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2. Vorapaxar in the secondary prevention of atherothrombotic events

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Braunwald E, Morrow DA, Scirica BM, Bonaca MP, McCabe CH, Morin S, Fish P, Lamp J, Gershman E, Murphy S, Deenadayalu N, Skene A, Hill K, Bennett L, Strony J, Plat F, Berman G, Lipka L, Kilian A, He W, Liu X, Fox KA, Aylward P, Bassand JP, Betriu A, Bounameaux H, Corbalan R, Creager M, Dalby A, De Ferrari G, Dellborg M, Diehm CH, Dietz R, Goto S, Grande P, Gurbel P, Hankey G, Isaza D, Jensen P, Kiss R, Lewis B, Merlini P, Moliterno D, Morais J, Nicolau JC, Nieminen M, Nilsen D, Olin J, Ophuis TO, Paolasso E, Pichler M, Shinohara Y, Spinar J, Teal P, Tendera M, Theroux P, Thomassen L, Van de Werf F, White H, Wilcox R, Alberts M, Ameriso S, Diener H, Mohr J, Welch M, Wiviott SD, Awtry E, Berger C, Desai A, Gelfand E, Ho C, Leeman D, Link M, Norden A, Pande A, Rost N, Ruberg R, Silverman S, Singhal A, Vita J, Frye RL, Bailey KR, Easton J, Hochman J, Steg PG, Verheught F, Lee K, Mauro DO, Centurion A, Carlevaro O, Cardozo E, Cartasegna L, Soccini N, Farras HA, Molina Aguirre E, Duronto E, Arrechavala L, Rey R, Stilman A, Fernández H, Marinsalta G, Tartaglione J, Chekherdemian M, Povedano G, Casares E, Kantor P, Reges P, Cuneo C, Martinez G, MacKinnon I, Bagnato B, Fernandez A, Funosas C, Lozada A, Barilati P, Ferrari J, Ferrari N, Llanos J, Casaccia G, Giannaula R, García Méndez C, Cirio J, García Dávila C, Estol C, Chiezzo D, Ramirez J, Garrido S, López M, Hominal M, Bianchini MV, Ramos M, Verdini E, Herrera G, Monne H, Ioli P, Samudio MA, Rotta Escalante R, Tarulla A, Reich E, Perez G, Milesi R, Berli M, Marino J, Funes I, Prado A, Bezi M, Fernandez R, Rojas M, Cimbaro Canella JP, Galarza Salazan M, Chew D, Horsfall L, Claxton A, French J, O'Brien K, Nelson G, Loxton A, McCann A, Downey C, Aroney C, Cleave P, Worthley S, Roach A, Amerena J, Long A, Thompson P, Ferguson L, Fitzpatrick M, Mackenzie M, Youssef G, Goldsmith H, Jayasinghe R, Quinlan S, Arstall M, Rose J, Counsell J, Martin M, Crimmins D, Slattery A, Anderson C, Paraskevaidis T, Davis S, Silver G, Gerraty RP, Gapper J, Donnan G, Petrolo S, Whelan A, Tulloch G, Singh B, Campo Ma, Dick R, Savage C, Hill A, Conway B, Waites J, Keays P, Kopp K, Hainzer D, Podczeck Schweighofer A, Priesnitz T, Drexel H, Hagspiel V, Foeger B, Hilbe C, Trinka E, Sinadinoska D, Pilger E, Brodmann M, Stöllberger C, Jungbauer LV, Koppensteiner R, Hoke M, Grisold W, Berger O, Gaul GB, Fazekas N, Wandaller C, Stockenhuber F, Rek A, Willeit J, Zangerle A, Kiechl S, Sturm W, Theurl M, Gruber F, Schacherl S, Auer J, Primus C, Eber B, Ammer M, Hofer JF, Mayr H, Moser S, Hoellmueller I, Van der Werf F, Motte S, Jorion M, Schroë H, Zwinnen W, Vermassen F, Geenens M, De Wolf L, Briké C, De Deyn P, Ongena P, De Klippel N, Meeuwissen K, Desfontaines P, Tincani G, Vandermeeren Y, de Fays K, Pandolfo M, Alaerts N, Peeters A, Findik A, Tack P, deGrande E, Thijs V, Marcelis E, Van Landegem W, Vanhagendoren S, Vanhooren G, Schotte V, Celen H, Bes N, De Letter J, Holvoet G, Claerbout B, Verhamme P, Debaveye B, Bourgeois P, Debrabandere K, Stalpaert S, Dhondt E, De Maeseneire S, De Bleecker J, de Koning K, Vincent M, Tahon S, Monté C, Maes J, Vossaert R, Vandenhoven C, Roosen J, Vissers C, Sinnaeve P, de Velder L, Thoeng J, Cauwenberghs J, Deceuninck F, Nicolau J, Ardito WR, Queirantes C, de Araujo Filho JD, Queirantes CS, Ribeiro JP, Guizzardi SP, Chaves ML, Titton NF, Pereira AH, Webber I, da Silva DG Jr, Uehara RM, Brasileiro J, Maia LN, Souza A, Bodanese LC, Homem R, Friedrich MA, Macagnan AP, Dutra OP, Brum AB, Rossi PR, Herek L, Feitosa GS, Bernardes Ade S, Braga J, Rodrigues D, Guimarães A, Teixeira AB, Marin Neto JA, Tonani M, Piegas LS, Amato V, Leães P, Osorio RL, Ganem F, Vieira AP, Leao P, Kanashiro V, Franken RA, Martins EP, Gagliardi RJ, Silva L, Caffaro RA, Novaes GS, Carvalho A, Laet VL, Miranda F. Jr, Crippa BA, Saraiva JF, Ormundo CT, Speciali JG, Guandolini G, de Albuquerque DC, Silva V, Abrantes JA, Pinheiro L, Teixeira MS, Guanaes DF, Resende ES, Andrade SF, Alves ÁR Jr, Oliveira OM, Tauil CB, Araujo E, de Souza J, de Freitas GR, Horokosky AP, Barbosa EC, Muniz P, de Moraes JB Jr, Cabral M, Faria Neto JR, Belemer A, Paiva MS, Brito A, Hernandes ME, Amorim R, Pittella FJ, Brito HH, Kouz S, Roy M, Gosselin G, David M, Huynh T, Boudreault C, Heath J, Scott L, Bhargava R, Stafford C, Klinke WP, Martin L, Chan YK, Zaniol D, Rebane T, Abramovich M, Vizel S, Fox B, Kornder J, Breakwell L, Constance C, Gauthier M, Cleveland D, Valley S, Dion D, Morissette A, Vertes G, Ross B, Pandey AS, Byrne M, Abramson B, Sodhi N, Ervin F, Thiessen S, Halperin F, Stedham V, Pesant Y, Sardin V, Saw J, Tarry L, Pouliot J, Marquette S, Belisle P, Gagne D, Ducas J, Munoz A, Sussex B, Newman S, Madan M, Hsu E, Bata I, Cossett J, Glanz A, Vilag C, Paddock V, Collings E, Sabbah E, Chausse I, Fortin C, Lepage C, Chehayeb R, Viau C, Ma P, Seib M, Lamy A, Rizzo A, Rajakumar AR, Eikel L, Nigro F, Stoger S, Welsh R, Lindholm L, Parker JD, Webber S, Winkler L, Hannah G, Gupta M, Kubiak A, Mukherjee A, Bozek B, Nguyen M, Dufort L, Haichin R, Toyota V, Bujold S, Syan G, Chinnasane S, Houde G, Rousseau S, Poirier P, Lariviere M, Dupuis R, Ouimet F, Audet J, Darveau C, Labonte R, Rice T, Nawaz S, Cantor W, Robbins K, Boucher P. Jr, Roberge J, Zadra R, McPherson C, Prieto JC, Noriega V, Cereño C, Mestas M, Yovaniniz P, Ferrada W, Pincetti C, Torres G, Perez L, Villan C, Escobar E, Martin R, Padilla I, Ramirez M, Hormazabal R, Pedemonte O, Suazo E, Hasbun S, Mejias M, Cardenas F, Donoso L, Godoy I, Henriquez P, Mariné L, Vergara T, Juri C, Vergara E, Muñoz M, Solano E, Toro J, Cardenas S, Mendoza F, Martinez S, Saaibi JF, Castillo KM, Ruiz NP, Castillo T, Orozco A, Muñoz C, Martínez J, Lopez D, Ochoa J, Andrade J, Jaramillo C, Garces GP, Botero R, Cáceres A, Jaramillo M, Mejia C, Schlesinger A, Munevar V, Rodriguez J, Granados LM, Jaramillo N, Aristizabal C, Cano N, Salazar JC, Urina M, Manco T, Valenzuela C, Hernandez HJ, Delgado PS, Vagner B, Castaño LA, Ucros P, Tellez M, Delgado JA, Piedrahita CA, Crump J, Fernandez V, Quintero CA, Moreno M, Hernandez Triana E, Cuentas I, Accini JL, Accini M, Manzur F, Rivera E, Reynales H, Huertas D, Hovorka J, Filipovsky J, Hirmerova J, Peska S, Jura R, Kanovsky P, Herzig R, Jansky P, Fiala R, Kalita Z, Gatkova A, Bauer J, Fiksa J, Sedlacek J, Monhart Z, Bren J, Linhart A, Skalicka L, Vitovec J, Hlinomaz O, Parenica J, Soucek M, Rihacek I, Branny M, Sknouril L, Klimsa Z, Holub M, Línkova H, Rektor I, Mikulik R, Mayer O. Sr, Novakova B, Bar M, Brodova P, Polasek R, Sabl P, Kos P, Lorenc Z, Macel I, Graversen KH, Galatius S, Soderberg LH, Sillesen H, Madelung S, Overgård K, Stan V, Rasmussen LH, Mortensen B, Iversen HK, Back C, Olesen C, Christensen H, Pedersen A, Nielsen T, Hasain M, Tanggaard L, Husted S, Christensen LL, Haas L, Mickley H, Hosbond S, Rosenlund I, Jepsen J, Kaspersen BB, Bronnum Schou J, Hempel H, Nyvad O, Feldthaus B, Jensen BS, Jensen MK, Andersen G, Thomsen RB, Rokkedal J, Joergensen A, Bülow M, Jeppesen J, Lederballe O, Scheibel I, Sjol A, Larsen J, Graner M, Svahn T, Melin J, Kaakkomäki A, Airaksinen J, Vasankari T, Tatlisumak T, Metso M, Remes A, Näppä M, Jäkälä P, Sivenius J, Kalinen M, Roine RO, Ketola R, Bassand J, Pales D, Coisne D, Berger N, Galinier M, Rosolin N, Elbaz M, Lacassagne L, Montalescot G, Vignolles N, Gully C, Lepage I, Roynard J, Hamon M, Brucato S, Macquin Mavier I, Beitar T, Berthezene P, Medkour T, Amarenco P, Gueblaoui N, Timsit S, Riou D, Mahagne M, Suissa L, Quere I, Clouzot S, Emmerich J, Martinez I, Moulin T, Cole M, Hosseini H, Monod V, Cottin Y, Bichat F, Galley D, Beltra C, Samson Y, Pires R, Bura Riviere A, Pelvet B, Giroud M, Lecheneaut C, Ohlmann P, Ait m. bark Z, Farah B, Petit F, Caussin C, Braun C, Diehm C, Mehrhof F, Inkrot S, Darius H, Heinze H, Radke P, Kulikowsky C, Ferrari M, Utschig S, Strasser R, Haacke K, Felix SB, Bruder M, Nienaber C, Pfaff H, Sohn H, Baylacher M, Mudra H, Setzer P, Konstantinides S, Hallmann A, Kreuzer J, Tsoy I, Schneider P, Appel KF, Habermeier A, Zeiher AM, Kretschmer T, Mitrovic V, Lehinant S, Bohlscheid V, Palme B, Heuer H, Espinola Klein C, Savvidis S, Kleinertz K, Hänel J, Schmidt E, Schmidt A, Ringleb PA, Ludwig I, Dietzold M, Schaffranka A, Ranft J, Cegla C, Berrouschot J, Stoll A, Tanislav C, Brandtner MA, Rosenkranz M, Otto D, Görtler M, Barleben M, Haberl R, Miedl S, Maschke M, Schröder K, Aral Becher B, Herzog Hauff S, Guenther A, Herzau C, Hoffmann U, Roth Zetzsche S, Grond M, Becker M, Hamann G, Simon K, Köhrmann M, Glahn J, Wuttig H, Nabavi DG, Seraphin D, Schellong S, Frommhold R, Dichgans M, Doerr A, Blessing E, Buss I, Butter C, Bettin D, Grosch B, Blank E, Wong L, Liu R, Lee S, Kong S, Yu C, So E, Jakal Á, Masszi G, Czuriga I, Kapocsi J, Soós E, Csiba L, Fekete K, Valikovics A, Dioszeghy P, Muskóczki E, Csányi A, Matoltsy A, Yuval R, Bornstein N, Elimelech R, Chajek Shaul T, Bursztyn M, Hayek T, Hazbon K, Gavish D, Anat N, Wexler D, Azar P, Mosseri M, Tsirulnikov E, Rozenman Y, Logvinenko S, Tanne D, Don A, Gross B, Feldman Y, Klainman E, Genin Dmitrishin I, Eldar M, Eizenberg N, Atar S, Lasri E, Hammerman H, Aharoni G, Zimlichman R, Zuker S, Telman G, Afanasiev S, Katz A, Biton A, Goldhaber A, Goldhaber M, Elian D, Linor A, Meyuhas S, Tsalihin D, Kissos D, Lampl Y, Israelson M, Gottlieb S, Dotan L, Elis A, Karny M, Hussein O, Shestatski K, Brenner H, Segal E, Baldini U, Gavazzi A, Poloni M, Censori B, Aiazzi L, Maraglino C, Marenzi G, Specchia G, Tritto I, Golino P, CIANFLONE , DOMENICO, Martignoni A, Tamburino C, Rubartelli P, Ardissino D, Tadonio I, Stramba Badiale M, Cernuschi P, Nardulli R, Sommariva L, Giordano A, Berni A, Cavallini C, Fiscella A, Azzarelli S, Esposito G, Cassese S, Danzi G, Fattore L, Barbieri E, De Caterina R, Odero A, Puttini M, Corrada E, Monzini N, Vadalà A, Pistarini C, Scrutinio D, Ferratini M, Marcheselli S, Moretti L, Partemi L, Pupilella T, Lazzari A, Ledda A, Geraci G, Rasura M, Beccia M, Cassadonte F, Vatrano M, Bongiorni D, Mos L, Marcuzzi G, Murena E, Uguccioni L, Ferretti C, Piti ATerrosu P, Perrone PF, Marconi R, Grasso L, Severi S, Evola R, Russo N, Agnelli G, Paci C, Carugo S, Silvestri O, Testa R, Novo S., Braunwald, E, Morrow, Da, Scirica, Bm, Bonaca, Mp, Mccabe, Ch, Morin, S, Fish, P, Lamp, J, Gershman, E, Murphy, S, Deenadayalu, N, Skene, A, Hill, K, Bennett, L, Strony, J, Plat, F, Berman, G, Lipka, L, Kilian, A, He, W, Liu, X, Fox, Ka, Aylward, P, Bassand, Jp, Betriu, A, Bounameaux, H, Corbalan, R, Creager, M, Dalby, A, De Ferrari, G, Dellborg, M, Diehm, Ch, Dietz, R, Goto, S, Grande, P, Gurbel, P, Hankey, G, Isaza, D, Jensen, P, Kiss, R, Lewis, B, Merlini, P, Moliterno, D, Morais, J, Nicolau, Jc, Nieminen, M, Nilsen, D, Olin, J, Ophuis, To, Paolasso, E, Pichler, M, Shinohara, Y, Spinar, J, Teal, P, Tendera, M, Theroux, P, Thomassen, L, Van de Werf, F, White, H, Wilcox, R, Alberts, M, Ameriso, S, Diener, H, Mohr, J, Welch, M, Wiviott, Sd, Awtry, E, Berger, C, Desai, A, Gelfand, E, Ho, C, Leeman, D, Link, M, Norden, A, Pande, A, Rost, N, Ruberg, R, Silverman, S, Singhal, A, Vita, J, Frye, Rl, Bailey, Kr, Easton, J, Hochman, J, Steg, Pg, Verheught, F, Lee, K, Mauro, Do, Centurion, A, Carlevaro, O, Cardozo, E, Cartasegna, L, Soccini, N, Farras, Ha, Molina Aguirre, E, Duronto, E, Arrechavala, L, Rey, R, Stilman, A, Fernández, H, Marinsalta, G, Tartaglione, J, Chekherdemian, M, Povedano, G, Casares, E, Kantor, P, Reges, P, Cuneo, C, Martinez, G, Mackinnon, I, Bagnato, B, Fernandez, A, Funosas, C, Lozada, A, Barilati, P, Ferrari, J, Ferrari, N, Llanos, J, Casaccia, G, Giannaula, R, García Méndez, C, Cirio, J, García Dávila, C, Estol, C, Chiezzo, D, Ramirez, J, Garrido, S, López, M, Hominal, M, Bianchini, Mv, Ramos, M, Verdini, E, Herrera, G, Monne, H, Ioli, P, Samudio, Ma, Rotta Escalante, R, Tarulla, A, Reich, E, Perez, G, Milesi, R, Berli, M, Marino, J, Funes, I, Prado, A, Bezi, M, Fernandez, R, Rojas, M, Cimbaro Canella, Jp, Galarza Salazan, M, Chew, D, Horsfall, L, Claxton, A, French, J, O'Brien, K, Nelson, G, Loxton, A, Mccann, A, Downey, C, Aroney, C, Cleave, P, Worthley, S, Roach, A, Amerena, J, Long, A, Thompson, P, Ferguson, L, Fitzpatrick, M, Mackenzie, M, Youssef, G, Goldsmith, H, Jayasinghe, R, Quinlan, S, Arstall, M, Rose, J, Counsell, J, Martin, M, Crimmins, D, Slattery, A, Anderson, C, Paraskevaidis, T, Davis, S, Silver, G, Gerraty, Rp, Gapper, J, Donnan, G, Petrolo, S, Whelan, A, Tulloch, G, Singh, B, Campo, Ma, Dick, R, Savage, C, Hill, A, Conway, B, Waites, J, Keays, P, Kopp, K, Hainzer, D, Podczeck Schweighofer, A, Priesnitz, T, Drexel, H, Hagspiel, V, Foeger, B, Hilbe, C, Trinka, E, Sinadinoska, D, Pilger, E, Brodmann, M, Stöllberger, C, Jungbauer, Lv, Koppensteiner, R, Hoke, M, Grisold, W, Berger, O, Gaul, Gb, Fazekas, N, Wandaller, C, Stockenhuber, F, Rek, A, Willeit, J, Zangerle, A, Kiechl, S, Sturm, W, Theurl, M, Gruber, F, Schacherl, S, Auer, J, Primus, C, Eber, B, Ammer, M, Hofer, Jf, Mayr, H, Moser, S, Hoellmueller, I, Van der Werf, F, Motte, S, Jorion, M, Schroë, H, Zwinnen, W, Vermassen, F, Geenens, M, De Wolf, L, Briké, C, De Deyn, P, Ongena, P, De Klippel, N, Meeuwissen, K, Desfontaines, P, Tincani, G, Vandermeeren, Y, de Fays, K, Pandolfo, M, Alaerts, N, Peeters, A, Findik, A, Tack, P, Degrande, E, Thijs, V, Marcelis, E, Van Landegem, W, Vanhagendoren, S, Vanhooren, G, Schotte, V, Celen, H, Bes, N, De Letter, J, Holvoet, G, Claerbout, B, Verhamme, P, Debaveye, B, Bourgeois, P, Debrabandere, K, Stalpaert, S, Dhondt, E, De Maeseneire, S, De Bleecker, J, de Koning, K, Vincent, M, Tahon, S, Monté, C, Maes, J, Vossaert, R, Vandenhoven, C, Roosen, J, Vissers, C, Sinnaeve, P, de Velder, L, Thoeng, J, Cauwenberghs, J, Deceuninck, F, Nicolau, J, Ardito, Wr, Queirantes, C, de Araujo Filho, Jd, Ribeiro, Jp, Guizzardi, Sp, Chaves, Ml, Titton, Nf, Pereira, Ah, Webber, I, da Silva DG, Jr, Uehara, Rm, Brasileiro, J, Maia, Ln, Souza, A, Bodanese, Lc, Homem, R, Friedrich, Ma, Macagnan, Ap, Dutra, Op, Brum, Ab, Rossi, Pr, Herek, L, Feitosa, G, Bernardes Ade, S, Braga, J, Rodrigues, D, Guimarães, A, Teixeira, Ab, Marin Neto, Ja, Tonani, M, Piegas, L, Amato, V, Leães, P, Osorio, Rl, Ganem, F, Vieira, Ap, Leao, P, Kanashiro, V, Franken, Ra, Martins, Ep, Gagliardi, Rj, Silva, L, Caffaro, Ra, Novaes, G, Carvalho, A, Laet, Vl, Miranda F., Jr, Crippa, Ba, Saraiva, Jf, Ormundo, Ct, Speciali, Jg, Guandolini, G, de Albuquerque, Dc, Silva, V, Abrantes, Ja, Pinheiro, L, Teixeira, M, Guanaes, Df, Resende, E, Andrade, Sf, Alves ÁR, Jr, Oliveira, Om, Tauil, Cb, Araujo, E, de Souza, J, de Freitas, Gr, Horokosky, Ap, Barbosa, Ec, Muniz, P, de Moraes JB, Jr, Cabral, M, Faria Neto, Jr, Belemer, A, Paiva, M, Brito, A, Hernandes, Me, Amorim, R, Pittella, Fj, Brito, Hh, Kouz, S, Roy, M, Gosselin, G, David, M, Huynh, T, Boudreault, C, Heath, J, Scott, L, Bhargava, R, Stafford, C, Klinke, Wp, Martin, L, Chan, Yk, Zaniol, D, Rebane, T, Abramovich, M, Vizel, S, Fox, B, Kornder, J, Breakwell, L, Constance, C, Gauthier, M, Cleveland, D, Valley, S, Dion, D, Morissette, A, Vertes, G, Ross, B, Pandey, A, Byrne, M, Abramson, B, Sodhi, N, Ervin, F, Thiessen, S, Halperin, F, Stedham, V, Pesant, Y, Sardin, V, Saw, J, Tarry, L, Pouliot, J, Marquette, S, Belisle, P, Gagne, D, Ducas, J, Munoz, A, Sussex, B, Newman, S, Madan, M, Hsu, E, Bata, I, Cossett, J, Glanz, A, Vilag, C, Paddock, V, Collings, E, Sabbah, E, Chausse, I, Fortin, C, Lepage, C, Chehayeb, R, Viau, C, Ma, P, Seib, M, Lamy, A, Rizzo, A, Rajakumar, Ar, Eikel, L, Nigro, F, Stoger, S, Welsh, R, Lindholm, L, Parker, Jd, Webber, S, Winkler, L, Hannah, G, Gupta, M, Kubiak, A, Mukherjee, A, Bozek, B, Nguyen, M, Dufort, L, Haichin, R, Toyota, V, Bujold, S, Syan, G, Chinnasane, S, Houde, G, Rousseau, S, Poirier, P, Lariviere, M, Dupuis, R, Ouimet, F, Audet, J, Darveau, C, Labonte, R, Rice, T, Nawaz, S, Cantor, W, Robbins, K, Boucher P., Jr, Roberge, J, Zadra, R, Mcpherson, C, Prieto, Jc, Noriega, V, Cereño, C, Mestas, M, Yovaniniz, P, Ferrada, W, Pincetti, C, Torres, G, Perez, L, Villan, C, Escobar, E, Martin, R, Padilla, I, Ramirez, M, Hormazabal, R, Pedemonte, O, Suazo, E, Hasbun, S, Mejias, M, Cardenas, F, Donoso, L, Godoy, I, Henriquez, P, Mariné, L, Vergara, T, Juri, C, Vergara, E, Muñoz, M, Solano, E, Toro, J, Cardenas, S, Mendoza, F, Martinez, S, Saaibi, Jf, Castillo, Km, Ruiz, Np, Castillo, T, Orozco, A, Muñoz, C, Martínez, J, Lopez, D, Ochoa, J, Andrade, J, Jaramillo, C, Garces, Gp, Botero, R, Cáceres, A, Jaramillo, M, Mejia, C, Schlesinger, A, Munevar, V, Rodriguez, J, Granados, Lm, Jaramillo, N, Aristizabal, C, Cano, N, Salazar, Jc, Urina, M, Manco, T, Valenzuela, C, Hernandez, Hj, Delgado, P, Vagner, B, Castaño, La, Ucros, P, Tellez, M, Delgado, Ja, Piedrahita, Ca, Crump, J, Fernandez, V, Quintero, Ca, Moreno, M, Hernandez Triana, E, Cuentas, I, Accini, Jl, Accini, M, Manzur, F, Rivera, E, Reynales, H, Huertas, D, Hovorka, J, Filipovsky, J, Hirmerova, J, Peska, S, Jura, R, Kanovsky, P, Herzig, R, Jansky, P, Fiala, R, Kalita, Z, Gatkova, A, Bauer, J, Fiksa, J, Sedlacek, J, Monhart, Z, Bren, J, Linhart, A, Skalicka, L, Vitovec, J, Hlinomaz, O, Parenica, J, Soucek, M, Rihacek, I, Branny, M, Sknouril, L, Klimsa, Z, Holub, M, Línkova, H, Rektor, I, Mikulik, R, Mayer O., Sr, Novakova, B, Bar, M, Brodova, P, Polasek, R, Sabl, P, Kos, P, Lorenc, Z, Macel, I, Graversen, Kh, Galatius, S, Soderberg, Lh, Sillesen, H, Madelung, S, Overgård, K, Stan, V, Rasmussen, Lh, Mortensen, B, Iversen, Hk, Back, C, Olesen, C, Christensen, H, Pedersen, A, Nielsen, T, Hasain, M, Tanggaard, L, Husted, S, Christensen, Ll, Haas, L, Mickley, H, Hosbond, S, Rosenlund, I, Jepsen, J, Kaspersen, Bb, Bronnum Schou, J, Hempel, H, Nyvad, O, Feldthaus, B, Jensen, B, Jensen, Mk, Andersen, G, Thomsen, Rb, Rokkedal, J, Joergensen, A, Bülow, M, Jeppesen, J, Lederballe, O, Scheibel, I, Sjol, A, Larsen, J, Graner, M, Svahn, T, Melin, J, Kaakkomäki, A, Airaksinen, J, Vasankari, T, Tatlisumak, T, Metso, M, Remes, A, Näppä, M, Jäkälä, P, Sivenius, J, Kalinen, M, Roine, Ro, Ketola, R, Bassand, J, Pales, D, Coisne, D, Berger, N, Galinier, M, Rosolin, N, Elbaz, M, Lacassagne, L, Montalescot, G, Vignolles, N, Gully, C, Lepage, I, Roynard, J, Hamon, M, Brucato, S, Macquin Mavier, I, Beitar, T, Berthezene, P, Medkour, T, Amarenco, P, Gueblaoui, N, Timsit, S, Riou, D, Mahagne, M, Suissa, L, Quere, I, Clouzot, S, Emmerich, J, Martinez, I, Moulin, T, Cole, M, Hosseini, H, Monod, V, Cottin, Y, Bichat, F, Galley, D, Beltra, C, Samson, Y, Pires, R, Bura Riviere, A, Pelvet, B, Giroud, M, Lecheneaut, C, Ohlmann, P, Ait m., bark Z, Farah, B, Petit, F, Caussin, C, Braun, C, Diehm, C, Mehrhof, F, Inkrot, S, Darius, H, Heinze, H, Radke, P, Kulikowsky, C, Ferrari, M, Utschig, S, Strasser, R, Haacke, K, Felix, Sb, Bruder, M, Nienaber, C, Pfaff, H, Sohn, H, Baylacher, M, Mudra, H, Setzer, P, Konstantinides, S, Hallmann, A, Kreuzer, J, Tsoy, I, Schneider, P, Appel, Kf, Habermeier, A, Zeiher, Am, Kretschmer, T, Mitrovic, V, Lehinant, S, Bohlscheid, V, Palme, B, Heuer, H, Espinola Klein, C, Savvidis, S, Kleinertz, K, Hänel, J, Schmidt, E, Schmidt, A, Ringleb, Pa, Ludwig, I, Dietzold, M, Schaffranka, A, Ranft, J, Cegla, C, Berrouschot, J, Stoll, A, Tanislav, C, Brandtner, Ma, Rosenkranz, M, Otto, D, Görtler, M, Barleben, M, Haberl, R, Miedl, S, Maschke, M, Schröder, K, Aral Becher, B, Herzog Hauff, S, Guenther, A, Herzau, C, Hoffmann, U, Roth Zetzsche, S, Grond, M, Becker, M, Hamann, G, Simon, K, Köhrmann, M, Glahn, J, Wuttig, H, Nabavi, Dg, Seraphin, D, Schellong, S, Frommhold, R, Dichgans, M, Doerr, A, Blessing, E, Buss, I, Butter, C, Bettin, D, Grosch, B, Blank, E, Wong, L, Liu, R, Lee, S, Kong, S, Yu, C, So, E, Jakal, Á, Masszi, G, Czuriga, I, Kapocsi, J, Soós, E, Csiba, L, Fekete, K, Valikovics, A, Dioszeghy, P, Muskóczki, E, Csányi, A, Matoltsy, A, Yuval, R, Bornstein, N, Elimelech, R, Chajek Shaul, T, Bursztyn, M, Hayek, T, Hazbon, K, Gavish, D, Anat, N, Wexler, D, Azar, P, Mosseri, M, Tsirulnikov, E, Rozenman, Y, Logvinenko, S, Tanne, D, Don, A, Gross, B, Feldman, Y, Klainman, E, Genin Dmitrishin, I, Eldar, M, Eizenberg, N, Atar, S, Lasri, E, Hammerman, H, Aharoni, G, Zimlichman, R, Zuker, S, Telman, G, Afanasiev, S, Katz, A, Biton, A, Goldhaber, A, Goldhaber, M, Elian, D, Linor, A, Meyuhas, S, Tsalihin, D, Kissos, D, Lampl, Y, Israelson, M, Gottlieb, S, Dotan, L, Elis, A, Karny, M, Hussein, O, Shestatski, K, Brenner, H, Segal, E, Baldini, U, Gavazzi, A, Poloni, M, Censori, B, Aiazzi, L, Maraglino, C, Marenzi, G, Specchia, G, Tritto, I, Golino, P, Cianflone, Domenico, Martignoni, A, Tamburino, C, Rubartelli, P, Ardissino, D, Tadonio, I, Stramba Badiale, M, Cernuschi, P, Nardulli, R, Sommariva, L, Giordano, A, Berni, A, Cavallini, C, Fiscella, A, Azzarelli, S, Esposito, G, Cassese, S, Danzi, G, Fattore, L, Barbieri, E, De Caterina, R, Odero, A, Puttini, M, Corrada, E, Monzini, N, Vadalà, A, Pistarini, C, Scrutinio, D, Ferratini, M, Marcheselli, S, Moretti, L, Partemi, L, Pupilella, T, Lazzari, A, Ledda, A, Geraci, G, Rasura, M, Beccia, M, Cassadonte, F, Vatrano, M, Bongiorni, D, Mos, L, Marcuzzi, G, Murena, E, Uguccioni, L, Ferretti, C, Piti ATerrosu, P, Perrone, Pf, Marconi, R, Grasso, L, Severi, S, Evola, R, Russo, N, Agnelli, G, Paci, C, Carugo, S, Silvestri, O, Testa, R, and Novo, S.

Abstract

BACKGROUND:Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1.METHODS:We randomly assigned 26,449 patients who had a history of myocardial infarction, ischemic stroke, or peripheral arterial disease to receive vorapaxar (2.5 mg daily) or matching placebo and followed them for a median of 30 months. The primary efficacy end point was the composite of death from cardiovascular causes, myocardial infarction, or stroke. After 2 years, the data and safety monitoring board recommended discontinuation of the study treatment in patients with a history of stroke owing to the risk of intracranial hemorrhage.RESULTS:At 3 years, the primary end point had occurred in 1028 patients (9.3%) in the vorapaxar group and in 1176 patients (10.5%) in the placebo group (hazard ratio for the vorapaxar group, 0.87; 95% confidence interval [CI], 0.80 to 0.94; P

Published
2012

3. Prognostic implications of left ventricular dilation in patients with nonischemic heart failure: interactions with restrictive filling pattern and mitral regurgitation

Author

Ghio, S, Temporelli, Pl, Marsan, Na, Poppe, K, Giannuzzi, P, Dini, Fl, Rossi, A, Doughty, Rn, Whalley, G, MeRGE HF collaborators, Gamble, Gd, Poppe, Kk, Somaratne, Jb, Whalley, Ga, Klein, Al, Møller, Je, Quintana, M, Yu, Cm, Bruch, C, Pinamonti, B, Prior, Dl, Breithardt, G, Eckardt, L, Gotzmann, M, Grude, M, Rothenburger, M, Scheld, Hh, Stypmann, J, Wenzelburger, F, Wichter, T, Bosimini, E, Corrà, U, Galli, M, Giordano, A, Imparato, A, Scapellato, F, Silva, P, Ajmone Marsan, N, Campana, C, Gavazzi, A, Klersy, C, Laudisa, Ml, Recusani, F, Sebastiani, R, Tavazzi, L, Baldini, U, Boni, A, Barsotti, L, Cortigiani, L, Micheli, G, Nuti, R, Cicoira, M, Bonapace, S, Camerini, F, Di Lenarda, A, Gregori, Dario, Sinagra, G, Zecchin, M, Walsh, Hj, Sharpe, N, Wright, Sp, Fogarty, A, Frampton, Cm, Lauer, Ms, Martin, M, Morehead, Aj, Nash, Pj, Pereira, Jj, Starling, Rc, Tang, W, Thomas, Jd, Troughton, R, and Young, J. B.

Subjects
Heart Failure, Male, Risk Factors, Heart Ventricles, Multivariate Analysis, Humans, Female, Middle Aged, Prognosis, Dilatation, Pathologic, Ultrasonography
Abstract

The aim of this study was to evaluate whether small left ventricular (LV) volumes increase the negative prognostic impact of a restrictive filling pattern (RFP) and that of mitral regurgitation (MR) in patients with nonischemic heart failure (HF). The Meta-analysis Research Group in Echocardiography (MeRGE) is a meta-analysis that collated individual patient data from several prospective echocardiography outcome studies. This analysis was restricted to 10 studies and 601 patients with nonischemic HF. The role of MR was tested in a subgroup of 252 patients. A total of 106 deaths occurred during a median follow-up of 32 months. At multivariate analysis, RFP (hazard ratio [HR], 4.16; 95% confidence interval [CI], 1.54-11.23; P=.005) and New York Heart Association class III or IV (HR, 2.15; 95% CI, 1.33-3.47; P=.001) were the independent predictors of poor prognosis, and there was no statistically significant interaction between LV dilation and RFP. Moderate/severe MR was associated with poorer outcome in the group of patients with normal volumes, whereas it was not a significant predictor of mortality in patients with any degree of LV dilation. In patients with nonischemic HF, RFP is the most important indicator of poor prognosis, irrespective of the degree of LV dilation. Normal LV volumes increase the negative prognostic impact of moderate to severe MR.

Published
2012

5. Impacto del castor (Castor canadensis, Rodentia) en bosques de lenga (Nothofagus pumilio) de Tierra del Fuego, Chile

Author

Baldini U, Aida, Oltremari A, Juan, and Ramírez, Mauricio

Subjects
Nothofagus pumilio, Castor canadensis, especies invasoras, invading species, environmental damages, daños ambientales
Abstract

Castor canadensis is a North American rodent introduced in the Argentinean part of Tierra del Fuego in 1946, invading Chilean territories located in the same area. In this zone, not only do beavers build dikes, but they also feed on arboreal material, mainly from Nothofagus pumilio. This study tried to prove that damage on both biomass and volume in the N. pumilio forest is caused by beavers. The objectives of the study were: to identify the type of damage and to quantify the loss of wood biomass and gross volume of the most abundant forest species. Results indicated that more than half of measured trees presented some damage; the highest damage being presented by N. pumilio. Loss in biomass reaches almost 15 t ha–1; amount superior to results found in studies made on the endemic environment of beavers. In relation to wood volume, over half of the stocks of N. pumilio forests associated to water resources have been lost in Tierra del Fuego due to the effect of beaver. The most important volume loss of this species derives from the death of individuals in flooded zones as a result of dike construction., Castor canadensis es un roedor de Norteamérica introducido a la porción argentina de Tierra del Fuego en el año 1946, invadiendo territorios chilenos del mismo sector. En esta zona los castores construyen diques y se alimentan de material arbóreo extraído principalmente de Nothofagus pumilio. En el estudio se intentó probar que los castores provocan daño en la biomasa y volumen de los bosques de N. pumilio. Los objetivos del estudio fueron identificar los tipos de daños y cuantificar las pérdidas de biomasa leñosa y de volumen bruto de la especie forestal más abundante. Los resultados indicaron que más de la mitad de los árboles medidos presentó algún daño, correspondiendo en su gran mayoría a N. pumilio. Las pérdidas en biomasa alcanzaron casi 15 t ha–1, cantidad superior a los resultados encontrados en estudios realizados en el ambiente endémico de los castores. Respecto a volumen de madera, más de la mitad de la existencia de bosques de N. pumilio asociados a cursos de agua ha sido dañada en Tierra del Fuego por efecto de los castores. La pérdida más importante de volumen de esta especie resulta de la muerte de individuos en zona de inundación de la represa castoril.

Published
2008

6. Impacto del castor (Castor canadensis, Rodentia) en bosques de lenga (Nothofagus pumilio) de Tierra del Fuego, Chile

Author

Mauricio Ramírez, Juan Oltremari A, and Aida Baldini U

Subjects
Castor canadensis, Nothofagus pumilio, biology, especies invasoras, Forestry, biology.organism_classification, daños ambientales
Abstract

Castor canadensis es un roedor de Norteamérica introducido a la porción argentina de Tierra del Fuego en el año 1946, invadiendo territorios chilenos del mismo sector. En esta zona los castores construyen diques y se alimentan de material arbóreo extraído principalmente de Nothofagus pumilio. En el estudio se intentó probar que los castores provocan daño en la biomasa y volumen de los bosques de N. pumilio. Los objetivos del estudio fueron identificar los tipos de daños y cuantificar las pérdidas de biomasa leñosa y de volumen bruto de la especie forestal más abundante. Los resultados indicaron que más de la mitad de los árboles medidos presentó algún daño, correspondiendo en su gran mayoría a N. pumilio. Las pérdidas en biomasa alcanzaron casi 15 t ha-1, cantidad superior a los resultados encontrados en estudios realizados en el ambiente endémico de los castores. Respecto a volumen de madera, más de la mitad de la existencia de bosques de N. pumilio asociados a cursos de agua ha sido dañada en Tierra del Fuego por efecto de los castores. La pérdida más importante de volumen de esta especie resulta de la muerte de individuos en zona de inundación de la represa castoril.

Published
2008
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9. Arterial CT in the diagnosis of hepatocellular carcinoma: initial experience with 12 patients

Author

Gattoni, F, Baldini, U, Raiteri, R, Pozzato, C, Uslenghi, C., DE COBELLI, FRANCESCO, Gattoni, F, Baldini, U, Raiteri, R, Pozzato, C, DE COBELLI, Francesco, and Uslenghi, C.

Abstract

Intra-arterial CT of the liver is a valuable method to evaluate hepatocellular carcinoma (HCC). It consists of an infusion of contrast medium into the hepatic artery during CT scanning. Twelve patients with suspected resectable HCCs were evaluated with CT arteriography before surgery. The results of CT arteriography were compared with those of US, of CT with intravenous contrast medium and of angiography; on the rule, all exams had been performed some days earlier. The diagnosis of HCC was confirmed by US-guided fine-needle biopsy. CT arteriography demonstrated liver lesions in 11 patients. The lesions were hyperdense in 3/11 patients (27.3%) and hypodense and surrounded by a hyperdense ring in 8/11 patients (72.7%). In 4 of 11 patients (36.4%) CT arteriography identified additional tumor nodules and thus surgery was excluded. In the latter cases, on the basis of CT arteriographic findings, US, CT with i.v. contrast medium and angiography were repeated but failed to demonstrate the additional nodules, either because they were too small or because of cirrhotic changes in liver parenchyma. Therefore, CT arteriography is recommended in the evaluation of selected patients, especially when detailed information on liver parenchyma is needed--e.g., before surgery. In these patients CT arteriography can be performed together with preoperative angiography.

Published
1993

10. MEDICAL SCIENCE. GISSI-2: A factorial randomised trial of alteplase versus streptokinase and heparin versus no heparin among 12 490 patients with acute myocardial infarction

Author

Feruglio, G. A., Lotto, A., Rovelli, F., Solinas, P., Tavazzi, L., Tognoni, G., De Vita, C., Franzosi, M. G., Maggiom, A. P., Mauri, F., Volpi, A., Selvini, A., Donato, L., Garattmi, S., Loi, U., Sirchia, G., Ambrosioni, E., Camerini, F., Campolo, L., Donati, M. B., Ferrari, M., Farchi, G., Geraci, E., Mannucci, P. M., Marubini, E., Neri Semeri, G. G., Peto, R., Prati, P. L., Specchia, G., Vecchio, C., Visani, L., Yusuf, S., Mezzanotte, G., Santoro, E., Bruno, M., Cappello, T., Coppini, A., Fincati, F., Mantovani, G., Pangrazzi, J., Pogna, M., Turazza, F. M., Ansehni, M., Barbonaglia, L., Bigi, R., Cavalli, A., Frigerio, M., Giordano, A., Gualtierotti, C., Torta, D., Vinci, P., Bossi, M., Furlanello, F., Braito, E., Giulia, V., Palmieri, M., Majoimo, P., Pinelli, G., Papi, L., Nardelli, A., Capestro, F., Rossi, A., Ricci, D., Mininni, N., Bianco, G., Barbuzzi, S., Plastina, F., Di Giovanna, F., Mereu, D., Giordano, F., Barlotti, R., Loparco, G., Boscarino, S., Ruggeri, G., Anastasi, R., Paciaroni, E., Tomassini, P. F., Purcaro, A., Francesconi, M., Figliolia, S., Tesse, S., Devoti, G., Giometti, R., Teoni, P., Burali, A., Zucconelli, V., Iervoglini, A., Amabili, S., Caratti, C. A., Zola, G., Ferraguto, P., Sagci, G., Rotiroti, D., Genovese, M., Da€™amato, N., Taurino, L., Colonna, L., Bovenzi, F., Messina, D., Sarcina, G., Compostella, L., Cucchini, F., Malacrida, R., Gradel, C., Bridda, A., Pellegrini, P., Acone, L., Bruno, A., Tespili, M., Guaghurrii, G., Casari, A., Bobba, F., Scaramuzzino, G., Berardi, C., De Castro, U., Fulvi, M., Lintner, W., Erlicher, A., Pitscheider, W., Scola Gagliardi, R., Bonizzato, G., Roggero, C., Perrini, A., Tsialtas, D., Straneo, U., Storelli, A., Verrienti, A., Albonico, B., Corradi, L., De Petra, V., Villani, C., Maxia, P., Bianco, A., Crabu, E., Centamore, G., Di Stefano, G., Vancheri, F., Amico, C., Baldini, F., Santopuoli, G., Pantaleoni, A., Contessotto, F., Terlizzi, R., Turchi, E., Teglio, V., Pignatti, F., Aletto, C., Gozzelino, G., Pettinati, G., De Santis, F., Correale, E., Romano, S., Perrotta, R., Tritto, C., May, L., Achilli, G., Suzzi, G., Cemetti, C., Longobardi, R., Somma, G., Palumbo, C., Gallone, P., Sorrentino, F., Dato, A., Della Monica, R., Pagano, L., Alberti, A., Orselli, L., Negrini, M., De Ponti, C., Acito, P., Capelletti, D., Bortolini, F., Coppola, V., Ciglia, C., De Cesare, M., De Lio, U., Maiolino, P., Giannini, R., Niccolini, A., Marinoni, C., Guasconi, C., Sonnino, S., Pagliei, M., Ferrari, G., Politi, A., Galli, M., De Rinaldis, G., Calcagnile, A., Bendinelli, S., Lusetti, L., Mollaioli, M., Cosmi, F., Venneri, N., Feraco, E., Lauro, A., Catelli, P., Poluzzi, C., Distante, S., Pedroni, P., Zampaglione, G., Lumare, R., Bruna, C., De Benedictis, N., Ziacchi, V., Lomanto, B., Riva, D., Bertocchi, P., Tirella, G., Tessitori, M., Bini, A., Peruzzi, F., Maresta, A., Pirazzini, L., Gaggi, S., Frausini, G., Malacame, C., Codeca, L., Cappato, R., Andreoli, L., Bastoni, L. A., Pucci, P., Sarro, F., Vergassola, R., Barchielli, M., De Matteis, D., Carrone, M., Liberati, R., Meniconi, L., Radogna, M., Tallone, M., Ieri, A., Ferreri, A., Guidali, P., Canziani, R., Mariello, F., Minelli, C., Muzio, L., Rota Baldini, M., Lupi, G., Cecchi, A., Giuliano, G., Bellotti, S., Livi, S., Corti, E., Rossi, P., Delfino, R., Iannetti, M., Pastorini, C., Pennesi, A., Di Giacinto, N., Bertolo, L., Slomp, L., Cresti, A., Svetoni, N., Distefano, S., Veneri, L., Moretti, S., Palermo, R., Giovanelli, N., Parchi, C., Dethomads, M., Paparella, N., Carrino, C., Aquaro, G., Idone, P., Marsili, P., Sideri, F., Valerio, A., Tullio, D., Ragazzini, G., Gramenzi, S., De Pasquale, B., Gelfo, P. G., Rosselli, P., De Marchi, E., Greco, M. R., Fazio, A. M., Savoia, M. T., Gerosa, C., Barbiero, M., Barbaresi, F., Volta, G., Da€™urbano, M., Passoni, F., Parola, G., Lanzini, A., Baldini, U., Del Bene, P., Orlandi, M., Oddone, A., Lazzari, M., Ballerini, B., Bozzi, L., Moccetti, T., Bemasconi, E., Sanguinetti, M., Tognoli, T., Bardelli, G., Maggi, A., Turato, R., Piva, M., Izzo, A., Tantalo, L., Rizzi, A., Scilabra, G., Varvaro, F., Colombo, G., Grieco, A., Dovico, E., Belluzzi, F., Casellato, F., Lecchi, G., Maugeri Sacci, C., Consolo, A., Piccolo, E., Zuin, G., Zappa, C., Sanna, G. P., Dossena, M. G., Corsini, C., Lettino, M., Marconi, M., Mafrici, A., Leonardi, G., Moreo, A., Seregni, R., Pastine, I., Casazza, F., Regalia, F., Maggiolini, S., Benenati, P. M., Rigo, R., Pascotto, P., Zanocco, A., Artusi, L., Cappelli, C., Bernardi, C., Pahnieri, M., Zilio, G., Sandri, R., Neri, G., Valagussa, F., Osculati, G., Cira, A., Da€™aniello, L., Piantadosi, F. R., Improta, M., Severino, S., Bisconti, C., Mostacci, M., Randon, L., Boschello, M., Allegri, M., Freggiaro, V., Mureddu, V., Soro, F., Marras, E., Marchi, S. M., De Luca, C., Manetta, M., Dalla Volta, S., Maddalena, F., Donzelli, M., Vitrano, M. G., Canonico, A., Ledda, A., Bellomare, D., Carrubba, A., Da€™antonio, E., Scardulla, C., Raineri, A., Traina, M., La Calce, C., Cirincione, V., Montanar, F., Strizzolo, L., Di Gregorio, D., Mantini, L., Chiriatti, G., Gazzola, U., Rosi, A., Mellini, M., Piazza, R., Micheli, G., Bechi, S., Martines, C., Marchese, D., Bigalli, A., Davini, P., Boem, A., Del Citerna, F., Giomi, A., Codeluppi, P., Negrelli, M., Brieda, M., Charmet, P. A., Petrella, A., Bardazzi, L., Bianco, G. A., Marco, A., Licitra, R., Lettica, G. V., Tumiotto, G., Bosi, S., Spitali, G., Casali, G., Bottoni, N., Parenti, G. F., Triulzi, E., Brighi, F., Benati, A., De Sanctis, A., Mene, A., Pesaresi, A., Bologna, F., Lumia, F., Barbato, G., Milazzotto, F., Proietti, F., Angrisani, G., Azzolini, P., Coppola, E., Trani, Carlo, Masini, V., Rocchi, M., Borgia, M. C., Luciani, C., Vitucci, N. C., Giuliani, P., Tugnoli, F., Vetta, C., Altieri, T., Gimigliano, F., Striano, U., Salituri, S., Zanazzi, G., Zonzin, P., Bugatti, U., Ravera, B., Allemano, P., Reynaud, S., Sanson, A., Milani, L., De Simone, M. V., Villella, A., Grazzini, M., Amidei, S., Ansehni, L., Benza, G., Tagliamonte, A., Messina, V., Etro, M. D., Vivaldi, F., Cortese, R., Ibba, G. V., Sannia, L., Pedrazzini, F., Gazzotti, G. L., Pizzuti, A., Antonielli, E., Becchi, G., Filice, A., Salmoiraghi, A., Caramanno, G., Caporicci, D., Brun, M., Ferrario, G., Giani, P., Ronconi, G., Douglas, S., Bianchi, C., Cucchi, G., Marieni, M., Marcellini, G., Speca, G., Beato, E., Serabni, N., Bazzucchi, M., Coronelli, R., Rossi, L., Basso, G., Presbitero, P., Bevilacqua, R., Pallisco, O., Di Leo, M., Golzio, P. G., Parigi, A., Belli, R., Trinchero, R., Gaschino, G., Barenghi, M., Poggio, G. L., Braschi, G. B., Sciacca, R., Sammartano, A., Braito, G., Cuzzato, V., Frigo, G., Perissinono, F., Galati, A., Accogli, M., Morgera, T., Barbieri, L., Slavich, G. A., Fresco, C., Cuda, A., Liguori, A., Cozzi, A., Caico, S., Alberio, M., Di Marco, G., De Vito, G., Valente, S., Zagatti, G., Zardini, P., Nidasio, G. P., Girardi, P., Mazzini, C., Nava, S., Achilli, A., Bisogno, A., Pasotti, C., Ballestra, A. M., and Giustarini, C.

Subjects
Aspirin, medicine.medical_specialty, business.industry, Streptokinase, acute myocardial infarction, General Medicine, Heparin, medicine.disease, Atenolol, Surgery, Anistreplase, Anesthesia, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, medicine, Myocardial infarction, business, Stroke, medicine.drug, Killip class
Abstract

A multicentre, randomised, open trial with a 2 x 2 factorial design was conducted to compare the benefits and risks of two thrombolytic agents, streptokinase (SK, 1·5 MU infused intravenously over 30-60 min) and alteplase (tPA, 100 mg infused intravenously over 3 h) in patients with acute myocardial infarction admitted to coronary care units within 6 h from onset of symptoms. The patients were also randomised to receive heparin (12 500 U subcutaneously twice daily until discharge from hospital, starting 12 h after beginning the tPA or SK infusion) or usual therapy. All patients without specific contraindications were given atenolol (5-10 mg iv) and aspirin (300-325 mg a day). The end-point of the study was the combined estimate of death plus severe left ventricular damage. 12 490 patients were randomised to four treatment groups (SK alone, SK plus heparin, tPA alone, tPA plus heparin). No specific differences between the two thrombolytic agents were detected as regards the combined end-point (tPA 23·1%; SK 22·5%; relative risk 1·04, 95% Cl 0·95-1·13), nor after the addition of heparin to the aspirin treatment (hep 22·7%, no hep 22·9%; RR 0·99, 95% Cl 0·91-1·08). The outcome of patients allocated to the four treatment groups was similar with respect to baseline risk factors such as age, Killip class, hours from onset of symptoms, and site and type of infarct. The rates of major in-hospital cardiac complications (reinfarction, post-infarction angina) were also similar. The incidence of major bleeds was significantly higher in SK and heparin treated patients (respectively, tPA 0·5%, SK 1·0%, RR 0·57, 95% Cl 0·38-0·85; hep 1·0%, no hep 0·6%, RR 1·64, 95% Cl 1·09-2·45), whereas the overall incidence of stroke was similar in all groups. SK and tPA appear equally effective and safe for use in routine conditions of care, in all infarct patients who have no contraindications, with or without post-thrombolytic heparin treatment. The 8·8% hospital mortality of the study population (compared with approximately 13% in the control cohort of the GISSI-1 trial) indicates the beneficial impact of the proven acute treatments for AMI.

Published
1990

15. 333 Relationship between stress echo results and angiographically assessed coronary artery disease severity

Author

G.C. Bini, L. Paperini, Frank Lloyd Dini, M. Pauletti, Baldini U, G. Magini, and Raugi M

Subjects
Coronary artery disease, medicine.medical_specialty, Stress Echo, business.industry, Internal medicine, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, General Medicine, Cardiology and Cardiovascular Medicine, business, medicine.disease
Published
1999
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16. The relationship between cognitive functioning and psychopathology in patients with psychiatric disorders: a transdiagnostic network analysis.

Author

Chavez-Baldini, U., Nieman, D., Keestra, A., Verweij, K., Vulink, N., Wigman, J., and Denys, D.

Subjects
*COGNITIVE ability, *PEOPLE with mental illness, *COGNITION, *MEMORY disorders, *SHORT-term memory, *POST-traumatic stress disorder, *VERBAL memory
Abstract

Introduction: Patients with psychiatric disorders often experience cognitive dysfunction, but the relationship between cognitive dysfunction and psychopathology remains unclear, partly due to research being conducted within specific psychiatric disorders. Current psychiatric diagnoses are not true representations of underlying disorders; therefore, a transdiagnostic approach may be useful for further elucidating the relationship between cognition and psychopathology. Objectives: The aim was to investigate the relationships between domains of cognitive functioning and psychopathology in a transdiagnostic sample using a data-driven approach. Methods: Network analyses using baseline data from 1016 patients with various psychiatric disorders were conducted to investigate the relationships between symptoms and cognitive domains, detect clusters, and assess the predictability of nodes in the network. Psychopathology symptoms were assessed using various standard questionnaires. Cognitive domains were assessed with a battery of automated tests. Results: Network analysis detected five clusters that we labelled as: general psychopathology, obsessive-compulsive symptoms, trauma symptoms, substance use, and cognition. Variables with the highest strength were depressed mood, anxiety, verbal memory, working memory, and hyperarousal. Most associations between cognition and symptoms were negative, i.e., increased symptom severity/frequency was associated with worse cognitive functioning. Conclusions: Cognition and psychopathology interact in ways that do not adhere to traditional diagnostic boundaries. Depressed mood, anxiety, verbal and working memory deficits and hyperarousal are especially relevant in this network and can be considered transdiagnostic targets for research and treatment. Moreover, future research on cognitive functioning should focus on symptom-specific interactions with cognitive domains rather than investigating cognitive functioning in diagnostic categories. [ABSTRACT FROM AUTHOR]

Published
2020

17. Diagnostic value of exercise electrocardiography and dipyridamole stress echocardiography in hypertensive and normotensive chest pain patients with right bundle branch block.

Author

Cortigiani L, Bigi R, Rigo F, Landi P, Baldini U, Mariani PR, Picano E, EPIC (Echo Persantine International Cooperative) Study Group, Cortigiani, Lauro, Bigi, Riccardo, Rigo, Fausto, Landi, Patrizia, Baldini, Umberto, Mariani, Pier Romano, Picano, Eugenio, and Echo Persantine International Cooperative Study Group

Published
2003
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18. Digital Subtraction Angiography of the Kidney.

Author

GATTONI, F., AVOGADRO, ANDREA, BALDINI, U., POZZATO, C., BONFANTI, MARIA T., GANDINI, DANIELA, FRANCH, L., and USLENGHI, C.

Abstract

- Intravenous and intra-arterial digital subtraction angiography (DSA) was performed in 88 patients: 34 with tumours, 10 with renal trauma, 26 with suspected renovascular hypertension, 6 with vascular impression on the renal pelvis, 8 with nephrolithiasis and 4 with sonographically abnormal kidneys. Venous and arterial DSA always gave diagnostically useful images. Intravenous DSA is valuable in patients with suspected renovascular hypertension or after vascular surgery, percutaneous transluminal angioplasty and transcatheter embolisation. Arterial DSA is preferable to venous DSA in other clinical situations, particularly in the evaluation of renal tumours, and may be recommended in preference to conventional angiography. [ABSTRACT FROM AUTHOR]

Published
1988
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19. Digital Subtraction Angiography of the Kidney

Author

M. T. Bonfanti, F. Gattoni, L. Franch, Baldini U, Carlo Uslenghi, Carlo Pozzato, Daniela Gandini, and Andrea Avogadro

Subjects
Adult, Male, medicine.medical_specialty, Percutaneous, Urology, Kidney, Renal Artery Obstruction, urologic and male genital diseases, Transluminal Angioplasty, Renovascular hypertension, medicine, Humans, In patient, Aged, medicine.diagnostic_test, business.industry, Digital subtraction angiography, Middle Aged, Vascular surgery, medicine.disease, Kidney Neoplasms, Radiographic Image Enhancement, body regions, Hypertension, Renovascular, medicine.anatomical_structure, Subtraction Technique, Female, Kidney Diseases, Radiology, business, Renal pelvis
Abstract

Summary— Intravenous and intra-arterial digital subtraction angiography (DSA) was performed in 88 patients: 34 with tumours, 10 with renal trauma, 26 with suspected renovascular hypertension, 6 with vascular impression on the renal pelvis, 8 with nephrolithiasis and 4 with sonographically abnormal kidneys. Venous and arterial DSA always gave diagnostically useful images. Intravenous DSA is valuable in patients with suspected renovascular hypertension or after vascular surgery, percutaneous transluminal angioplasty and transcatheter embolisation. Arterial DSA is preferable to venous DSA in other clinical situations, particularly in the evaluation of renal tumours, and may be recommended in preference to conventional angiography.

Published
1988
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23. DETERMINANTS OF 6-MONTH MORTALITY IN SURVIVORS OF MYOCARDIAL-INFARCTION AFTER THROMBOLYSIS - RESULTS OF THE GISSI-2 DATA-BASE

Author

VOLPI A, DEVITA C, FRANZOSI MG, GERACI E, MAGGIONI AP, MAURI F, NEGRI E, SANTORO E, TAVAZZI L, TOGNONI G, FERUGLIO GA, LOTTO A, ROVELLI F, SOLINAS P, BRUNO M, CAPPELLO T, COPPINI A, FINCATI F, MANTOVANI G, PANGRAZZI J, POGNA M, TURAZZA FM, ANSELMI M, BARBONAGLIA L, BIGI R, CAVALLI A, FRIGERIO M, GIORDANO A, GUALTIEROTTI C, TORTA D, CAROLA R, GIORDANO F, BARLOTTI R, LOPARCO G, VIGLINO GL, RUGGERI G, GIAMUNDO L, DANESI A, PACIARONI E, GAMBINI C, URBANO G, PURCARO A, FRANCESCONI M, FIGLIOLIA S, CANNONE M, ANTOLINI R, DEVOTI G, CRISTALLINI P, PORCIELLO PI, TEONI P, BURALI A, ZUCCONELLI V, DEMATTEIS C, IERVOGLINI A, SCATASTA M, AMABILI S, CARATTI CA, ZOLA G, FERRAGUTO P, SALICI G, CENTARO A, ROTIROTI D, GENOVESE M, GINEVRINO P, DAMATO N, ALTAMURA CM, COLONNA L, CASTELLANETA G, BOVENZI F, MESSINA D, GALANTINO A, CAMPOREALE N, CUCCHINI F, CAMPOSTELLA L, MALACRIDA R, GENONI M, PELLEGRINI P, BRIDDA A, RIGGI L, ACONE L, MOSCATIELLO G, BRUNO A, INVERNIZZI G, TESPILI M, GUAGLIUMI G, CASARI A, ALBANO T, TOMASSINI B, DIBIASE G, SCARAMUZZINO G, RUGGERO S, BRACCHETTI D, DECASTRO U, FULVI M, BRAITO E, ERLICHER A, OBERLECHNER W, GAGLIARDI RS, BIGHIGNOLI L, BONIZZATO G, RIZZI GM, SCAZZINA L, PERRINI A, STRANEO G, STRANEO U, SCIRE A, VERRIENTI A, GUADALUPI M, STORELLI A, ZUCCA L, DABUSTI M, ALBONICO B, DEPETRA V, TABACCHI GC, SCERVINO R, MEREU D, MAXIA P, BIANCO A, CRABU E, MANGIAMELI S, CENTAMORE G, MALFITANO D, AMICO C, VANCHERI F, SANTOPUOLI G, BALDINI F, PANTALEONI A, CONTESSOTTO F, TERLIZZI R, MERIGHI A, TURCHI E, TEGLIO V, PIGNATTI F, PEZZANA A, GOZZOLINO G, GIGLIO M, PETTINATI G, IEVA M, CIRICUGNO S, CORREALE E, ROMANO S, DIFUCCIA A, CASTELLANO B, NATALE A, CERNETTI C, CELEGON L, CANDELPERGHER G, ARIENZO F, RUSSO F, DEVIVO L, MAY L, ACHILLI G, BLASI A, SORRENTINO F, DATO A, GALLONE P, PALUMBO C, DELLAMONICA R, PAGANO L, ALBERTI A, ORSELLI L, DEPONTI C, PARMIGIANI ML, FERRARI M, ACITO P, BUSI F, DELLAVITTORIA G, BELLET C, BORTOLINI F, ROSSI A, CORONA C, BONDI S, NICCOLINI D, GAMBERI G, ARCURI G, MAIOLINO P, CARROZZA A, DELIO U, CAPRETTI G, MARINONI C, GUASCONI C, SONNINO S, PAGLIEI M, FERRARI G, LOMBARDI R, AGNELLI D, DERINALDIS G, CALCAGNILE A, SIGNORELLI S, BENDINELLI S, LUSETTI L, MOLLAIOLI M, COSMI F, PLASTINA F, VENNERI N, FERACO E, CATELLI P, POLUZZI C, DISTANTE S, BIANCHI C, COPPETTI S, ZAMPAGLIONE G, GATTO C, ZURLO R, USLENGHI E, MARGARIA F, MILANESE U, LOMANTO B, ZIACCHI V, RIVA D, BERTOCCHI P, TIRELLA G, DAULERIO M, SAURO G, BINI A, MAZZONI V, POGGI P, MARESTA A, JACOPI F, PATRONCINI A, PUPITA F, GAGGI S, FRAUSINI G, ANTONIOLI GE, MALACARNE C, CODECA L, CAPPATO R, ANDREOLI L, VARACCA S, BUIO E, FAZZINI PF, PUCCI P, SARRO F, VERGASSOLA R, BARCHIELLI M, DEMATTEIS D, CARRONE M, BRUNOZZI LT, MENICONI L, LIBERATI R, RADOGNA M, TALLONE M, CONTE R, IERI A, ZIPOLI A, SANSONI M, CANZIANI R, GUIDALI P, CRISTALLO E, MARIELLO F, MUZIO L, BENVENUTO MR, BALDINI MR, VECCHIO C, CHIARELLA F, FALCIDIENO M, CECCHI A, GIULIANO G, SEU V, PERUGINI P, TOSELLI A, BASSO F, CORTI E, ROSSI P, DELFINO R, CAPONNETTO S, GNECCO G, GHIGLIOTTI G, PENNESI A, LOMBARDI G, RUGGIERI A, BERTOLO L, SLOMP L, LANZETTA T, MAZZARONE L, CRESTI A, BELLODI G, ZUARINI AM, VENERI L, PARCHI C, GIOVANELLI N, NEGRONI S, DETHOMATIS M, BARGHINI A, MARINO E, RICCI D, LEMME P, DIGIACOMO U, AQUARO G, RONZANI G, OTTELLO B, VONTI V, MORETTI S, PALERMO R, MARSILI P, SIDERI F, RAGAZZINI G, GRAMENZI S, BATTISTINI S, DIODATO T, VALERIO A, TUCCI C, DEPASQUALE B, GELFO PG, BERTULLA A, BOLLINI R, DEMARCHI E, BACCA F, DEGIORGI V, LOCATELLI V, SAVOIA MT, FERRACINI C, BARBARESI F, COTOGNI A, FRANCO G, PASSONI F, DURBANO M, MORETTI G, PEROTTI S, CAPRETTI M, DELBENE P, CASCONE M, BALDINI U, ORLANDI M, ODDONE A, CAIZZI V, MASINI G, LAZZARI M, BALLERINI B, BOZZI L, MOCETTI T, BERTOLINI A, PASOTTI E, SANGUINETTI M, MANTOVANI R, TOGNOLI T, MAGGI A, TUSA M, CAMERONI E, GUERRA GP, REGGIANI A, REDAELLI S, GIUSTI S, TANTALO L, RIZZI A, DIGIOVANNI N, GUZZO V, GABRIELE M, COLOMBO G, ALBERZONI A, SALVIOLI G, GALFETTI F, DOVICO E, BELLUZZI F, GOLA E, CASELLATO F, LECCHI G, CONSOLO F, SACCA CB, CONSOLO A, PICCOLO E, GASPARINI G, MASSA D, BELLI C, DOSSENA MG, CORSINI C, SANNA GP, AZZOLLINI M, TRUAZZA F, NADOR F, DEMARTINI M, BOZZI G, SEREGNI R, PASTINE I, MORPURGO M, CASAZZA F, REGALIA F, MAGGIOLINI S, RIGO R, PANCALDI S, POZZETTI D, PASCOTTO P, FRANCESCHI L, DAINESE F, MELINI L, CAPPELLI C, BERNARDI C, PALMIERI M, BORGIONI L, ZILIO G, SANDRI R, ALITTO F, MASARO G, VALAGUSSA F, SCHIAVINA R, RAVESI D, DANIELLO L, PIANTADOSI FR, BARRA P, ROMEO D, MININNI N, SEVERINO S, MOSTACCI M, CASTELLARI M, BANDA D, ROLANDI R, VILLA WD, CARBONE V, ALLEGRI M, FASCIOLO L, PITTALIS M, MUREDDU V, SORO F, DELEDDA MG, MARRAS E, MARCHI SM, DELUCA C, MANETTA M, VOLTA SD, SPERANDEO V, DONZELLI M, VITRANO MG, PITROLO F, LAMONICA S, BELLANCA G, MESSINA G, MIRTO U, RAINERI A, TRAINA M, DIBENEDETTO A, RIBAUDO E, DIFRANCESCO M, RONCHITELLI R, CARONE M, DIGREGORIO D, DIPAOLO G, PASQUALE M, COREA L, COCCHIERI M, ALUNNI G, PAPI L, CHIRIATTI G, LUPETTI M, GAZZOLA U, ARRUZZOLI S, VILLANI GQ, MELLINI M, MADRUZZA L, PIAZZA R, MICHELI G, FRANCHINI C, BECHI S, MARTINES C, MARCHESE D, GABBIA G, BIGALLI A, CIUTI M, CABANI E, DELCITERNA F, ALFIERI A, CHITI M, LONGHINI J, CODELUPPI P, NEGRELLI M, ZANUTTINI D, NICOLOSI GL, MARTIN G, PETRELLA A, BARDAZZI L, BIANCO GA, CELLAMARE G, GIANNELLI F, LICITRA G, LICITRA R, LETTICA GV, TUMIOTTO G, BELLANTI G, BOSI S, CASALI G, MONDUCCI I, BARONE A, PARENTI F, HEYMAN J, COZZI E, BALDACCI G, BACCOS D, BRIGHI F, DESANCTIS A, BOCK R, ROSSI F, AMATI P, SEMPRINI P, NARDELLI A, BOTTERO G, VARTOLO C, MILAZZOTTO F, DICROCE G, DIMARIO F, ANGRISANI G, AZZOLINI P, NEJA CP, MANZOLI U, ROSSI E, TRANI C, MASINI V, SEBASTIANI F, TOPAI M, BORGIA MC, LUCIANI C, FERRI F, DEPAOLA D, CAPURSO S, TUGNOLI F, VETTA C, ALTIERI T, BORZI M, VISCOMI A, STRIANO U, SALITURI S, ZONZIN P, FIORENCIS R, BADIN A, RAVERA B, BALDI C, SILVESTRI F, ALLEMANO P, REYNAUD S, SANSON A, MILANI L, DESIMONE MV, RUSSO A, VILLELLA A, GRAZINI M, AMIDEI S, ANSELMI L, PICCANICOLINO R, MASCELLI G, TAGLIAMONTE A, MESSINA V, TEDESCHI C, BOSSI M, BISIOLI M, TACCHI G, PAGNI G, VIVALDI F, IBBA GV, SANNIA L, PEDRAZZINI F, BAGNI E, FABII S, ALVINO A, ANTONIELLI E, DORONZO B, MARTINENGO E, BECCHI G, SALMOIRAGHI A, DIGIOVANNA F, CARAMANNO G, CAPORICCI D, BRUN M, GIANI P, FERRARIO G, PECI P, RONCONI G, SKOUSE D, GIUSTINIANI S, CUCCHI GF, TAVASCI E, SILVERII A, MARCELLINI G, SPECA G, STANISCIA D, CIMINO A, SERAFINI N, DEBONIS P, CERRUTI P, BAZZUCCHI M, DALPRA F, SPEROTTO C, MOLE GD, BARBANO G, POMARI F, GASCHINO G, PARIGI A, GANDOLFO N, RONDONI F, BRUSCA A, DILEO M, GOLZIO PG, ABRATE M, SCLAVO MG, ROCCI R, POGGIO G, GIANI S, CUZZUCREA D, BRASCHI GB, SCIACCA R, SAMMARTANO A, FURLANELLO F, BRAITO G, CUZZATO V, TOTIS O, FAURETTO F, LEO F, GALATI A, PALMA P, CAMERINI F, MORGERA T, BARBIERI L, SLAVICK GA, FRESCO C, CUDA A, SARNICOLA P, ARZILLO P, BINAGHI G, MACCHI G, CALVERI G, DIMARCO G, LEVANTESI G, PANERAI C, CATURELLI G, FACCHIN L, SARTORE G, ZARDINI P, MARINO P, CARBONIERI E, NAVA S, MAZZINI C, NAVA R, SERRA N, SASSARA M, NICROSINI F, GANDOLFI P, BERGOGNONI G, BALLESTRA AM, VIOLO C, VOLPI A, DEVITA C, FRANZOSI MG, GERACI E, MAGGIONI AP, MAURI F, NEGRI E, SANTORO E, TAVAZZI L, TOGNONI G, FERUGLIO GA, LOTTO A, ROVELLI F, SOLINAS P, BRUNO M, CAPPELLO T, COPPINI A, FINCATI F, MANTOVANI G, PANGRAZZI J, POGNA M, TURAZZA FM, ANSELMI M, BARBONAGLIA L, BIGI R, CAVALLI A, FRIGERIO M, GIORDANO A, GUALTIEROTTI C, TORTA D, CAROLA R, GIORDANO F, BARLOTTI R, LOPARCO G, VIGLINO GL, RUGGERI G, GIAMUNDO L, DANESI A, PACIARONI E, GAMBINI C, URBANO G, PURCARO A, FRANCESCONI M, FIGLIOLIA S, CANNONE M, ANTOLINI R, DEVOTI G, CRISTALLINI P, PORCIELLO PI, TEONI P, BURALI A, ZUCCONELLI V, DEMATTEIS C, IERVOGLINI A, SCATASTA M, AMABILI S, CARATTI CA, ZOLA G, FERRAGUTO P, SALICI G, CENTARO A, ROTIROTI D, GENOVESE M, GINEVRINO P, DAMATO N, ALTAMURA CM, COLONNA L, CASTELLANETA G, BOVENZI F, MESSINA D, GALANTINO A, CAMPOREALE N, CUCCHINI F, CAMPOSTELLA L, MALACRIDA R, GENONI M, PELLEGRINI P, BRIDDA A, RIGGI L, ACONE L, MOSCATIELLO G, BRUNO A, INVERNIZZI G, TESPILI M, GUAGLIUMI G, CASARI A, ALBANO T, TOMASSINI B, DIBIASE G, SCARAMUZZINO G, RUGGERO S, BRACCHETTI D, DECASTRO U, FULVI M, BRAITO E, ERLICHER A, OBERLECHNER W, GAGLIARDI RS, BIGHIGNOLI L, BONIZZATO G, RIZZI GM, SCAZZINA L, PERRINI A, STRANEO G, STRANEO U, SCIRE A, VERRIENTI A, GUADALUPI M, STORELLI A, ZUCCA L, DABUSTI M, ALBONICO B, DEPETRA V, TABACCHI GC, SCERVINO R, MEREU D, MAXIA P, BIANCO A, CRABU E, MANGIAMELI S, CENTAMORE G, MALFITANO D, AMICO C, VANCHERI F, SANTOPUOLI G, BALDINI F, PANTALEONI A, CONTESSOTTO F, TERLIZZI R, MERIGHI A, TURCHI E, TEGLIO V, PIGNATTI F, PEZZANA A, GOZZOLINO G, GIGLIO M, PETTINATI G, IEVA M, CIRICUGNO S, CORREALE E, ROMANO S, DIFUCCIA A, CASTELLANO B, NATALE A, CERNETTI C, CELEGON L, CANDELPERGHER G, ARIENZO F, RUSSO F, DEVIVO L, MAY L, ACHILLI G, BLASI A, SORRENTINO F, DATO A, GALLONE P, PALUMBO C, DELLAMONICA R, PAGANO L, ALBERTI A, ORSELLI L, DEPONTI C, PARMIGIANI ML, FERRARI M, ACITO P, BUSI F, DELLAVITTORIA G, BELLET C, BORTOLINI F, ROSSI A, CORONA C, BONDI S, NICCOLINI D, GAMBERI G, ARCURI G, MAIOLINO P, CARROZZA A, DELIO U, CAPRETTI G, MARINONI C, GUASCONI C, SONNINO S, PAGLIEI M, FERRARI G, LOMBARDI R, AGNELLI D, DERINALDIS G, CALCAGNILE A, SIGNORELLI S, BENDINELLI S, LUSETTI L, MOLLAIOLI M, COSMI F, PLASTINA F, VENNERI N, FERACO E, CATELLI P, POLUZZI C, DISTANTE S, BIANCHI C, COPPETTI S, ZAMPAGLIONE G, GATTO C, ZURLO R, USLENGHI E, MARGARIA F, MILANESE U, LOMANTO B, ZIACCHI V, RIVA D, BERTOCCHI P, TIRELLA G, DAULERIO M, SAURO G, BINI A, MAZZONI V, POGGI P, MARESTA A, JACOPI F, PATRONCINI A, PUPITA F, GAGGI S, FRAUSINI G, ANTONIOLI GE, MALACARNE C, CODECA L, CAPPATO R, ANDREOLI L, VARACCA S, BUIO E, FAZZINI PF, PUCCI P, SARRO F, VERGASSOLA R, BARCHIELLI M, DEMATTEIS D, CARRONE M, BRUNOZZI LT, MENICONI L, LIBERATI R, RADOGNA M, TALLONE M, CONTE R, IERI A, ZIPOLI A, SANSONI M, CANZIANI R, GUIDALI P, CRISTALLO E, MARIELLO F, MUZIO L, BENVENUTO MR, BALDINI MR, VECCHIO C, CHIARELLA F, FALCIDIENO M, CECCHI A, GIULIANO G, SEU V, PERUGINI P, TOSELLI A, BASSO F, CORTI E, ROSSI P, DELFINO R, CAPONNETTO S, GNECCO G, GHIGLIOTTI G, PENNESI A, LOMBARDI G, RUGGIERI A, BERTOLO L, SLOMP L, LANZETTA T, MAZZARONE L, CRESTI A, BELLODI G, ZUARINI AM, VENERI L, PARCHI C, GIOVANELLI N, NEGRONI S, DETHOMATIS M, BARGHINI A, MARINO E, RICCI D, LEMME P, DIGIACOMO U, AQUARO G, RONZANI G, OTTELLO B, VONTI V, MORETTI S, PALERMO R, MARSILI P, SIDERI F, RAGAZZINI G, GRAMENZI S, BATTISTINI S, DIODATO T, VALERIO A, TUCCI C, DEPASQUALE B, GELFO PG, BERTULLA A, BOLLINI R, DEMARCHI E, BACCA F, DEGIORGI V, LOCATELLI V, SAVOIA MT, FERRACINI C, BARBARESI F, COTOGNI A, FRANCO G, PASSONI F, DURBANO M, MORETTI G, PEROTTI S, CAPRETTI M, DELBENE P, CASCONE M, BALDINI U, ORLANDI M, ODDONE A, CAIZZI V, MASINI G, LAZZARI M, BALLERINI B, BOZZI L, MOCETTI T, BERTOLINI A, PASOTTI E, SANGUINETTI M, MANTOVANI R, TOGNOLI T, MAGGI A, TUSA M, CAMERONI E, GUERRA GP, REGGIANI A, REDAELLI S, GIUSTI S, TANTALO L, RIZZI A, DIGIOVANNI N, GUZZO V, GABRIELE M, COLOMBO G, ALBERZONI A, SALVIOLI G, GALFETTI F, DOVICO E, BELLUZZI F, GOLA E, CASELLATO F, LECCHI G, CONSOLO F, SACCA CB, CONSOLO A, PICCOLO E, GASPARINI G, MASSA D, BELLI C, DOSSENA MG, CORSINI C, SANNA GP, AZZOLLINI M, TRUAZZA F, NADOR F, DEMARTINI M, BOZZI G, SEREGNI R, PASTINE I, MORPURGO M, CASAZZA F, REGALIA F, MAGGIOLINI S, RIGO R, PANCALDI S, POZZETTI D, PASCOTTO P, FRANCESCHI L, DAINESE F, MELINI L, CAPPELLI C, BERNARDI C, PALMIERI M, BORGIONI L, ZILIO G, SANDRI R, ALITTO F, MASARO G, VALAGUSSA F, SCHIAVINA R, RAVESI D, DANIELLO L, PIANTADOSI FR, BARRA P, ROMEO D, MININNI N, SEVERINO S, MOSTACCI M, CASTELLARI M, BANDA D, ROLANDI R, VILLA WD, CARBONE V, ALLEGRI M, FASCIOLO L, PITTALIS M, MUREDDU V, SORO F, DELEDDA MG, MARRAS E, MARCHI SM, DELUCA C, MANETTA M, VOLTA SD, SPERANDEO V, DONZELLI M, VITRANO MG, PITROLO F, LAMONICA S, BELLANCA G, MESSINA G, MIRTO U, RAINERI A, TRAINA M, DIBENEDETTO A, RIBAUDO E, DIFRANCESCO M, RONCHITELLI R, CARONE M, DIGREGORIO D, DIPAOLO G, PASQUALE M, COREA L, COCCHIERI M, ALUNNI G, PAPI L, CHIRIATTI G, LUPETTI M, GAZZOLA U, ARRUZZOLI S, VILLANI GQ, MELLINI M, MADRUZZA L, PIAZZA R, MICHELI G, FRANCHINI C, BECHI S, MARTINES C, MARCHESE D, GABBIA G, BIGALLI A, CIUTI M, CABANI E, DELCITERNA F, ALFIERI A, CHITI M, LONGHINI J, CODELUPPI P, NEGRELLI M, ZANUTTINI D, NICOLOSI GL, MARTIN G, PETRELLA A, BARDAZZI L, BIANCO GA, CELLAMARE G, GIANNELLI F, LICITRA G, LICITRA R, LETTICA GV, TUMIOTTO G, BELLANTI G, BOSI S, CASALI G, MONDUCCI I, BARONE A, PARENTI F, HEYMAN J, COZZI E, BALDACCI G, BACCOS D, BRIGHI F, DESANCTIS A, BOCK R, ROSSI F, AMATI P, SEMPRINI P, NARDELLI A, BOTTERO G, VARTOLO C, MILAZZOTTO F, DICROCE G, DIMARIO F, ANGRISANI G, AZZOLINI P, NEJA CP, MANZOLI U, ROSSI E, TRANI C, MASINI V, SEBASTIANI F, TOPAI M, BORGIA MC, LUCIANI C, FERRI F, DEPAOLA D, CAPURSO S, TUGNOLI F, VETTA C, ALTIERI T, BORZI M, VISCOMI A, STRIANO U, SALITURI S, ZONZIN P, FIORENCIS R, BADIN A, RAVERA B, BALDI C, SILVESTRI F, ALLEMANO P, REYNAUD S, SANSON A, MILANI L, DESIMONE MV, RUSSO A, VILLELLA A, GRAZINI M, AMIDEI S, ANSELMI L, PICCANICOLINO R, MASCELLI G, TAGLIAMONTE A, MESSINA V, TEDESCHI C, BOSSI M, BISIOLI M, TACCHI G, PAGNI G, VIVALDI F, IBBA GV, SANNIA L, PEDRAZZINI F, BAGNI E, FABII S, ALVINO A, ANTONIELLI E, DORONZO B, MARTINENGO E, BECCHI G, SALMOIRAGHI A, DIGIOVANNA F, CARAMANNO G, CAPORICCI D, BRUN M, GIANI P, FERRARIO G, PECI P, RONCONI G, SKOUSE D, GIUSTINIANI S, CUCCHI GF, TAVASCI E, SILVERII A, MARCELLINI G, SPECA G, STANISCIA D, CIMINO A, SERAFINI N, DEBONIS P, CERRUTI P, BAZZUCCHI M, DALPRA F, SPEROTTO C, MOLE GD, BARBANO G, POMARI F, GASCHINO G, PARIGI A, GANDOLFO N, RONDONI F, BRUSCA A, DILEO M, GOLZIO PG, ABRATE M, SCLAVO MG, ROCCI R, POGGIO G, GIANI S, CUZZUCREA D, BRASCHI GB, SCIACCA R, SAMMARTANO A, FURLANELLO F, BRAITO G, CUZZATO V, TOTIS O, FAURETTO F, LEO F, GALATI A, PALMA P, CAMERINI F, MORGERA T, BARBIERI L, SLAVICK GA, FRESCO C, CUDA A, SARNICOLA P, ARZILLO P, BINAGHI G, MACCHI G, CALVERI G, DIMARCO G, LEVANTESI G, PANERAI C, CATURELLI G, FACCHIN L, SARTORE G, ZARDINI P, MARINO P, CARBONIERI E, NAVA S, MAZZINI C, NAVA R, SERRA N, SASSARA M, NICROSINI F, GANDOLFI P, BERGOGNONI G, BALLESTRA AM, and VIOLO C

Subjects
cardiovascular diseases
Abstract

Background. Current knowledge of risk assessment in survivors of myocardial infarction is largely based on data gathered before the advent of thrombolysis. It must be determined whether and to what extent available information and proposed criteria of prognostication are applicable in the thrombolytic era. Methods and Results. We reassessed risk prediction in the 10 219 survivors of myocardial infarction with follow-up data available (ie, 98% of the total) who had been enrolled in the GISSI-2 trial, relying on a set of prespecified variables. The 3.5% 6-month all-cause mortality rate of these patients compared with the higher value of 4.6% found in the corresponding GISSI-1 cohort, originally allocated to streptokinase therapy, indicates a 24% reduction in postdischarge 6-month mortality. On multivariate analysis (Cox model), the following variables were predictors of 6-month all-cause mortality: ineligibility for exercise test for both cardiac (relative risk [RR], 3.30; 95% confidence interval [CI], 2.36-4.62) and noncardiac reasons (RR, 3.28; 95% CI, 2.23-4.72), early left ventricular failure (RR, 2.41; 95% Cl, 1.87-3.09), echocardiographic evidence of recovery phase left ventricular dysfunction (RR, 2.30; 95% CI, 1.78-2.98), advanced (more than 70 years) age (RR, 1.81; 95% Cl, 1.43 -2.30), electrical instability (ie, frequent and/or complex ventricular arrhythmias) (RR, 1.70; 95% Cl, 1.32-2.19), late left ventricular failure (RR, 1.54; 95% Cl, 1.17-2.03), previous myocardial infarction (RR, 1.47; 95% CI, 1.14-1.89), and a history of treated hypertension (RR, 1.32; 95% Cl, 1.05-1.65). Early post-myocardial infarction angina, a positive exercise test, female sex, history of angina, history of insulin-dependent diabetes, and anterior site of myocardial infarction were not risk predictors. On further multivariate analysis, performed on 8315 patients with the echocardiographic indicator of left ventricular dysfunction available, only previous myocardial infarction was not retained as an independent risk predictor. Conclusions. A decline in 6-month mortality of myocardial infarction survivors, seen within 6 hours of symptom onset, has been observed in recent years. Ineligibility for exercise test, early left ventricular failure, and recovery-phase left ventricular dysfunction are the most powerful (RR, >2) predictors of 6-month mortality among patients recovering from myocardial infarction after thrombolysis. Qualitative variables reflecting residual myocardial ischemia do not appear to be risk predictors. The lack of an independent adverse influence of early post-myocardial infarction angina on 6-month survival represents a major difference between this study and those of the prethrombolytic era.

29. L'umanesimo riformatore di Juan Luis Vives e di Johann Sturm

Author

NEGRUZZO, SIMONA, Baldini U, Brizzi GP, and NEGRUZZO S

Subjects
Settore M-PED/02 - STORIA DELLA PEDAGOGIA, Juan Luis Vive, riforma, Settore M-STO/07 - STORIA DEL CRISTIANESIMO E DELLE CHIESE, Juan Luis Vives, Johann Sturm, Settore M-STO/02 - STORIA MODERNA, umanesimo
Abstract

La corrente umanistica e riformatrice permeò l'opera dello spagnolo Juan Luis Vives e del tedesco Johann Sturm.

Published
2013

30. Exploring Aromanticism Through an Online Qualitative Investigation With the Aromantic Community: "Freeing, Alienating, and Utterly Fantastic".

Author

Fowler JA, Mendis M, Crook A, Chavez-Baldini U, Baca T, and Dean JA

Abstract

Objective: To explore what aromanticism is, common misconceptions about this identity, and the experiences people have connecting with an aromantic identity., Methods: An online, international open-ended survey with a convenience sample of aromantic individuals ( N  = 1642) analyzed with thematic analysis., Results: To identify as aromantic involves a spectrum of experiences with romance commonly tied to experiencing stigma. Connecting with an aromantic identity allows for a greater understanding of the self and a connection to a community., Conclusions: Future research is needed to explore the experiences and perspectives of this community to gather better understanding of their needs and how to prevent/limit stigmatizing experiences., Competing Interests: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper., (© 2024 The Author(s). Published with license by Taylor & Francis Group, LLC.)

Published
2024
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31. Acute pericarditis as a major clinical manifestation of long COVID-19 syndrome.

Author

Dini FL, Baldini U, Bytyçi I, Pugliese NR, Bajraktari G, and Henein MY

Subjects
Humans, Female, Middle Aged, Male, Post-Acute COVID-19 Syndrome, Retrospective Studies, Pericardium, COVID-19 complications, COVID-19 diagnosis, Pericarditis diagnosis, Pericarditis epidemiology
Abstract

Background: The long COVID-19 syndrome has been recently described and some reports have suggested that acute pericarditis represents important manifestation of long COVID-19 syndrome. The aim of this study was to identify the prevalence and clinical characteristics of patients with long COVID-19, presenting with acute pericarditis., Methods: We retrospectively included 180 patients (median age 47 years, 62% female) previously diagnosed with COVID-19, exhibiting persistence or new-onset symptoms ≥12 weeks from a negative naso-pharyngeal SARS CoV2 swamp test. The original diagnosis of COVID-19 infection was determined by a positive swab. All patients had undergone a thorough physical examination. Patients with suspected heart involvement were referred to a complete cardiovascular evaluation. Echocardiography was performed based on clinical need and diagnosis of acute pericarditis was achieved according to current guidelines., Results: Among the study population, shortness of breath/fatigue was reported in 52%, chest pain/discomfort in 34% and heart palpitations/arrhythmias in 37%. Diagnosis of acute pericarditis was made in 39 patients (22%). Mild-to-moderate pericardial effusion was reported in 12, while thickened and bright pericardial layers with small effusions (< 5 mm) with or without comet tails arising from the pericardium (pericardial B-lines) in 27. Heart palpitations/arrhythmias (OR:3.748, p = 0.0030), and autoimmune disease and allergic disorders (OR:4.147, p = 0.0073) were independently related to the diagnosis of acute pericarditis, with a borderline contribution of less likelihood of hospitalization during COVID-19 (OR: 0.100, p = 0.0512)., Conclusion: Our findings suggest a high prevalence of acute pericarditis in patients with long COVID-19 syndrome. Autoimmune and allergic disorders, and palpitations/arrhythmias were frequently associated with pericardial disease., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Published
2023
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32. The relationship between cognitive functioning and psychopathology in patients with psychiatric disorders: a transdiagnostic network analysis.

Author

Chavez-Baldini U, Nieman DH, Keestra A, Lok A, Mocking RJT, de Koning P, Krzhizhanovskaya VV, Bockting CLH, van Rooijen G, Smit DJA, Sutterland AL, Verweij KJH, van Wingen G, Wigman JTW, Vulink NC, and Denys D

Subjects
Humans, Cross-Sectional Studies, Cognition, Psychotic Disorders epidemiology, Psychotic Disorders psychology, Schizophrenia, Cognition Disorders psychology
Abstract

Background: Patients with psychiatric disorders often experience cognitive dysfunction, but the precise relationship between cognitive deficits and psychopathology remains unclear. We investigated the relationships between domains of cognitive functioning and psychopathology in a transdiagnostic sample using a data-driven approach., Methods: Cross-sectional network analyses were conducted to investigate the relationships between domains of psychopathology and cognitive functioning and detect clusters in the network. This naturalistic transdiagnostic sample consists of 1016 psychiatric patients who have a variety of psychiatric diagnoses, such as depressive disorders, anxiety disorders, obsessive-compulsive and related disorders, and schizophrenia spectrum and other psychotic disorders. Psychopathology symptoms were assessed using various questionnaires. Core cognitive domains were assessed with a battery of automated tests., Results: Network analysis detected three clusters that we labelled: general psychopathology, substance use, and cognition. Depressive and anxiety symptoms, verbal memory, and visual attention were the most central nodes in the network. Most associations between cognitive functioning and symptoms were negative, i.e. increased symptom severity was associated with worse cognitive functioning. Cannabis use, (subclinical) psychotic experiences, and anhedonia had the strongest total negative relationships with cognitive variables., Conclusions: Cognitive functioning and psychopathology are independent but related dimensions, which interact in a transdiagnostic manner. Depression, anxiety, verbal memory, and visual attention are especially relevant in this network and can be considered independent transdiagnostic targets for research and treatment in psychiatry. Moreover, future research on cognitive functioning in psychopathology should take a transdiagnostic approach, focusing on symptom-specific interactions with cognitive domains rather than investigating cognitive functioning within diagnostic categories.

Published
2023
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33. The interplay between psychopathological symptoms: transdiagnostic cross-lagged panel network model.

Author

Chavez-Baldini U, Verweij K, de Beurs D, Bockting C, Lok A, Sutterland AL, van Rooijen G, van Wingen G, Denys D, Vulink N, and Nieman D

Abstract

Background: Recent paradigm shifts suggest that psychopathology manifests through dynamic interactions between individual symptoms., Aims: To investigate the longitudinal relationships between symptoms in a transdiagnostic sample of patients with psychiatric disorders., Method: A two-wave, cross-lagged panel network model of 15 nodes representing symptoms of depression, (social) anxiety and attenuated psychotic symptoms was estimated, using baseline and 1-year follow-up data of 222 individuals with psychiatric disorders. Centrality indices were calculated to determine important predictors and outcomes., Results: Our results demonstrated that the strongest relationships in the network were between (a) more suicidal ideation predicting more negative self-view, and (b) autoregressive relationships of social anxiety symptoms positively reinforcing themselves. Negative self-view was the most predictable node in the network as it had the highest 'in-expected influence' centrality, and may be an important transdiagnostic outcome symptom., Conclusions: The results give insight into longitudinal interactions between symptoms, which interact in ways that do not adhere to broader diagnostic categories. Our results suggest that self-view can also be a transdiagnostic outcome of psychopathology rather than just a predictor, as is normally posited, and may especially have an important relationship with suicidal ideation. Overall, our study demonstrates the dynamic complexity of psychopathology, and further supports the importance of investigating symptom interactions of different psychopathological dimensions over time and across disorders.

Published
2022
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34. Resting-state brain oscillations predict cognitive function in psychiatric disorders: A transdiagnostic machine learning approach.

Author

Sargent K, Chavez-Baldini U, Master SL, Verweij KJH, Lok A, Sutterland AL, Vulink NC, Denys D, Smit DJA, and Nieman DH

Subjects
Brain, Electroencephalography, Humans, Machine Learning, Neuropsychological Tests, Cognition, Quality of Life
Abstract

Background: Cognitive dysfunction is widespread in psychiatric disorders and can significantly impact quality of life. Deficits cut across traditional diagnostic boundaries, necessitating new approaches to understand how cognitive function relates to large-scale brain activity and psychiatric symptoms across the diagnostic spectrum., Objective: Using random forest regression, we aimed to identify transdiagnostic patterns linking cognitive function to resting-state EEG oscillations., Methods: 216 participants recruited through an outpatient psychiatric clinic completed the Cambridge Neuropsychological Test Automated Battery and underwent a 5-minute eyes-closed resting state EEG recording. We built random forest regression models to predict performance on each cognitive test using the resting-state EEG power spectrum as input, and we compared model performance to a sampling distribution constructed with random permutations. For models that performed significantly better than chance, we used feature importance estimates to identify features of the EEG power spectrum that are predictive of cognitive functioning., Results: Random forest models successfully predicted performance on measures of episodic memory and associative learning (Paired Associates Learning, PAL), information processing speed (Choice Reaction Time, CRT), and attentional set-shifting and executive function (Intra-Extra Dimensional Set Shift, IED). Oscillatory power in the upper alpha range was associated with better performance on PAL and CRT, while low alpha power was associated with worse CRT performance. Beta power predicted poor performance on all three tests. Theta power was associated with good performance on PAL, and delta and theta oscillations were identified as predictors of good performance on IED. No differences in cognitive performance were found between diagnostic categories., Conclusion: Resting oscillations are predictive of certain dimensions of cognitive function across various psychiatric disorders. These findings may inform treatment development to improve cognition., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)

Published
2021
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35. Protocol Across study: longitudinal transdiagnostic cognitive functioning, psychiatric symptoms, and biological parameters in patients with a psychiatric disorder.

Author

Nieman DH, Chavez-Baldini U, Vulink NC, Smit DJA, van Wingen G, de Koning P, Sutterland AL, Mocking RJT, Bockting C, Verweij KJH, Lok A, and Denys D

Subjects
Clinical Protocols, Humans, Netherlands, Cognition physiology, Depressive Disorder, Major blood, Depressive Disorder, Major diagnosis, Schizophrenia blood, Schizophrenia diagnosis
Abstract

Background: Patients with psychiatric disorders, such as major depressive disorder, schizophrenia or obsessive-compulsive disorder, often suffer from cognitive dysfunction. The nature of these dysfunctions and their relation with clinical symptoms and biological parameters is not yet clear. Traditionally, cognitive dysfunction is studied in patients with specific psychiatric disorders, disregarding the fact that cognitive deficits are shared across disorders. The Across study aims to investigate cognitive functioning and its relation with psychiatric symptoms and biological parameters transdiagnostically and longitudinally., Methods: The study recruits patients diagnosed with a variety of psychiatric disorders and has a longitudinal cohort design with an assessment at baseline and at one-year follow-up. The primary outcome measure is cognitive functioning. The secondary outcome measures include clinical symptoms, electroencephalographic, genetic and blood markers (e.g., fatty acids), and hair cortisol concentration levels., Discussion: The Across study provides an opportunity for a transdiagnostic, bottom-up, data-driven approach of investigating cognition in relation to symptoms and biological parameters longitudinally in patients with psychiatric disorders. The study may help to find new clusters of symptoms, biological markers, and cognitive dysfunctions that have better prognostic value than the current diagnostic categories. Furthermore, increased insight into the relationship among cognitive deficits, biological parameters, and psychiatric symptoms can lead to new treatment possibilities., Trial Registration: Netherlands Trial Register (NTR): NL8170.

Published
2020
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36. Expressive suppression in psychosis: The association with social context.

Author

Chavez-Baldini U, Wichers M, Reininghaus U, and Wigman JTW

Subjects
Adult, Case-Control Studies, Emotions, Executive Function, Female, Follow-Up Studies, Humans, Male, Middle Aged, Psychotic Disorders genetics, Psychotic Disorders metabolism, Psychotic Disorders pathology, Social Environment
Abstract

As emotion regulation deficits have been implicated in psychotic disorders, it is imperative to investigate not only the effect of regulation strategies but also how they are used. One such strategy is expressive suppression, the inhibition of emotion-expressive behavior, which may be influenced by social context. Therefore, this study aimed to investigate whether the use of expressive suppression was associated with social context and affect in daily life and if this differed between patients with psychosis and controls. Multilevel models using experience sampling method (ESM) data of 34 patients with psychotic disorders and 53 controls from the Genetic Risk and Outcome in Psychosis (GROUP) project were conducted. Expressive suppression and social context were assessed once a day for six days and daily affect was averaged per participant per day. Social context was significantly associated with the use of expressive suppression in daily life, so that the use of expressive suppression differed when in the presence of familiar versus non-familiar company when receiving negative feedback. This finding did not differ between patients and controls. This demonstrates that taking the situation into account when studying expressive suppression, and emotion regulation in general, may improve our understanding of how regulation takes place., Competing Interests: The GROUP study received funding from commercial sources: Lundbeck, AstraZeneca, Eli Lilly, and Janssen Cilag. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials. All other authors report no financial interests or potential conflicts of interest.

Published
2020
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37. Transdiagnostic dimensions of psychosis in the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP).

Author

Reininghaus U, Böhnke JR, Chavez-Baldini U, Gibbons R, Ivleva E, Clementz BA, Pearlson GD, Keshavan MS, Sweeney JA, and Tamminga CA

Abstract

The validity of the classification of non-affective and affective psychoses as distinct entities has been disputed, but, despite calls for alternative approaches to defining psychosis syndromes, there is a dearth of empirical efforts to identify transdiagnostic phenotypes of psychosis. We aimed to investigate the validity and utility of general and specific symptom dimensions of psychosis cutting across schizophrenia, schizoaffective disorder and bipolar I disorder with psychosis. Multidimensional item-response modeling was conducted on symptom ratings of the Positive and Negative Syndrome Scale, Young Mania Rating Scale, and Montgomery-Åsberg Depression Rating Scale in the multicentre Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium, which included 933 patients with a diagnosis of schizophrenia (N=397), schizoaffective disorder (N=224), or bipolar I disorder with psychosis (N=312). A bifactor model with one general symptom dimension, two distinct dimensions of non-affective and affective psychosis, and five specific symptom dimensions of positive, negative, disorganized, manic and depressive symptoms provided the best model fit. There was further evidence on the utility of symptom dimensions for predicting B-SNIP psychosis biotypes with greater accuracy than categorical DSM diagnoses. General, positive, negative and disorganized symptom dimension scores were higher in African American vs. Caucasian patients. Symptom dimensions accurately classified patients into categorical DSM diagnoses. This study provides evidence on the validity and utility of transdiagnostic symptom dimensions of psychosis that transcend traditional diagnostic boundaries of psychotic disorders. Findings further show promising avenues for research at the interface of dimensional psychopathological phenotypes and basic neurobiological dimensions of psychopathology., (© 2019 World Psychiatric Association.)

Published
2019
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38. Modeling the Interplay Between Psychological Processes and Adverse, Stressful Contexts and Experiences in Pathways to Psychosis: An Experience Sampling Study.

Author

Klippel A, Myin-Germeys I, Chavez-Baldini U, Preacher KJ, Kempton M, Valmaggia L, Calem M, So S, Beards S, Hubbard K, Gayer-Anderson C, Onyejiaka A, Wichers M, McGuire P, Murray R, Garety P, van Os J, Wykes T, Morgan C, and Reininghaus U

Subjects
Adolescent, Adult, Ecological Momentary Assessment, Female, Humans, Male, Risk, Young Adult, Models, Statistical, Psychotic Disorders etiology, Psychotic Disorders physiopathology, Psychotic Disorders psychology, Stress, Psychological complications
Abstract

Several integrated models of psychosis have implicated adverse, stressful contexts and experiences, and affective and cognitive processes in the onset of psychosis. In these models, the effects of stress are posited to contribute to the development of psychotic experiences via pathways through affective disturbance, cognitive biases, and anomalous experiences. However, attempts to systematically test comprehensive models of these pathways remain sparse. Using the Experience Sampling Method in 51 individuals with first-episode psychosis (FEP), 46 individuals with an at-risk mental state (ARMS) for psychosis, and 53 controls, we investigated how stress, enhanced threat anticipation, and experiences of aberrant salience combine to increase the intensity of psychotic experiences. We fitted multilevel moderated mediation models to investigate indirect effects across these groups. We found that the effects of stress on psychotic experiences were mediated via pathways through affective disturbance in all 3 groups. The effect of stress on psychotic experiences was mediated by threat anticipation in FEP individuals and controls but not in ARMS individuals. There was only weak evidence of mediation via aberrant salience. However, aberrant salience retained a substantial direct effect on psychotic experiences, independently of stress, in all 3 groups. Our findings provide novel insights on the role of affective disturbance and threat anticipation in pathways through which stress impacts on the formation of psychotic experiences across different stages of early psychosis in daily life.

Published
2017
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39. A hanging mass in the ascending aorta diagnosed by transthoracic echocardiography in a totally asymptomatic subject.

Author

Baldini U, Chiaramonti F, Minzioni G, and Galli M

Subjects
Diagnosis, Differential, Humans, Male, Middle Aged, Aorta diagnostic imaging, Aortic Diseases diagnostic imaging, Echocardiography methods, Thrombosis diagnostic imaging
Abstract

Aortic mural thrombosis is generally associated with several diseases, including coagulopathies, aortic dissection or trauma, tumors, and complicated atherosclerotic plaques. The development of a friable mobile thrombus, especially in the ascending aorta or proximal aortic arch, is a rare event with potentially ominous consequences because of a life-threatening risk of stroke and peripheral embolization. The treatment of choice of this condition is still controversial. We report a case of an absolutely asymptomatic 57-year-old patient with a mobile, pedunculated mass attached to the posterior wall of an otherwise normal ascending aorta. The aortic mass, identified by transthoracic echocardiography, was surgically removed and demonstrated to be a thrombus, and the aortic wall specimen was microscopically normal.

Published
2009
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40. Incremental prognostic value of stress echo positivity in the left anterior descending coronary artery territory.

Author

Baldini U, Dini FL, Raugi M, and Genovesi-Ebert A

Subjects
Adult, Aged, Coronary Artery Disease mortality, Dipyridamole, Humans, Middle Aged, Prognosis, Coronary Artery Disease diagnostic imaging, Echocardiography, Stress
Abstract

Background: Dipyridamole stress echo (DSE) positivity is usually titrated according to presence and severity of the induced wall motion abnormalities. The purpose of our study is to assess whether the location of DSE positivity might add to prognostic stratification., Methods: The study enrolled 112 patients with known or suspected coronary artery disease (CAD) and without a history of prior myocardial infarction. They were consecutively submitted to DSE (0.84 mg/Kg in 10 min followed by atropine administration, when needed) and coronary angiography (within a 15+/-7 day period). End points at follow-up were cardiac death and acute coronary syndromes., Results: Twenty-seven patients had a negative, and 85 a positive DSE (47 in the LAD territory). Angiographically assessed CAD was present in 82 patients (LAD in 59). At a follow-up of 9+/-7 months, there were 28 events of cardiac deaths or acute coronary syndromes. Event-free survival was lower in patients with positive DSE (any location) compared to those with negative DSE (47% vs 89%, p=0.003). In the subset with positive DSE, event-free survival was lower in patients with wall motion abnormalities in the LAD territory compared to those with dysfunction in the left circumflex and right coronary artery territory (31% vs 72%, p=0.00012 ). At multivariate analysis, stress echo positivity in the LAD territory was independently associated with increased risk (HR: 9.51, CI: 1.61 to 56.11, p<0.013) and outperformed angiographically assessed LAD stenosis (HR: 0.36, CI: 0.06 to 2.24, p: NS)., Conclusions: In CAD patients, wall motion abnormalities in the LAD territory during DSE identified a higher risk subgroup. Functional stress echo positivity on the LAD territory overcame the prognostic impact of an anatomic, angiographically assessed LAD disease.

Published
2006
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41. Heart involvement in T cell lymphoma through hypereosinophilic syndrome: a common complication of a rare condition.

Author

Genovesi-Ebert A, Lombardi M, Capochiani E, Simi U, Savoia MT, Baldini U, Digiorgio A, Carluccio M, Di Santo D, and Galli M

Subjects
Adult, Contrast Media, Electrocardiography, Endomyocardial Fibrosis etiology, Gadolinium DTPA, Humans, Magnetic Resonance Imaging, Cine, Male, Endomyocardial Fibrosis diagnosis, Hypereosinophilic Syndrome complications, Lymphoma, T-Cell diagnosis
Abstract

This case describes a 42-year-old male affected by hypereosinophilic syndrome associated with angioimmunoblastic lymphoma. Heart involvement was suspected at ECG mimicking left ventricular hypertrophy. MRI clarified the extensive endomyocardial fibrosis, confirming the role of this technique in in-vivo tissue characterization. Finally, the study investigates the association of T cell lymphoma, hypereosinophilic syndrome, and Loeffler endomyocardial disease.

Published
2005
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42. [Stress imaging in coronary artery disease: state of the art].

Author

Baldini U, Venturini C, Genovesi-Ebert A, Savoia MT, Raugi M, Pauletti M, Carluccio M, Digiorgio A, Gasperetti G, and Galli M

Subjects
Coronary Disease economics, Dobutamine, Electrocardiography, Exercise Test, Humans, Prognosis, Research, Thallium Radioisotopes, Coronary Disease diagnostic imaging, Echocardiography, Stress economics, Tomography, Emission-Computed methods, Tomography, Emission-Computed, Single-Photon methods
Abstract

To date, several diagnostic tools allow an accurate non-invasive evaluation of coronary artery disease; this is due to the great progress in echocardiographic and nuclear imaging techniques in the last 10 years. The large availability of different stress imaging techniques allows to choose the most appropriate technique for each patient according to the clinical characteristics. This paper presents the state of the art of echocardiographic and nuclear stress imaging for the diagnosis of coronary artery disease and for the prognostic stratification of infarcted patients. Advantages and limits of the different techniques are described rather than putting in competition echo and nuclear cardiology as has often been done in the past. Cardiologists should select among the various techniques on the basis of clinical characteristics of single patients, center's experience and an objective evaluation of economical aspects.

Published
2004

43. Ciaglia percutaneous dilational tracheostomy. Early and late complications and follow-up.

Author

Gambale G, Cancellieri F, Baldini U, Vacchi Suzzi M, Baroncini S, Ferrari F, and Petrini F

Subjects
Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Complications epidemiology, Prospective Studies, Surveys and Questionnaires, Time Factors, Tracheostomy adverse effects, Tracheostomy methods
Abstract

Aim: Evaluation of the safety of percutaneous dilational tracheostomy (PDT) for perioperative, early and late complications., Design: we prospectively collected complications in patients who underwent PDT for mechanical ventilation; patients were interviewed 8 months after discharge, symptomatic cases underwent ENT control., Setting: 10 bed general ICU in a 650 -bed general hospital treating 450 patients per year., Participants and Intervention: 181 patients admitted between July 1998 and June 2000 who underwent PDT for mechanical ventilation. Prospe-ctive collection of data on patients and procedures and screening by a phone interview for symptoms possibly related to the tracheostomy. Symptomatic patients were referred to the ENT specialist. RESULTA: We found 17 perioperative minor complications and 10 minor during hospital stay complications. We traced 83 patients, alive 8 months after discharge. Sixty-one patients (73.5%) were symptom free. Four (4.8) complained of minimal dysphonia. Eighteen patients (21.7%) complained of symptoms deserving ENT control. Eleven patients came to the ENT control that was positive in 5 cases. In 2 patients swallowing uncoordination was found, in 1 arytenoid movement uncoordination. In 1 case (1.2%) a 25% tracheal stenosis was found. The stenosis was asymptomatic. One patient (1.2%) had a severe tracheal stenosis and had a Montgomery tracheal stent in place., Conclusions: In our experience Ciaglia PDT had an overall low rate of complications (21.8%). No patient had severe early complication. We found only 1 (1.2%) severe late complication. In selected patients, Ciaglia PDT with endoscopic control guarantees a high safety standard.

Published
2003

44. [A balloon attached to a thread].

Author

Ebert AG, Baldini U, Paperini L, Savoia MT, Raugi M, Venturini C, Digiorgio A, Pauletti M, and Galli M

Subjects
Aged, Aortic Aneurysm, Abdominal complications, Aortic Aneurysm, Abdominal surgery, Candidiasis diagnostic imaging, Candidiasis surgery, Cardiac Surgical Procedures, Diagnosis, Differential, Echocardiography, Endocarditis diagnostic imaging, Endocarditis surgery, Gastrointestinal Hemorrhage complications, Gastrointestinal Hemorrhage surgery, Humans, Male, Staphylococcal Infections diagnostic imaging, Staphylococcal Infections microbiology, Staphylococcal Infections surgery, Blood Vessel Prosthesis adverse effects, Candidiasis diagnosis, Cardiac Pacing, Artificial adverse effects, Endocarditis diagnosis, Endocarditis microbiology, Staphylococcal Infections diagnosis, Staphylococcus epidermidis
Published
2002

45. Noninvasive pacemaker stress echocardiography for diagnosis of coronary artery disease: a multicenter study.

Author

Picano E, Alaimo A, Chubuchny V, Plonska E, Baldo V, Baldini U, Pauletti M, Perticucci R, Fonseca L, Villarraga HR, Emanuelli C, Miracapillo G, Hoffmann E, and De Nes M

Subjects
Aged, Bias, Cardiac Pacing, Artificial standards, Coronary Angiography standards, Coronary Disease physiopathology, Echocardiography, Stress standards, False Negative Reactions, Feasibility Studies, Female, Heart Rate, Hemodynamics, Humans, Male, Patient Selection, Prognosis, Prospective Studies, Safety, Sensitivity and Specificity, Severity of Illness Index, Cardiac Pacing, Artificial methods, Coronary Disease diagnostic imaging, Echocardiography, Stress methods
Abstract

Objective: We evaluated the feasibility, safety, and diagnostic accuracy of noninvasive pacemaker stress echocardiography (PASE) test as a potential alternative to exercise or pharmacologic stress in patients with suspected or known coronary artery disease (CAD)., Background: Transesophageal atrial pacing echocardiography is an accurate test for detection of CAD, but its practical impact has been blunted by semi-invasiveness. In the expanding population of patients with permanent pacemakers (PMs), a pacing stress test can be administered noninvasively by external programming of the PM., Methods: In a prospective, multicenter, international study design, transthoracic stress-pacing echocardiography was performed in 46 consecutive patients with a permanent PM (33 men, 13 women; age 66.6 +/- 11.1 years) with suspected or known CAD. All patients underwent noninvasive PM-stress test by external programming (10 beats/min increments up to ischemia or target heart rate). Coronary angiography was performed in all patients independently of test results. Significant CAD was defined as >/=50% visually assessed diameter reduction in at least one major epicardial coronary artery. All coronary angiograms were scored by Duke prognostic weight values., Results: Fifteen patients were stimulated in atrial, and the remaining 31 in ventricular mode during stress. No significant side effects were observed. Echocardiographic images were interpretable in all patients. The average duration of stress was 8.9 +/- 3.5 min. Significant CAD was found in 27 patients. Sensitivity of PASE for identifying patients with significant CAD was 70%, specificity was 90%, and accuracy was 78%. When any abnormal wall motion at rest that remained unchanged at peak stress was regarded as a positive result of PASE, then the sensitivity, specificity, and accuracy levels for identifying patients with significant CAD were 85%, 84%, and 85%, respectively. Four of the eight patients with a false negative did not reach the target heart rate. The Duke values had significant correlation with values of wall motion score index at peak stress (r = 0.67) and with peak heart rate (r = -0.3)., Conclusions: Noninvasive PASE is a simple, rapid, safe, and diagnostically efficient option for patients with permanent PM and suspected or known CAD.

Published
2002
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46. Doppler-derived mitral and pulmonary venous flow variables are predictors of pulmonary hypertension in dilated cardiomyopathy.

Author

Dini FL, Nuti R, Barsotti L, Baldini U, Dell'Anna R, and Micheli G

Subjects
Aged, Cardiomyopathy, Dilated diagnostic imaging, Case-Control Studies, Female, Humans, Hypertension, Pulmonary diagnostic imaging, Male, Mitral Valve diagnostic imaging, Prospective Studies, Pulmonary Circulation, Pulmonary Veins diagnostic imaging, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Dysfunction, Left physiopathology, Cardiomyopathy, Dilated complications, Echocardiography, Doppler, Hypertension, Pulmonary etiology
Abstract

This study assessed whether Doppler-derived mitral and pulmonary venous flow parameters were predictors of pulmonary artery hypertension in patients with left ventricular dysfunction. Doppler echocardiographic examinations were performed in patients (n = 100) with dilated cardiomyopathy in sinus rhythm either symptomatic or asymptomatic before and after optimized therapy with ACE inhibitors, diuretics, and vasodilators. In case of weak or poor Doppler signals, measurable tricuspid regurgitation and pulmonary venous flow tracings were obtained after intravenous administration of 2.5 grams of Levovist at 400 mg/ml. At baseline, left ventricular ejection fraction was 30% +/- 7% and pulmonary artery systolic pressure was 48 +/- 14 mmHg. At the follow-up study carried out after 6 +/- 2 months, reversibility of pulmonary artery hypertension was apparent only in those patients exhibiting favorable changes of mitral flow curve from the restrictive or pseudonormal to impaired relaxation pattern (53 +/- 7 mmHg vs 38 +/- 8 mmHg; P < 0.0001). Numerous variables correlated significantly with pulmonary artery systolic pressure at baseline, while the correlations were generally weaker at the follow-up study. The closest correlations were found with E wave deceleration rate (r = 0.73) at baseline and with the systolic fraction of pulmonary venous flow forward peak velocities (r = -0.67) at follow-up. The stepwise regression model showed that the E wave deceleration rate and the degree of mitral regurgitation were the strongest independent predictors of pulmonary hypertension at baseline, while the ratio between pulmonary venous flow reverse and mitral wave velocities at atrial systole and ejection fraction added minor contributions, leading to a cumulative r value of 0.81. The systolic fraction was the strongest at the follow-up study, with minor contributions provided by the E wave deceleration rate and the left atrial dimension index, leading to a cumulative r value of 0.71.

Published
2002
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47. [Holter-detected myocardial ischemia. Impact for prognosis and decision making after acute myocardial infarction].

Author

Genovesi Ebert A, Paperini L, Baldini U, Raugi M, Digiorgio A, and Magini G

Subjects
Aged, Aged, 80 and over, Decision Making, Female, Humans, Male, Middle Aged, Myocardial Infarction complications, Myocardial Ischemia etiology, Myocardial Ischemia therapy, Myocardial Revascularization, Predictive Value of Tests, Prognosis, Recurrence, Electrocardiography, Ambulatory, Myocardial Infarction physiopathology, Myocardial Ischemia diagnosis, Myocardial Ischemia physiopathology
Abstract

Background: Aim of the study was to evaluate the prognostic and decision making value of Holter detected myocardial ischemia after acute myocardial infarction in comparison with clinically detected postinfarction angina and exercise test., Methods: To this aim the patients consecutively admitted to our coronary care unit with acute myocardial infarction during one year were retrospectively evaluated. One hundred and eighty-nine patients (age 70+/-11 years, 137 male and 51 female) had a 24 hour Holter monitoring. One-year follow up of these patients was obtained., Results: Myocardial ischemia was detected by Holter monitoring in 21 patients (11%), 4 with and 17 without angina. Symptom limited exercise test was obtained before discharge in 116 patients (62%): 45% were positive, 42% non-diagnostic and 13 negative for myocardial ischemia. Post infarction angina was present in 15 patients (9%). Patients with Holter detected myocardial ischemia were older (73+/-10 vs 66+/-11 years, p<0.05) and had higher prevalence of both angina and positive exercise test (p<0.01). One-year follow up was obtained in 186 patients. Holter detected myocardial ischemia positive predictive value for death or reinfarction was 15%, negative predictive value was 90%, similar to the absence of angina (90%) and the absence of positive exercise test (93%). Angina and exercise test identified 62% of patients with Holter detected myocardial ischemia. Residual myocardial ischemia was exclusively observed by Holter monitoring in 4% of the population, particularly in 1 patients with and 7 without exercise test., Conclusions: The additive contribution of Holter detected myocardial ischemia in the prognosis and decision making of post infarction patients is rather scanty.

Published
2002

48. Prognostic value of left atrial enlargement in patients with idiopathic dilated cardiomyopathy and ischemic cardiomyopathy.

Author

Dini FL, Cortigiani L, Baldini U, Boni A, Nuti R, Barsotti L, and Micheli G

Subjects
Aged, Aged, 80 and over, Cardiomyopathy, Dilated mortality, Cardiomyopathy, Dilated physiopathology, Cause of Death, Echocardiography, Doppler, Female, Heart Failure diagnosis, Heart Failure mortality, Heart Failure physiopathology, Hemodynamics physiology, Humans, Male, Middle Aged, Mitral Valve physiopathology, Mitral Valve Insufficiency diagnosis, Mitral Valve Insufficiency mortality, Mitral Valve Insufficiency physiopathology, Myocardial Ischemia mortality, Myocardial Ischemia physiopathology, Prognosis, Proportional Hazards Models, Risk Factors, Ventricular Dysfunction, Left diagnosis, Ventricular Dysfunction, Left mortality, Ventricular Dysfunction, Left physiopathology, Ventricular Function, Left physiology, Atrial Function, Left physiology, Cardiomyopathy, Dilated diagnosis, Myocardial Ischemia diagnosis
Abstract

Previous studies have shown that abnormal mitral flow patterns and left atrial (LA) enlargement are independently associated with survival in patients with left ventricular (LV) dysfunction. However, it is not known whether these outcome indicators can provide different information in patients of various age groups. This study was designed to assess the prognostic value of the restrictive mitral flow pattern (RMFP) and increased LA size in patients with LV dysfunction (ejection fraction <45%) grouped into those < or = 70 years old (n = 102; mean age 61) and those >70 years old (n = 105; mean age 78). Echocardiographic and Doppler indexes were recorded in patients with LV systolic dysfunction due to dilated cardiomyopathy who were followed up for 22 plus minus 14 months. In patients >70 years, indexed LA size (>26 mm/m(2)) was the single best predictor of death (hazard ratio [HR] 3.0, p = 0.018) and emerged as the most important outcome variable of the combined end point (HR 2.2, p = 0.016) on multivariate analysis. In patients < or =70 years, RMFP, characterized by an early wave deceleration time <140 ms, was independently associated with cardiac death or heart failure hospitalization (HR 5.7, p = 0.0013). When demographics, clinical, echocardiographic, and Doppler measurements were analyzed in hierarchical order, indexed LA size yielded the most valuable contribution in predicting the combined end point in older patients (global chi-square from 11.5 to 18.7). RMFP was associated with the higher additional prognostic value in younger patients (global chi-square from 14.4 to 24.1). These data suggest that LA enlargement has an independent and additional prognostic value in elderly patients with LV dysfunction.

Published
2002
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49. [Hematoma of right ventricular outflow tract mimicking an infiltrating tumor as a consequence of acute aortic dissection].

Author

Puccioni E, Verunelli F, Baldini U, and Ballestra AM

Subjects
Acute Disease, Aged, Diagnosis, Differential, Humans, Male, Aortic Dissection complications, Aortic Dissection diagnosis, Aortic Aneurysm, Thoracic complications, Aortic Aneurysm, Thoracic diagnosis, Hematoma diagnosis, Hematoma etiology, Neoplastic Cells, Circulating, Ventricular Outflow Obstruction diagnosis, Ventricular Outflow Obstruction etiology
Abstract

The aortic dissection may be associated with unusual complications such as fistula formation and vascular compression. We describe a case of a 71-year-old patient admitted to our Hospital because of acute chest pain; transthoracic and transesophageal echocardiography revealed the presence of a type A aortic dissection associated with a mass infiltrating the right ventricular outflow and proximal tract of the pulmonary artery. The ultrasonographic morphology and the surgical findings showed the presence of a hematoma which was consequent to acute aortic dissection and which mimicked a tumor infiltrating the right ventricular outflow.

Published
2001

50. [Pulmonary hypertension in patients with left ventricular dysfunction studied with contrast-enhanced Doppler echocardiography: relations with diastolic parameters and prognostic implications].

Author

Dini FL, Dell'Anna R, Baldini U, Bechi S, Becuzzi L, Micheli A, Iurato A, Cordoni M, and Barsotti A

Subjects
Aged, Aged, 80 and over, Contrast Media, Coronary Circulation, Data Interpretation, Statistical, Female, Follow-Up Studies, Heart Failure diagnosis, Heart Failure physiopathology, Humans, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary physiopathology, Male, Middle Aged, Polysaccharides, Prognosis, Pulmonary Circulation, Systole, Time Factors, Ventricular Dysfunction, Left diagnostic imaging, Echocardiography, Doppler methods, Hypertension, Pulmonary diagnostic imaging, Ventricular Dysfunction, Left physiopathology
Abstract

In patients with left ventricular dysfunction, the prognostic value of both pulmonary hypertension and mitral flow patterns has been recognized. However, the effect of the association of different degrees of pulmonary hypertension on prognosis and the corresponding left ventricular diastolic dysfunction is not clear. Accordingly, we considered the impact on survival of a categorization based on the relationship between pulmonary artery pressure and left ventricular diastolic dysfunction, as assessed by mitral and pulmonary venous flow analyses. Transthoracic Doppler echocardiography was carried out in 92 patients with ejection fraction < 45%, pulmonary artery systolic pressure > 25 mmHg and sinus rhythm. Tricuspid regurgitant velocity and Doppler parameters derived from transmitral and pulmonary venous flows were evaluated. In the case of inadequate baseline tracings, weak or poor Doppler signals were enhanced by intravenous injection of a galactose-based contrast agent (Levovist 8 ml suspension at a concentration of 400 mg/ml). To select those whose pulmonary hypertension was either proportional or unproportional to left side filling pressures, patients were divided as follows: Group 1 (n = 69) with low discrepancies and Group 2 (n = 23) with marked discrepancies between Doppler estimates of pulmonary artery systolic pressure and left side filling abnormalities. The patients of each group were also classified according to their mitral flow pattern: abnormal relaxation, pseudonormal and restrictive. Mean pulmonary artery systolic pressure was 49 +/- 16 mmHg in the total population, 43 +/- 11 mmHg in Group 1 and 68 +/- 14 mmHg in Group 2 (p < 0.0001). Several mitral and pulmonary venous flow variables significantly correlated with pulmonary artery systolic pressure in the total population and in the study groups. The best correlations were observed in Group 1 as regards the ratio of reverse-to-forward atrial wave duration (r = 0.83), E wave deceleration rate (r = 0.81), E wave deceleration time (r = -0.81) and the systolic fraction of pulmonary venous flow peak velocities (r = -0.75). In Group 1, the lower heart failure-free survival rate at 10 months was observed in patients with restrictive pattern (68%) as opposed to those with pseudonormal (94%) and abnormal relaxation patterns (97%). The overall heart failure-free survival rate in Group 2 was 86%. In conclusion, the classification according to the relationship between pulmonary hypertension and the alterations of left chamber filling may contribute to the prognostic stratification of patients with left ventricular dysfunction. The patients with pulmonary hypertension proportional to the increase in left chamber filling pressures and restrictive pattern exhibited the worst prognosis.

Published
1998

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