JOSE RODRIGUES PARGA FILHO

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/65, Hospital das Clínicas, Faculdade de Medicina

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  • article 6 Citação(ões) na Scopus
    Evaluation of Myocardial Perfusion by Computed Tomography - Principles, Technical Background and Recommendations
    (2019) MAGALHAES, Tiago Augusto; CURY, Roberto Caldeira; CERCI, Rodrigo Julio; PARGA FILHO, Jose Rodrigues; GOTTLIEB, Ilan; NACIF, Marcelo Souto; PINTO, Ibraim Masciarelli; ROCHITTE, Carlos Eduardo; VILAS-BOAS, Fabio; SCHVARTZMAN, Paulo R.
    Coronary computed tomography angiography (CCTA) has gained a prominent role in the evaluation of coronary artery disease. However, its anatomical nature does not allow the evaluation of the functional repercussion of coronary obstructions. It has been made possible to evaluate Myocardial computed tomography perfusion (Myocardial CTP) recently, based on myocardial contrast changes related to coronary stenoses. Several studies have validated this technique against the anatomical reference method (cardiac catheterization) and other functional methods, including myocardial perfusion scintigraphy and fractional flow reserve. The Myocardial CTP is performed in conjunction with the CCTA, a combined analysis of anatomy and function. The stress phase (with assessment of myocardial perfusion) can be performed before or after the resting phase (assessment of resting perfusion and coronary arteries), and different acquisition parameters are proposed according to the protocol and type of equipment used. Stressors used are based on coronary vasodilation (e.g. dipyridamole, adenosine). Image interpretation, similar to other perfusion assessment methods, is based on the identification and quantification of myocardial perfusion defects. The integration of both perfusion and anatomical findings is fundamental for the examination interpretation algorithm, allowing to define if the stenoses identified are hemodynamically significant and may be related to myocardial ischemia.
  • article 2 Citação(ões) na Scopus
    Clinical evaluation of left ventricular function and morphology using an accelerated k-t sensitivity encoding method in cardiovascular magnetic resonance
    (2019) ASSUNCAO- JR., Antonildes Nascimento; DANTAS- JR., Roberto Nery; VAL, Renata Margarida do; GIANOTTO, Priscilla; MARIN, Angela dos Santos; GOLDEN, Mark; GUTIERREZ, Marco Antonio; PARGA, Jose Rodrigues; NOMURA, Cesar Higa
    ObjectivesTo provide clinical validation of a recent 2D SENSE-based accelerated cardiovascular magnetic resonance (CMR) sequence (accelerated k-t SENSE), investigating whether this technique accurately quantifies left ventricle (LV) volumes, function, and mass as compared to 2D cine steady-state free precession (2D-SSFP).MethodsHealthy volunteers (n=16) and consecutive heart failure patients (n=26) were scanned using a 1.5T MRI system. Two LV short axis (SA) stacks were acquired: (1) accelerated k-t SENSE (5-6 breath-holds; temporal/spatial resolution: 37ms/1.82x1.87mm; acceleration factor = 4) and (2) standard 2D-SSFP (10-12 breath-holds; temporal/spatial resolution: 49ms/1.67x1.87mm, parallel imaging). Ascending aorta phase-contrast was performed on all volunteers as a reference to compare LV stroke volumes (LVSV) and validate the sequences. An image quality score for SA images was used, with lower scores indicating better quality (from 0 to 18).ResultsThere was a high agreement between accelerated k-t SENSE and 2D-SSFP for LV measurements: bias (limits of agreement) of 2.4% (-5.4% to 10.1%), 6.9mL/m(2) (-4.7 to 18.6mL/m(2)), -1.5 (-8.3 to 5.2mL/m(2)), and -0.2g/m(2) (-11.9 to 12.3g/m(2)) for LV ejection fraction, end-diastolic volume index, end-systolic volume index, and mass index, respectively. LVSV by accelerated k-t SENSE presented good agreement with aortic flow. Interobserver and intraobserver variabilities for all LV parameters were also high.ConclusionThe accelerated k-t SENSE CMR sequence is clinically feasible and accurately quantifies LV volumes, function, and mass, with short acquisition time and good image quality.