56 results on '"Camaioni C"'
Search Results
2. Asymmetric septal thickening is observed in hypertrophic cardiomyopathy mutation carriers without left ventricular hypertrophy: insights from AI analysis
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Shiwani, H, primary, Hughes, R K, additional, Camaioni, C, additional, Augusto, J B, additional, Knott, K, additional, Rosmini, S, additional, Burke, L, additional, Pierce, I, additional, Moon, J C, additional, and Davies, R H, additional
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- 2022
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3. Improving the diagnostic accuracy of apical hypertrophic cardiomyopathy using machine learning
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Shiwani, H, primary, Hughes, R K, additional, Camaioni, C, additional, Augusto, J B, additional, Knott, K, additional, Rosmini, S, additional, Khoury, S, additional, Malcolmson, J, additional, Kellman, P, additional, Xue, H, additional, Burke, L, additional, Pierce, I, additional, Moon, J C, additional, and Davies, R H, additional
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- 2022
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4. Impact of DAA-Based Regimens on HCV-Related Extra-Hepatic Damage: A Narrative Review
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Sagnelli E, Sagnelli C, Russo A, Pisaturo M, Camaioni C, Astorri R, Coppola N, Sagnelli, E., Sagnelli, C., Russo, A., Pisaturo, M., Camaioni, C., Astorri, R., Coppola, N., Sagnelli, E, Sagnelli, C, Russo, A, Pisaturo, M, Camaioni, C, Astorri, R, and Coppola, N
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Antiviral Agent ,Hepaciviru ,HCV extrahepatic manifestation ,virus diseases ,Interferon-free DAA regimen ,Hepacivirus ,Hepatitis C, Chronic ,Antiviral Agents ,Hepatitis C ,digestive system diseases ,Cryoglobulinemia ,Humans ,Hepatitis C viru ,Human - Abstract
Two-third of patients with chronic hepatitis C show extrahepatic manifestations due to HCV infection of B lymphocytes, such as mixed cryoglobulinemia and non-Hodgkin B-cell lymphoma, or develop a chronic inflammatory status that may favor the development of adverse cardiovascular events, kidney diseases or metabolic abnormalities. DAAs treatments induce HCV eradication in 95% of treated patients, which also improves the clinical course of extrahepatic manifestations, but with some limitations. After HCV eradication a good compensation of T2DM has been observed, but doubts persist about the possibility of obtaining a stable reduction in fasting glucose and HbA1c levels. Chronic HCV infection is associated with low total and LDL cholesterol serum levels, which however increase significantly after HCV elimination, possibly due to the disruption of HCV/lipid metabolism interaction. Despite this adverse effect, HCV eradication exerts a favorable action on cardiovascular system, possibly by eliminating numerous other harmful effects exerted by HCV on this system. DAA treatment is also indicated for the treatment of patients with mixed cryoglobulinemia syndrome, since HCV eradication results in symptom reduction and, in particular, is effective in cryoglobulinemic vasculitis. Furthermore, HCV eradication exerts a favorable action on HCV-related lymphoproliferative disorders, with frequent remission or reduction of clinical manifestations. There is also evidence that HCV clearance may improve impaired renal functions, but same conflicting data persist on the effect of some DAAs on eGFR.
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- 2020
5. Influences on myocardial perfusion in non-obstructive coronary disease: an observational quantitative perfusion mapping study
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Knott, K, primary, Seraphim, A, additional, Augusto, JB, additional, Camaioni, C, additional, Kotecha, T, additional, Xue, H, additional, Joy, G, additional, Bhuva, AN, additional, Manisty, C, additional, Brown, LAE, additional, Wong, J, additional, Fontana, M, additional, Kellman, P, additional, Plein, S, additional, and Moon, JC, additional
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- 2021
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6. High-Resolution Late Gadolinium Enhancement Magnetic Resonance for the Diagnosis of Myocardial Infarction With Nonobstructed Coronary Arteries
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Lintingre, P.-F., Nivet, H., Clément-Guinaudeau, S., Camaioni, C., Sridi, S., Corneloup, O., Gerbaud, E., Coste, P., Dournes, G., Latrabe, V., Laurent, F., Montaudon, M., Cochet, H.
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- 2020
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7. Cardiovascular System in COVID-19: Simply a Viewer or a Leading Actor?
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Mottola F. F., Verde N., Ricciolino R., Di Mauro M., Migliaccio M. G., Carfora V., Spiniello G., Coppola N., Macera M., Calo F., Sagnelli C., Monari C., Martini S., Stornaiuolo G., Stanzione M., De Pascalis S., Cascone A., Bianco A., Gentile V., Camaioni C., De Angelis G., Marino G., Astorri R., Starace M., Minichini C., Di Fraia A., De Sio I., Niosi M., Borrelli S., Celia B., Ceparano M., Cirillo S., De Luca M., Mazzeo G., Paoli G., Russo M. G., Russo A., Mottola, F. F., Verde, N., Ricciolino, R., Di Mauro, M., Migliaccio, M. G., Carfora, V., Spiniello, G., Coppola, N., Macera, M., Calo, F., Sagnelli, C., Monari, C., Martini, S., Stornaiuolo, G., Stanzione, M., De Pascalis, S., Cascone, A., Bianco, A., Gentile, V., Camaioni, C., De Angelis, G., Marino, G., Astorri, R., Starace, M., Minichini, C., Di Fraia, A., De Sio, I., Niosi, M., Borrelli, S., Celia, B., Ceparano, M., Cirillo, S., De Luca, M., Mazzeo, G., Paoli, G., Russo, M. G., and Russo, A.
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medicine.medical_specialty ,Myocarditis ,heart failure ,Review ,Disease ,030204 cardiovascular system & hematology ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Pericarditis ,0302 clinical medicine ,Diabetes mellitus ,Pandemic ,medicine ,myocardial injury ,030212 general & internal medicine ,lcsh:Science ,Intensive care medicine ,Ecology, Evolution, Behavior and Systematics ,business.industry ,Mechanism (biology) ,SARS-CoV-2 infection ,Paleontology ,Cancer ,medicine.disease ,Space and Planetary Science ,Heart failure ,cardiovascular system ,lcsh:Q ,business - Abstract
As of January 2020, a new pandemic has spread from Wuhan and caused thousands of deaths worldwide. Several studies have observed a relationship between coronavirus disease (COVID-19) infection and the cardiovascular system with the appearance of myocardial damage, myocarditis, pericarditis, heart failure and various arrhythmic manifestations, as well as an increase in thromboembolic risk. Cardiovascular manifestations have been highlighted especially in older and more fragile patients and in those with multiple cardiovascular risk factors such as cancer, diabetes, obesity and hypertension. In this review, we will examine the cardiac involvement associated with SARS-CoV-2 infection, focusing on the pathophysiological mechanism underlying manifestations and their clinical implication, taking into account the main scientific papers published to date.
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- 2020
8. Quantitative myocardial perfusion in coronary artery disease: A perfusion mapping study
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Knott, KD, Camaioni, C, Ramasamy, A, Augusto, JA, Bhuva, AN, Xue, H, Manisty, C, Hughes, RK, Brown, LAE, Amersey, R, Bourantas, C, Kellman, P, Plein, S, and Moon, JC
- Abstract
Background Cardiac MR stress perfusion remains a qualitative technique in clinical practice due to technical and postprocessing challenges. However, automated inline perfusion mapping now permits myocardial blood flow (MBF, ml/g/min) quantification on‐the‐fly without user input. Purpose To investigate the diagnostic performance of this novel technique in detecting occlusive coronary artery disease (CAD) in patients scheduled to undergo coronary angiography. Study Type Prospective, observational. Subjects Fifty patients with suspected CAD and 24 healthy volunteers. Field Strength 1.5T. Sequence "Dual" sequence multislice 2D saturation recovery. Assessment All patients underwent cardiac MR with perfusion mapping and invasive coronary angiography; the healthy volunteers had MR with perfusion mapping alone. Statistical Tests Comparison between numerical variables was performed using an independent t‐test. Receiver operator characteristic (ROC) curves were generated for transmyocardial, endocardial stress MBF, and myocardial perfusion reserve (MPR, the stress:rest MBF ratio) to diagnose severe (>70%) stenoses as measured by 3D quantitative coronary angiography (QCA). ROC curves were compared by the method of DeLong et al. Results Compared with volunteers, patients had lower stress MBF and MPR even in vessels with 70%), MBF and MPR decreased. To diagnose occlusive (>70%) CAD, endocardial and transmyocardial stress MBF were superior to MPR (area under the curve 0.92 [95% CI 0.86–0.97] vs. 0.90 [95% CI 0.84–0.95] and 0.80 [95% CI 0.72–0.87], respectively). An endocardial threshold of 1.31 ml/g/min provided a per‐coronary artery sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 90%, 82%, 50%, and 98%, with a per‐patient diagnostic performance of 100%, 66%, 57%, and 100%, respectively. Data Conclusion Perfusion mapping can diagnose occlusive CAD with high accuracy and, in particular, high sensitivity and NPV make it a potential "rule‐out" test. Level of Evidence: 1 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:756–762
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- 2019
9. Focal scar and diffuse myocardial fibrosis are independent imaging markers in repaired tetralogy of Fallot
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Cochet, H., Iriart, X., Allain-Nicolaï, A., Camaioni, C., Sridi, S., Nivet, H., Fournier, E., Dinet, M.-L., Jalal, Z., Laurent, F., Montaudon, M., Thambo, J.-B.
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- 2019
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10. HEALTH AND URBAN PLANNING. ATTEMPTS AT DISCIPLINARY INTEGRATION AND INNOVATION
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Camaioni, C., D’Onofrio, R., Pellegrino, Piera, Stimilli, F., Tolli, M., and Trusiani, E.
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- 2018
11. Per una riconfigurazione della forma urbana contemporanea
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Sargolini, M. and Camaioni, C.
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- 2018
12. 304Quantitative perfusion mapping in Fabry disease
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Knott, K, primary, Augusto, J B, additional, Nordin, S, additional, Kozor, R, additional, Camaioni, C, additional, Xue, H, additional, Hughes, R K, additional, Manisty, C, additional, Brown, L A E, additional, Ramaswami, U, additional, Hughes, D, additional, Kellman, P, additional, Plein, S, additional, and Moon, J C, additional
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- 2019
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13. 267Myocardial perfusion defects in genotype-positive hypertrophic cardiomyopathy without left ventricular hypertrophy
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Hughes, R K, primary, Camaioni, C, additional, Knott, K D, additional, Quinn, E, additional, Captur, G, additional, Syrris, P, additional, Kellman, P, additional, Elliott, P M, additional, Mohiddin, S, additional, Xue, H, additional, Lopes, L, additional, and Moon, J, additional
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- 2019
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14. 3004Pulmonary blood volume index as a quantitative biomarker of diastolic function in hypertrophic cardiomyopathy
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Ricci, F, primary, Aung, N, additional, Boubertakh, R, additional, Camaioni, C, additional, Doimo, S, additional, Fung, K, additional, Khanji, M, additional, Malcomson, J, additional, Mantini, C, additional, Paiva, J, additional, Gallina, S, additional, Fedorowski, A, additional, Mohiddin, S, additional, Aquaro, G D, additional, and Petersen, S E, additional
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- 2018
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15. Moderated Posters: Practical applications of cardiac CT and/or radionuclide imagingP806Calcium but not fat is an additional marker for sub-clinical atherosclerosis in type 2 diabetes mellitusP807Assessment of diastolic heart function with multi-detector computed tomography (MDCT)P808Automated measurement of left atrial appendage orifice dimensions and their variation in patients with atrial fibrillation using MDCT imagesP809Presence and extent of cardiac CT angiography defined coronary artery disease in patients presenting with syncopeP810Dobutamine stress myocardial perfusion imaging by SPECT adds incremental prognostic value across a high risk cohortP811Prevalence and consequences of incidental findings detected by computed tomography in patients undergoing pulmonary vein isolation or transcatheter aortic valve implantationP812Low dose computed tomography angiography for evaluation of the thoracic aorta and coronary arteries using 160 mm detector coverage and iterative reconstruction algorithmP813Differential prognostic value of thoracic aorta calcium score on clinical outcomes in elderly individuals according to the presence of left ventricular hypertrophy
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Farrag, AAM, primary, Mustafa, A., primary, Wielandts, JY., primary, Altintas, S., primary, Ahmed, A., primary, Hesselink, T., primary, Annoni, A., primary, Cho, IJ., primary, Sorour, S, additional, Salem, MA, additional, Bakhoum, S., additional, Shahin, S., additional, Abdelkader, M., additional, Rashid, T., additional, De Buck, S., additional, Camaioni, C., additional, Frontera, A., additional, Haissaguerre, M., additional, Jais, P., additional, Thambo, JB., additional, Iriart, X., additional, Cochet, H., additional, Dinh, T., additional, Marcks, NGHM, additional, Kok, M., additional, Aerts, AJJ, additional, Weijs, B., additional, Blaauw, Y., additional, Wildberger, JE., additional, Das, M., additional, Kietselaer, BLJH, additional, Crijns, HJGM, additional, Qureshi, W., additional, Al-Mallah, M., additional, Molenaar, MMD, additional, Scholten, LFA, additional, Meijs, MF., additional, Stevenhagen, YJ., additional, Stoel, MG., additional, Van Dessel, PHFM, additional, Van Opstal, JM., additional, Van Houwelingen, KG., additional, Scholten, MF., additional, Formenti, A., additional, Mancini, E., additional, Mushtaq, S., additional, Conte, E., additional, Baggiano, A., additional, Guglielmo, M., additional, Beltrama, V., additional, Andreini, D., additional, Pepi, M., additional, Chang, HJ., additional, Lee, SE., additional, Cho, I., additional, Shim, CY., additional, Hong, GR., additional, and Chung, N., additional
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- 2016
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16. Knowledge and processes of sustainable development for the South East Europe
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Sargolini, Massimo, Camaioni, C., and Pierantoni, I.
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- 2014
17. Levels of Platelet-Derived Microparticles Are Related to Angiographic No-Reflow Phenomenon in Patients With ST-Elevation Myocardial Infarction Undergoing Primary-PCI
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Biasucci, Lm, Porto, I, De Maria GL, Di Vito, L, Burzotta, F, Tritarelli, A, Massimo, G, Camaioni, C, Cautilli, G, and Crea, F
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- 2010
18. 304 Quantitative perfusion mapping in Fabry disease.
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Knott, K, Augusto, J B, Nordin, S, Kozor, R, Camaioni, C, Xue, H, Hughes, R K, Manisty, C, Brown, L A E, Ramaswami, U, Hughes, D, Kellman, P, Plein, S, and Moon, J C
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CONFERENCES & conventions ,MAGNETIC resonance imaging ,ANGIOKERATOMA corporis diffusum - Published
- 2019
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19. 267 Myocardial perfusion defects in genotype-positive hypertrophic cardiomyopathy without left ventricular hypertrophy.
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Hughes, R K, Camaioni, C, Knott, K D, Quinn, E, Captur, G, Syrris, P, Kellman, P, Elliott, P M, Mohiddin, S, Xue, H, Lopes, L, and Moon, J
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CONFERENCES & conventions ,CARDIAC hypertrophy ,HEART function tests ,MAGNETIC resonance imaging ,MYOCARDIUM ,PERFUSION ,GENOTYPES ,LEFT ventricular hypertrophy - Published
- 2019
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20. What's new about Clopidogrel
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Pio Cialdella, Gustapane, M., Camaioni, C., and Biasucci, L. M.
21. Dementia as Risk Factor for Severe Coronavirus Disease 2019: A Case-Control Study
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Mariantonietta Pisaturo, Federica Calò, Antonio Russo, Clarissa Camaioni, Agnese Giaccone, Biagio Pinchera, Ivan Gentile, Filomena Simeone, Angelo Iodice, Paolo Maggi, Nicola Coppola, Pisaturo, Mariantonietta, Calò, Federica, Russo, Antonio, Camaioni, Clarissa, Giaccone, Agnese, Pinchera, Biagio, Gentile, Ivan, Simeone, Filomena, Iodice, Angelo, Maggi, Paolo, Coppola, Nicola, Pisaturo, M., Calo, F., Russo, A., Camaioni, C., Giaccone, A., Pinchera, B., Gentile, I., Simeone, F., Iodice, A., Maggi, P., and Coppola, N.
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medicine.medical_specialty ,Aging ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Cognitive Neuroscience ,severity ,Neurosciences. Biological psychiatry. Neuropsychiatry ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,death ,Medicine ,Dementia ,030212 general & internal medicine ,Risk factor ,Original Research ,business.industry ,SARS-CoV-2 ,Case-control study ,COVID-19 ,medicine.disease ,Delirium ,Observational study ,medicine.symptom ,business ,030217 neurology & neurosurgery ,RC321-571 ,Neuroscience ,dementia - Abstract
BackgroundThe aim of the present study was to investigate the outcome of patients with SARS-CoV-2 infection and dementia.Patients and MethodsIn a multicenter, observational, 1:2 matched case-control study all 23 patients with a history of dementia, hospitalized with a diagnosis of SARS-CoV-2 infection from February 28th 2020 to January 31st 2021 were enrolled. For each Case, 2 patients without dementia observed in the same period study, pair matched for gender, age (±5 years), PaO2/FiO2 (P/F) ratio at admission (200), number of comorbidities (±1; excluding dementia) were chosen (Control group).ResultsThe majority of patients were males (60.9% of Cases and Controls) and very elderly [median age 82 years (IQR: 75.5–85) in the Cases and 80 (IQR: 75.5–83.75) in the Controls]. The prevalence of co-pathologies was very high: all the Cases and 43 (93.5%) Controls showed a Charlson comorbidity index of at least 2. During hospitalization the patients in the Case group less frequently had a moderate disease of COVID-19 (35 vs. 67.4%, p = 0.02), more frequently a severe disease (48 vs. 22%, p = 0.03) and more frequently died (48 vs. 22%, p = 0.03). Moreover, during coronavirus disease 2019 (COVID-19), 14 (60.8%) patients in the Case group and 1 (2.1%; p < 0.000) in the Control group showed signs and symptoms of delirium.ConclusionPatients with dementia are vulnerable and have an increased risk of a severe disease and death when infected with COVID-19.
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- 2021
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22. More Severe COVID-19 in Patients With Active Cancer: Results of a Multicenter Cohort Study
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Paolo Maggi, Caterina Sagnelli, Angelo Salomone Megna, Alfonso Masullo, Mario Catalano, Elio Manzillo, Giovanni Porta, Mariantonietta Pisaturo, Vincenzo Sangiovanni, Vincenzo Esposito, Enrico Allegorico, Raffaella Pisapia, Carolina Rescigno, Vincenzo Messina, Michele Gambardella, Caterina Monari, Clarissa Camaioni, Giuseppe Signoriello, Fabio Giuliano Numis, Giosuele Calabria, Angela Salzillo, Ivan Gentile, Grazia Russo, Nicola Coppola, Biagio Pinchera, Monari, C., Sagnelli, C., Maggi, P., Sangiovanni, V., Numis, F. G., Gentile, I., Masullo, A., Rescigno, C., Calabria, G., Megna, A. S., Gambardella, M., Manzillo, E., Russo, G., Esposito, V., Camaioni, C., Messina, V., Pisaturo, M., Allegorico, E., Pinchera, B., Pisapia, R., Catalano, M., Salzillo, A., Porta, G., Signoriello, G., Coppola, N., Monari, Caterina, Sagnelli, Caterina, Maggi, Paolo, Sangiovanni, Vincenzo, Numis, Fabio Giuliano, Gentile, Ivan, Masullo, Alfonso, Rescigno, Carolina, Calabria, Giosuele, Megna, Angelo Salomone, Gambardella, Michele, Manzillo, Elio, Russo, Grazia, Esposito, Vincenzo, Camaioni, Clarissa, Messina, Vincenzo, Pisaturo, Mariantonietta, Allegorico, Enrico, Pinchera, Biagio, Pisapia, Raffaella, Catalano, Mario, Salzillo, Angela, Porta, Giovanni, Signoriello, Giuseppe, and Coppola, Nicola
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0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,oncologic patient ,severity disease ,active cancer ,Malignancy ,03 medical and health sciences ,0302 clinical medicine ,Intensive care ,Internal medicine ,medicine ,Stage (cooking) ,RC254-282 ,Original Research ,Mechanical ventilation ,SARS-CoV-2 ,business.industry ,COVID-19 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Cancer ,Retrospective cohort study ,medicine.disease ,oncologic patients ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,business ,Cohort study - Abstract
BackgroundThe aim of the study was to compare coronavirus disease 2019 (COVID-19) severity presentation between oncologic and non-oncologic patients and to evaluate the impact of cancer type and stage on COVID-19 course.MethodsWe performed a multicentre, retrospective study involving 13 COVID-19 Units in Campania region from February to May 2020. We defined as severe COVID-19 presentation the cases that required mechanical ventilation and/or admission to Intensive Care Units (ICU) and/or in case of death.ResultsWe enrolled 371 COVID-19 patients, of whom 34 (9.2%) had a history or a diagnosis of cancer (24 solid, 6 onco-hematological). Oncologic patients were older (pConclusionsSince the higher risk of severe evolution of COVID-19, cancer patients, especially those with an active malignancy, should be candidates for early evaluation of symptoms and early treatment for COVID-19.
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- 2021
23. Anticoagulant treatment in COVID-19: a narrative review
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Carfora, Vincenzo, Spiniello, Giorgio, Ricciolino, Riccardo, Di Mauro, Marco, Migliaccio, Marco Giuseppe, Mottola, Filiberto Fausto, Verde, Nicoletta, Coppola, Nicola, Sagnelli, Caterina, De Pascalis, Stefania, Stanzione, Maria, Stornaiuolo, Gianfranca, Cascone, Angela, Martini, Salvatore, Macera, Margherita, Monari, Caterina, Calò, Federica, Bianco, Andrea, Russo, Antonio, Gentile, Valeria, Camaioni, Clarissa, De Angelis, Giulia, Marino, Giulia, Astorri, Roberta, De Sio, Ilario, Niosi, Marco, Borrelli, Serena, Celia, Benito, Ceparano, Maria, Cirillo, Salvatore, De Luca, Maria, Mazzeo, Grazia, Paoli, Giorgio, Russo, Maria Giovanna, Carfora, V., Spiniello, G., Ricciolino, R., Di Mauro, M., Migliaccio, M. G., Mottola, F. F., Verde, N., Coppola, N., Sagnelli, C., De Pascalis, S., Stanzione, M., Stornaiuolo, G., Cascone, A., Martini, S., Macera, M., Monari, C., Calo, F., Bianco, A., Gentile, V., Camaioni, C., De Angelis, G., Marino, G., Astorri, R., De Sio, I., Niosi, M., Borrelli, S., Celia, B., Ceparano, M., Cirillo, S., De Luca, M., Mazzeo, G., Paoli, G., Russo, M. G., and Russo, A.
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medicine.medical_specialty ,Disease ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Article ,Pathogenesis ,03 medical and health sciences ,Anticoagulation ,0302 clinical medicine ,Internal medicine ,Pandemic ,medicine ,Humans ,Thrombophilia ,Endothelial dysfunction ,Intensive care medicine ,030304 developmental biology ,Coronavirus ,0303 health sciences ,Hematology ,business.industry ,SARS-CoV-2 ,Anticoagulants ,COVID-19 ,Thrombosis ,medicine.disease ,COVID-19 Drug Treatment ,Host-Pathogen Interactions ,business ,Cytokine storm ,Cardiology and Cardiovascular Medicine ,Algorithms - Abstract
The actual Coronavirus Disease (COVID 19) pandemic is due to Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the coronavirus family. Besides the respiratory involvement, COVID 19 patients frequently develop a pro-coagulative state caused by virus-induced endothelial dysfunction, cytokine storm and complement cascade hyperactivation. It is common to observe diffuse microvascular thrombi in multiple organs, mostly in pulmonary microvessels. Thrombotic risk seems to be directly related to disease severity and worsens patients’ prognosis. Therefore, the correct understanding of the mechanisms underlying COVID-19 induced prothrombotic state can lead to a thorough assessment of the possible management strategies. Hence, we review the pathogenesis and therapy of COVID 19-related thrombosis disease, focusing on the available evidence on the possible treatment strategies and proposing an algorithm for the anticoagulation strategy based on disease severity.
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- 2020
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24. A Focus on the Nowadays Potential Antiviral Strategies in Early Phase of Coronavirus Disease 2019 (Covid-19): A Narrative Review
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Caterina Monari, Valeria Gentile, Clarissa Camaioni, Giulia Marino, Nicola Coppola, Vanvitelli COVID-19 group, Monari, C., Gentile, V., Camaioni, C., Marino, G., and Coppola, N.
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0301 basic medicine ,Drug ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,media_common.quotation_subject ,MEDLINE ,Review ,Disease ,General Biochemistry, Genetics and Molecular Biology ,Scientific evidence ,law.invention ,early phase ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,current evidences ,Pandemic ,antiviral therapy ,Global health ,medicine ,Current recommendation ,030212 general & internal medicine ,Intensive care medicine ,lcsh:Science ,Ecology, Evolution, Behavior and Systematics ,current recommendations ,media_common ,business.industry ,Paleontology ,COVID-19 ,Current evidence ,030104 developmental biology ,Space and Planetary Science ,lcsh:Q ,business ,management - Abstract
Background: The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the related disease (COVID-19) has rapidly spread to a pandemic proportion, increasing the demands on health systems for the containment and management of COVID-19. Nowadays, one of the critical issues still to be pointed out regards COVID-19 treatment regimens and timing: which drug, in which phase, for how long? Methods: Our narrative review, developed using MEDLINE and EMBASE, summarizes the main evidences in favor or against the current proposed treatment regimens for COVID-19, with a particular focus on antiviral agents. Results: Although many agents have been proposed as possible treatment, to date, any of the potential drugs against SARS-CoV-2 has shown to be safe and effective for treating COVID-19. Despite the lack of definitive evidence, remdesivir remains the only antiviral with encouraging effects in hospitalized patients with COVID-19. Conclusions: In such a complex moment of global health emergency, it is hard to demand scientific evidence. Nevertheless, randomized clinical trials aiming to identify effective and safe drugs against SARS-CoV-2 infection are urgently needed in order to confirm or reject the currently available evidence.
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- 2020
25. Burden, risk assessment, surveillance and management of SARS-CoV-2 infection in health workers: A scoping review
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Clarissa Camaioni, Stefania De Pascalis, Nicola Coppola, Federica Calò, Antonio Russo, Calo, F., Russo, A., Camaioni, C., De Pascalis, S., and Coppola, N.
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0301 basic medicine ,Databases, Factual ,Scoping Review ,Post-Exposure Prophylaxi ,0302 clinical medicine ,Public health surveillance ,Risk Factors ,Health care ,Epidemiology ,Medicine ,Infection control ,Public Health Surveillance ,030212 general & internal medicine ,Disease management (health) ,Surveillance ,lcsh:Public aspects of medicine ,Disease Management ,General Medicine ,Hospitals ,Management ,Infectious Diseases ,Epidemiological Monitoring ,Coronavirus Infections ,Post-Exposure Prophylaxis ,Risk assessment ,Human ,medicine.medical_specialty ,Health worker ,Infectious Disease Transmission, Patient-to-Professional ,Health Personnel ,030106 microbiology ,Pneumonia, Viral ,Risk Assessment ,lcsh:Infectious and parasitic diseases ,Betacoronavirus ,03 medical and health sciences ,Hospital ,Humans ,lcsh:RC109-216 ,Intensive care medicine ,Pandemics ,Betacoronaviru ,Pandemic ,business.industry ,Coronavirus Infection ,SARS-CoV-2 ,Public health ,Risk Factor ,Public Health, Environmental and Occupational Health ,COVID-19 ,lcsh:RA1-1270 ,Healthcare worker ,business - Abstract
Background Health workers (HWs) are at increased risk for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection and a possible source of nosocomial transmission clusters. Despite the increased risk, the best surveillance strategy and management of exposed HWs are not yet well known. The aim of this review was to summarize and critically analyze the existing evidence related to this topic in order to support public health strategies aimed at protecting HWs in the hospital setting. Main text A comprehensive computerized literature research from 1 January 2020 up to 22 May 2020 was made to identify studies analyzing the burden of infection, risk assessment, surveillance and management of HWs exposed to SARS-CoV-2. Among 1623 citation identified using MEDLINE, Embase, Google Scholar and manual search, we included 43 studies, 14 webpages and 5 ongoing trials. Health workers have a high risk of acquiring infection while caring for coronavirus disease 2019 (COVID-19) patients. In particular, some types exposures and their duration, as well as the inadequate or non-use of personal protective equipment (PPE) are associated with increased infection risk. Strict infection prevention and control procedures (IPC), adequate training programs on the appropriate use of PPE and close monitoring of HWs with symptom surveillance and testing are essential to significantly reduce the risk. At the moment there is not enough evidence to provide precise indications regarding pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Conclusions During the spread of COVID-19 outbreak, numerous published papers investigated the epidemiology, risk assessment and prevention and control of SARS-CoV-2. However, more high-quality studies are needed to provide valid recommendations for better management and for the clinical and microbiological surveillance of healthcare personnel.
- Published
- 2020
26. Does COVID-19 Vaccination with BNT162b2 Influence HIV-Related Immunological and Virological Markers? Data from 235 Persons Living with HIV at Cotugno Hospital, Naples, Italy: Immune Response After Second and Third Doses, and Influence on Immunovirological Markers.
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Fusco FM, Carleo MA, Sangiovanni N, D'Abbraccio M, Tambaro O, Borrelli F, Viglietti R, Camaioni C, Bruner V, Falanga R, Pisapia R, Palmiero G, Rizzo V, Rosario P, Cuomo N, Spatarella M, Esposito V, and Sangiovanni V
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- Humans, BNT162 Vaccine, COVID-19 Vaccines, RNA, Viral, SARS-CoV-2, Italy epidemiology, Vaccination, Hospitals, Immunity, Antibodies, Viral, COVID-19 prevention & control, HIV Infections
- Abstract
Few data are available on the impact of COVID-19 vaccination on CD4 counts and HIV-RNA in persons living with HIV (PLWH). We present the data of 235 PLWH who were vaccinated with BNT162b2 in March 2021-February 2022 at the "Cotugno" hospital in Naples. PLWH treated at the "Cotugno" hospital, who were vaccinated at the hospital vaccination center, without prior COVID-19 and for whom immunological/virological data were available in the last 12 months and in the 6 months after vaccination were included. Antispike Ab were available for 187 and 64 PLWH after the second and third doses: PLWH with antispikes >33 binding antibodies units (BAU)/mL increased from 91% to 98%. Antinucleocapsid Ab performed in 147 and 56 patients identified 19 (13%) asymptomatic/paucisymptomatic COVID-19 infections after the second dose and an additional 15 (27%) after the third dose. Immunological/virological data were collected before vaccination (T0), after the second dose (T1), and after the third dose (T2). The absolute number of CD4 increased after the third dose (median 663, 657, and 707 at T0, T1, and T2; p < 0.000 T0 vs. T2). The proportion of patients with HIV-RNA <50 copies/mL increases significantly after the second dose (73%; 85.7%; 87.7%; p < 0.000 T0 vs. T2). The presence of COVID-19 asymptomatic/paucisymptomatic infections (demonstrated by the presence of antinucleocapsid Ab) significantly increases SARS-CoV-2 antispike Ab after second dose, but not after third dose. Asymptomatic/paucisymptomatic COVID-19 infections do not have influence on CD4 cell number and HIV-RNA level. Similarly, the presence of not-controlled HIV-RNA (HIV-RNA >50 copies/mL) does not influence antispike Ab response. According to our data, the response to SARS-CoV2 vaccination is effective in people living with HIV. Vaccination against COVID-19 appears to positively affect immunological and virological levels in people living with HIV.
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- 2023
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27. SARS-CoV-2 infection: a hurricane that does not ignore chronic hepatitis.
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Sagnelli C, Macera M, Camaioni C, Salvati A, Coppola N, and Sagnelli E
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- Humans, Pandemics prevention & control, SARS-CoV-2, COVID-19 epidemiology, Cyclonic Storms, Hepatitis B, Chronic complications, Hepatitis B, Chronic drug therapy, Hepatitis B, Chronic epidemiology
- Abstract
Background: The COVID-19 pandemic significantly compromised screening, laboratory controls, clinical surveillance and treatment of chronic hepatitis patients and worsened their outcome, as evidenced by its significant correlation with advanced cirrhosis, liver decompensation and mortality., Results: This pandemic significantly impaired also the sector of liver transplantation, whose wards, operating rooms, outpatients' facilities, and healthcare personnel have been dedicated to patients with COVID-19. In addition, screening and treatment for HBV infection have been delayed or suspended in in most countries, with an increased risk of viral reactivation. Similar delay or suspension have also occurred for universal hepatitis B vaccination programs in many countries. Likewise, COVID-19 pandemic has made unreachable the goal of elimination of HCV infection as a worldwide public-health issue predicted for 2030 by the WHO., Conclusion: This review article demonstrates how COVID-19 pandemic is causing serious damage to the sector of liver disease, which has quickly lost the beneficial effects of years of study, research, and clinical and technological application, as well as considerable financial investments., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
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- 2022
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28. Ante-mortem characterization of sudden deaths as first-manifestation in Italy.
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Frontera A, Anselmino M, Matta M, Baccelli A, Vlachos K, Bonsignore A, Camaioni C, Notarstefano P, Mahida S, Nesti M, Sacher F, Tunzi R, Landoni G, Aschieri D, Castelli V, Hocini M, Jaïs P, Gaita F, Derval N, and Haïssaguerre M
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- Adolescent, Adult, Autopsy, Child, Child, Preschool, Humans, Infant, Medical History Taking, Reproducibility of Results, Young Adult, Cardiomyopathy, Hypertrophic complications, Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac etiology
- Abstract
Purpose: There is a relative paucity of data on ante-mortem clinical characteristics of young (age 1 to 35 years) sudden death (SD) victims. The aim of the study was to characterize ante-mortem characteristics of SD victims, in a selected national cohort identified by a web search., Methods: A dataset of all SD (January 2010 and December 2015) was built from national forensic data and medical records, integrated with Google search model. Families were contacted to obtain consent for interviews. Data were obtained on ante-mortem symptoms. ECG characteristics and autopsy data were available., Results: Out of 301 SD cases collected, medical and family history was available in 132 (43.9%). Twenty-eight (21.1%) had a positive family history for SD. SD occurred during sport/effort in 76 (57.6%). One hundred twelve (85%) SD cases had no prior reported symptoms. Autopsy data were available in 100/132 (75.8%) cases: an extra cardiac cause was identified in 20 (20%). Among the 61 cases with a cardiac diagnosis, 21 (34%) had hypertrophic cardiomyopathy. Among the 19 (19%) victims without structural abnormalities, molecular autopsy identified pathogenic variants for channelopathies in 9 cases. Ten (10%) victims had no identifiable cause., Conclusions: Most SD were due to cardiac causes and occurred in previously asymptomatic patients. SD events mainly occurred during strenuous activity. In a minority of cases, no cause was identified. The web-based selection criteria, and incomplete data retrieval, need to be carefully taken into account for data interpretation and reproducibility., (© 2021. The Author(s).)
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- 2022
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29. Risk and Prevention of Hepatitis B Virus Reactivation during Immunosuppression for Non-Oncological Diseases.
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Onorato L, Pisaturo M, Camaioni C, Grimaldi P, Codella AV, Calò F, and Coppola N
- Abstract
Reactivation of overt or occult HBV infection (HBVr) is a well-known, potentially life-threatening event which can occur during the course of immunosuppressive treatments. Although it has been described mainly in subjects receiving therapy for oncological or hematological diseases, the increasing use of immunosuppressant agents in non-oncological patients observed in recent years has raised concerns about the risk of reactivation in several other settings. However, few data can be found in the literature on the occurrence of HBVr in these populations, and few clear recommendations on its management have been defined. The present paper was written to provide an overview of the risk of HBV reactivation in non-neoplastic patients treated with immunosuppressive drugs, particularly for rheumatological, gastrointestinal, dermatological and neurological diseases, and for COVID-19 patients receiving immunomodulating agents; and to discuss the potential strategies for prevention and treatment of HBVr in these settings.
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- 2021
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30. Left atrial shape is independent predictor of arrhythmia recurrence after catheter ablation for atrial fibrillation: A shape statistics study.
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Jia S, Nivet H, Harrison J, Pennec X, Camaioni C, Jaïs P, Cochet H, and Sermesant M
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Background: Markers of left atrial (LA) shape may improve the prediction of postablation outcomes in atrial fibrillation (AF). Correlations to LA volume and AF persistence limit their incremental value over current clinical predictors., Objective: To develop a shape score independent from AF persistence and LA volume using shape-based statistics, and to test its ability to predict postablation outcome., Methods: Preablation computed tomography (CT) images from 141 patients with paroxysmal (57%) or persistent (43%) AF were segmented. Deformation of an average LA shape into each patient encoded patient-specific shape. Local analysis investigates regional differences between patient groups. Linear regression was used to remove shape variations related to LA volume and AF persistence, and to build a shape score to predict postablation outcome. Cross-validation was performed to evaluate its accuracy., Results: Ablation failure rate was 23% over a median 12-month follow-up. Regions associated with ablation failure mostly consisted of a large area on posteroinferior LA, mitral isthmus, and left inferior vein. On univariate analysis, strongest predictors were AF persistence ( P = .005), LA indexed volume ( P = .02), and the proposed shape score ( P = .001). On multivariate analysis, all 3 were independent predictors of ablation failure, with the LA shape score showing the highest predictive value (odds ratio [OR] = 6.2 [2.5-15.8], P < .001), followed by LA indexed volume (OR = 3.1 [1.2-7.9], P = .019) and AF persistence (OR = 2.9 [1.2-7.6], P = .022)., Conclusion: Posteroinferior LA, mitral isthmus, and left inferior vein are the regions whose shape have the highest impact on outcome. LA shape predicts AF ablation failure independently from, and more accurately than, atrial volume and AF persistence., (© 2021 Heart Rhythm Society. Published by Elsevier Inc.)
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- 2021
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31. Maximal Wall Thickness Measurement in Hypertrophic Cardiomyopathy: Biomarker Variability and its Impact on Clinical Care.
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Captur G, Manisty CH, Raman B, Marchi A, Wong TC, Ariga R, Bhuva A, Ormondroyd E, Lobascio I, Camaioni C, Loizos S, Bonsu-Ofori J, Turer A, Zaha VG, Augutsto JB, Davies RH, Taylor AJ, Nasis A, Al-Mallah MH, Valentin S, Perez de Arenaza D, Patel V, Westwood M, Petersen SE, Li C, Tang L, Nakamori S, Nezafat R, Kwong RY, Ho CY, Fraser AG, Watkins H, Elliott PM, Neubauer S, Lloyd G, Olivotto I, Nihoyannopoulos P, and Moon JC
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- Biomarkers, Death, Sudden, Cardiac, Echocardiography, Humans, Predictive Value of Tests, Risk Assessment, Cardiomyopathy, Hypertrophic diagnostic imaging, Cardiomyopathy, Hypertrophic therapy, Defibrillators, Implantable
- Abstract
Objectives: The aim of this study was to define the variability of maximal wall thickness (MWT) measurements across modalities and predict its impact on care in patients with hypertrophic cardiomyopathy (HCM)., Background: Left ventricular MWT measured by echocardiography or cardiovascular magnetic resonance (CMR) contributes to the diagnosis of HCM, stratifies risk, and guides key decisions, including whether to place an implantable cardioverter-defibrillator (ICD)., Methods: A 20-center global network provided paired echocardiographic and CMR data sets from patients with HCM, from which 17 paired data sets of the highest quality were selected. These were presented as 7 randomly ordered pairs (at 6 cardiac conferences) to experienced readers who report HCM imaging in their daily practice, and their MWT caliper measurements were captured. The impact of measurement variability on ICD insertion decisions was estimated in 769 separately recruited multicenter patients with HCM using the European Society of Cardiology algorithm for 5-year risk for sudden cardiac death., Results: MWT analysis was completed by 70 readers (from 6 continents; 91% with >5 years' experience). Seventy-nine percent and 68% scored echocardiographic and CMR image quality as excellent. For both modalities (echocardiographic and then CMR results), intramodality inter-reader MWT percentage variability was large (range -59% to 117% [SD ±20%] and -61% to 52% [SD ±11%], respectively). Agreement between modalities was low (SE of measurement 4.8 mm; 95% CI 4.3 mm-5.2 mm; r = 0.56 [modest correlation]). In the multicenter HCM cohort, this estimated echocardiographic MWT percentage variability (±20%) applied to the European Society of Cardiology algorithm reclassified risk in 19.5% of patients, which would have led to inappropriate ICD decision making in 1 in 7 patients with HCM (8.7% would have had ICD placement recommended despite potential low risk, and 6.8% would not have had ICD placement recommended despite intermediate or high risk)., Conclusions: Using the best available images and experienced readers, MWT as a biomarker in HCM has a high degree of inter-reader variability and should be applied with caution as part of decision making for ICD insertion. Better standardization efforts in HCM recommendations by current governing societies are needed to improve clinical decision making in patients with HCM., Competing Interests: Funding Support and Author Disclosures This program was funded by Barts Charity grant 1107/2356/MRC0140 to Dr Captur. Dr Captur is supported by British Heart Foundation Special Programme Grant MyoFit46 (SP/20/2/34841), the National Institute for Health Research (NIHR) Rare Diseases Translational Research Collaboration, and the NIHR UCL Hospitals Biomedical Research Center. Dr Petersen has received support from the Barts Biomedical Research Centre, funded by the NIHR. Dr Moon is directly and indirectly supported by the UCL Hospitals NIHR BRC and Biomedical Research Unit at Barts Hospital, respectively. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
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- 2021
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32. Myocardial Perfusion Defects in Hypertrophic Cardiomyopathy Mutation Carriers.
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Hughes RK, Camaioni C, Augusto JB, Knott K, Quinn E, Captur G, Seraphim A, Joy G, Syrris P, Elliott PM, Mohiddin S, Kellman P, Xue H, Lopes LR, and Moon JC
- Subjects
- Adult, Coronary Circulation physiology, Electrocardiography methods, Female, Genetic Testing methods, Heart Ventricles diagnostic imaging, Heterozygote, Humans, Magnetic Resonance Angiography methods, Male, Microcirculation, Mutation, Sarcomeres genetics, Sarcomeres pathology, Cardiac Myosins genetics, Cardiomyopathy, Hypertrophic, Familial diagnostic imaging, Cardiomyopathy, Hypertrophic, Familial genetics, Cardiomyopathy, Hypertrophic, Familial physiopathology, Hypertrophy, Left Ventricular diagnosis, Hypertrophy, Left Ventricular etiology, Magnetic Resonance Imaging, Cine methods, Myocardial Perfusion Imaging methods
- Abstract
Background Impaired myocardial blood flow (MBF) in the absence of epicardial coronary disease is a feature of hypertrophic cardiomyopathy (HCM). Although most evident in hypertrophied or scarred segments, reduced MBF can occur in apparently normal segments. We hypothesized that impaired MBF and myocardial perfusion reserve, quantified using perfusion mapping cardiac magnetic resonance, might occur in the absence of overt left ventricular hypertrophy (LVH) and late gadolinium enhancement, in mutation carriers without LVH criteria for HCM (genotype-positive, left ventricular hypertrophy-negative). Methods and Results A single center, case-control study investigated MBF and myocardial perfusion reserve (the ratio of MBF at stress:rest), along with other pre-phenotypic features of HCM. Individuals with genotype-positive, left ventricular hypertrophy-negative (n=50) with likely pathogenic/pathogenic variants and no evidence of LVH, and matched controls (n=28) underwent cardiac magnetic resonance. Cardiac magnetic resonance identified LVH-fulfilling criteria for HCM in 5 patients who were excluded. Individuals with genotype-positive, left ventricular hypertrophy-negative had longer indexed anterior mitral valve leaflet length (12.52±2.1 versus 11.55±1.6 mm/m
2 , P =0.03), lower left ventricular end-systolic volume (21.0±6.9 versus 26.7±6.2 mm/m2 , P ≤0.005) and higher left ventricular ejection fraction (71.9±5.5 versus 65.8±4.4%, P≤ 0.005). Maximum wall thickness was not significantly different (9.03±1.95 versus 8.37±1.2 mm, P =0.075), and no subject had significant late gadolinium enhancement (minor right ventricle‒insertion point late gadolinium enhancement only). Perfusion mapping demonstrated visual perfusion defects in 9 (20%) carriers versus 0 controls ( P =0.011). These were almost all septal or near right ventricle insertion points. Globally, myocardial perfusion reserve was lower in carriers (2.77±0.83 versus 3.24±0.63, P =0.009), with a subendocardial:subepicardial myocardial perfusion reserve gradient (2.55±0.75 versus 3.2±0.65, P =<0.005; 3.01±0.96 versus 3.47±0.75, P =0.026) but equivalent MBF (2.75±0.82 versus 2.65±0.69 mL/g per min, P =0.826). Conclusions Regional and global impaired myocardial perfusion can occur in HCM mutation carriers, in the absence of significant hypertrophy or scarring.- Published
- 2021
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33. Dementia as Risk Factor for Severe Coronavirus Disease 2019: A Case-Control Study.
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Pisaturo M, Calò F, Russo A, Camaioni C, Giaccone A, Pinchera B, Gentile I, Simeone F, Iodice A, Maggi P, and Coppola N
- Abstract
Background: The aim of the present study was to investigate the outcome of patients with SARS-CoV-2 infection and dementia., Patients and Methods: In a multicenter, observational, 1:2 matched case-control study all 23 patients with a history of dementia, hospitalized with a diagnosis of SARS-CoV-2 infection from February 28th 2020 to January 31st 2021 were enrolled. For each Case, 2 patients without dementia observed in the same period study, pair matched for gender, age (±5 years), PaO
2 /FiO2 (P/F) ratio at admission (<200, or >200), number of comorbidities (±1; excluding dementia) were chosen (Control group)., Results: The majority of patients were males (60.9% of Cases and Controls) and very elderly [median age 82 years (IQR: 75.5-85) in the Cases and 80 (IQR: 75.5-83.75) in the Controls]. The prevalence of co-pathologies was very high: all the Cases and 43 (93.5%) Controls showed a Charlson comorbidity index of at least 2. During hospitalization the patients in the Case group less frequently had a moderate disease of COVID-19 (35 vs. 67.4%, p = 0.02), more frequently a severe disease (48 vs. 22%, p = 0.03) and more frequently died (48 vs. 22%, p = 0.03). Moreover, during coronavirus disease 2019 (COVID-19), 14 (60.8%) patients in the Case group and 1 (2.1%; p < 0.000) in the Control group showed signs and symptoms of delirium., Conclusion: Patients with dementia are vulnerable and have an increased risk of a severe disease and death when infected with COVID-19., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Pisaturo, Calò, Russo, Camaioni, Giaccone, Pinchera, Gentile, Simeone, Iodice, Maggi and Coppola.)- Published
- 2021
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34. More Severe COVID-19 in Patients With Active Cancer: Results of a Multicenter Cohort Study.
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Monari C, Sagnelli C, Maggi P, Sangiovanni V, Numis FG, Gentile I, Masullo A, Rescigno C, Calabria G, Megna AS, Gambardella M, Manzillo E, Russo G, Esposito V, Camaioni C, Messina V, Pisaturo M, Allegorico E, Pinchera B, Pisapia R, Catalano M, Salzillo A, Porta G, Signoriello G, and Coppola N
- Abstract
Background: The aim of the study was to compare coronavirus disease 2019 (COVID-19) severity presentation between oncologic and non-oncologic patients and to evaluate the impact of cancer type and stage on COVID-19 course., Methods: We performed a multicentre, retrospective study involving 13 COVID-19 Units in Campania region from February to May 2020. We defined as severe COVID-19 presentation the cases that required mechanical ventilation and/or admission to Intensive Care Units (ICU) and/or in case of death., Results: We enrolled 371 COVID-19 patients, of whom 34 (9.2%) had a history or a diagnosis of cancer (24 solid, 6 onco-hematological). Oncologic patients were older (p<0.001), had more comorbidities (p<0.001) and showed a higher rate of severe COVID-19 presentation (p=0.001) and of death (p<0.001). Compared to 12 patients with non-active cancer and to 337 without cancer, the 17 patients with active cancer had more comorbidities and showed a higher rate of severe COVID-19 and of mortality (all p values <0.001). Compared to the 281 non-severe patients, the 90 subjects with a severe presentation of COVID-19 were older (p<0.01), with more comorbidities (p<0.001) and with a higher rate of cancer (p=0.001). At multivariate analysis, age (OR 1.08, 95% CI: 1.04-1.11) and suffering from cancer in an active stage (OR 5.33, 95% CI: 1.77-16.53) were independently associated with severe COVID-19., Conclusions: Since the higher risk of severe evolution of COVID-19, cancer patients, especially those with an active malignancy, should be candidates for early evaluation of symptoms and early treatment for COVID-19., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Monari, Sagnelli, Maggi, Sangiovanni, Numis, Gentile, Masullo, Rescigno, Calabria, Megna, Gambardella, Manzillo, Russo, Esposito, Camaioni, Messina, Pisaturo, Allegorico, Pinchera, Pisapia, Catalano, Salzillo, Porta, Signoriello and Coppola.)
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- 2021
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35. Impact of DAA-Based Regimens on HCV-Related Extra-Hepatic Damage: A Narrative Review.
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Sagnelli E, Sagnelli C, Russo A, Pisaturo M, Camaioni C, Astorri R, and Coppola N
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- Antiviral Agents therapeutic use, Hepacivirus genetics, Humans, Cryoglobulinemia drug therapy, Hepatitis C complications, Hepatitis C drug therapy, Hepatitis C, Chronic drug therapy
- Abstract
Two-third of patients with chronic hepatitis C show extrahepatic manifestations due to HCV infection of B lymphocytes, such as mixed cryoglobulinemia and non-Hodgkin B-cell lymphoma, or develop a chronic inflammatory status that may favor the development of adverse cardiovascular events, kidney diseases or metabolic abnormalities.DAAs treatments induce HCV eradication in 95% of treated patients, which also improves the clinical course of extrahepatic manifestations, but with some limitations. After HCV eradication a good compensation of T2DM has been observed, but doubts persist about the possibility of obtaining a stable reduction in fasting glucose and HbA1c levels.Chronic HCV infection is associated with low total and LDL cholesterol serum levels, which however increase significantly after HCV elimination, possibly due to the disruption of HCV/lipid metabolism interaction. Despite this adverse effect, HCV eradication exerts a favorable action on cardiovascular system, possibly by eliminating numerous other harmful effects exerted by HCV on this system.DAA treatment is also indicated for the treatment of patients with mixed cryoglobulinemia syndrome, since HCV eradication results in symptom reduction and, in particular, is effective in cryoglobulinemic vasculitis. Furthermore, HCV eradication exerts a favorable action on HCV-related lymphoproliferative disorders, with frequent remission or reduction of clinical manifestations.There is also evidence that HCV clearance may improve impaired renal functions, but same conflicting data persist on the effect of some DAAs on eGFR.
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- 2021
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36. Burden, risk assessment, surveillance and management of SARS-CoV-2 infection in health workers: a scoping review.
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Calò F, Russo A, Camaioni C, De Pascalis S, and Coppola N
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- Betacoronavirus isolation & purification, COVID-19, Coronavirus Infections epidemiology, Coronavirus Infections transmission, Databases, Factual, Disease Management, Epidemiological Monitoring, Hospitals, Humans, Infectious Disease Transmission, Patient-to-Professional, Pandemics, Pneumonia, Viral epidemiology, Pneumonia, Viral transmission, Post-Exposure Prophylaxis, Public Health Surveillance, Risk Assessment methods, Risk Factors, SARS-CoV-2, Coronavirus Infections diagnosis, Coronavirus Infections therapy, Health Personnel statistics & numerical data, Pneumonia, Viral diagnosis, Pneumonia, Viral therapy
- Abstract
Background: Health workers (HWs) are at increased risk for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection and a possible source of nosocomial transmission clusters. Despite the increased risk, the best surveillance strategy and management of exposed HWs are not yet well known. The aim of this review was to summarize and critically analyze the existing evidence related to this topic in order to support public health strategies aimed at protecting HWs in the hospital setting., Main Text: A comprehensive computerized literature research from 1 January 2020 up to 22 May 2020 was made to identify studies analyzing the burden of infection, risk assessment, surveillance and management of HWs exposed to SARS-CoV-2. Among 1623 citation identified using MEDLINE, Embase, Google Scholar and manual search, we included 43 studies, 14 webpages and 5 ongoing trials. Health workers have a high risk of acquiring infection while caring for coronavirus disease 2019 (COVID-19) patients. In particular, some types exposures and their duration, as well as the inadequate or non-use of personal protective equipment (PPE) are associated with increased infection risk. Strict infection prevention and control procedures (IPC), adequate training programs on the appropriate use of PPE and close monitoring of HWs with symptom surveillance and testing are essential to significantly reduce the risk. At the moment there is not enough evidence to provide precise indications regarding pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP)., Conclusions: During the spread of COVID-19 outbreak, numerous published papers investigated the epidemiology, risk assessment and prevention and control of SARS-CoV-2. However, more high-quality studies are needed to provide valid recommendations for better management and for the clinical and microbiological surveillance of healthcare personnel.
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- 2020
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37. A Focus on the Nowadays Potential Antiviral Strategies in Early Phase of Coronavirus Disease 2019 (Covid-19): A Narrative Review.
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Monari C, Gentile V, Camaioni C, Marino G, Coppola N, and Vanvitelli Covid-Group
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Background : The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the related disease (COVID-19) has rapidly spread to a pandemic proportion, increasing the demands on health systems for the containment and management of COVID-19. Nowadays, one of the critical issues still to be pointed out regards COVID-19 treatment regimens and timing: which drug, in which phase, for how long? Methods : Our narrative review, developed using MEDLINE and EMBASE, summarizes the main evidences in favor or against the current proposed treatment regimens for COVID-19, with a particular focus on antiviral agents. Results: Although many agents have been proposed as possible treatment, to date, any of the potential drugs against SARS-CoV-2 has shown to be safe and effective for treating COVID-19. Despite the lack of definitive evidence, remdesivir remains the only antiviral with encouraging effects in hospitalized patients with COVID-19. Conclusions : In such a complex moment of global health emergency, it is hard to demand scientific evidence. Nevertheless, randomized clinical trials aiming to identify effective and safe drugs against SARS-CoV-2 infection are urgently needed in order to confirm or reject the currently available evidence.
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- 2020
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38. Inline perfusion mapping provides insights into the disease mechanism in hypertrophic cardiomyopathy.
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Camaioni C, Knott KD, Augusto JB, Seraphim A, Rosmini S, Ricci F, Boubertakh R, Xue H, Hughes R, Captur G, Lopes LR, Brown LAE, Manisty C, Petersen SE, Plein S, Kellman P, Mohiddin SA, and Moon JC
- Subjects
- Cardiomyopathy, Hypertrophic physiopathology, Coronary Vessels diagnostic imaging, Coronary Vessels physiopathology, Female, Follow-Up Studies, Humans, Image Interpretation, Computer-Assisted, Male, Middle Aged, Retrospective Studies, Cardiomyopathy, Hypertrophic diagnosis, Coronary Circulation physiology, Magnetic Resonance Imaging, Cine methods, Microcirculation physiology, Myocardial Perfusion Imaging methods
- Abstract
Objective: In patients with hypertrophic cardiomyopathy (HCM), the role of small vessel disease and myocardial perfusion remains incompletely understood and data on absolute myocardial blood flow (MBF, mL/g/min) are scarce. We measured MBF using cardiovascular magnetic resonance fully quantitative perfusion mapping to determine the relationship between perfusion, hypertrophy and late gadolinium enhancement (LGE) in HCM., Methods: 101 patients with HCM with unobstructed epicardial coronary arteries and 30 controls (with matched cardiovascular risk factors) underwent pixel-wise perfusion mapping during adenosine stress and rest. Stress, rest MBF and the myocardial perfusion reserve (MPR, ratio of stress to rest) were calculated globally and segmentally and then associated with segmental wall thickness and LGE., Results: In HCM, 79% had a perfusion defect on clinical read. Stress MBF and MPR were reduced compared with controls (mean±SD 1.63±0.60 vs 2.30±0.64 mL/g/min, p<0.0001 and 2.21±0.87 vs 2.90±0.90, p=0.0003, respectively). Globally, stress MBF fell with increasing indexed left ventricle mass (R
2 for the model 0.186, p=0.036) and segmentally with increasing wall thickness and LGE (both p<0.0001). In 21% of patients with HCM, MBF was lower during stress than rest (MPR <1) in at least one myocardial segment, a phenomenon which was predominantly subendocardial. Apparently normal HCM segments (normal wall thickness, no LGE) had reduced stress MBF and MPR compared with controls (mean±SD 1.88±0.81 mL/g/min vs 2.32±0.78 mL/g/min, p<0.0001)., Conclusions: Microvascular dysfunction is common in HCM and associated with hypertrophy and LGE. Perfusion can fall during vasodilator stress and is abnormal even in apparently normal myocardium suggesting it may be an early disease marker., Competing Interests: Competing interests: SEP provides consultancy to Circle Cardiovascular Imaging (Calgary, Alberta, Canada)., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)- Published
- 2020
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39. Pulmonary blood volume index as a quantitative biomarker of haemodynamic congestion in hypertrophic cardiomyopathy.
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Ricci F, Aung N, Thomson R, Boubertakh R, Camaioni C, Doimo S, Sanghvi MM, Fung K, Khanji MY, Lee A, Malcolmson J, Mantini C, Paiva J, Gallina S, Fedorowski A, Mohiddin SA, Aquaro GD, and Petersen SE
- Subjects
- Aged, Biomarkers, Blood Volume, Female, Hemodynamics, Humans, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Retrospective Studies, Cardiomyopathy, Hypertrophic diagnostic imaging
- Abstract
Aims: The non-invasive assessment of left ventricular (LV) diastolic function and filling pressure in hypertrophic cardiomyopathy (HCM) is still an open issue. Pulmonary blood volume index (PBVI) by cardiovascular magnetic resonance (CMR) has been proposed as a quantitative biomarker of haemodynamic congestion. We aimed to assess the diagnostic accuracy of PBVI for left atrial pressure (LAP) estimation in patients with HCM., Methods and Results: We retrospectively identified 69 consecutive HCM outpatients (age 58 ± 11 years; 83% men) who underwent both transthoracic echocardiography (TTE) and CMR. Guideline-based detection of LV diastolic dysfunction was assessed by TTE, blinded to CMR results. PBVI was calculated as the product of right ventricular stroke volume index and the number of cardiac cycles for a bolus of gadolinium to pass through the pulmonary circulation as assessed by first-pass perfusion imaging. Compared to patients with normal LAP, patients with increased LAP showed significantly larger PBVI (463 ± 127 vs. 310 ± 86 mL/m2, P < 0.001). PBVI increased progressively with worsening New York Heart Association functional class and echocardiographic stages of diastolic dysfunction (P < 0.001 for both). At the best cut-off point of 413 mL/m2, PBVI yielded good diagnostic accuracy for the diagnosis of LV diastolic dysfunction with increased LAP [C-statistic = 0.83; 95% confidence interval (CI): 0.73-0.94]. At multivariable logistic regression analysis, PBVI was an independent predictor of increased LAP (odds ratio per 10% increase: 1.97, 95% CI: 1.06-3.68; P = 0.03)., Conclusion: PBVI is a promising CMR application for assessment of diastolic function and LAP in patients with HCM and may serve as a quantitative marker for detection, grading, and monitoring of haemodynamic congestion., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2019
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40. Quantitative myocardial perfusion in coronary artery disease: A perfusion mapping study.
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Knott KD, Camaioni C, Ramasamy A, Augusto JA, Bhuva AN, Xue H, Manisty C, Hughes RK, Brown LAE, Amersey R, Bourantas C, Kellman P, Plein S, and Moon JC
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- Adult, Contrast Media, Coronary Vessels diagnostic imaging, Female, Gadolinium, Humans, Image Enhancement methods, Male, Middle Aged, Prospective Studies, Sensitivity and Specificity, Coronary Artery Disease diagnostic imaging, Image Interpretation, Computer-Assisted methods, Magnetic Resonance Imaging methods
- Abstract
Background: Cardiac MR stress perfusion remains a qualitative technique in clinical practice due to technical and postprocessing challenges. However, automated inline perfusion mapping now permits myocardial blood flow (MBF, ml/g/min) quantification on-the-fly without user input., Purpose: To investigate the diagnostic performance of this novel technique in detecting occlusive coronary artery disease (CAD) in patients scheduled to undergo coronary angiography., Study Type: Prospective, observational., Subjects: Fifty patients with suspected CAD and 24 healthy volunteers., Field Strength: 1.5T. SEQUENCE: "Dual" sequence multislice 2D saturation recovery., Assessment: All patients underwent cardiac MR with perfusion mapping and invasive coronary angiography; the healthy volunteers had MR with perfusion mapping alone., Statistical Tests: Comparison between numerical variables was performed using an independent t-test. Receiver operator characteristic (ROC) curves were generated for transmyocardial, endocardial stress MBF, and myocardial perfusion reserve (MPR, the stress:rest MBF ratio) to diagnose severe (>70%) stenoses as measured by 3D quantitative coronary angiography (QCA). ROC curves were compared by the method of DeLong et al. RESULTS: Compared with volunteers, patients had lower stress MBF and MPR even in vessels with <50% stenosis (2.00 vs. 3.08 ml/g/min, respectively). As stenosis severity increased (<50%, 50-70%, >70%), MBF and MPR decreased. To diagnose occlusive (>70%) CAD, endocardial and transmyocardial stress MBF were superior to MPR (area under the curve 0.92 [95% CI 0.86-0.97] vs. 0.90 [95% CI 0.84-0.95] and 0.80 [95% CI 0.72-0.87], respectively). An endocardial threshold of 1.31 ml/g/min provided a per-coronary artery sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 90%, 82%, 50%, and 98%, with a per-patient diagnostic performance of 100%, 66%, 57%, and 100%, respectively., Data Conclusion: Perfusion mapping can diagnose occlusive CAD with high accuracy and, in particular, high sensitivity and NPV make it a potential "rule-out" test., Level of Evidence: 1 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:756-762., (© 2019 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)
- Published
- 2019
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41. Quantitative Myocardial Perfusion in Fabry Disease.
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Knott KD, Augusto JB, Nordin S, Kozor R, Camaioni C, Xue H, Hughes RK, Manisty C, Brown LAE, Kellman P, Ramaswami U, Hughes D, Plein S, and Moon JC
- Subjects
- Adult, Fabry Disease physiopathology, Female, Humans, Male, Middle Aged, Prospective Studies, Ventricular Dysfunction, Left physiopathology, Fabry Disease complications, Heart diagnostic imaging, Heart physiopathology, Multiparametric Magnetic Resonance Imaging methods, Ventricular Dysfunction, Left complications, Ventricular Dysfunction, Left diagnostic imaging
- Abstract
Background: Fabry disease (FD) is an X-linked lysosomal storage disease resulting in tissue accumulation of sphingolipids. Key myocardial processes that lead to adverse outcomes in FD include storage, hypertrophy, inflammation, and fibrosis. These are quantifiable by multiparametric cardiovascular magnetic resonance. Recent developments in cardiovascular magnetic resonance perfusion mapping allow rapid in-line perfusion quantification permitting broader clinical application, including the assessment of microvascular dysfunction. We hypothesized that microvascular dysfunction in FD would be associated with storage, fibrosis, and edema., Methods: A prospective, observational study of 44 FD patients (49 years, 43% male, 24 [55%] with left ventricular hypertrophy [LVH]) and 27 healthy controls with multiparametric cardiovascular magnetic resonance including vasodilator stress perfusion mapping. Myocardial blood flow (MBF) was measured and its associations with other processes investigated., Results: Compared with LVH- FD, LVH+ FD had higher left ventricular ejection fraction (73% versus 68%), more late gadolinium enhancement (85% versus 15%), and a lower stress MBF (1.76 versus 2.36 mL/g per minute). The reduction in stress MBF was more pronounced in the subendocardium than subepicardium. LVH- FD had lower stress MBF than controls (2.36 versus 3.00 mL/g per minute; P=0.002). Across all FD, late gadolinium enhancement and low native T1 were independently associated with reduced stress MBF. On a per-segment basis, stress MBF was independently associated with wall thickness, T2, extracellular volume fraction, and late gadolinium enhancement., Conclusions: FD patients have reduced perfusion, particularly in the subendocardium with greater reductions with LVH, storage, edema, and scar. Perfusion is reduced even without LVH suggesting it is an early disease marker.
- Published
- 2019
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42. Two-Minute k-Space and Time-accelerated Aortic Four-dimensional Flow MRI: Dual-Center Study of Feasibility and Impact on Velocity and Wall Shear Stress Quantification.
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Bollache E, Knott KD, Jarvis K, Boubertakh R, Dolan RS, Camaioni C, Collins L, Scully P, Rabin S, Treibel T, Carr JC, van Ooij P, Collins JD, Geiger J, Moon JC, Barker AJ, Petersen SE, and Markl M
- Abstract
Purpose: To investigate the two-center feasibility of highly k-space and time (k-t)-accelerated 2-minute aortic four-dimensional (4D) flow MRI and to evaluate its performance for the quantification of velocities and wall shear stress (WSS)., Materials and Methods: This cross-sectional study prospectively included 68 participants (center 1, 11 healthy volunteers [mean age ± standard deviation, 61 years ± 15] and 16 patients with aortic disease [mean age, 60 years ± 10]; center 2, 14 healthy volunteers [mean age, 38 years ± 13] and 27 patients with aortic or cardiac disease [mean age, 78 years ± 18]). Each participant underwent highly accelerated 4D flow MRI (k-t acceleration, acceleration factor of 5) of the thoracic aorta. For comparison, conventional 4D flow MRI (acceleration factor of 2) was acquired in the participants at center 1 ( n = 27). Regional aortic peak systolic velocities and three-dimensional WSS were quantified., Results: k-t-accelerated scan times (center 1, 2:03 minutes ± 0:29; center 2, 2:06 minutes ± 0:20) were significantly reduced compared with conventional 4D flow MRI (center 1, 12:38 minutes ± 2:25; P < .0001). Overall good agreement was found between the two techniques (absolute differences ≤15%), but proximal aortic WSS was significantly underestimated in patients by using k-t-accelerated 4D flow when compared with conventional 4D flow ( P ≤ .03). k-t-accelerated 4D flow MRI was reproducible (intra- and interobserver intraclass correlation coefficient ≥0.98) and identified significantly increased peak velocities and WSS in patients with stenotic ( P ≤ .003) or bicuspid ( P ≤ .04) aortic valves compared with healthy volunteers. In addition, k-t-accelerated 4D flow MRI-derived velocities and WSS were inversely related to age ( r ≥-0.53; P ≤ .03) over all healthy volunteers., Conclusion: k-t-accelerated aortic 4D flow MRI providing 2-minute scan times was feasible and reproducible at two centers. Although consistent healthy aging- and disease-related changes in aortic hemodynamics were observed, care should be taken when considering WSS, which can be underestimated in patients.© RSNA, 2019See also the commentary by François in this issue., (2019 by the Radiological Society of North America, Inc.)
- Published
- 2019
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43. Relationship between atrial scar on cardiac magnetic resonance and pulmonary vein reconnection after catheter ablation for paroxysmal atrial fibrillation.
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Jefairi NA, Camaioni C, Sridi S, Cheniti G, Takigawa M, Nivet H, Denis A, Derval N, Mathilde Merle, Laurent F, Montaudon M, Sacher F, Hocini M, Haissaguerre M, Jais P, and Cochet H
- Subjects
- Action Potentials, Aged, Atrial Fibrillation diagnosis, Atrial Fibrillation physiopathology, Electrophysiologic Techniques, Cardiac, Female, Fibrosis, Heart Atria physiopathology, Heart Rate, Humans, Male, Middle Aged, Operative Time, Predictive Value of Tests, Prospective Studies, Pulmonary Veins physiopathology, Recurrence, Risk Factors, Time Factors, Treatment Outcome, Atrial Fibrillation surgery, Atrial Remodeling, Catheter Ablation adverse effects, Heart Atria diagnostic imaging, Magnetic Resonance Imaging, Cine, Pulmonary Veins surgery
- Abstract
Introduction: Pulmonary vein (PV) reconnection is frequent in patients showing atrial fibrillation (AF) recurrence after PV isolation (PVI). Its detection with cardiac magnetic resonance (CMR) may help predict outcome and guide redo procedures. We assessed the relationship between scar on CMR and PV reconnection after catheter ablation for paroxysmal AF., Methods and Results: Fifty-one patients with paroxysmal AF underwent CMR before PVI using either a conventional single-electrode catheter (N = 28) or a circular multielectrode catheter (N = 23). At 3 months, a second CMR study was performed, followed by a systematic electrophysiological procedure to look for PV reconnection, regardless of AF recurrence. Preablation fibrosis and postablation scar were quantified and mapped from late gadolinium-enhanced CMR. CMR results were compared to the distribution and extent of PV reconnection. CMR and electrophysiological findings were compared between catheter types. Three months after successful PVI, scar gaps were found in 39 (76%) patients, and 78 (39%) veins. Electrical PV reconnection was detected in 45 (88%) patients, and 99 (50%) veins. The extent of PV reconnection related closely to the number of gaps (R = 0.55; P < .001), and to scar burden (R = -0.63; P < .001). However, the agreement was only fair for the localization of PV reconnection (k = 0.37; P < .001), scar gaps particularly lacking sensitivity in areas of pre-existing fibrosis. The circular catheter was associated with shorter procedures (P < .001), more scar (P = .01), less gaps (P = .01), and less reconnected veins (P = .03)., Conclusion: PV reconnection is extremely frequent after PVI. CMR scar imaging accurately predicts its extent, but poorly predicts its location. Multielectrode circular catheters induce more complete ablation., (© 2019 Wiley Periodicals, Inc.)
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- 2019
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44. Left atrial appendage patency and device-related thrombus after percutaneous left atrial appendage occlusion: a computed tomography study.
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Cochet H, Iriart X, Sridi S, Camaioni C, Corneloup O, Montaudon M, Laurent F, Selmi W, Renou P, Jalal Z, and Thambo JB
- Subjects
- Aged, Aged, 80 and over, Anastomotic Leak diagnostic imaging, Atrial Appendage pathology, Cohort Studies, Echocardiography methods, Female, Follow-Up Studies, Humans, Ischemic Attack, Transient diagnostic imaging, Ischemic Attack, Transient therapy, Male, Prosthesis Failure, Retrospective Studies, Treatment Outcome, Anastomotic Leak therapy, Atrial Appendage diagnostic imaging, Cardiac Catheterization methods, Ischemic Attack, Transient etiology, Septal Occluder Device adverse effects, Tomography, X-Ray Computed methods
- Abstract
Aims: Transoesophageal echocardiography studies have reported frequent peri-device leaks and device-related thrombi (DRT) after percutaneous left atrial appendage (LAA) occlusion. We assessed the prevalence, characteristics and correlates of leaks and DRT on cardiac computed tomography (CT) after LAA occlusion., Methods and Results: Consecutive patients underwent cardiac CT before LAA occlusion to assess left atrial (LA) volume, LAA shape, and landing zone diameter. Follow-up CT was performed after >3 months to assess device implantation criteria, device leaks and DRT. CT findings were related to patient and device characteristics, as well as to outcome during follow-up. One-hundred and seventeen patients (age 74 ± 9, 37% women, CHA2DS2VASc 4.4 ± 1.3, and HASBLED 3.5 ± 1.0) were implanted with Amplatzer cardiac plug (ACP)/Amulet (71%) or Watchman (29%). LAA patency was detected in 44% on arterial phase CT images and 69% on venous phase images. The most common leak location was postero-inferior. LAA patency related to LA dilatation, left ventricular ejection fraction impairment, non-chicken wing LAA shape, large landing zone diameter, incomplete device lobe thrombosis, and disc/lobe misalignment in patients with ACP/Amulet. DRT were detected in 19 (16%), most being laminated and of antero-superior location. DRT did not relate to clinical or imaging characteristics nor to implantation criteria, but to total thrombosis of device lobe. Over a mean 13 months follow-up, stroke/transient ischaemic attack occurred in eight patients, unrelated to DRT or LAA patency., Conclusion: LAA patency on CT is common after LAA occlusion, particularly on venous phase images. Leaks relate to LA/LAA size at baseline, and device malposition and incomplete thrombosis at follow-up. DRT is also quite common but poorly predicted by patient and device-related factors.
- Published
- 2018
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45. Predictors of future onset of atrial fibrillation in hypertrophic cardiomyopathy.
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Cochet H, Morlon L, Vergé MP, Salel M, Camaioni C, Reynaud A, Peyrou J, Ritter P, Jais P, Laurent F, Lafitte S, Montaudon M, and Réant P
- Subjects
- Adult, Aged, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation physiopathology, Cardiomyopathy, Hypertrophic physiopathology, Echocardiography, Electrocardiography, Ambulatory, Female, Fibrosis, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Time Factors, Ventricular Function, Left, Ventricular Remodeling, Atrial Fibrillation etiology, Cardiomyopathy, Hypertrophic complications, Cardiomyopathy, Hypertrophic diagnostic imaging, Magnetic Resonance Imaging, Cine, Multimodal Imaging methods
- Abstract
Background: Novel predictors of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) are desirable., Aim: To detect new multimodality imaging variables predictive of de novo AF in HCM., Methods: Consecutive patients with HCM underwent clinical assessment and 48-hour Holter electrocardiography to detect AF episodes. Left ventricular (LV) morphology, function and fibrosis, and the left atrium (LA) were characterized by cardiac magnetic resonance. Mitral valve, systolic pulmonary artery pressure, LV filling and maximum gradients were assessed by echocardiography. Patients with no previous history of AF were followed with Holter recordings., Results: Two hundred and nine patients were included (mean age 53±16 years; 140 men), 46 (22%) of whom had a history of AF and a longer duration from HCM diagnosis, more frequent use of heart failure medication, a higher systolic pulmonary artery pressure, a lower LV ejection fraction, a higher extent of LV fibrosis and prevalence of fibrosis on right ventricular (RV)-LV insertions, a higher LA volume and lower LA phasic function. Patients with no AF at inclusion were followed for 26 (17-42) months, and 15 (9%) developed de novo AF. Among clinical characteristics, New York Heart Association class was the only significant AF predictor in the multivariable analysis (hazard ratio 2.65 per class, 95% confidence interval [CI] 1.15-6.10; P=0.02). Among imaging characteristics, two independent predictors were identified: myocardial fibrosis on RV insertions (hazard ratio 2.8, 95% CI 1.3-5.9; P=0.008); and LA volume (hazard ratio 1.03 per mL/m
2 , 95% CI 1.01-1.06; P=0.006)., Conclusions: AF in HCM is predicted by New York Heart Association class, LA volume and LV fibrosis on RV-LV insertions on cardiac magnetic resonance imaging. The mechanisms relating the ventricular phenotype to AF should be clarified in future studies., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)- Published
- 2018
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46. High-resolution three-dimensional late gadolinium-enhanced cardiac magnetic resonance imaging to identify the underlying substrate of ventricular arrhythmia.
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Hennig A, Salel M, Sacher F, Camaioni C, Sridi S, Denis A, Montaudon M, Laurent F, Jais P, and Cochet H
- Subjects
- Adult, Aged, Cardiomyopathies complications, Cardiomyopathies physiopathology, Death, Sudden, Cardiac etiology, Female, Heart Ventricles physiopathology, Humans, Male, Middle Aged, Predictive Value of Tests, Prognosis, Prospective Studies, Reproducibility of Results, Risk Factors, Tachycardia, Ventricular etiology, Tachycardia, Ventricular physiopathology, Ventricular Fibrillation etiology, Ventricular Fibrillation physiopathology, Cardiomyopathies diagnostic imaging, Contrast Media administration & dosage, Heart Ventricles diagnostic imaging, Image Interpretation, Computer-Assisted methods, Imaging, Three-Dimensional methods, Magnetic Resonance Imaging, Cine methods, Meglumine administration & dosage, Organometallic Compounds administration & dosage, Tachycardia, Ventricular diagnostic imaging, Ventricular Fibrillation diagnostic imaging
- Abstract
Aims: Cardiac magnetic resonance (CMR) is recommended as a second-line method to diagnose ventricular arrhythmia (VA) substrate. We assessed the diagnostic yield of CMR including high-resolution late gadolinium-enhanced (LGE) imaging., Methods and Results: Consecutive patients with sustained ventricular tachycardia (VT), non-sustained VT (NSVT), or ventricular fibrillation/aborted sudden death (VF/SCD) underwent a non-CMR diagnostic workup according to current guidelines, and CMR including LGE imaging with both a conventional breath-held and a free-breathing method enabling higher spatial resolution (HR-LGE). The diagnostic yield of CMR was compared with the non-CMR workup, including the incremental value of HR-LGE. A total of 157 patients were enrolled [age 54 ± 17 years; 75% males; 88 (56%) sustained VT, 52 (33%) NSVT, 17 (11%) VF/SCD]. Of these, 112 (71%) patients had no history of structural heart disease (SHD). All patients underwent electrocardiography and echocardiography, 72% coronary angiography, and 51% exercise testing. Pre-CMR diagnoses were 84 (54%) no SHD, 39 (25%) ischaemic cardiomyopathy (ICM), 11 (7%) non-ischaemic cardiomyopathy (NICM), 3 (2%) arrhythmogenic right ventricular cardiomyopathy (ARVC), 2 (1%) hypertrophic cardiomyopathy (HCM), and 18 (11%) other. CMR modified these diagnoses in 48 patients (31% of all and 43% of those with no SHD history). New diagnoses were 9 ICM, 28 NICM, 8 ARVC, 1 HCM, and 2 other. CMR modified therapy in 19 (12%) patients. In patients with no SHD after non-CMR tests, SHD was found in 32 of 84 (38%) patients. Eighteen of these patients showed positive HR-LGE and negative conventional LGE. Thus, HR-LGE significantly increased the CMR detection of SHD (17-38%, P < 0.001)., Conclusion: CMR including HR-LGE imaging has high diagnostic value in patients with VAs. This has major prognostic and therapeutic implications, particularly in patients with negative pre-CMR workup.
- Published
- 2018
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47. Influence of contact force on voltage mapping: A combined magnetic resonance imaging and electroanatomic mapping study in patients with tetralogy of Fallot.
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Teijeira-Fernandez E, Cochet H, Bourier F, Takigawa M, Cheniti G, Thompson N, Frontera A, Camaioni C, Massouille G, Jalal Z, Derval N, Iriart X, Denis A, Hocini M, Haissaguerre M, Jais P, Thambo JB, and Sacher F
- Subjects
- Adult, Cardiac Surgical Procedures, Cicatrix pathology, Female, Heart Conduction System diagnostic imaging, Heart Ventricles physiopathology, Humans, Male, Postoperative Period, Reproducibility of Results, Retrospective Studies, Tetralogy of Fallot surgery, Body Surface Potential Mapping methods, Heart Conduction System physiopathology, Heart Ventricles diagnostic imaging, Imaging, Three-Dimensional, Magnetic Resonance Imaging, Cine methods, Myocardium pathology, Tetralogy of Fallot physiopathology
- Abstract
Background: Voltage criteria for ventricular mapping have been obtained from small series of patients and prioritizing high specificity., Objective: The purpose of this study was to analyse the potential influence of contact force (CF) on voltage mapping and to define voltage cutoff values for right ventricular (RV) scar using the tetralogy of Fallot as a model of transmural RV scar and magnetic resonance imaging (MRI) as reference., Methods: Fourteen patients (age 32.6 ± 14.3 years; 5 female) with repaired tetralogy of Fallot underwent high-resolution cardiac MRI (1.25 × 1.25 × 2.5 mm). Scar, defined as pixels with intensity >50% maximum, was mapped over the RV geometry and merged within the CARTO system to RV endocardial voltage maps acquired using a 3.5-mm ablation catheter with CF technology (SmartTouch, Biosense Webster)., Results: In total, 2446 points were analyzed, 915 within scars and 1531 in healthy tissue according to MRI. CF correlated to unipolar (ρ = 0.186; P <.001) and bipolar voltage in healthy tissue (ρ = 0.245; P <.001) and in scar tissue. Receiver operating characteristic curve analysis excluding points with very low CF (<5g) identified optimal voltage cutoffs of 5.19 mV for unipolar voltage and 1.76 mV for bipolar voltage, yielding sensitivity/specificity of 0.89/0.85 and 0.9/0.9, respectively., Conclusion: CF is an important factor to be taken into account for voltage mapping. If good CF is applied, unipolar and bipolar voltage cutoffs of 5.19 mV and 1.76 mV are optimal for identifying RV scar on endocardial mapping with the SmartTouch catheter. Data on the diagnostic accuracy of different voltage cutoff values are provided., (Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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48. What's new about clopidogrel.
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Cialdella P, Gustapane M, Camaioni C, and Biasucci LM
- Subjects
- Aryl Hydrocarbon Hydroxylases genetics, Clopidogrel, Cytochrome P-450 CYP2C19, Drug Interactions, Drug Resistance, Humans, Platelet Aggregation Inhibitors pharmacokinetics, Platelet Aggregation Inhibitors pharmacology, Proton Pump Inhibitors pharmacology, Stents, Thrombosis prevention & control, Ticlopidine pharmacokinetics, Ticlopidine pharmacology, Ticlopidine therapeutic use, Treatment Failure, Acute Coronary Syndrome drug therapy, Platelet Aggregation Inhibitors therapeutic use, Ticlopidine analogs & derivatives
- Abstract
Clopidogrel is an oral tyenopiridin with a central role in the management of acute coronary syndromes and after stent implantation. Despite the use of this drug, many patients continue to experience thrombotic events which are usually referred as "therapy failure". Actually, to date, only stent thrombosis is considered therapy failure: mainly, it could be due to patient genetic predisposition or drug interaction, in particular with proton pump inhibitors. Genetic mutations in the CYP2C19 cytochrome (involved in the metabolism of clopidogrel and many other drugs) may lead to a lower concentration of active metabolites of the drug. In the same way, proton pump inhibitors interaction with the cytochrome may reduce clopidogrel activation. To overcome the problem some authors have suggested to increase the dosage of the drug, to use other drugs, to genotype patients, and not to use proton pomp inhibitors in patients on double antiplatelet therapy. Recent studies have shown that the interaction between clopidogrel and proton pump inhibitors is far to be clinically relevant and that the variability between the different assay to determine patients response to the drug does not allow, to date, to rely on their use. Moreover, double clopidogrel dose is as effective as low one in preventing major cardiovascular events, with a significant reduction in stent thrombosis in spite of a modest increase in major bleeding. Aim of this review article was to update current knowledge on clopidogrel, particularly focusing on the problem of "resistance" and PPI interaction. Moreover, we will discuss current strategies to overcome the resistance.
- Published
- 2013
49. Microparticles and microRNAs: new players in the complex field of coagulation.
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Camaioni C, Gustapane M, Cialdella P, Della Bona R, and Biasucci LM
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- Apoptosis physiology, Atherosclerosis physiopathology, Cell Membrane physiology, Cell Proliferation, Endothelial Cells physiology, Endothelium, Vascular physiopathology, Humans, MicroRNAs genetics, Thrombosis physiopathology, Atherosclerosis metabolism, Blood Coagulation, Cell-Derived Microparticles metabolism, MicroRNAs metabolism, Thrombosis metabolism
- Abstract
Atherosclerosis is a complex process that begins with endothelial dysfunction, and continues with several inflammatory processes leading, eventually, to plaque rupture and formation of arterial thrombus. Increased platelet reactivity and classical coagulation pathways are not the only players of the whole thrombotic process: microparticles (MPs), irregularly shaped small vesicles released from the plasma membrane after cell activation, apoptosis, or exposure to shear stress have been demonstrated to be involved in such a process. MicroRNAs (MiRs), small-non-coding single-strand RNAs acting as post-transcriptional modulator of target gene expression are expressed in the large majority of eukaryotes. MiRs are implicated in several phenomena: control of metabolism, control of cell-differentiation, control of cell-proliferation and control of cell-apoptosis, therefore contributing to physiologic and pathogenic processes in hematologic, genetic, infective and cardiac diseases. Microparticles operate as a delivery system of MiRs, playing an active and important role in processes such as coagulation and thrombosis. These novel findings also suggest MPs and, in particular MIRs, as possible and promising therapeutic targets.
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- 2013
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50. Immediate evidence of the benefit of distal protection in vein graft intervention.
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Porto I, Cautilli G, and Camaioni C
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- Aged, Coronary Angiography, Graft Occlusion, Vascular diagnostic imaging, Graft Occlusion, Vascular etiology, Humans, Male, Saphenous Vein diagnostic imaging, Stents, Thromboembolism etiology, Treatment Outcome, Venous Thrombosis diagnostic imaging, Venous Thrombosis etiology, Angioplasty, Balloon, Coronary instrumentation, Coronary Artery Bypass adverse effects, Embolic Protection Devices, Graft Occlusion, Vascular therapy, Saphenous Vein transplantation, Thromboembolism prevention & control, Venous Thrombosis therapy
- Abstract
Percutaneous intervention carries a higher risk of distal embolization and fatal outcome in saphenous vein grafts (SVG) than in native coronary vessels. Most of these adverse clinical events, predominantly myocardial infarction and reduced antegrade flow (no reflow phenomenon), are due to distal embolization of atherothrombotic debris and distal microvascular occlusion. For this reason, in current interventional practice, the use of distal protection devices is mandatory. Our case report provides direct and dramatic evidence of the usefulness of a low-profile filter device in the setting of massively thrombotic SVG.
- Published
- 2012
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