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5. Contemporary antithrombotic strategies in patients with acute coronary syndromes managed without revascularization: insights from the EYESHOT study

Author

De Luca, Leonardo, Leonardi, Sergio, Smecca, Ignazio Maria, Formigli, Dario, Lucci, Donata, Gonzini, Lucio, Tuccillo, Bernardino, Olivari, Zoran, Gulizia, Michele Massimo, Bovenzi, Francesco Maria, De Servi, Stefano, Caporale, R., Cavallini, C., Ceravolo, R., Lupi, A., Musumeci, G., Rakar, S., Maggioni, A. P., Lorimer, A., Orsini, G., Fabbri, Giorgio, Bianchini, E., Abrignani, M. G., Bonura, F., Trimarco, B., Galasso, Giorgia, Misuraca, G., Manes, M. T., Irace, Lorenzo, Totis, O., Ledda, A., Mauro, C., Boccalatte, M., Iliceto, S., Cacciavillani, L., Savonitto, S., Tortorella, G., Esposito, L., DE ROSA, Paolo, Calabrò, P., Bianchi, R., Napoletano, C., Lalla Piccioni, L., Pavesi, P. C., Boni, Allegra, Merenda, R., Wolff, S., De Ferrari, G. M., Camporotondo, R., Gambino, Paolo, Cutaia, A., Picariello, C., Cemin, R., Chiarella, F., Grazioli Gauthier, L., Mircoli, L., Del Pinto, M., Finocchiaro, M. L., Scioli, R., Farina, R., Naddeo, C., Scherillo, M., Santopietro, S., Metra, M., Costa, F., Calculli, G., Troito, G., Pennisi, V., Adornato, E. M. F., Pirelli, S., Fadin, B. M., Di Biase, M., Ieva, R., Zuin, G., Sanfilippo, N., Mancuso, LAURA CATERINA, Pani, Luisa Anna, Serra, Eleonora, Marenzi, G., Assanelli, E. M., Ansalone, G., Cacciotti, L., Morocutti, G., Fresco, C., Berti, S., Paradossi, U., Bozzano, A., Mauro, A., Noussan, P., Zanini, P., Bolognese, L., Falsini, G., Costa, P., Manca, G., Caldarola, P., Locuratolo, N., Cipolla, T., Becchina, M., Cocco, Gabriele, Scalera, G., Stefanelli, S., Giunta, N., Sinagra, G., Meloni, L., Lai, O., Chiaranda, G., Luca, G., Sleiman Helou, J., Biscottini, E., Magliari, F., Callerame, M., Uguccioni, M., Pugliese, M., Sanchez, F., Tartaglione, S., Ignone, G., Mavilio, G., Mantovan, R., Bini, R., Caico, S. I., Demolli, V., Proietti, F., Michisanti, M., Musmeci, G., Cantamessa, P., Sicuso, G., Micalef, S. S., Accogli, M., Zaccaria, MICHELA MARIA, Caputo, M., Di Paolo, G., Piatti, L., Farina, A., Vicinelli, P., Paloscia, L., Di Clemente, D., Felis, S., Castini, D., Rota, C., Casu, Gabriella, Bonano, S., Margheri, M., Ricci Lucchi, G., Serdoz, R., Proietti, P., Autore, C., Conti, E., Russo, V., Orlando, P., Ramondo, A. B., Bontorin, M., Marcolongo, M., Marrara, F., Maestroni, A., Vitti, P., Rodella, P., Bonetti, P., Elia, M., Lumare, R., Politi, A., Gritti, S., Poletti, F., Mafrici, A., Fusco, R., Bongo, A. S., Bacchini, S., Gasparetto, V., Ferraiuolo, G., Campana, C., Bonatti, R., Gaita, F., Bergerone, S., Bonmassari, R., Zeni, P., Langialonga, T., Scarcia, A., Caravita, L., Musacchio, E., Augello, G., Usmiani, T., Stomaci, B., Cirino, D., Pierini, S., Bottiglieri, G., Liso, A., Mussardo, M., Tosi, P., Sala, R., Belloni, A., Blengino, S., Lisi, E., Delfino, P., Auguadro, C., Brunazzi, M. C., Pacchioni, E., Fattore, L., Bosco, B., Blandizzi, S., Pajes, G., Patruno, N., Perna, G. P., Francioni, M., Favale, S., Vestito, D., Lombardi, A., Capecchi, A., Ferrero, P., De Vincenzo, C., Magri, G., Indolfi, C., De Rosa, S., Rossi, M., Collarini, L., Agnelli, D., Conti, G., Tonelli, C., Spadaro, C., Negroni, S., Di Noto, G., Lanari, A., Casolo, G., Del Meglio, J., Negrini, M., Celentano, A., Sifola, C., Rellini, G., Della Mattia, A., Molero, U., Piovaccari, G., Grosseto, D., Callegarin, L., Fiasconaro, G., Crivello, R., Thiebat, B., Leone, G., Tamburino, C., Caruso, G., Cassadonte, F., Sassone, B., Fuca, G., Sormani, L., Percoco, G. F., Mazzucco, R., Cazzani, E., Gianni, M., Limido, A., Luvini, M., Guglielmi, R., Mannarini, A., Moruzzi, P., Pastori, P., Golia, B., Marzano, A., Orazi, S., Marchese, I., Anselmi, M., Girardi, P., Nassiacos, D., Meloni, S., Busacca, P., Generali, C. A., Corda, S., Costanza, G., Montalto, S., Argenziano, L., Tommasini, P., Emdin, M., Pasanisi, E. M., Colivicchi, F., Tubaro, M., Azzolini, P., Luciani, C., Doronzo, B., Coppolino, A., Dellavesa, P., Zenone, F., Di Marco, A., De Conti, F., Piccinni, G. C., Gualtieri, M. R., Bisignani, G., Leone, A., Arcuri, G. M., Marinacci, L., Rossi, P., Perotti, S., Cotti Cometti, V., Arcidiacono, S., Tramontana, M., Bazzucchi, M., Mezzetti, P., Romano, M., Villani, R., Di Giovambattista, R., Volpe, B., Tedesco, L., Carini, M., Vinci, S., Paolini, E. A., Busoni, F., Piergentili, C., Navazio, A., Manca, F., Cocco, F., Pennetta, C. A., Maggiolini, S., Galbiati, R., Bruna, C., Ferrero, L., Brigido, S., Barducci, E., Musacchio, D., Manduca, B., Marchese, D., Patrassi, L. A., Pattarino, F. A., Rocchi, M., Briglia, S., Fanelli, R., Villella, M., Gronda, E., Massa, D., Lenti, V., Di Gregorio, L., Bottero, M., Bazzanini, F., Braggion, G., Antoniceli, R., Caraceni, D., Guzzo, V., Di Giovanni, P., Scarpini, S., Severgnini, B., Musolino, M. F., Della Casa, S., Gobbi, M., Arena, G., Bonizzato, S., Agnoletto, V., Sansoni, S., Pes, R. A. M., Denti, S., Polizzi, G. M., Pino, R., Commisso, B., Merlino, A., Di Lorenzo, L., Porchetta, I., Del Furia, F., Colombi, E., Covini, D., Cavalieri, F., Antonaci, S., Rubino, G., Ciulla, A., Bui, F., Casorelli, E., Caliendo, L., Laezza, A., Americo, L., Schillaci, A. M., Cordoni, M., Barsotti, L., Gaudio, C., Barilla, F., Cannone, M., Memeo, R., Truncellito, L., Andriani, A., Salituri, S., Verrina, F., Pafi, M., Sebastiani, M. L., Amico, A. F., Scolozzi, D., D'Alea, A., Catanzariti, D., Angheben, C., Ottaviano, A., and Levantesi, G.

Subjects
Male, Ticagrelor, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Conservative strategy, Population, Acute coronary syndromes, Revascularization, acute coronary syndromes, anticoagulant, antithrombotic therapy, conservative strategy, prasugrel, ticagrelor, aged, coronary care units, female, fibrinolytic agents, follow-up studies, hospital mortality, humans, iItaly, length of stay, male, myocardial revascularization, retrospective studies, survival rate, thrombolytic therapy, practice guidelines as topic, Fibrinolytic Agents, Anticoagulant, Antithrombotic therapy, Prasugrel, Acute Coronary Syndrome, Aged, Coronary Care Units, Female, Follow-Up Studies, Hospital Mortality, Humans, Italy, Length of Stay, Myocardial Revascularization, Retrospective Studies, Survival Rate, Thrombolytic Therapy, Practice Guidelines as Topic, Cardiology and Cardiovascular Medicine, Pharmacology (medical), Internal medicine, Antithrombotic, medicine, education, Survival rate, education.field_of_study, business.industry, Clopidogrel, medicine.disease, Cardiology, business, Fibrinolytic agent, medicine.drug
Abstract

Aims Patients with acute coronary syndromes (ACSs) who are managed without coronary revascularization represent a mixed and understudied population that seems to receive suboptimal pharmacological treatment. Methods and results We assessed patterns of antithrombotic therapies employed during the hospitalization and in-hospital clinical events of medically managed patients with ACS enrolled in the prospective, multicentre, nationwide EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units) registry. Among the 2585 consecutive ACS patients enrolled in EYESHOT, 783 (30.3%) did not receive any revascularization during hospital admission. Of these, 478 (61.0%) underwent coronary angiography (CA), whereas 305 (39.0%) did not. The median GRACE and CRUSADE risk scores were significantly higher among patients who did not undergo CA compared with those who did (180 vs. 145, P < 0.0001 and 50 vs. 33, P < 0.0001, respectively). Antithrombotic therapies employed during hospitalization significantly differ between patients who received CA and those who did not with unfractioned heparin and novel P2Y12 inhibitors more frequently used in the first group, and low-molecular-weight heparins and clopidogrel in the latter group. During the index hospitalization, patients who did not receive CA presented a higher incidence of ischaemic cerebrovascular events and of mortality compared with those who underwent CA (1.6 vs. 0.2%, P = 0.04 and 7.9 vs. 2.7%, P = 0.0009, respectively). Conclusion Almost one-third of ACS patients are managed without revascularization during the index hospitalization. In this population, a lower use of recommended antiplatelet therapy and worse clinical outcome were observed in those who did not undergo CA when compared with those who did. Clinical Trial Registration Unique identifier: [NCT02015624][1], . [10.1093/ehjcvp/pvv017][2] [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02015624&atom=%2Fehjcardpharm%2F1%2F3%2F168.atom [2]: /lookup/doi/10.1093/ehjcvp/pvv017

Published
2015
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6. Antithrombotic strategies in the catheterization laboratory for patients with acute coronary syndromes undergoing percutaneous coronary interventions: insights from the EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units Registry

Author

De Luca, L., Musumeci, G., Leonardi, S., Gonzini, L., Cavallini, C., Calabro, P., Mauro, C., Cacciavillani, L., Savonitto, S., De Servi, S., Caporale, R., Ceravolo, R., Formigli, D., Lupi, A., Rakar, S., Smecca, I. M., Maggioni, A. P., Lucci, D., Lorimer, A., Orsini, G., Fabbri, G., Bianchini, E., Abrignani, M. G., Bonura, F., Trimarco, B., Galasso, G., Misuraca, G., Manes, M. T., Tuccillo, B., Irace, L., Olivari, Z., Totis, O., Ledda, A., Boccalatte, M., Iliceto, S., Tortorella, G., Esposito, L., De Rosa, P., Bianchi, R., Napoletano, C., Piccioni, L. L., Pavesi, P. C., Bovenzi, F. M., Boni, A., Merenda, R., Wolff, S., De Ferrari, G. M., Camporotondo, R., Gambino, P., Cutaia, A., Picariello, C., Cemin, R., Chiarella, F., Gauthier, L. G., Mircoli, L., Del Pinto, M., Finocchiaro, M. L., Scioli, R., Farina, R., Naddeo, C., Scherillo, M., Santopietro, S., Metra, M., Costa, F., Calculli, G., Troito, G., Pennisi, V., Adornato, E. M. F., Pirelli, S., Fadin, B. M., DI Biase, M., Ieva, R., Zuin, G., Sanfilippo, N., Mancuso, L., Pani, A., Serra, E., Marenzi, G., Assanelli, E. M., Ansalone, G., Cacciotti, L., Morocutti, G., Fresco, C., Berti, S., Paradossi, U., Bozzano, A., Mauro, A., Noussan, P., Zanini, P., Bolognese, L., Falsini, G., Costa, P., Manca, G., Caldarola, P., Locuratolo, N., Cipolla, T., Becchina, M., Cocco, G., Scalera, G., Stefanelli, S., Giunta, N., Sinagra, G., Meloni, L., Lai, O., Chiaranda, G., Luca, G., Helou, J. S., Biscottini, E., Magliari, F., Callerame, M., Uguccioni, M., Pugliese, M., Sanchez, F., Tartaglione, S., Ignone, G., Mavilio, G., Mantovan, R., Bini, R., Caico, S. I., Demolli, V., Proietti, F., Michisanti, M., Musmeci, G., Cantamessa, P., Sicuso, G., Micalef, S. S., Accogli, M., Zaccaria, M., Caputo, M., DI Paolo, G., Piatti, L., Farina, A., Vicinelli, P., Paloscia, L., DI Clemente, D., Felis, S., Castini, D., Rota, C., Casu, G., Bonano, S., Margheri, M., Lucchi, G. R., Serdoz, R., Proietti, P., Autore, C., Conti, E., Russo, V., Orlando, P., Ramondo, A. B., Bontorin, M., Marcolongo, M., Santagostino, M., Maestroni, A., Vitti, P., Rodella, P., Bonetti, P., Elia, M., Lumare, R., Politi, A., Gritti, S., Poletti, F., Mafrici, A., Fusco, R., Bongo, A. S., Bacchini, S., Gasparetto, V., Ferraiuolo, G., De Luca, M., Campana, C., Bonatti, R., Gaita, F., Bergerone, S., Bonmassari, R., Zeni, P., Langialonga, T., Scarcia, A., Caravita, L., Musacchio, E., Augello, G., Usmiani, T., Stomaci, B., Cirino, D., Pierini, S., Bottiglieri, G., Liso, A., Mussardo, M., Tosi, P., Sala, R., Belloni, A., Blengino, S., Lisi, E., Delfino, P., Auguadro, C., Brunazzi, M. C., Pacchioni, E., Fattore, L., Bosco, B., Blandizzi, S., Pajes, G., Patruno, N., Perna, G. P., Francioni, M., Favale, S., Vestito, D., Lombardi, A., Capecchi, A., Ferrero, P., De Vincenzo, C., Magri, G., Indolfi, C., De Rosa, S., Rossi, M., Collarini, L., Agnelli, D., Conti, G., Tonelli, C., Spadaro, C., Negroni, S., DI Noto, G., Lanari, A., Casolo, G., Del Meglio, J., Negrini, M., Celentano, A., Sifola, C., Rellini, G., Mattia, A. D., Molero, U., Piovaccari, G., Grosseto, D., Callegarin, L., Fiasconaro, G., Crivello, R., Thiebat, B., Leone, G., Tamburino, C., Caruso, G., Cassadonte, F., Sassone, B., Fuca, G., Sormani, L., Percoco, G. F., Mazzucco, R., Cazzani, E., Gianni, M., Limido, A., Luvini, M., Guglielmi, R., Mannarini, A., Moruzzi, P., Pastori, P., Golia, B., Marzano, A., Orazi, S., Marchese, I., Anselmi, M., Girardi, P., Nassiacos, D., Meloni, S., Busacca, P., Generali, C. A., Corda, S., Costanza, G., Montalto, S., Argenziano, L., Tommasini, P., Emdin, M., Pasanisi, E. M., Colivicchi, F., Tubaro, M., Azzolini, P., Luciani, C., Doronzo, B., Coppolino, A., Dellavesa, P., Zenone, F., DI Marco, A., De Conti, F., Piccinni, G. C., Gualtieri, M. R., Bisignani, G., Leone, A., Arcuri, G. M., Marinacci, L., Rossi, P., Perotti, S., Cometti, V. C., Arcidiacono, S., Tramontana, M., Bazzucchi, M., Mezzetti, P., Romano, M., Villani, R., DI Giovambattista, R., Volpe, B., Tedesco, L., Carini, M., Vinci, S., Paolini, E. A., Busoni, F., Piergentili, C., Navazio, A., Manca, F., Cocco, F., Pennetta, C. A., Maggiolini, S., Galbiati, R., Bruna, C., Ferrero, L., Brigido, S., Barducci, E., Musacchio, D., Manduca, B., Marchese, D., Patrassi, L. A., Pattarino, F. A., Rocchi, M., Briglia, S., Fanelli, R., Villella, M., Gronda, E., Massa, D., Lenti, V., DI Gregorio, L., Bottero, M., Bazzanini, F., Braggion, G., Antoniceli, R., Caraceni, D., Guzzo, V., DI Giovanni, P., Scarpini, S., Severgnini, B., Musolino, M. F., Casa, S. D., Gobbi, M., Arena, G., Bonizzato, S., Agnoletto, V., Sansoni, S., Pes, R. A. M., Denti, S., Polizzi, G. M., Pino, R., Commisso, B., Merlino, A., DI Lorenzo, L., Porchetta, I., Del Furia, F., Colombi, E., Covini, D., Cavalieri, F., Antonaci, S., Rubino, G., Ciulla, A., Bui, F., Casorelli, E., Caliendo, L., Laezza, A., Americo, L., Schillaci, A. M., Cordoni, M., Barsotti, L., Gaudio, C., Barilla, F., Cannone, M., Memeo, R., Truncellito, L., Andriani, A., Salituri, S., Verrina, F., Pafi, M., Sebastiani, M. L., Amico, A. F., Scolozzi, D., Lupi, G., D'Alea, A., Catanzariti, D., Angheben, C., Ottaviano, A., Levantesi, G., de Luca, Leonardo, Musumeci, Giuseppe, Leonardi, Sergio, Gonzini, Lucio, Cavallini, Claudio, Calabrò, Paolo, Mauro, Ciro, Cacciavillani, Luisa, Savonitto, Stefano, de Servi, Stefano, Caporale, Roberto, Ceravolo, Roberto, Formigli, Dario, Lupi, Alessandro, Rakar, Sadir, Smecca, Ivan, Maggioni, Aldo Pietro, Lucci, Donata, Lorimer, Andrea, Orsini, Giampietro, Fabbri, Gianna, Bianchini, Elisa, Abrignani, Maurizio Giuseppe, Bonura, Francesc, Trimarco, Bruno, Galasso, Gennaro, Misuraca, Gianfranco, Manes, Maria Teresa, Tuccillo, Bernardino, and Irace, Luigi.

Subjects
Male, Prasugrel, medicine.medical_treatment, Myocardial Infarction, antithrombotic therapy, 030204 cardiovascular system & hematology, acute coronary syndromes, bivalirudin, heparins, percutaneous coronary intervention, prasugrel, ticagrelor, 0302 clinical medicine, Antithrombotic, 80 and over, Bivalirudin, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Registries, Aged, 80 and over, General Medicine, Hirudins, Middle Aged, Recombinant Proteins, Italy, Female, Cardiology and Cardiovascular Medicine, Ticagrelor, medicine.drug, medicine.medical_specialty, Platelet Glycoprotein GPIIb-IIIa Complex, NO, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, Acute Coronary Syndrome, Aged, Aspirin, business.industry, Heparin, Percutaneous coronary intervention, Anticoagulants, medicine.disease, Peptide Fragments, Clinical trial, Cross-Sectional Studies, Logistic Models, Conventional PCI, Multivariate Analysis, business
Abstract

Aims In the last decades, several new therapies have emerged for the treatment of acute coronary syndromes (ACS). We sought to describe real-world patterns of use of antithrombotic treatments in the catheterization laboratory for ACS patients undergoing percutaneous coronary interventions (PCI). Methods EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in ACS patients in Italy. Results Over a 3-week period, a total of 2585 consecutive ACS patients have been enrolled in 203 cardiac care units across Italy. Among these patients, 1755 underwent PCI (923 with ST-elevation myocardial infarction and 832 with non-ST-elevation ACS). In the catheterization laboratory, unfractioned heparin was the most used antithrombotic drug in both ST-elevation myocardial infarction (64.7%) and non-ST-elevation ACS (77.5%) undergoing PCI and, as aspirin, bivalirudin and glycoprotein IIb/IIIa inhibitors (GPIs) more frequently employed before or during PCI compared with the postprocedural period. Any crossover of heparin therapy occurred in 36.0% of cases, whereas switching from one P2Y12 inhibitor to another occurred in 3.7% of patients. Multivariable analysis yielded several independent predictors of GPIs and of bivalirudin use in the catheterization laboratory, mainly related to clinical presentation, PCI complexity and presence of complications during the procedure. Conclusion In our contemporary, nationwide, all-comers cohort of ACS patients undergoing PCI, antithrombotic therapies were commonly initiated before the catheterization laboratory. In the periprocedural period, the most frequently employed drugs were unfractioned heparin, leading to a high rate of crossover, followed by GPIs and bivalirudin, mainly used during complex PCI. Clinical trial registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02015624.

Published
2017

7. Sympathetic nervous system and hypertension in diabetic patients

Author

Carmine Vecchione, Argenziano L, Fratta L, Pompeo F, Trimarco B, Vecchione, C, Argenziano, L, Fratta, L, Pompeo, F, and Trimarco, Bruno

Subjects
Diabetes Complications, Sympathetic Nervous System, Vasoconstriction, Hypertension, Humans, Environment, Insulin Resistance, Sodium Chloride
Abstract

Although it has been demonstrated that the sympathetic nervous system participates in the genesis of essential hypertension, it is still unclear whether this system can also account for the increased incidence of arterial hypertension in diabetic patients. However, there are some observations which make this hypothesis extremely likely. In fact, it has been demonstrated that in diabetic normotensive patients the reflex control of the sympathetic discharge is normal, but in hypertensive patients there are some derangements of the autonomic nervous tone control which may contribute to increasing the incidence of arterial hypertension in patients with Type 2 diabetes mellitus. In particular, on the one hand, it has been reported that in hypertensive patients hyperinsulinemia is able to induce a reflex activation of the sympathetic tone which is 3-fold higher than that observed in normotensive subjects. On the other hand, it has been demonstrated that this abnormal sympathetic response is particularly harmful in subjects prone to develop essential hypertension since they are characterized by vascular insulin resistance, which plays a permissive role in the development of essential hypertension. Vascular insulin resistance is a type of endothelial dysfunction which impairs the insulin modulation of the vascular effects of sympathetic nervous activation.

Published
2000

9. Efficacy of adenosine two-dimensional echocardiography in the diagnosis of viable myocardium. Comparison with thallium scintigraphy

Author

Ricciardelli, B., Luca, N., Argenziano, L., Gisonni, P., Carmine MORISCO, Nappi, A., Cuocolo, A., Ricciardelli, B., De Luca, N., Argenziano, L., Gisonni, P., Morisco, C., Nappi, A., and Cuocolo, A.

Abstract

The aim of this study was to assess the feasibility, safety and diagnostic accuracy of two-dimensional echocardiography performed during adenosine infusion (140 μg/Kg/min for 6 min) in recognizing segments of viable myocardium as assessed by thallium-201 scintigraphy (exercise-redistribution-reinjection protocol). For this purpose, 27 patients (25 males and 2 females, mean age 54 ± 6 years) with previous myocardial infarction, angiographically proven coronary artery disease and mild left ventricular systolic dysfunction (election fraction 35-45%) performed adenosine two-dimensional echocardiography and thallium-201 scintigraphy within 7 days in the absence of effective treatment. A 22 segment model of the left ventricle was used for both techniques. A score index ranging from 1 (normokinesia) to 4 (dyskinesia) was used for two-dimensional echocardiography. In the 102 segments identified as a-dyskinetic at rest echocardiography, 40 were classified as viable during echo-adenosine (improvement of ≤ 1 grade at peak hyperkinesia) and 62 necrotic. A concordance of 97.5% was found between the two diagnostic techniques in the former segments and of 82% in the latter. Our results indicate that iv adenosine infusion combined with two-dimensional echocardiography imaging can safely be used for the diagnosis of viable myocardium and may represent a useful alternative to thallium-201 scintigraphy in evaluating patients to be addressed to revascularization procedures.

Published
1996

11. Valutazione dell'ispessimento parietale sistolico del ventricolo sinistro con tecnezio-99m metossi isobutil isonitrile: relazione con l'anatomia coronarica

Author

Nicolai E, Cuocolo A, Pace L, Nappi A, Imbriaco M, Cardei S, MORISCO, CARMINE, Argenziano L, Salvatore M., MAUREA, SIMONE, Nicolai, E, Cuocolo, A, Pace, L, Maurea, Simone, Nappi, A, Imbriaco, M, Cardei, S, Morisco, Carmine, Argenziano, L, and Salvatore, M.

Abstract

Forty-three patients (40 men and 3 women, mean age 54 +/- 9 years) with coronary artery disease underwent 99mTc methoxy isobutyl isonitrile (sestamibi) myocardial scintigraphy and coronary arteriography. Sestamibi uptake and wall thickening index (WTI) were quantitatively evaluated in each myocardial segment. Segments were divided into group 1 (normal coronary arteries, no. = 94), group 2 (coronary artery stenosis 50-99%, no. = 79), and group 3 (coronary artery stenosis 100%, no. = 42). Group 3 segments were subdivided into group 3A (with collaterals, no. = 18) and group 3B (without collaterals, no. = 24) segments. Both sestamibi uptake and WTI were significantly lower (p < 0.01) in group 3 than in groups 1 and 2. However, only WTI was significantly reduced (p < 0.01) in group 3B vs group 3A. Diagnostic capabilities (i.e. identification of segments supplied by stenosed coronary arteries) of sestamibi uptake, WTI, and a combination of both variables with a discriminant function were compared by analysis of receiver operator characteristic curve (ROC) areas. The diagnostic capabilities of sestamibi uptake (ROC area = 0.65 +/- 0.04) were significantly lower (p < 0.05) than those of WTI (ROC area = 0.81 +/- 0.03) and discriminant function (ROC area = 0.83 +/- 0.03). In conclusion, our data suggest that combined analysis of myocardial perfusion and regional ventricular function may increase the diagnostic accuracy of sestamibi myocardial scintigraphy in identifying myocardial segments supplied by stenosed coronary arteries

Published
1994

13. Evaluation of systolic parietal thickening of the left ventricle using technetium-99m methoxy isobutyl isonitrile. Relationship with coronary anatomy

Author

NICOLAI E, CUOCOLO A, MAUREA S, NAPPI A, IMBRIACO M, CARDEI S, MORISCO, CARMINE, ARGENZIANO L, SALVATORE M., PACE, LEONARDO, Nicolai, E, Cuocolo, Alberto, Pace, L, Maurea, Simone, Nappi, A, Imbriaco, Massimo, Cardei, S, Morisco, Carmine, Argenziano, L, Salvatore, Marco, Cuocolo, A, Pace, Leonardo, Maurea, S, Imbriaco, M, and Salvatore, M.

Published
1994

16. The practical aspects of treatment in heart failure

Author

MORISCO, CARMINE, CUOCOLO, ALBERTO, TRIMARCO, BRUNO, Argenziano L, Sarno D, Romano M, Morisco, Carmine, Argenziano, L, Sarno, D, Cuocolo, Alberto, Romano, M, and Trimarco, Bruno

Published
1993

17. PREAMI: Perindopril and remodelling in elderly with acute myocardial infarction: Study rationale and design

Author

Battaglia, A., Ferraro, L., Lo Monaco, M., Palumbo, A., Mariani, M., Biadi, O., Boccalatte, A., Polimeno, S., Rosa, V., Liguori, L., Cuomo, S., Boccanelli, A., Morosetti, P., D Angelo, G., Bottiglieri, P., Brunelli, C., Spallarossa, P., Rolandi, A., Rossettini, Pf, Campa, P., Francesco BARILLA', Biase, L., Biscosi, C., Zampino, D., Capponi, E., Buccolieri, M., Gattobigio, R., Capucci, A., Passerini, F., Piepoli, M., Castello, A., Chiariello, M., Betocchi, S., Ciampi, Q., Losi, M., Corsini, G., Melorio, S., Dalle Mule, J., Mazzella, M., Cristinziani, Gr, Mario, L., Luca, I., Fusco, F., Del Salvatore, B., Sorino, M., Delise, P., Mozzato, Mg, Bilardo, G., Coro, L., Fantinel, M., Zasso, A., Fedele, F., Di Donato, D., Romano, S., Pascale, F., Giasi, M., Ciarcia, L., Lizzardo, A., Mastursi, M., Giordano, A., Benigno, M., Zanelli, E., Campana, M., Giovannini, E., Lacche, A., Pulignano, G., Giuffrida, G., Montana, G., Licciardello, G., L Abbate, A., Carpeggiani, C., Morales, A., Leghissa, R., Mandorla, S., Del Pinto, M., Borgioni, C., Mininni, N., Petrillo, Me, Moretti, G., Bonaglia, M., Zoni, A., Piscicelli, C., Orlandi, M., Panciroli, C., Oddone, A., Caizzi, V., Tartarini, G., Lattanzi, F., Reisenhofer, B., Pascotto, P., Zanocco, A., Dabizzi, Rp, Bini, L., Mondanelli, D., Frascarelli, F., Pitscheider, W., Erlicher, A., Rauhe, W., Bonsante, E., Polimeni, M., Catananti, F., Guerrisi, G., Magnani, B., Rapezzi, C., Ferlito, M., Amati, S., Di Leo, L., Manzo, M., Baldi, C., Cristofaro, M., Citro, R., Raviele, A., Turiano, G., Zuin, G., Rengo, F., Furgi, G., Papa, A., Rotiroti, D., Rosato, G., Siano, F., Pagliuca, MR, Rovelli, G., Heyman, J., Locati, I., Sanguinetti, M., Tomassini, F., Mantovani, R., Sanna, A., Marras, L., Crabu, E., Locci, G., Moio, N., Scilla, C., Tavazzi, L., Magrini, G., Bersano, C., Laudisa, Ml, Trimarco, B., Argenziano, L., Silvestri, S., Valagussa, F., Ciro, E., Cantu, E., Trocino, G., Rossillo, A., Valagussa, L., Finocchi, G., Benvenuto, Gm, Bonanno, C., Ometto, R., Risica, G., Gualandi, G., Facchin, L., Tenderini, P., Nicolosi, Gl, Burelli, C., Macor, F., Bellone, E., Laiso, D., Carvalho, P., Peila, C., Fagiano, A., Gardiol, S., Ganci, B., Presutto, P., Fontanelli, A., Morgera, T., Scarpino, L., Barbuzzi, S., Capogrosso, V., Terrosu, Pf, Contini, Gm, Sabino, G., Pes, R., Uneddu, F., Mecca, D., Tommaso, I., Rusconi, C., Brunazzi, Mc, Codeluppi, P., Pasqualini, M., Gorni, R., Negrelli, M., Paparoni, S., Core, A., Pecce, P., Petrella, L., Zennaro, Rg, Garuti, W., Alfano, G., Bacca, F., Petrucci, G., Paci, Am, Bigalli, G., Mangiameli, S., Gulizia, M., Cardillo, R., Ferrari, G., Tettamanti, F., Butti, E., Picchione, N., Sulla, A., Stroder, P., Perna, Gp, Ricci, S., Generali, Ca, Adornato, E., Ghisio, A., Tidu, M., Ferrari, R., Mele, D., Cicchitelli, G., Merli, E., Russa, O., Azcarate, Jma, Gonzales, Pz, Vilchez, F., Alonso, Lfi, Montero, Jmm, Zarzosa, Cd, Martin, Es, Ros, Jo, Martinez, Mh, Palau, Vm, Carranza, Mst, Mayor, Djlb, Cocina, Eg, Valderrama, Jc, Jimenez, Rp, Pardo, Jam, Cortada, Jb, Lorente, Lj, Guerrero, Jjg, Martinez, A., Coronado, Jlb, Casado, Rs, Cendon, Aa, Cokkinos, D., Maounis, T., Karatasakis, G., Kremastinos, D., Iliodromitis, S., Karatzas, D., Georgiadis, M., Paraskevaidis, I., Toutouzas, P., Antoniadis, P., Angeli, C., Vadas, P., Kaleboubas, M., Stamatelopoulos, S., Nanas, I., Kanakakis, A., Dalianis, A., Zacharoulis, A., Fotiadis, I., Pyrgakis, V., Liata, O., Mazen, B., Kardaras, F., Kardara, D., Krokos, V., Sioras, H., Fousas, S., Stefanidis, A., Papadopoulos, G., Papadopoulos, C., Papagiannis, I., Karidas, I., Zobolos, S., Preami, Investigators, A., Battaglia, L., Ferraro, M. L., Monaco, A., Palumbo, M., Mariani, O., Biadi, A., Boccalatte, S., Polimeno, V. D., Rosa, L., Liguori, S., Cuomo, A., Boccanelli, P., Morosetti, G., D'Angelo, P., Bottiglieri, C., Brunelli, P., Spallarossa, A., Rolandi, P. F., Rossettini, P., Campa, F., Barilla, L. D., Biase, C., Biscosi, D., Zampino, E., Capponi, M., Buccolieri, R., Gattobigio, A., Capucci, F., Passerini, M., Piepoli, A., Castello, M., Chiariello, Betocchi, Sandro, Q., Ciampi, Losi, MARIA ANGELA, G., Corsini, S., Melorio, J. D., Mule, M., Mazzella, G. R., Cristinziani, L., Mario, I. D., Luca, F., Fusco, B. D., Salvatore, M., Sorino, P., Delise, M. G., Mozzato, G., Bilardo, L., Coro', M., Fantinel, A., Zasso, F., Fedele, D. D., Donato, S., Romano, F. D., Pascale, M., Giasi, L., Ciarcia, A., Lizzardo, M., Mastursi, A., Giordano, M., Benigno, E., Zanelli, M., Campana, E., Giovannini, A., Lacche, G., Pulignano, G., Giuffrida, G., Montana, G., Licciardello, A., L'Abbate, C., Carpeggiani, A., Morale, R., Leghissa, S., Mandorla, M. D., Pinto, C., Borgioni, N., Mininni, M. E., Petrillo, G., Moretti, M., Bonaglia, A., Zoni, C., Piscicelli, M., Orlandi, C., Panciroli, A., Oddone, V., Caizzi, G., Tartarini, F., Lattanzi, B., Reisenhofer, P., Pascotto, A., Zanocco, R. P., Dabizzi, L., Bini, D., Mondanelli, F., Frascarelli, W., Pitscheider, A., Erlicher, W., Rauhe, E., Bonsante, M., Polimeni, F., Catananti, G., Guerrisi, B., Magnani, C., Rapezzi, M., Ferlito, S., Amati, L. D., Leo, M., Manzo, C., Baldi, M. D., Cristofaro, R., Citro, A., Raviele, G., Turiano, G., Zuin, F., Rengo, G., Furgi, A., Papa, D., Rotiroti, G., Rosato, F., Siano, M. R., Pagliuca, G., Rovelli, J., Heyman, I., Locati, M., Sanguinetti, F., Tomassini, R., Mantovani, A., Sanna, L., Marra, E., Crabu, G., Locci, N., Moio, C., Scilla, L., Tavazzi, G., Magrini, C., Bersano, M. L., Laudisa, Trimarco, Bruno, L., Argenziano, S., Silvestri, F., Valagussa, E., Ciro, E., Cantu, G., Trocino, A., Rossillo, L., Valagussa, G., Finocchi, G. M., Benvenuto, C., Bonanno, R., Ometto, G., Risica, G., Gualandi, L., Facchin, P., Tenderini, G. L., Nicolosi, C., Burelli, F., Macor, E., Bellone, D., Laiso, P., Carvalho, C., Peila, A., Fagiano, S., Gardiol, B., Ganci, P., Presutto, A., Fontanelli, T., Morgera, L., Scarpino, S., Barbuzzi, V., Capogrosso, P. F., Terrosu, G. M., Contini, G., Sabino, R., Pe, F., Uneddu, D., Mecca, I. D., Tommaso, C., Rusconi, M. C., Brunazzi, P., Codeluppi, M., Pasqualini, R., Gorni, M., Negrelli, S., Paparoni, A., Core, P., Pecce, L., Petrella, R. G., Zennaro, W., Garuti, G., Alfano, F., Bacca, G., Petrucci, A. M., Paci, G., Bigalli, S., Mangiameli, M., Gulizia, R., Cardillo, G., Ferrari, F., Tettamanti, E., Butti, N., Picchione, A., Sulla, P., Stroder, G. P., Perna, S., Ricci, C. A., Generali, E., Adornato, A., Ghisio, M., Tidu, R., Ferrari, D., Mele, G., Cicchitelli, E., Merli, O., Russa, J. M., A., P. Z., Gonzale, F., Vilchez, L. F. I., J. M. M., C. D., Zarzosa, E. S., Martin, J. O., De, M. H., Martinez, V. M., Palau, M. S. T., D. J. L., E. G., Cocina, J. C., Valderrama, R. P., Jimenez, J. A., M., J. B., Cortada, L. J., Lorente, J. J., G., A., Martinez, J. L., B., R. S., Casado, A. A., Cendon, D., Cokkino, T., Maouni, G., Karatasaki, D., Kremastino, S., Iliodromiti, D., Karatza, M., Georgiadi, I., Paraskevaidi, P., Toutouza, P., Antoniadi, C., Angeli, P., Vada, M., Kalebouba, S., Stamatelopoulo, I., Nana, A., Kanakaki, A., Daliani, A., Zacharouli, I., Fotiadi, V., Pyrgaki, O., Liata, B., Mazen, F., Kardara, D., Kardara, V., Kroko, H., Siora, S., Fousa, A., Stefanidi, G., Papadopoulo, C., Papadopoulo, I., Papagianni, I., Karida, and S., Zobolos

Subjects
Male, Ventricular Remodeling, Myocardial Infarction, Angiotensin-Converting Enzyme Inhibitors, Electrocardiography, ace inhibitors, elderly, heart rate variability, left ventricular remodeling, myocardial infarction, perindopril, Double-Blind Method, Echocardiography, Research Design, Perindopril, Electrocardiography, Ambulatory, Humans, Female, Aged
Abstract

Angiotensin-converting enzyme (ACE) inhibitors reduce mortality, the development of remodeling, left ventricular (LV) dysfunction, and ischemic events, both when administered alone as long-term treatment in patients with impaired LV function and/or heart failure (HF) and as short-term treatment, early after acute myocardial infarction (AMI) and/or HF. The few data available on the use of ACE inhibitors in the elderly after AMI are conflicting. Nothing is known about the effects of ACE inhibitors in elderly postinfarction patients with preserved LV function: these patients have a remarkable medium- to long-term mortality and HF incidence after infarction. The aim of this study is to evaluate, in patients with AMI agedor =65 years, the effects of Perindopril on the combined outcome of death, hospitalization for HF, and heart remodeling, considered to be aor =8% increase in LV end-diastolic volume (LVEDV). Secondary objectives include the same factors listed in the primary end points but considered separately. In addition, safety of the drug, ventricular remodeling, and adaptation are being evaluated. A total of 1100 patients with AMI (first episode or reinfarction), agedor =65 years, and preserved or only moderately depressed LV (LV ejection fractionor =40%), are to be enrolled and randomly assigned to treatment (8 mg for 12 months of Perindopril or placebo, in double-blind conditions). Clinical assessment is performed at fixed times, and periodic evaluations of (1) ventricular shape, dimensions, and function by quantitative 2-D echocardiography, and (2) heart rate variability and arrhythmias by ambulatory electrocardiographic monitoring are anticipated. The results and conclusions will be available by 2002 year.

Published
2000

18. Epicardial ventricular ablation in high risk patients

Author

Coronella, G, primary, Argenziano, L, additional, Oliviero, P, additional, Contaldo, A, additional, Petteruti, F, additional, Pescatore, G, additional, Giordano, S, additional, La Marca, A, additional, Pepino, P, additional, and Nardi, S, additional

Published
2013
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21. [Arterial hypertension and atherosclerosis: their epidemiology and physiopathology]

Author

Lembo G, Carmine Vecchione, Morisco C, Fratta L, Argenziano L, Sarno D, and Trimarco B

Subjects
Arteriosclerosis, Humans, Hypertension, Risk Factors
Abstract

Several epidemiologic studies have demonstrated that hypertensive patients have an increased risk for the development of atherosclerosis. Although the appearance of atherosclerosis only in those parts of vascular system subjected to high blood pressure suggests that the mechanical stress is the principal factor involved in the development of atherosclerosis, the mechanisms underlying the linkage between hypertension and atherosclerosis are not yet completely understood. In fact, the evidence that antihypertensive treatments are not able to abolish the increased incidence of ischemic accidents in hypertensive patients suggests that other cellular and molecular mechanisms are involved in the pathogenesis of atherosclerosis. The pathogenesis of hypertension is a multifactorial process that involves the interaction of genetic and environmental factors which determine the abnormalities of volume regulation, the enhanced vasoconstriction and the remodeling of the arterial wall which is characterized by hypertrophy and proliferation of vascular smooth muscle cells. On the other hand, the increased growth response of vascular smooth muscle cells represents one of the principal characteristics of atherosclerosis. Thus, increased vascular smooth muscle cell growth is a common feature in the pathogenesis of both atherosclerosis and hypertension.

Published
1995

23. A preliminary setup model and protocol for checking electromagnetic interference between pacemakers and RFID (Radio Frequency IDentification).

Author

Jarm, Tomaz, Kramar, Peter, Zupanic, Anze, Tranfaglia, Riccardo, Bracale, M., Pone, A., Argenziano, L., and Pecchia, L.

Abstract

In the last few years, the enormous growth in electronic equipments which communicate a radiofrequency have only emphasized the problem of so-called electromagnetic smog. At the same time, the continuous attempts to improve the quality of life of the patient (because of the research of new technology) has permitted the emergence of devices to control and cure the health conditions especially for the electrical problems of the heart: pacemakers. The main conflict between these two evolutionary processes is the interference of the elements with the pacemaker. Pacemakers are composed of electronic circuits and can sense and elaborate the electrical signals from the heart, as well as conduct electricity into it. Therefore, they are very sensitive to electromagnetic interaction. The RFID (Radio Frequency Identification) is the most important example of using radio frequency signals to exchange different types of data at a distance. The aim of this paper is to create a setup and protocol for the measurements of the interactions between pacemaker and RFID technology. An electrical model has been realized to simulate the way in which the pacemaker regulates the cardiological activity. In addition, we created a test protocol to evaluate the interaction between them. [ABSTRACT FROM AUTHOR]

Published
2007
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24. Technology Assessment for evaluating integration of Ambulatory Follow-up and Home Monitoring.

Author

Jarm, Tomaz, Kramar, Peter, Zupanic, Anze, Bracale, Marcello, Bisaccia, L., Melillo, P., Argenziano, L., and Bracale, M.

Abstract

The introduction of new services into a complex system, as it is the Health System, is not an easy challenge. Health Technology Assessment could support decision makers and drive decision making regarding the introduction of new health services. This paper describes an analysis to evaluate those clinical and patient's needs that could be satisfied by integration of Ambulatory Follow-up and Home Monitoring. Then a cost-analysis on the ambulatory follow-up and a preliminary cost-estimation on Web Service are performed in order to assess the economical impact of these services on the follow-up. [ABSTRACT FROM AUTHOR]

Published
2007
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36. Management of left ventricular hypertrophy

Author

Morisco, C., Argenziano, L., Izzo, R., Fratta, L., Sarno, D., Luca, N., Santonastaso, F., Bruno Trimarco, Morisco, Carmine, Argenziano, L, Izzo, Raffaele, Fratta, L, Sarno, D, DE LUCA, Nicola, Santonastaso, F, and Trimarco, Bruno

Abstract

Left ventricular hypertrophy is a common feature of essential hypertension, and represents at the same time an adaptive process to the increased workload and an independent risk factor for cardiovascular morbidity and mortality. Thus, the reversal of left ventricular hypertrophy has to be considered as the fundamental end point of antihypertensive therapy. Left ventricular hypertrophy is a complex phenotype which is determined by hemodynamic (ie arterial blood pressure and arterial compliance), neurohormonal (ie renin-angiotensin-aldosterone and sympathetic nervous system activity), and hereditary factors (ie race, deletion polymorphism of the angiotensin-converting enzyme gene). Although it is well established that blood pressure reduction is accompanied by a decrease in left ventricular mass, some drugs seem to be more effective than others in preventing or reversing left ventricular hypertrophy despite a similar antihypertensive efficacy. Thus, the choice of therapeutic strategy in the management of left ventricular hypertrophy should take in account this characteristic and above all the ability of the antihypertensive therapy to positively interfere with the pathogenetic mechanisms involved in the development of LV hypertrophy. © 1998, Medikal Press.

47. Effects of short-term enalapril treatment on hemodynamic response to exercise in patients with congestive heart failure: a pilot study

Author

Alberto Cuocolo, Massimo Romano, D. Sarno, Massimo Raponi, Carmine Morisco, L. Argenziano, Francesco Monti, Monti, F., Morisco, C., Argenziano, L., Sarno, D., Romano, M., Raponi, M., and Cuocolo, A.

Subjects
Pharmacology, Ejection fraction, medicine.medical_specialty, Heart disease, business.industry, Hemodynamics, Physical exercise, medicine.disease, Crossover study, Surgery, Internal medicine, Heart failure, ACE inhibitor, medicine, Cardiology, Radionuclide monitoring, Therapy, angiotensin- converting enzyme inhibitors, Pharmacology (medical), cardiovascular diseases, Enalapril, business, medicine.drug
Abstract

This study was conducted to determine the effects of short-term enalapril treatment on left ventricular response to physical exercise in patients with congestive heart failure (CHF). The study followed a randomized, double-masked, placebo-controlled, crossover design. Twelve male patients (mean age, 52.8 ± 5.6 years; mean body weight, 75.6 ± 8.7 kg) with clinically documented CHF (left ventricular ejection fraction [EF]

Published
1997
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48. Technetium 99m-labeled tetrofosmin myocardial tomography in patients with coronary artery disease: Comparison between adenosine and dynamic exercise stress testing

Author

Alberto Cuocolo, L. Argenziano, Andrea Soricelli, Peter J. Ell, Antonio Nappi, Emanuele Nicolai, Stefania Cardei, Leonardo Pace, Pasquale Sullo, Marco Salvatore, Cuocolo, A, Nicolai, E, Soricelli, A, Pace, Leonardo, Nappi, A, Sullo, P, Cardei, S, Argenziano, L, Ell, Pj, Salvatore, M., Cuocolo, Alberto, Pace, L, and Salvatore, Marco

Subjects
Adult, Male, medicine.medical_specialty, Adenosine, Coronary Disease, Vasodilation, Coronary Angiography, Coronary artery disease, Electrocardiography, Organophosphorus Compounds, Coronary Circulation, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, In patient, Cardiac imaging, Aged, Tomography, Emission-Computed, Single-Photon, business.industry, Hemodynamics, Organotechnetium Compounds, Middle Aged, medicine.disease, Dipyridamole, Exercise Test, Cardiology, Female, Tomography, Radiology, Cardiology and Cardiovascular Medicine, business, Technetium-99m, medicine.drug
Abstract

Pharmacologic coronary vasodilation with adenosine, combined with myocardial scintigraphy, is a useful test for the diagnosis of coronary artery disease (CAD) in patients unable to exercise. It has been demonstrated recently that exercise 99mTc-labeled tetrofosmin cardiac imaging can be used for the detection of CAD. However, no data are available comparing 99mTc-labeled tetrofosmin adenosine and exercise tests in the same patients.The results of adenosine and exercise 99mTc-labeled tetrofosmin myocardial tomography were compared in 41 patients (37 men and four women; mean age 53 +/- 8 years) with suspected or known CAD who underwent coronary angiography. All patients were submitted, on separate days, to three injections of 99mTc-labeled tetrofosmin (740 MBq intravenously): one at rest, one during bicycle exercise, and one during adenosine infusion (140 micrograms/kg/min for 6 minutes with injection of 99mTc-labeled tetrofosmin at 4 minutes). A total of 902 myocardial segments were analyzed quantitatively. One patient had normal coronary vessels, 19 patients had single-vessel CAD, 12 patients had two-vessel CAD, and nine patients had three-vessel CAD (50% coronary stenosis) on coronary angiography. Adenosine induced a significant increase in heart rate (88 +/- 16 beats/min at peak vs 72 +/- 11 beats/min at rest; p0.01). Systolic and diastolic blood pressure was not significantly different after adenosine infusion compared with rest. Double product was 22931 +/- 7039 at peak exercise and 11229 +/- 3413 after adenosine (p0.01). Agreement on the presence of abnormal single-photon emission computed tomography by adenosine and exercise was 100% by quantitative analysis. In all segments a significant relationship between exercise and adenosine 99mTc-99m-labeled tetrofosmin uptake was observed (r = 0.90; p0.001). Segmental agreement for regional 99mTc-labeled tetrofosmin uptake score between exercise and adenosine was observed in 737 (82%) of the 902 segments (kappa value of 0.66). Concordance between the two studies for identification of perfusion status was observed in 809 (90%) of the segments (kappa value of 0.80). Sensitivity and specificity for detection of stenosed vessels were not different for dynamic exercise stress testing and adenosine 99mTc-labeled tetrofosmin cardiac tomography.Despite different hemodynamic effects, adenosine and dynamic exercise 99mTc-labeled tetrofosmin single-photon emission computed tomographic imaging provides similar information in the diagnosis and localization of CAD.

Published
1996
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49. Noninvasive evaluation of cardiac hemodynamics during exercise in patients with chronic heart failure: Effects of short-term Coenzyme Q10 treatment

Author

D. Sarno, Maurizio Romano, L. Argenziano, D. Fonatana, Massimo Imbriaco, Antonio Nappi, G. Rosiello, Alberto Cuocolo, E. Nicolai, Carmine Morisco, Morisco, Carmine, Nappi, A, Argenziano, L, Sarno, D, Fonatana, D, Imbriaco, Massimo, Nicolai, E, Romano, M, Rosiello, G, and Cuocolo, Alberto

Subjects
Adult, medicine.medical_specialty, Cardiac output, Ubiquinone, Clinical Biochemistry, Coenzymes, Monitoring, Ambulatory, Hemodynamics, Biochemistry, Ventricular Function, Left, chemistry.chemical_compound, Double-Blind Method, Heart Rate, Internal medicine, Heart rate, medicine, Humans, Molecular Biology, Heart Failure, Coenzyme Q10, Cross-Over Studies, Ejection fraction, business.industry, Stroke Volume, General Medicine, Stroke volume, Middle Aged, medicine.disease, chemistry, Heart failure, Exercise Test, Cardiology, Molecular Medicine, VEST, business
Abstract

In patients with chronic heart failure (CHF), the addition of coenzyme Q10 to conventional therapy reduces the hospitalization rate for worsening of heart failure and the incidence of serious cardiovascular complications. The present study was planned to assess the hemodynamic mechanisms underlying this phenomenon. Cardiac hemodynamics was evaluated continuously using an ambulatory radionuclide detector (VEST) which allows a noninvasive monitoring of left ventricular function. Six patients wit CHF (mean ejection fraction (EF): 29%) clinically documented were studied. This study was organized as a randomized double-blind, placebo controlled, cross-over trial. The enrolled patients, after a washout period, underwent the first hemodynamic evaluation with VEST. Subsequently they were randomized to receive placebo or coenzyme Q10 for 4 weeks. At the end of this period they underwent the second VEST study. The third VEST study was performed after a further 4-week period with inverted treatment. Cardiac hemodynamics were evaluated during bicycle exercise. The EF in control conditions (CC) changed from 27 +/- 11%, at rest, to 24 +/- 8%, at peak exercise. During coenzyme Q10 treatment EF showed a significant increase both at rest (33 +/- 13%, P < 0.05 vs CC) and at peak exercise (30 +/- 12%, P < 0.05 vs CC). The same trends were recorded for the stroke volume and the cardiac output. Our results demonstrate that coenzyme Q10 improves cardiac hemodynamic response to exercise in patients with CHF and suggest that noninvasive monitoring of left ventricular function allows a more reliable assessment of therapy efficacy.

Published
1994
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50. Premessa

Author

GAMBARDELLA, Carmine, ZERLENGA, Ornella, PISACANE, Nicola, ARGENZIANO, Pasquale, L. Carlomagno, C. Gambardella, O. Zerlenga, N. Pisacane, P. Argenziano, L. Carlomagno, Gambardella, Carmine, Zerlenga, Ornella, Pisacane, Nicola, Argenziano, Pasquale, and L., Carlomagno

Subjects
Mostra-concorso, disegno dell'architettura, rilievo dell'architettura
Abstract

Il volume raccoglie i poster della mostra relativa al concorso disciplinare sul tema del 6° forum internazionale di studi svoltosi a Capri dal 6 al 7 giugno 2009.

Published
2009

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