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Dante a écrit des lettres tout au long de sa vie et de son activité d’écrivain. Cette remarque peut sembler banale ; toutefois, il est rare que ces épîtres, de qualité et d’intérêt variables, soient connues hors du cercle étroit des spécialistes. À vrai dire, même les spécialistes leur ont rarement accordé l’attention qu’elles méritent. Et pourtant, les épîtres en disent long sur les pratiques d’écriture du temps, puisqu’elles héritent de la longue tradition d’un enseignement de la compositio...

AIMS The safety and efficacy of single vs. dual antiplatelet therapy (DAPT) in patients undergoing TAVI remain to be addressed. The aim of our study was to evaluate the usefulness of a DAPT compared to a single platelet therapy in patients undergoing TAVI with a balloon-expandable prosthesis. METHODS AND RESULTS All consecutive patients enrolled in the ITER registry were included. Patients undergoing TAVI discharged with aspirin alone were compared to those taking DAPT before and after selection using propensity score with matching. Subgroup analysis was performed for those on OAT. Prosthetic heart valve dysfunction at follow-up was the primary endpoint, whereas all-cause death, cardiovascular death, bleedings, vascular complications and cerebrovascular accidents were the secondary ones. From 1,364 patients, after propensity score with matching, 605 were selected for each group (aspirin alone vs. DAPT). At 30 days, rates of VARC mortality were lower in patients with aspirin alone (1.5% vs. 4.1%, p=0.003), mainly driven by a reduction of major vascular complications (5.3% vs. 10.7%, p

Il processo di irreggimentazione della cittadinanza e dell'ortodossia, che si realizza in significativo parallelismo nelle istituzioni laiche ed ecclesiastiche in pieno Trecento, accompagna, nel secolo precedente, l'emergere e l'affermarsi della cultura volgare in Italia. I momenti di particolare conflitto (quali quelli intorno al Concilio di Lione II e all'inasprirsi delle lotte di fazione nei Comuni oppure durante il pontificato di Bonifacio VIII) scandiscono questa affermazione in una maniera che non è stata ancora scandagliata dagli studiosi. L'articolo propone, a partire proprio da questo intreccio, un'ipotesi che riguarda l'itinerario biografico del poeta franciscano di Todi lacopone. Partendo dai recenti studi sull'evoluzione politica del comune umbro, l'autore sostiene che lacopone sia stato protagonista dell'esperienza del "primo popolo" a Todi, e che questa esperienza abbia anche contraddistinto la sua esperienza di frate e poeta legato al dissenso francescano, proprio nel momento in cui la città stringe i rapporti con il papato e istituisce un modello politico originale. Uno dei modi per studiare questo processo è costituito dall' affermarsi di un lessico e di un immaginario dell'esclusione, che attraversa l'intero arco della produzione poetica di lacopone e prepara la presunta e problematica novità dantesca, che consiste in una rivendicazione dell'esilio quale dimensione costitutiva dell'auctor., Le processus de contrôle de la population et de l'orthodoxie, que les institutions laïques et ecclésiastiques mettent en œuvre, de façon significativement parallèle, au XIVe siècle, avait accompagné, au XIIIe siècle, l'émergence et l'affirmation, en Italie, de la culture en langue vernaculaire. Des phases de conflit (autour du concile de Lyon II, à cause de la recrudescence des luttes entre factions dans les Communes ou pendant le pontificat de Boniface VIII) marquent cette affirmation d'une manière qui n'a pas encore été étudiée en profondeur. A partir du constat de ces interactions, l'auteur de cette contribution avance une hypothèse concernant l'itinéraire biographique du poète franciscain de Todi, Iacopone. Se rapportant aux études récentes sur l'évolution politique de cette Commune ombrienne, l'auteur attribue à Iacopone un rôle de protagoniste dans l'expérience du "primo popolo" à Todi et considère que cette expérience a marqué son existence de religieux et de poète lié à la dissidence franciscaine, au moment précisément où Todi resserrait ses liens avec la papauté et mettait en place un modèle politique original. Cela ressort notamment de la présence, dans la poésie de Iacopone, d'un lexique et d'un imaginaire de l'exclusion qui traverse toute sa production, anticipant la nouveauté, bien problématique, de l'approche dantesque de l'exil, revendiqué en tant qu'élément constitutif de l'auctor., Montefusco Antonio, Combes Malika. La vie effacée du poète dissident : Iacopone et le «peuple» à Todi. In: Arzanà 16-17, 2013. Écritures de l’exil dans l’Italie médiévale, sous la direction de Anna Fontes Baratto et Marina Gagliano. pp. 53-73.

1. Il corpus Il lavoro preparatorio per una nuova edizione criticamente sorvegliata del Miles armatus di Pierre de Jean Olivi e l’indagine sulla circolazione di manoscritti volgari legati al movimento di dissidenza francescana tra Due e Trecento mi ha permesso di affrontare il complesso nodo di problemi che riguarda una parte dell’opera e della scrittura del frate linguadociano che è rimasta ai margini dell’attenzione scientifica. Mi riferisco a un gruppo di opere brevi di tematica devozional...

Aim: To evaluate short-term changes in tricuspid regurgitation (TR) after transcatheter edge-to-edge mitral valve repair (M-TEER) in secondary mitral regurgitation (SMR), their predictors and impact on mortality. Methods and results: This is a retrospective analysis of SMR patients undergoing successful M-TEER (post-procedural mitral regurgitation ≤2+) at 13 European centres. Among 503 patients evaluated 79 (interquartile range [IQR] 40-152) days after M-TEER, 173 (35%) showed ≥1 degree of TR improvement, 97 (19%) had worsening of TR, and 233 (46%) remained unchanged. Smaller baseline left atrial diameter and residual mitral regurgitation 0/1+ were independent predictors of TR ≤2+ after M-TEER. There was a significant association between TR changes and New York Heart Association class and pulmonary artery systolic pressure decrease at echocardiographic re-assessment. At a median follow-up of 590 (IQR 209-1103) days from short-term echocardiographic re-assessment, all-cause mortality was lower in patients with improved compared to those with unchanged/worsened TR (29.6% vs. 42.3% at 3 years; log-rank p = 0.034). Baseline TR severity was not associated with mortality, whereas TR 0/1+ and 2+ at short-term follow-up was associated with lower all-cause mortality compared to TR 3/4+ (30.6% and 35.6% vs. 55.6% at 3 years; p < 0.001). A TR ≤2+ after M-TEER was independently associated with a 42% decreased risk of mortality (p = 0.011). Conclusion: More than one third of patients with SMR undergoing successful M-TEER experienced an improvement in TR. Pre-procedural TR was not associated with outcome, but a TR ≤2+ at short-term follow-up was independently associated with long-term mortality. Optimal M-TEER result and a small left atrium were associated with a higher likelihood of TR ≤2+ after M-TEER.

Transradial access (TRA) is often avoided in favor of the transfemoral access (TFA) during percutaneous coronary interventions of the unprotected left main coronary artery (ULM), due to technical and safety concerns. The aim of this study was to compare the performance of TRA and TFA in the treatment of ULM with second-generation drug-eluting stents. Consecutive patients who underwent percutaneous coronary intervention on ULM with second-generation drug-eluting stents were retrospectively enrolled in the multicenter Failure in Left Main Study With 2nd Generation Stents (FAILS 2) registry. Patients were stratified according to the arterial access. The choice between TRA and TFA was left to each operator's preferences. Bleedings during index hospitalization were the primary end point. Secondary end points were major adverse cardiovascular events (a composite of death, reinfarction, and target lesion revascularization), the single components of major adverse cardiovascular events at follow-up and stent thrombosis. Propensity score matching was executed to account for possible confounding. Overall, 1,247 patients were enrolled (23.2% [289] of female gender, mean age 70.2 ± 10.2 years). Diagnosis at presentation was stable angina in 603 (48.7%) cases, non–ST-segment elevation acute coronary syndrome in 465 (37.3%), ST-segment elevation myocardial infarction in 117 (9.5%). Mean follow-up was 726 ± 654 days. After propensity score with matching, 354 patients were included. The primary end point was significantly reduced in patients treated with TRA (2.0% vs 4.0%, p = 0.042), whereas no differences emerged pertaining the secondary end points, including target lesion revascularization and reinfarction. In conclusion, TRA may reduce in-hospital bleedings in patients undergoing percutaneous treatment of the ULM, without increasing the rate of adverse cardiovascular events at follow-up, and may therefore be safely used in the treatment of the ULM.

Incidence, predictors, and impact on prognosis of target lesion revascularization (TLR) for patients treated with second-generation drug-eluting stents (DESs) on unprotected left main (ULM) remain to be defined. The present study is a multicenter study including patients treated with a second-generation DES on ULM from June 2007 to January 2015. Rate of TLR was the primary end point. All cause death, myocardial infarction, target vessel revascularization, and stent thrombosis were the secondary end points. A total of 1,270 patients were enrolled: after a follow-up of 650 days (230 to 1,170), 47 (3.7%) of them underwent a re–percutaneous coronary intervention TLR on the left main, 22 during a planned angiographic follow-up. Extent of coronary artery disease was similar among groups (median value of Syntax of 27 ± 10 vs 26 ± 9, p = 0.45), as localization of the lesion in the ULM. Of patients reporting with TLR on ULM, 56% presented with a focal restenosis, 33% diffuse and 10% proliferative. At multivariate analysis, insulin-dependent diabetes mellitus increased risk of TLR (hazard ratio [HR] 2.0: 1.1 to 3.6, p = 0.04), whereas use of intravascular ultrasound resulted protective (HR 0.5: 0.3 to 0.9, p = 0.02). At follow-up, rates of cardiovascular death did not differ among the 2 groups (4% vs 4%, p = 0.95). At multivariate analysis, TLR on LM did not increase risk of all cause death (HR 0.4: 0.1 to 1.6, p = 0.22), whereas cardiogenic shock and III tertile of Syntax portended a worse prognosis (HR 4.5: 2.1 to 10.2, p = 0.01 and HR 1.4: 1.1 to 1.6, p = 0.03, respectively). In conclusion, repeated revascularization after implantation of second-generation DES on ULM represents an unfrequent event, being increased in insulin-dependent patients and reduced by intravascular ultrasound. Impact on prognosis remains neutral, being related to clinical presentation and extent of coronary artery disease.