24 results on '"Flavia Nicoli"'
Search Results
2. Multiparametric Mapping via Cardiovascular Magnetic Resonance in the Risk Stratification of Ventricular Arrhythmias and Sudden Cardiac Death
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Maria Lo Monaco, Kamil Stankowski, Stefano Figliozzi, Flavia Nicoli, Vincenzo Scialò, Alessandro Gad, Costanza Lisi, Federico Marchini, Carlo Maria Dellino, Rocco Mollace, Federica Catapano, Giulio Giuseppe Stefanini, Lorenzo Monti, Gianluigi Condorelli, Erika Bertella, and Marco Francone
- Subjects
ventricular arrhythmias ,sudden cardiac death ,cardiovascular magnetic resonance ,mapping ,Medicine (General) ,R5-920 - Abstract
Risk stratification for malignant ventricular arrhythmias and sudden cardiac death is a daunting task for physicians in daily practice. Multiparametric mapping sequences obtained via cardiovascular magnetic resonance imaging can improve the risk stratification for malignant ventricular arrhythmias by unveiling the presence of pathophysiological pro-arrhythmogenic processes. However, their employment in clinical practice is still restricted. The present review explores the current evidence supporting the association between mapping abnormalities and the risk of ventricular arrhythmias in several cardiovascular diseases. The key message is that further clinical studies are needed to test the additional value of mapping techniques beyond conventional cardiovascular magnetic resonance imaging for selecting patients eligible for an implantable cardioverter defibrillator.
- Published
- 2024
- Full Text
- View/download PDF
3. Multi-Modality Imaging in Dilated Cardiomyopathy: With a Focus on the Role of Cardiac Magnetic Resonance
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Panagiota Mitropoulou, Georgios Georgiopoulos, Stefano Figliozzi, Dimitrios Klettas, Flavia Nicoli, and Pier Giorgio Masci
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cardiac imaging ,dilated cardiomyopathy ,cardiac magnetic resonance ,non-ischemic cardiomyopathy ,heart failure ,sudden cardiac death ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Heart failure (HF) is recognized as a leading cause of morbidity and mortality worldwide. Dilated cardiomyopathy (DCM) is a common phenotype in patients presenting with HF. Timely diagnosis, appropriate identification of the underlying cause, individualized risk stratification, and prediction of clinical response to treatment have improved the prognosis of DCM over the last few decades. In this article, we reviewed the current evidence on available imaging techniques used for DCM patients. In this direction, we evaluated appropriate scenarios for the implementation of echocardiography, nuclear imaging, and cardiac computed tomography, and we focused on the primordial role that cardiac magnetic resonance (CMR) holds in the diagnosis, prognosis, and tailoring of therapeutic options in this population of special clinical interest. We explored the predictive value of CMR toward left ventricular reverse remodeling and prediction of sudden cardiac death, thus guiding the decisions for device therapy. Principles underpinning the use of state-of-the-art CMR techniques such as parametric mapping and feature-tracking strain analysis are also provided, along with expectations for the anticipated future advances in this field. We also attempted to correlate the evidence with clinical practice, with the intent to address questions on selecting the optimal imaging method for different indications and clinical needs. Overall, we recommend a comprehensive assessment of DCM patients at baseline and at follow-up intervals depending on the clinical status, with the addition of CMR as a second-line modality to other imaging techniques. We also provide an algorithm to guide the detailed imaging approach of the patient with DCM. We expect that future guidelines will upgrade their clinical recommendations for the utilization of CMR in DCM, which is expected to further improve the quality of care and the outcomes. This review provides an up-to-date perspective on the imaging of dilated cardiomyopathy patients and will be of clinical value to training doctors and physicians involved in the area of heart failure.
- Published
- 2020
- Full Text
- View/download PDF
4. Comparison of Demographic, Clinical, Biochemical, and Imaging Findings in Hypertrophic Cardiomyopathy Prognosis
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Georgios Georgiopoulos, Stefano Figliozzi, Konstantinos Pateras, Flavia Nicoli, Dimitrios Bampatsias, Matteo Beltrami, Gherardo Finocchiaro, Amedeo Chiribiri, Pier Giorgio Masci, and Iacopo Olivotto
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Cardiology and Cardiovascular Medicine - Published
- 2023
5. The prognostic role of right ventricular dysfunction in patients with hypertrophic cardiomyopathy
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Saima Mushtaq, Lorenzo Monti, Alexia Rossi, Gianluca Pontone, Edoardo Conte, Flavia Nicoli, Luca Di Odoardo, Marco Guglielmo, Eleonora Indolfi, Sara Bombace, Andrea Baggiano, Paola Gripari, Mauro Pepi, Antonio Bartorelli, Margarida Oliveira, Ana Santos, Marco Francone, and Daniele Andreini
- Abstract
Background. Hypertrophic cardiomyopathy (HCM) primarily affects the left ventricle (LV) sparing the right ventricle (RV) in vast majority of cases. However, several studies employing CMR have revealed that myocardial hypertrophy may also involve the RV.Aim of the study. To assess RV size and function in a large prospectively cohort of HCM patients and to evaluate whether these parameters in association with other MR findings can predict cardiac eventsMethods. Two participating centers prospectively included patients with known or suspected HCM between 2011 and 2017. CMR studies were performed with three different scanners. Outcome measures were a composite of ventricular arrhythmias, hospitalization for HF and cardiac death.Results. Of 607 consecutive patients with known or suspected HCM, 315 had complete follow-up information (mean 65 ± 20 months). Among them, 115 patients developed major cardiac events (MACE) during follow-up. At CMR evaluation, patients with events had higher left atrium (LA) diameter (41.5 ± 8 mm vs. 37.17 ± 7.6 mm, p Conclusions Anatomic and functional RV anomalies detected and characterized with CMR may have may have a major role in predicting the prognosis of HCM patients.
- Published
- 2023
6. Cardiac magnetic resonance features of left dominant arrhythmogenic cardiomyopathy: differential diagnosis with myocarditis
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Cristina Basso, Antonio Dello Russo, Gianluca Pontone, Edoardo Conte, Saima Mushtaq, Giulia Vettor, Daniele Andreini, Stefania Rizzo, Patrizia Carità, Elena Sommariva, Michela Casella, Flavia Nicoli, Claudio Tondo, Mauro Pepi, Alessio Gasperetti, and Valentina Catto
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medicine.medical_specialty ,Magnetic Resonance Spectroscopy ,Myocarditis ,Cardiac magnetic resonance ,Left-dominant arrhythmogenic cardiomyopathy ,Ventricular arrhythmias ,Cardiomyopathy ,Magnetic Resonance Imaging, Cine ,Diagnosis, Differential ,Predictive Value of Tests ,Internal medicine ,Biopsy ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Cardiac imaging ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Ventricle ,Cardiology ,Differential diagnosis ,Cardiology and Cardiovascular Medicine ,business ,LEFT DOMINANT - Abstract
Cardiac magnetic resonance (CMR) findings suggesting a suspected left-dominant arrhythmogenic cardiomyopathy (LDAC) may be difficult to distinguish from those related to previous myocarditis; however, especially in patients with ventricular arrhythmias (VA) with ECG morphology consistent with a left ventricle (LV) origin differential diagnosis is fundamental. Aim of the study was to identify potential imaging features at CMR specific for LDAC diagnosis. Between January 2011 and December 2019, we enrolled 15 consecutive stable patients with a recent diagnosis of significant VA and ECG morphology consistent with a LV origin, detection of potential LV arrhythmic substrate at CMR and undergoing a clinically-indicated LV endomyocardial biopsy showing tissue abnormalities consistent with the diagnosis of LDAC. From the same CMR-endomyocardial biopsy registry, a second group of 30 consecutive patients who underwent CMR and biopsy with a histological diagnosis of previous myocarditis were identified. (1) Subepicardial LGE at the level of the posterolateral wall of the LV was detected in 13 cases of LDAC vs. 21 cases of myocarditis; (2) fat infiltration, and particularly subepicardial posterolateral fat infiltration, was found in almost all LDAC patients vs. one myocarditis only (p
- Published
- 2021
7. Comparison of Demographic, Clinical, Biochemical, and Imaging Findings in Hypertrophic Cardiomyopathy Prognosis: A Network Meta-Analysis
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Georgios, Georgiopoulos, Stefano, Figliozzi, Konstantinos, Pateras, Flavia, Nicoli, Dimitrios, Bampatsias, Matteo, Beltrami, Gherardo, Finocchiaro, Amedeo, Chiribiri, Pier Giorgio, Masci, and Iacopo, Olivotto
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Heart Failure ,Death, Sudden, Cardiac ,Risk Factors ,Network Meta-Analysis ,Humans ,Contrast Media ,Gadolinium ,Cardiomyopathy, Hypertrophic ,Prognosis ,Magnetic Resonance Imaging ,Risk Assessment ,Demography - Abstract
Despite hypertrophic cardiomyopathy (HCM) being the most common inherited heart disease and conferring increased risk for heart failure (HF) and sudden cardiac death (SCD), risk assessment in HCM patients is still largely unresolved.This study aims to synthesize and compare the prognostic impact of demographic, clinical, biochemical, and imaging findings in patients with HCM.The authors searched PubMed, Embase, and Cochrane Library for studies published from 1955 to November 2020, and the endpoints were: 1) all-cause death; 2) an arrhythmic endpoint including SCD, sustained ventricular tachycardia, ventricular fibrillation, or aborted SCD; and 3) a composite endpoint including (1) or (2) plus hospitalization for HF or cardiac transplantation. The authors performed a pairwise meta-analysis obtaining the pooled estimate separately for the association between baseline variables and study endpoints. A random-effects network meta-analysis was subsequently used to comparatively assess the prognostic value of outcome associates.A total of 112 studies with 58,732 HCM patients were included. Among others, increased brain natriuretic peptide/N-terminal pro-B-type natriuretic peptide, late gadolinium enhancement (LGE), positive genotype, impaired global longitudinal strain, and presence of apical aneurysm conferred increased risk for the composite endpoint. At network meta-analysis, LGE showed the highest prognostic value for all endpoints and was superior to all other associates except New York Heart Association functional classclass II. A multiparametric imaging-based model was superior in predicting the composite endpoint compared to a prespecified model based on conventional risk factors.This network meta-analysis supports the development of multiparametric risk prediction algorithms, including advanced imaging markers additively to conventional risk factors, for refined risk stratification in HCM. (Long-term prognosis of hypertrophic cardiomyopathy according to genetic, clinical, biochemical and imaging findings: a systemic review and meta-analysis; CRD42020185219).
- Published
- 2022
8. Prognostic role of transferrin saturation in heart failure patients
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Piergiuseppe Agostoni, Irene Motta, M.D. Cappellini, Alice Bonomi, Jeness Campodonico, Margherita Migone De Amicis, and Flavia Nicoli
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medicine.medical_specialty ,Epidemiology ,Renal function ,Gastroenterology ,Interquartile range ,Internal medicine ,medicine ,Humans ,Risk factor ,Survival rate ,Heart Failure ,Anemia, Iron-Deficiency ,biology ,business.industry ,Transferrin saturation ,Mortality rate ,Transferrin ,Prognosis ,medicine.disease ,Ferritin ,Heart failure ,Ferritins ,biology.protein ,Transferrins ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims In heart failure (HF) iron deficiency (ID) is frequently observed and represents a major mortality risk factor. Purpose of this study was to evaluate the correlation between mortality and ID in a cohort of 661 consecutive patients hospitalized for HF worsening. Methods and results Patients were grouped: (i)according to presence(+)/absence(−) of anaemia (A) and ID defined following World Health Organization (WHO) and European Society of Cardiology (ESC)–American College of Cardiology/American Heart Association/HF society of America (ACC/AHA/HFSA) definitions, respectively: Group A−ID− (n = 123), Group A+ID− (n = 80), Group A+ID+ (n = 247), and Group A−ID+ (n = 211); (ii) according to presence of absolute (serum ferritin < 100μg/L) and functional ID [ferritin between 100 and 300μg/L and transferrin saturation (TSAT) < 20%]; and (iii) according to TSAT Conclusion We confirmed that in HF anaemia is associated to a poor prognosis. Moreover, we showed that patients with TSAT
- Published
- 2021
9. Rationale and design of the EPLURIBUS Study (Evidence for a comPrehensive evaLUation of left ventRicle dysfnctIon By a whole-heart coverage cardiac compUted tomography Scanner)
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Antonio L. Bartorelli, Marco Guglielmo, Alberto Formenti, Gianluca Pontone, Alessandra Magini, Alessandra Tanzilli, Cesare Fiorentini, Mauro Pepi, Piergiuseppe Agostoni, Maria Elisabetta Mancini, Giuseppe Muscogiuri, Daniele Andreini, Andrea Baggiano, Edoardo Conte, Saima Mushtaq, Andrea Annoni, Flavia Nicoli, Andreini, D, Conte, E, Mushtaq, S, Pontone, G, Guglielmo, M, Baggiano, A, Annoni, A, Mancini, M, Formenti, A, Nicoli, F, Tanzilli, A, Muscogiuri, G, Magini, A, Agostoni, P, Bartorelli, A, Fiorentini, C, and Pepi, M
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medicine.medical_specialty ,Time Factors ,Tomography Scanners, X-Ray Computed ,Time Factor ,Cardiac computed tomography ,Prognosi ,Magnetic Resonance Imaging, Cine ,Predictive Value of Test ,Delayed enhancement ,030204 cardiovascular system & hematology ,Coronary Angiography ,Share Rationale and design of the EPLURIBUS Study (Evidence for a comPrehensive evaLUation of left ventRicle dysfnctIon By a whole-heart coverage cardiac compUted tomography Scanner) ,Risk Assessment ,Ventricular Function, Left ,Ventricular Dysfunction, Left ,03 medical and health sciences ,Impaired renal function ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Lv dysfunction ,Multidetector Computed Tomography ,Clinical endpoint ,medicine ,Humans ,Late gadolinium enhancement ,030212 general & internal medicine ,Ejection fraction ,business.industry ,Risk Factor ,Stroke Volume ,Equipment Design ,General Medicine ,Prognosis ,Feasibility Studie ,medicine.anatomical_structure ,Research Design ,Ventricle ,cardiovascular system ,Cardiology ,Feasibility Studies ,Cardiology and Cardiovascular Medicine ,business ,Human - Abstract
BACKGROUND: Cardiac magnetic resonance (CMR) is the standard of reference for myocardial fibrosis detection by late gadolinium enhancement. Cardiac computed tomography (CCT) is emerging as a promising alternative. The Evidence for a comPrehensive evaLUation of left ventRicle dysfnctIon By a whole-heart coverage cardiac compUted tomography Scanner study will assess the feasibility and diagnostic accuracy of a comprehensive functional and anatomical cardiac evaluation with CCT as compared with CMR and invasive coronary angiography as standard of reference. METHODS: Consecutive patients with a newly diagnosed left ventricle (LV) dysfunction (left ventricular ejection fraction
- Published
- 2020
10. State-of-the-art-myocardial perfusion stress testing: Static CT perfusion
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Marco Guglielmo, Maria Elisabetta Mancini, Gianluca Pontone, Flavia Nicoli, Andrea Baggiano, Alessandra Tanzilli, Alberto Formenti, Giuseppe Muscogiuri, Antonio L. Bartorelli, Andrea Annoni, Daniele Andreini, Edoardo Conte, Saima Mushtaq, Mauro Pepi, Mushtaq, S, Conte, E, Pontone, G, Baggiano, A, Annoni, A, Formenti, A, Mancini, M, Guglielmo, M, Muscogiuri, G, Tanzilli, A, Nicoli, F, Bartorelli, A, Pepi, M, and Andreini, D
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Male ,medicine.medical_specialty ,Computed Tomography Angiography ,Stress testing ,Perfusion scanning ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,Myocardial perfusion ,Static modality ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,medicine ,Stress Echocardiography ,Myocardial ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Functional evaluation ,business.industry ,Myocardial Perfusion Imaging ,Reproducibility of Results ,Middle Aged ,Prognosis ,medicine.disease ,CT perfusion ,Functional assessment ,Coronary Vessels ,Female ,Fractional Flow Reserve, Myocardial ,Fractional Flow Reserve ,Radiation exposure ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Cardiac magnetic resonance ,Perfusion - Abstract
Large multicenter studies and meta-analysis have documented the diagnostic accuracy and the prognostic implications of stress echocardiography, cardiac magnetic resonance and, mainly, nuclear stress tests. However, none of them provides a comprehensive anatomical and functional evaluation within the same study as stress CT perfusion. Myocardial CT perfusion is the only non-invasive modality that allows to quantifying coronary stenosis and determining its functional relevance, constituting a potential “one-stop-shop” method for the diagnosis and global management of patients with known or suspected coronary artery disease. In comparison with the dynamic modality, that requires increased radiation, precise acquisition protocols and dedicated post-processing softwares, static CT perfusion was associated with less radiation exposure, non-inferior diagnostic accuracy, easier interpretation of images and is nowadays more widely available.
- Published
- 2020
11. The usefulness of cardiac CT integrated with FFRCT for planning myocardial revascularization in complex coronary artery disease: A lesson from SYNTAX studies
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Mariachiara Mei, Giulio Pompilio, Flavia Nicoli, Eleonora Melotti, Daniele Andreini, Edoardo Conte, Patrick W. Serruys, Saima Mushtaq, Antonio L. Bartorelli, Mauro Pepi, Yoshinobu Onuma, and Cardiology
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medicine.medical_specialty ,Myocardial revascularization ,Syntax (programming languages) ,business.industry ,medicine.medical_treatment ,CAD ,030204 cardiovascular system & hematology ,Revascularization ,medicine.disease ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,03 medical and health sciences ,Stenosis ,0302 clinical medicine ,Conventional PCI ,medicine ,In patient ,Radiology ,Review Article on Impact of Cardiac CT in Clinical Practice ,Cardiology and Cardiovascular Medicine ,business - Abstract
After two decades of clinical use, during which coronary CT angiography (CCTA) was considered an appropriate method for the non-invasive assessment of patients with suspected stable coronary artery disease (CAD) and low-to-intermediate pretest likelihood of CAD, a growing body of literature is showing that CCTA may have also a clinical role in patients with high pretest likelihood of CAD, known CAD and complex and diffuse CAD. Particularly, the SYNTAX studies demonstrated the usefulness of CCTA in the field of non-invasive assessment of these patients and planning of interventional and surgical coronary procedures, thanks to its ability to combine, in a single method, precise stenosis quantification, accurate plaque characterization, functional assessment and selection of the revascularization modality for any individual patient and of the vessels that need to be revascularized. Of note, the SYNTAX III Revolution trial showed, in patients with three-vessel CAD, that treatment decision-making between PCI and CABG based on CCTA only has an almost perfect agreement with the treatment decision derived from invasive coronary angiography (ICA). Moreover, the SYNTAX Score II demonstrated a high degree of correlation between the two diagnostic strategies, suggesting the potential feasibility of a treatment decision-making based solely on non-invasive imaging and clinical information. New research prospects have opened up for the future to demonstrate the true feasibility and safety of this innovative approach in the clinical arena.
- Published
- 2020
12. Cardiac magnetic resonance features of left dominant arrhythmogenic cardiomyopathy: differential diagnosis with myocarditis
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Cristina Basso, Elena Sommariva, A. Dello Russo, Valentina Catto, Daniele Andreini, M Casella, Stefania Rizzo, Flavia Nicoli, Gianluca Pontone, Claudio Tondo, Giulia Vettor, Edoardo Conte, Saima Mushtaq, and Mauro Pepi
- Subjects
medicine.medical_specialty ,Myocarditis ,medicine.diagnostic_test ,business.industry ,Cardiomyopathy ,medicine.disease ,Linear gingival erythema ,Internal medicine ,Biopsy ,medicine ,Cardiology ,Differential diagnosis ,Cardiology and Cardiovascular Medicine ,LEFT DOMINANT ,business ,Cardiac magnetic resonance - Abstract
Objectives To identify potential imaging features at cardiac magnetic resonance (CMR) specific for left-dominant arrhythmogenic cardiomyopathy (LDAC) diagnosis. Materials and methods Between January 2011 and May 2016, we considered 36 consecutive stable patients with a recent diagnosis of significant VA and ECG morphology consistent with a LV origin, detection of potential LV arrhythmic substrate at CMR, undergoing a clinically-indicated LV endomyocardial biopsy. Exclusion criteria were history of known cardiac disease, contraindications to CMR and impaired CMR image quality. After application of these criteria, in 9 patients endomyocardial biopsy showed tissue abnormalities consistent with the diagnosis of LDAC. From the same CMR-endomyocardial biopsy registry, a second group of 9 consecutive patients with a histological diagnosis of previous myocarditis were identified. Results Mid-wall LGE in the interventricular septum was detected in 5 myocarditis, without findings in LDAC group (p=0.03), whereas subepicardial LGE at the level of posterolateral wall of LV was detected in 8 cases of LDAC vs. 2 cases of myocarditis (p=0.02). Fat infiltration, and particularly subepicardial posterolateral fat infiltration, was found in all LDAC patients vs. one myocarditis only (p Conclusions In patients with significant VA and ECG morphology consistent with a LV origin, identification of morpho-functional involvement of the subepicardial layer of LV posterolateral wall at CMR (LGE, fat infiltration, wall dyskinesis) is consistent with a diagnosis of LDAC. Funding Acknowledgement Type of funding source: None
- Published
- 2020
13. Multi-Modality Imaging in Dilated Cardiomyopathy: With a Focus on the Role of Cardiac Magnetic Resonance
- Author
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Pier Giorgio Masci, Georgios Georgiopoulos, Dimitrios Klettas, Stefano Figliozzi, Panagiota Mitropoulou, and Flavia Nicoli
- Subjects
0301 basic medicine ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Population ,heart failure ,Review ,030204 cardiovascular system & hematology ,Cardiovascular Medicine ,Multi modality ,cardiac imaging ,cardiac magnetic resonance ,sudden cardiac death ,Sudden cardiac death ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,cardiovascular diseases ,education ,Intensive care medicine ,Cardiac imaging ,education.field_of_study ,business.industry ,Dilated cardiomyopathy ,medicine.disease ,Response to treatment ,dilated cardiomyopathy ,non-ischemic cardiomyopathy ,030104 developmental biology ,lcsh:RC666-701 ,Heart failure ,cardiovascular system ,Cardiology and Cardiovascular Medicine ,business ,Cardiac magnetic resonance - Abstract
Heart failure (HF) is recognized as a leading cause of morbidity and mortality worldwide. Dilated cardiomyopathy (DCM) is a common phenotype in patients presenting with HF. Timely diagnosis, appropriate identification of the underlying cause, individualized risk stratification, and prediction of clinical response to treatment have improved the prognosis of DCM over the last few decades. In this article, we reviewed the current evidence on available imaging techniques used for DCM patients. In this direction, we evaluated appropriate scenarios for the implementation of echocardiography, nuclear imaging, and cardiac computed tomography, and we focused on the primordial role that cardiac magnetic resonance (CMR) holds in the diagnosis, prognosis, and tailoring of therapeutic options in this population of special clinical interest. We explored the predictive value of CMR toward left ventricular reverse remodeling and prediction of sudden cardiac death, thus guiding the decisions for device therapy. Principles underpinning the use of state-of-the-art CMR techniques such as parametric mapping and feature-tracking strain analysis are also provided, along with expectations for the anticipated future advances in this field. We also attempted to correlate the evidence with clinical practice, with the intent to address questions on selecting the optimal imaging method for different indications and clinical needs. Overall, we recommend a comprehensive assessment of DCM patients at baseline and at follow-up intervals depending on the clinical status, with the addition of CMR as a second-line modality to other imaging techniques. We also provide an algorithm to guide the detailed imaging approach of the patient with DCM. We expect that future guidelines will upgrade their clinical recommendations for the utilization of CMR in DCM, which is expected to further improve the quality of care and the outcomes. This review provides an up-to-date perspective on the imaging of dilated cardiomyopathy patients and will be of clinical value to training doctors and physicians involved in the area of heart failure.
- Published
- 2020
14. Plaque quantification by coronary computed tomography angiography using intravascular ultrasound as a reference standard: a comparison between standard and last generation computed tomography scanners
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Gianluca Pontone, Marco Guglielmo, Andrea Annoni, Cesare Fiorentini, Giuseppe Muscogiuri, Piero Montorsi, Edoardo Conte, Paolo Ravagnani, Jeroen Sonck, Saima Mushtaq, Andrea Baggiano, Maria Elisabetta Mancini, Luca Di Odoardo, Mauro Pepi, Stefano Galli, Antonio L. Bartorelli, Carlotta Poggi, Daniele Andreini, Daniela Trabattoni, Alberto Formenti, Carlos Collet, Flavia Nicoli, Letizia Li Piani, Marco Magatelli, Graduate School, ACS - Heart failure & arrhythmias, Conte, E, Mushtaq, S, Pontone, G, Li Piani, L, Ravagnani, P, Galli, S, Collet, C, Sonck, J, Di Odoardo, L, Guglielmo, M, Baggiano, A, Trabattoni, D, Annoni, A, Mancini, M, Formenti, A, Muscogiuri, G, Magatelli, M, Nicoli, F, Poggi, C, Fiorentini, C, Bartorelli, A, Pepi, M, Montorsi, P, and Andreini, D
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Computed Tomography Angiography ,whole-heart coverage CT ,Computed tomography ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,intravascular ultrasound ,03 medical and health sciences ,atherosclerosi ,0302 clinical medicine ,Coronary plaque ,Plaque volume ,Intravascular ultrasound ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,coronary plaque analysi ,Reference standards ,Ultrasonography, Interventional ,medicine.diagnostic_test ,business.industry ,Radiation dose ,Coronary computed tomography angiography ,General Medicine ,Reference Standards ,coronary plaque volume ,Plaque, Atherosclerotic ,Heart Rhythm ,coronary computed tomography angiography ,atherosclerosis ,Cardiology and Cardiovascular Medicine ,Nuclear medicine ,business ,Tomography, X-Ray Computed ,coronary plaque analysis - Abstract
Aims: The emerging role of coronary computed tomography angiography (CCTA) as a non-invasive tool for atherosclerosis evaluation is supported by data reporting a good correlation between CCTA and intravascular ultrasound (IVUS) for plaque volume quantification. Aim of the present study was to evaluate whether a last generation CT-scanner may improve coronary plaque volume assessment using IVUS as standard-of-reference. Methods and results: From a registry of 1915 consecutive, all-comers, patients who underwent a clinically indicated IVUS evaluation we enrolled 59 patients who underwent CCTA with a 64-slice CT (Group 1) and 59 patients who underwent CCTA with whole-heart coverage CT scanner (Group 2). Patients who underwent CCTA with unfavourable heart rhythm were not excluded from the analysis. Image quality (4-point Likert scale) focused on plaque analysis was evaluated. Plaque volume quantification by CCTA was compared to IVUS. No difference in clinical characteristics was found between Group 1 and Group 2. Plaque volume quantification by CCTA was considered not feasible in 11 plaques of Group 1 and in 4 plaques of Group 2 (P = 0.09). Higher correlation for plaque volume quantification by CCTA vs. IVUS was demonstrated in Group 2 when compared with Group 1 (r = 0.9888 vs. 0.9499; P < 0.0001). The Bland-Altman analysis showed plaque volume overestimation by CCTA of 11.9 mm3 in Group 1 and 4 mm2 in Group 2 (P < 0.001). Effective radiation dose of CCTA was significantly lower in Group 2 vs. Group 1 (2.7 ± 0.9 vs. 8.1 ± 3.6 mSv, respectively; P < 0.001). Conclusions: CCTA using a new scanner generation showed to be an accurate non-invasive tool to assess and quantify coronary plaque volume.
- Published
- 2020
15. FFRCT and CT perfusion
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Bernard De Bruyne, Daniele Andreini, Alessandra Tanzilli, Emanuele Barbato, Takuya Mizukami, Carlos Collet, Flavia Nicoli, Jeroen Sonck, Edoardo Conte, Saima Mushtaq, Clinical sciences, Conte, E., Sonck, J., Mushtaq, S., Collet, C., Mizukami, T., Barbato, E., Tanzilli, A., Nicoli, F., De Bruyne, B., and Andreini, D.
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medicine.medical_specialty ,Cardiac CT ,Coronary artery disease ,FFR ,CT ,Myocardial CT perfusion ,Clinical Trials as Topic ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Stenosis ,Fractional Flow Reserve, Myocardial ,Humans ,business.industry ,Coronary computed tomography angiography ,Hemodynamics ,Perfusion scanning ,Functional impact ,Coronary stenosis ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,Stenosis ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,Radiology ,business ,Cardiology and Cardiovascular Medicine ,CARDIAC CT ,coronary artery disease - Abstract
Coronary computed tomography angiography (CCTA) is at the frontline of the diagnostic strategies to detect coronary artery disease (CAD). Anatomical information have proven to be insufficient to detect hemodynamic significant epicardial stenosis. In the present invited review we discuss on FFRCT and stress CTP, emerging technologies for an accurate and comprehensive evaluation of patients with suspected CAD, offering both anatomical (i.e. luminal and plaque) and functional assessment in one single technique.
- Published
- 2020
16. P119Comprehensive evaluation of newly diagnosed left ventricle dysfunction by a novel whole-heart coverage cardiac CT: preliminary results of the E-PLURIBUS study
- Author
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Edoardo Conte, Saima Mushtaq, Alberto Formenti, Gianluca Pontone, Marco Guglielmo, A Baggiano, Andrea Annoni, Daniele Andreini, Giuseppe Muscogiuri, E Mancini, Flavia Nicoli, and Mauro Pepi
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medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Ventricle ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Newly diagnosed ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Poster: "ECR 2019 / C-1071 / Comprehensive evaluation of newly diagnosed left ventricle dysfunction by a novel whole-heart coverage cardiac CT: preliminary results of the E-PLURIBUS study " by: " E. Conte , S. Mushtaq, M. E. Mancini, A. D. Annoni, A. Formenti, M. Guglielmo, G. Muscogiuri, G. Pontone, D. Andreini; Milan/IT"
- Published
- 2019
17. 321Cardiac magnetic resonance for identifying the substrate of ventricular arrhythmias in patients with normal echocardiography
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M Casella, Mauro Pepi, A. Dello Russo, Daniele Andreini, Flavia Nicoli, Marco Guglielmo, A Tanzilli, Paola Gripari, Eleonora Melotti, Edoardo Conte, Saima Mushtaq, A Baggiano, Gianluca Pontone, Claudio Tondo, and Corrado Carbucicchio
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Nuclear magnetic resonance ,medicine.diagnostic_test ,business.industry ,Medicine ,Substrate (chemistry) ,Radiology, Nuclear Medicine and imaging ,In patient ,Magnetic resonance imaging ,General Medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2019
18. FFR
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Edoardo, Conte, Jeroen, Sonck, Saima, Mushtaq, Carlos, Collet, Takuya, Mizukami, Emanuele, Barbato, Alessandra, Tanzilli, Flavia, Nicoli, Bernard, De Bruyne, and Daniele, Andreini
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Fractional Flow Reserve, Myocardial ,Clinical Trials as Topic ,Computed Tomography Angiography ,Coronary Stenosis ,Humans ,Coronary Angiography - Abstract
Coronary computed tomography angiography (CCTA) is at the frontline of the diagnostic strategies to detect coronary artery disease (CAD). Anatomical information have proven to be insufficient to detect hemodynamic significant epicardial stenosis. In the present invited review we discuss on FFR
- Published
- 2019
19. Minimally invasive coronary artery bypass: Twenty-year experience
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Alberto Repossini, Alessandra Stara, Flavia Nicoli, Lorenzo Di Bacco, Claudio Muneretto, Bruno Passaretti, and Bejko Jonida
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Hybrid coronary revascularization ,medicine.medical_treatment ,Coronary Disease ,long-term follow-up ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,hybrid revascularization ,law.invention ,Angina ,03 medical and health sciences ,Thoracic Arteries ,0302 clinical medicine ,Interquartile range ,law ,medicine ,Cardiopulmonary bypass ,Humans ,Minimally Invasive Surgical Procedures ,coronary artery revascularization ,Coronary Artery Bypass ,Aged ,Retrospective Studies ,business.industry ,MIDCAB ,Percutaneous coronary intervention ,medicine.disease ,Survival Analysis ,Confidence interval ,Surgery ,medicine.anatomical_structure ,030228 respiratory system ,Drug-eluting stent ,Female ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Objective Minimally invasive direct coronary artery bypass for the left thoracic artery on the left anterior descending artery is a safe and less traumatic surgical technique. We retrospectively evaluated long-term outcomes in a large series of patients undergoing minimally invasive direct coronary artery bypass. Methods From 1997 to 2016, 1060 patients underwent minimally invasive direct coronary artery bypass: 646 patients (61%) with isolated proximal left anterior descending disease and 414 patients (39%) with multivessel disease as a part of hybrid coronary revascularization or in association with medical therapy. Long-term follow-up, major cardiac and cerebral adverse events, and freedom from angina were analyzed. Results Mean age of patients was 71 ± 12.5 years, and median European System for Cardiac Operative Risk Evaluation II was 3.2% (interquartile range, 0.6%-7.8%). Postoperative death occurred in 9 patients (0.8%), and perioperative stroke occurred in 3 patients (0.3%). An angiogram or computed tomography scan was performed and was available in patients within 10 years of follow-up (n = 696), demonstrating a 96.8% graft patency rate. At 13.9 ± 5.6 years of follow-up, no surgical reintervention was performed for left thoracic artery on left anterior descending artery graft failure, but 14 patients underwent left anterior descending or left thoracic artery on left anterior descending artery percutaneous coronary intervention. Kaplan–Meier survival curve shows 87.1% at 5 years (95% confidence interval, 81-92.5), 84.3% at 10 years (95% confidence interval, 77.1-91.4), and 79.8% at 15 years (95% confidence interval, 72.2-87.3). Survival freedom from major adverse events was 87.0% (95% confidence interval, 85.9-88.1) at 5 years and 70.5% (95% confidence interval, 66.4-74.6) at 15 years. Conclusions Minimally invasive direct coronary artery bypass can be safely performed with low postoperative mortality and morbidity with excellent short- and long-term survival and freedom from major adverse events and angina with a reduced surgical invasiveness.
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- 2019
20. Qualitative and quantitative evaluation of a new wearable device for ECG and respiratory Holter monitoring
- Author
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Alessandra Scoccia, Alessandra Leonardi, Andrea Aliverti, Dario Ossola, Carlo Vignati, Carolina Lombardi, Flavia Nicoli, Rudy Rigoni, Massimo Mapelli, Piergiuseppe Agostoni, Antonio Sarmento, Stefania Paolillo, Sarmento, A., Vignati, C., Paolillo, S., Lombardi, C., Scoccia, A., Nicoli, F., Mapelli, M., Leonardi, A., Ossola, D., Rigoni, R., Agostoni, P., Aliverti, A., Sarmento, A, Vignati, C, Paolillo, S, Lombardi, C, Scoccia, A, Nicoli, F, Mapelli, M, Leonardi, A, Ossola, D, Rigoni, R, Agostoni, P, and Aliverti, A
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Apnea ,ECG monitoring ,Respiratory monitoring, wearable device ,Male ,medicine.medical_specialty ,Respiratory rate ,wearable device ,Respiratory physiology ,Respiratory monitoring ,030204 cardiovascular system & hematology ,Clothing ,03 medical and health sciences ,QRS complex ,Wearable Electronic Devices ,0302 clinical medicine ,Heart Rate ,Internal medicine ,Medicine ,ST segment ,Humans ,Tidal volume ,Aged ,Aged, 80 and over ,Cross-Sectional Studie ,Respiratory Mechanic ,business.industry ,Cardiorespiratory fitness ,Middle Aged ,Cross-Sectional Studies ,030228 respiratory system ,Breathing ,Cardiology ,Respiratory Mechanics ,Electrocardiography, Ambulatory ,Female ,Wearable Electronic Device ,Cardiology and Cardiovascular Medicine ,business ,Human - Abstract
Background Recent advances in wearable technology make continuous cardiorespiratory monitoring possible, with potential applications in assessment of cardiopulmonary patients, healthy subjects and athletes. The aim of the present study was to qualitatively and quantitatively evaluate a new wearable device (Learn Inspire Free Entertain = L.I.F.E.) by embedding in a compression shirt a 12‑lead ECG system and 5 respiratory sensors. Methods Thirty cardiorespiratory patients and ten healthy subjects were studied for 24 h during their usual life activities. In 8 healthy subjects, simultaneous measurements of the device and of an ergo-spirometer were performed during different levels of ventilation in five different body positions. The quality of ECG signals in terms of measurability of heart rate, P wave, QRS complex and ST segment, was analyzed by four expert cardiologists/respiratory physiologists using an arbitrary 1–5 scale. The sum of the respiratory signals was used to calculate the respiratory rate, inspiratory time and relative changes of tidal volume. These parameters were compared to ergo-spirometer measurements. Results Median quality value was >3 for heart rate, QRS complex, ST segment and P wave (except in L3, aVL, aVF, V1 and V2 leads). Median quality of respiratory traces was >4 in patients and between 3 and 4 in healthy subjects. The respiratory monitoring of respiratory rate and inspiratory time was accurate in all body positions. Tidal volumes were underestimated due to a high level of ventilation. Conclusions The L.I.F.E. device provides an accurate continuous monitoring of cardiorespiratory signals during the 24 h both in normal subjects and cardiorespiratory patients.
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- 2018
21. Lvad pump speed increase is associated with increased peak exercise cardiac output and vo2, postponed anaerobic threshold and improved ventilatory efficiency
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Anna Apostolo, Carlo Vignati, Susanna Sciomer, Vincenzo Tarzia, Alberico Del Torto, Jonida Bejko, Erminio Sisillo, Tomaso Bottio, Piergiuseppe Agostoni, Gaia Cattadori, Stefania Paolillo, Flavia Nicoli, Gino Gerosa, Francesco Alamanni, Silvia Scuri, and Stefania Farina
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Spirometry ,Cardiac output ,medicine.medical_specialty ,LVAD ,Exercise testing ,Heart failure ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,030212 general & internal medicine ,Peak exercise ,medicine.diagnostic_test ,business.industry ,Medicine (all) ,VO2 max ,medicine.disease ,Crossover study ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Anaerobic exercise ,Clinical evaluation - Abstract
Backgrounds Peak exercise cardiac output (CO) increase is associated with an increase of peak oxygen uptake (VO 2 ), provided that arteriovenous O 2 difference [Δ(Ca−Cv)O 2 ] does not decrease. At anaerobic threshold, VO 2 , is related to CO. We tested the hypothesis that, in heart failure (HF) patients with left ventricular assistance device (LVAD), an acute increase of CO obtained through changes in LVAD pump speed is associated with peak exercise and anaerobic threshold VO 2 increase. Methods Fifteen of 20 patients bearing LVAD (Jarvik 2000) enrolled in the study successfully performed peak exercise evaluation. All patients had severe HF as shown by clinical evaluation, laboratory tests, echocardiography, spirometry with alveolar-capillary diffusion, and maximal cardiopulmonary exercise testing (CPET). CPETs with non-invasive CO measurements at rest and peak exercise were done on 2days at LVAD pump speed set randomly at 2 and 4. Results Increasing LVAD pump speed from 2 to 4 increased CO from 3.4±0.9 to 3.8±1.0L/min (ΔCO 0.4±0.6L/min, p =0.04) and from 5.3±1.3 to 5.9±1.4L/min (ΔCO 0.6±0.7L/min, p 2 increased from 788±169 to 841±152mL/min (ΔVO 2 52±76mL/min, p =0.01) and from 568±116 to 619±124mL/min (ΔVO 2 69±96mL/min, p =0.02) at peak exercise and at anaerobic threshold, respectively. Δ(Ca−Cv)O 2 did not change significantly, while ventilatory efficiency improved (VE/VCO 2 slope from 39.9±5.4 to 34.9±8.3, ΔVE/VCO 2 −5.0±6.4, p Conclusions In HF, an increase in CO with a higher LVAD pump speed is associated with increased peak VO 2 , postponed anaerobic threshold, and improved ventilatory efficiency.
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- 2017
22. In reply to 'The novel whole-organ high-definition CT scanner: A promising diagnostic method for coronary stented patients with unfavorable HR'
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Daniele Andreini, Edoardo Conte, Alessandra Tanzilli, Flavia Nicoli, and Saima Mushtaq
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Scanner ,medicine.medical_specialty ,Tomography Scanners, X-Ray Computed ,Diagnostic methods ,Computed Tomography Angiography ,business.industry ,medicine.medical_treatment ,Coronary ct angiography ,Coronary Angiography ,Coronary stent ,medicine ,Humans ,High definition ,Stents ,Radiology ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business - Published
- 2019
23. Lvad pump speed increase is associated with increased peak exercise cardiac output and vo
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Carlo, Vignati, Anna, Apostolo, Gaia, Cattadori, Stefania, Farina, Alberico, Del Torto, Silvia, Scuri, Gino, Gerosa, Tomaso, Bottio, Vincenzo, Tarzia, Jonida, Bejko, Erminio, Sisillo, Flavia, Nicoli, Susanna, Sciomer, Francesco, Alamanni, Stefania, Paolillo, and Piergiuseppe, Agostoni
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Heart Failure ,Male ,Cross-Over Studies ,Oxygen Consumption ,Anaerobic Threshold ,Double-Blind Method ,Pulmonary Gas Exchange ,Humans ,Female ,Heart-Assist Devices ,Cardiac Output ,Middle Aged ,Exercise - Abstract
Peak exercise cardiac output (CO) increase is associated with an increase of peak oxygen uptake (VOFifteen of 20 patients bearing LVAD (Jarvik 2000) enrolled in the study successfully performed peak exercise evaluation. All patients had severe HF as shown by clinical evaluation, laboratory tests, echocardiography, spirometry with alveolar-capillary diffusion, and maximal cardiopulmonary exercise testing (CPET). CPETs with non-invasive CO measurements at rest and peak exercise were done on 2days at LVAD pump speed set randomly at 2 and 4.Increasing LVAD pump speed from 2 to 4 increased CO from 3.4±0.9 to 3.8±1.0L/min (ΔCO 0.4±0.6L/min, p=0.04) and from 5.3±1.3 to 5.9±1.4L/min (ΔCO 0.6±0.7L/min, p0.01) at rest and peak exercise, respectively. Similarly, VOIn HF, an increase in CO with a higher LVAD pump speed is associated with increased peak VO
- Published
- 2016
24. 093 * LONG-TERM RESULTS OF MINIMALLY INVASIVE DIRECT CORONARY ARTERY BYPASS: TEN-YEAR EXPERIENCE AND FOLLOW-UP
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Alberto Repossini, Igor A. Kotelnikov, Claudio Muneretto, Fabrizio Rosati, Flavia Nicoli, and L. Di Bacco
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Ejection fraction ,business.industry ,medicine.medical_treatment ,Percutaneous coronary intervention ,Internal thoracic artery ,Revascularization ,Surgery ,Term (time) ,Laparotomy ,medicine.artery ,medicine ,Minimally invasive direct coronary artery bypass surgery ,Minimally invasive direct coronary artery bypass ,Cardiology and Cardiovascular Medicine ,business - Published
- 2013
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