32 results on '"SCRUTINIO, DOMENICO"'
Search Results
2. Pick Your Threshold
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Salvioni, Elisabetta, Mapelli, Massimo, Bonomi, Alice, Magrì, Damiano, Piepoli, Massimo, Frigerio, Maria, Paolillo, Stefania, Corrà, Ugo, Raimondo, Rosa, Lagioia, Rocco, Badagliacca, Roberto, Filardi, Pasquale Perrone, Senni, Michele, Correale, Michele, Cicoira, Mariantonietta, Perna, Enrico, Metra, Marco, Guazzi, Marco, Limongelli, Giuseppe, Sinagra, Gianfranco, Parati, Gianfranco, Cattadori, Gaia, Bandera, Francesco, Bussotti, Maurizio, Re, Federica, Vignati, Carlo, Lombardi, Carlo, Scardovi, Angela B., Sciomer, Susanna, Passantino, Andrea, Emdin, Michele, Passino, Claudio, Santolamazza, Caterina, Girola, Davide, Zaffalon, Denise, De Martino, Fabiana, Agostoni, Piergiuseppe, Farina, Stefania, Pezzuto, Beatrice, Apostolo, Anna, Palermo, Pietro, Contini, Mauro, Gugliandolo, Paola, Mattavelli, Irene, Della Rocca, Michele, Gallo, Giovanna, Moscucci, Federica, Iorio, Anita, Halasz, Geza, Capelli, Bruno, Binno, Simone, Pacileo, Giuseppe, Valente, Fabio, Vastarella, Rossella, Zaffalon, Denise, Carriere, Cosimo, Masè, Marco, Cittar, Marco, Di Lenarda, Andrea, Caravita, Sergio, Viganò, Elena, Marchese, Giovanni, Ricci, Roberto, Arcari, Luca, Scrutinio, Domenico, Battaia, Elisa, Moretti, Michele, Matassini, Maria Vittoria, Shkoza, Matilda, Herberg, Roland, Cittadini, Antonio, Salzano, Andrea, Marra, Alberto, Lafranca, Eluisa, and Vitale, Giuseppe
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In clinical practice, anaerobic threshold (AT) is used to guide training and rehabilitation programs, to define risk of major thoracic or abdominal surgery, and to assess prognosis in heart failure (HF). AT of oxygen uptake (V.O2; V.O2AT) has been reported as an absolute value (V.O2ATabs), as a percentage of predicted peak V.O2(V.O2AT%peak_pred), or as a percentage of observed peak V.O2(V.O2AT%peak_obs). A direct comparison of the prognostic power among these different ways to report AT is missing.
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- 2022
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3. Old and new equations for maximal heart rate prediction in patients with heart failure and reduced ejection fraction on beta-blockers treatment: results from the MECKI score data set
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Magrì, Damiano, Piepoli, Massimo, Gallo, Giovanna, Corrà, Ugo, Metra, Marco, Paolillo, Stefania, Filardi, Pasquale Perrone, Maruotti, Antonello, Salvioni, Elisabetta, Mapelli, Massimo, Vignati, Carlo, Senni, Michele, Limongelli, Giuseppe, Lagioia, Rocco, Scrutinio, Domenico, Emdin, Michele, Passino, Claudio, Parati, Gianfranco, Sinagra, Gianfranco, Correale, Michele, Badagliacca, Roberto, Sciomer, Susanna, Di Lenarda, Andrea, and Agostoni, Piergiuseppe
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- 2022
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4. Cardiovascular Death Risk in Recovered Mid-Range Ejection Fraction Heart Failure: Insights From Cardiopulmonary Exercise Test.
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MAGRÌ, DAMIANO, PIEPOLI, MASSIMO, CORRÀ, UGO, GALLO, GIOVANNA, MARUOTTI, ANTONELLO, VIGNATI, CARLO, SALVIONI, ELISABETTA, MAPELLI, MASSIMO, PAOLILLO, STEFANIA, PERRONE FILARDI, PASQUALE, GIROLA, DAVIDE, METRA, MARCO, SCARDOVI, ANGELA B., LAGIOIA, ROCCO, LIMONGELLI, GIUSEPPE, SENNI, MICHELE, SCRUTINIO, DOMENICO, EMDIN, MICHELE, PASSINO, CLAUDIO, and LOMBARDI, CARLO
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Background: Heart failure with midrange ejection fraction (HFmrEF) represents a heterogeneous category where phenotype, as well as prognostic assessment, remains debated. The present study explores a specific HFmrEF subset, namely those who recovered from a reduced EF (rec-HFmrEF) and, particularly, it focuses on the possible additive prognostic role of cardiopulmonary exercise testing.Methods and Results: We analyzed data from 4535 patients with HFrEF and 1176 patients with rec-HFmrEF from the Metabolic Exercise combined with Cardiac and Kidney Indexes database. The end point was cardiovascular death at 5 years. The median follow-up was 1343 days (25th-75th range 627-2403 days). Cardiovascular death occurred in 552 HFrEF and 61 rec-HFmrEF patients. The multivariate analysis confirmed an independent role of the MECKI score's variables in HFrEF (C-index = 0.744) whereas, in the rec-HFmrEF group, only age and peak oxygen uptake (pVO2) remained associated to the end point (C-index = 0.745). A peak oxygen uptake of ≤55% of predicted and a ventilatory efficiency of ≥31 resulted as the most accurate cut-off values in the outcome prediction.Conclusions: Present data support the cardiopulmonary exercise test and, particularly, the peak oxygen uptake, as a useful tool in the rec-HFmrEF prognostic assessment. A peak VO2 of ≤55% predicted and ventilatory efficiency of ≥31 might help to identify a high-risk rec-HFmrEF subgroup. [ABSTRACT FROM AUTHOR]- Published
- 2020
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5. Association Between Malnutrition and Outcomes in Patients With Severe Ischemic Stroke Undergoing Rehabilitation.
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Scrutinio, Domenico, Lanzillo, Bernardo, Guida, Pietro, Passantino, Andrea, Spaccavento, Simona, and Battista, Petronilla
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To investigate the incremental prognostic significance of malnutrition in patients with severe poststroke disability. Retrospective cohort study. The patients were recruited from 3 specialized inpatient rehabilitation facilities. Nutritional status was assessed using the Prognostic Nutritional Index (PNI), which is calculated from serum albumin and total lymphocyte count. Scores >38 points reflect normal nutrition status, scores of 35-38 indicate moderate malnutrition, and scores <35 indicate severe malnutrition. The association of PNI categories with outcomes was assessed using multivariable regression analyses. Inpatient rehabilitation facility. Patients (N=668) with ischemic stroke admitted to inpatient rehabilitation within 90 days from stroke occurrence and classified as Case-Mix Groups 0108, 0109, and 0110 of the current Medicare case-mix classification system. Not applicable. Three outcomes were examined: (1) the combined outcome of transfer to acute care and death within 90 days from admission to rehabilitation; (2) 2-year mortality; and (3) FIM motor effectiveness, calculated as (FIM motor change/maximum FIM motor−admission FIM motor score)×100. Overall, the median time to rehabilitation admission was 18 days (range, 12-26 days). The prevalence of moderate and severe malnutrition was 12.7% and 11.5%, respectively. Ninety-one patients (13.6%) experienced the combined outcome. After adjusting for independent predictors including sex, atrial fibrillation, dysphagia, FIM cognitive score, and hemoglobin levels, neither moderate (P =.280) nor severe malnutrition (P =.482) were associated with the combined outcome. Similar results were observed when looking at 2-year mortality. Overall, FIM motor effectiveness was 30%±24%. After adjusting for independent predictors, severe malnutrition (β coefficient −0.458±0.216; P =.034) was associated with FIM motor effectiveness. Approximately 1 in every 9 patients presented severe malnutrition. On top of the independent predictors, severe malnutrition did not provide additional prognostic information concerning risk of the combined outcome or 2-year mortality. Conversely, severe malnutrition was associated with poorer functional outcome as expressed by FIM motor effectiveness. • We examined the prognostic role of malnutrition in patients post stroke. • We studied 668 patients with severe ischemic strokes undergoing rehabilitation. • Malnutrition was not associated with clinical outcomes. • Malnutrition was associated with poorer functional outcome after rehabilitation. [ABSTRACT FROM AUTHOR]
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- 2020
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6. Role of comorbidities in heart failure prognosis Part 2: Chronic kidney disease, elevated serum uric acid
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Tedeschi, Andrea, Agostoni, Piergiuseppe, Pezzuto, Beatrice, Corra’, Ugo, Scrutinio, Domenico, La Gioia, Rocco, Raimondo, Rosa, Passantino, Andrea, and Piepoli, Massimo F
- Abstract
Despite improvements in pharmacotherapy, morbidity and mortality rates in community-based populations with chronic heart failure still remain high. The increase in medical complexity among patients with heart failure may be reflected by an increase in concomitant non-cardiovascular comorbidities, which are recognized as independent prognostic factors in this population. Heart failure and chronic kidney disease share many risk factors, and often coexist. The presence of kidney failure is associated with incremented risk of cardiovascular and non-cardiovascular mortality in heart failure patients. Chronic kidney disease is also linked with underutilization of evidence-based heart failure therapy that may reduce morbidity and mortality. More targeted therapies would be important to improve the prognosis of patients with these diseases. In recent years, serum uric acid as a determinant of cardiovascular risk has gained interest. Epidemiological, experimental and clinical data show that patients with hyperuricaemia are at increased risk of cardiac, renal and vascular damage and cardiovascular events. Moreover, elevated serum uric acid predicts worse outcome in both acute and chronic heart failure. While studies have raised the possibility of preventing heart failure through the use of uric acid lowering agents, the literature is still inconclusive on whether the reduction in uric acid will result in a measurable clinical benefit. Available evidences suggest that chronic kidney disease and elevated uric acid could worsen heart failure patients’ prognosis. The aim of this review is to analyse a possible utilization of these comorbidities in risk stratification and as a therapeutic target to get a prognostic improvement in heart failure patients.
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- 2020
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7. La medicina riabilitativa e i criteri di appropriatezza: tra cronicità, multimorbilità e complessità.
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Scrutinio, Domenico and Carone, Mauro
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DISABILITIES ,POPULATION aging ,REHABILITATION ,PEOPLE with disabilities - Abstract
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- Published
- 2019
8. Development and Validation of a Predictive Model for Functional Outcome After Stroke Rehabilitation: The Maugeri Model.
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Scrutinio, Domenico, Lanzillo, Bernardo, Guida, Pietro, Mastropasqua, Filippo, Monitillo, Vincenzo, Pusineri, Monica, Formica, Roberto, Russo, Giovanna, Guarnaschelli, Caterina, Ferretti, Chiara, and Calabrese, Gianluigi
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- 2017
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9. Relationship among body mass index, NT-proBNP, and mortality in decompensated chronic heart failure.
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Scrutinio, Domenico, Passantino, Andrea, Guida, Pietro, Ammirati, Enrico, Oliva, Fabrizio, Sarzi Braga, Simona, La Rovere, Maria Teresa, Lagioia, Rocco, Frigerio, Maria, and Di Somma, Salvatore
- Abstract
Background Obesity has been suggested to confer a survival benefit in acute heart failure. The concentrations of NT-proBNP may be reduced in patients with high body mass index (BMI). Objectives To investigate the relationship among BMI, NT-proBNP, and mortality risk in decompensated chronic heart failure (DCHF). Methods This was a retrospective study. We studied 1001 patients with DCHF. Hazard ratios (HR) were calculated with Cox regression analysis. Results During the 1-year follow-up, 295 patients died. Compared with normal-weight patients, the unadjusted HR for death were 1.02 (95% CIs 0.79–1.33; p = 0.862) for patients with a BMI of 25.0–29.9 kg/m 2 and 0.83 (95% CIs 0.61–1.12; p = 0.213) for patients with a BMI ≥ 30 kg/m 2 . NT-proBNP remained independently associated with mortality across the BMI categories. There was no statistically significant interaction between BMI and NT-proBNP levels for risk prediction. Conclusions Obesity was not associated with mortality risk. NT-proBNP remained an independent prognostic factor across the BMI categories. [ABSTRACT FROM AUTHOR]
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- 2017
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10. Development and Validation of a Predictive Model for Functional Outcome After Stroke Rehabilitation
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Scrutinio, Domenico, Lanzillo, Bernardo, Guida, Pietro, Mastropasqua, Filippo, Monitillo, Vincenzo, Pusineri, Monica, Formica, Roberto, Russo, Giovanna, Guarnaschelli, Caterina, Ferretti, Chiara, and Calabrese, Gianluigi
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Supplemental Digital Content is available in the text.
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- 2017
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11. Incremental utility of prognostic variables at discharge for risk prediction in hospitalized patients with acutely decompensated chronic heart failure.
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Scrutinio, Domenico, Passantino, Andrea, Guida, Pietro, Ammirati, Enrico, Oliva, Fabrizio, Lagioia, Rocco, Braga, Simona Sarzi, Agostoni, Piergiuseppe, and Frigerio, Maria
- Abstract
Objectives: To assess the incremental prognostic utility of discharge serum creatinine (SCr), systolic blood pressure (SBP), and NT-proBNP and sodium concentrations in hospitalized patients with acutely decompensated chronic heart failure. Background: Whether key prognostic variables at discharge provide incremental prognostic information beyond that provided by a model based on admission variables (referent) remains incompletely defined. Methods: The primary outcome was a composite of death, urgent heart transplantation, or ventricular assist device implantation at 1 year. The gain in predictive performance was assessed using C index, Bayesian Information Criterion, and Net Reclassification Improvement. Results: The best fit was obtained when discharge NT-proBNP was added to the referent model. No interaction between admission and discharge NT-proBNP was found. Discharge SCr, SBP, and sodium did not improve goodness-of-fit. Conclusions: Admission and discharge NT-proBNP provide complementary and independent prognostic information; as such, they should be taken into account concurrently. [ABSTRACT FROM AUTHOR]
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- 2016
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12. Functional Gain After Inpatient Stroke Rehabilitation: Correlates and Impact on Long-Term Survival.
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Scrutinio, Domenico, Monitillo, Vincenzo, Guida, Pietro, Nardulli, Roberto, Multari, Vincenzo, Monitillo, Francesco, Calabrese, Gianluigi, and Fiore, Pietro
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- 2015
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13. Characteristics, Outcomes, and Long-Term Survival of Patients With Heart Failure Undergoing Inpatient Cardiac Rehabilitation.
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Scrutinio, Domenico, Guida, Pietro, Passantino, Andrea, Scalvini, Simonetta, Bussotti, Maurizio, Forni, Giovanni, Vaninetti, Raffaella, and La Rovere, Maria Teresa
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• The characteristics and outcomes of patients with heart failure (HF) admitted to inpatient cardiac rehabilitation (CR) are poorly defined. • This lack of knowledge may generate uncertainty about the role of inpatient CR. • Patients admitted to inpatient CR have a poor clinical and functional profile. • In patient CR is effective in improving functional capacity. • In patients with post-acute HF, inpatient CR is associated with improved long-term survival. To investigate the association of cardiac rehabilitation (CR) participation with all-cause mortality after a hospitalization for heart failure (HF) and to describe the characteristics and functional and clinical outcomes of HF patients undergoing inpatient CR. Multicenter cohort study. The association between CR participation and all-cause mortality from discharge from the acute care setting was assessed using Cox regression analysis adjusting for established prognostic factors. Six inpatient rehabilitation facilities. A total of 3219 patients with HF admitted to inpatient CR between January 2013 and December 2016. Of these patients, 1455 had been transferred directly from acute care hospitals after a hospitalization for HF (CR-group 1) and 1764 had been admitted from the community due to worsening functional disability or worsening clinical conditions (CR-group 2). Serving as a control group were 633 patients not referred to CR after a hospitalization for HF served as control group (non–CR group). Cardiac rehabilitation. Long-term mortality. Secondary outcomes were: (1) change in functional capacity, as assessed by change in 6-minute walking distance from admission to discharge; (2) clinical outcomes of the index inpatient rehabilitation admission, including in-hospital mortality and unplanned readmission to the acute care. Compared with the non–CR group, the adjusted hazard ratios of mortality at 1, 3, and 5 years for CR-group 1 patients were 0.82 (range, 0.68-0.97), 0.81 (range, 0.71-0.93), and 0.80 (range, 0.70-0.91). The 6-minute walking distance increased from 230-292 meters (P <.001), and 43.4% of the patients gained >50 m improvement. Overall, 2.5% of the patients died in hospital and 4.7% of the patients experienced unplanned readmissions to acute care, with significant differences between group 1 and group 2. Our data show that inpatient CR is effective in improving functional capacity and suggest that inpatient CR provided in the earliest period after a hospitalization for HF is associated with long-term improved survival. [ABSTRACT FROM AUTHOR]
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- 2022
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14. Tricuspid Annular Plane Systolic Excursion in Acute Decompensated Heart Failure: Relevance for Risk Stratification
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Scrutinio, Domenico, Catanzaro, Raffaella, Santoro, Daniela, Ammirati, Enrico, Passantino, Andrea, Oliva, Fabrizio, La Rovere, Maria Teresa, De Salvo, Maria, Guzzetti, Daniela, Vaninetti, Raffaella, Venezia, Mario, and Frigerio, Maria
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Although the prognostic value of right ventricular dysfunction in chronic heart failure (HF) has been studied extensively, it remains insufficiently characterized in the setting of acute decompensated HF (ADHF). We sought to assess whether measurement of tricuspid annular plane systolic excursion (TAPSE) or TAPSE-to–estimated pulmonary arterial systolic pressure (ePASP) ratio allows improvement of risk prediction in ADHF.
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- 2016
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15. Mutational Spectrum of CYP24A1Gene in a Cohort of Italian Patients with Idiopathic Infantile Hypercalcemia
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Gigante, Maddalena, Santangelo, Luisa, Diella, Sterpeta, Caridi, Gianluca, Argentiero, Lucia, D''Alessandro, Maria Michela, Martino, Marida, Stea, Emma Diletta, Ardissino, Gianluigi, Carbone, Vincenza, Pepe, Silvana, Scrutinio, Domenico, Maringhini, Silvio, Ghiggeri, Gian Marco, Grandaliano, Giuseppe, Giordano, Mario, and Gesualdo, Loreto
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Background/Aims:Loss-of-function mutations in the CYP24A1gene, which encodes the vitamin D-24 hydroxylase, have been recognized as a cause of elevated 1,25-dihydroxyvitamin D concentrations, hypercalcemia, hypercalciuria, nephrocalcinosis and nephrolithiasis in infants and adults. As only a case report describing 2 adult patients has been reported in Italian population, we report here the mutation analysis of CYP24A1gene in an Italian cohort of 12 pediatric and adult patients with idiopathic infantile hypercalcemia (IIH). Methods:We performed mutational screening of CYP24A1 gene in a cohort of 12 Italian patients: 8 children with nephrocalcinosis, hypercalcemia and PTH levels <10 pg/ml and 4 adult patients with nephrolithiasis, mild hypercalcemia and PTH levels <10 pg/ml from 11 unrelated Italian families. Clinical and biochemical data were collected. Genomic DNA was extracted from peripheral blood leucocytes using standard methods, and whole coding sequence of CYP24A1 gene was analysed in all patients and family members by polymerase chain reaction and direct sequencing. The potential pathogenicity of the newly identified missense mutations was evaluated by 3 different in silico approaches (Sorting Intolerant from Tolerant, Polyphen and Mutation Taster) and by comparative analysis in 14 different species using ClustalW software. Results:CYP24A1 bi-allelic mutations were found in 8 individuals from 7 Italian families (7/11; 64%). Overall, 6 different CYP24A1 mutations, including one small deletion (p.Glu143del), 4 missense mutations (p.Leu148Pro; p.Arg396Trp; p.Pro503Leu; p.Glu383Gln) and one nonsense mutation (p.Tyr220*) were identified. Two out of 6 mutations (p.Tyr220* and p.Pro503Leu) were not previously described. Moreover, a new CYP24A1variant was identified by genetic screening of asymptomatic controls. Conclusion:To the best of our knowledge, this is the first report of a CYP24A1molecular analysis performed in an Italian cohort of adult and pediatric Italian patients. This study (1) confirms that CYP24A1 plays a causal role in some but not all cases of IIH (64%); (2) expands the spectrum of known CYP24A1pathogenic mutations; (3) describes 2 hotspots detected in 50% of all Italian cases; and (4) emphasizes the importance of recognition and genetic diagnosis of CYP24A1defects in infantile as well as adult hypercalcemia.
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- 2016
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16. Sex Profile and Risk Assessment With Cardiopulmonary Exercise Testing in Heart Failure: Propensity Score Matching for Sex Selection Bias
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Corrà, Ugo, Agostoni, Piergiuseppe, Giordano, Andrea, Cattadori, Gaia, Battaia, Elisa, La Gioia, Rocco, Scardovi, Angela B., Emdin, Michele, Metra, Marco, Sinagra, Gianfranco, Limongelli, Giuseppe, Raimondo, Rosa, Re, Federica, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Magrì, Damiano, Fiorentini, Cesare, Cicoira, Mariantonietta, Salvioni, Elisabetta, Giovannardi, Marta, Veglia, Fabrizio, Mezzani, Alessandro, Scrutinio, Domenico, Di Lenarda, Andrea, Ricci, Roberto, Apostolo, Anna, Iorio, Anna Maria, Paolillo, Stefania, Palermo, Pietro, Contini, Mauro, Vassanelli, Corrado, Passino, Claudio, Giannuzzi, Pantaleo, and Piepoli, Massimo F.
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In heart failure (HF), women show better survival despite a comparatively low peak oxygen consumption (V˙o2): this raises doubt about the accuracy of risk assessment by cardiopulmonary exercise testing (CPET) in women. Accordingly, we aimed to check (1) whether the predictive role of well-known CPET risk indexes, ie, peak V˙o2and ventilatory response (V˙e/V˙co2slope), is sex independent and (2) if sex-related characteristics that impact outcome in HF should be considered as associations that may confound the effect of sex on survival.
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- 2016
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17. Functional Gain After Inpatient Stroke Rehabilitation
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Scrutinio, Domenico, Monitillo, Vincenzo, Guida, Pietro, Nardulli, Roberto, Multari, Vincenzo, Monitillo, Francesco, Calabrese, Gianluigi, and Fiore, Pietro
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- 2015
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18. Deceptive meaning of oxygen uptake measured at the anaerobic threshold in patients with systolic heart failure and atrial fibrillation
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Magrì, Damiano, Agostoni, Piergiuseppe, Corrà, Ugo, Passino, Claudio, Scrutinio, Domenico, Perrone-Filardi, Pasquale, Correale, Michele, Cattadori, Gaia, Metra, Marco, Girola, Davide, Piepoli, Massimo F, Iorio, AnnaMaria, Emdin, Michele, Raimondo, Rosa, Re, Federica, Cicoira, Mariantonietta, Belardinelli, Romualdo, Guazzi, Marco, Limongelli, Giuseppe, Clemenza, Francesco, Parati, Gianfranco, Frigerio, Maria, Casenghi, Matteo, Scardovi, Angela B, Ferraironi, Alessandro, Di Lenarda, Andrea, Bussotti, Maurizio, Apostolo, Anna, Paolillo, Stefania, La Gioia, Rocco, Gargiulo, Paola, Palermo, Pietro, Minà, Chiara, Farina, Stefania, Battaia, Elisa, Maruotti, Antonello, Pacileo, Giuseppe, Contini, Mauro, Oliva, Fabrizio, Ricci, Roberto, and Sinagra, Gianfranco
- Abstract
Background Oxygen uptake at the anaerobic threshold (VO2AT), a submaximal exercise-derived variable, independent of patients’ motivation, is a marker of outcome in heart failure (HF). However, previous evidence of VO2AT values paradoxically higher in HF patients with permanent atrial fibrillation (AF) than in those with sinus rhythm (SR) raised uncertainties.Design We tested the prognostic role of VO2AT in a large cohort of systolic HF patients, focusing on possible differences between SR and AF.Methods Altogether 2976 HF patients (2578 with SR and 398 with AF) were prospectively followed. Besides a clinical examination, each patient underwent a maximal cardiopulmonary exercise test (CPET).Results The follow-up was analysed for up to 1500 days. Cardiovascular death or urgent cardiac transplantation occurred in 303 patients (250 (9.6%) patients with SR and 53 (13.3%) patients with AF, p= 0.023). In the entire population, multivariate analysis including peak oxygen uptake (VO2) showed a prognostic capacity (C-index) similar to that obtained including VO2AT (0.76 vs 0.72). Also, left ventricular ejection fraction, ventilation vs carbon dioxide production slope, β-blocker and digoxin therapy proved to be significant prognostic indexes. The receiver-operating characteristic (ROC) curves analysis showed that the best predictive VO2AT cut-off for the SR group was 11.7 ml/kg/min, while it was 12.8 ml/kg/min for the AF group.Conclusions VO2AT, a submaximal CPET-derived parameter, is reliable for long-term cardiovascular mortality prognostication in stable systolic HF. However, different VO2AT cut-off values between SR and AF HF patients should be adopted.
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- 2015
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19. High-sensitivity C-reactive protein predicts cardiovascular events and myocardial damage after vascular surgery.
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Scrutinio, Domenico, Passantino, Andrea, Di Serio, Francesca, Angiletta, Domenico, Santoro, Daniela, and Regina, Guido
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VASCULAR surgery ,SURGICAL complications ,C-reactive protein ,CARDIOVASCULAR diseases ,CARDIOMYOPATHIES ,REGRESSION analysis ,ELECTIVE surgery ,RECEIVER operating characteristic curves - Abstract
Objective: To assess the association of high-sensitivity C-reactive protein (hsCRP) to adverse cardiovascular events and perioperative myocardial damage in patients after elective vascular surgery. Methods: This was a prospective observational study in a tertiary-care teaching hospital, with 239 patients undergoing elective vascular surgery. The receiver-operating characteristic (ROC) curve was calculated to assess the optimal cut-off value of hsCRP. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Multiple logistic regression analysis was used to identify the predictors of the primary outcome. The primary outcome was a composite of periprocedural myocardial damage, defined as cardiac troponin I (cTn-I) elevation above the decision limit of 0.15 μg/L, death, acute coronary syndrome, stroke, acute heart failure, or intrastent thrombosis within 30 days of surgery. Results: On ROC analysis, the optimal cut-off value of hsCRP was 3.2 mg/L. The primary outcome occurred in 48 patients (20.1%). On univariate analysis, smoking (P = .009), known hypercholesterolemia (P = .01), previous ischemic heart disease (P = .0003), open surgery (P = .03), and hsCRP levels (P < .0001) were associated with the primary outcome. On multiple logistic regression analysis, only hsCRP was independently associated with the primary outcome. The unadjusted and adjusted ORs for the primary outcome among patients with hsCRP levels >3.2 mg/L were 7.5 (CI, 3.7-15.2; P < .0001) and 4.6 (CI, 2.1-9.9; P = .0001), respectively. Conclusion: Our data suggest that higher levels of hsCRP are independently associated with an increased risk of perioperative myocardial damage and early adverse cardiovascular events in patients undergoing elective vascular surgery. This may have implications for risk stratification and therapeutic approach. [ABSTRACT FROM AUTHOR]
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- 2011
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20. Cardiac Rehabilitation in the Elderly: Patient Selection and Outcomes.
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Ferrara, Nicola, Corbi, Graziamaria, Bosimini, Enzo, Cobelli, Franco, Furgi, Giuseppe, Giannuzzi, Pantaleo, Giordano, Amerigo, Pedretti, Roberto, Scrutinio, Domenico, and Rengo, Franco
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In Western countries, the aging and improving survival of patients with coronary heart disease are responsible for an increasing number of older adults (65 years of age and older) who are eligible for cardiac rehabilitation. The elderly with coronary heart disease represent a special population with changes induced by aging and lifestyle, comorbidity, cognitive dysfunction, and high risk of disability. Although the elderly account for the majority of cardiac admissions and procedures, studies on cardiac rehabilitation have traditionally focused on younger patients. In aged experimental animals, there is evidence that exercise training is able to improve hemodynamic parameters and biologic markers. Moreover, in older patients, exercise improves functional capacity and reduces myocardial work, similar to that seen in younger patients. As for younger patients, cardiac rehabilitation requires a multidisciplinary approach, including comprehensive assessment, treatment of risk factors and comorbidity, and psychosocial assessment. Cardiac rehabilitation is safe and helpful for elderly coronary patients. Physicians must be encouraged to prescribe cardiac rehabilitation programs for the elderly following major coronary events and coronary revascularization procedures. [ABSTRACT FROM AUTHOR]
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- 2006
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21. Combined Use of High-sensitivity C-Reactive Protein and N-Terminal Pro-B-type Natriuretic Peptide for Risk Stratification of Vascular Surgery Patients
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Scrutinio, Domenico, Guido, Gloria, Guida, Piero, Passantino, Andrea, Angiletta, Domenico, Santoro, Daniela, Marinazzo, Davide, and Regina, Guido
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We sought to assess whether high-sensitivity C-reactive protein (hs-CRP) and pro-B-type natriuretic peptide (NT-proBNP) improve risk prediction when added to an established predictive tool and develop a point-based risk score.
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- 2014
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22. Prognostic Value of Indeterminable Anaerobic Threshold in Heart Failure
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Agostoni, Piergiuseppe, Corrà, Ugo, Cattadori, Gaia, Veglia, Fabrizio, Battaia, Elisa, La Gioia, Rocco, Scardovi, Angela B., Emdin, Michele, Metra, Marco, Sinagra, Gianfranco, Limongelli, Giuseppe, Raimondo, Rosa, Re, Federica, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Magrì, Damiano, Fiorentini, Cesare, Cicoira, Mariantonietta, Salvioni, Elisabetta, Giovannardi, Marta, Mezzani, Alessandro, Scrutinio, Domenico, Di Lenarda, Andrea, Mantegazza, Valentina, Ricci, Roberto, Apostolo, Anna, Iorio, AnnaMaria, Paolillo, Stefania, Palermo, Pietro, Contini, Mauro, Vassanelli, Corrado, Passino, Claudio, and Piepoli, Massimo F.
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In patients with heart failure (HF), during maximal cardiopulmonary exercise test, anaerobic threshold (AT) is not always identified. We evaluated whether this finding has a prognostic meaning.
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- 2013
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23. Inpatient Cardiac Rehabilitation Soon After Hospitalization for Acute Decompensated Heart Failure
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Scrutinio, Domenico, Passantino, Andrea, Catanzaro, Raffaella, Farinola, Giuseppe, Lagioia, Rocco, Mastropasqua, Filippo, Ricci, Antonio, and Santoro, Daniela
- Abstract
Postdischarge management of acute decompensated heart failure (ADHF) remains an ongoing challenge. We sought to assess whether inpatient cardiac rehabilitation (CR) soon after hospitalization for ADHF improves outcome.
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- 2012
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24. The Potential of Lifestyle Changes for Improving the Clinical Outcome of Patients with Coronary Heart Disease: Mechanisms of Benefit and Clinical Results
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Scrutinio, Domenico
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There is overwhelming evidence that smoking cessation, regular physical activity, and combined dietary changes are beneficial in patients with coronary heart disease. Effect size estimates for these lifestyle goals vary between 20 and 35 of mortality rate reductions. Despite the evidence, achieving healthy lifestyles remains the most difficult problem in secondary prevention. In this paper, I review the effects of lifestyle changes on the clinical outcome of patients with coronary heart disease and the underlying mechanisms of benefit, as well as two recently published, controlled, clinical trials addressing the issue of achieving therapeutic lifestyle changes in coronary heart disease patients.
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- 2010
25. Comorbidity in patients undergoing coronary artery bypass graft surgery: impact on outcome and implications for cardiac rehabilitation
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Scrutinio, Domenico and Giannuzzi, Pantaleo
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The increasing comorbid disease burden among patients undergoing coronary artery bypass graft surgery (CABG) and the improved operative survival are expanding the number of post-CABG patients living with prognostically significant comorbidities. In a large contemporary database, 29.9% of the patients receiving isolated CABG had diabetes mellitus, 16% peripheral vascular disease, 18.6% chronic obstructive pulmonary disease, and 27.5% renal dysfunction. Patients with comorbidity are more likely to be old and often female, may have special care-requirements early after discharge, and are at increased risk for adverse outcomes. Contemporary available evidence indicates that older individuals, women, and patients with comorbidities are significantly less likely to receive cardiac rehabilitation. In addition, compliance with proven atherosclerosis risk reduction strategies for CABG patients is suboptimal. In this article we will review the impact of comorbidity on short-term and long-term outcome after CABG and their implications for cardiac rehabilitation.
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- 2008
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26. Ticlopidine versus aspirin after myocardial infarction (stami) trial
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Scrutinio, Domenico, Cimminiello, Claudio, Marubini, Ettore, Vittoria Pitzalis, Maria, Di Biase, Matteo, and Rizzon, Paolo
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OBJECTIVES
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- 2001
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27. Effects of l-carnitine administration on left ventricular remodeling after acute anterior myocardial infarction: the l-Carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) trial
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Iliceto, Sabino, Scrutinio, Domenico, Bruzzi, Paolo, D'Ambrosio, Gaetano, Boni, Luca, Di Biase, Matteo, Biasco, Giuseppina, Hugenholtz, Paul G., and Rizzon, Paolo
- Abstract
Objectives. This study was performed to evaluate the effects of l-carnitine administration on long-term left ventricular dilation in patients with acute anterior myocardial infarction.
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- 1995
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28. A Digital Network for Long-distance Echocardiographic Image and Data Transmission in Clinical Trials: The CEDIM Study Experience
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Iliceto, Sabino, D'Ambrosio, Gaetano, Scrutinio, Domenico, Marangelli, Vito, Boni, Luca, and Rizzon, Paolo
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A special computer network has been specifically designed and realized to connect 36 Italian cardiological institutions to a central core laboratory. This network, which has been created to run the CEDIM Multicenter Trial (effects of L-carnitine on left ventricular function in patients with myocardial infarction assessed by digital echocardiography), enables automatic verification, via computer, 24 hours a day, of patient eligibility criteria, randomization, transmission, and filing of real-time left ventricular echocardiographic examinations. All the investigators participating in the CEDIM trial underwent several training courses as well as dummy run procedures to achieve optimal performance of all the operational procedures required for the network to function smoothly and correctly. This paper describes the aims of this special network, its technical characteristics, and the investigator training and dummy run procedures.
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- 1993
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29. Rehabilitation Outcomes of Patients With Severe Disability Poststroke.
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Scrutinio, Domenico, Guida, Pietro, Lanzillo, Bernardo, Ferretti, Chiara, Loverre, Anna, Montrone, Nicola, and Spaccavento, Simona
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Abstract Objective To characterize rehabilitation outcomes of patients with severe poststroke motor impairment (MI) and develop a predictive model for treatment failure. Design Retrospective cohort study. Correlates of treatment failure, defined as the persistence of severe MI after rehabilitation, were identified using logistic regression analysis. Then, an integer-based scoring rule was developed from the logistic model. Setting Three specialized inpatient rehabilitation facilities. Participants Patients (N=1265) classified as case-mix groups (CMGs) 0108, 0109, and 0110 of the Medicare classification system. Interventions Not applicable. Main Outcome Measure Change in the severity of MI, as assessed by the FIM, from admission to discharge. Results Median FIM-motor (FIM-M) score increased from 17 (interquartile range [IQR] 14-23) to 38 (IQR, 25-55) points. Median proportional recovery, as expressed by FIM-M effectiveness, was 26% (IQR, 12-47). Median FIM-M change was 18 (IQR, 9-34) points. About 38.5% patients achieved the minimal clinically important difference. Eighteen point six percent and 32.0% of the patients recovered to a stage of either mild (FIM-M ≥62) or moderate (FIM-M 38-61) MI, respectively. All between-CMG differences were statistically significant. Outcomes have also been analyzed according to classification systems used in Australia and Canada. The scoring rule had an area under the curve of 0.833 (95% confidence interval, 0.808-0.858). Decision curve analysis displayed large net benefit of using the risk score compared with the treat all strategy. Conclusions This study provides a snapshot of rehabilitation outcomes in a large cohort of patients with severe poststroke MI, thus filling a gap in knowledge. The scoring rule accurately identified the patients at risk for treatment failure. [ABSTRACT FROM AUTHOR]
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- 2019
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30. Response by Guida and Scrutinio to Letter Regarding Article, "Development and Validation of a Predictive Model for Functional Outcome After Stroke Rehabilitation: The Maugeri Model".
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Guida, Pietro and Scrutinio, Domenico
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- 2018
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31. Response by Guida and Scrutinio to Letter Regarding Article, “Development and Validation of a Predictive Model for Functional Outcome After Stroke Rehabilitation: The Maugeri Model”
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Guida, Pietro and Scrutinio, Domenico
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- 2018
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32. 923-2 Effects of L-Carnitine on Left Ventricular Function After Acute Myocardial Infarction. Results of the CEDIM (Carnitina Ecocardiografia Digitale Infarto Miocardico) Trial
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Iliceto, Sabino, Marangelli, Vito, Santoro, Giuseppe, Bani, Luca, D’Ambrosio, Gaetano, Scrutinio, Domenico, Bruzzi, Paolo, Hugenholtz, Paul G., and Rizzon, Paolo
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Limitation of left ventricular (LV) dilatation (LV remodeling) after acute myocardial infarction (AMI) has become an essential therapeutic goal since the entity of LV dilatation after AMI is now recognized to be the most powerful prognostic predictor for clinical outcome. L-Carnitine (L-C) is an essential compound of cardiac metabolism that favours the optimal utilization of energetic substrates. Experimental studies have demonstrated that L-C administration during and after myocardial ischemia restores L-C cardiac depletion following ischemia and exerts a beneficial effect on LV function. To test the hypothesis, that timely restoration of adequate intracardiac L-C levels after AMI could limit LV dilatation on a long-term basis in a clinical setting, a multicenter, randomized, double-blind, placebo controlled trial was undertaken (CEDIM trial). 472 pts with first, anterior AMI and high quality entry 20 echo were enrolled (370/472 pts underwent thrombolysis). Pts were randomized to placebo (PI) or L-C (6g/day iv for the first 5 days and 9g/day orally for the following 12 months). 20 echo was digitally performed on admission, at 3, 6, 12 months after AMI. 2D echo images were transmitted via modem using a long-distance network to a Core Laboratory where end-diastolic and endsystolic volumes (EDV, ESV) were assessed. Baseline clinical and echocardiographic characteristics were similar in L-C and PI groups. Percent variation (Δ %) of EDV and ESV at 3, 6,12 months from baseline was evaluated in both PI and L-C groups.Results:3 months6 months12 monthsΔ%-EDVL-C11.1±30.212.7±26.819.1±36.2PI18.0±33.0*19.5±30.6*28.5±40.2*Δ%-ESVL-C12.6±41.615.1±36.828.9±51.4PI22.5±42.8*25.6±42.3**39.9±55.1**p<0.05.**p=0.01 (Student's t test L-C vs PI)
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- 1995
- Full Text
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