MARCOS SANTOS LIMA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
conferenceObject Coronary flow reserve by PET 13N-ammonia in patients with hereditary transthyretin amyloidosis with and without cardiac involvement(2022) ALENCAR NETO, A. C.; CAFEZEIRO, C. R. F.; BUENO, B. V. K.; SOUZA, F. Ribeiro De; RISSATO, J. H. S. Henrique; BORGES, T. Souza; CARVALHAL, S. Freitas; LIMA, M. Santos; BUCHPIGUEL, C. Alberto; CHALELA, W. Azem; RAMIRES, F. J. Alvarez; SZOR, R. Shcolnik; KALIL FILHO, R.; ROCHITTE, C. E.; FERNANDES, F.- In-depth cardiovascular and pulmonary assessments in children with multisystem inflammatory syndrome after SARS-CoV-2 infection: A case series study(2022) ASTLEY, Camilla; PEREIRA, Maria Fernanda Badue; LIMA, Marcos Santos; BUCHPIGUEL, Carlos Alberto; CARNEIRO, Camila G.; SAPIENZA, Marcelo Tatit; LEAL, Gabriela Nunes; PRADO, Danilo Marcelo Leite do; PECANHA, Tiago; SIECZKOWSKA, Sofia Mendes; MATSUO, Olivia Mari; LINDOSO, Livia; MARQUES, Heloisa Helena; SILVA, Clovis Artur; GUALANO, BrunoWe assessed PET-CT myocardial blood flow (MBF) using N-13 ammonia, brachial flow-mediated dilation, and cardiopulmonary exercise test in five post-discarged MIS-C survivors. None of the patients (median age: 9, range: 7-18 years; 3 females; 2 males) had preexisting pediatric chronic conditions. At the follow-up visit, two patients exhibited severe perfusion defect developed in the left ventricular cavity, suggesting extensive myocardial ischemia (MBF <2.0) and one patient showed persistent mild pericardial effusion. Others two patients demonstrated endothelial dysfunction. Nevertheless, all patients had lower predicted values in the VO2peak, VO2VAT, OUES, and O-2 Pulse (range: 35.2%-64.5%; 15.6%-38.2%; 1.0-1.3 L/min; 4-7 ml/beat), respectively. Our d suggested that previously health MIS-C patients had impaired MBF, endothelial dysfunction and lower cardiopulmonary capacity at follow-up analysis. Multidisciplinary further investigations should be conducted to reinforce these findings.
- Segmental cardiac strain assessment by two-dimensional speckle-tracking echocardiography in surviving MIS-c patients: Correlations with myocardial flow reserve (MFR) by 13 N-ammonia PET-CT(2022) LEAL, Gabriela Nunes; ASTLEY, Camila; LIMA, Marcos Santos; DINIZ, Maria de Fatima Rodrigues; LIANZA, Alessandro Cavalcanti; SAWAMURA, Karen Saori Shiraishi; MENEZES, Carolina Rocha Brito; SILVA, Camila Lino Martins Rodrigues da; BAIN, Vera; IMADA, Rodrigo; CHALELA, William; PEREIRA, Maria Fernanda Badue; MARQUES, Heloisa Helena de Sousa; BUCHPIGUEL, Carlos Alberto; GUALANO, Bruno; SILVA, Clovis ArturBackground Multisystem inflammatory syndrome in children (MIS-c) is associated with severe cardiovascular impairment and eventually death. Pathophysiological mechanisms involved in myocardial injury were scarcely investigated, and cardiovascular outcomes are uncertain. Autopsy studies suggested that microvascular dysfunction may be relevant to LV impairment. Objective We aimed to evaluate segmental LV longitudinal strain by 2DST echocardiography and myocardial flow reserve (MFR) by 13 N-ammonia PET-CT, in six surviving MIS-c patients. Methods Each patient generated 34 LV segments for combined 2DST and MRF analysis. MFR was considered abnormal when <2, borderline when between 2 and 2.5 and normal when >2.5. Results From July 2020 to February 2021, six patients were admitted with MIS-c: three males, aged 9.3 (6.6-15.7) years. Time from admission to the follow-up visit was 6.05 (2-10.3) months. Although all patients were asymptomatic and LV EF was >= 55%, 43/102 (42.1%) LV segments showed MFR r = .36, p = .03 for basal segments; r = .41, p = .022 for mid segments; r = .42, p = .021 for apical segments. Median peak systolic longitudinal strain was different among MRF categories: 18% (12%-24%) for abnormal, 18.5% (11%-35%) for borderline, and 21% (12%-32%) for normal MFR (p = .006). Conclusion We provided preliminary evidence that surviving MIS-c patients may present subclinical impairment of myocardial microcirculation. Segmental cardiac strain assessment 2DST seems useful for MIS-c cardiovascular follow-up, given its good correlation with 13 N-ammonia PET-CT derived MFR.
- Does [18F]F-FDG-PET/MRI add metabolic information to magnetic resonance image in childhood-onset Takayasu's arteritis patients? A multicenter case series(2022) CLEMENTE, Gleice; SOUZA, Alexandre W. de; LEAO FILHO, Hilton; COELHO, Fernando M. A.; BUCHPIGUEL, Carlos; LIMA, Marcos; CARNEIRO, Camila; PEREIRA, Rosa M. R.; AIKAWA, Nadia; SILVA, Clovis A.; CAMPOS, Lucia M. A.; ALVES, Gabriel; ASTLEY, Camilla; GUALANO, Bruno; TERRERI, Maria TeresaBackground The observation that 2-deoxy-2[18F]fluoro-D-glucose-positron emission tomography/magnetic resonance imaging ([18F]F-FDG-PET/MRI) revealed high-grade arterial wall FDG uptake, without arterial wall thickening with contrast-enhancement, in a considerable number of c-TA patients in our previous study, encouraged us to compare patients with both PET and MR angiography (MRA) positives, with those with PET positive but MRA negative. Our aim was to evaluate the relevance of these two imaging modalities together. Methods A three-center cross-sectional study with 17 patients who fulfilled the EULAR/PRINTO/PReS criteria for c-TA and who underwent [18F]F-FDG-PET/MRI was previously performed. Herein we compared patients/vessels with positive PET (arterial wall F-18-FDG uptake higher than liver) and positive MRA (arterial wall thickening with contrast-enhancement)-group 1, with those with positive PET but negative MRA-group 2. Results Median disease duration of 17 c-TA patients was 10.4 years. Nine patients were classified as group 1 and six as group 2. Median of metabolic inflammatory volume (MIV) of all arterial segments was significantly higher in group 1 (2346 vs. 1177 cm(3); p = 0.036). Fifty-four (19%) from 284 available arterial segments presented positive findings in vessel wall in one or both images. Positive findings were concordant between PET and MRA in only 13% arterial segments (group 1); most changes (28-59.6%) that were discordant between both images, were positive in PET and negative in MRA (group 2). Conclusion Our study demonstrated that [18F]F-FDG-PET/MRI added information about inflammation in vessel wall of c-TA patients. Prospective multicenter studies are needed in order to get solid data to guide immunosuppressive tapering and withdrawal.
- Concerns about Prognostic Meaning of Quantitative PET Analysis in Classical Hodgkin Lymphoma(2022) SANTOS, Fernanda Maria Maria; MARIN, Jose Flavio Gomes; LIMA, Marcos Santos; SILVA, Wellington F.; VELASQUES, Rodrigo D.; MAIA, Ana Carolina Arrais; ATANAZIO, Marcelo Junqueira; ALVES, Lucas Bassolli de Oliveira; MOREIRA, Frederico Rafael; BUCHPIGUEL, Carlos Alberto; BUCCHERI, Valeria; ROCHA, Vanderson
- Is positron emission tomography/magnetic resonance imaging a reliable tool for detecting vascular activity in treated childhood-onset Takayasu's arteritis? A multicentre study(2022) CLEMENTE, Gleice; PEREIRA, Rosa M. R.; AIKAWA, Nadia; SILVA, Clovis A.; CAMPOS, Lucia M. A.; ALVES, Gabriel; BUCHPIGUEL, Carlos; LIMA, Marcos; CARNEIRO, Camila; FILHO, Hilton L.; MORBECK, Fernando; NETO, Guilherme; FILHO, Vicente O.; SOUZA, Alexandre W. D.; TERRERI, Maria TeresaObjectives Toassess whether F-18-fluordeoxiglucose (F-18-FDG) PET/MRI) with angiographic sequences can contribute to detecting vessel wall inflammation in patients with childhood-onset Takayasu's arteritis (c-TA) under immunosuppressive therapy. Methods A three-centre cross-sectional study was conducted. F-18-FDG PET/MRI scans were performed in c-TA patients and in oncologic patients, who served as the control group. Clinical and laboratory characteristics were also analysed. Results Seventeen c-TA patients (65% females) between the ages of 6 and 21 years with a mean disease duration of 9.4 years were recruited. Only one patient presented clinical disease activity and six (35.6%) had increased ESR and/or CRP levels. The most frequent magnetic resonance angiography (MRA) findings were stenosis and thickening, observed in 82.4 and 70.6% of c-TA patients, respectively. F-18-FDG PET revealed F-18-FDG uptake greater than the liver in at least one arterial segment in 15 (88.2%) patients in a qualitative analysis and a median maximum standardized uptake value (SUVmax) of 3.22 (interquartile range 2.76-3.69) in a semi-quantitative analysis. c-TA patients presented significantly higher SUVmax values than oncologic patients (P < 0.001). A positive correlation between SUVmax and CRP levels (rho = 0.528, P = 0.029) was seen. Conclusion A state-of-the-art imaging modality was used in c-TA patients and revealed a strong arterial FDG uptake even in patients in apparent remission. We suppose that this finding may represent silent activity in the vessel wall; however, we cannot exclude the possibility of arterial remodelling. Importantly, a negative imaging scan may help in immunosuppression withdrawal in daily clinical practice.