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1. Atrial and ventricular strain using cardiovascular magnetic resonance in the prediction of outcomes of pericarditis patients: a pilot study

Author

Cau, R, Pisu, F, Muscogiuri, G, Sironi, S, Suri, J, Pontone, G, Salgado, R, Saba, L, Cau R., Pisu F., Muscogiuri G., Sironi S., Suri J. S., Pontone G., Salgado R., Saba L., Cau, R, Pisu, F, Muscogiuri, G, Sironi, S, Suri, J, Pontone, G, Salgado, R, Saba, L, Cau R., Pisu F., Muscogiuri G., Sironi S., Suri J. S., Pontone G., Salgado R., and Saba L.

Abstract

Objective: Our study aimed to explore with cardiovascular magnetic resonance (CMR) the impact of left atrial (LA) and left ventricular (LV) myocardial strain in patients with acute pericarditis and to investigate their possible prognostic significance in adverse outcomes. Method: This retrospective study performed CMR scans in 36 consecutive patients with acute pericarditis (24 males, age 52 [23–52]). The primary endpoint was the combination of recurrent pericarditis, constrictive pericarditis, and surgery for pericardial diseases defined as pericardial events. Atrial and ventricular strain function were performed on conventional cine SSFP sequences. Results: After a median follow-up time of 16 months (interquartile range [13–24]), 12 patients with acute pericarditis reached the primary endpoint. In multivariable Cox regression analysis, LA reservoir and LA conduit strain parameters were all independent determinants of adverse pericardial diseases. Conversely, LV myocardial strain parameters did not remain an independent predictor of outcome. With receiving operating characteristics curve analysis, LA conduit and reservoir strain showed excellent predictive performance (area under the curve of 0.914 and 0.895, respectively) for outcome prediction at 12 months. Conclusion: LA reservoir and conduit mechanisms on CMR are independently associated with a higher risk of adverse pericardial events. Including atrial strain parameters in the management of acute pericarditis may improve risk stratification. Clinical relevance statement: Atrial strain could be a suitable non-invasive and non-contrast cardiovascular magnetic resonance parameter for predicting adverse pericardial complications in patients with acute pericarditis. Key Points: • Myocardial strain is a well-validated CMR parameter for risk stratification in cardiovascular diseases. • LA reservoir and conduit functions are significantly associated with adverse pericardial events. • Atrial strain may serve

Published
2024

3. Exploring the EVolution in PrognOstic CapabiLity of MUltisequence Cardiac MagneTIc ResOnance in PatieNts Affected by Takotsubo Cardiomyopathy Based on Machine Learning Analysis: Design and Rationale of the EVOLUTION Study

Author

Cau, R, Muscogiuri, G, Pisu, F, Gatti, M, Velthuis, B, Loewe, C, Cademartiri, F, Pontone, G, Montisci, R, Guglielmo, M, Sironi, S, Esposito, A, Francone, M, Dacher, N, Peebles, C, Bastarrika, G, Salgado, R, Saba, L, Cau R., Muscogiuri G., Pisu F., Gatti M., Velthuis B., Loewe C., Cademartiri F., Pontone G., Montisci R., Guglielmo M., Sironi S., Esposito A., Francone M., Dacher N., Peebles C., Bastarrika G., Salgado R., Saba L., Cau, R, Muscogiuri, G, Pisu, F, Gatti, M, Velthuis, B, Loewe, C, Cademartiri, F, Pontone, G, Montisci, R, Guglielmo, M, Sironi, S, Esposito, A, Francone, M, Dacher, N, Peebles, C, Bastarrika, G, Salgado, R, Saba, L, Cau R., Muscogiuri G., Pisu F., Gatti M., Velthuis B., Loewe C., Cademartiri F., Pontone G., Montisci R., Guglielmo M., Sironi S., Esposito A., Francone M., Dacher N., Peebles C., Bastarrika G., Salgado R., and Saba L.

Abstract

Purpose: Takotsubo cardiomyopathy (TTC) is a transient but severe acute myocardial dysfunction with a wide range of outcomes from favorable to life-threatening. The current risk stratification scores of TTC patients do not include cardiac magnetic resonance (CMR) parameters. To date, it is still unknown whether and how clinical, trans-thoracic echocardiography (TTE), and CMR data can be integrated to improve risk stratification. Methods: EVOLUTION (Exploring the eVolution in prognOstic capabiLity of mUlti-sequence cardiac magneTIc resOnance in patieNts affected by Takotsubo cardiomyopathy) is a multicenter, international registry of TTC patients who will undergo a clinical, TTE, and CMR evaluation. Clinical data including demographics, risk factors, comorbidities, laboratory values, ECG, and results from TTE and CMR analysis will be collected, and each patient will be followed-up for in-hospital and long-term outcomes. Clinical outcome measures during hospitalization will include cardiovascular death, pulmonary edema, arrhythmias, stroke, or transient ischemic attack. Clinical long-term outcome measures will include cardiovascular death, pulmonary edema, heart failure, arrhythmias, sudden cardiac death, and major adverse cardiac and cerebrovascular events defined as a composite endpoint of death from any cause, myocardial infarction, recurrence of TTC, transient ischemic attack, and stroke. We will develop a comprehensive clinical and imaging score that predicts TTC outcomes and test the value of machine learning models, incorporating clinical and imaging parameters to predict prognosis. Conclusions: The main goal of the study is to develop a comprehensive clinical and imaging score, that includes TTE and CMR data, in a large cohort of TTC patients for risk stratification and outcome prediction as a basis for possible changes in patient management.

Published
2023

4. Machine learning approach in diagnosing Takotsubo cardiomyopathy: The role of the combined evaluation of atrial and ventricular strain, and parametric mapping

Author

Cau, R, Pisu, F, Porcu, M, Cademartiri, F, Montisci, R, Bassareo, P, Muscogiuri, G, Amadu, A, Sironi, S, Esposito, A, Suri, J, Saba, L, Cau R., Pisu F., Porcu M., Cademartiri F., Montisci R., Bassareo P., Muscogiuri G., Amadu A., Sironi S., Esposito A., Suri J. S., Saba L., Cau, R, Pisu, F, Porcu, M, Cademartiri, F, Montisci, R, Bassareo, P, Muscogiuri, G, Amadu, A, Sironi, S, Esposito, A, Suri, J, Saba, L, Cau R., Pisu F., Porcu M., Cademartiri F., Montisci R., Bassareo P., Muscogiuri G., Amadu A., Sironi S., Esposito A., Suri J. S., and Saba L.

Abstract

Background: Cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) is a key diagnostic tool in the differential diagnosis between non-ischemic cause of cardiac chest pain. Some patients are not eligible for a gadolinium contrast-enhanced CMR; in this scenario, the diagnosis remains challenging without invasive examination. Our purpose was to derive a machine learning model integrating some non-contrast CMR parameters and demographic factors to identify Takotsubo cardiomyopathy (TTC) in subjects with cardiac chest pain. Material and methods: Three groups of patients were retrospectively studied: TTC, acute myocarditis, and healthy controls. Global and regional left ventricular longitudinal, circumferential, and radial strain (RS) analysis included were assessed. Reservoir, conduit, and booster bi-atrial functions were evaluated by tissue-tracking. Parametric mapping values were also assessed in all the patients. Five different tree-based ensemble learning algorithms were tested concerning their ability in recognizing TTC in a fully cross-validated framework. Results: The CMR-based machine learning (ML) ensemble model, by using the Extremely Randomized Trees algorithm with Elastic Net feature selection, showed a sensitivity of 92% (95% CI 78–100), specificity of 86% (95% CI 80–92) and area under the ROC of 0.94 (95% CI 0.90–0.99) in diagnosing TTC. Among non-contrast CMR parameters, the Shapley additive explanations analysis revealed that left atrial (LA) strain and strain rate were the top imaging markers in identifying TTC patients. Conclusions: Our study demonstrated that using a tree-based ensemble learning algorithm on non-contrast CMR parameters and demographic factors enables the identification of subjects with TTC with good diagnostic accuracy. Translational outlook: Our results suggest that non-contrast CMR features can be implemented in a ML model to accurately identify TTC subjects. This model could be a valuable tool for aiding in the diag

Published
2023

5. Application of AI in cardiovascular multimodality imaging

Author

Muscogiuri, G, Volpato, V, Cau, R, Chiesa, M, Saba, L, Guglielmo, M, Senatieri, A, Chierchia, G, Pontone, G, Dell'Aversana, S, Schoepf, U, Andrews, M, Basile, P, Guaricci, A, Marra, P, Muraru, D, Badano, L, Sironi, S, Muscogiuri G., Volpato V., Cau R., Chiesa M., Saba L., Guglielmo M., Senatieri A., Chierchia G., Pontone G., Dell'Aversana S., Schoepf U. J., Andrews M. G., Basile P., Guaricci A. I., Marra P., Muraru D., Badano L., Sironi S., Muscogiuri, G, Volpato, V, Cau, R, Chiesa, M, Saba, L, Guglielmo, M, Senatieri, A, Chierchia, G, Pontone, G, Dell'Aversana, S, Schoepf, U, Andrews, M, Basile, P, Guaricci, A, Marra, P, Muraru, D, Badano, L, Sironi, S, Muscogiuri G., Volpato V., Cau R., Chiesa M., Saba L., Guglielmo M., Senatieri A., Chierchia G., Pontone G., Dell'Aversana S., Schoepf U. J., Andrews M. G., Basile P., Guaricci A. I., Marra P., Muraru D., Badano L., and Sironi S.

Abstract

Technical advances in artificial intelligence (AI) in cardiac imaging are rapidly improving the reproducibility of this approach and the possibility to reduce time necessary to generate a report. In cardiac computed tomography angiography (CCTA) the main application of AI in clinical practice is focused on detection of stenosis, characterization of coronary plaques, and detection of myocardial ischemia. In cardiac magnetic resonance (CMR) the application of AI is focused on post-processing and particularly on the segmentation of cardiac chambers during late gadolinium enhancement. In echocardiography, the application of AI is focused on segmentation of cardiac chambers and is helpful for valvular function and wall motion abnormalities. The common thread represented by all of these techniques aims to shorten the time of interpretation without loss of information compared to the standard approach. In this review we provide an overview of AI applications in multimodality cardiac imaging.

Published
2022

6. Non-invasive coronary imaging in patients with COVID-19: A narrative review

Author

Onnis, C, Muscogiuri, G, Paolo Bassareo, P, Cau, R, Mannelli, L, Cadeddu, C, Suri, J, Cerrone, G, Gerosa, C, Sironi, S, Faa, G, Carriero, A, Pontone, G, Saba, L, Onnis C, Muscogiuri G, Paolo Bassareo P, Cau R, Mannelli L, Cadeddu C, Suri JS, Cerrone G, Gerosa C, Sironi S, Faa G, Carriero A, Pontone G, Saba L, Onnis, C, Muscogiuri, G, Paolo Bassareo, P, Cau, R, Mannelli, L, Cadeddu, C, Suri, J, Cerrone, G, Gerosa, C, Sironi, S, Faa, G, Carriero, A, Pontone, G, Saba, L, Onnis C, Muscogiuri G, Paolo Bassareo P, Cau R, Mannelli L, Cadeddu C, Suri JS, Cerrone G, Gerosa C, Sironi S, Faa G, Carriero A, Pontone G, and Saba L

Abstract

SARS-CoV-2 infection, responsible for COVID-19 outbreak, can cause cardiac complications, worsening outcome and prognosis. In particular, it can exacerbate any underlying cardiovascular condition, leading to atherosclerosis and increased plaque vulnerability, which may cause acute coronary syndrome. We review current knowledge on the mechanisms by which SARS-CoV-2 can trigger endothelial/myocardial damage and cause plaque formation, instability and deterioration. The aim of this review is to evaluate current non-invasive diagnostic techniques for coronary arteries evaluation in COVID-19 patients, such as coronary CT angiography and atherosclerotic plaque imaging, and their clinical implications. We also discuss the role of artificial intelligence, deep learning and radiomics in the context of coronary imaging in COVID-19 patients.

Published
2022

7. Multimodality Imaging in Ischemic Chronic Cardiomyopathy

Author

Muscogiuri, G, Guglielmo, M, Serra, A, Gatti, M, Volpato, V, Schoepf, U, Saba, L, Cau, R, Faletti, R, Mcgill, L, De Cecco, C, Pontone, G, Dell'Aversana, S, Sironi, S, Muscogiuri G, Guglielmo M, Serra A, Gatti M, Volpato V, Schoepf UJ, Saba L, Cau R, Faletti R, McGill LJ, De Cecco CN, Pontone G, Dell'Aversana S, Sironi S, Muscogiuri, G, Guglielmo, M, Serra, A, Gatti, M, Volpato, V, Schoepf, U, Saba, L, Cau, R, Faletti, R, Mcgill, L, De Cecco, C, Pontone, G, Dell'Aversana, S, Sironi, S, Muscogiuri G, Guglielmo M, Serra A, Gatti M, Volpato V, Schoepf UJ, Saba L, Cau R, Faletti R, McGill LJ, De Cecco CN, Pontone G, Dell'Aversana S, and Sironi S

Abstract

Ischemic chronic cardiomyopathy (ICC) is still one of the most common cardiac diseases leading to the development of myocardial ischemia, infarction, or heart failure. The application of several imaging modalities can provide information regarding coronary anatomy, coronary artery disease, myocardial ischemia and tissue characterization. In particular, coronary computed tomography angiography (CCTA) can provide information regarding coronary plaque stenosis, its composition, and the possible evaluation of myocardial ischemia using fractional flow reserve CT or CT perfusion. Cardiac magnetic resonance (CMR) can be used to evaluate cardiac function as well as the presence of ischemia. In addition, CMR can be used to characterize the myocardial tissue of hibernated or infarcted myocardium. Echocardiography is the most widely used technique to achieve information regarding function and myocardial wall motion abnormalities during myocardial ischemia. Nuclear medicine can be used to evaluate perfusion in both qualitative and quantitative assessment. In this review we aim to provide an overview regarding the different noninvasive imaging techniques for the evaluation of ICC, providing information ranging from the anatomical assessment of coronary artery arteries to the assessment of ischemic myocardium and myocardial infarction. In particular this review is going to show the different noninvasive approaches based on the specific clinical history of patients with ICC.

Published
2022

8. Computed tomography predictors of structural valve degeneration in patients undergoing transcatheter aortic valve implantation with balloon-expandable prostheses

Author

Guglielmo, M, Fusini, L, Muratori, M, Tamborini, G, Mantegazza, V, Andreini, D, Annoni, A, Babbaro, M, Baggiano, A, Conte, E, Carriero, S, Formenti, A, Guaricci, A, Mancini, E, Mollace, R, Muscogiuri, G, Mushtaq, S, Ricci, F, Rossi, A, Scafuri, S, Alushi, B, Cau, C, Cau, R, Cesarano, M, Saba, L, Rabbat, M, Pepi, M, Pontone, G, Guglielmo M., Fusini L., Muratori M., Tamborini G., Mantegazza V., Andreini D., Annoni A., Babbaro M., Baggiano A., Conte E., Carriero S., Formenti A., Guaricci A. I., Mancini E., Mollace R., Muscogiuri G., Mushtaq S., Ricci F., Rossi A., Scafuri S., Alushi B., Cau C., Cau R., Cesarano M., Saba L., Rabbat M., Pepi M., Pontone G., Guglielmo, M, Fusini, L, Muratori, M, Tamborini, G, Mantegazza, V, Andreini, D, Annoni, A, Babbaro, M, Baggiano, A, Conte, E, Carriero, S, Formenti, A, Guaricci, A, Mancini, E, Mollace, R, Muscogiuri, G, Mushtaq, S, Ricci, F, Rossi, A, Scafuri, S, Alushi, B, Cau, C, Cau, R, Cesarano, M, Saba, L, Rabbat, M, Pepi, M, Pontone, G, Guglielmo M., Fusini L., Muratori M., Tamborini G., Mantegazza V., Andreini D., Annoni A., Babbaro M., Baggiano A., Conte E., Carriero S., Formenti A., Guaricci A. I., Mancini E., Mollace R., Muscogiuri G., Mushtaq S., Ricci F., Rossi A., Scafuri S., Alushi B., Cau C., Cau R., Cesarano M., Saba L., Rabbat M., Pepi M., and Pontone G.

Abstract

Objectives: Computed tomography (CT) provides excellent anatomy assessment of the aortic annulus (AoA) and is utilized for pre-procedural planning of transcatheter aortic valve implantation (TAVI). We sought to investigate if geometrical characteristics of the AoA determined by CT may represent predictors of structural valve degeneration (SVD) in patients undergoing TAVI with balloon-expandable valves. Methods: This is a retrospective study on 124 consecutive patients (mean age: 79 ± 7 years; female: 61%) undergoing balloon-expandable TAVI prospectively enrolled in a registry. AoA maximum diameter (Dmax), minimum diameter (Dmin), and area were assessed using pre-procedural CT. SVD was identified during follow-up with transthoracic echocardiography documenting structural prosthetic valve abnormalities with or without hemodynamic changes. Results: The mean follow-up was 5.9 ± 1.7 years. SVD was found in 48 out of 124 patients (38%). AoA Dmax, Dmin, and area were significantly smaller in patients with SVD compared to patients without SVD (25.6 ± 2.2 mm vs. 27.1 ± 2.8 mm, p = 0.012; 20.5 ± 2.1 mm vs. 21.8 ± 2.1 mm, p = 0.001 and 419 ± 77 mm2 vs. 467 ± 88 mm2, p = 0.002, respectively). At univariable analysis, female sex, BSA, 23-mm prosthetic valve size, Dmax < 27.1 mm, and a Dmin < 19.9 mm were associated with SVD, whereas at multivariable analysis, only Dmin < 19.9 mm (OR = 2.873, 95% CI: 1.191–6.929, p = 0.019) and female sex (OR = 2.659, 95% CI: 1.095–6.458, p = 0.031) were independent predictors of SVD. Conclusions: Female sex and AoA Dmin < 19.9 mm are associated with SVD in patients undergoing TAVI with balloon-expandable valves. When implanting large prostheses in order to avoid paraprosthetic regurgitation, caution should be observed due to the risk of excessive stretching of the AoA Dmin, which may play a role in SVD. Key Points: • Long-term durability is a concern for transcatheter aortic valve bioprosthesis. • CT provides an excellent assessment

Published
2022

9. Multimodality imaging in acute myocarditis

Author

Muscogiuri, G, Guaricci, A, Cau, R, Saba, L, Senatieri, A, Chierchia, G, Pontone, G, Volpato, V, Palmisano, A, Esposito, A, Basile, P, Marra, P, D'Angelo, T, Booz, C, Rabbat, M, Sironi, S, Muscogiuri G., Guaricci A. I., Cau R., Saba L., Senatieri A., Chierchia G., Pontone G., Volpato V., Palmisano A., Esposito A., Basile P., Marra P., D'angelo T., Booz C., Rabbat M., Sironi S., Muscogiuri, G, Guaricci, A, Cau, R, Saba, L, Senatieri, A, Chierchia, G, Pontone, G, Volpato, V, Palmisano, A, Esposito, A, Basile, P, Marra, P, D'Angelo, T, Booz, C, Rabbat, M, Sironi, S, Muscogiuri G., Guaricci A. I., Cau R., Saba L., Senatieri A., Chierchia G., Pontone G., Volpato V., Palmisano A., Esposito A., Basile P., Marra P., D'angelo T., Booz C., Rabbat M., and Sironi S.

Abstract

The diagnosis of acute myocarditis often involves several noninvasive techniques that can provide information regarding volumes, ejection fraction, and tissue characterization. In particular, echocardiography is extremely helpful for the evaluation of biventricular volumes, strain and ejection fraction. Cardiac magnetic resonance, beyond biventricular volumes, strain, and ejection fraction allows to characterize myocardial tissue providing information regarding edema, hyperemia, and fibrosis. Contemporary cardiac computed tomography angiography (CCTA) can not only be extremely important for the assessment of coronary arteries, pulmonary arteries and aorta but also tissue characterization using CCTA can be an additional tool that can explain chest pain with a diagnosis of myocarditis.

Published
2022

10. Multimodality Imaging of Sudden Cardiac Death and Acute Complications in Acute Coronary Syndrome

Author

Muscogiuri, G, Guaricci, A, Soldato, N, Cau, R, Saba, L, Siena, P, Tarsitano, M, Giannetta, E, Sala, D, Sganzerla, P, Gatti, M, Faletti, R, Senatieri, A, Chierchia, G, Pontone, G, Marra, P, Rabbat, M, Sironi, S, Muscogiuri G., Guaricci A. I., Soldato N., Cau R., Saba L., Siena P., Tarsitano M. G., Giannetta E., Sala D., Sganzerla P., Gatti M., Faletti R., Senatieri A., Chierchia G., Pontone G., Marra P., Rabbat M. G., Sironi S., Muscogiuri, G, Guaricci, A, Soldato, N, Cau, R, Saba, L, Siena, P, Tarsitano, M, Giannetta, E, Sala, D, Sganzerla, P, Gatti, M, Faletti, R, Senatieri, A, Chierchia, G, Pontone, G, Marra, P, Rabbat, M, Sironi, S, Muscogiuri G., Guaricci A. I., Soldato N., Cau R., Saba L., Siena P., Tarsitano M. G., Giannetta E., Sala D., Sganzerla P., Gatti M., Faletti R., Senatieri A., Chierchia G., Pontone G., Marra P., Rabbat M. G., and Sironi S.

Abstract

Sudden cardiac death (SCD) is a potentially fatal event usually caused by a cardiac arrhythmia, which is often the result of coronary artery disease (CAD). Up to 80% of patients suffering from SCD have concomitant CAD. Arrhythmic complications may occur in patients with acute coronary syndrome (ACS) before admission, during revascularization procedures, and in hospital intensive care monitoring. In addition, about 20% of patients who survive cardiac arrest develop a transmural myocardial infarction (MI). Prevention of ACS can be evaluated in selected patients using cardiac computed tomography angiography (CCTA), while diagnosis can be depicted using electrocardiography (ECG), and complications can be evaluated with cardiac magnetic resonance (CMR) and echocardiography. CCTA can evaluate plaque, burden of disease, stenosis, and adverse plaque characteristics, in patients with chest pain. ECG and echocardiography are the first-line tests for ACS and are affordable and useful for diagnosis. CMR can evaluate function and the presence of complications after ACS, such as development of ventricular thrombus and presence of myocardial tissue characterization abnormalities that can be the substrate of ventricular arrhythmias.

Published
2022

11. Pearls and Pitfalls of Carotid Artery Imaging Ultrasound, Computed Tomography Angiography, and MR Imaging

Author

Cau, R., Gupta, A., Kooi, M.E., Saba, L., Cau, R., Gupta, A., Kooi, M.E., and Saba, L.

Abstract

Various non-invasive plaque imaging modalities can provide detailed information on the carotid plaque with supplementary and complementary roles in identifying high-risk features. Further evi-dence is necessary to incorporate each of these imaging modalities with their advantages and lim-itations into a standardized diagnostic flowchart with the purpose to offer a significant contribution to risk stratification and patient management.

Published
2023

13. The human carotid atherosclerotic plaque: an observational review of histological scoring systems.

Author

GEROSA, C., CERRONE, G., SURI, J. S., AIMOLA, V., CAU, F., CONI, P., PIRAS, M., CAU, R., BALESTRIERI, A., SCANO, A., ORRÙ, G., VAN EYKEN, P., LA NASA, G., COGHE, F., CASTAGNOLA, M., GIBO, Y., FANNI, D., and SABA, L.

Abstract

OBJECTIVE: The atherosclerotic plaque is a complex dynamic pathological lesion of the arterial wall, characterized by multiple elementary lesions of different diagnostic and prognostic significance. Fibrous cap thickness, lipid necrotic core dimension, inflammation, intra-plaque hemorrhage (IPH), plaque neovascularization and endothelial dysfunction (erosions) are generally considered the most relevant morphological details of plaque morphology. In this review, the most relevant features able to discriminate between stable and vulnerable plaques at histological level are discussed. SUBJECTS AND METHODS: Retrospectively, we have evaluated the laboratory results from one hundred old histological samples from patients treated with carotid endarterectomy. These results were analyzed to assess elementary lesions that characterize stable and unstable plaques. RESULTS: A thin fibrous cap (<65 micron), loss of smooth muscle cells, collagen depletion, a large lipid-rich necrotic core, infiltrating macrophages, IPH and intra-plaque vascularization are identified as the most important risk factors associated with plaque rupture. CONCLUSIONS: Immunohistochemistry for smooth muscle actin (smooth muscle cell marker) and for CD68 (marker of monocytes/macrophages) and glycophorin (marker of red blood cells) are suggested as useful tools for an in deep characterization of any carotid plaque and for distinguishing plaque phenotypes at histology. Since patients with a carotid vulnerable plaque are at higher risk of developing vulnerable plaques in other arteries as well, the definition of the vulnerability index is underlined, in order to stratify patients at higher risk for undergoing cardiovascular events. [ABSTRACT FROM AUTHOR]

Published
2023

14. Test of Cure Return Rate and Test Positivity, Strengthening the US Response to Resistant Gonorrhea, United States, 2018–2019

Author

Vonda Pabon, Masayo Nishiyama, Julia A. Schillinger, Robert P. Kohn, Christina Thibault, Jamie M. Black, Karen Schlanger, Emily R. Learner, Helen Hermus, Joey Dewater, Sancta B. St. Cyr, Robert D. Kirkcaldy, Cau R Pham, and Kerry Mauk

Subjects
Microbiology (medical), Male, medicine.medical_specialty, Gonorrhea, Dermatology, Azithromycin, Asymptomatic, Article, Men who have sex with men, Sexual and Gender Minorities, Interquartile range, Internal medicine, medicine, Humans, Homosexuality, Male, business.industry, Public Health, Environmental and Occupational Health, medicine.disease, Confidence interval, Neisseria gonorrhoeae, United States, Anti-Bacterial Agents, Infectious Diseases, Ceftriaxone, Female, medicine.symptom, business, Cefixime, medicine.drug
Abstract

BACKGROUND: Reduced antibiotic susceptibility (RS) in Neisseria gonorrhoeae (GC) may increase treatment failure. Conducting tests of cure (TOC) for patients with RS-GC may facilitate identification of treatment failures. METHODS: We examined 2018 to 2019 data from 8 jurisdictions participating in the US Centers for Disease Control and Prevention’s Strengthening US Response to Resistant Gonorrhea project. Jurisdictions collected GC isolates and epidemiological data from patients and performed antimicrobial susceptibility testing. Minimum inhibitory concentrations of ceftriaxone, 0.125 μg/mL or greater; cefixime, 0.250 μg/mL or greater; or azithromycin, 2.0 μg/mL or greater were defined as RS. Patients with RS infections were asked to return for a TOC 8 to 10 days posttreatment. We calculated a weighted TOC return rate and described time to TOC and suspected reasons for any positive TOC results. RESULTS: Overall, 1165 patients were diagnosed with RS infections. Over half returned for TOC (weighted TOC, 61%; 95% confidence interval, 50.1%–72.6%; range by jurisdiction, 32%–80%). Test of cure rates were higher among asymptomatic (68%) than symptomatic patients (53%, P = 0.001), and men who have sex with men (62%) compared with men who have sex with women (50%; P < 0.001). Median time between treatment and TOC was 12 days (interquartile range, 9–16). Of the 31 (4.5%) TOC patients with positive results, 13 (42%) were suspected because of reinfection and 11 (36%) because of false-positive results. There were no treatment failures suspected to be due to RS-GC. CONCLUSIONS: Most patients with a RS infection returned for a TOC, though return rates varied by jurisdiction and patient characteristics. Test of cure can identify and facilitate treatment of reinfections, but false-positive TOC results may complicate interpretation and clinical management.

Published
2021

15. Molecular pathways triggered by COVID-19 in different organs: ACE2 receptor-expressing cells under attack? A review

Author

Saba L., Gerosa C., Fanni D., Marongiu F., Nasa G. L. A., Caocci G., Barcellona D., Balestrieri A., Coghe F., Orru G., Coni P., Piras M., Ledda F., Suri J. S., Ronchi A., D'Andrea F., Cau R., Castagnola M., Faa G., Saba, L., Gerosa, C., Fanni, D., Marongiu, F., Nasa, G. L. A., Caocci, G., Barcellona, D., Balestrieri, A., Coghe, F., Orru, G., Coni, P., Piras, M., Ledda, F., Suri, J. S., Ronchi, A., D'Andrea, F., Cau, R., Castagnola, M., and Faa, G.

Subjects
Liver Cirrhosis, COVID -19, Molecular pathway, Fibrosi, Liver Cirrhosi, Myocarditi, ACE2, Capillary Permeability, Renin-Angiotensin System, SARS- COV-2, Atrial Fibrillation, Humans, Cytokine, Blood Coagulation, Cardiomyopathie, SARS-CoV-2, Angiotensin II, Receptors, Coronaviru, COVID-19, Thrombosis, Fibroblasts, Virus Internalization, Fibrosis, Systemic Inflammatory Response Syndrome, Myocarditis, Thrombosi, Fibroblast, Cytokines, Angiotensin-Converting Enzyme 2, Endothelium, Vascular, Angiotensin I, Cardiomyopathies, Cytokine Release Syndrome, Human, Receptors, Coronavirus
Abstract

OBJECTIVE: In human pathology, SARS-CoV-2 utilizes multiple molecular pathways to determine structural and biochemical changes within the different organs and cell types. The clinical picture of patients with COVID-19 is characterized by a very large spectrum. The reason for this variability has not been clarified yet, causing the inability to make a prognosis on the evolution of the disease. MATERIALS AND METHODS: PubMed search was performed focusing on the role of ACE 2 receptors in allowing the viral entry into cells, the role of ACE 2 downregulation in triggering the tissue pathology or in accelerating previous disease states, the role of increased levels of Angiotensin II in determining endothelial dysfunction and the enhanced vascular permeability, the role of the dysregulation of the renin angiotensin system in COVID-19 and the role of cytokine storm. RESULTS: The pathological changes induced by SARS-CoV-2 infection in the different organs, the correlations between the single cell types targeted by the virus in the different human organs and the clinical consequences, COVID-19 chronic pathologies in liver fibrosis, cardiac fibrosis and atrial arrhythmias, glomerulosclerosis and pulmonary fibrosis, due to the systemic fibroblast activation induced by angiotensin II are discussed. CONCLUSIONS: The main pathways involved showed different pathological changes in multiple tissues and the different clinical presentations. Even if ACE2 is the main receptor of SARS-CoV-2 and the main entry point into cells for the virus, ACE2 expression does not always explain the observed marked inter-individual variability in clinical presentation and outcome, evidencing the complexity of this disorder. The proper interpretation of the growing data available might allow to better classifying COVID-19 in human pathology.

Published
2020

17. Type 2 diabetes treatment and progression of chronic kidney disease in Italian family practice

Author

Ermini G., Tosetti C., Zocchi D., Mandreoli M., Caletti M. T., Marchesini G., Balduzzi A., Bandi G., Bassi B., Borghi P., Brini L., Cammarata A., Casadio R., Cau R., Cecchini L., DelVecchio A., DeVicariis M. I., Ehrlich S., Franco L., Ini A., LaFratta V., Maccaferri M., Masi A., Matra A., MazzettiGaito P., Mazzoni G., Monti D., Mori M., Oggianu M., Palasciano M., Paternico A., Perrone F., Pierallini R., Quadrelli S., Rubini S., Salera M., Serio A., Silletti A., Simoncini E., Simoni L., Speziali P., Velona P., Verri A., Zisa D., Ermini G., Tosetti C., Zocchi D., Mandreoli M., Caletti M.T., Marchesini G., Balduzzi A., Bandi G., Bassi B., Borghi P., Brini L., Cammarata A., Casadio R., Cau R., Cecchini L., DelVecchio A., DeVicariis M.I., Ehrlich S., Franco L., Ini A., LaFratta V., Maccaferri M., Masi A., Matra A., MazzettiGaito P., Mazzoni G., Monti D., Mori M., Oggianu M., Palasciano M., Paternico A., Perrone F., Pierallini R., Quadrelli S., Rubini S., Salera M., Serio A., Silletti A., Simoncini E., Simoni L., Speziali P., Velona P., Verri A., and Zisa D.

Subjects
Male, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, urologic and male genital diseases, chemistry.chemical_compound, 0302 clinical medicine, Endocrinology, Body mass index, Incidence, Prognosis, Repaglinide, Metformin, Albumin excretion, Italy, 030220 oncology & carcinogenesis, Disease Progression, Female, medicine.symptom, Family Practice, Human, Glomerular Filtration Rate, medicine.drug, medicine.medical_specialty, Prognosi, Renal function, 030209 endocrinology & metabolism, Follow-Up Studie, 03 medical and health sciences, Internal medicine, medicine, Humans, Hypoglycemic Agents, Renal Insufficiency, Chronic, Glucose-lowering drug, Aged, Creatinine, Hypoglycemic Agent, business.industry, nutritional and metabolic diseases, Type 2 Diabetes Mellitus, Biomarker, medicine.disease, Cardiovascular prevention, Diabetes Mellitus, Type 2, chemistry, Albuminuria, business, Biomarkers, Follow-Up Studies, Kidney disease
Abstract

Aims: Progressive chronic kidney disease represents a dreadful complication of type 2 diabetes mellitus (T2DM). We tested the pattern of use and the renal effects of old glucose-lowering drugs in T2DM patients cared for by Italian general practitioners (GPs). Methods: Data of 2606 T2DM patients were extracted from the databases of GPs, who do not have access to the most recent glucose-lowering drugs in Italy. The rate of kidney function decline was calculated by CKD-EPIcr, based on two consecutive creatinine values. Results: Metformin was used in 55% of cases, either alone or with sulfonylureas/repaglinide, across the whole spectrum of CKD (from 66% in stage G1 to only 8% in G4). Sulfonylurea use peaked at 21–22% in stage G2–G3a, whereas repaglinide use significantly increased from 8% in G1 to 22% in G4. The median rate of CKD decline was − 1.64mL/min/1.73m2 per year; it was higher in G1 (− 3.22 per year) and progressively lower with CKD severity. 826 cases (31.7%) were classified as fast progressors (eGFR decline more negative than − 5mL/min/1.73m2 per year). The risk of fast progressing CKD was associated with increasing BMI, albuminuria, and sulfonylurea use, alone (OR, 1.47; 95% confidence interval, 1.16–1.85), or in association with metformin (OR, 1.40; 95% CI 1.04–1.88). No associations were demonstrated for metformin, cardiovascular and lipid lowering drug use. Conclusion: In the setting of Italian family practice, sulfonylurea use is associated with progressive CKD in patients with T2DM. Metformin, at doses progressively reduced according to CKD stages, as recommended by guidelines, is not associated with fast progression.

Published
2018

18. Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes 11 Medical and Health Sciences 1103 Clinical Sciences

Author

Mirijello, A, Viazzi, F, Fioretto, P, Giorda, C, Ceriello, A, Russo, G, Guida, P, Pontremoli, R, De Cosmo, S, Cimino, A, Fava, D, Meloncelli, I, Nicolucci, A, Pellegrini, F, Rossi, M, Turco, S, Vespasiani, G, Graziano, G, Lucisano, G, Memmo, R, Pellicciotta, E, Paciotti, V, Pupillo, M, Armentano, G, Giovannini, C, Armentano, V, Laudato, M, Acquati, S, Ciardullo, A, Laffi, G, Felace, G, Taboga, C, Tortul, C, Santantonio, G, Suraci, C, Ghisoni, G, Raffa, M, Genovese, S, Lovagnini-Scher, C, Rampini, P, Rocca, A, Ruggeri, P, Tortato, E, Cotti, L, Cristofaro, M, Tagliaferri, M, Comoglio, M, Fornengo, R, Gentile, F, Gigante, A, Mastinu, F, Di Benedetto, A, Pata, P, Arcangeli, A, Orsini, P, Acler, P, De Blasi, G, Cicioni, G, Pocciati, S, Marangoni, A, Nogara, A, Lanero, M, Bertero, M, Damassino, R, Bergonzini, C, Schumtz, L, Seksich, L, Pipitone, A, Boaretto, M, Manfroi, I, Parmesan, L, Conte, B, Soccol, F, Pagano, A, Papini, E, Rinaldi, R, Petrucci, L, Graziano, F, Chianelli, M, Silvagni, S, Rosco, M, Ansaldi, E, Malvicino, F, Battezzati, M, Maresca, P, Palenzona, C, Boemi, M, Rabini, R, Brandoni, G, Lanari, L, Gatti, C, Testa, I, Cherubini, V, Doveri, G, Pecorelli, L, Ciccarelli, A, Gallardini, M, Courthoud, R, Sara Bredy, S, Ricciardi, G, Vitalone, G, Setti, D, Contrini, P, Corsi, A, Ghigliotti, V, Oddone, G, Ponzani, P, Valbonesi, G, Mazzini, V, Di Berardino, P, Colleluori, P, Montani, V, Trosini, V, Velussi, M, Alfidi, P, Verdecchia, B, Baliva, L, Di Pietro, A, Franchi, G, Luce, R, Pianta, A, Ferrari, M, Balzano, S, Beltranello, G, Dal Fabbro, S, Arico, C, Cervo, L, Zanon, R, Rossa, S, Di Pace, M, Ciavarella, A, Giangiulio, S, Grimaldi, M, Mustacchio, A, Fattor, B, Monauni, T, Cristini, M, Orion, G, Crazzolara, D, Amor, F, Eisath, J, Lintner, S, Garavelli, S, Calari, T, Marini, P, Sandri, O, Scala, M, Stroppa, C, Trentin, A, Carlin, R, Carli, B, Sandona, M, Zortea, C, Bonet, L, Pradel, L, Reato, S, Buschini, M, Bonfiglioli, D, Mones, D, Beldi, F, Morea, A, Bondesan, L, Perbellini, S, Valentini, U, Agosti, B, Corsini, R, Girelli, A, Zarra, E, Rocca, L, Bergmann, M, Pradi, I, Unterkircher, S, Piok, M, Pichler, M, Trinchera, A, Palama, G, Palma, P, Carboni, L, Murtas, M, Mudadu, T, Turco, M, Floris, M, Delogu, A, Farris, L, Songini, M, Piras, G, Seguro, R, Floris, R, Corona, G, Lai, M, Piras, E, Contini, P, Cocco, S, Pilosu, R, Sannia, M, Spanu, F, Busciantella Ricci, N, Cartechini, M, Agostinelli, G, Fiorelli, C, Nuzzi, A, Ballauri, C, Lesina, A, Romeo, F, Giudici, G, Maciejewska, E, Deroma, A, Paduano, M, Rossi, L, Vagnini, C, Dolci, M, Mori, M, Baccetti, F, Gregori, G, Straface, E, Pozzuoli, G, Barone, M, Stasio, G, Tondini, S, Borgoni, F, Grosso, J, Scarsellato, C, Sciulli, A, De Marco, F, Confortin, L, Marin, N, Lamonica, M, Gialdino, S, Borzi, V, Gatta, C, Rapisard, R, Strano, S, Calabro, M, Puccio, L, Zolli, M, Coracina, A, Starnone, V, Del Buono, A, Terracciano, A, Monda, M, Castro, F, Guaglianone, A, Maccari, V, Corsi, L, Versari, G, Falivene, M, Boletto, N, Corsi, S, Marafetti, L, Vitacolonna, E, Capani, F, Caputo, L, Di Nisio, L, Simonetti, F, Boscolo Bariga, A, Ballarin, G, De Boni, S, Di Benedetto, S, Chiambretti, A, Di Vito, L, Pascuzzo, M, Urli, P, Rumi, P, Balzarini, B, Galli, P, Castellan, M, Giannetti, A, Russotti, C, De Blasi, A, Perna, A, Campanelli, C, Ranchelli, A, Biccheri, D, Dadi, G, Massa, L, Baldi, G, Sciacca, F, Costanzo, E, Spada, M, Paolini, G, Ziller, P, Portolan, F, Pasolini, G, Ghilardi, G, Fiorina, P, Grata, M, Capretti, L, Speroni, G, Fugazza, L, Massafra, C, Lovagnini Scher, A, Cimicchi, M, Percudani, C, Risolo, T, Sacco, P, Gidoni Guarnieri, G, Piccolo, D, Bravin, C, De Noni, E, Scarpel, M, Marcon, M, Giacon, F, Panebianco, G, Tadiotto, F, Da Tos, V, D'Ambrosio, M, Pellizzola, D, Zampini, M, Frezzati, E, Mari, E, Raminelli, E, Gaiti, D, Bosi, E, Chierici, G, Pilla, S, Copelli, M, Zanichelli, P, Bertelli, L, Caretta, P, Vezzani, V, Bodecchi, S, Longobucco, A, Di Lembo, S, Spotti, E, Carrai, E, Degli Innocenti, A, Manini, L, Persico, R, Rossi, C, Magro, G, Marelli, G, Vilei, V, Andrioli, M, Bellato, L, Fedeli, M, Merlini, A, Pinelli, G, Marin, G, Contin, M, Gallo, A, Parlato, P, Pecchielan, W, Jacovacci, J, Placentino, G, Richini, D, Molinari, S, Strazzeri, R, Fabbri, T, Di Bartolo, P, Garrapa, G, D'Incau, F, Lagomanzini, P, Conte, P, Todesco, F, Foglini, P, Pantanetti, P, Bedetta, C, Maricotti, R, Tomasi, F, Monesi, M, Graziani, R, Beretta, F, Penna, L, Guberti, A, Dazzi, D, Forte, E, Gasbarrone, A, Marrocco, T, Moschetta, R, Tuccinardi, F, De Meo, F, Coppola, A, Pirolozzi, P, Placitelli, E, Vallefuoco, R, Catone, B, Ceschia, S, Urban, M, Fabbri, F, Torresani, M, Crovetto, R, Battistini, M, Carosia, P, Viviani, G, Durante, A, Pais, F, Lilliu, V, Quieto, C, D'Ugo, E, Squadrone, M, Amenduni, T, Iovannisci, M, Della Penna, L, Potente, F, Delle Donne, T, Massa, C, Ulisse, M, De Berardinis, S, Guarnieri, I, Pace, S, Splendiani, M, Di Giuseppe, R, Brunato, B, Assaloni, R, Muraro, R, Loro, R, Bucciol, S, Lavacca, C, Sabbatini, G, Quadri, F, Sambuco, L, Santacroce, C, Paola Caretta, D, Marino, C, Micheletti, A, Petrelli, A, Corda, A, Pisano, L, Guaita, G, Deias, C, Trevisan, G, Coletti, I, Iannarelli, R, De Luca, A, Minnucci, A, Antenucci, D, Di Florio, C, Angelicola, G, Bosco, A, Fresco, R, Di Marco, G, Ugolotti, D, Cadossi, T, Di Caro, P, Mazzocchetti, M, Buzzetti, R, Leto, G, Gnessi, C, Cipolloni, L, Foffi, C, Moretti, C, Venditti, C, Meniconi, R, Bertoli, S, Cosimi, S, Di Cianni, G, Turco, A, Richini, A, Marconi, S, Sannino, C, Lemmi, P, Giuntoli, S, Manfre, N, Giannini, F, Di Carlo, A, Casadidio, I, Melandri, P, Maolo, G, Polenta, B, Piccinini, N, Vincenti, C, Pastore, N, Mega, P, Magurano, E, Cananiello, A, Francescutto, C, Brussa Toi, E, Gaspardo, G, Angeli, L, Ronchese, L, Sciangula, L, Ciucci, A, Contartese, A, Banfi, E, Castelli, E, Tatti, P, Bloise, D, Di Mauro, P, Masselli, L, Lo Presti, A, Scarpitta, A, Gambina, F, Venezia, A, Morea, R, Lagonigro, G, Copeta, G, Iannucci, V, Milano, V, Trupo, M, Lochmann, A, Marchetto, P, Incelli, G, De Paola, G, Steiger, M, Gamper, M, Breitenberger, S, Holzner, M, Frischmann, J, Lambiase, C, Di Vece, T, D'Aniello, M, Fezza, M, Giordano, C, Leo, F, Saitta, G, Cucinotta, D, Di Vieste, G, Pintaudi, B, Mancuso, T, Musacchio, N, Giancaterini, A, Pessina, L, Salis, G, Schivalocchi, F, Testori, G, Cerutti, N, Morpugo, P, Cavaletto, M, Bonino, G, Morreale, F, Mariani, G, Ragonesi, P, Bollati, P, Colapinto, P, Falqui, L, Bortolato, L, Cosma, A, Pistolato, P, Centenaro, B, Ceccato, A, Campobasso, G, Zaurino, F, Mazzotta, G, Manti, R, Da Ros, R, Carlucci, S, Narduzzi, L, Bortolotto, D, D'Acunto, L, Stanic, L, Volpi, A, Cospite, A, Manicardi, V, Michelini, M, Finardi, L, Borghi, F, Manicardi, E, Lombardi, S, Tommasi, C, Iaccarino, M, Cozza, S, Binotto, M, Marini, F, Mecenero, I, Massignani, S, Stecco, P, Urbani, E, Massariol, W, Parolin, R, Gatti, A, Bonavita, M, Creso, E, Giannettino, R, Gobbo, M, Iovine, C, Riccardi, G, Iazzetta, N, Giannattasio, C, Egione, O, Galdieri, S, Velotti, A, Azzolina, A, Annicelli, G, Sorrentino, T, Gaeta, I, Zenari, L, Bertolini, L, Sorgato, C, Grippaldi, F, Stroppiana, M, Popolizio, R, Carbone, N, Grasso, S, Abate, S, Gaggero, G, Strazzabosco, M, Brun, E, Carlesi, G, Garrone, S, Cicalo, A, Clausi, C, Cau, R, Manconi, A, Carboni, A, Angius, M, Pinna, A, Caria, S, Filigheddu, G, Tonolo, G, Carta, I, Calebich, S, Burlotti, C, Saglietti, G, Schellino, A, Madau, G, Cossu, M, Mulas, F, Zoccheddu, S, Balsanelli, M, Fetonti, M, Rotolo, A, Sambo, P, Secchi, E, Angotzi, M, Loddoni, S, Brundu, I, Careddu, F, Becciu, A, Gabriella Piras, G, Novara, F, Cipro, F, Torchio, G, Palumbo, P, Bianchi, A, Colucci, G, La Motta, G, Tiengo, A, Avogaro, A, Bruttomesso, D, Crepaldi, C, Fadini, G, Guarnieri, G, Lavagnini, M, Maran, A, Vedovato, M, De Kreutzenberg, V, Fedele, D, Lapolla, A, Sartore, G, Bax, G, Cardone, C, Dalfra, M, Masin, M, Toniato, R, Piarulli, F, Mattina, G, Fulantelli, M, Gioia, D, Conti, M, Ridola, G, D'Agati, F, Grossi, G, Zavaroni, I, Dei Cas, A, Franzini, L, Usberti, E, Antonimi, M, Anelli, N, Poli, R, Ridolfi, V, Michela, M, Haddoub, S, Prampolini, G, Muoio, A, Filippi, D, Bucci, F, Tardio, S, Calderini, M, Magotti, M, Quarantelli, C, Vernazza, M, Carolfi, A, Saracca, R, Picchio, E, Del Sindaco, P, Spalluto, A, Maggiulli, L, Torreggiani, V, Rastelletti, S, Ugolini, C, Pucci, N, Magi, S, Muratori, S, La Penna, G, Consoli, A, Galeone, F, Magiar, A, Gherardini, V, Moretti, L, Bientinesi, M, Landi, L, Bernardi, A, Del Prato, S, Miccoli, R, Bianchi, C, Penno, G, Venditti, F, Anichini, R, De Bellis, A, Bruschi, T, Butelli, L, Gioffredi, M, Gori, R, Picciafuochi, R, Malagoli, R, Bernini, A, Gelisio, R, Zanon, M, Del Bianco, A, Bamiston, A, Signorato, M, Citro, G, Calabrese, M, Ianni, L, Lorenzetti, M, Marsocci, A, Guizzotti, S, Memoli, G, Cabasino, F, Farci, F, Atzori, A, Sanna, A, Ghiani, M, Siotto, I, Sedda, M, Manis, A, Loddo, C, Loddo, I, Seguro, P, Cuomo, A, Orlando, L, Olanda, G, Pucci, A, Massenzo, M, Sardu, C, Perrone, G, Corazziere, F, La Puzza, I, Tripodi, P, Riggio, S, Giampaolo, A, Mannino, D, Aleandri, A, Guidi, M, Battisti, B, Faraglia, M, Lilli, V, Leotta, S, Visalli, N, Gagliardi, A, Fontana, L, Altomare, M, Carletti, S, Abbruzzese, S, Chiaramonte, F, Giordano, R, Rossini, M, Migneco, G, Cappelloni, D, Urbani, A, Piergiovanni, F, Simonetta, A, Massimiani, F, Bulzomi, R, Giuliano, M, Pennafina, M, Di Perna, P, D'Accinni, M, Paolucci, D, D'Ubaldi, A, D'Angelo, M, Masaro, G, Pietrantoni, M, Fratini, M, La Rosa, R, Poggi, M, Piccirilli, F, Pisano, R, Saponara, C, Conforti, I, Penza, A, Scalpone, R, Lo Pinto, S, Iacovella, L, Caccamo, C, Sposito, S, Teodonio, C, Restuccia, M, Mirto, G, Girardello, R, Gennaro, R, De Moliner, L, Bettini, E, Mattuzzi, A, Speese, K, Frisinghelli, F, Locatelli, F, Nicoletti, M, Trojan, N, Centis, R, L Volsi, P, Levis, E, Zanette, G, Comba, G, Ballatore, L, Cattaneo, A, Aglialoro, A, Guido, R, Patrone, M, Zecchini, M, Clementi, L, Galetta, M, Marconi, V, Bordin, P, Perale, L, Vinci, C, Sira Zanon, M, Geretto, L, Toffolo, C, Furlan, M, Mazzanti, G, Vinci, M, Sica, V, Armeni, M, Derai, R, Ennas, O, Mamusa, S, Pisano, M, Carreras, L, Rauseo, A, Cervone, S, Leggieri, A, Pontonio, M, Sturaro, R, Quattrocchi, F, Molinaro, M, Trasatti, M, Ferretti, B, Labarile, G, Baule, G, Gentilini, A, Spanu, M, Fancellu, A, Bianco, P, Lione, L, Massazza, G, Bocchio, G, Bosco, E, Monachesi, M, Carta, G, Boschetti, M, Ceresola, E, Venier, E, Calcaterra, F, Cataldi, F, Miola, M, Manfrini, S, Lai, A, Locci, B, Putzu, D, Tanganelli, I, Leonini, M, Egger, K, Marchiotto, W, Vincis, L, Orlandini, V, Pilloni, C, Farci, R, Pelligra, I, Renier, G, Mameli, M, Pala, A, Devigus, E, Fumagalli, I, Lalli, C, Leandri, M, Agliani, M, De Pascalis, L, Malci, F, De Ciocchis, A, Diodati, M, Macerola, B, Davi, S, Caccavale, A, Brocato, L, Pognant Gros, M, Borla, S, Lattanzi, E, Piersanti, C, Piersanti, A, Spinelli, I, Tuzzoli, L, Tulini, V, Quaranta, G, Iorio, V, Tirabovi, M, De Terlizi, C, Massarelli, M, Venturi, S, Travaglini, A, Draghi, P, Pomante, P, Richiardi, L, Clerico, A, Bruno, A, Cavallo Perin, P, Ghigo, E, Porta, M, Scuntero, P, Arcari, R, Bertaina, S, Bo, S, Broglio, F, Bruno, G, Degiovanni, M, Fornengo, P, Grassi, G, Inglese, V, Maccario, M, Maghenzani, G, Marena, S, Martina, V, Passera, P, Ruiu, G, Tagliabue, M, Zanone, M, Monge, M, Boffano, G, Macri, K, Maio, P, Ozzello, A, Pergolizzi, E, Gaia, D, Gennari, P, Micali, G, Rossetto, E, Dalmazzo, C, Oreglia, M, Stefani, T, Dossena, C, Paglia, P, Bosoni, S, Romanelli, T, Inchiostro, S, Dauriz, M, Bossi, C, Meregalli, G, Balini, A, Berzi, D, Filippini, B, Crotto, G, Paccagnella, A, Orrasch, M, Sambataro, M, Citro, T, Kiwanuka, E, Bagolin, E, Almoto, B, Macchia, A, Branca, M, Filesi, M, Candido, R, Caroli, E, Manca, E, Petrucco, A, Tommasi, E, Jagodnik, G, Baskar, B, Daris, N, Dal Col, P, Pellegrini, M, Tonutti, L, Venturini, G, Andreani, M, Turchi, F, Fedrighelli, F, Martinelli, G, Rongioletti, R, Candidi, M, Pais, M, Moro, E, Cervellino, F, Sinisi, R, Zampino, A, Mingardi, R, Lora, L, Reitano, R, Stocchiero, C, Simoncini, M, Mesturino, C, Zen, F, Di Pietro, S, Scoponi, C, Tilaro, L, Pelliccioni, S, Slongo, R, Vita, E, Garofalo, A, Vitale, F, Campanella, B, Mastrilli, V, Borrelli, T, D'Avino, A, Perbellini, A, Mirijello A., Viazzi F., Fioretto P., Giorda C. B., Ceriello A., Russo G. T., Guida P., Pontremoli R., De Cosmo S., Cimino A., Fava D., Meloncelli I., Nicolucci A., Pellegrini F., Rossi M. C., Turco S., Vespasiani G., Graziano G., Lucisano G., Memmo R., Pellicciotta E., Paciotti V., Pupillo M., Armentano G., Giovannini C., Armentano V., Laudato M., Acquati S., Ciardullo A. V., Laffi G., Felace G., Taboga C., Tortul C., Santantonio G., Suraci C., Ghisoni G., Raffa M., Genovese S., Lovagnini-Scher C. A., Rampini P., Rocca A., Ruggeri P., Tortato E., Cotti L., Cristofaro M. R., Tagliaferri M., Comoglio M., Fornengo R., Gentile F. M., Gigante A., Mastinu F., Di Benedetto A., Pata P., Arcangeli A., Orsini P., Acler P., De Blasi G., Cicioni G., Pocciati S., Marangoni A., Nogara A., Lanero M., Bertero M. G., Damassino R., Bergonzini C., Schumtz L., Seksich L., Pipitone A., Boaretto M., Manfroi I., Parmesan L., Conte B., Soccol F., Pagano A., Papini E., Rinaldi R., Petrucci L., Graziano F., Chianelli M., Silvagni S., Rosco M., Ansaldi E., Malvicino F., Battezzati M., Maresca P., Palenzona C., Boemi M., Rabini R. A., Brandoni G., Lanari L., Gatti C., Testa I., Cherubini V., Doveri G., Pecorelli L., Ciccarelli A., Gallardini M. B., Courthoud R., Sara Bredy S., Ricciardi G. P., Vitalone G., Setti D., Contrini P., Corsi A., Ghigliotti V., Oddone G., Ponzani P., Valbonesi G., Mazzini V., Di Berardino P., Colleluori P., Montani V., Trosini V., Velussi M., Alfidi P., Verdecchia B., Baliva L., Di Pietro A., Franchi G., Luce R. P., Pianta A., Ferrari M., Balzano S., Beltranello G., Dal Fabbro S., Arico C. N., Cervo L., Zanon R., Rossa S., Di Pace M. C., Ciavarella A., Giangiulio S., Grimaldi M., Mustacchio A., Fattor B., Monauni T., Cristini M., Orion G., Crazzolara D., Amor F., Eisath J. E., Lintner S., Garavelli S., Calari T., Marini P., Sandri O., Scala M., Stroppa C., Trentin A., Carlin R., Carli B., Sandona M., Zortea C., Bonet L., Pradel L., Reato S., Buschini M., Bonfiglioli D., Mones D., Beldi F., Morea A., Bondesan L., Perbellini S., Valentini U., Agosti B., Corsini R., Girelli A., Zarra E., Rocca L., Bergmann M., Pradi I., Unterkircher S., Piok M., Pichler M., Trinchera A., Palama G., Palma P., Carboni L., Murtas M. G., Mudadu T., Turco M. P., Floris M., Delogu A., Farris L., Songini M., Piras G., Seguro R., Floris R., Corona G., Lai M., Piras E., Contini P. P., Cocco S., Pilosu R. M., Sannia M. C., Spanu F., Busciantella Ricci N., Cartechini M. G., Agostinelli G., Fiorelli C., Nuzzi A., Ballauri C., Lesina A., Romeo F., Giudici G., Maciejewska E. G., Deroma A., Paduano M., Rossi L., Vagnini C., Dolci M., Mori M., Baccetti F., Gregori G., Straface E., Pozzuoli G., Barone M., Stasio G. B., Tondini S., Borgoni F., Grosso J., Scarsellato C., Sciulli A., De Marco F., Confortin L., Marin N., Lamonica M., Gialdino S., Borzi V., Gatta C., Rapisard R., Strano S., Calabro M., Puccio L., Zolli M., Coracina A., Starnone V., Del Buono A., Terracciano A. M., Monda M. V., Castro F., Guaglianone A., Maccari V., Corsi L., Versari G., Falivene M. R., Boletto N., Corsi S., Marafetti L., Vitacolonna E., Capani F., Caputo L., Di Nisio L., Simonetti F., Boscolo Bariga A., Ballarin G., De Boni S., Di Benedetto S., Chiambretti A. M., Di Vito L., Pascuzzo M. D., Urli P., Rumi P., Balzarini B., Galli P., Castellan M., Giannetti A., Russotti C., De Blasi A., Perna A., Campanelli C., Ranchelli A., Biccheri D., Dadi G., Massa L., Baldi G. P., Sciacca F., Costanzo E., Spada M., Paolini G., Ziller P., Portolan F., Pasolini G., Ghilardi G., Fiorina P., Grata M. L., Capretti L., Speroni G., Fugazza L., Massafra C., Lovagnini Scher A., Cimicchi M. C., Percudani C., Risolo T., Sacco P., Gidoni Guarnieri G. L., Piccolo D., Bravin C., De Noni E., Scarpel M., Marcon M., Giacon F., Panebianco G., Tadiotto F., Da Tos V., D'Ambrosio M., Pellizzola D., Zampini M. A., Frezzati E., Mari E., Raminelli E., Gaiti D., Bosi E. A., Chierici G., Pilla S., Copelli M., Zanichelli P., Bertelli L., Caretta P., Vezzani V., Bodecchi S., Longobucco A., Di Lembo S., Spotti E., Carrai E., Degli Innocenti A., Manini L., Persico R., Rossi C., Magro G., Marelli G., Vilei V., Andrioli M., Bellato L., Fedeli M., Merlini A., Pinelli G., Marin G., Contin M. L., Gallo A., Parlato P., Pecchielan W., Jacovacci J., Placentino G., Richini D., Molinari S., Strazzeri R., Fabbri T., Di Bartolo P., Garrapa G., D'Incau F., Lagomanzini P., Conte P., Todesco F., Foglini P., Pantanetti P., Bedetta C., Maricotti R., Tomasi F., Monesi M., Graziani R., Beretta F., Penna L., Guberti A., Dazzi D., Forte E., Gasbarrone A., Marrocco T., Moschetta R., Tuccinardi F., De Meo F., Coppola A., Pirolozzi P., Placitelli E., Vallefuoco R., Catone B., Ceschia S., Urban M., Fabbri F., Torresani M., Crovetto R., Battistini M., Carosia P., Viviani G. L., Durante A., Pais F., Lilliu V., Quieto C., D'Ugo E., Squadrone M., Amenduni T., Iovannisci M. M., Della Penna L., Potente F., Delle Donne T., Massa C., Ulisse M. A., De Berardinis S., Guarnieri I., Pace S., Splendiani M., Di Giuseppe R., Brunato B., Assaloni R., Muraro R., Loro R., Bucciol S., Lavacca C., Rossi M., Sabbatini G., Quadri F., Sambuco L., Santacroce C., Paola Caretta D., Marino C., Micheletti A., Petrelli A., Corda A., Pisano L., Guaita G., Deias C., Trevisan G., Coletti I., Iannarelli R., De Luca A., Minnucci A., Antenucci D., Di Florio C., Angelicola G., Bosco A., Fresco R., Di Marco G., Ugolotti D., Cadossi T., Di Caro P., Mazzocchetti M., Buzzetti R., Leto G., Gnessi C., Cipolloni L., Foffi C., Moretti C., Venditti C., Meniconi R., Bertoli S., Cosimi S., Di Cianni G., Turco A., Richini A., Marconi S., Sannino C., Lemmi P., Giuntoli S., Manfre N., Giannini F., Di Carlo A., Casadidio I., Melandri P., Maolo G., Polenta B., Piccinini N., Vincenti C., Pastore N., Mega P., Magurano E., Cananiello A., Francescutto C. A., Brussa Toi E., Gaspardo G., Angeli L., Ronchese L., Sciangula L., Ciucci A., Contartese A., Banfi E., Castelli E., Tatti P., Bloise D., Di Mauro P., Masselli L., Lo Presti A., Scarpitta A. M., Gambina F., Venezia A., Morea R., Lagonigro G., Copeta G., Iannucci V., Milano V., Trupo M., Lochmann A., Marchetto P. E., Incelli G., De Paola G., Steiger M. M., Gamper M. A., Breitenberger S., Holzner M., Frischmann J., Lambiase C., Di Vece T., D'Aniello M., Fezza M., Giordano C., Leo F., Saitta G., Cucinotta D., Di Vieste G., Pintaudi B., Mancuso T., Musacchio N., Giancaterini A., Pessina L., Salis G., Schivalocchi F., Testori G., Cerutti N., Morpugo P. S., Cavaletto M. L., Bonino G., Morreale F., Mariani G., Ragonesi P. D., Bollati P., Colapinto P., Falqui L., Bortolato L., Cosma A., Pistolato P., Centenaro B., Ceccato A., Campobasso G., Zaurino F., Mazzotta G., Manti R., Da Ros R., Carlucci S., Narduzzi L., Bortolotto D., D'Acunto L., Stanic L., Volpi A., Cospite A. M., Manicardi V., Michelini M., Finardi L., Borghi F., Manicardi E., Lombardi S., Tommasi C., Iaccarino M., Cozza S., Binotto M., Marini F., Mecenero I., Massignani S., Stecco P., Urbani E., Massariol W., Parolin R., Gatti A., Bonavita M., Creso E., Giannettino R., Gobbo M., Iovine C., Riccardi G., Iazzetta N., Giannattasio C., Egione O., Galdieri S., Velotti A., Azzolina A., Annicelli G., Sorrentino T., Gaeta I., Zenari L., Bertolini L., Sorgato C., Grippaldi F., Stroppiana M., Popolizio R., Carbone N., Grasso S., Abate S., Gaggero G. C., Strazzabosco M., Brun E., Carlesi G. P., Garrone S., Cicalo A. M., Clausi C., Cau R., Manconi A., Carboni A., Angius M. F., Pinna A. A., Caria S., Filigheddu G. D., Tonolo G., Carta I., Calebich S., Burlotti C., Saglietti G., Schellino A., Madau G., Cossu M., Mulas F., Zoccheddu S., Balsanelli M., Fetonti M., Rotolo A., Sambo P., Secchi E., Angotzi M. A., Loddoni S., Brundu I., Careddu F., Becciu A., Gabriella Piras G., Novara F., Cipro F., Torchio G., Palumbo P., Bianchi A., Colucci G., La Motta G., Tiengo A., Avogaro A., Bruttomesso D., Crepaldi C., Fadini G., Guarnieri G., Lavagnini M. T., Maran A., Vedovato M., De Kreutzenberg V., Fedele D., Lapolla A., Sartore G., Bax G., Cardone C., Dalfra M. G., Masin M., Toniato R., Piarulli F., Mattina G., Fulantelli M. A., Gioia D., Conti M., Ridola G., D'Agati F., Grossi G., Zavaroni I., Dei Cas A., Franzini L., Usberti E., Antonimi M., Anelli N., Poli R., Ridolfi V., Michela M., Haddoub S., Prampolini G., Muoio A., Filippi D., Bucci F., Tardio S. M., Calderini M. C., Magotti M. G., Quarantelli C., Vernazza M. A., Carolfi A., Saracca R., Picchio E., Del Sindaco P., Spalluto A., Maggiulli L., Torreggiani V., Rastelletti S., Ugolini C., Pucci N., Magi S., Muratori S., La Penna G., Consoli A., Galeone F., Magiar A. V., Gherardini V., Moretti L., Bientinesi M., Landi L., Bernardi A., Del Prato S., Miccoli R., Bianchi C., Penno G., Venditti F., Anichini R., De Bellis A., Bruschi T., Butelli L., Gioffredi M., Gori R., Picciafuochi R., Malagoli R., Bernini A., Gelisio R., Zanon M., Del Bianco A., Bamiston A., Signorato M., Citro G., Calabrese M., Ianni L., Lorenzetti M., Marsocci A., Guizzotti S., Memoli G., Cabasino F., Farci F., Atzori A., Sanna A., Ghiani M., Siotto I., Sedda M., Manis A., Loddo C., Loddo I., Seguro P., Cuomo A., Orlando L., Olanda G. B., Pucci A., Massenzo M., Sardu C., Perrone G., Corazziere F., La Puzza I., Tripodi P. F., Riggio S., Giampaolo A., Mannino D., Aleandri A. R., Guidi M. V., Battisti B., Faraglia M. R., Lilli V., Leotta S., Visalli N., Gagliardi A., Fontana L., Altomare M., Carletti S., Abbruzzese S., Chiaramonte F., Giordano R., Rossini M., Migneco G., Cappelloni D., Urbani A., Piergiovanni F., Simonetta A., Massimiani F., Bulzomi R., Giuliano M., Pennafina M. G., Di Perna P., D'Accinni M. P., Paolucci D., D'Ubaldi A., D'Angelo M. T., Masaro G., Pietrantoni M., Fratini M., La Rosa R., Poggi M., Piccirilli F., Pisano R., Saponara C., Conforti I., Penza A., Scalpone R., Lo Pinto S., Iacovella L., Caccamo C., Sposito S., Teodonio C., Restuccia M. G., Mirto G., Girardello R., Gennaro R., De Moliner L., Bettini E., Mattuzzi A., Speese K., Frisinghelli F., Locatelli F., Nicoletti M., Trojan N., Centis R., L Volsi P., Levis E., Zanette G., Comba G., Ballatore L., Cattaneo A., Aglialoro A., Guido R., Patrone M., Zecchini M., Clementi L., Galetta M., Marconi V., Bordin P., Perale L., Vinci C., Sira Zanon M., Geretto L., Toffolo C., Furlan M. G., Mazzanti G., Vinci M., Sica V., Armeni M., Derai R., Ennas O., Mamusa S., Pisano M. A., Carreras L., Rauseo A., Cervone S., Leggieri A., Pontonio M., Sturaro R., Quattrocchi F., Molinaro M., Trasatti M., Ferretti B., Labarile G., Baule G. M., Gentilini A., Spanu M. A., Fancellu A., Bianco P., Lione L., Massazza G., Bocchio G., Bosco E., Monachesi M., Carta G., Boschetti M., Ceresola E., Venier E., Calcaterra F., Cataldi F., Miola M., Manfrini S., Lai A., Locci B., Putzu D., Tanganelli I., Leonini M., Egger K., Marchiotto W., Vincis L., Orlandini V., Pilloni C., Farci R., Pelligra I., Renier G., Mameli M., Pala A., Devigus E., Fumagalli I., Lalli C., Leandri M., Agliani M., De Pascalis L., Malci F., De Ciocchis A., Diodati M. B., Macerola B., Davi S., Caccavale A., Brocato L., Pognant Gros M., Borla S., Lattanzi E., Piersanti C., Piersanti A., Spinelli I., Tuzzoli L., Tulini V., Quaranta G., Iorio V., Tirabovi M., De Terlizi C., Massarelli M. G., Venturi S., Travaglini A., Draghi P., Pomante P., Richiardi L., Clerico A., Bruno A., Cavallo Perin P., Ghigo E., Porta M., Scuntero P., Arcari R., Bertaina S., Bo S., Broglio F., Bruno G., Degiovanni M., Fornengo P., Grassi G., Inglese V., Maccario M., Maghenzani G., Marena S., Martina V., Passera P., Ruiu G., Tagliabue M., Zanone M., Monge M., Boffano G. M., Macri K., Maio P., Ozzello A., Pergolizzi E., Gaia D., Gennari P., Micali G., Rossetto E., Dalmazzo C., Oreglia M., Stefani T., Dossena C., Paglia P., Bosoni S., Romanelli T., Inchiostro S., Dauriz M., Bossi C. A., Meregalli G., Balini A., Berzi D., Filippini B., Crotto G., Paccagnella A., Orrasch M., Sambataro M., Citro T., Kiwanuka E., Bagolin E., Almoto B., Macchia A., Branca M. T., Filesi M., Candido R., Caroli E., Manca E., Petrucco A., Tommasi E., Jagodnik G., Baskar B., Daris N., Dal Col P., Pellegrini M. A., Tonutti L., Venturini G., Andreani M., Turchi F., Fedrighelli F., Martinelli G., Rongioletti R., Candidi M., Pais M., Moro E., Cervellino F., Sinisi R., Zampino A., Mingardi R., Lora L., Reitano R., Stocchiero C., Simoncini M., Mesturino C. 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A., Tonutti L., Venturini G., Andreani M., Turchi F., Fedrighelli F., Martinelli G., Rongioletti R., Candidi M., Pais M., Moro E., Cervellino F., Sinisi R., Zampino A., Mingardi R., Lora L., Reitano R., Stocchiero C., Simoncini M., Mesturino C. A., Zen F., Di Pietro S., Scoponi C., Tilaro L., Pelliccioni S., Slongo R., Vita E., Garofalo A., Vitale F., Campanella B., Mastrilli V., Borrelli T., D'Avino A., and Perbellini A.

Abstract

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ≥3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ≥3 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage ≥3 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 ± 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage ≥3 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage ≥3 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening.

Published
2018

19. Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes 11 Medical and Health Sciences 1103 Clinical Sciences

Author

Mirijello, Antonio, Viazzi, Francesca, Fioretto, Paola, Giorda, C. B., Ceriello, Antonio, Russo, Giuspina T., Guida, Pietro, Pontremoli, Roberto, De Cosmo, S., Cimino, Antonino, Fava, Danila, Meloncelli, Illidio, Nicolucci, Antonio, Pellegrini, Fabio, Rossi, Maria Chiara, Turco, Salvatore, Vespasiani, Giacomo, Graziano, G., Lucisano, G., Memmo, R., Pellicciotta, E., Paciotti, V., Pupillo, M., Armentano, G., Giovannini, C., Armentano, V., Laudato, M., Acquati, S., Ciardullo, A. V., Laffi, G., Felace, G., Taboga, C., Tortul, C., Santantonio, G., Suraci, C., Ghisoni, G., Raffa, M., Genovese, S., Lovagnini-Scher, C. A., Rampini, P., Rocca, A., Ruggeri, P., Tortato, E., Cotti, L., Cristofaro, M. R., Tagliaferri, M., Comoglio, M., Fornengo, R., Gentile, F. M., Gigante, Antonio, Mastinu, F., Di Benedetto, A., Pata, P., Arcangeli, A., Orsini, P., Acler, P., De Blasi, G., Cicioni, G., Pocciati, S., Marangoni, A., Nogara, A., Lanero, M., Bertero, M. 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Bergonzini, C, Schumtz, L, Seksich, L, Pipitone, A, Boaretto, M, Manfroi, I, Parmesan, L, Conte, B, Soccol, F, Pagano, A, Papini, E, Rinaldi, R, Petrucci, L, Graziano, F, Chianelli, M, Silvagni, S, Rosco, M, Ansaldi, E, Malvicino, F, Battezzati, M, Maresca, P, Palenzona, C, Boemi, M, Rabini, R, Brandoni, G, Lanari, L, Gatti, C, Testa, I, Cherubini, V, Doveri, G, Pecorelli, L, Ciccarelli, A, Gallardini, M, Courthoud, R, Sara Bredy, S, Ricciardi, G, Vitalone, G, Setti, D, Contrini, P, Corsi, A, Ghigliotti, V, Oddone, G, Ponzani, P, Valbonesi, G, Mazzini, V, Di Berardino, P, Colleluori, P, Montani, V, Trosini, V, Velussi, M, Alfidi, P, Verdecchia, B, Baliva, L, Di Pietro, A, Franchi, G, Luce, R, Pianta, A, Ferrari, M, Balzano, S, Beltranello, G, Dal Fabbro, S, Arico, C, Cervo, L, Zanon, R, Rossa, S, Di Pace, M, Ciavarella, A, Giangiulio, S, Grimaldi, M, Mustacchio, A, Fattor, B, Monauni, T, Cristini, M, Orion, G, Crazzolara, D, Amor, F, Eisath, J, Lintner, S, Garavelli, S, Calari, T, Marini, P, Sandri, O, Scala, M, Stroppa, C, Trentin, A, Carlin, R, Carli, B, Sandona, M, Zortea, C, Bonet, L, Pradel, L, Reato, S, Buschini, M, Bonfiglioli, D, Mones, D, Beldi, F, Morea, A, Bondesan, L, Perbellini, S, Valentini, U, Agosti, B, Corsini, R, Girelli, A, Zarra, E, Rocca, L, Bergmann, M, Pradi, I, Unterkircher, S, Piok, M, Pichler, M, Trinchera, A, Palama, G, Palma, P, Carboni, L, Murtas, M, Mudadu, T, Turco, M, Floris, M, Delogu, A, Farris, L, Songini, M, Piras, G, Seguro, R, Floris, R, Corona, G, Lai, M, Piras, E, Contini, P, Cocco, S, Pilosu, R, Sannia, M, Spanu, F, Busciantella Ricci, N, Cartechini, M, Agostinelli, G, Fiorelli, C, Nuzzi, A, Ballauri, C, Lesina, A, Romeo, F, Giudici, G, Maciejewska, E, Deroma, A, Paduano, M, Rossi, L, Vagnini, C, Dolci, M, Mori, M, Baccetti, F, Gregori, G, Straface, E, Pozzuoli, G, Barone, M, Stasio, G, Tondini, S, Borgoni, F, Grosso, J, Scarsellato, C, Sciulli, A, De Marco, F, Confortin, L, Marin, N, Lamonica, M, Gialdino, S, Borzi, V, Gatta, C, Rapisard, R, Strano, S, Calabro, M, Puccio, L, Zolli, M, Coracina, A, Starnone, V, Del Buono, A, Terracciano, A, Monda, M, Castro, F, Guaglianone, A, Maccari, V, Corsi, L, Versari, G, Falivene, M, Boletto, N, Corsi, S, Marafetti, L, Vitacolonna, E, Capani, F, Caputo, L, Di Nisio, L, Simonetti, F, Boscolo Bariga, A, Ballarin, G, De Boni, S, Di Benedetto, S, Chiambretti, A, Di Vito, L, Pascuzzo, M, Urli, P, Rumi, P, Balzarini, B, Galli, P, Castellan, M, Giannetti, A, Russotti, C, De Blasi, A, Perna, A, Campanelli, C, Ranchelli, A, Biccheri, D, Dadi, G, Massa, L, Baldi, G, Sciacca, F, Costanzo, E, Spada, M, Paolini, G, Ziller, P, Portolan, F, Pasolini, G, Ghilardi, G, Fiorina, P, Grata, M, Capretti, L, Speroni, G, Fugazza, L, Massafra, C, Lovagnini Scher, A, Cimicchi, M, Percudani, C, Risolo, T, Sacco, P, Gidoni Guarnieri, G, Piccolo, D, Bravin, C, De Noni, E, Scarpel, M, Marcon, M, Giacon, F, Panebianco, G, Tadiotto, F, Da Tos, V, D'Ambrosio, M, Pellizzola, D, Zampini, M, Frezzati, E, Mari, E, Raminelli, E, Gaiti, D, Bosi, E, Chierici, G, Pilla, S, Copelli, M, Zanichelli, P, Bertelli, L, Caretta, P, Vezzani, V, Bodecchi, S, Longobucco, A, Di Lembo, S, Spotti, E, Carrai, E, Degli Innocenti, A, Manini, L, Persico, R, Rossi, C, Magro, G, Marelli, G, Vilei, V, Andrioli, M, Bellato, L, Fedeli, M, Merlini, A, Pinelli, G, Marin, G, Contin, M, Gallo, A, Parlato, P, Pecchielan, W, Jacovacci, J, Placentino, G, Richini, D, Molinari, S, Strazzeri, R, Fabbri, T, Di Bartolo, P, Garrapa, G, D'Incau, F, Lagomanzini, P, Conte, P, Todesco, F, Foglini, P, Pantanetti, P, Bedetta, C, Maricotti, R, Tomasi, F, Monesi, M, Graziani, R, Beretta, F, Penna, L, Guberti, A, Dazzi, D, Forte, E, Gasbarrone, A, Marrocco, T, Moschetta, R, Tuccinardi, F, De Meo, F, Coppola, A, Pirolozzi, P, Placitelli, E, Vallefuoco, R, Catone, B, Ceschia, S, Urban, M, Fabbri, F, Torresani, M, Crovetto, R, Battistini, M, Carosia, P, Viviani, G, Durante, A, Pais, F, Lilliu, V, Quieto, C, D'Ugo, E, Squadrone, M, Amenduni, T, Iovannisci, M, Della Penna, L, Potente, F, Delle Donne, T, Massa, C, Ulisse, M, De Berardinis, S, Guarnieri, I, Pace, S, Splendiani, M, Di Giuseppe, R, Brunato, B, Assaloni, R, Muraro, R, Loro, R, Bucciol, S, Lavacca, C, Sabbatini, G, Quadri, F, Sambuco, L, Santacroce, C, Paola Caretta, D, Marino, C, Micheletti, A, Petrelli, A, Corda, A, Pisano, L, Guaita, G, Deias, C, Trevisan, G, Coletti, I, Iannarelli, R, De Luca, A, Minnucci, A, Antenucci, D, Di Florio, C, Angelicola, G, Bosco, A, Fresco, R, Di Marco, G, Ugolotti, D, Cadossi, T, Di Caro, P, Mazzocchetti, M, Buzzetti, R, Leto, G, Gnessi, C, Cipolloni, L, Foffi, C, Moretti, C, Venditti, C, Meniconi, R, Bertoli, S, Cosimi, S, Di Cianni, G, Turco, A, Richini, A, Marconi, S, Sannino, C, Lemmi, P, Giuntoli, S, Manfre, N, Giannini, F, Di Carlo, A, Casadidio, I, Melandri, P, Maolo, G, Polenta, B, Piccinini, N, Vincenti, C, Pastore, N, Mega, P, Magurano, E, Cananiello, A, Francescutto, C, Brussa Toi, E, Gaspardo, G, Angeli, L, Ronchese, L, Sciangula, L, Ciucci, A, Contartese, A, Banfi, E, Castelli, E, Tatti, P, Bloise, D, Di Mauro, P, Masselli, L, Lo Presti, A, Scarpitta, A, Gambina, F, Venezia, A, Morea, R, Lagonigro, G, Copeta, G, Iannucci, V, Milano, V, Trupo, M, Lochmann, A, Marchetto, P, Incelli, G, De Paola, G, Steiger, M, Gamper, M, Breitenberger, S, Holzner, M, Frischmann, J, Lambiase, C, Di Vece, T, D'Aniello, M, Fezza, M, Giordano, C, Leo, F, Saitta, G, Cucinotta, D, Di Vieste, G, Pintaudi, B, Mancuso, T, Musacchio, N, Giancaterini, A, Pessina, L, Salis, G, Schivalocchi, F, Testori, G, Cerutti, N, Morpugo, P, Cavaletto, M, Bonino, G, Morreale, F, Mariani, G, Ragonesi, P, Bollati, P, Colapinto, P, Falqui, L, Bortolato, L, Cosma, A, Pistolato, P, Centenaro, B, Ceccato, A, Campobasso, G, Zaurino, F, Mazzotta, G, Manti, R, Da Ros, R, Carlucci, S, Narduzzi, L, Bortolotto, D, D'Acunto, L, Stanic, L, Volpi, A, Cospite, A, Manicardi, V, Michelini, M, Finardi, L, Borghi, F, Manicardi, E, Lombardi, S, Tommasi, C, Iaccarino, M, Cozza, S, Binotto, M, Marini, F, Mecenero, I, Massignani, S, Stecco, P, Urbani, E, Massariol, W, Parolin, R, Gatti, A, Bonavita, M, Creso, E, Giannettino, R, Gobbo, M, Iovine, C, Riccardi, G, Iazzetta, N, Giannattasio, C, Egione, O, Galdieri, S, Velotti, A, Azzolina, A, Annicelli, G, Sorrentino, T, Gaeta, I, Zenari, L, Bertolini, L, Sorgato, C, Grippaldi, F, Stroppiana, M, Popolizio, R, Carbone, N, Grasso, S, Abate, S, Gaggero, G, Strazzabosco, M, Brun, E, Carlesi, G, Garrone, S, Cicalo, A, Clausi, C, Cau, R, Manconi, A, Carboni, A, Angius, M, Pinna, A, Caria, S, Filigheddu, G, Tonolo, G, Carta, I, Calebich, S, Burlotti, C, Saglietti, G, Schellino, A, Madau, G, Cossu, M, Mulas, F, Zoccheddu, S, Balsanelli, M, Fetonti, M, Rotolo, A, Sambo, P, Secchi, E, Angotzi, M, Loddoni, S, Brundu, I, Careddu, F, Becciu, A, Gabriella Piras, G, Novara, F, Cipro, F, Torchio, G, Palumbo, P, Bianchi, A, Colucci, G, La Motta, G, Tiengo, A, Avogaro, A, Bruttomesso, D, Crepaldi, C, Fadini, G, Guarnieri, G, Lavagnini, M, Maran, A, Vedovato, M, De Kreutzenberg, V, Fedele, D, Lapolla, A, Sartore, G, Bax, G, Cardone, C, Dalfra, M, Masin, M, Toniato, R, Piarulli, F, Mattina, G, Fulantelli, M, Gioia, D, Conti, M, Ridola, G, D'Agati, F, Grossi, G, Zavaroni, I, Dei Cas, A, Franzini, L, Usberti, E, Antonimi, M, Anelli, N, Poli, R, Ridolfi, V, Michela, M, Haddoub, S, Prampolini, G, Muoio, A, Filippi, D, Bucci, F, Tardio, S, Calderini, M, Magotti, M, Quarantelli, C, Vernazza, M, Carolfi, A, Saracca, R, Picchio, E, Del Sindaco, P, Spalluto, A, Maggiulli, L, Torreggiani, V, Rastelletti, S, Ugolini, C, Pucci, N, Magi, S, Muratori, S, La Penna, G, Consoli, A, Galeone, F, Magiar, A, Gherardini, V, Moretti, L, Bientinesi, M, Landi, L, Bernardi, A, Del Prato, S, Miccoli, R, Bianchi, C, Penno, G, Venditti, F, Anichini, R, De Bellis, A, Bruschi, T, Butelli, L, Gioffredi, M, Gori, R, Picciafuochi, R, Malagoli, R, Bernini, A, Gelisio, R, Zanon, M, Del Bianco, A, Bamiston, A, Signorato, M, Citro, G, Calabrese, M, Ianni, L, Lorenzetti, M, Marsocci, A, Guizzotti, S, Memoli, G, Cabasino, F, Farci, F, Atzori, A, Sanna, A, Ghiani, M, Siotto, I, Sedda, M, Manis, A, Loddo, C, Loddo, I, Seguro, P, Cuomo, A, Orlando, L, Olanda, G, Pucci, A, Massenzo, M, Sardu, C, Perrone, G, Corazziere, F, La Puzza, I, Tripodi, P, Riggio, S, Giampaolo, A, Mannino, D, Aleandri, A, Guidi, M, Battisti, B, Faraglia, M, Lilli, V, Leotta, S, Visalli, N, Gagliardi, A, Fontana, L, Altomare, M, Carletti, S, Abbruzzese, S, Chiaramonte, F, Giordano, R, Rossini, M, Migneco, G, Cappelloni, D, Urbani, A, Piergiovanni, F, Simonetta, A, Massimiani, F, Bulzomi, R, Giuliano, M, Pennafina, M, Di Perna, P, D'Accinni, M, Paolucci, D, D'Ubaldi, A, D'Angelo, M, Masaro, G, Pietrantoni, M, Fratini, M, La Rosa, R, Poggi, M, Piccirilli, F, Pisano, R, Saponara, C, Conforti, I, Penza, A, Scalpone, R, Lo Pinto, S, Iacovella, L, Caccamo, C, Sposito, S, Teodonio, C, Restuccia, M, Mirto, G, Girardello, R, Gennaro, R, De Moliner, L, Bettini, E, Mattuzzi, A, Speese, K, Frisinghelli, F, Locatelli, F, Nicoletti, M, Trojan, N, Centis, R, L Volsi, P, Levis, E, Zanette, G, Comba, G, Ballatore, L, Cattaneo, A, Aglialoro, A, Guido, R, Patrone, M, Zecchini, M, Clementi, L, Galetta, M, Marconi, V, Bordin, P, Perale, L, Vinci, C, Sira Zanon, M, Geretto, L, Toffolo, C, Furlan, M, Mazzanti, G, Vinci, M, Sica, V, Armeni, M, Derai, R, Ennas, O, Mamusa, S, Pisano, M, Carreras, L, Rauseo, A, Cervone, S, Leggieri, A, Pontonio, M, Sturaro, R, Quattrocchi, F, Molinaro, M, Trasatti, M, Ferretti, B, Labarile, G, Baule, G, Gentilini, A, Spanu, M, Fancellu, A, Bianco, P, Lione, L, Massazza, G, Bocchio, G, Bosco, E, Monachesi, M, Carta, G, Boschetti, M, Ceresola, E, Venier, E, Calcaterra, F, Cataldi, F, Miola, M, Manfrini, S, Lai, A, Locci, B, Putzu, D, Tanganelli, I, Leonini, M, Egger, K, Marchiotto, W, Vincis, L, Orlandini, V, Pilloni, C, Farci, R, Pelligra, I, Renier, G, Mameli, M, Pala, A, Devigus, E, Fumagalli, I, Lalli, C, Leandri, M, Agliani, M, De Pascalis, L, Malci, F, De Ciocchis, A, Diodati, M, Macerola, B, Davi, S, Caccavale, A, Brocato, L, Pognant Gros, M, Borla, S, Lattanzi, E, Piersanti, C, Piersanti, A, Spinelli, I, Tuzzoli, L, Tulini, V, Quaranta, G, Iorio, V, Tirabovi, M, De Terlizi, C, Massarelli, M, Venturi, S, Travaglini, A, Draghi, P, Pomante, P, Richiardi, L, Clerico, A, Bruno, A, Cavallo Perin, P, Ghigo, E, Porta, M, Scuntero, P, Arcari, R, Bertaina, S, Bo, S, Broglio, F, Bruno, G, Degiovanni, M, Fornengo, P, Grassi, G, Inglese, V, Maccario, M, Maghenzani, G, Marena, S, Martina, V, Passera, P, Ruiu, G, Tagliabue, M, Zanone, M, Monge, M, Boffano, G, Macri, K, Maio, P, Ozzello, A, Pergolizzi, E, Gaia, D, Gennari, P, Micali, G, Rossetto, E, Dalmazzo, C, Oreglia, M, Stefani, T, Dossena, C, Paglia, P, Bosoni, S, Romanelli, T, Inchiostro, S, Dauriz, M, Bossi, C, Meregalli, G, Balini, A, Berzi, D, Filippini, B, Crotto, G, Paccagnella, A, Orrasch, M, Sambataro, M, Citro, T, Kiwanuka, E, Bagolin, E, Almoto, B, Macchia, A, Branca, M, Filesi, M, Candido, R, Caroli, E, Manca, E, Petrucco, A, Tommasi, E, Jagodnik, G, Baskar, B, Daris, N, Dal Col, P, Pellegrini, M, Tonutti, L, Venturini, G, Andreani, M, Turchi, F, Fedrighelli, F, Martinelli, G, Rongioletti, R, Candidi, M, Pais, M, Moro, E, Cervellino, F, Sinisi, R, Zampino, A, Mingardi, R, Lora, L, Reitano, R, Stocchiero, C, Simoncini, M, Mesturino, C, Zen, F, Di Pietro, S, Scoponi, C, Tilaro, L, Pelliccioni, S, Slongo, R, Vita, E, Garofalo, A, Vitale, F, Campanella, B, Mastrilli, V, Borrelli, T, D'Avino, A, and Perbellini, A

Subjects
Albuminuria, Diabetic kidney disease, GFR, Albuminuria, Diabetic kidney disease, GFR, Nephrology
Abstract

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ≥3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ≥3 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage ≥3 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 ± 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage ≥3 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage ≥3 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening.

Published
2018

21. Scanning electron microscopy of lung disease due to COVID-19 - a case report and a review of the literature.

Author

CONGIU, T., DEMONTIS, R., CAU, F., PIRAS, M., FANNI, D., GEROSA, C., BOTTA, C., SCANO, A., CHIGHINE, A., FAEDDA, E., CAU, R., VAN EYKEN, P., MARONGIU, F., BARCELLONA, D., SABA, L., ORRÙ5, G., COGHE, F., SURI, J. S., FAA, G., and D'ALOJA, E.

Abstract

OBJECTIVE: The ongoing Coronavirus pandemic (COVID-19) showed similar characteristics with the severe acute respiratory syndrome (SARS). In the most compromised cases, COVID-19 infection leads to death due to severe respiratory complications. COVID-19-related acute respiratory distress syndrome (ARDS) is the primary cause of death in these patients. In the present study, we show an ultrastructural analysis on the lungs of a patient affected by COVID-19. PATIENTS AND METHODS: Lung specimens obtained at autopsy from a 63-years old patient affected by COVID-19 were fixed in 1% paraformaldehyde. Slices of 300 µm thickness were dehydrated and dried by Critical Point Drying in CO2. Slices were covered with a conductive gold film approximately 30 nm thick and observed at a Zeiss Sigma 300 SEM FEG in the secondary electron (SE) and backscattered electron (BSE) modes. As case control a lung biopsy from a 60-year-old man was considered. RESULTS: At low power in all COVID-19 lung specimens severe changes in the pulmonary architecture were found, due to the collapse of air spaces. Moreover, alveolar cavities were covered by large membranes. At high power, alveolar membranes showed a fibrillar structure, suggestive of a loose network of fibrin. It has been also found that intra-alveolar red blood cells were frequently present in the alveolar spaces, surrounded by a reticular fibrin network, suggestive for fibrin-hemorrhagic alveolitis. Alveolar changes were constantly associated with pathological features related to the pulmonary vessels. Vascular changes were prominent, including endothelial damage and thrombosis of large pulmonary vessels. Fibrinous microthrombi were frequently detected in the inter-alveolar septal capillaries. In addition, it has been frequently detected capillary proliferation in the alveolar septa with finding suggestive for intussusceptive neo-angiogenesis. CONCLUSIONS: In conclusion, our electron microscopy analysis showed that COVID-19-related lung disease is characterized by a substantial architectural distortion, with the interactions between alveolar and vascular changes. Intra-alveolar hyaline membranes are associated with macroand micro-thrombotic angiopathy, ending with capillary proliferation. The new blood vessel formation originates from the septa and extends into the surrounding parenchyma. Our findings confirm previous reports on the specificity of the multiple and complex morphological pattern typical, and apparently specific, of COVID-19-related lung disease. [ABSTRACT FROM AUTHOR]

Published
2021

23. Fetal programming of atherosclerosis: may the barker hypothesis explain the susceptibility of a subset of patients to develop stroke or cardiac infarct?

Author

GEROSA, C., FAA, G., FANNI, D., CERRONE, G., SURI, J. S., BARCELLONA, D., CONI, P., CONGIU, T., LAI, M. L., PIRAS, M., CAU, F., COGHE, F., BALESTRIERI, A., CAU, R., ORRU', G., SCANO, A., VAN EYKEN, P., LA NASA, G., CAMPAGNA, M., and CASTAGNOLA, M.

Abstract

The risk stratification of young adults between subjects who will develop a mild form of atherosclerosis and subjects who will undergo a severe disease remains inaccurate. In the eighties of the previous century, David JP Barker has demonstrated the relationship between fetal conditions and occurrence of pathologies in adulthood. In this paper, the multiple evidence that might explain the increased susceptibility to severe forms of atherosclerosis, including stroke and cardiac infarct, in subjects who underwent intrauterine growth restriction (IUGR) will be analyzed. Specifically, we will review those inter-connected data indicating an association between a low weight at birth and an adult phenotype which might favor a severe outcome of atherosclerosis. Young and adult subjects born too small (IUGR) or too early (pre-terms) might represent a subgroup of "at risk subjects", more susceptible toward severe forms of atherosclerosis. Given that low birth weight (LBW) may be considered a surrogate of IUGR, this phenotypic feature could be considered among those indispensable clinical data collected in every patient presenting with atherosclerosis, irrespectively of age. According to the hypothesis that structural arterial changes might represent the link between LBW and susceptibility to atherosclerosis later in life, we suggest that the prevention of atherosclerosis should begin at birth. Regenerative and physiological substances such as thymosin Beta-4 could be challenged for a new "arterial regenerative medicine" in the perinatal period. The goal of this new approach should be the reinforcement of the structure of the arterial wall, allowing LBW newborns to avoid the most severe complications of atherosclerosis later in life: a dream that our research could contribute to bringing to life. [ABSTRACT FROM AUTHOR]

Published
2021

24. Fetal programming of COVID-19: may the barker hypothesis explain the susceptibility of a subset of young adults to develop severe disease?

Author

GEROSA, C., FAA, G., FANNI, D., MANCHIA, M., SURI, J. S., RAVARINO, A., BARCELLONA, D., PICHIRI, G., CONI, P., CONGIU, T., PIRAS, M., CERRONE, G., CAU, F., LEDDA, F., AIMOLA, V., COGHE, F., PORCU, M., CAU, R., ORRU’, G., and VAN EYKEN, P.

Abstract

The risk stratification of young adults between subjects who will develop a mild form COVID-19 and subjects who will undergo a severe disease remains inaccurate. In this review, we propose that the Barker hypothesis might explain the increased susceptibility to severe forms of COVID-19 in subjects who underwent intrauterine growth restriction (IUGR). In this paper evidence indicating an association between a low birth weight and an adult phenotype which might favor a severe outcome of SARS-CoV-2 infection are presented: lower lung functional capacity; increased respiratory morbidity; changes in fibrinogen and Factor VII serum levels and dysregulation of the hemostasis and thrombosis system; acquisition of a pro-thrombotic phenotype; low nephron number, with decreased ability to sustain renal function and increased renal morbidity; heart remodeling, with a less efficient cardiac function; endothelial dysfunction, a risk factor for the insurgence of the multiple organ failure; remodeling of arteries, with changes in the elastic properties of the arterial wall, predisposing to the insurgence and progression of atherosclerosis; dysfunction of the innate immune system, a risk factor for immune diseases in adulthood. These data suggest that young and adult subjects born too small (IUGR) or too early (pre-terms) might represent a subgroup of “at risk subjects”, more susceptible toward severe forms of COVID-19. Given that LBW may be considered a surrogate of IUGR, this phenotypic marker should be included among the indispensable clinical data collected in every patient presenting with SARSCOV- 2 infection, irrespectively of his/her age. [ABSTRACT FROM AUTHOR]

Published
2021

26. Plasma cells in the carotid plaque: occurrence and significance.

Author

CERRONE, G., FANNI, D., LAI, M. L., GEROSA, C., CAU, R., BALESTRIERI, A., ORRÙ, G., SENES, G., FAA, G., and SABA, L.

Abstract

OBJECTIVE: Atherosclerosis is one of the leading causes of disability and mortality worldwide. Inflammation, including monocytes, T and B cells, plays a key role in its pathogenesis. Our purpose was to evaluate plasma cells' presence in a large series of carotid artery plaques and the clinical association. PATIENTS AND METHODS: Forty-eight consecutive patients treated with carotid endarterectomy were retrospectively analyzed to assess plasma cells' presence inside the plaque. A semiquantitative grading score was applied, ranging from absence, scattered, clusters of 5-10, and sheets of >10 plasma cells. Plasma cell's location, as intraplaque, subendothelial or peri-adventitial, was also defined. RESULTS: In 75% of plaques analyzed, plasma cells were detected: scattered in 63.9%, in clusters in 22.2%, and in sheets in 13.9% of cases. In all cases, plasma cells were observed only inside the plaque. In 13.9% and in 11.1% of cases, plasma cells showed, respectively, a concomitant subendothelial or peri-adventitial distribution. In 5.6% of plaques, there was a simultaneous distribution in subendothelial, peri-adventitial layer, and intraplaque. Association between the presence of symptoms and plasma cells infiltrate was found. CONCLUSIONS: Our results suggest that plasma cells could be a key parameter linked to plaque instability. Some types of configurations are significantly associated with the occurrence of cerebrovascular symptoms. [ABSTRACT FROM AUTHOR]

Published
2021

27. Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Author

Mirijello, Antonio, Viazzi, Francesca, Fioretto, Paola, Giorda, Carlo, Ceriello, Antonio, Russo, Giuspina T., Guida, Pietro, Pontremoli, Roberto, De Cosmo, Salvatore, Cimino, Antonino, Fava, Danila, Giorda, Carlo Bruno, Meloncelli, Illidio, Nicolucci, Antonio, Pellegrini, Fabio, Rossi, Maria Chiara, Turco, Salvatore, Vespasiani, Giacomo, Pellegrini, F., Graziano, G., Lucisano, G., Memmo, R., Pellicciotta, E., Paciotti, V., Pupillo, M., Armentano, G., Giovannini, C., Armentano, V., Laudato, M., Turco, S., Acquati, S., Ciardullo, A. V., Laffi, G., Felace, G., Taboga, C., Tortul, C., Santantonio, G., Suraci, C., Ghisoni, G., Raffa, M., Genovese, S., Lovagnini-Scher, C. A., Rampini, P., Rocca, A., Ruggeri, P., Tortato, E., Cotti, L., Cristofaro, M. R., Tagliaferri, M., Comoglio, M., Fornengo, R., De Cosmo, S., Gentile, F. M., Gigante, A., Mastinu, F., Di Benedetto, A., Pata, P., Arcangeli, A., Orsini, P., Acler, P., De Blasi, G., Cicioni, G., Pocciati, S., Marangoni, A., Nogara, A., Lanero, M., Bertero, M. G., Damassino, R., Bergonzini, C., Schumtz, L., Seksich, L., Pipitone, A., Boaretto, M., Manfroi, I., Parmesan, L., Conte, B., Soccol, F., Pagano, A., Papini, E., Rinaldi, R., Petrucci, L., Graziano, F., Chianelli, M., Silvagni, S., Rosco, M., Ansaldi, E., Malvicino, F., Battezzati, M., Maresca, P., Palenzona, C., Boemi, M., Rabini, R. A., Brandoni, G., Lanari, L., Gatti, C., Testa, I., Cherubini, V., Doveri, G., Pecorelli, L., Ciccarelli, A., Gallardini, M. B., Courthoud, R., Sara Bredy, S., Ricciardi, G. P., Vitalone, G., Setti, D., Contrini, P., Corsi, A., Ghigliotti, V., Oddone, G., Ponzani, P., Valbonesi, G., Mazzini, V., Di Berardino, P., Colleluori, P., Montani, V., Trosini, V., Velussi, M., Alfidi, P., Verdecchia, B., Baliva, L., Di Pietro, A., Franchi, G., Luce, R. P., Pianta, A., Ferrari, M., Balzano, S., Beltranello, G., Dal Fabbro, S., Aricò, C. N., Cervo, L., Zanon, R., Rossa, S., Di Pace, M. C., Ciavarella, A., Giangiulio, S., Grimaldi, M., Mustacchio, A., Santacroce, G., Fattor, B., Monauni, T., Cristini, M., Orion, G., Crazzolara, D., Amor, F., Eisath, J. E., Lintner, S., Garavelli, S., Calari, T., Marini, P., Sandri, O., Scala, M., Stroppa, C., Trentin, A., Carlin, R., Carli, B., Sandonà, M., Zortea, C., Bonet, L., Pradel, L., Reato, S., Buschini, M., Bonfiglioli, D., Mones, D., Beldì, F., Morea, A., Bondesan, L., Perbellini, S., Cimino, A., Valentini, U., Agosti, B., Corsini, R., Girelli, A., Zarra, E., Rocca, L., Bergmann, M., Pradi, I., Unterkircher, S., Piok, M., Pichler, M., Trinchera, A., Palamà, G., Palma, P., Carboni, L., Murtas, M. G., Mudadu, T., Turco, M. P., Floris, M., Delogu, A., Farris, L., Songini, M., Piras, G., Seguro, R., Floris, R., Corona, G., Lai, M., Piras, E., Contini, P. P., Cocco, S., Pilosu, R. M., Sannia, M. C., Spanu, F., Busciantella Ricci, N., Cartechini, M. G., Agostinelli, G., Fiorelli, C., Nuzzi, A., Ballauri, C., Giorda, C. B., Lesina, A., Romeo, F., Giudici, G., Maciejewska, E. G., Deroma, A., Paduano, M., Rossi, L., Vagnini, C., Dolci, M., Mori, M., Baccetti, F., Gregori, G., Straface, E., Pozzuoli, G., Barone, M., Stasio, G. B., Tondini, S., Borgoni, F., Grosso, J., Scarsellato, C., Sciulli, A., De Marco, F., Confortin, L., Marin, N., Lamonica, M., Gialdino, S., Borzì, V., Gatta, C., Rapisard, R., Strano, S., Calabrò, M., Puccio, L., Zolli, M., Coracina, A., Starnone, V., Del Buono, A., Terracciano, A. M., Monda, M. V., Castro, F., Guaglianone, A., Maccari, V., Corsi, L., Versari, G., Falivene, M. R., Boletto, N., Corsi, S., Marafetti, L., Vitacolonna, E., Capani, F., Caputo, L., Di Nisio, L., Simonetti, F., Boscolo Bariga, A., Ballarin, G., De Boni, S., Di Benedetto, S., Chiambretti, A. M., Di Vito, L., Pascuzzo, M. D., Urli, P., Rumi, P., Balzarini, B., Galli, P., Castellan, M., Giannetti, A., Russotti, C., De Blasi, A., Perna, A., Campanelli, C., Ranchelli, A., Biccheri, D., Dadi, G., Massa, L., Baldi, G. P., Sciacca, F., Costanzo, E., Spada, M., Paolini, G., Ziller, P., Portolan, F., Pasolini, G., Ghilardi, G., Fiorina, P., Grata, M. L., Capretti, L., Speroni, G., Fugazza, L., Massafra, C., Lovagnini Scher, A., Cimicchi, M. C., Percudani, C., Risolo, T., Saccò, P., Gidoni Guarnieri, G. L., Piccolo, D., Bravin, C., De Noni, E., Scarpel, M., Marcon, M., Giacon, F., Panebianco, G., Tadiotto, F., Da Tos, V., D'Ambrosio, M., Pellizzola, D., Zampini, M. A., Frezzati, E., Mari, E., Raminelli, E., Gaiti, D., Bosi, E. A., Chierici, G., Pilla, S., Copelli, M., Zanichelli, P., Bertelli, L., Caretta, P., Vezzani, V., Bodecchi, S., Longobucco, A., Di Lembo, S., Spotti, E., Carrai, E., Degli Innocenti, A., Manini, L., Persico, R., Rossi, C., Magro, G., Marelli, G., Vilei, V., Andrioli, M., Bellato, L., Fedeli, M., Merlini, A., Pinelli, G., Marin, G., Contin, M. L., Gallo, A., Parlato, P., Pecchielan, W., Jacovacci, J., Placentino, G., Richini, D., Molinari, S., Strazzeri, R., Fabbri, T., Di Bartolo, P., Garrapa, G., D'Incau, F., Lagomanzini, P., Conte, P., Todesco, F., Foglini, P., Pantanetti, P., Bedetta, C., Maricotti, R., Tomasi, F., Monesi, M., Graziani, R., Beretta, F., Penna, L., Guberti, A., Dazzi, D., Forte, E., Gasbarrone, A., Marrocco, T., Moschetta, R., Tuccinardi, F., De Meo, F., Coppola, A., Pirolozzi, P., Placitelli, E., Vallefuoco, R., Catone, B., Ceschia, S., Urban, M., Fabbri, F., Torresani, M., Crovetto, R., Battistini, M., Carosia, P., Viviani, G. L., Durante, A., Pais, F., Lilliu, V., Quieto, C., D'Ugo, E., Squadrone, M., Amenduni, T., Iovannisci, M. M., Della Penna, L., Potente, F., Delle Donne, T., Massa, C., Ulisse, M. A., De Berardinis, S., Guarnieri, I., Pace, S., Splendiani, M., Di Giuseppe, R., Brunato, B., Assaloni, R., Muraro, R., Loro, R., Bucciol, S., Lavacca, C., Rossi, M., Sabbatini, G., Quadri, F., Sambuco, L., Santacroce, C., Paola Caretta, D., Marino, C., Micheletti, A., Petrelli, A., Corda, A., Pisano, L., Guaita, G., Deias, C., Trevisan, G., Coletti, I., Iannarelli, R., De Luca, A., Minnucci, A., Antenucci, D., Di Florio, C., Angelicola, G., Bosco, A., Fresco, R., Di Marco, G., Ugolotti, D., Cadossi, T., Di Caro, P., Mazzocchetti, M., Buzzetti, R., Leto, G., Gnessi, C., Cipolloni, L., Foffi, C., Moretti, C., Venditti, C., Meniconi, R., Bertoli, S., Cosimi, S., Di Cianni, G., Turco, A., Richini, A., Marconi, S., Sannino, C., Lemmi, P., Giuntoli, S., Manfrè, N., Giannini, F., Di Carlo, A., Casadidio, I., Melandri, P., Maolo, G., Polenta, B., Piccinini, N., Vincenti, C., Pastore, N., Mega, P., Magurano, E., Cananiello, A., Francescutto, C. A., Brussa Toi, E., Gaspardo, G., Angeli, L., Ronchese, L., Sciangula, L., Ciucci, A., Contartese, A., Banfi, E., Castelli, E., Tatti, P., Bloise, D., Di Mauro, P., Masselli, L., Lo Presti, A., Scarpitta, A. M., Gambina, F., Venezia, A., Morea, R., Lagonigro, G., Copeta, G., Iannucci, V., Milano, V., Trupo, M., Lochmann, A., Marchetto, P. E., Incelli, G., De Paola, G., Steiger, M. M., Gamper, M. A., Breitenberger, S., Holzner, M., Frischmann, J., Lambiase, C., Di Vece, T., D'Aniello, M., Fezza, M., Giordano, C., Leo, F., Saitta, G., Cucinotta, D., Di Vieste, G., Pintaudi, B., Mancuso, T., Musacchio, N., Giancaterini, A., Pessina, L., Salis, G., Schivalocchi, F., Testori, G., Rampini, P. A., Cerutti, N., Morpugo, P. S., Cavaletto, M. L., Bonino, G., Morreale, F., Mariani, G., Ragonesi, P. D., Bollati, P., Colapinto, P., Bosi, E., Falqui, L., Bortolato, L., Cosma, A., Pistolato, P., Centenaro, B., Ceccato, A., Campobasso, G., Zaurino, F., Mazzotta, G., Manti, R., Da Ros, R., Carlucci, S., Narduzzi, L., Bortolotto, D., D'Acunto, L., Stanic, L., Volpi, A., Cospite, A. M., Manicardi, V., Michelini, M., Finardi, L., Borghi, F., Manicardi, E., Lombardi, S., Tommasi, C., Iaccarino, M., Cozza, S., Binotto, M., Marini, F., Mecenero, I., Massignani, S., Stecco, P., Urbani, E., Massariol, W., Parolin, R., Gatti, A., Bonavita, M., Creso, E., Giannettino, R., Gobbo, M., Iovine, C., Turco, A. A., Riccardi, G., Iazzetta, N., Giannattasio, C., Egione, O., Galdieri, S., Velotti, A., Azzolina, A., Annicelli, G., Sorrentino, T., Gaeta, I., Zenari, L., Bertolini, L., Sorgato, C., Grippaldi, F., Stroppiana, M., Popolizio, R., Carbone, N., Grasso, S., Abate, S., Gaggero, G. C., Strazzabosco, M., Brun, E., Carlesi, G. P., Garrone, S., Cicalò, A. M., Clausi, C., Cau, R., Manconi, A., Carboni, A., Angius, M. F., Pinna, A. A., Caria, S., Filigheddu, G. D., Tonolo, G., Carta, I., Calebich, S., Burlotti, C., Saglietti, G., Schellino, A., Madau, G., Cossu, M., Mulas, F., Zoccheddu, S., Balsanelli, M., Fetonti, M., Rotolo, A., Sambo, P., Secchi, E., Angotzi, M. A., Loddoni, S., Brundu, I., Careddu, F., Becciu, A., Gabriella Piras, G., Novara, F., Cipro, F., Torchio, G., Palumbo, P., Bianchi, A., Colucci, G., La Motta, G., Tiengo, A., Avogaro, A., Bruttomesso, D., Crepaldi, C., Fadini, G., Guarnieri, G., Lavagnini, M. T., Maran, A., Vedovato, M., De Kreutzenberg, V., Fedele, D., Lapolla, A., Sartore, G., Bax, G., Cardone, C., Dalfrà, M. G., Masin, M., Toniato, R., Piarulli, Francesco, Mattina, G., Fulantelli, M. A., Gioia, D., Conti, M., Ridola, G., D'Agati, F., Grossi, G., De Berardinis, F., Zavaroni, I., Dei Cas, A., Franzini, L., Usberti, E., Antonimi, M., Anelli, N., Poli, R., Ridolfi, V., Michela, M., Haddoub, S., Prampolini, G., Muoio, A., Filippi, D., Bucci, F., Tardio, S. M., Calderini, M. C., Magotti, M. G., Quarantelli, C., Vernazza, M. A., Carolfi, A., Saracca, R., Picchio, E., Del Sindaco, P., Spalluto, A., Maggiulli, L., Torreggiani, V., Rastelletti, S., Ugolini, C., Pucci, N., Magi, S., Muratori, S., La Penna, G., Consoli, A., Galeone, F., Magiar, A. V., Gherardini, V., Moretti, L., Bientinesi, M., Landi, L., Bernardi, A., Del Prato, S., Miccoli, R., Bianchi, C., Penno, G., Venditti, F., Anichini, R., De Bellis, A., Bruschi, T., Butelli, L., Gioffredi, M., Gori, R., Picciafuochi, R., Malagoli, R., Bernini, A., Gelisio, R., Zanon, M., Del Bianco, A., Bamiston, A., Signorato, M., Citro, G., Calabrese, M., Ianni, L., Lorenzetti, M., Marsocci, A., Guizzotti, S., Memoli, G., Cabasino, F., Farci, F., Atzori, A., Sanna, A., Ghiani, M., Siotto, I., Sedda, M., Manis, A., Loddo, C., Loddo, I., Seguro, P., Cuomo, A., Orlando, L., Olanda, G. B., Pucci, A., Massenzo, M., Sardu, C., Perrone, G., Corazziere, F., La Puzza, I., Tripodi, P. F., Riggio, S., Giampaolo, A., Mannino, D., Aleandri, A. R., Guidi, M. V., Battisti, B., Faraglia, M. R., Lilli, V., Leotta, S., Visalli, N., Gagliardi, A., Fontana, L., Altomare, M., Carletti, S., Abbruzzese, S., Chiaramonte, F., Giordano, R., Rossini, M., Migneco, G., Cappelloni, D., Urbani, A., Piergiovanni, F., Fava, D., Simonetta, A., Massimiani, F., Bulzomì, R., Giuliano, M., Pennafina, M. G., Di Perna, P., D'Accinni, M. P., Paolucci, D., D'Ubaldi, A., D'Angelo, M. T., Masaro, G., Pietrantoni, M., Fratini, M., La Rosa, R., Poggi, M., Piccirilli, F., Pisano, R., Saponara, C., Conforti, I., Penza, A., Scalpone, R., Lo Pinto, S., Iacovella, L., Caccamo, C., Sposito, S., Teodonio, C., Restuccia, M. G., Mirto, G., Girardello, R., Gennaro, R., De Moliner, L., Bettini, E., Mattuzzi, A., Speese, K., Frisinghelli, F., Locatelli, F., Nicoletti, M., Trojan, N., Centis, R., L Volsi, P., Levis, E., Zanette, G., Comba, G., Ballatore, L., Cattaneo, A., Aglialoro, A., Guido, R., Patrone, M., Zecchini, M., Vespasiani, G., Meloncelli, I., Clementi, L., Galetta, M., Marconi, V., Bordin, P., Perale, L., Vinci, C., Sira Zanon, M., Geretto, L., Toffolo, C., Furlan, M. G., Mazzanti, G., Vinci, M., Sica, V., Armeni, M., Derai, R., Ennas, O., Mamusa, S., Pisano, M. A., Carreras, L., Rauseo, A., Cervone, S., Leggieri, A., Pontonio, M., Sturaro, R., Quattrocchi, F., Molinaro, M., Trasatti, M., Ferretti, B., Labarile, G., Baule, G. M., Gentilini, A., Spanu, M. A., Fancellu, A., Bianco, P., Lione, L., Massazza, G., Bocchio, G., Bosco, E., Monachesi, M., Carta, G., Boschetti, M., Ceresola, E., Venier, E., Calcaterra, F., Cataldi, F., Miola, M., Manfrini, S., Lai, A., Locci, B., Putzu, D., Tanganelli, I., Leonini, M., Egger, K., Marchiotto, W., Vincis, L., Orlandini, V., Pilloni, C., Farci, R., Pelligra, I., Renier, G., Mameli, M., Pala, A., Devigus, E., Fumagalli, I., Lalli, C., Leandri, M., Agliani, M., De Pascalis, L., Malci, F., De Ciocchis, A., Diodati, M. B., Macerola, B., Davì, S., Caccavale, A., Brocato, L., Pognant Gros, M., Borla, S., Lattanzi, E., Piersanti, C., Piersanti, A., Spinelli, I., Tuzzoli, L., Tulini, V., Quaranta, G., Iorio, V., Tirabovi, M., De Terlizi, Candia, Massarelli, M. G., Venturi, S., Travaglini, A., Draghi, P., Pomante, P., Richiardi, L., Clerico, A., Bruno, A., Cavallo Perin, P., Ghigo, E., Porta, M., Scuntero, P., Arcari, R., Bertaina, S., Bo, S., Broglio, F., Bruno, G., Degiovanni, M., Fornengo, P., Grassi, G., Inglese, V., Maccario, M., Maghenzani, G., Marena, S., Martina, V., Passera, P., Ruiu, G., Tagliabue, M., Zanone, M., Monge, M., Boffano, G. M., Macrì, K., Maio, P., Ozzello, A., Pergolizzi, E., Gaia, D., Gennari, P., Micali, G., Rossetto, E., Dalmazzo, C., Oreglia, M., Stefani, T., Dossena, C., Paglia, P., Bosoni, S., Romanelli, T., Inchiostro, S., Dauriz, M., Bossi, C. A., Meregalli, G., Balini, A., Berzi, D., Filippini, B., Crotto, G., Paccagnella, A., Orrasch, M., Sambataro, M., Citro, T., Kiwanuka, E., Bagolin, E., Almoto, B., Macchia, A., Branca, M. T., Filesi, M., Candido, R., Caroli, E., Manca, E., Petrucco, A., Tommasi, E., Jagodnik, G., Baskar, B., Daris, N., Dal Col, P., Pellegrini, M. A., Tonutti, L., Venturini, G., Andreani, M., Turchi, F., Fedrighelli, F., Martinelli, G., Rongioletti, R., Candidi, M., Pais, M., Moro, E., Cervellino, F., Sinisi, R., Zampino, A., Mingardi, R., Lora, L., Reitano, R., Stocchiero, C., Simoncini, M., Mesturino, C. A., Zen, F., Di Pietro, S., Scoponi, C., Tilaro, L., Pelliccioni, S., Slongo, R., Vita, E., Garofalo, A., Vitale, F., Campanella, B., Mastrilli, V., Borrelli, T., D'Avino, A., Perbellini, A., Mirijello, Antonio, Viazzi, Francesca, Fioretto, Paola, Giorda, Carlo, Ceriello, Antonio, Russo, Giuspina T, Guida, Pietro, Pontremoli, Roberto, and De Cosmo, Salvatore, Giordano, Carla

Subjects
Adult, Male, Nephrology, medicine.medical_specialty, endocrine system diseases, Renal function, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, lcsh:RC870-923, Kidney, urologic and male genital diseases, GFR, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Diabetes mellitus, medicine, Humans, Albuminuria, Diabetic kidney disease, Type 1 diabetes, urogenital system, business.industry, Incidence (epidemiology), Middle Aged, lcsh:Diseases of the genitourinary system. Urology, medicine.disease, female genital diseases and pregnancy complications, Albuminuria, Diabetic kidney disease, GFR, Nephrology, Diabetes Mellitus, Type 1, medicine.anatomical_structure, Italy, Disease Progression, Female, medicine.symptom, business, Research Article, Follow-Up Studies, Glomerular Filtration Rate, Kidney disease
Abstract

Background Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ≥3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ≥3 CKD in a large cohort of patients affected by T1DM. Methods A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage ≥3 CKD (eGFR 30% from baseline was evaluated. Results The mean estimated GFR was 98 ± 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions Albuminuria and eGFR reduction represent independent risk factors for incident stage ≥3 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening. Electronic supplementary material The online version of this article (10.1186/s12882-018-1136-6) contains supplementary material, which is available to authorized users.

Published
2018

28. Robotic (super) microsurgery: Feasibility of a new master-slave platform in an in vivo animal model and future directions

Author

Mulken, T.J.M. van, Schols, R.M., Qiu, S.S., Brouwers, K., Hoekstra, L.T., Booi, D.I., Cau, R., Schoenmakers, F., Scharmga, A.M.J., Hulst, R van der, Mulken, T.J.M. van, Schols, R.M., Qiu, S.S., Brouwers, K., Hoekstra, L.T., Booi, D.I., Cau, R., Schoenmakers, F., Scharmga, A.M.J., and Hulst, R van der

Abstract

Contains fulltext : 200372.pdf (Publisher’s version ) (Open Access), Advanced microsurgical procedures are currently limited by human precision and manual dexterity. The potential of robotics in microsurgery is highlighted, including a general overview of applications of robotic assistance in microsurgery and its introduction in different surgical specialties. A new robotic platform especially designed for (super) microsurgery is presented. Results of an in vivo animal study underline its feasibility and encourage further development toward clinical studies. Future directions of robotic microsurgery are proposed.

Published
2018

31. Clinical features in insulin-treated diabetes with comorbid diabulimia, disordered eating behaviors and eating disorders

Author

Deiana, V., primary, Diana, E., additional, Pinna, F., additional, Atzeni, M.G., additional, Medda, F., additional, Manca, D., additional, Mascia, E., additional, Farci, F., additional, Ghiani, M., additional, Cau, R., additional, Tuveri, M., additional, Cossu, E., additional, Elena, L., additional, Mariotti, S., additional, and Carpiniello, B., additional

Published
2016
Full Text
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36. Letter to the Editors 99mTc-SestaMIBI scintigraphy of thyroid gland in a patient with primary hyperparathyroidism: unusual features due to coesistence of a thyroid papillary carcinoma.

Author

Boi, F., Cau, R., Piga, M., Serra, A., Loy, M., Lai, M. L., and Mariotti, S.

Subjects
*LETTERS to the editor, *INTERNAL medicine, *SERIAL publications
Abstract

Presents letters to the editor commenting on internal medicine published in the December 2003 issue of the journal "Clinical Endocrinology."

Published
2003
Full Text
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37. Application of AI in cardiovascular multimodality imaging

Author

Giuseppe Muscogiuri, Valentina Volpato, Riccardo Cau, Mattia Chiesa, Luca Saba, Marco Guglielmo, Alberto Senatieri, Gregorio Chierchia, Gianluca Pontone, Serena Dell’Aversana, U. Joseph Schoepf, Mason G. Andrews, Paolo Basile, Andrea Igoren Guaricci, Paolo Marra, Denisa Muraru, Luigi P. Badano, Sandro Sironi, Muscogiuri, G, Volpato, V, Cau, R, Chiesa, M, Saba, L, Guglielmo, M, Senatieri, A, Chierchia, G, Pontone, G, Dell'Aversana, S, Schoepf, U, Andrews, M, Basile, P, Guaricci, A, Marra, P, Muraru, D, Badano, L, and Sironi, S

Subjects
Artificial intelligence, Multidisciplinary, Cardiac magnetic resonance, echocardiography, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Cardiac computed tomography angiography, Coronary plaque, Late gadolinium enhancement
Abstract

Technical advances in artificial intelligence (AI) in cardiac imaging are rapidly improving the reproducibility of this approach and the possibility to reduce time necessary to generate a report. In cardiac computed tomography angiography (CCTA) the main application of AI in clinical practice is focused on detection of stenosis, characterization of coronary plaques, and detection of myocardial ischemia. In cardiac magnetic resonance (CMR) the application of AI is focused on post-processing and particularly on the segmentation of cardiac chambers during late gadolinium enhancement. In echocardiography, the application of AI is focused on segmentation of cardiac chambers and is helpful for valvular function and wall motion abnormalities. The common thread represented by all of these techniques aims to shorten the time of interpretation without loss of information compared to the standard approach. In this review we provide an overview of AI applications in multimodality cardiac imaging.

Published
2022

38. Multimodality Imaging in Ischemic Chronic Cardiomyopathy

Author

Giuseppe Muscogiuri, Marco Guglielmo, Alessandra Serra, Marco Gatti, Valentina Volpato, Uwe Joseph Schoepf, Luca Saba, Riccardo Cau, Riccardo Faletti, Liam J. McGill, Carlo Nicola De Cecco, Gianluca Pontone, Serena Dell’Aversana, Sandro Sironi, Muscogiuri, G, Guglielmo, M, Serra, A, Gatti, M, Volpato, V, Schoepf, U, Saba, L, Cau, R, Faletti, R, Mcgill, L, De Cecco, C, Pontone, G, Dell'Aversana, S, and Sironi, S

Subjects
Cardiac magnetic resonance, Chronic ischemic cardiomyopathy, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Computer Graphics and Computer-Aided Design, Multimodality imaging, Computed tomography angiography, Echocardiography, Nuclear medicine, cardiovascular system, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Computer Vision and Pattern Recognition, Electrical and Electronic Engineering, cardiac magnetic resonance, chronic ischemic cardiomyopathy, computed tomography angiography, echocardiography, multimodality imaging, nuclear medicine
Abstract

Ischemic chronic cardiomyopathy (ICC) is still one of the most common cardiac diseases leading to the development of myocardial ischemia, infarction, or heart failure. The application of several imaging modalities can provide information regarding coronary anatomy, coronary artery disease, myocardial ischemia and tissue characterization. In particular, coronary computed tomography angiography (CCTA) can provide information regarding coronary plaque stenosis, its composition, and the possible evaluation of myocardial ischemia using fractional flow reserve CT or CT perfusion. Cardiac magnetic resonance (CMR) can be used to evaluate cardiac function as well as the presence of ischemia. In addition, CMR can be used to characterize the myocardial tissue of hibernated or infarcted myocardium. Echocardiography is the most widely used technique to achieve information regarding function and myocardial wall motion abnormalities during myocardial ischemia. Nuclear medicine can be used to evaluate perfusion in both qualitative and quantitative assessment. In this review we aim to provide an overview regarding the different noninvasive imaging techniques for the evaluation of ICC, providing information ranging from the anatomical assessment of coronary artery arteries to the assessment of ischemic myocardium and myocardial infarction. In particular this review is going to show the different noninvasive approaches based on the specific clinical history of patients with ICC.

Published
2022

39. Computed tomography predictors of structural valve degeneration in patients undergoing transcatheter aortic valve implantation with balloon-expandable prostheses

Author

Marco Guglielmo, Laura Fusini, Manuela Muratori, Gloria Tamborini, Valentina Mantegazza, Daniele Andreini, Andrea Annoni, Mario Babbaro, Andrea Baggiano, Edoardo Conte, Serena Carriero, Alberto Formenti, Andrea Igoren Guaricci, Elisabetta Mancini, Rocco Mollace, Giuseppe Muscogiuri, Saima Mushtaq, Francesca Ricci, Alexia Rossi, Stefano Scafuri, Brunilda Alushi, Claudio Cau, Riccardo Cau, Margherita Cesarano, Luca Saba, Mark Rabbat, Mauro Pepi, Gianluca Pontone, Guglielmo, M, Fusini, L, Muratori, M, Tamborini, G, Mantegazza, V, Andreini, D, Annoni, A, Babbaro, M, Baggiano, A, Conte, E, Carriero, S, Formenti, A, Guaricci, A, Mancini, E, Mollace, R, Muscogiuri, G, Mushtaq, S, Ricci, F, Rossi, A, Scafuri, S, Alushi, B, Cau, C, Cau, R, Cesarano, M, Saba, L, Rabbat, M, Pepi, M, and Pontone, G

Subjects
Aged, 80 and over, Heart Valve Prosthesis Implantation, Transcatheter aortic valve implantation, Computed tomography, Structural valve degeneration, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, General Medicine, Aortic Valve Stenosis, Prosthesis Design, Transcatheter Aortic Valve Replacement, Treatment Outcome, Aortic Valve, Heart Valve Prosthesis, Humans, Radiology, Nuclear Medicine and imaging, Female, Tomography, X-Ray Computed, Aged, Retrospective Studies
Abstract

Objectives: Computed tomography (CT) provides excellent anatomy assessment of the aortic annulus (AoA) and is utilized for pre-procedural planning of transcatheter aortic valve implantation (TAVI). We sought to investigate if geometrical characteristics of the AoA determined by CT may represent predictors of structural valve degeneration (SVD) in patients undergoing TAVI with balloon-expandable valves. Methods: This is a retrospective study on 124 consecutive patients (mean age: 79 ± 7 years; female: 61%) undergoing balloon-expandable TAVI prospectively enrolled in a registry. AoA maximum diameter (Dmax), minimum diameter (Dmin), and area were assessed using pre-procedural CT. SVD was identified during follow-up with transthoracic echocardiography documenting structural prosthetic valve abnormalities with or without hemodynamic changes. Results: The mean follow-up was 5.9 ± 1.7 years. SVD was found in 48 out of 124 patients (38%). AoA Dmax, Dmin, and area were significantly smaller in patients with SVD compared to patients without SVD (25.6 ± 2.2 mm vs. 27.1 ± 2.8 mm, p = 0.012; 20.5 ± 2.1 mm vs. 21.8 ± 2.1 mm, p = 0.001 and 419 ± 77 mm2 vs. 467 ± 88 mm2, p = 0.002, respectively). At univariable analysis, female sex, BSA, 23-mm prosthetic valve size, Dmax < 27.1 mm, and a Dmin < 19.9 mm were associated with SVD, whereas at multivariable analysis, only Dmin < 19.9 mm (OR = 2.873, 95% CI: 1.191–6.929, p = 0.019) and female sex (OR = 2.659, 95% CI: 1.095–6.458, p = 0.031) were independent predictors of SVD. Conclusions: Female sex and AoA Dmin < 19.9 mm are associated with SVD in patients undergoing TAVI with balloon-expandable valves. When implanting large prostheses in order to avoid paraprosthetic regurgitation, caution should be observed due to the risk of excessive stretching of the AoA Dmin, which may play a role in SVD. Key Points: • Long-term durability is a concern for transcatheter aortic valve bioprosthesis. • CT provides an excellent assessment of the aortic annulus’s geometrical characteristics for prosthesis sizing before transcatheter aortic valve implantation (TAVI). • Female sex and a small minimum aortic annulus diameter measured with CT are independent predictors of structural valve degeneration in patients undergoing TAVI with balloon-expandable valves.

Published
2021

40. Non-invasive coronary imaging in patients with COVID-19: A narrative review

Author

Carlotta Onnis, Giuseppe Muscogiuri, Pier Paolo Bassareo, Riccardo Cau, Lorenzo Mannelli, Christian Cadeddu, Jasjit S. Suri, Giulia Cerrone, Clara Gerosa, Sandro Sironi, Gavino Faa, Alessandro Carriero, Gianluca Pontone, Luca Saba, Onnis, C, Muscogiuri, G, Paolo Bassareo, P, Cau, R, Mannelli, L, Cadeddu, C, Suri, J, Cerrone, G, Gerosa, C, Sironi, S, Faa, G, Carriero, A, Pontone, G, and Saba, L

Subjects
SARS-CoV-2, fungi, COVID-19, Coronary Artery Disease, General Medicine, Coronary Angiography, coronary CT angiography, Coronary Vessels, Article, Plaque, Atherosclerotic, Artificial Intelligence, Atherosclerosi, Humans, Radiology, Nuclear Medicine and imaging, atherosclerosis, coronary imaging
Abstract

SARS-CoV-2 infection, responsible for COVID-19 outbreak, can cause cardiac complications, worsening outcome and prognosis. In particular, it can exacerbate any underlying cardiovascular condition, leading to atherosclerosis and increased plaque vulnerability, which may cause acute coronary syndrome. We review current knowledge on the mechanisms by which SARS-CoV-2 can trigger endothelial/myocardial damage and cause plaque formation, instability and deterioration. The aim of this review is to evaluate current non-invasive diagnostic techniques for coronary arteries evaluation in COVID-19 patients, such as coronary CT angiography and atherosclerotic plaque imaging, and their clinical implications. We also discuss the role of artificial intelligence, deep learning and radiomics in the context of coronary imaging in COVID-19 patients.

Published
2022

42. Cardiovascular magnetic resonance in β-thalassemia major: beyond T2.

Author

Meloni A, Saba L, Cademartiri F, Positano V, Pistoia L, and Cau R

Abstract

Β-thalassemia major (TM) patients underwent regular transfusions to prevent complications of chronic anemia. However, these regular transfusions result in progressive iron accumulation in vital organs, including the heart. Myocardial iron overload can lead to cardiac dysfunction and ultimately to heart failure. Diagnosis of cardiac dysfunction in β-TM patients is usually made through clinical examination, electrocardiogram, and echocardiography. Cardiac magnetic resonance (CMR), through the measurement of T2* relaxation time, represents the diagnostic modality of choice for assessing myocardial iron overload and guiding the iron chelation therapy. Despite a tailored chelation therapy reducing myocardial iron overload, heart failure remains the leading cause of morbidity and mortality even in well-treated β-TM patients. Advances in CMR, including myocardial strain, parametric mapping (T1, T2, and extracellular volume), and late gadolinium enhancement (LGE) measurements, have expanded its role in the diagnosis, prognosis, and follow-up of these patients. This review seeks to offer a thorough overview of the potential uses of CMR in β-TM, extending beyond the established role of T2* measurement in guiding chelation therapy. It delves into the emerging applications of new CMR imaging biomarkers that could improve the overall management of β-TM patients., (© 2024. Italian Society of Medical Radiology.)

Published
2024
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43. Pericarotid Fat as a Marker of Cerebrovascular Risk.

Author

Cau R, Anzalone N, Mannelli L, Edjlali M, Balestrieri A, Nardi V, Lanzino G, Lerman A, Suri JS, and Saba L

Subjects
Humans, Cerebrovascular Disorders diagnostic imaging, Biomarkers blood, Plaque, Atherosclerotic diagnostic imaging, Risk Factors, Adipose Tissue diagnostic imaging
Abstract

Vascular inflammation is widely recognized as an important factor in the atherosclerotic process, particularly in terms of plaque development and progression. Conventional tests, such as measuring circulating inflammatory biomarkers, lack the precision to identify specific areas of vascular inflammation. In this context, noninvasive imaging modalities can detect perivascular fat changes, serving as a marker of vascular inflammation. This review aims to provide a comprehensive overview of the key concepts related to perivascular carotid fat and its pathophysiology. Additionally, we examine the existing literature on the association of pericarotid fat with features of plaque vulnerability and cerebrovascular events. Finally, we scrutinize the advantages and limitations of the noninvasive assessment of pericarotid fat., (© 2024 by American Journal of Neuroradiology.)

Published
2024
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44. Pathophysiology and clinical implications of coronary artery calcifications.

Author

Saba L, Costa F, and Cau R

Subjects
Humans, Coronary Vessels diagnostic imaging, Coronary Vessels physiopathology, Risk Assessment methods, Risk Factors, Coronary Artery Disease physiopathology, Vascular Calcification
Abstract

Purpose of Review: To provide a summary of current understanding of coronary artery calcifications (CACs), outlining the role of calcium in atherosclerosis to comprehend the clinical implications of CAC., Recent Findings: CAC serves as a reliable indicator of coronary artery disease (CAD) and it is associated with cardiovascular events. In recognition of its significance, recent global guidelines have integrated CAC assessment into risk evaluation protocols, highlighting its role as a noninvasive tool for evaluating and stratifying patients' risk for cardiovascular events. Beyond the amount of CAC values, also, calcium morphology had been linked to cardiovascular events.By leveraging CAC assessment, healthcare providers can effectively up or down reclassify patients' risk and tailor preventive strategies accordingly. This comprehensive approach may involve lifestyle modifications, meticulous management of risk factors, and judicious use of preventive medications to mitigate the likelihood of future cardiovascular events, or withhold treatments in those without signs of CAC, to optimize resource use., Summary: The identification of CAC burden and morphology through noninvasive imaging modalities can reclassify the prediction of future cardiovascular risk and serve as a risk modifier for atherosclerosis. These data underscore the utility of selectively using CAC assessment in both primary and secondary prevention strategies for atherosclerotic cardiovascular disease., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Published
2024
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45. Hippocampus and olfactory impairment in Parkinson disease: a comparative exploratory combined volumetric/functional MRI study.

Author

Porcu M, Cocco L, Marrosu F, Cau R, Puig J, Suri JS, and Saba L

Subjects
Humans, Male, Female, Aged, Middle Aged, Case-Control Studies, Parkinson Disease diagnostic imaging, Parkinson Disease complications, Parkinson Disease physiopathology, Magnetic Resonance Imaging methods, Hippocampus diagnostic imaging, Hippocampus pathology, Olfaction Disorders diagnostic imaging, Olfaction Disorders etiology, Olfaction Disorders physiopathology
Abstract

Introduction: Patients with Parkinson's Disease (PD) commonly experience Olfactory Dysfunction (OD). Our exploratory study examined hippocampal volumetric and resting-state functional magnetic resonance imaging (rs-fMRI) variations in a Healthy Control (HC) group versus a cognitively normal PD group, further categorized into PD with No/Mild Hyposmia (PD-N/MH) and PD with Severe Hyposmia (PD-SH)., Methods: We calculated participants' relative Total Hippocampal Volume (rTHV) and performed Spearman's partial correlations, controlled for age and gender, to examine the correlation between rTHV and olfactory performance assessed by the Odor Stick Identification Test for the Japanese (OSIT-J) score. Mann-Whitney U tests assessed rTHV differences across groups and subgroups, rejecting the null hypothesis for p < 0.05. Furthermore, a seed-based rs-fMRI analysis compared hippocampal connectivity differences using a one-way ANCOVA covariate model with controls for age and gender., Results: Spearman's partial correlations indicated a moderate positive correlation between rTHV and OSIT-J in the whole study population (ρ = 0.406; p = 0.007), PD group (ρ = 0.493; p = 0.008), and PD-N/MH subgroup (ρ = 0.617; p = 0.025). Mann-Whitney U tests demonstrated lower rTHV in PD-SH subgroup compared to both HC group (p = 0.013) and PD-N/MH subgroup (p = 0.029). Seed-to-voxel rsfMRI analysis revealed reduced hippocampal connectivity in PD-SH subjects compared to HC subjects with a single cluster of voxels., Conclusions: Although the design of the study do not allow to make firm conclusions, it is reasonable to speculate that the progressive involvement of the hippocampus in PD patients is associated with the progression of OD., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2024
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46. Whys and Wherefores of Coronary Arterial Positive Remodeling.

Author

Onnis C, Virmani R, Madra A, Nardi V, Salgado R, Montisci R, Cau R, Boi A, Lerman A, De Cecco CN, Libby P, and Saba L

Abstract

Positive remodeling (PR) is an atherosclerotic plaque feature defined as an increase in arterial caliber at the level of an atheroma, in response to increasing plaque burden. The mechanisms that lead to its formation are incompletely understood, but its role in coronary atherosclerosis has major clinical implications. Indeed, plaques with PR have elevated risk of provoking acute cardiac events. Hence, PR figures among the high-risk plaque features that cardiac imaging studies should report. This review aims to provide an overview of the current literature on coronary PR. It outlines the pathophysiology of PR, the different techniques used to assess its presence, and the imaging findings associated to PR, on both noninvasive and invasive studies. This review also summarizes clinical observations, trials, and studies, focused on the impact of PR on clinical outcome.

Published
2024
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47. Global longitudinal strain by cardiac magnetic resonance is associated with cardiac iron and complications in beta-thalassemia major patients.

Author

Meloni A, Saba L, Positano V, Pistoia L, Campanella A, Spasiano A, Putti MC, Fotzi I, Cossu A, Corigliano E, Massa A, Keilberg P, Cademartiri F, and Cau R

Subjects
Humans, Female, Male, Cross-Sectional Studies, Adult, Middle Aged, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Dysfunction, Left etiology, Ventricular Dysfunction, Left physiopathology, Ventricular Function, Left physiology, Iron metabolism, Global Longitudinal Strain, beta-Thalassemia complications, beta-Thalassemia diagnostic imaging, Magnetic Resonance Imaging, Cine methods, Iron Overload diagnostic imaging, Iron Overload etiology
Abstract

Background: The aim of this cross-sectional study was to investigate the association of left ventricular (LV) strain parameters with demographics, clinical data, cardiovascular magnetic resonance (CMR) findings, and cardiac complications (heart failure and arrhythmias) in patients with β-thalassemia major (β-TM)., Method: We considered 266 β-TM patients (134 females, 37.08 ± 11.60 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia (E-MIOT) project and 80 healthy controls (50 females, mean age 39.77 ± 11.29 years). The CMR protocol included cine images for the assessment of global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) using feature tracking (FT) and for the quantification of LV function parameters, the T2* technique for the assessment of myocardial iron overload, and late gadolinium enhancement (LGE) technique., Results: In comparison to the healthy control group, β-TM patients showed impaired GLS, GCS, and GRS values. Among β-TM patients, sex was identified as the sole independent determinant of all LV strain parameters. All LV strain parameters displayed a significant correlation with LV end-diastolic volume index, end-systolic volume index, mass index, and ejection fraction, and with the number of segments exhibiting LGE. Only GLS exhibited a significant correlation with global heart T2* values and the number of segments with T2* < 20 ms. Patients with cardiac complications exhibited significantly impaired GLS compared to those without cardiac complications., Conclusion: In patients with β-TM, GLS, GCS, and GRS were impaired in comparison with control subjects. Among LV strain parameters, only GLS demonstrated a significant association with cardiac iron levels and complications., Competing Interests: Declaration of competing interest The authors have nothing to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Published
2024
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48. Cardiovascular Magnetic Resonance Imaging of Takotsubo Syndrome: Evolving Diagnostic and Prognostic Perspectives.

Author

Cau R, Masala S, Manelli L, Porcu M, Scaglione M, D'Angelo T, Salgado R, and Saba L

Subjects
Humans, Prognosis, Magnetic Resonance Imaging methods, Takotsubo Cardiomyopathy diagnostic imaging, Takotsubo Cardiomyopathy physiopathology, Takotsubo Cardiomyopathy diagnosis, Magnetic Resonance Imaging, Cine methods
Abstract

Takotsubo syndrome (TS) is a temporary form of left ventricular (LV) dysfunction characterized by a distinct pattern of LV impairment, often triggered by a physical or emotional stressful event. Historically, TS was considered a benign condition due to its prompt restoration of myocardial function and generally excellent outcomes. However, recent studies have shown that complications similar to those seen after myocardial infarction can occur, necessitating careful monitoring of these patients. Among noninvasive imaging techniques, cardiovascular magnetic resonance (CMR) is becoming increasingly important in evaluating patients with TS. CMR offers a unique ability to noninvasively assess myocardial tissue characteristics, allowing for detecting the typical features of TS, such as specific wall motion abnormalities and myocardial edema. Beyond its well-established diagnostic utility in the clinical management of TS, CMR has also proven valuable in prognosis and risk stratification for these patients. Advances in CMR, including myocardial strain and parametric mapping have expanded its role in the diagnosis, prognosis, and follow-up of these patients. This review aims to provide a comprehensive overview of the potential applications of CMR in the diagnostic and prognostic evaluation of TS patients. It explores the emerging use of novel CMR imaging biomarkers that may enhance diagnosis, improve prognostic accuracy, and contribute to the overall management of these patients., (© 2024 Wiley Periodicals LLC.)

Published
2024
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49. Carotid artery calcium score: Definition, classification, application, and limits.

Author

Saba L, Benson JC, Scicolone R, Paraskevas KI, Gupta A, Cau R, Suri JS, Schindler A, Balestrieri A, Nardi V, Song JW, Wintermark M, and Lanzino G

Subjects
Humans, Female, Male, Aged, Middle Aged, Carotid Artery Diseases diagnostic imaging, Aged, 80 and over, Carotid Arteries diagnostic imaging, Vascular Calcification diagnostic imaging
Abstract

Introduction: In the current paper, the "carotid artery calcium score" method is presented with the target to offer a metric method to quantify the amount of calcification in the carotid artery., Model and Definition: The Volume of Interest (VOI) should be extracted and those voxels, with a Hounsfield Unit (HU) value ≥130, should be considered. The total weight value is determined by calculating the sum of the HU attenuation values of all voxels with values ≥130 HU. This value should be multiplied by the conversion factor ("or voxel size") and divided by a weighting factor, the attenuation threshold to consider a voxel as calcified (and therefore 130 HU): this equation determines the Carotid Artery Calcium Score (CACS) ., Results: In order to provide the demonstration of the potential feasibility of the model, the CACS was calculated in 131 subjects (94 males; mean age 72.7 years) for 235 carotid arteries (in 27 subjects, unilateral plaque was present) considered. The CACS value ranged from 0.67 to 11716. A statistically significant correlation was found (rho value = 0.663, p value = .0001) between the CACS in the right and left carotid plaques. Moreover, a statistically significant correlation between the age and the total CACS was present (rho value = 0.244, p value = .005), whereas no statistically significant difference was found in the distribution of CACS by gender ( p = .148). The CACS was also tested at baseline and after contrast and no statistically significant difference was found., Conclusion: In conclusion, this method is of easy application, and it weights at the same time the volume and the degree of calcification in a unique parameter. This method needs to be tested to verify its potential utility, similar to the coronary artery calcium score, for the risk stratification of the occurrence of cerebrovascular events of the anterior circulation. Further studies using this new diagnostic tool to determine the prognostic value of carotid calcium quantification are needed., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2024
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50. Photon-Counting Computed Tomography Angiography of Carotid Arteries: A Topical Narrative Review with Case Examples.

Author

Meloni A, Cau R, Saba L, Positano V, De Gori C, Occhipinti M, Celi S, Bossone E, Bertacchi J, Punzo B, Mantini C, Cavaliere C, Maffei E, and Cademartiri F

Abstract

Photon counting computed tomography (PCCT) represents a paradigm shift from conventional CT imaging, propelled by a new generation of X-ray detectors capable of counting individual photons and measuring their energy. The first part of this narrative review is focused on the technical aspects of PCCT and describes its key advancements and benefits compared to conventional CT but also its limitations. By synthesizing the existing literature, the second part of the review seeks to elucidate the potential of PCCT as a valuable tool for assessing carotid artery disease. Thanks to the enhanced spatial resolution and image quality, PCCT allows for an accurate evaluation of carotid luminal stenosis. With its ability to finely discriminate between different tissue types, PCCT allows for detailed characterization of plaque morphology and composition, which is crucial for assessing plaque vulnerability and the risk of cerebrovascular events.

Published
2024
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