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2. Effect of Rehabilitation Treatments on Disability in Persons With Disorders of Consciousness: A Propensity Score Study

Author

Sattin D., Leonardi M., Nelli B., Bramanti P., Marino S., Ferro S., Basaglia N., Guido D., Dolce G., Lucca L. F, Cortese M. D., Ermio C., Dattilo T. L., Capomolla S., Di Iasi G., Estraneo A., De Tanti A., Maradini N., Piperno R., Ferri A., Basaglia N, Bergonzoni A., Chiavaroli F., Di Marco F., Carli S., Biasutti E., Marin D., Formisano R., Rizza F., Pisarri F. M., Vichi R., D'Urso A., Grillo G., Leto A., Guerrasio M., Taliento C., Napolitano F., Castelli E., Lispi M. L., Diverio M., Barbieri C., Bini P. P., Angelino G., Dada O., Orlandi A., Pistarini C., Pisoni C., Manera M., Compostini A., Aiachini B., Pessina A., Musio A., Colombetti E., Taraschi S., Aluas M., Croci M., Negri M., Zucchella M. A., Guizzetti G. B., Salamone E., De Valle G., Caroppi S. M., Ramorino E., Salina D., Spannocchi G., Strazzer S., Villa F., Guarnerio C., Chiambretto P., Dartizio R., Feller S., Franzoni L., Giunco F., Massironi L., Azimonti R., Marcolli S. S., Meinecke C., Buse G., Marchesi V, Molteni F., Gramigna C., Lanfranchi M., Pisani L., Sozzi M., Borri G., Cannata A. P., Grillo A., Roca S., Locati D., Arenare F., Magnoni A., Perin C., Sussele M., Quintana T. Y., Camici M. E., Magistrelli F., Samueli T., San Felici L., Manganelli F., Vignati M., Bellanova L., Cattaneo N., Ferraro F., Olgiati E., Brizioli E., Vallasciani M., Gironelli L., Calderisi E., Novelli A., Scaramuzzo R., Perino C., Forno R., Zamponi E., Corna S., Ferrario S., Lamberti G., Rosso S., Colonna F., Navarro J., Trabacca A., Gennaro L., Bertolini A., Addante L., Amenduni M. T., Fiore P., Amoruso M. T., Colella D., Angelillo M. T., Melis G., Desogus G., Baglieri A., Galardi G., Sant'Angelo A., Posteraro F., Forte F., Logi F., Potenza F., Lino M., Zaccara G., Ragazzoni A., Chiaramonti R., March A., Grober G., Kaczor M., Zelger P, Mazzini N., Monti A., Zampolini M., Scarponi F., Avesani R., Salvi L., Tonin P., Cosentino E., Furlanetto N., Bordin M., Martinuzzi A., Buffoni M., Boldrini P., Semerjian M., Sattin, D, Leonardi, M, Nelli, B, Bramanti, P, Marino, S, Ferro, S, Basaglia, N, Guido, D, Dolce, G, Lucca, L, Cortese, M, Ermio, C, Dattilo, T, Capomolla, S, Di Iasi, G, Estraneo, A, De Tanti, A, Maradini, N, Piperno, R, Ferri, A, Bergonzoni, A, Chiavaroli, F, Di Marco, F, Carli, S, Biasutti, E, Marin, D, Formisano, R, Rizza, F, Pisarri, F, Vichi, R, D'Urso, A, Grillo, G, Leto, A, Guerrasio, M, Taliento, C, Napolitano, F, Castelli, E, Lispi, M, Diverio, M, Barbieri, C, Bini, P, Angelino, G, Dada, O, Orlandi, A, Pistarini, C, Pisoni, C, Manera, M, Compostini, A, Aiachini, B, Pessina, A, Musio, A, Colombetti, E, Taraschi, S, Aluas, M, Croci, M, Negri, M, Zucchella, M, Guizzetti, G, Salamone, E, De Valle, G, Caroppi, S, Ramorino, E, Salina, D, Spannocchi, G, Strazzer, S, Villa, F, Guarnerio, C, Chiambretto, P, Dartizio, R, Feller, S, Franzoni, L, Giunco, F, Massironi, L, Azimonti, R, Marcolli, S, Meinecke, C, Buse, G, Marchesi, V, Molteni, F, Gramigna, C, Lanfranchi, M, Pisani, L, Sozzi, M, Borri, G, Cannata, A, Grillo, A, Roca, S, Locati, D, Arenare, F, Magnoni, A, Perin, C, Sussele, M, Quintana, T, Camici, M, Magistrelli, F, Samueli, T, San Felici, L, Manganelli, F, Vignati, M, Bellanova, L, Cattaneo, N, Ferraro, F, Olgiati, E, Brizioli, E, Vallasciani, M, Gironelli, L, Calderisi, E, Novelli, A, Scaramuzzo, R, Perino, C, Forno, R, Zamponi, E, Corna, S, Ferrario, S, Lamberti, G, Rosso, S, Colonna, F, Navarro, J, Trabacca, A, Gennaro, L, Bertolini, A, Addante, L, Amenduni, M, Fiore, P, Amoruso, M, Colella, D, Angelillo, M, Melis, G, Desogus, G, Baglieri, A, Galardi, G, Sant'Angelo, A, Posteraro, F, Forte, F, Logi, F, Potenza, F, Lino, M, Zaccara, G, Ragazzoni, A, Chiaramonti, R, March, A, Grober, G, Kaczor, M, Zelger, P, Mazzini, N, Monti, A, Zampolini, M, Scarponi, F, Avesani, R, Salvi, L, Tonin, P, Cosentino, E, Furlanetto, N, Bordin, M, Martinuzzi, A, Buffoni, M, Boldrini, P, and Semerjian, M

Subjects
Adult, Male, 030506 rehabilitation, medicine.medical_specialty, Propensity score, medicine.medical_treatment, Physical Therapy, Sports Therapy and Rehabilitation, Disorders of consciousness, Severity of Illness Index, Disability Evaluation, 03 medical and health sciences, 0302 clinical medicine, Clinical Protocols, Severity of illness, medicine, Humans, Longitudinal Studies, Aged, Vegetative state, Rehabilitation, business.industry, Minimally conscious state, Recovery of Function, Disability Rating Scale, Middle Aged, medicine.disease, Treatment Outcome, Italy, Propensity score matching, Physical therapy, Consciousness Disorders, Female, Observational study, 0305 other medical science, business, 030217 neurology & neurosurgery
Abstract

To evaluate the effects of rehabilitation (physical and cognitive) treatments on the diagnosis severity and Disability Rating Scale (DRS) scores, adjusted for a number of potential confounders measured at baseline, in a large cohort of patients with disorders of consciousness across time.An observational, longitudinal (2 evaluations), multicenter project was made in 90 Italian centers.Patients (N=364) with a diagnosis of disorders of consciousness.Primary outcome was the severity of diagnosis, expressed on an ordinal scale (OtherMCSVSdeath). In the Other group were included patients who emerged from an MCS and recovered consciousness. The secondary outcome was the DRS score (range of 0-30 with 30 being the worst value). The DRS is a tool used to define the level of residual disability, commonly used to classify the level of functional impairment in patients with acquired brain injury. Both outcomes were measured for each wave.A total of 364 subjects having a complete set of demographic, clinical, and pharmacologic data were included in the propensity score (PS) analysis. Results showed that the rehabilitation treatments (physical and cognitive) reduced the clinical worsening over time in both severity diagnosis and DRS (around 6.5 points) in patients with disorders of consciousness across different propensity score strategies (ie, PS matching, PS adjustment, and PS-weighted procedures). In addition, cognitive protocols seem to be limited to patients with a median value of DRS=23.Our propensity score analysis suggests that rehabilitation treatment protocols seem effective and should be applied to a broader spectrum of patients with disorders of consciousness.

Published
2020
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3. Effect of Rehabilitation Treatments on Disability in Persons With Disorders of Consciousness: A Propensity Score Study

Author

Sattin, D, Leonardi, M, Nelli, B, Bramanti, P, Marino, S, Ferro, S, Basaglia, N, Guido, D, Dolce, G, Lucca, L, Cortese, M, Ermio, C, Dattilo, T, Capomolla, S, Di Iasi, G, Estraneo, A, De Tanti, A, Maradini, N, Piperno, R, Ferri, A, Bergonzoni, A, Chiavaroli, F, Di Marco, F, Carli, S, Biasutti, E, Marin, D, Formisano, R, Rizza, F, Pisarri, F, Vichi, R, D'Urso, A, Grillo, G, Leto, A, Guerrasio, M, Taliento, C, Napolitano, F, Castelli, E, Lispi, M, Diverio, M, Barbieri, C, Bini, P, Angelino, G, Dada, O, Orlandi, A, Pistarini, C, Pisoni, C, Manera, M, Compostini, A, Aiachini, B, Pessina, A, Musio, A, Colombetti, E, Taraschi, S, Aluas, M, Croci, M, Negri, M, Zucchella, M, Guizzetti, G, Salamone, E, De Valle, G, Caroppi, S, Ramorino, E, Salina, D, Spannocchi, G, Strazzer, S, Villa, F, Guarnerio, C, Chiambretto, P, Dartizio, R, Feller, S, Franzoni, L, Giunco, F, Massironi, L, Azimonti, R, Marcolli, S, Meinecke, C, Buse, G, Marchesi, V, Molteni, F, Gramigna, C, Lanfranchi, M, Pisani, L, Sozzi, M, Borri, G, Cannata, A, Grillo, A, Roca, S, Locati, D, Arenare, F, Magnoni, A, Perin, C, Sussele, M, Quintana, T, Camici, M, Magistrelli, F, Samueli, T, San Felici, L, Manganelli, F, Vignati, M, Bellanova, L, Cattaneo, N, Ferraro, F, Olgiati, E, Brizioli, E, Vallasciani, M, Gironelli, L, Calderisi, E, Novelli, A, Scaramuzzo, R, Perino, C, Forno, R, Zamponi, E, Corna, S, Ferrario, S, Lamberti, G, Rosso, S, Colonna, F, Navarro, J, Trabacca, A, Gennaro, L, Bertolini, A, Addante, L, Amenduni, M, Fiore, P, Amoruso, M, Colella, D, Angelillo, M, Melis, G, Desogus, G, Baglieri, A, Galardi, G, Sant'Angelo, A, Posteraro, F, Forte, F, Logi, F, Potenza, F, Lino, M, Zaccara, G, Ragazzoni, A, Chiaramonti, R, March, A, Grober, G, Kaczor, M, Zelger, P, Mazzini, N, Monti, A, Zampolini, M, Scarponi, F, Avesani, R, Salvi, L, Tonin, P, Cosentino, E, Furlanetto, N, Bordin, M, Martinuzzi, A, Buffoni, M, Boldrini, P, Semerjian, M, Sattin D., Leonardi M., Nelli B., Bramanti P., Marino S., Ferro S., Basaglia N., Guido D., Dolce G., Lucca L. F, Cortese M. D., Ermio C., Dattilo T. L., Capomolla S., Di Iasi G., Estraneo A., De Tanti A., Maradini N., Piperno R., Ferri A., Basaglia N, Bergonzoni A., Chiavaroli F., Di Marco F., Carli S., Biasutti E., Marin D., Formisano R., Rizza F., Pisarri F. M., Vichi R., D'Urso A., Grillo G., Leto A., Guerrasio M., Taliento C., Napolitano F., Castelli E., Lispi M. L., Diverio M., Barbieri C., Bini P. P., Angelino G., Dada O., Orlandi A., Pistarini C., Pisoni C., Manera M., Compostini A., Aiachini B., Pessina A., Musio A., Colombetti E., Taraschi S., Aluas M., Croci M., Negri M., Zucchella M. A., Guizzetti G. B., Salamone E., De Valle G., Caroppi S. M., Ramorino E., Salina D., Spannocchi G., Strazzer S., Villa F., Guarnerio C., Chiambretto P., Dartizio R., Feller S., Franzoni L., Giunco F., Massironi L., Azimonti R., Marcolli S. S., Meinecke C., Buse G., Marchesi V, Molteni F., Gramigna C., Lanfranchi M., Pisani L., Sozzi M., Borri G., Cannata A. P., Grillo A., Roca S., Locati D., Arenare F., Magnoni A., Perin C., Sussele M., Quintana T. Y., Camici M. E., Magistrelli F., Samueli T., San Felici L., Manganelli F., Vignati M., Bellanova L., Cattaneo N., Ferraro F., Olgiati E., Brizioli E., Vallasciani M., Gironelli L., Calderisi E., Novelli A., Scaramuzzo R., Perino C., Forno R., Zamponi E., Corna S., Ferrario S., Lamberti G., Rosso S., Colonna F., Navarro J., Trabacca A., Gennaro L., Bertolini A., Addante L., Amenduni M. T., Fiore P., Amoruso M. T., Colella D., Angelillo M. T., Melis G., Desogus G., Baglieri A., Galardi G., Sant'Angelo A., Posteraro F., Forte F., Logi F., Potenza F., Lino M., Zaccara G., Ragazzoni A., Chiaramonti R., March A., Grober G., Kaczor M., Zelger P, Mazzini N., Monti A., Zampolini M., Scarponi F., Avesani R., Salvi L., Tonin P., Cosentino E., Furlanetto N., Bordin M., Martinuzzi A., Buffoni M., Boldrini P., Semerjian M., Sattin, D, Leonardi, M, Nelli, B, Bramanti, P, Marino, S, Ferro, S, Basaglia, N, Guido, D, Dolce, G, Lucca, L, Cortese, M, Ermio, C, Dattilo, T, Capomolla, S, Di Iasi, G, Estraneo, A, De Tanti, A, Maradini, N, Piperno, R, Ferri, A, Bergonzoni, A, Chiavaroli, F, Di Marco, F, Carli, S, Biasutti, E, Marin, D, Formisano, R, Rizza, F, Pisarri, F, Vichi, R, D'Urso, A, Grillo, G, Leto, A, Guerrasio, M, Taliento, C, Napolitano, F, Castelli, E, Lispi, M, Diverio, M, Barbieri, C, Bini, P, Angelino, G, Dada, O, Orlandi, A, Pistarini, C, Pisoni, C, Manera, M, Compostini, A, Aiachini, B, Pessina, A, Musio, A, Colombetti, E, Taraschi, S, Aluas, M, Croci, M, Negri, M, Zucchella, M, Guizzetti, G, Salamone, E, De Valle, G, Caroppi, S, Ramorino, E, Salina, D, Spannocchi, G, Strazzer, S, Villa, F, Guarnerio, C, Chiambretto, P, Dartizio, R, Feller, S, Franzoni, L, Giunco, F, Massironi, L, Azimonti, R, Marcolli, S, Meinecke, C, Buse, G, Marchesi, V, Molteni, F, Gramigna, C, Lanfranchi, M, Pisani, L, Sozzi, M, Borri, G, Cannata, A, Grillo, A, Roca, S, Locati, D, Arenare, F, Magnoni, A, Perin, C, Sussele, M, Quintana, T, Camici, M, Magistrelli, F, Samueli, T, San Felici, L, Manganelli, F, Vignati, M, Bellanova, L, Cattaneo, N, Ferraro, F, Olgiati, E, Brizioli, E, Vallasciani, M, Gironelli, L, Calderisi, E, Novelli, A, Scaramuzzo, R, Perino, C, Forno, R, Zamponi, E, Corna, S, Ferrario, S, Lamberti, G, Rosso, S, Colonna, F, Navarro, J, Trabacca, A, Gennaro, L, Bertolini, A, Addante, L, Amenduni, M, Fiore, P, Amoruso, M, Colella, D, Angelillo, M, Melis, G, Desogus, G, Baglieri, A, Galardi, G, Sant'Angelo, A, Posteraro, F, Forte, F, Logi, F, Potenza, F, Lino, M, Zaccara, G, Ragazzoni, A, Chiaramonti, R, March, A, Grober, G, Kaczor, M, Zelger, P, Mazzini, N, Monti, A, Zampolini, M, Scarponi, F, Avesani, R, Salvi, L, Tonin, P, Cosentino, E, Furlanetto, N, Bordin, M, Martinuzzi, A, Buffoni, M, Boldrini, P, Semerjian, M, Sattin D., Leonardi M., Nelli B., Bramanti P., Marino S., Ferro S., Basaglia N., Guido D., Dolce G., Lucca L. F, Cortese M. D., Ermio C., Dattilo T. L., Capomolla S., Di Iasi G., Estraneo A., De Tanti A., Maradini N., Piperno R., Ferri A., Basaglia N, Bergonzoni A., Chiavaroli F., Di Marco F., Carli S., Biasutti E., Marin D., Formisano R., Rizza F., Pisarri F. M., Vichi R., D'Urso A., Grillo G., Leto A., Guerrasio M., Taliento C., Napolitano F., Castelli E., Lispi M. L., Diverio M., Barbieri C., Bini P. P., Angelino G., Dada O., Orlandi A., Pistarini C., Pisoni C., Manera M., Compostini A., Aiachini B., Pessina A., Musio A., Colombetti E., Taraschi S., Aluas M., Croci M., Negri M., Zucchella M. A., Guizzetti G. B., Salamone E., De Valle G., Caroppi S. M., Ramorino E., Salina D., Spannocchi G., Strazzer S., Villa F., Guarnerio C., Chiambretto P., Dartizio R., Feller S., Franzoni L., Giunco F., Massironi L., Azimonti R., Marcolli S. S., Meinecke C., Buse G., Marchesi V, Molteni F., Gramigna C., Lanfranchi M., Pisani L., Sozzi M., Borri G., Cannata A. P., Grillo A., Roca S., Locati D., Arenare F., Magnoni A., Perin C., Sussele M., Quintana T. Y., Camici M. E., Magistrelli F., Samueli T., San Felici L., Manganelli F., Vignati M., Bellanova L., Cattaneo N., Ferraro F., Olgiati E., Brizioli E., Vallasciani M., Gironelli L., Calderisi E., Novelli A., Scaramuzzo R., Perino C., Forno R., Zamponi E., Corna S., Ferrario S., Lamberti G., Rosso S., Colonna F., Navarro J., Trabacca A., Gennaro L., Bertolini A., Addante L., Amenduni M. T., Fiore P., Amoruso M. T., Colella D., Angelillo M. T., Melis G., Desogus G., Baglieri A., Galardi G., Sant'Angelo A., Posteraro F., Forte F., Logi F., Potenza F., Lino M., Zaccara G., Ragazzoni A., Chiaramonti R., March A., Grober G., Kaczor M., Zelger P, Mazzini N., Monti A., Zampolini M., Scarponi F., Avesani R., Salvi L., Tonin P., Cosentino E., Furlanetto N., Bordin M., Martinuzzi A., Buffoni M., Boldrini P., and Semerjian M.

Abstract

Objective: To evaluate the effects of rehabilitation (physical and cognitive) treatments on the diagnosis severity and Disability Rating Scale (DRS) scores, adjusted for a number of potential confounders measured at baseline, in a large cohort of patients with disorders of consciousness across time. Design and Setting: An observational, longitudinal (2 evaluations), multicenter project was made in 90 Italian centers. Participants: Patients (N=364) with a diagnosis of disorders of consciousness. Main Outcome Measures: Primary outcome was the severity of diagnosis, expressed on an ordinal scale (Other

Published
2020

12. GISSI-3 - EFFECTS OF LISINOPRIL AND TRANSDERMAL GLYCERYL TRINITRATE SINGLY AND TOGETHER ON 6-WEEK MORTALITY AND VENTRICULAR-FUNCTION AFTER ACUTE MYOCARDIAL-INFARCTION

Author

Devita, C., Fazzini, P. F., Geraci, E., Tavazzi, L., Tognoni, G., Vecchio, C., Boeri, R., Damico, G., Loi, U., Marubini, E., Pagliaro, L., Rovelli, F., Franzosi, M. G., Latini, R., Maggioni, A. P., Mauri, F., Volpi, A., Barlera, S., Negri, E., Nicolis, E., Santoro, E., Santoro, L., Bonfanti, E., Capello, T., Casati, A., Corato, A., Gardinale, E., Negrini, M., Nobili, A., Staszewsky, L., Tavanelli, M., Torta, D., Gambelli, G., Moroni, L., Pellanda, J. J., Pietropaolo, F., Balli, E., Barbieri, A., Bechi, S., Carrone, M., Catanzaro, M., Fasciolo, L., Fresco, C., Ghiani, A., Iacuitti, G., Ledda, A., Levantesi, G., Pasini, P., Peci, P., Pizzetti, F., Sagone, A., Turazza, F., Villella, A., Villella, M., Braggio, N., Disertori, M., Frezzati, S., Garattini, S., Marino, P., Maseri, A., Mazzotta, G., Nicolosi, G., Pirelli, S., Sanna, G. P., Valagussa, F., Dargie, H. J., Peto, R., Pocock, S., Sleight, P., Yusuf, S., Giordano, F., Varlese, A., Loparco, G., Iberti, V., Giamundo, L., Anastasi, R., Paciaroni, E., Raffaeli, S., Purcaro, A., Ciampani, N., Rita, E., Cuccaroni, G., Baldinelli, A., Altieri, A., Giornetti, R., Azzaro, G., Ferraguto, P., Salici, G., Laconi, E., Tiburzi, F. M., Bernardi, D., Lunardi, M., Colonna, L., Bovenzi, F., Amodio, F., Sarcina, G., Carpagnano, A., Matera, A., Malacrida, R., Rigotti, R., Dallemule, J., Debiasi, A., Bridda, A., Invernizzi, G., Piti, A., Colombo, L., Tomassini, B., Biasia, R., Solda, P., Scaramuzzino, G., Mirri, A., Bracchetti, D., Decastro, U., Lintner, W., Erlicher, A., Gronda, M., Devecchi, P., Gagliardi, R. S., Battistoni, N., Storelli, A., Guadalupi, M., Nadovezza, S., Zuffiano, D., Depetra, V., Scervino, R., Tabacchi, G., Dessalvi, F., Scorcu, G., Giardina, G., Raffo, M., Boi, W., Cammalleri, G., Gruttadauria, G., Baldini, F., Paolone, P., Pantaleoni, A., Contessotto, F., Deconti, F., Pignatti, F., Frignani, A., Ivaldi, M., Aletto, C., Pettinati, G., Ciricugno, A., Muscella, A., Correale, E., Romano, S., Dandrea, D., Murena, E., Longobardi, R., Dimartino, N., Paolini, E., Gaddi, P., Calvelli, C., Dulcetti, F., Galassi, A., Coco, R., Coppola, A., Centamore, G., Calabrese, G., Sgalambro, G., Circo, A., Raciti, S., Dellamonica, R., Malinconico, M., Deponti, C., Parmigiani, M. L., Bellet, C., Bortolini, F., Buffoli, L., Tiberi, A., Ferrari, A., Rossi, A., Ciglia, C., Dicenso, M., Mangiarotti, E., Ornaghi, M., Do, V., Spapperi, D., Maiolino, P., Delio, U., Carrozza, A., Marinoni, C., Guasconi, C., Sandro Sonnino, Pagliei, M., Ferrari, G., Politi, A., Delazzaro, M., Rinaldis, G., Calcagnile, A., Lusetti, L., Bendinelli, S., Mollaioli, M., Cosmi, F., Plastina, F., Misuraca, G., Serafini, O., Venneri, N., Catelli, P., Poluzzi, C., Bergamaschi, G., Fadin, M. B., Dechiara, F., Zampaglione, G., Elia, M., Racca, E., Meinardi, F., Casasso, F., Bertocchi, P., Donzelli, W., Pessina, S., Tirella, G., Sauro, G., Tessitori, M., Bini, A., Bartoletti, A., Agnelli, D., Zagami, A., Andreoli, L., Bastoni, L., Pucci, P., Santini, A., Buonamici, P. G., Filice, M., Badolati, S., Zerauchek, M., Dematteis, D., Maulucci, G., Dantuono, C., Liberti, R., Menicono, L., Mattoli, A., Tallone, M., Divita, G., Manca, G., Licci, E., Canziani, R., Guidali, P., Rancan, E., Mariello, F., Pennetta, A., Minelli, C., Baldini, M. R., Cazzani, E., Romano, M., Bellotti, P., Camerini, A., Davi, R., Piazza, R., Musso, G., Rossi, P., Giacchero, C., Seu, V., Toselli, A., Digiacinto, N., Dicio, G., Spanghero, M., Cresti, A., Svetoni, N., Bruno, G., Distefano, S., Giovanelli, N., Fini, M., Dethomatis, M., Pandini, R., Carrino, C., Giammaria, M., Pistelli, P., Ronzani, G., Ottello, B., Melappioni, A., Zappelli, L., Marsili, P., Scimia, A., Ragazzini, G., Gramenzi, S., Motto, A., Tullio, D., Tucci, D., Rosselli, P., Gaggioli, G., Bollini, R., Fazio, A. M., Russo, R., Bossi, M., Savoia, M., Valsecchi, M. A., Barbaresi, F., Barbiero, M., Bonofiglio, C., Gemelli, M., Bonaglia, M., Bossoni, E., Lanzini, A., Delbene, P., Cascone, M., Orlandi, M., Oddone, A., Sallazzo, V., Panuccio, D., Cane, G., Moccetti, T., Pasotti, E., Tognoli, T., Caravita, L., Maggi, A., Bardelli, G. C., Tusa, M., Maggi, G., Guerra, G. P., Reggiani, A., Izzo, A., Colombo, G., Foti, F., Consolo, F., Arrigo, F., Sacca, A. M., Mafrici, A., Alberti, A., Belli, C., Dossena, M. G., Spinola, A., Casiraghi, M. G., Azzollini, M., Pozzoni, L., Salmoirago, E., Massironi, L., Sala, R., Bressi, R., Rigo, R., Cappelli, S., Malavasi, V., Pascotto, P., Pasqual, A. S., Sarto, P., Sani, F., Tosoni, D., Spinnler, M. T., Persico, D., Orsi, R., Lugliengo, V., Parolini, V., Zilio, G., Sandri, R., Neri, G., Alitto, F., Petri, D., Cusa, E. N., Mazzitelli, L., Piantadosi, F. R., Daniello, L., Polimeno, S., Mininni, N., Greco, R., Bisconti, C., Cucchiari, C., Dallavilla, W., Randon, L., Allegri, M., Marchi, S. M., Sanna, E., Deluca, C., Manetta, M., Dallavolta, S., Maddalena, F., Donzelli, M., Pulisano, U., Dimaria, B., Celona, G., Marchi, S., Vivirito, A., Carrubba, A., Lamalfa, R. G., Schicchi, R., Bellanca, G., Battaglia, A., Cirrincione, V., Ribaudo, E., Strizzolo, L., Carone, M., Digregorio, D., Mantini, L., Corea, L., Cocchieri, M., Notaristefano, A., Catanese, C., Faleburle, M., Sgarbi, E., Cesaroni, P., Baldini, P. M., Papi, L., Lavarini, L., Lorenzini, M., Tarditi, V., Menara, N., Conti, M., Ferro, M., Gianotti, A., Crivello, R., Micheli, G., Conti, U., Cabani, E., Davini, P., Delciterna, F., Giomi, A., Alfieri, A., Chiti, M., Codeluppi, P., Smerieri, O., Dinapoli, T., Capozzoli, M. R., Topi, P. L., Paperini, L., Topi, A., Zanuttini, D., Nicolosi, G. L., Visentin, P., Charmet, P. A., Petrella, A., Bardazzi, L., Nassi, F., Bianco, G. A., Cellammare, G., Licitra, R., Cintolo, C., Spadola, V., Guarrella, L., Casali, G., Monducci, I., Zobbi, G., Guiducci, U., Cerri, P., Violi, E., Rovelli, G., Triulzi, E., Rusconi, L., Sabattini, R., Desanctis, A., Bock, R., Orazi, S., Palmieri, M., Rossi, F., Pesaresi, A., Cioppi, F., Palamara, A., Mancini, P., Ferraiuolo, G., Azzolini, P., Neja, C. P., Risa, M. P., Borgia, M. C., Borgia, C., Zanchi, E., Risa, A. L., Colace, F., Tozzi, Q., Jesi, A. P., Tassoni, G., Vitucci, N. C., Lironcurti, C., Altieri, T., Viscomi, A., Striano, U., Salituri, S., Tarantino, F., Girardini, D., Zonzin, P., Roncon, L., Ferrarese, E., Ravera, B., Bugatti, U., Padula, G., Gigantino, A., Allemano, P., Reynaud, S., Fanelli, R., Derito, V., Croce, A., Galli, M., Bertoli, D., Vivaldi, F., Pedrazzini, F., Barani, R., Dileo, M., Doronzo, B., Gambarati, G. P., Zobbi, M., Caramanno, G., Craparo, F. G., Giani, P., Antongiovanni, G. B., Grasso, V., Mossuti, E., Rosella, M. G., Skouse, D., Giustiniani, S., Cucchi, G., Conti, E., Fagagnini, L., Pardi, L., Core, A., Staniscia, D., Serafini, N., Cerruti, P., Bazzucchi, M., Petrucci, G., Trinchero, R., Cecchi, E., Demarie, D., Brusasco, G., Gandolfo, N., Saviolo, R., Bergerone, S., Bergandi, G., Barbieri, D., Mina, E., Biondo, G. B., Ledda, G., Trapani, G., Frigo, G., Benettin, A., Galati, A., Accogli, M., Feruglio, G. A., Gianfagna, P., Prelli, L., Giamperi, M., Gheller, G., Cudali, A., Liguori, G., Dimarco, G., Bottari, E., Valente, S., Giglioli, C., Ramoscello, G., Rizzi, G. M., Pellinghelli, G., Perrini, A., Deluca, F., Savelli, S., Capezzuto, A., Gandolfi, P., Bergognoni, G., Ballestra, A. M., and Violo, C.

13. The effect of posture in patients with patent foramen ovale: Evaluation of the right-to-left shunt with transcranial Doppler and transthoracic echocardiography and correlation with the arterial oxygen saturation,L'effetto della postura nei pazienti con forame ovale pervio: Valutazione dello shunt destro-sinistro con Doppler transcranico ed ecocardiografia transtoracica e correlazione con la saturazione arteriosa di ossigeno

Author

Stefano Lucreziotti, Debenedetti, C., Massironi, L., Mantero, A., Di Marco, F., Chessa, M., and Carugo, S.

14. L’effetto della postura nei pazienti con forame ovale pervio : valutazione dello shunt destro-sinistro con Doppler transcranico ed ecocardiografia transtoracica e correlazione con la saturazione arteriosa di ossigeno

Author

S. Lucreziotti, C. Debenedetti, L. Massironi, A. Mantero, F. Di Marco, M. Chessa, S. Carugo, Lucreziotti, S., Debenedetti, C., Massironi, L., Mantero, A., Di Marco, F., Chessa, M., and Carugo, S.

Subjects
transthoracic echocardiography, patent foramen ovale, transcranial Doppler echocardiography, right-to-left shunt, oxygen saturation
Abstract

Background. Transcranial Doppler echocardiography and transthoracic echocardiography may detect with high accuracy right-to-left shunt (RLS) due to patent foramen ovale (PFO). However, a standardized diagnostic protocol has never been established. It has been suggested that standing or sitting positions may improve sensitivity of transcranial Doppler due to increased LRS in such positions. We aimed to test efficacy of the sitting position in addition to the supine position in the grading of RLS in patients with PFO. We have also evaluated whether an increase in RLS is associated with a fall in oxygen saturation (SaO2). Methods. From September 2015 to February 2016, 70 consecutive patients with suspected PFO underwent transcranial Doppler echocardiography and transthoracic echocardiography with microbubble count and evaluation of SaO2. Results. RLS due to PFO was diagnosed in 58 patients (82.9%). An increase in RLS grade in the sitting position was observed in 28 out of 58 patients (48.3%) (group 1), whereas no increase was detected in 30 patients (51.7%) (group 2). Among the clinical and echocardiographic variables considered, group 1 and group 2 differed only in the prevalence of atrial septal aneurysm (35.7 vs 3.3%, p=0.002). Postural changes were not associated with a fall in SaO2. Conclusions. RLS increases in about half of patients with PFO in the sitting position compared with the supine position, whereas no changes occur in SaO2.

Published
2017

15. Left Ventricular Diastolic Dysfunction in ARDS Patients.

Author

Formenti P, Coppola S, Massironi L, Annibali G, Mazza F, Gilardi L, Pozzi T, and Chiumello D

Abstract

Background: The aim of this study was to evaluate the possible presence of diastolic dysfunction and its possible effects in terms of respiratory mechanics, gas exchange and lung recruitability in mechanically ventilated ARDS., Methods: Consecutive patients admitted in intensive care unit (ICU) with ARDS were enrolled. Echocardiographic evaluation was acquired at clinical PEEP level. Lung CT-scan was performed at 5 and 45 cmH 2 O. In the study, 2 levels of PEEP (5 and 15 cmH 2 O) were randomly applied., Results: A total of 30 patients were enrolled with a mean PaO 2 /FiO 2 and a median PEEP of 137 ± 52 and 10 [9-10] cmH 2 O, respectively. Of those, 9 patients (30%) had a diastolic dysfunction of grade 1, 2 and 3 in 33%, 45% and 22%, respectively, without any difference in gas exchange and respiratory mechanics. The total lung weight was significantly higher in patients with diastolic dysfunction (1669 [1354-1909] versus 1554 [1146-1942] g) but the lung recruitability was similar between groups (33.3 [27.3-41.4] versus 30.6 [20.0-38.8] %). Left ventricular ejection fraction (57 [39-62] versus 60 [57-60]%) and TAPSE (20.0 [17.0-24.0] versus 24.0 [20.0-27.0] mL) were similar between the two groups. The response to changes of PEEP from 5 to 15 cmH 2 O in terms of oxygenation and respiratory mechanics was not affected by the presence of diastolic dysfunction., Conclusions: ARDS patients with left ventricular diastolic dysfunction presented a higher amount of lung edema and worse outcome.

Published
2022
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16. Prevalence of left atrial thrombus by real time three-dimensional echocardiography in patients undergoing electrical cardioversion of atrial fibrillation: A contemporary cohort study.

Author

Bursi F, Santangelo G, Ferrante G, Massironi L, and Carugo S

Subjects
Aged, Aged, 80 and over, Anticoagulants therapeutic use, Cohort Studies, Echocardiography, Transesophageal, Electric Countershock, Female, Humans, Male, Middle Aged, Prevalence, Stroke Volume, Ventricular Function, Left, Atrial Appendage diagnostic imaging, Atrial Fibrillation complications, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation therapy, Echocardiography, Three-Dimensional, Thrombosis epidemiology
Abstract

Background: The prevalence of left atrial thrombi in patients scheduled for electrical cardioversion (ECV) of atrial fibrillation (AF) remains unknown in contemporary real-life practice., Methods and Results: Patients scheduled for ECV underwent transesophageal echocardiography (TEE) regardless of AF duration and type of anticoagulant. Of 277 consecutive patients (65% men, mean age 71 ± 10 years, CHA 2 DS 2 -VASc 3.1 ± 1.4), 92 were on direct oral anticoagulants (DOACs) and 99 on antivitamin K (AVK) oral agents for at least 3 weeks before and 4 after ECV. Eighty-five patients with paroxysmal AF on low-molecular-weight heparin were also considered. Real time three-dimensional TEE detected left atrial appendage (LAA) thrombus in 7% of patients, without significant difference among three groups (P = .334). Anticoagulation was ineffective in eight patients on AVK oral agents, two of them had thrombus. Eight patients assumed incorrectly DOACs, four of them had thrombus. Among the 175 patients on effective anticoagulation, five showed thrombus, three on AVK oral agents, and two on DOACs (P = .716). Effective anticoagulation was associated with reduced risk of thrombosis (OR: 0.16, 95%CI: 0.06-0.45, P = .001). In patients with correct anticoagulation, predictors of thrombus were CHA 2 DS 2 VASc (for each point of increment OR: 1.97, 95%CI: 1.08-3.61, P = .029), low left ventricular ejection fraction (OR: 0.92, 95%CI: 0.86-0.99, P = .026), and degree of spontaneous echo-contrast (for each point increase OR: 10, 95%CI: 2-39, P < .0001)., Conclusion: Patients with AF, on effective anticoagulation, had a prevalence of thrombus not negligible regardless of type of anticoagulant. TEE is prudent before ECV and mandatory if unsuccessful anticoagulation is proved or suspected., (© 2021 Wiley Periodicals LLC.)

Published
2021
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17. Arrhythmic event prediction in patients with heart failure and reduced ejection fraction.

Author

Santangelo G, Bursi F, Negroni MS, Gentile D, Provenzale G, Turriziani L, Zambelli DL, Fiorista L, Bacchioni G, Massironi L, Tarricone DG, and Carugo S

Subjects
Aged, Echocardiography, Female, Follow-Up Studies, Heart Failure mortality, Heart Failure physiopathology, Heart Ventricles physiopathology, Humans, Italy epidemiology, Male, Prognosis, Retrospective Studies, Survival Rate trends, Tachycardia, Ventricular epidemiology, Tachycardia, Ventricular physiopathology, Defibrillators, Implantable, Heart Failure complications, Heart Ventricles diagnostic imaging, Primary Prevention methods, Stroke Volume physiology, Tachycardia, Ventricular prevention & control, Ventricular Function, Left physiology
Abstract

Aims: Implantable cardioverter defibrillator (ICD) is an effective treatment to reduce mortality in patients with symptomatic heart failure and left ventricular ejection fraction (LVEF) 35% or less. LVEF presents a low sensitivity for predicting arrhythmic events. Aim of this study was to identify predictors of sustained ventricular arrhythmias (SVAs), overall and according to the cause of heart failure., Methods: Single-center, retrospective, cohort study of 193 patients (51 nonischemic and 142 ischemic) with chronic heart failure and LVEF less than 35% who had received ICD for primary prevention of sudden cardiac death. We collected clinical data, echocardiographic parameters and SVAs detected by the ICD., Results: During a median follow-up of 1440 days, 32 (16.2%) patients had SVAs. SVAs incidence was similar in patients with nonischemic (15.6%) and ischemic cause of heart failure (16.9%). Hypertension, diabetes, chronic renal failure, atrial fibrillation, chronic obstructive pulmonary disease, New York Heart Association class at least III were predictors at univariate analysis of SVAs. A clinical score, assigning one point to each of these variables, was associated with a significantly increased risk of SVAs [odds ratio for each point increase = 1.92, 95% confidence interval 1.40-2.65, P < 0.0001, area under the curve (AUC) 0.73], with 72% sensitivity and 60% specificity for a cutoff at least three and remained significant in nonischemic (AUC 0.84) and ischemic (AUC 0.68) patients., Conclusion: Our study shows the benefit of ICD implantation in primary prevention and its independency of cause. A simple clinical score, based on comorbidities, identifies patients with more benefits from ICD implantation., (Copyright © 2020 Italian Federation of Cardiology - I.F.C. All rights reserved.)

Published
2021
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18. SARS-CoV-2-related ARDS in a maintenance hemodialysis patient: case report on tailored approach by daily hemodialysis, noninvasive ventilation, tocilizumab, anxiolytics, and point-of-care ultrasound.

Author

Galassi A, Casanova F, Gazzola L, Rinaldo R, Ceresa M, Restelli E, Giorgini A, Birocchi S, Giovenzana M, Zoni U, Valli F, Massironi L, Belletti S, Magagnoli L, Stucchi A, Ippolito M, Carugo S, Parazzini E, and Cozzolino M

Abstract

Without rescue drugs approved, holistic approach by daily hemodialysis, noninvasive ventilation, anti-inflammatory medications, fluid assessment by bedside ultrasound, and anxiolytics improved outcomes of a maintenance hemodialysis patient affected by severe COVID-19., Competing Interests: None declared., (© 2020 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Published
2020
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19. Diastolic dysfunction grade in acute coronary syndromes: Application of 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations.

Author

Bursi F, Persampieri S, Sabatelli L, Bencini C, Santangelo G, Bosotti L, Tayar A, Valli F, Ferrante G, Caretta A, Torta D, Massironi L, Castini D, and Carugo S

Subjects
Aged, Biomarkers, Echocardiography, Female, Humans, Male, Middle Aged, Natriuretic Peptide, Brain, Peptide Fragments, Reproducibility of Results, United States, Acute Coronary Syndrome diagnostic imaging, Acute Coronary Syndrome epidemiology, Heart Failure
Abstract

Background: Diagnosis and grading of diastolic dysfunction (DD) is challenging, with different studies using heterogeneous criteria and guidelines not routinely applied in clinical practice. Our aim was to apply the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging classification of DD among a contemporary population of patients with acute coronary syndromes (ACS) by analyzing its correlation with N-terminal pro b-type natriuretic peptide (NT-proBNP) and impact on clinical outcomes., Methods: Independent investigators blinded to each other and to the clinical history reviewed digitally stored images to apply 2016 and 2009 DD definitions to 380 patients (mean age 66 ± 13 years, 75% men) with ACS admitted to the coronary care unit between January 2016 and March 2018., Results: DD was frequent with both definitions, yet the concordance was weak (kappa =0.21, p < 0.01). Inter-observer reliability was greater by applying the 2016 algorithm (kappa = 0.89, p < 0.001). There was a significant correlation between NT-proBNP and worsening DD (Spearman's rho r = 0.54 for 2016 and r = 0.24 for 2009 algorithms, both p < 0.001). Worse DD was associated with worse clinical presentation and increased risk of events (HR for the cumulative incidence of heart failure and death during follow-up 2.15 [95% CI 1.66-2.78, p < 0.001] and 1.82 [95% CI 1.39-2.40, p < 0.001] for 2016 and 2009 classifications, respectively, all p < 0.001)., Conclusions: The agreement between 2016 and 2009 DD definitions was poor, with newer guidelines having grater interobserver reliability. The positive graded association between 2016 DD classification and NT-proBNP and its association with clinical outcomes provide a validation of the latest guideline algorithm in ACS patients., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Published
2020
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20. Sacubitril/valsartan improves medium-term reverse left ventricular remodeling: why wait?

Author

Santangelo G, Bursi F, Toriello F, Valli F, Tombolini E, Torta D, Bosotti L, Massironi L, and Carugo S

Subjects
Aged, Aged, 80 and over, Aminobutyrates adverse effects, Angiotensin II Type 1 Receptor Blockers adverse effects, Biphenyl Compounds, Drug Combinations, Female, Heart Failure diagnostic imaging, Heart Failure physiopathology, Humans, Male, Middle Aged, Protease Inhibitors adverse effects, Recovery of Function, Retrospective Studies, Tetrazoles adverse effects, Time Factors, Time-to-Treatment, Treatment Outcome, Valsartan, Aminobutyrates therapeutic use, Angiotensin II Type 1 Receptor Blockers therapeutic use, Heart Failure drug therapy, Neprilysin antagonists & inhibitors, Protease Inhibitors therapeutic use, Stroke Volume drug effects, Tetrazoles therapeutic use, Ventricular Function, Left drug effects, Ventricular Remodeling drug effects
Published
2019
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22. An Unexpected Guest in the Proximal Ascending Aorta.

Author

Toffetti L, Pugno A, Massironi L, Tresoldi S, and Mantero AG

Subjects
Aged, Coronary Artery Disease complications, Coronary Artery Disease diagnostic imaging, Diagnosis, Differential, Female, Humans, Treatment Outcome, Ultrasonography, Aorta diagnostic imaging, Aorta injuries, Coronary Artery Disease surgery, Foreign-Body Migration diagnostic imaging, Foreign-Body Migration etiology, Stents adverse effects
Published
2015
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23. Rapid recovery from peripartum cardiomyopathy after inhibition of prolactin.

Author

Lucreziotti S, Belletti S, Massironi L, and Lombardi F

Subjects
Adult, Cardiomyopathies diagnostic imaging, Cardiomyopathies drug therapy, Female, Hormone Antagonists pharmacology, Hormone Antagonists therapeutic use, Humans, Peripartum Period drug effects, Pregnancy, Pregnancy Complications, Cardiovascular diagnostic imaging, Pregnancy Complications, Cardiovascular drug therapy, Recovery of Function drug effects, Time Factors, Ultrasonography, Cardiomyopathies blood, Peripartum Period blood, Pregnancy Complications, Cardiovascular blood, Prolactin antagonists & inhibitors, Prolactin blood, Recovery of Function physiology
Published
2011
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25. [Pulmonary hypertension in autoimmune rheumatic diseases].

Author

Marasini B, Massarotti M, Cossutta R, Massironi L, and Mantero A

Subjects
Adult, Aged, Aged, 80 and over, Arthritis, Rheumatoid complications, Female, Humans, Hypertension, Pulmonary diagnostic imaging, Hypertension, Pulmonary epidemiology, Italy epidemiology, Lupus Erythematosus, Systemic complications, Male, Middle Aged, Mixed Connective Tissue Disease complications, Risk Factors, Scleroderma, Systemic complications, Ultrasonography, Young Adult, Autoimmune Diseases complications, Connective Tissue Diseases complications, Hypertension, Pulmonary etiology, Rheumatic Diseases complications
Abstract

Objective: Pulmonary hypertension is a severe and rapidly progressive disease, particularly frequent in patients with rheumatic diseases. The aims of this study were the following: to determine the prevalence of pulmonary hypertension in Italian patients with autoimmune rheumatic diseases, and to evaluate if the presence of a rheumatic disease in general, or of a specific autoimmune rheumatic disease, is a risk factor for the development of pulmonary hypertension., Patients and Methods: One hundred and thirteen Italian patients with connective tissue diseases (105 females, 8 males), aged 19 to 83 yrs, entered the study. Fifty-one had systemic sclerosis (SSc): 49 were females, 2 males, aged 34 to 83 yrs; 41 had limited cutaneous SSc, 8 diffuse cutaneous SSc, and 2 SSc sine scleroderma. Thirty-three patients had systemic lupus erythematosus (SLE): all but one were females, their age ranged from 19 to 82 yrs. Twenty-five had rheumatoid arthritis (RA): 21 females, 4 males, aged 26 to 45 yrs. Three females and one male, 51-77 yrs, had mixed connective tissue disease (MCTD). Systolic pulmonary arterial pressure (SPAP) was assessed by Doppler echocardiography., Results: Twenty three patients had pulmonary hypertension, which was more frequent in MCTD than in SLE (75% vs 6.1%, p=0.0002) or in AR (20%, p=0.0313). Pulmonary hypertension was more frequent in SSc than in SLE (25.5% vs 6.1%, p=0.0028) and in limited than in diffuse SSc (21.6% vs 3.9%). SPAP was significantly related to age (r=0.35, p=0.0275), with patients with pulmonary hypertension older than patients with normal SPAP (66+/-13 vs 52+/-16 yrs, p=0.0003)., Conclusions: These data show a significant association between pulmonary hypertension and autoimmune rheumatic diseases. Therefore, pulmonary hypertension assessment seems mandatory, at least in MCTD and SSc. However, more studies are needed to clarify the relationship between age and pulmonary hypertension and to verify whether the low prevalence of pulmonary hypertension we found in our SLE patients is related or not to their lower age.

Published
2005
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