guideline-2020
    (2020) HAJJAR, Ludhmila Abrahao; COSTA, Isabela Bispo Santos da Silva da; LOPES, Marcelo Antonio Cartaxo Queiroga; HOFF, Paulo Marcelo Gehm; DIZ, Maria Del Pilar Estevez; FONSECA, Silvia Moulin Ribeiro; BITTAR, Cristina Salvadori; REHDER, Marilia Harumi Higuchi dos Santos; RIZK, Stephanie Itala; ALMEIDA, Dirceu Rodrigues; FERNANDES, Gustavo S. Santos; BECK-DA-SILVA, Luis; CAMPOS, Carlos Augusto Homem de Magalhaes; MONTERA, Marcelo Westerlund; ALVES, Silvia Marinho Martins; FUKUSHIMA, Julia Tizue; SANTOS, Maria Veronica Camara dos; NEGRAO, Carlos Eduardo; SILVA, Thiago Liguori Feliciano da; FERREIRA, Silvia Moreira Ayub; MALACHIAS, Marcus Vinicius Bolivar; MOREIRA, Maria da Consolacao Vieira; VALENTE NETO, Manuel Maria Ramos; FONSECA, Veronica Cristina Quiroga; SOEIRO, Maria da Carolina Feres de Almeida; ALVES, Juliana Barbosa Sobral; SILVA, Carolina Maria Pinto Domingues Carvalho; SBANO, Joao; PAVANELLO, Ricardo; PINTO, Ibraim Masciarelli F.; SIMAO, Antonio Felipe; DRACOULAKIS, Marianna Deway Andrade; HOFF, Ana Oliveira; ASSUNCAO, Bruna Morhy Borges Leal; NOVIS, Yana; TESTA, Laura; ALENCAR FILHO, Aristoteles Comte de; CRUZ, Cecilia Beatriz Bittencourt Viana; PEREIRA, Juliana; GARCIA, Diego Ribeiro; NOMURA, Cesar Higa; ROCHITTE, Carlos Eduardo; MACEDO, Ariane Vieira Scarlatelli; MARCATTI, Patricia Tavares Felipe; MATHIAS JUNIOR, Wilson; WIERMANN, Evanius Garcia; VAL, Renata do; FREITAS, Helano; COUTINHO, Anelisa; MATHIAS, Clarissa Maria de Cerqueira; VIEIRA, Fernando Meton de Alencar Camara; SASSE, Andre Deeke; ROCHA, Vanderson; RAMIRES, Jose Antonio Franchini; KALIL FILHO, Roberto
  • article 1 Citação(ões) na Scopus
    Dipyridamole stress myocardial perfusion by computed tomography in patients with left bundle branch block
    (2015) CABEDA, Estevan Vieira; FALCAO, Andrea Maria Gomes; SOARES JR., Jose; ROCHITTE, Carlos Eduardo; NOMURA, Cesar Higa; AVILA, Luiz Francisco Rodrigues; PARGA, Jose Rodrigues
    Background: Functional tests have limited accuracy for identifying myocardial ischemia in patients with left bundle branch block (LBBB). Objective: To assess the diagnostic accuracy of dipyridamole-stress myocardial computed tomography perfusion (CTP) by 320-detector CT in patients with LBBB using invasive quantitative coronary angiography (QCA) (stenosis >= 70%) as reference; to investigate the advantage of adding CTP to coronary computed tomography angiography (CTA) and compare the results with those of single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy. Methods: Thirty patients with LBBB who had undergone SPECT for the investigation of coronary artery disease were referred for stress tomography. Independent examiners performed per-patient and per-coronary territory assessments. All patients gave written informed consent to participate in the study that was approved by the institution's ethics committee. Results: The patients' mean age was 62 +/- 10 years. The mean dose of radiation for the tomography protocol was 9.3 +/- 4.6 mSv. With regard to CTP, the per-patient values for sensitivity, specificity, positive and negative predictive values, and accuracy were 86%, 81%, 80%, 87%, and 83%, respectively (p = 0.001). The per-territory values were 63%, 86%, 65%, 84%, and 79%, respectively (p < 0.001). In both analyses, the addition of CTP to CTA achieved higher diagnostic accuracy for detecting myocardial ischemia than SPECT (p < 0.001). Conclusion: The use of the stress tomography protocol is feasible and has good diagnostic accuracy for assessing myocardial ischemia in patients with LBBB.
  • bookPart
    A tomografia computadorizada do coração e seus componentes
    (2020) SCOPPETTA, Raphael; NOMURA, Cesar Higa
  • bookPart
    Radiografia de tórax
    (2016) CERRI, Giovanni Guido; NOMURA, Cesar Higa; ARAúJO FILHO, José de Arimateia Batista; REISER, Carolina Sander
  • article 6 Citação(ões) na Scopus
    Evaluation of Morphological and Clinical Factors Related to Failure of Percutaneous Treatment with Thrombin Injection of Femoral Pseudoaneurysms from Cardiac Catheterization
    (2019) LEITE, Tulio Fabiano de Oliveira; BORTOLINI, Edgar; LINARD, Bruno; BOUERI, Breno Affonso; CARNEVALE, Francisco Cesar; NOMURA, Cesar Higa; LEAL FILHO, Joaquim Mauricio da Motta
    Background: Ultrasound-guided thrombin injection (UGTI) has become the method of choice in the treatment of pseudoaneurysm caused by endovascular procedures because it is minimally invasive, costs less, and effective, with short hospitalization time. The objective was identify the morphological aspects of femoral pseudoaneurysms and clinical aspects of patients that may lead to the failure of UGTI in femoral pseudoaneurysms after cardiac catheterization. Population and Method: From December 2012 to December 2016, 60 patients with pseudoaneurysms caused by cardiac catheterization were referred to the interventional radiology unit to be treated with UGTI. Medical charts were retrospectively reviewed for comorbidities, use of antiplatelet agents, anticoagulation, indication of cardiac catheterization, and so forth. Morphological aspects of the pseudoaneurysms such as volume, diameter (anteroposterior, laterolateral, and longitudinal), length, and diameter of the neck were analyzed. Results: Technical success of UGTI was achieved in 100%. No clinical aspects of the patients were statistically significant for UGTI failure in occlusion of the pseudoaneurysms. For morphological aspects of pseudoaneurysm: anteroposterior (P = 0.029), longitudinal (P = 0.020), and neck diameters (P = 0.004) were statistically significant for UGTI failure. Logistic regression analysis for longitudinal diameter showed that for each centimeter, there was a 2.66 chance of failure of pseudoaneurysm thrombosis in a single thrombin injection session (95% confidence interval: 1.33-5.30). For longitudinal and neck diameters greater than 1.8 cm and 0.55 cm, respectively, there is a greater probability of needing more than one UGTI session for complete thrombosis. Conclusions: Among variables, the longitudinal dimension was more significant, and in a larger diameter, the treatment with thrombin injection presented greater complexity.
  • conferenceObject
    Noncontrast Transcatheter Aortic Valve Implantation for Patients With Aortic Stenosis and Chronic Kidney Disease: Long-Term Follow-Up of The Pilot Study
    (2023) FILIPPINI, Filippe; FREIRE, Antonio Fernando; NICZ, Pedro; BRATZ, Guilherme; SESSA, Bruno; RIBEIRO, Henrique; ACCORSI, Tarso; LIBERATO, Gabriela; NOMURA, Cesar Higa; CASSAR, Renata; VIEIRA, Marcelo; BIHAN, David Le; BARRETTO, Rodrigo; MATHIAS, Wilson; POMERANTZEFF, Pablo; TARASOUTCHI, Flavio; ABIZAID, Alexandre; BRITO JR., Fabio
  • article 6 Citação(ões) na Scopus
    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 Rodrigues
    Despite 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.