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1. Real-time three-dimensional speckle tracking echocardiography: technical aspects and clinical applications

Author

Sorrentino R, Esposito R, Pezzullo E, and Galderisi M

Subjects
Speckle-tracking echocardiography, Three-dimensional echocardiography, Myocardial deformation, Validation, Clinical applications, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Regina Sorrentino, Roberta Esposito, Enrica Pezzullo, Maurizio Galderisi Department of Advanced Biomedical Sciences, Interdepartmental Laboratory of Cardiac Imaging, Federico II University Hospital, Naples, Italy Abstract: Three-dimensional speckle tracking echocardiography (3D STE) is a novel technique for the quantification of cardiac deformation based on tracking of ultrasonic speckles in gray scale full-volume 3D images. Developments in ultrasound technologies have made 3D speckle tracking widely available. Two-dimensional echocardiography has intrinsic limitations regarding estimation of left ventricular (LV) volumes, ejection fraction, and LV mechanics, due to its inherent foreshortening errors and dependency on geometric models. The development of 3D echocardiography has improved reproducibility and accuracy. Data regarding the feasibility, accuracy, and clinical applications of 3D STE are rapidly assembling. From the tracking results, 3D STE derives several parameters, including longitudinal, circumferential and radial strain, as well as a combined assessment of longitudinal and circumferential strain, termed area strain. 3D STE can also quantify LV rotational movements such as rotation, twist, and torsion. 3D STE provides a better insight on global and regional myocardial deformation. Main applications include detection of subclinical myocardial involvement in heart failure, arterial hypertension, dyssynchrony, and ischemic heart disease. Emerging areas of application include a large spectrum of heart-involving systemic conditions, such as prediction of rejection in heart transplant patients, early detection of cardiotoxicity in patients receiving chemotherapy for cancer, and deeper physiological understanding of LV contraction mechanics in different types of athletes. Aim of this review is to discuss background, technical acquisition and processing aspects as well as recognized and developing clinical applications of this emerging ultrasound technology. Keywords: speckle tracking echocardiography, three-dimensional echocardiography, myocardial deformation, validation, clinical applications

Published
2016

2. Long-term proactive management of psoriasis with calcipotriol and betamethasone dipropionate foam: an Italian consensus through a combined nominal group technique and Delphi approach

Author

De Simone, C, Dapavo, P, Malagoli, P, Martella, A, Campanati, A, Campione, E, Errichetti, E, Franchi, C, Gambardella, A, Megna, M, Osti, F, Ribero, S, Zagni, G, Calzavara-Pinton, P, Fabbrocini, G, Amoruso, G, Baglieri, F, Biamonte, A, Bianchelli, T, Bigi, L, Bortoli, J, Brunetti, B, Buligan, C, Cagni, E, Calderoni, O, Caputo, A, Carrera, C, Carugno, A, Chersi, K, Cicchelli, S, De Natale, F, Di Maria, D, Ferrari, A, Fogli, E, Forconi, R, Galeazzi, A, Giovannini, A, Giura, M, Iuculano, M, Lazzaretti, G, Leporati, C, Magnanini, M, Marconi, B, Maruccia, A, Miglietta, R, Minuti, A, Mocci, L, Modica, S, Narcisi, A, Odorici, G, Pazzaglia, M, Peila, R, Pertusi, G, Pezza, M, Pezzullo, E, Puccia, N, Raulo, U, Rossi, M, Rusignuolo, S, Sapienza, G, Savarese, C, Scalisi, M, Strippoli, D, Stroppiana, E, Tiberio, R, Trischitta, A, Tucci, M, Vaira, F, Verrone, A, Villa, L, Zagni, F, Zoccali, A, De Simone C., Dapavo P., Malagoli P., Martella A., Campanati A., Campione E., Errichetti E., Franchi C., Gambardella A., Megna M., Osti F., Ribero S., Zagni G., Calzavara-Pinton P., Fabbrocini G., Amoruso G. F., Baglieri F., Biamonte A. S., Bianchelli T., Bigi L., Bortoli J., Brunetti B., Buligan C., Cagni E., Calderoni O., Caputo A., Carrera C. G., Carugno A., Chersi K., Cicchelli S., De Natale F., Di Maria D., Ferrari A. S., Fogli E., Forconi R., Galeazzi A., Giovannini A., Giura M. T., Iuculano M., Lazzaretti G., Leporati C., Magnanini M., Marconi B., Maruccia A., Miglietta R., Minuti A., Mocci L., Modica S., Narcisi A., Odorici G., Pazzaglia M., Peila R., Pertusi G., Pezza M., Pezzullo E., Puccia N., Raulo U., Rossi M., Rusignuolo S., Sapienza G., Savarese C., Scalisi M., Strippoli D., Stroppiana E., Tiberio R., Trischitta A., Tucci M. G., Vaira F., Verrone A., Villa L., Zagni F., Zoccali A., De Simone, C, Dapavo, P, Malagoli, P, Martella, A, Campanati, A, Campione, E, Errichetti, E, Franchi, C, Gambardella, A, Megna, M, Osti, F, Ribero, S, Zagni, G, Calzavara-Pinton, P, Fabbrocini, G, Amoruso, G, Baglieri, F, Biamonte, A, Bianchelli, T, Bigi, L, Bortoli, J, Brunetti, B, Buligan, C, Cagni, E, Calderoni, O, Caputo, A, Carrera, C, Carugno, A, Chersi, K, Cicchelli, S, De Natale, F, Di Maria, D, Ferrari, A, Fogli, E, Forconi, R, Galeazzi, A, Giovannini, A, Giura, M, Iuculano, M, Lazzaretti, G, Leporati, C, Magnanini, M, Marconi, B, Maruccia, A, Miglietta, R, Minuti, A, Mocci, L, Modica, S, Narcisi, A, Odorici, G, Pazzaglia, M, Peila, R, Pertusi, G, Pezza, M, Pezzullo, E, Puccia, N, Raulo, U, Rossi, M, Rusignuolo, S, Sapienza, G, Savarese, C, Scalisi, M, Strippoli, D, Stroppiana, E, Tiberio, R, Trischitta, A, Tucci, M, Vaira, F, Verrone, A, Villa, L, Zagni, F, Zoccali, A, De Simone C., Dapavo P., Malagoli P., Martella A., Campanati A., Campione E., Errichetti E., Franchi C., Gambardella A., Megna M., Osti F., Ribero S., Zagni G., Calzavara-Pinton P., Fabbrocini G., Amoruso G. F., Baglieri F., Biamonte A. S., Bianchelli T., Bigi L., Bortoli J., Brunetti B., Buligan C., Cagni E., Calderoni O., Caputo A., Carrera C. G., Carugno A., Chersi K., Cicchelli S., De Natale F., Di Maria D., Ferrari A. S., Fogli E., Forconi R., Galeazzi A., Giovannini A., Giura M. T., Iuculano M., Lazzaretti G., Leporati C., Magnanini M., Marconi B., Maruccia A., Miglietta R., Minuti A., Mocci L., Modica S., Narcisi A., Odorici G., Pazzaglia M., Peila R., Pertusi G., Pezza M., Pezzullo E., Puccia N., Raulo U., Rossi M., Rusignuolo S., Sapienza G., Savarese C., Scalisi M., Strippoli D., Stroppiana E., Tiberio R., Trischitta A., Tucci M. G., Vaira F., Verrone A., Villa L., Zagni F., and Zoccali A.

Abstract

Background: Although long-term management of psoriasis is paramount, this approach is challenging in clinical practice. In the recent PSO-LONG trial, a fixed-dose combination of betamethasone dipropionate (BD) and calcipotriol (Cal) foam applied twice a week on non-consecutive days for 52 weeks (proactive treatment) reduced the risk of relapse. However, the role of Cal/BD foam in the long-term management of psoriasis needs further clarifications. The ProActive Management (PAM) program, a nationwide Italian project, aims at reaching a consensus on the role of proactive management of psoriasis. Methods: A steering committee generated some statements through the nominal group technique (NGT). The statements were voted by an expert panel in an adapted Delphi voting process. Results: Eighteen statements were proposed, and the majority of them (14/18) reached a consensus during the Delphi voting. The need to provide long-term proactive topical treatment to reduce the risk of relapse for the treatment of challenging diseases sites or in patients where phototherapy or systemic therapies are contraindicated/ineffective was widely recognized. A consensus was reached about the possibility to associate the proactive treatment with systemic and biological therapies, without the need for dose intensification, thus favoring a prolonged remission. Moreover, the proactive treatment was recognized as more effective than weekend therapy in increasing time free from relapses. Approaches to improve adherence, on the other hand, need further investigation. Conclusions: The inclusion in guidelines of a proactive strategy among the effective treatment options will be a fundamental step in the evolution of a mild-moderate psoriasis therapeutic approach.

Published
2022

3. P404 MYOCARDIAL WORK EVALUATION IN PATIENTS WITH SEVERE AORTIC STENOSIS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT

Author

D’Arienzo, D, primary, Sperlongano, S, additional, Iannuzzi, A, additional, Renon, F, additional, Del Giudice, C, additional, Liccardo, B, additional, Pezzullo, E, additional, Bocchetti, M, additional, Totaro, A, additional, Bianchi, R, additional, Loffredo, F, additional, Cappelli Bigazzi, M, additional, and Golino, P, additional

Published
2023
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11. “A BROKEN TRANSPLANTED HEART”: A CASE OF TAKOTSUBO SYNDROME IN A HEART TRANSPLANT RECIPIENT

Author

Delle Femine, F, Liccardo, B, Loffredo, F, Pezzullo, E, D‘Arienzo, D, Amarelli, C, and Golino, P

Abstract

75–year–old female patient went to the emergency department for oppressive chest pain radiating to the left arm and dyspnea, developed after an argument with family members. The patient underwent heart transplant in 2010 because of chronic ischemic heart disease. In history: systemic arterial hypertension, former smoking, dyslipidemia, and chronic renal failure. At blood tests: TnIHS 78.4 ng/L (<29 ng/L), CK–MB 1.9 microg/L, PROBNP–NT 43,000 pg/ml, creatinine 2 mg/dL. ECG showed inverted T waves in DI, AVL and V4 to V6 (fig 1). Transthoracic echocardiography was remarkable for a moderate reduction in systolic function (EF 38%), akinesia of apical portion, mid–segment of the IVS and mid–segment of posterior wall. Coronarography showed epicardial coronaries free of angiographically significant lesions. We decided to not perform ventriculography to avoid worsening renal function. At clinical stabilization, the patient underwent cardiac MRI with evidence of hypokinesia of the mid–ventricular segments with preserved global systolic function and hypo/akinesia of right ventricular apex with endocavitary thrombosis. Tissue characterization images were compatible with the presence of diffuse phlogistic involvement of the left ventricular myocardium (most evident at the mid–ventricular segments), in the absence of areas of myocardial necrosis. On pre–dimission echocardiogram, global left ventricular systolic function appeared markedly improved (auto EF 52%). DISCUSSION Our case is a rare case of Takotsubo syndrome (TS) in a transplanted heart. While TS accounts for 1–2% of all ACS in the general population, there is no precise data on its prevalence in heart transplant recipients. Although the pathophysiological mechanism underlying TS is still debated, there is evidence of hyperactivation of the sympathetic system with excessive catecholamine release. What is particular in our clinical case is that transplanted heart is denervated (because of resection of the post–ganglionic neural axons), although in some patients there is progressive reinnervation starting around the second year. Myocardial scintigraphy with iodine–123 meta iodobenzylguanidine can be used to study reinnervation. In our case, the presence of typical angor may be a clinical indicator of reinnervation, as many transplant patients present with CAV in the absence of chest pain.

Published
2024
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13. DESMOPLAKIN ASSOCIATED NON DILATED LEFT VENTRICULAR CARDIOMYOPATHY TREATED WITH ANAKINRA

Author

Pezzullo, E, Caputo, A, Catapano, D, Alfieri, R, Covino, S, D‘Elia, S, Golino, P, and Loffredo, F

Abstract

A 24 year old female patient experienced,from 2010 to November 2023,12 myocarditis–like episodes, often related to emotional stress, characterized by chest pain,increased markers of myocardial necrosis, normal C–reactive Protein values,normal left ventricular systolic function on echocardiogram.She was admitted to our division for the first time in July 2019 because of recurrent acute myocarditis, extensive non–ischemic fibrosis and myocardial edema on magnetic resonance imaging (MRI) and interstitial edema with monocytic lymphocytic infiltrates (CD3 +>7/mm2) and cardiomyocyte necrosis at endomyocardial biopsy.A genetic test was performed leading to the identification of a novel frameshift mutation in the tail C domain of desmoplakin (DSP) producing a truncated protein.Destabilization of desmosome can be associated,to massive troponin release,innate immune activation resulting in autoantibody formation to intracellular cardiomyocyte protein.Mutations in DSP can link to arrhythmogenic cardiomyopathy,characterized by intermittent myocardial inflammatory episodes that appear clinically similar to myocarditis,leading to left ventricular fibrosis and to high incidence of ventricular arrhythmias.Our patient was initially treated with intravenous high dose corticosteroid therapy with oral tapering at discharge but two relapses(December 2020 and April 2021)occurred at corticosteroid withdrawal.In April 2021 immunosuppressive therapy with azathioprine was initiated in association with colchicine and oral corticosteroids,however after three months a new recurrence occurred.In July 2021 off–label Anakinra 100 mg subcutaneously daily was started.Anakinra is an interleukin (IL)–1 beta recombinant receptor antagonist used to treat idiopathic recurrent pericarditis.A number of studies have stressed the possible role IL–1 in the pathogenesis of myocardial inflammation involving inflammasome activation,cardiomyocytes loss ultimately leading to heart failure and arrhythmias.Anakinra showed a good response and tolerability and allowed corticosteroid withdrawal.The patient did not experience any further recurrence until November 2023.This episode was however characterized by milder and shorter chest pain,lower release of troponin in absence of edema on magnetic resonance imaging and inflammation on cardiac (18)F–fluoro–2–deoxyglucose positron emission tomography suggesting that modulation of cardiac inflammation may be crucial also when associated with pathogenic mutations.

Published
2024
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14. NEW ONSET OF PULMONARY HYPERTENSION IN A PATIENT AFFECTED BY RECURRENT LUNG CANCER

Author

Pezzullo, E, Del Giudice, C, Cappelli, M, Natale, F, Cimmino, G, Ciaramella, F, Golino, P, and Loffredo, F

Abstract

39 years old non–smoker female patient came to our observation in July 2023 complaining dyspnea on mild exertion. She had a history of lung adenocarcinoma with epidermal growth factor receptor (EGFR) positive for exon 19 deletion treated with left pneumonectomy and ipsilateral hilar mediastinal lymphadenectomy 5 years earlier, and contralateral disease progression currently treated with chemotherapy. Transthoracic echocardiogram showed circumferential prepericardial effusion requiring pericardiocentesis with transient clinical benefit. Indeed, after a month, she presented with worsening dyspnea and echocardiographic evidence of dilated and hypokinetic right ventricle and severe pulmonary hypertension associated with distal right pulmonary artery stenosis secondary to extrinsic compression by the neoplastic mass as shown by the chest CT scan (fig 1). A right heart catheterization confirmed this finding (minimum diameter of right pulmonary artery of 6 mm, maximum systolic pulmonary blood pressure of 99 mmHg) and a palliative stenting of the distal portion of the right pulmonary artery was performed with resolution of the stenosis, reduction of the pulmonary gradient (fig 2 and 3) and resolution of the dyspnea.

Published
2024
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15. The strong correlation between right ventricular function evaluated by 3D echography and functional impairment in patients with dilated cardiomyopathy

Author

D'Andrea A., Gravino R., Salerno G., Padalino R., Riegler L., Scarafile R., Pezzullo E., Nunziata L., Romano M., Limongelli G., Bossone E., Pacileo G., Caso P., Russo M. G., Calabro R., D'Andrea, A, Gravino, R, Salerno, G, Padalino, R, Riegler, L, Scarafile, R, Pezzullo, E, Nunziata, L, Romano, M, Limongelli, G, Bossone, E, Pacileo, G, Caso, P, Russo, Mg, Calabrò, R., D'Andrea, A., Gravino, R., Salerno, G., Padalino, R., Riegler, L., Scarafile, R., Pezzullo, E., Nunziata, L., Romano, M., Limongelli, G., Bossone, E., Pacileo, G., Caso, P., Russo, M. G., and Calabro, R.

Subjects
3D echocardiography, Cardiac magnetic resonance, Exercise capacity, Cardiopulmonary test, Right ventricle
Abstract

Objectives: The aim of the study was to detect if right ventricular (RV) ejection fraction assessed by real-time 3D echocardiography (RT3DE) could predict patients with dilated cardiomyopathy (DCM) with greater functional impairment in response to cardiopulmonary exercise. Materials and methods: 55 chronic heart failure patients with DCM (56.5 ± 9.1 years; 40 males; 30 ischaemic; NYHA class III: 40) and 30 healthy controls underwent both left ventricular (LV) and RV analysis by RT3DE. Post-processing software provided data of RT3DE systolic dyssynchrony index (SDI) of 16 LV segments, and of both LV and RV ejection fraction. Cardiac magnetic resonance was performed in a subgroup of 20 DCM patients to confirm RT3DE measurements. DCM patients underwent also bicycle cardiopulmonary exercise test with evaluation of VO 2 peak (percentage of the predicted value), VE/VCO 2 slope and circulatory power (CP). Results: In DCM patients mean LV ejection fraction was 29.8 ± 4.6%. RT3DE LV SDI was 8.4.4 ± 4.2, and RV ejection fraction was 51.3 ± 4.6%. By cardiopulmonary test, mean VO 2 peak was 15.2 ± 4.4 mL/kg/min, and mean CP was 2.1 ± 0.8. By univariable analysis, RV ejection fraction directly correlated with VO 2 peak % (r = 0,55; p < 0.0001) and inversely with VE/VCO 2 slope (r = -0.42; p < 0.001). By multivariable analysis, SDI (beta coefficient = -0.46; p < 0.001) and 3D RV ejection fraction (beta coefficient = 0.42; p < 0.001) emerged as the only independent determinant of VO 2 peak % during cardiopulmonary test. Conclusions: Impaired RV function in DCM patients is independently associated with worse ability to perform aerobic exercise. © 2011 Società Italiana di Ecografia Cardiovascolare. Published by Elsevier Srl. All rights reserved.

Published
2011

16. P1513Adherence to PCSK9 inhibitors in high cardiovascular risk patients in real-world setting: results from a single-center experience and comparison with statin therapy

Author

Gragnano, F., primary, Concilio, C., additional, Cesaro, A., additional, Crisci, M., additional, Sperlongano, S., additional, Fimiani, F., additional, Natale, F., additional, Pezzullo, E., additional, Calabro', R., additional, Russo, M.G., additional, and Calabro', P., additional

Published
2017
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17. P260Right cardiac chambers remodeling in marathon and ultra-trail athletes detected by speckle-tracking echocardiographyP261Speckle tracking determination of tissue motion annular displacement: comparison with strain and ejection fraction, and association with outcomes in haemodialysis patientsP262Value of right ventricular 2D-speckle tracking parameters in predicting the TIMI flow grade of the RCA in patients with acute RV infarctionP263The correlation between left atrial deformation indices and the CHA2DS2 - VASc risk score in patients with atrial fibrillationP264Right atrial and ventricular function evaluated with speckle tracking in patients with acute pulmonary embolismP265Enhanced accuracy of a speckle tracking strain based artificial intelligence model to differentiate ischaemic myocardial disease and cardiomyopathyP266Detection of early left ventricular and left atrial dysfunction in type I diabetes mellitus using 2D speckle tracking echocardiographyP267Two-dimensional left ventricular global longitudinal strain dynamics after percutaneous coronary intervention in stable single-vessel coronary artery disease patientsP268Left ventricular twist, torsion and strain in the fetus by 3D echocardiography: feasibility and comparisons with 2DP269Left atrial deformation analysis in acromegaly - a three-dimensional speckle-tracking echocardiographic studyP270Impact of hemodialysis on three-dimensional left ventricular myocardial deformation in end-stage renal disease: relationships with preload reductionP271Right atrial function in noncompaction cardiomyopathy - a three-dimensional speckle-tracking echocardiographic studyP272CABG failure in the era of cardiac computed tomography - after 8 years half the patients have at least one graft affected

Author

Ujka, K., primary, Chiu, D Y Y, primary, Tayel, H., primary, Mostafa, SHAIMA, primary, Ramberg, E., primary, Walsh, JL., primary, Hassan, M., primary, Pavlyukova, EN., primary, Li, L., primary, Nemes, A., primary, Sorrentino, R., primary, Modas Daniel, P., primary, Bruno, RM., additional, Catuzzo, B., additional, Bastiani, L., additional, Tonacci, A., additional, D'angelo, G., additional, Mrakic-Sposta, S., additional, Vezzoli, A., additional, Giardini, G., additional, Pratali, L., additional, Kalra, PA., additional, Green, D., additional, Hughes, J., additional, Sinha, S., additional, Abidin, N., additional, Sabry, SHAIMA, additional, Mostafa, SHERIN, additional, Mohamed, HAMODA, additional, Aboelenein, HESHAM, additional, Olausson, M., additional, Joergensen, TBS, additional, Bhadwad, P., additional, Nepper, ML., additional, Binko, TS., additional, Petersen, JR., additional, Fornitz, GG., additional, Lamaa, N., additional, Sakr, G., additional, Abou Hassan, OK., additional, Jalkh, K., additional, Al Jaroudi, W., additional, Ismaeel, H., additional, Abd Alrahman, T., additional, Mazen, A., additional, Hegazy, SH., additional, Gladkih, NN., additional, Klein, IR., additional, Karpov, RS., additional, Craft, MC., additional, Winter, JW., additional, Hsu, HH., additional, Joseph, NJ., additional, Klas, BK., additional, Kutty, SK., additional, Domsik, P., additional, Kalapos, A., additional, Oszlanczi, M., additional, Orosz, A., additional, Valkusz, Z., additional, Forster, T., additional, Lengyel, C., additional, Santoro, C., additional, Esposito, R., additional, Pezzullo, E., additional, Buonauro, A., additional, Schiano-Lomoriello, V., additional, Cocozza, S., additional, Vaccaro, A., additional, Trimarco, B., additional, Galderisi, M., additional, Ramos, R., additional, Teixeira, PP., additional, Barbosa, C., additional, Leal, C., additional, Morais, E., additional, Caveirinha, D., additional, Oliveira, E., additional, Figueiredo, L., additional, and Ferreira, RC., additional

Published
2016
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18. P1113Relationship between left atrium and hypertensive retinopathy in patients with systemic hypertension: a real-time three-dimensional echocardiography-based studyP1114Detection of early left ventricular systolic dysfunction in hypertensive patients with preserved ejection fraction using deformation imagingP1115Left ventricular strain in systemic sclerosis with and without pulmonary hypertension; a cardiac magnetic resonance studyP1116End-stage chronic kidney disease and routine annual transthoracic echocardiograpyP1117arrhythmogenic right ventricular cardiomyopathy or athlete's heart adaptations ?P1118Reduced left ventricular function in long term follow-up in women with previous severe preeclampsiaP1119Preload dependent changes of left ventricular twisting and torsion during pregnancy: a three-dimensional strain studyP1120Pre-procedural renal resistive index predicts contrast-induced acute kidney injury following coronary angiographyP1121Simplified 10 point ultrasound in diagnosis of pulmonary congestion in heart failureP1122Pulmonary and systemic vascular resistance during graded exercise in patients with ventricular septal defect repair versus healthy controlsP1123Effect of percutaneous stent implantation on arterial hypertension and aortic flow dynamics in patients with aortic coarctation: identification of responders and non respondersP1124The use of vitamin k antagonists is associated with increased levels of vascular calcification in low-risk patients with atrial fibrillationP1125Stress echo positivity predicts cancer deathP1126Assessment of the agreement between instantaneous wave-free ratio (iFR) and dobutamine stress echo in real world stable angina patientsP1127Impact of AVAproj on severity reclassification of LFLG AS with persistent area - gradient discordanceP1128 The prognostic value of rest and exercise- induced B-lines in heart failure patientsP1129Stress-induced worsening of left ventricular diastolic function as a new marker of myocardial ischemia: a retrospective observational studyP1130Prediction and management of stable angina in senior populationP1131Risk assessment of coronary heart desease in men before revascularization of non-coronary arteriesP1132Relation of elevated C - reactive protien level to left atrial size and left atrial thrombus in patients with valvular and non-valvular atrial fibrillationP1133Transesophageal echocardiographic assessment of left atrial appendage function as a cardioembolic source in atrial fibrillationP1134Correlations of three-dimensional mitral valve geometry with chronic ischemic mitral regurgitation severity in compliance with tethering phenotypesP1135Aortic root physiology in patients with aortic valvulopathyP1136Comparison of layer-specific strain to other contemporary deformation parameters for coronary artery disease prediction in patients with non-ST-segment elevation acute coronary syndromeP1137Machine-learning based diagnosis of heart failure with preserved ejection fraction: how much do we agree with the guidelines?

Author

Kanar, B., primary, Hamdy, RM., primary, Lindholm, A., primary, Puga, L., primary, Zaroui, A., primary, Groenningsaeter, L., primary, Sorrentino, R., primary, Wybraniec, M., primary, Tsverava, M., primary, Gabriels, C., primary, Laik, J., primary, Peeters, FECM, primary, Carpeggiani, C., primary, Keramida, K., primary, Moura Ferreira, J., primary, Scali, MC., primary, Chammas, E., primary, Cirkovic, S., primary, Naiden, TV., primary, Abdel Razek, GA., primary, Hafez Mohamed, EMAN, primary, Andrianova, A., primary, Boretti, I., primary, Murat, G., primary, Sanchez-Martinez, S., primary, Kanar, HS., additional, Karatay, A., additional, Tigen, MK., additional, Hamdy, AM., additional, Fereig, HM., additional, Ali, BA., additional, Hesselstrand, R., additional, Radegran, G., additional, Ostenfeld, E., additional, Ribeiro, J., additional, Teixeira, R., additional, Costa, M., additional, Goncalves, L., additional, Rezine, Z., additional, Drissi, MF., additional, Mechmeche, R., additional, Langesaeter, E., additional, Estensen, ME., additional, Esposito, R., additional, Santoro, C., additional, Pezzullo, E., additional, Schiano-Lomoriello, V., additional, Petitto, M., additional, Riccardi, C., additional, Di Carlo, C., additional, Trimarco, B., additional, Galderisi, M., additional, Bozentowicz-Wikarek, M., additional, Chudek, J., additional, Mizia-Stec, K., additional, Tsverava, DM., additional, Fresiello, L., additional, Van De Bruaene, A., additional, Helsen, F., additional, Budts, W., additional, Buys, R., additional, Iriart, X., additional, Jalal, Z., additional, Moceri, P., additional, Squara, F., additional, Farrugia, G., additional, Thambo, J-B, additional, Dudink, EAMP, additional, Weijs, B., additional, Altintas, S., additional, Kimenai, DM., additional, Heckman, L., additional, Das, M., additional, Meex, SJR, additional, Kietselaer, BLJH, additional, Crijns, HJGM, additional, Landi, P., additional, Andreassi, MG., additional, Sicari, R., additional, Picano, E., additional, Panoulas, V., additional, Boleti, O., additional, Flessas, D., additional, Petropoulou, M., additional, Loizos, S., additional, Nihoyannopoulos, P., additional, Moreira, N., additional, Martins, R., additional, Ferreira, MJ., additional, Pego, M., additional, Cortigiani, L., additional, Simionuc, A., additional, Marzilli, M., additional, Mansour, M., additional, Jaroudi, W., additional, Mroueh, A., additional, Hamoui, O., additional, Hneine, W., additional, Khoury, N., additional, Abi Nassif, J., additional, Delic, Z., additional, Boskovic, N., additional, Rakocevic, I., additional, Giga, V., additional, Nedeljkovic, I., additional, Stepanovic, J., additional, Beleslin, B., additional, Djordjevic Dikic, A., additional, Bartosh-Zelenaya, SJ., additional, Elkhashab, KK., additional, Malwany, MM., additional, Mohamed Fereig, HANAA, additional, Abd Elazeez Hasan, OLA, additional, Saidova, MA., additional, Bolotova, MN., additional, Dobrovolskaya, SV., additional, Makeev, MI., additional, Fernandez-Golfin Loban, C., additional, Casas Rojo, E., additional, Gonzalez Gomez, A., additional, Del Val, D., additional, Berlot, B., additional, Garcia Martin, A., additional, Hinojar Baides, R., additional, Jimenez Nacher, JJ., additional, Moya Mur, JL., additional, Megias, A., additional, Zamorano Gomez, JL., additional, Cognet, T., additional, Mejean, S., additional, Bocquillon, L., additional, Bouisset, F., additional, Elbaz, M., additional, Galinier, M., additional, Carrie, D., additional, Lairez, O., additional, Gautier, M., additional, Duchateau, N., additional, Erdei, T., additional, Kunszt, G., additional, Degiovanni, A., additional, Carluccio, E., additional, Fraser, AG., additional, Piella, G., additional, and Bijnens, BH., additional

Published
2016
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19. Related citations 18.Left ventricular myocardial velocities and deformation indexes in top-level athletes

Author

D'ANDREA A, COCCHIA R, RIEGLER L, SCARAFILE R, SALERNO G, GRAVINO R, GOLIA E, PEZZULLO E, CITRO R, LIMONGELLI, Giuseppe, PACILEO G, CUOMO S, CASO P, BOSSONE E, CALABRÒ R., RUSSO, Maria Giovanna, D'Andrea, A, Cocchia, R, Riegler, L, Scarafile, R, Salerno, G, Gravino, R, Golia, E, Pezzullo, E, Citro, R, Limongelli, Giuseppe, Pacileo, G, Cuomo, S, Caso, P, Russo, Maria Giovanna, Bossone, E, and Calabrò, R.

Published
2010

21. P200 A POSITIVE CORRELATION BETWEEN THE OVERALL ECHOGENICITY OF CAROTID INTIMA MEDIA COMPLEX AND ARTERIAL STIFFNESS OF HYPERTENSIVE PATIENTS: BEYOND THE INTIMA MEDIA THICKNESS ASSESSMENT

Author

Natale, F, Loffredo, F, Molinari, R, Alfieri, R, Covino, S, De Luca, L, Limatola, M, Mollo, N, Pezzullo, E, and Cimmino, G

Abstract

According to the latest ESC guidelines on CVD prevention (2021) arterial stiffness (AS) still has a role in predicting future CVD risk and defining patients’ CVD risk level. However, significative measurement difficulties make a widespread evaluation of the AS problematic, especially in the ambulatorial outpatient setting. The IMT measurement is no longer recommended in the CVD risk assessment due to lack of standardization in measurement protocol and low power to reclassify patients toward higher CV risk. Understanding the correlation between the structure and function of the large arteries can lead to an optimization of cardiovascular disease prevention strategies. At present, indices of arterial stiffness have not been associated with qualitative morphological characteristics of intima–media complex. The IM GSM is a relatively simple measurement that can be acquired during a carotid color–Doppler ultrasound exam. The aim of this study was to investigate the relationship between indices of arterial stiffness and echogenicity of intima media complex (IM GSM) of the common carotid arteries in subjects with arterial hypertension. In our study population of 421 hypertensive patients, subjects with IM GSM > 30 showed a significantly increased arterial stiffness and LVMI (P < 0.001). A weak positive correlation was found between IM GSM and SBP (r =0.35, P< 0.001), and duration of hypertension (r = 0.31, P < 0.01). Our study suggests that increased stiffness observed in hypertensives is associated with qualitative changes in carotid arterial wall.

Published
2023
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22. Poster Session 3: Friday 9 December 2011, 08:30-12:30 * Location: Poster Area

Author

Kenny, C., primary, Adhya, S., additional, Dworakowski, R., additional, Brickham, B., additional, Maccarthy, P., additional, Monaghan, M., additional, Guzzo, A., additional, Innocenti, F., additional, Vicidomini, S., additional, Lazzeretti, D., additional, Squarciotta, S., additional, De Villa, E., additional, Donnini, C., additional, Bulletti, F., additional, Guerrini, E., additional, Pini, R., additional, Bendjelid, K., additional, Viale, J., additional, Duperret, S., additional, Piriou, V., additional, Jacques, D., additional, Shahgaldi, K., additional, Silva, C., additional, Pedro, F., additional, Deister, L., additional, Brodin, L.-A., additional, Sahlen, A., additional, Manouras, A., additional, Winter, R., additional, Berjeb, N., additional, Cimadevilla, C., additional, Dreyfus, J., additional, Cueff, C., additional, Malanca, M., additional, Chiampan, A., additional, Vahanian, A., additional, Messika-Zeitoun, D., additional, Muraru, D., additional, Peluso, D., additional, Dal Bianco, L., additional, Beraldo, M., additional, Solda', E., additional, Tuveri, M., additional, Cucchini, U., additional, Al Mamary, A., additional, Badano, L., additional, Iliceto, S., additional, Almuntaser, I., additional, King, G., additional, Norris, S., additional, Daly, C., additional, Ellis, E., additional, Murphy, R., additional, Erdei, T., additional, Denes, M., additional, Kardos, A., additional, Foldesi, C., additional, Temesvari, A., additional, Lengyel, M., additional, Bouzas Mosquera, A., additional, Broullon, F., additional, Alvarez-Garcia, N., additional, Peteiro, J., additional, Barge-Caballero, G., additional, Lopez-Perez, M., additional, Lopez-Sainz, A., additional, Castro-Beiras, A., additional, Luotolahti, M., additional, Luotolahti, H., additional, Kantola, I., additional, Viikari, J., additional, Andersen, M., additional, Ersboell, M., additional, Bro-Jeppesen, J., additional, Gustafsson, F., additional, Koeber, L., additional, Hassager, C., additional, Moller, J., additional, Coisne, D., additional, Diakov, C., additional, Vallet, F., additional, Lequeux, B., additional, Blouin, P., additional, Christiaens, L., additional, Esposito, R., additional, Santoro, A., additional, Schiano Lomoriello, V., additional, Raia, R., additional, Santoro, C., additional, De Simone, G., additional, Galderisi, M., additional, Abdula, G., additional, Kosmala, W., additional, Szczepanik-Osadnik, H., additional, Przewlocka-Kosmala, M., additional, Mysiak, A., additional, O' Moore-Sullivan, T., additional, Marwick, T., additional, Tan, Y. T., additional, Wenzelburger, F., additional, Leyva, F., additional, Sanderson, J., additional, Pichler, P., additional, Syeda, B., additional, Hoefer, P., additional, Zuckermann, A., additional, Binder, T., additional, Fijalkowski, M., additional, Koprowski, A., additional, Galaska, R., additional, Blaut, K., additional, Sworczak, K., additional, Rynkiewicz, A., additional, Lee, S., additional, Kim, W., additional, Jung, L., additional, Yun, H., additional, Song, M., additional, Ko, J., additional, Khalifa, E. A., additional, Szymanski, P., additional, Lipczynska, M., additional, Klisieiwcz, A., additional, Hoffman, P., additional, Jorge, C., additional, Silva Marques, J., additional, Robalo Martins, S., additional, Calisto, C., additional, Mieiro, M., additional, Vieira, S., additional, Correia, M., additional, Carvalho De Sousa, J., additional, Almeida, A., additional, Nunes Diogo, A., additional, Park, C., additional, March, K., additional, Tillin, T., additional, Mayet, J., additional, Chaturvedi, N., additional, Hughes, A., additional, Di Bello, V., additional, Giannini, C., additional, Delle Donne, M., additional, De Sanctis, F., additional, Spontoni, P., additional, Cucco, C., additional, Corciu, A., additional, Grigoratos, C., additional, Bogazzi, F., additional, Balbarini, A., additional, Enescu, O., additional, Suran, B., additional, Florescu, M., additional, Cinteza, M., additional, Vinereanu, D., additional, Higuchi, Y., additional, Iwakura, K., additional, Okamura, A., additional, Date, M., additional, Fujii, K., additional, Cortez-Dias, N., additional, Silva, D., additional, Carrilho-Ferreira, P., additional, Magalhaes, A., additional, Ribeiro, S., additional, Goncalves, S., additional, Fiuza, M., additional, Pinto, F., additional, Placido, R., additional, Bordalo, A., additional, Grzywocz, P., additional, Mizia-Stec, K., additional, Chudek, J., additional, Gasior, Z., additional, Maceira Gonzalez, A. M., additional, Cosin Sales, J., additional, Dalli, E., additional, Igual, B., additional, Diago, J., additional, Aguilar, J., additional, Ruvira, J., additional, Cimino, S., additional, Pedrizzetti, G., additional, Tonti, G., additional, Canali, E., additional, Petronilli, V., additional, Boccalini, F., additional, Mattatelli, A., additional, Hiramoto, Y., additional, Iacoboni, C., additional, Agati, L., additional, Trifunovic, D., additional, Ostojic, M., additional, Vujisic-Tesic, B., additional, Petrovic, M., additional, Nedeljkovic, I., additional, Banovic, M., additional, Boricic-Kostic, M., additional, Draganic, G., additional, Tesic, M., additional, Gavina, C., additional, Lopes, R., additional, Lourenco, A., additional, Almeida, J., additional, Rodrigues, J., additional, Pinho, P., additional, Zamorano, J., additional, Leite-Moreira, A., additional, Rocha-Goncalves, F., additional, Clavel, M.-A., additional, Capoulade, R., additional, Dumesnil, J., additional, Mathieu, P., additional, Despres, J.-P., additional, Pibarot, P., additional, Bull, S., additional, Pitcher, A., additional, Augustine, D., additional, D'arcy, J., additional, Karamitsos, T., additional, Rai, A., additional, Prendergast, B., additional, Becher, H., additional, Neubauer, S., additional, Myerson, S., additional, Magne, J., additional, Donal, E., additional, Davin, L., additional, O'connor, K., additional, Pirlet, C., additional, Rosca, M., additional, Szymanski, C., additional, Cosyns, B., additional, Pierard, L., additional, Lancellotti, P., additional, Calin, A., additional, Popescu, B., additional, Beladan, C., additional, Enache, R., additional, Lupascu, L., additional, Sandu, C., additional, Ginghina, C., additional, Kamperidis, V., additional, Hadjimiltiadis, S., additional, Sianos, G., additional, Anastasiadis, K., additional, Grosomanidis, V., additional, Efthimiadis, G., additional, Karvounis, H., additional, Parharidis, G., additional, Styliadis, I., additional, Gonzalez Canovas, C., additional, Munoz-Esparza, C., additional, Bonaque Gonzalez, J., additional, Fernandez, A., additional, Salar Alcaraz, M., additional, Saura Espin, D., additional, Pinar Bermudez, E., additional, Oliva-Sandoval, M., additional, De La Morena Valenzuela, G., additional, Valdes Chavarri, M., additional, Brochet, E., additional, Lepage, L., additional, Attias, D., additional, Detaint, D., additional, Himbert, D., additional, Iung, B., additional, Pirat, B., additional, Little, S., additional, Chang, S., additional, Tiller, L., additional, Kumar, R., additional, Zoghbi, W., additional, Lee, A. P.-W., additional, Hsiung, M., additional, Wan, S., additional, Wong, R., additional, Luo, F., additional, Fang, F., additional, Xie, J., additional, Underwood, M., additional, Sun, J., additional, Yu, C., additional, Jansen, R., additional, Tietge, W., additional, Sijbrandij, K., additional, Cramer, M., additional, De Heer, L., additional, Kluin, J., additional, Chamuleau, S. A. J., additional, Oliveras Vila, T., additional, Ferrer Sistach, E., additional, Delgado Ramis, L., additional, Lopez Ayerbe, J., additional, Vallejo Camazon, N., additional, Gual Capllonch, F., additional, Garcia Alonso, C., additional, Teis Soley, A., additional, Ruyra Baliarda, X., additional, Bayes Genis, A., additional, Negrea, S., additional, Alexandrescu, C., additional, Bourlon, F., additional, Civaia, F., additional, Dreyfus, G., additional, Paetzold, S., additional, Luha, O., additional, Hoedl, R., additional, Stoschitzky, G., additional, Pfeiffer, K., additional, Zweiker, D., additional, Pieske, B., additional, Maier, R., additional, Sevilla, T., additional, Revilla, A., additional, Lopez, J., additional, Vilacosta, I., additional, Arnold, R., additional, Gomez, I., additional, San Roman, J., additional, Nikcevic, G., additional, Djordjevic Dikic, A., additional, Djordjevic, S., additional, Raspopovic, S., additional, Jovanovic, V., additional, Kircanski, B., additional, Pavlovic, S., additional, Milasinovic, G., additional, Ruiz-Zamora, I., additional, Cabrera Bueno, F., additional, Molina, M., additional, Fernandez-Pastor, J., additional, Pena, J., additional, Linde, A., additional, Barrera, A., additional, Alzueta, J., additional, Bremont, C., additional, Bensaid, A., additional, Alonso, H., additional, Zaghden, O., additional, Nahum, J., additional, Dubois-Rande, J., additional, Gueret, P., additional, Lim, P., additional, Lee, S.-P., additional, Park, K., additional, Kim, H.-R., additional, Lee, J.-H., additional, Ahn, H.-S., additional, Kim, J.-H., additional, Kim, H.-K., additional, Kim, Y.-J., additional, Sohn, D.-W., additional, Niemann, M., additional, Herrmann, S., additional, Hu, K., additional, Liu, D., additional, Beer, M., additional, Ertl, G., additional, Wanner, C., additional, Takenaka, T., additional, Tei, C., additional, Weidemann, F., additional, Madeira, H., additional, Mendes Pedro, M., additional, Brito, D., additional, Ippolito, R., additional, De Palma, D., additional, Gati, S., additional, Oxborough, D., additional, Reed, M., additional, Zaidi, A., additional, Ghani, S., additional, Sheikh, N., additional, Papadakis, M., additional, Sharma, S., additional, Chow, V., additional, Ng, A., additional, Pasqualon, T., additional, Zhao, W., additional, Hanzek, D., additional, Chung, T., additional, Yeoh, T., additional, Kritharides, L., additional, Magda, L., additional, Mihalcea, D., additional, Jinga, D., additional, Mincu, R., additional, Ferrazzi, E., additional, Segato, G., additional, Folino, F., additional, Famoso, G., additional, Senzolo, M., additional, Bellu, R., additional, Corbetti, F., additional, Tona, F., additional, Azevedo, O., additional, Quelhas, I., additional, Guardado, J., additional, Fernandes, M., additional, Pereira, V., additional, Medeiros, R., additional, Sousa, P., additional, Santos, W., additional, Pereira, S., additional, Marques, N., additional, Mimoso, J., additional, Marques, V., additional, Jesus, I., additional, Rustad, L., additional, Nytroen, K., additional, Gullestad, L., additional, Amundsen, B., additional, Aakhus, S., additional, Linhartova, K., additional, Sterbakova, G., additional, Necas, J., additional, Kovalova, S., additional, Cerbak, R., additional, Nelassov, N., additional, Korotkijan, N., additional, Shishkina, A., additional, Gagieva, B., additional, Nagaplev, M., additional, Eroshenko, O., additional, Morgunov, M., additional, Parmon, S., additional, Velthuis, S., additional, Van Gent, M., additional, Post, M., additional, Westermann, C., additional, Mager, J., additional, Snijder, R., additional, Koyalakonda, S. P., additional, Anderson, M., additional, Burgess, M., additional, Bergenzaun, L., additional, Chew, M., additional, Ohlin, H., additional, Gjerdalen, G. F., additional, Hisdal, J., additional, Solberg, E., additional, Andersen, T., additional, Radunovic, Z., additional, Steine, K., additional, Rutz, T., additional, Kuehn, A., additional, Petzuch, K., additional, Pekala, M., additional, Elmenhorst, J., additional, Fratz, S., additional, Mueller, J., additional, Hager, A., additional, Hess, J., additional, Vogt, M., additional, Van Der Linde, D., additional, Van De Laar, I., additional, Wessels, M., additional, Bekkers, J., additional, Moelker, A., additional, Tanghe, H., additional, Van Kooten, F., additional, Oldenburg, R., additional, Bertoli-Avella, A., additional, Roos-Hesselink, J., additional, Cresti, A., additional, Fontani, L., additional, Calabria, P., additional, Capati, E., additional, Severi, S., additional, Lynch, M., additional, Saraf, S., additional, Sandler, B., additional, Yoon, S., additional, Kim, S., additional, Ko, C., additional, Ryu, S., additional, Byun, Y., additional, Seo, H., additional, Ciampi, Q., additional, Rigo, F., additional, Pratali, L., additional, Gherardi, S., additional, Villari, B., additional, Picano, E., additional, Sicari, R., additional, Celutkiene, J., additional, Zakarkaite, D., additional, Skorniakov, V., additional, Zvironaite, V., additional, Grabauskiene, V., additional, Sinicyna, J., additional, Gruodyte, G., additional, Janonyte, K., additional, Laucevicius, A., additional, O'driscoll, J., additional, Schmid, K., additional, Marciniak, A., additional, Saha, A., additional, Gupta, S., additional, Smith, R., additional, Sharma, R., additional, Alvarez Garcia, N., additional, Prada, O., additional, Rodriguez Vilela, A., additional, Barge Caballero, G., additional, Lopez Perez, M., additional, Lopez Sainz, A., additional, Castro Beiras, A., additional, Kochanowski, J., additional, Scislo, P., additional, Piatkowski, R., additional, Grabowski, M., additional, Marchel, M., additional, Roik, M., additional, Kosior, D., additional, Opolski, G., additional, Van De Heyning, C. M., additional, Mahjoub, H., additional, Clausen, H., additional, Basaggianis, C., additional, Newton, J., additional, Del Pasqua, A., additional, Carotti, A., additional, Di Carlo, D., additional, Cetrano, E., additional, Toscano, A., additional, Iacobelli, R., additional, Esposito, C., additional, Chinali, M., additional, Pongiglione, G., additional, Rinelli, G., additional, Larsson, M., additional, Bjallmark, A., additional, Caidahl, K., additional, Brodin, L., additional, Gao, H., additional, Lugiez, M., additional, Guivier, C., additional, Rieu, R., additional, D'hooge, J., additional, Hang, G., additional, Guerin, C., additional, Menard, M., additional, Voigt, J.-U., additional, Dungu, J., additional, Campos, G., additional, Jaffarulla, R., additional, Gomes-Pereira, S., additional, Sutaria, N., additional, Baker, C., additional, Nihoyannopoulos, P., additional, Bellamy, M., additional, Harries, D., additional, Walker, N., additional, Pearson, P., additional, Reiken, J., additional, Batteson, J., additional, Kamdar, R., additional, Murgatroyd, F., additional, D'andrea, A., additional, Riegler, L., additional, Scarafile, R., additional, Pezzullo, E., additional, Salerno, G., additional, Bossone, E., additional, Limongelli, G., additional, Russo, M., additional, Pacileo, G., additional, Calabro', R., additional, Kang, Y., additional, Cui, J., additional, Chen, H., additional, Pan, C., additional, Shu, X., additional, Kiotsekoglou, A., additional, Saha, S., additional, Toole, R., additional, Govind, S., additional, Gopal, A., additional, Crispi, F., additional, Bijnens, B., additional, Sepulveda-Swatson, E., additional, Rojas-Benavente, J., additional, Dominguez, J., additional, Illa, M., additional, Eixarch, E., additional, Sitges, M., additional, Gratacos, E., additional, Prinz, C., additional, Faludi, R., additional, Walker, A., additional, Amzulescu, M., additional, Uejima, T., additional, Fraser, A., additional, Voigt, J., additional, Esmaeilzadeh, M., additional, Maleki, M., additional, Amin, A., additional, Vakilian, F., additional, Noohi, F., additional, Ojaghi Haghighi, Z., additional, Nakhostin Davari, P., additional, Bakhshandeh Abkenar, H., additional, Rimbas, R., additional, Dulgheru, R., additional, Margulescu, A., additional, D' Asaro, M., additional, Mizzon, C., additional, Parisi, F., additional, Jung, B.-C., additional, Lee, B.-Y., additional, Kang, H.-J., additional, Kim, M., additional, Kim, Y., additional, Cho, D., additional, Park, S., additional, Hong, S., additional, Lim, D., additional, Shim, W., additional, Bellsham-Revell, H., additional, Tibby, S., additional, Bell, A. J., additional, Miller, O. I., additional, Greil, G., additional, Simpson, J. M., additional, Providencia, R. A., additional, Trigo, J., additional, Botelho, A., additional, Gomes, P., additional, Seca, L., additional, Barra, S., additional, Faustino, A., additional, Costa, G., additional, Quintal, N., additional, Leitao-Marques, A., additional, Nestaas, E., additional, Stoylen, A., additional, Fugelseth, D., additional, Mornos, C., additional, Ionac, A., additional, Petrescu, L., additional, Cozma, D., additional, Dragulescu, D., additional, Mornos, A., additional, Pescariu, S., additional, Fontana, A., additional, Abbate, M., additional, Cazzaniga, M., additional, Giannattasio, C., additional, Trocino, G., additional, Laser, K., additional, Faber, L., additional, Fischer, M., additional, Koerperich, H., additional, Kececioglu, D., additional, Elnoamany, M. F., additional, Dawood, A., additional, Elhabashy, M., additional, Khalil, Y., additional, Piriou, N., additional, Warin-Fresse, K., additional, Caza, M., additional, Fau, G., additional, Crochet, D., additional, Xhabija, N., additional, Allajbeu, I., additional, Petrela, E., additional, Heba, M., additional, Barreiro Perez, M., additional, Martin Fernandez, M., additional, Renilla Gonzalez, A., additional, Florez Munoz, J., additional, Fernandez Cimadevilla, O., additional, Alvarez Pichel, I., additional, Velasco Alonso, E., additional, Leon Duran, D., additional, Benito Martin, E., additional, Secades Gonzalez, S., additional, Gargani, L., additional, Pang, P., additional, Davis, E., additional, Schumacher, A., additional, Silva Ferreira, A., additional, Bettencourt, N., additional, Matos, P., additional, Oliveira, L., additional, Cosin-Sales, J., additional, Lopez Lereu, M., additional, Monmeneu, J., additional, Estornell, J., additional, Tsverava, M., additional, Tsverava, D., additional, Varela, A., additional, Salagianni, M., additional, Galani, I., additional, Andreakos, E., additional, Davos, C., additional, Ikonomidis, I., additional, Lekakis, J., additional, Tritakis, V., additional, Kadoglou, N., additional, Papadakis, J., additional, Trivilou, P., additional, Tzortzis, S., additional, Koukoulis, C., additional, Paraskevaidis, I., additional, Anastasiou-Nana, M., additional, Kim, G., additional, Youn, H., additional, Ibrahimi, P., additional, Bajraktari, G., additional, Jashari, F., additional, Ahmeti, A., additional, Poniku, A., additional, Haliti, E., additional, Henein, M., additional, Pezo Nikolic, B., additional, Jurin, H., additional, Lovric, D., additional, Baricevic, Z., additional, Ivanac Vranesic, I., additional, Lovric Bencic, M., additional, Ernst, A., additional, and Separovic Hanzevacki, J., additional

Published
2011
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24. A cure for sexism.

Author

Brownlee, S. and Pezzullo, E.

Subjects
STUDY & teaching of medicine
Abstract

Examines how women doctors are heralding a kinder, gentler way to practice medicine. The `feminization' of medicine; Feminine nurturing will soften the traditional authoritarian style; Significant changes wrought by the arrival of an increase offemales in medical school; Male bias; Women students have few role models; Discouragement women face when they're choosing the specialties; What primary care offers women.

Published
1992

25. Best small colleges.

Author

Gabor, A. and Pezzullo, E.

Subjects
*UNIVERSITY rankings
Abstract

Lists, in chart form, the top 25 national liberal-arts colleges, which, for many students and parents, represent what higher education in America is all about. Top five schools: Amherst College (Ma.), Swarthmore College (Pa.), Williams College (Ma.), Bowdoin College (Me.), Wellesley College (Ma.). INSET: Student profile (Kendall Price)..

Published
1990

27. Early impairment of myocardial function in systemic sclerosis: non-invasive assessment by Doppler myocardial and strain rate imaging.

Author

D'Andrea A, Stisi S, Bellissimo S, Vigorito F, di Uccio FS, Tozzi N, Moscato F, Pezzullo E, Calabrò R, and Scherillo M

Abstract

BackgroundAim of the present study was to analyze both left (LV) and right ventricular (RV) myocardial function in patients with Systemic Sclerosis (SSc), and their relation to other instrumental features of the disease.Methods and resultsTwenty-five healthy subjects and 23 age- and sex-comparable asymptomatic patients classified as having either diffuse (11 patients) or limited form (12 patients) of SSc underwent clinical examination, serological tests, high-resolution chest-CT, standard Doppler echo, pulsed Doppler myocardial imaging (DMI) and strain rate imaging (SRI) of both LV and RV lateral walls. By chest-CT, 11 patients showed interstitial pulmonary fibrosis. Serological antibodies analysis detected anti-centromere pattern in 8 patients, and anti Scl-70 in 15 patients. LV diameters and ejection fraction were comparable between the two groups, while RV end-diastolic diameter was increased in SSc (p < 0.01). Tricuspid inflow E/A ratio was slightly decreased in SSc (p < 0.01), while systolic pulmonary pressure was increased (p < 0.001). Pulsed DMI detected in SSc impaired myocardial RV early-diastolic (E[m]) peak velocity (p < 0.0001), and prolonged myocardial time intervals at tricuspid annulus level. In SSc, peak systolic RV SR and strain were both reduced in basal, middle and apical RV lateral free walls, and in basal and middle LV lateral walls. By multivariate analysis, independent inverse association of RV peak Em velocity with both Rodnan Skin Score (p < 0.0005) and pulmonary systolic pressure (p < 0.0001), as well as independent inverse correlation of the same RV peak E[m] velocity with pulmonary fibrosis (<0.0005) in SSc patients were observed. In addition, RV Em was an independent predictor of the anti Scl-70 antibody pattern (p < 0.001).ConclusionsPulsed DMI and SRI are valuable non-invasive and easy-repeatable tools for detecting RV and LV myocardial involvement caused by SSc, and may therefore be useful to early identify patients with more diffused and severe form of SSc. [ABSTRACT FROM AUTHOR]

Published
2005

28. Whoops.

Author

Pezzullo, E.

Subjects
*PUBLISHING
Abstract

Reports that the Texas Board of Education last week approved use of four new history textbooks published by some of America's leading publishers provided the publishers fix the more than 3,700 errors found in the books and pay $239,500 in fines for making them. Examples of some of the slight errors made; No guarantee the textbooks will be totally accurate; What publishers should concentrate on.

Published
1992

29. Range of right heart measurements in top-level athletes: the training impact

Author

Giovanni Di Salvo, Raffaella Scarafile, Maria Giovanna Russo, Pio Caso, Luigi Nunziata, Enrica Pezzullo, Lucia Riegler, Rosangela Cocchia, Sergio Cuomo, Enrica Golia, Raffaele Calabrò, Antonello D'Andrea, Gemma Salerno, Rodolfo Citro, Eduardo Bossone, Antonio Cittadini, D'Andrea, A., Riegler, L., Golia, E., Cocchia, R., Salerno, G., Pezzullo, E., Nunziata, L., Citro, R., Cuomo, S., Caso, P., DI Salvo, G., Cittadini, Antonio, Russo, M. G., Calabro', R., Bossone, E., D'Andrea, A, Riegler, L, Golia, E, Cocchia, R, Scarafile, R, Salerno, G, Pezzullo, E, Nunziata, L, Citro, R, Cuomo, S, Caso, P, DI SALVO, Giovanni, Cittadini, A, Russo, Maria Giovanna, and Calabro', Raffaele

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Adolescent, Physiological, Physical exercise, Doppler echocardiography, Athlete's heart, Endurance, Pulmonary pressure, Right atrium, Right ventricle, Adaptation, Physiological, Athletes, Echocardiography, Female, Heart, Humans, Young Adult, Exercise, Physical Endurance, Sports, right atrium, medicine.artery, Internal medicine, medicine, Adaptation, Body surface area, endurance, medicine.diagnostic_test, business.industry, Stroke volume, medicine.anatomical_structure, Blood pressure, Pulmonary artery, Ventricular pressure, Vascular resistance, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Objectives: To explore the full range of right heart dimensions and the impact of long-term intensive training in athletes. Background: Although echocardiography has been widely used to distinguish the athlete's heart from pathologic left ventricular (LV) hypertrophy, only few reports have described right ventricular (RV) and right atrial (RA) adaptations to extensive physical exercise. Methods: 650 top-level athletes [395 endurance-(ATE) and 255 strength-trained (ATS); 410 males (63.1%); mean age 28.4 +/- 10.1; 18-40 years] and 230 healthy age-and sex-comparable controls underwent a transthoracic echocardiographic exam. Along with left heart parameters, right heart measurements included: RV end-diastolic diameters at the basal and mid-cavity level; RV base-to-apex length; RV proximal and distal outflow tract diameters; RA long and short diameters; and RA area. Tricuspid annular plane systolic excursion and RV tissue Doppler systolic peak velocity were assessed as indexes of RV systolic function. Pulmonary artery systolic pressure (PASP) was estimated from the peak tricuspid regurgitant velocity. Results: ATS showed increased sum of wall thickness and relative wall thickness, whereas left atrial volume, LV end-diastolic volume, LV stroke volume and PASP were significantly higher in ATE. RV and RA measurements were all significantly greater in ATE than in ATS and controls. ATE also showed improved early diastolic RV function, whereas RV systolic indexes were comparable among groups. On multivariate analysis, type and duration of training (p

Published
2011

30. Long-term proactive management of psoriasis with calcipotriol and betamethasone dipropionate foam: an Italian consensus through a combined nominal group technique and Delphi approach

Author

De Simone, Clara, Dapavo, Paolo, Malagoli, Piergiorgio, Martella, Alessandro, Campanati, Anna, Campione, Elena, Errichetti, Enzo, Franchi, Chiara, Gambardella, Alessio, Megna, Matteo, Osti, Federica, Ribero, Simone, Zagni, Giovanni, Calzavara-Pinton, Piergiacomo, Fabbrocini, Gabriella, Amoruso, Giuseppe Fabrizio, Baglieri, Francesco, Biamonte, Anna Silvia, Bianchelli, Tommaso, Bigi, Laura, Bortoli, Jarno, Brunetti, Bruno, Buligan, Cinzia, Cagni, Elisabetta, Calderoni, Ombretta, Caputo, Alighiero, Carrera, Carlo Giovanni, Carugno, Andrea, Chersi, Karin, Cicchelli, Stefano, De Natale, Flora, Di Maria, Domenico, Ferrari, Angelo Salvatore, Fogli, Emanuela, Forconi, Riccardo, Galeazzi, Augusto, Giovannini, Andrea, Giura, Maria Teresa, Iuculano, Massimo, Lazzaretti, Giuseppe, Leporati, Claudia, Magnanini, Massimiliano, Marconi, Barbara, Maruccia, Adriana, Miglietta, Roberta, Minuti, Anna, Mocci, Luigi, Modica, Sonia, Narcisi, Alessandra, Odorici, Giulia, Pazzaglia, Massimiliano, Peila, Rossana, Pertusi, Ginevra, Pezza, Michele, Pezzullo, Elio, Puccia, Nunzio, Raulo, Umberto, Rossi, Mariateresa, Rusignuolo, Sergio, Sapienza, Giada, Savarese, Catello, Scalisi, Mariaelena, Strippoli, Davide, Stroppiana, Elena, Tiberio, Rossana, Trischitta, Antonino, Tucci, Maria Giovanna, Vaira, Fabrizio, Verrone, Anna, Villa, Lucia, Zagni, Fabio, Zoccali, Andrea, De Simone, C, Dapavo, P, Malagoli, P, Martella, A, Campanati, A, Campione, E, Errichetti, E, Franchi, C, Gambardella, A, Megna, M, Osti, F, Ribero, S, Zagni, G, Calzavara-Pinton, P, Fabbrocini, G, Amoruso, G, Baglieri, F, Biamonte, A, Bianchelli, T, Bigi, L, Bortoli, J, Brunetti, B, Buligan, C, Cagni, E, Calderoni, O, Caputo, A, Carrera, C, Carugno, A, Chersi, K, Cicchelli, S, De Natale, F, Di Maria, D, Ferrari, A, Fogli, E, Forconi, R, Galeazzi, A, Giovannini, A, Giura, M, Iuculano, M, Lazzaretti, G, Leporati, C, Magnanini, M, Marconi, B, Maruccia, A, Miglietta, R, Minuti, A, Mocci, L, Modica, S, Narcisi, A, Odorici, G, Pazzaglia, M, Peila, R, Pertusi, G, Pezza, M, Pezzullo, E, Puccia, N, Raulo, U, Rossi, M, Rusignuolo, S, Sapienza, G, Savarese, C, Scalisi, M, Strippoli, D, Stroppiana, E, Tiberio, R, Trischitta, A, Tucci, M, Vaira, F, Verrone, A, Villa, L, Zagni, F, Zoccali, A, De Simone, Clara, Dapavo, Paolo, Malagoli, Piergiorgio, Martella, Alessandro, Campanati, Anna, Campione, Elena, Errichetti, Enzo, Franchi, Chiara, Gambardella, Alessio, Megna, Matteo, Osti, Federica, Ribero, Simone, Zagni, Giovanni, Calzavara-Pinton, Piergiacomo, Fabbrocini, Gabriella, Amoruso, Giuseppe Fabrizio, Baglieri, Francesco, Biamonte, Anna Silvia, Bianchelli, Tommaso, Bigi, Laura, Bortoli, Jarno, Brunetti, Bruno, Buligan, Cinzia, Cagni, Elisabetta, Calderoni, Ombretta, Caputo, Alighiero, Carrera, Carlo Giovanni, Carugno, Andrea, Chersi, Karin, Cicchelli, Stefano, De Natale, Flora, Di Maria, Domenico, Ferrari, Angelo Salvatore, Fogli, Emanuela, Forconi, Riccardo, Galeazzi, Augusto, Giovannini, Andrea, Giura, Maria Teresa, Iuculano, Massimo, Lazzaretti, Giuseppe, Leporati, Claudia, Magnanini, Massimiliano, Marconi, Barbara, Maruccia, Adriana, Miglietta, Roberta, Minuti, Anna, Mocci, Luigi, Modica, Sonia, Narcisi, Alessandra, Odorici, Giulia, Pazzaglia, Massimiliano, Peila, Rossana, Pertusi, Ginevra, Pezza, Michele, Pezzullo, Elio, Puccia, Nunzio, Raulo, Umberto, Rossi, Mariateresa, Rusignuolo, Sergio, Sapienza, Giada, Savarese, Catello, Scalisi, Mariaelena, Strippoli, Davide, Stroppiana, Elena, Tiberio, Rossana, Trischitta, Antonino, Tucci, Maria Giovanna, Vaira, Fabrizio, Verrone, Anna, Villa, Lucia, Zagni, Fabio, and Zoccali, Andrea

Subjects
Aerosols, long-term, proactive management, Dermatology, psoriasis, Betamethasone, Drug Combinations, Treatment Outcome, Recurrence, consensus, Cal/BD, adherence, consensu, Humans, Dermatologic Agents, psoriasi
Abstract

Background: Although long-term management of psoriasis is paramount, this approach is challenging in clinical practice. In the recent PSO-LONG trial, a fixed-dose combination of betamethasone dipropionate (BD) and calcipotriol (Cal) foam applied twice a week on non-consecutive days for 52 weeks (proactive treatment) reduced the risk of relapse. However, the role of Cal/BD foam in the long-term management of psoriasis needs further clarifications. The ProActive Management (PAM) program, a nationwide Italian project, aims at reaching a consensus on the role of proactive management of psoriasis. Methods: A steering committee generated some statements through the nominal group technique (NGT). The statements were voted by an expert panel in an adapted Delphi voting process. Results: Eighteen statements were proposed, and the majority of them (14/18) reached a consensus during the Delphi voting. The need to provide long-term proactive topical treatment to reduce the risk of relapse for the treatment of challenging diseases sites or in patients where phototherapy or systemic therapies are contraindicated/ineffective was widely recognized. A consensus was reached about the possibility to associate the proactive treatment with systemic and biological therapies, without the need for dose intensification, thus favoring a prolonged remission. Moreover, the proactive treatment was recognized as more effective than weekend therapy in increasing time free from relapses. Approaches to improve adherence, on the other hand, need further investigation. Conclusions: The inclusion in guidelines of a proactive strategy among the effective treatment options will be a fundamental step in the evolution of a mild-moderate psoriasis therapeutic approach.

Published
2022

31. Non Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients Scheduled for Electrical Cardioversion: A Real-Life Propensity Score Matched Study

Author

Valentina Parisi, Emilio Attena, Francesco Martone, Marco Malvezzi Caracciolo d'Aquino, Gabriella Scognamiglio, Vincenzo Russo, Enrica Pezzullo, Anna Rago, Paolo Golino, Valentina Maria Caso, Gerardo Nigro, Antonio D'Onofrio, Rago, A., Pezzullo, E., D'Aquino, M. M. C., Scognamiglio, G., Caso, V. M., Martone, F., Attena, E., Parisi, V., D'Onofrio, A., Golino, P., Nigro, G., and Russo, V.

Subjects
medicine.medical_specialty, medicine.drug_class, non-vitamin K antagonist oral anticoagulants, transesophageal echocardiogram, Non-vitamin K antagonist oral anticoagulant, 030204 cardiovascular system & hematology, Transesophageal echocardiogram, Journal of Blood Medicine, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, atrial fibrillation, Stroke, Original Research, medicine.diagnostic_test, business.industry, discontinuation rate, Incidence (epidemiology), Antagonist, Atrial fibrillation, Hematology, Vitamin K antagonist, medicine.disease, Discontinuation, vitamin K antagonists, 030220 oncology & carcinogenesis, Propensity score matching, Cardiology, business, electrical cardioversion
Abstract

Anna Rago,1 Enrica Pezzullo,1 Marco Malvezzi Caracciolo d’Aquino,1 Gabriella Scognamiglio,1 Valentina Maria Caso,2 Francesco Martone,3 Emilio Attena,4 Valentina Parisi,5 Antonio D’Onofrio,4 Paolo Golino,1 Gerardo Nigro,1 Vincenzo Russo1 1Department of Cardiology, Monaldi Hospital, Naples, Italy; 2Department of Medical Translational Sciences, University of the Study of Campania “Luigi Vanvitelli”, Naples, Italy; 3Clinical Biochemistry Unit, Monaldi Hospital, Naples, Italy; 4Departmental Unit of Electrophysiology, Monaldi Hospital, Naples, Italy; 5Department of Translational Medical Sciences, University of Naples Federico II, Naples, ItalyCorrespondence: Vincenzo RussoDepartment of Medical Transalational Sciences, University of Campania - Monaldi Hospital, Via Leonardo Bianchi, Naples, 80131, ItalyFax +39-0817587482Email v.p.russo@libero.itAim: The aim of the present study was to assess the safety and effectiveness of non-vitamin K antagonist oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) in atrial fibrillation (AF) patients undergoing electrical cardioversion (EC).Methods: A propensity score-matched analysis was performed in order to identify two homogeneous groups including AF patients on NOACs and VKAs treatment scheduled for EC. The primary safety endpoint was major bleeding. The composite of stroke, transient ischemic attack (TIA) and systemic embolism (SE) was the primary effectiveness endpoint. The discontinuation rate of anticoagulant therapy was assessed.Results: A total of 495 AF patients on NOACs therapy and scheduled for EC were compared to 495 VKAs recipients. No statistically significant differences in the incidence of both major bleeding (1.01% versus 1.4%; P= 0.5) and thromboembolic events (0.6% versus 0.8%; P= 0.7) were observed during a mean follow-up of 15 ± 3 months. The discontinuation rate of NOACs was significantly lower compared to VKAs (1.6% versus 3.6%, P=0.04).Conclusion: We showed a safe and effective clinical profile of NOACs among AF patients scheduled for electrical cardioversion in real-life setting. Patients on NOACs therapy showed a lower discontinuation rate compared to those on VKAs.Keywords: atrial fibrillation, electrical cardioversion, transesophageal echocardiogram, non-vitamin K antagonist oral anticoagulants, discontinuation rate, vitamin K antagonists

Published
2021

32. Right Ventricular Changes in Highly Trained Athletes: Between Physiology and Pathophysiology

Author

Antonello D'Andrea, Eduardo Bossone, Rosangela Cocchia, Raffaele Calabrò, Enrica Pezzullo, Lucia Riegler, Enrica Golia, Agostino Mattera Iacono, Raffaella Scarafile, Maria Giovanna Russo, Alberto Morello, D'Andrea, A, Morello, A, Iacono, Am, Scarafile, R, Cocchia, R, Riegler, L, Pezzullo, E, Golia, E, Bossone, E, Calabro, R, and Russo, Mg

Subjects
Cardiac function curve, medicine.medical_specialty, sport training, Cardiomyopathy, Athletes heart, Review Article, strain, Internal medicine, Medicine, Radiology, Nuclear Medicine and imaging, skin and connective tissue diseases, right heart, Sport training, biology, business.industry, Athletes, Doppler, medicine.disease, biology.organism_classification, Pathophysiology, medicine.anatomical_structure, Ventricle, exercise-induced cardiomyopathy, Right heart, Cardiology, sense organs, Cardiology and Cardiovascular Medicine, business
Abstract

Several studies have described the adaptive remodeling of the heart during exercise. In some more practiced endurance athletes, there is a disproportionate load on the right ventricle (RV), at least during exercise, and this might be the basis for a chronic pro-arrhythmic RV remodeling. Especially, in these kinds of athletes the recovery after detraining might be incomplete, in particular for RV changes. The observation of acute myocardial injury based on transient elevation of biomarkers and chronic myocardial scar, not completely reversible changes of the RV and an increased prevalence of some arrhythmias support the existence of an "exercise-induced cardiomyopathy." The aim of this paper is to review current knowledge about changes in the right heart in highly trained athletes and how these change influence cardiac function.

Published
2015

33. Transcranial Doppler ultrasound: Physical principles and principal applications in Neurocritical care unit

Author

Marianna Conte, Enrica Pezzullo, Antonello D'Andrea, Raffaella Scarafile, Giovanni Gregorio, Rosangela Cocchia, Maria Giovanna Russo, Massimo Cavallaro, Raffaele Calabrò, Lucia Riegler, Francesco Natale, Andreina Carbone, D'Andrea, A., Conte, M., Scarafile, R., Riegler, L., Cocchia, R., Pezzullo, E., Cavallaro, M., Carbone, A., Natale, F., Russo, M. G., Gregorio, G., and Calabro, R.

Subjects
medicine.medical_specialty, Subarachnoid hemorrhage, Traumatic brain injury, subarachnoid hemorrhage, patent foramen ovale, Cerebral arteries, Review Article, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, vasospasm, business.industry, mean cerebral brain flow, traumatic brain injury, Neurointensive care, Vasospasm, paradoxical embolism, medicine.disease, Transcranial Doppler, Brain stem death, Cerebral blood flow, Anesthesia, Neurocritical Unit Care, Cardiology, Patent foramen ovale, cardiovascular system, cryptogenic stroke, transcranial Doppler ultrasonography, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery
Abstract

Transcranial Doppler (TCD) ultrasonography is a noninvasive ultrasound study, which has been extensively applied on both outpatient and inpatient settings. It involves the use of a low-frequency (≤2 MHz) transducer, placed on the scalp, to insonate the basal cerebral arteries through relatively thin bone windows and to measure the cerebral blood flow velocity and its alteration in many different conditions. In neurointensive care setting, TCD is useful for both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoid hemorrhage, traumatic brain injury, acute ischemic stroke, and brain stem death. It also allows to investigate the cerebrovascular autoregulation in setting of carotid disease and syncope. In this review, we will describe physical principles underlying TCD, flow indices most frequently used in clinical practice and critical care applications in Neurocritical Unit care.

Published
2016

34. XStrain 4D analysis predicts left ventricular remodeling in patients with recent non-ST-segment elevation myocardial infarction

Author

Matteo Cameli, Donato Mele, Andrea Rossi, Roberta Esposito, Roberta Montisci, Antonello D'Andrea, Sabina Gallina, Enrica Pezzullo, Maurizio Galderisi, Giuseppina Novo, Sergio Mondillo, Eduardo Bossone, Eustachio Agricola, D'Andrea, A., Mele, D., Agricola, E., Pezzullo, E., Cameli, M., Rossi, A., Esposito, R., Novo, G., Mondillo, S., Montisci, R., Gallina, S., Bossone, E., Galderisi, M., D'Andrea, Antonello, Mele, Donato, Agricola, Eustachio, Pezzullo, Enrica, Cameli, Matteo, Rossi, Andrea, Esposito, Roberta, Novo, Giuseppina, Mondillo, Sergio, Montisci, Roberta, Gallina, Sabina, Bossone, Eduardo, and Galderisi, Maurizio

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Myocardial Infarction, Predictive Value of Test, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Predictive Value of Tests, Internal medicine, Image Interpretation, Computer-Assisted, medicine, ST segment, Humans, In patient, 030212 general & internal medicine, Myocardial infarction, Ventricular remodeling, Echocardiography, Four-Dimensional, Ventricular Remodeling, business.industry, Percutaneous coronary intervention, Electrocardiography in myocardial infarction, Middle Aged, medicine.disease, Cardiology, Female, business, Cardiology and Cardiovascular Medicine, Human
Published
2016

35. Left Ventricular Myocardial Velocities and Deformation Indexes in Top-Level Athletes

Author

Eduardo Bossone, Enrica Pezzullo, Giuseppe Pacileo, Sergio Cuomo, Gemma Salerno, Rosangela Cocchia, Pio Caso, Lucia Riegler, Enrica Golia, Rita Gravino, Antonello D'Andrea, Giuseppe Limongelli, Raffaele Calabrò, Rodolfo Citro, Raffaella Scarafile, Maria Giovanna Russo, D'Andrea, A, Cocchia, R, Riegler, L, Scarafile, R, Salerno, G, Gravino, R, Golia, E, Pezzullo, E, Citro, R, Limongelli, Giuseppe, Pacileo, G, Cuomo, S, Caso, P, Russo, Maria Giovanna, Bossone, E, Calabro', Raffaele, Limongelli, G, Russo, Mg, and Calabro, R

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Systole, Population, Diastole, Blood Pressure, Left ventricular hypertrophy, Ventricular Function, Left, Young Adult, Tissue Doppler echocardiography, Heart Rate, Reference Values, Internal medicine, Heart Septum, Image Processing, Computer-Assisted, medicine, Humans, Radiology, Nuclear Medicine and imaging, Interventricular septum, education, Exercise, Echocardiography, Doppler, Pulsed, education.field_of_study, Ejection fraction, biology, Athletes, business.industry, Resistance Training, Stroke Volume, biology.organism_classification, medicine.disease, Myocardial Contraction, Biomechanical Phenomena, Blood pressure, medicine.anatomical_structure, Echocardiography, Physical Fitness, Multivariate Analysis, Physical Endurance, Cardiology, Hypertrophy, Left Ventricular, Cardiology and Cardiovascular Medicine, business, Software
Abstract

BACKGROUND: The aim of this study was to define the range of left ventricular (LV) velocities and deformation indexes in highly trained athletes, analyzing potential differences induced by different long-term training protocols. METHODS: Standard echocardiography, pulsed-wave tissue Doppler echocardiography, and two-dimensional strain echocardiography of the interventricular septum and lateral wall were performed in 370 endurance athletes and 280 power athletes. Using pulsed-wave tissue Doppler, the following parameters of myocardial function were assessed: systolic peak velocities (S(m)), early (E(m)) and late (A(m)) diastolic velocities, and the E(m)/A(m) ratio. By two-dimensional strain echocardiography, peaks of regional systolic strain and LV global longitudinal strain were calculated. RESULTS: LV mass index and ejection fraction did not significantly differ between the two groups. However, power athletes showed an increased sum of wall thicknesses (P < .01) and relative wall thickness, while LV stroke volume and LV end-diastolic diameter (P < .001) were greater in endurance athletes. By pulsed-wave tissue Doppler analysis, E(m) and E(m)/A(m) at both the septal and lateral wall levels were higher in endurance athletes. By two-dimensional strain echocardiography, myocardial deformation indexes were comparable between the two groups. E(m)/A(m) ratios ≥ 1 were found in the overall population, while 90 % of athletes had an E(m) ≥ 16 cm/sec, S(m) ≥ 10 cm/sec, and global longitudinal strain ≤ -16%. Multivariate analyses evidenced independent positive association between Em peak velocity and LV end-diastolic volume (P < .001) and an independent correlation of global longitudinal strain with the sum of LV wall thicknesses (P < .005). CONCLUSIONS: This study describes the full spectrum of systolic and diastolic myocardial velocities and deformation indexes in a large population of competitive athletes.

Published
2010

36. Transcranial Doppler ultrasonography: From methodology to major clinical applications

Author

Eduardo Bossone, Giuseppe Santoro, Raffaele Calabrò, Antonello D'Andrea, Lucia Riegler, Marianna Conte, Raffaella Scarafile, Massimo Cavallaro, Rosangela Cocchia, Maria Giovanna Russo, Enrica Pezzullo, Andreina Carbone, Francesco Natale, Pio Caso, D'Andrea, A, Conte, M, Cavallaro, M, Scarafile, R, Riegler, L, Cocchia, R, Pezzullo, E, Carbone, A, Natale, F, Santoro, G, Caso, P, Russo, Mg, Bossone, E, and Calabro, R

Subjects
medicine.medical_specialty, Traumatic brain injury, business.industry, Neurointensive care, 030204 cardiovascular system & hematology, medicine.disease, Transcranial Doppler, 03 medical and health sciences, 0302 clinical medicine, Paradoxical embolism, Cerebral blood flow, Diagnostic Advances, medicine.artery, Internal medicine, Anesthesia, Middle cerebral artery, cardiovascular system, medicine, Patent foramen ovale, Cardiology, Cardiology and Cardiovascular Medicine, business, Stroke, 030217 neurology & neurosurgery
Abstract

Non-invasive Doppler ultrasonographic study of cerebral arteries [transcranial Doppler (TCD)] has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency (≤ 2 MHz) transducer on the scalp of the patient over specific acoustic windows, in order to visualize the intracranial arterial vessels and to evaluate the cerebral blood flow velocity and its alteration in many different conditions. Nowadays the most widespread indication for TCD in outpatient setting is the research of right to left shunting, responsable of so called “paradoxical embolism”, most often due to patency of foramen ovale which is responsable of the majority of cryptogenic strokes occuring in patients younger than 55 years old. TCD also allows to classify the grade of severity of such shunts using the so called “microembolic signal grading score”. In addition TCD has found many useful applications in neurocritical care practice. It is useful on both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoidal haemorrhage (caused by aneurysm rupture or traumatic injury), traumatic brain injury, brain stem death. It is used also to evaluate cerebral hemodynamic changes after stroke. It also allows to investigate cerebral pressure autoregulation and for the clinical evaluation of cerebral autoregulatory reserve.

Published
2016

37. Association between right ventricular two-dimensional strain and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy

Author

Gemma Salerno, Maria Giovanna Russo, Giovanni Di Salvo, Massimo Romano, Sergio Cuomo, Rita Gravino, Raffaella Scarafile, Antonello D'Andrea, Lucia Riegler, Raffaele Calabrò, Enrica Pezzullo, Giuseppe Limongelli, Eduardo Bossone, Giuseppe Pacileo, Pio Caso, Salerno, G, D'Andrea, A, Bossone, E, Scarafile, R, Riegler, L, Di Salvo, G, Gravino, R, Pezzullo, E, Limongelli, G, Romano, M, Cuomo, S, Pacileo, G, Caso, P, Russo, Mg, Calabro, R, DI SALVO, Giovanni, Limongelli, Giuseppe, Russo, Maria Giovanna, and Calabro', Raffaele

Subjects
Male, Ventricular Dysfunction, Right, Left, Myocardial Ischemia, heart failure, right ventricle, Ventricular Function, Left, Dilated, Ventricular Dysfunction, Ventricular Function, Observer Variation, Exercise Tolerance, resynchronization therapy, Doppler, Dilated cardiomyopathy, General Medicine, two-dimensional strain imaging, Exercise capacity, Middle Aged, Echocardiography, Doppler, Right, medicine.anatomical_structure, Italy, Echocardiography, Circulatory system, Cardiology, cardiovascular system, Female, cardiopulmonary exercise test, dilated cardiomyopathy, right ventricular function, Adult, Cardiomyopathy, Dilated, Humans, Linear Models, Positron-Emission Tomography, Predictive Value of Tests, Proportional Hazards Models, Pulmonary Ventilation, Reproducibility of Results, Exercise Test, Ventricular Function, Right, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Cardiomyopathy, Work rate, Internal medicine, medicine, Aerobic exercise, In patient, cardiovascular diseases, business.industry, medicine.disease, Ventricle, Two dimensional strain, business
Abstract

OBJECTIVES: To detect right ventricular myocardial function in dilated cardiomyopathy (DCM) using two-dimensional strain echocardiography (2DSE) and to evaluate the relationship between right ventricular dysfunction and response to cardiopulmonary exercise test (CPET). METHODS: Seventy-five DCM patients (44 idiopathic and 31 ischemic) without clinical signs of right ventricular failure underwent standard echo, 2DSE analysis of right ventricle and bicycle CPET. RESULTS: The two groups were comparable for clinical and standard two-dimensional echocardiographic and Doppler variables, except for right ventricular diameters that were mildly increased in patients with idiopathic DCM. Right ventricular global longitudinal strain (RV GLS) and regional peak myocardial right ventricular strain were significantly impaired in patients with idiopathic DCM compared with ischemic DCM (both P

Published
2011

38. Early impairment of myocardial function in systemic sclerosis: Non-invasive assessment by Doppler myocardial and strain rate imaging

Author

M. Scherillo, Antonello D'Andrea, Enrica Pezzullo, Nicola Tozzi, Francesco Moscato, Fortunato Scotto di Uccio, Raffaele Calabrò, Salvatore Bellissimo, Stefano Stisi, Francesco Vigorito, D'Andrea, A, Stisi, S, Bellissimo, S, Vigorito, F, SCOTTO DI UCCIO, F, Tozzi, N, Moscato, F, Pezzullo, E, Calabro', Raffaele, and Scherillo, M.

Subjects
Male, medicine.medical_specialty, Systole, Heart Ventricles, Hypertension, Pulmonary, Pulmonary Fibrosis, Diastole, Systemic scleroderma, Asymptomatic, Sensitivity and Specificity, Basal (phylogenetics), Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Autoantibodies, Echocardiography, Doppler, Pulsed, Lung, Ejection fraction, Scleroderma, Systemic, business.industry, Nuclear Proteins, Reproducibility of Results, Heart, General Medicine, Middle Aged, medicine.disease, medicine.anatomical_structure, DNA Topoisomerases, Type I, Strain rate imaging, Multivariate Analysis, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract

Aim of the present study was to analyze both left (LV) and right ventricular (RV) myocardial function in patients with Systemic Sclerosis (SSc), and their relation to other instrumental features of the disease.Twenty-five healthy subjects and 23 age- and sex-comparable asymptomatic patients classified as having either diffuse (11 patients) or limited form (12 patients) of SSc underwent clinical examination, serological tests, high-resolution chest-CT, standard Doppler echo, pulsed Doppler myocardial imaging (DMI) and strain rate imaging (SRI) of both LV and RV lateral walls. By chest-CT, 11 patients showed interstitial pulmonary fibrosis. Serological antibodies analysis detected anti-centromere pattern in 8 patients, and anti Scl-70 in 15 patients. LV diameters and ejection fraction were comparable between the two groups, while RV end-diastolic diameter was increased in SSc (p0.01). Tricuspid inflow E/A ratio was slightly decreased in SSc (p0.01), while systolic pulmonary pressure was increased (p0.001). Pulsed DMI detected in SSc impaired myocardial RV early-diastolic (Em) peak velocity (p0.0001), and prolonged myocardial time intervals at tricuspid annulus level. In SSc, peak systolic RV SR and strain were both reduced in basal, middle and apical RV lateral free walls, and in basal and middle LV lateral walls. By multivariate analysis, independent inverse association of RV peak Em velocity with both Rodnan Skin Score (p0.0005) and pulmonary systolic pressure (p0.0001), as well as independent inverse correlation of the same RV peak Em velocity with pulmonary fibrosis (0.0005) in SSc patients were observed. In addition, RV Em was an independent predictor of the anti Scl-70 antibody pattern (p0.001).Pulsed DMI and SRI are valuable non-invasive and easy-repeatable tools for detecting RV and LV myocardial involvement caused by SSc, and may therefore be useful to early identify patients with more diffused and severe form of SSc.

Published
2005

39. The Desmoplakin Phenotype Spectrum: Is the Inflammation the "Fil Rouge" Linking Myocarditis, Arrhythmogenic Cardiomyopathy, and Uncommon Autoinflammatory Systemic Disease?

Author

D'Elia S, Caputo A, Natale F, Pezzullo E, Limongelli G, Golino P, Cimmino G, and Loffredo FS

Subjects
Humans, Arrhythmias, Cardiac genetics, Arrhythmias, Cardiac pathology, Cardiomyopathy, Dilated genetics, Cardiomyopathy, Dilated pathology, Genetic Predisposition to Disease, Inflammation genetics, Inflammation pathology, Mutation, Phenotype, Desmoplakins genetics, Myocarditis genetics, Myocarditis pathology
Abstract

Myocarditis is an inflammatory condition of cardiac tissue presenting significant variability in clinical manifestations and outcomes. Its etiology is diverse, encompassing infectious agents (primarily viruses, but also bacteria, protozoa, and helminths) and non-infectious factors (autoimmune responses, toxins, and drugs), though often the specific cause remains unidentified. Recent research has highlighted the potential role of genetic susceptibility in the development of myocarditis (and in some cases the development of inflammatory dilated cardiomyopathy, i.e., the condition in which there is chronic inflammation (>3 months) and left ventricular dysfunction\dilatation), with several studies indicating a correlation between myocarditis and genetic backgrounds. Notably, pathogenic genetic variants linked to dilated or arrhythmic cardiomyopathy are found in 8-16% of myocarditis patients. Genetic predispositions can lead to recurrent myocarditis and a higher incidence of ventricular arrhythmias and heart failure. Moreover, the presence of DSP mutations has been associated with distinct pathological patterns and clinical outcomes in arrhythmogenic cardiomyopathy (hot phases). The interplay between genetic factors and environmental triggers, such as viral infections and physical stress, is crucial in understanding the pathogenesis of myocarditis. Identifying these genetic markers can improve the diagnosis, risk stratification, and management of patients with myocarditis, potentially guiding tailored therapeutic interventions. This review aims to synthesize current knowledge on the genetic underpinnings of myocarditis, with an emphasis on desmoplakin-related arrhythmogenic cardiomyopathy, to enhance clinical understanding and inform future research directions.

Published
2024
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40. Predictors of Plasma Levels of Direct Oral Anticoagulants Among Patients with Atrial Fibrillation in Need of Elective Cardiac Procedures.

Author

Russo V, Caiazza E, Femine FCD, Pezzullo E, Sarpa S, Ianniciello A, Alfredo C, D'Andrea A, Golino P, and Nigro G

Abstract

Background: The withdrawal timing of direct oral anticoagulants (DOACs) among patients in need of elective invasive surgery is based on DOAC pharmacokinetics in order to perform the procedure out of the DOAC peak plasma concentration. We aimed to investigate the prevalence and predictors of plasma levels of DOACs out of trough range in patients with atrial fibrillation (AF) in need of elective cardiac procedure., Materials and Methods: We evaluated all consecutive AF patients on DOAC therapy in need of elective cardiac procedure, admitted to our division from January 2022 to March 2022. All patients underwent DOAC plasma dosing the morning of procedure day. They were categorized as in range, above range, and below range, according to the DOAC reference range at the downstream point. The timing of discontinuation of DOAC therapy was considered as appropriate or not, according to the current recommendations. The clinical predictors of out-of-range DOAC plasma levels have been evaluated., Results: We included 90 consecutive AF patients (56.6% male, mean age 72.95 ± 10.12 years); 74 patients (82.22%) showed DOAC concentration out of the expected reference range. In half of them (n, 37), the DOAC plasma concentration was below the trough reference range. Of the study population, 17.7% received inappropriate DOAC dosages (10% overdosing, 7% underdosing), and 35.5% had incorrect timing of DOAC withdrawal (26% prolonged, 9.5% shortened). At multivariable analysis, inappropriate longer DOAC withdrawal period (OR 10.13; P ≤ 0.0001) and increased creatinine clearance (OR 1.01; P = 0.0095) were the independent predictors of plasma DOAC levels below the therapeutic trough range. In contrast, diabetes mellitus (OR 4.57; P = 0.001) was the only independent predictor of DOAC plasma level above the therapeutic trough range., Conclusion: Increased creatinine clearance and inappropriate longer drug withdrawal period are the only independent predictors of DOAC plasma levels below the reference range; in contrast, diabetes is significantly correlated with DOAC plasma levels above the reference., (© 2024. The Author(s).)

Published
2024
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41. Catch the Cath or Not? A Hamletic Dilemma after 10 Years.

Author

Natale F, Raucci G, Molinari R, Alfieri R, D'Arienzo D, Pezzullo E, Loffredo FS, Golino P, and Cimmino G

Abstract

In the last few years, a tremendous advancement has been made in the therapeutical management of several diseases with an increasing need for parental drug administration. To avoid repeated venous insertions and the patient's anxiety related to these procedures, it is now common practice to insert a catheter to leave it in place for a longer time. However, these procedures may generate some complications, such as failure of insertion, embolization, and infection. Different noninvasive techniques have been proposed and used for the retrieval of lost or misplaced foreign objects. Here, we presented a case of the lost fragmented catheter in a young female who underwent a central venous catheter insertion 10 years ago, incidentally detected during an echocardiographic examination. Here, we presented a case of a lost fragmented catheter in a young female who underwent a central venous catheter insertion 10 years before., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Cardiovascular Echography.)

Published
2023
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42. Improvement of Global Longitudinal Strain and Myocardial Work in Type 2 Diabetes Patients on Sodium-Glucose Cotransporter 2 Inhibitors Therapy.

Author

Russo V, Malvezzi Caracciolo D'Aquino M, Caturano A, Scognamiglio G, Pezzullo E, Fabiani D, Del Giudice C, Carbone A, Bottino R, Caso V, Nigro G, Golino P, Liccardo B, and D'Andrea A

Subjects
Humans, Male, Female, Stroke Volume, Ventricular Function, Left, Sodium-Glucose Transporter 2 pharmacology, Sodium-Glucose Transporter 2 therapeutic use, Global Longitudinal Strain, Glucose, Sodium, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 drug therapy, Ventricular Dysfunction, Left
Abstract

Abstract: Sodium-glucose cotransporter 2 inhibitors (SGLT2-i) are a novel class of oral hypoglycemic agents currently used among patients with type 2 diabetes mellitus (T2DM). The effects of SGLT2-i inhibitors on cardiac structure and function are not fully understood. The aim of this study is to evaluate the echocardiographic changing among patients with well-controlled T2DM treated with SGLT2-i in real-world setting. Thirty-five well-controlled T2DM patients (65 ± 9 years, 43.7% male) with preserved left ventricular ejection fraction (LVEF) and 35 age and sex-matched controls were included. T2DM patients underwent clinical and laboratory evaluation; 12-lead surface electrocardiogram; 2-dimensional color Doppler echocardiography at enrolment, before SGLT2-i administration, and at 6 months follow-up after an uninterrupted 10 mg once daily of empagliflozin (n: 21) or dapagliflozin (n: 14). Standard echocardiographic measurements, LV global longitudinal strain (LV-GLS), global wasted work, and global work efficiency were calculated. T2DM patients showed higher E\E' ratio (8.3 ± 2.5 vs. 6.3 ± 0.9; P < 0.0001 ) and lower LV-GLS (15.8 ± 8.1 vs. 22.1 ± 1.4%; P < 0.0001 ) and global myocardial work efficiency (91 ± 4 vs. 94 ± 3%; P: 0.0007 ) compared with age and sex-matched controls. At 6-month follow-up, T2DM patients showed a significant increase in LVEF (58.9 ± 3.2 vs. 62 ± 3.2; P < 0.0001 ), LV-GLS (16.2 ± 2.8 vs. 18.7 ± 2.4%; P = 0.003 ), and global work efficiency (90.3 ± 3.5 vs. 93.3 ± 3.2%; P = 0.0004 ) values; conversely, global wasted work values (161.2 ± 33.6 vs. 112.72 ± 37.3 mm Hg%; P < 0.0001 ) significantly decreased. Well-controlled T2DM patients with preserved LVEF who are treated with a SGLT2-i on top of the guidelines direct medical therapy showed a favorable cardiac remodeling, characterized by the improvement of LV-GLS and myocardial work efficiency., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2023
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43. Fulminant Myocarditis Unmasking Adult-Onset Still's Disease and Desmoplakin Truncation.

Author

Catapano D, Tontodonato M, D'Elia S, Pezzullo E, Ciaramella F, Vettori S, Bussani R, Ciucci G, Collesi C, Sinagra G, Golino P, and Loffredo FS

Subjects
Adult, Humans, Desmoplakins genetics, Still's Disease, Adult-Onset complications, Still's Disease, Adult-Onset diagnosis, Still's Disease, Adult-Onset drug therapy, Myocarditis diagnostic imaging
Abstract

Competing Interests: Disclosures None.

Published
2023
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44. A pitfall in the echographic diagnosis of abdominal aortic aneurysm: when para-aortic lymph nodes are the trick.

Author

Natale F, Molinari R, Covino S, Alfieri R, Limatola M, De Luca L, Pezzullo E, Izzo A, and Cimmino G

Subjects
Humans, Abdomen, Ultrasonography, Lymph Nodes diagnostic imaging, Aortic Aneurysm, Abdominal diagnostic imaging, Aortic Aneurysm, Abdominal complications
Abstract

The abdominal aortic aneurysm (AAA) is a potentially fatal asymptomatic disease. It progresses silently with clinical complications that, when they occur, constitute a very serious event, frequently resulting in the patient's exitus. As a result, early detection and treatment are critical because the right therapeutic strategy can halt the disease's natural progression. AAA is frequently discovered as an incidental finding during an abdominal ultrasound or a plain X-ray of the abdomen, which is required for other pathologies. The primary diagnostic tool for AAA identification is abdominal B-mode ultrasound. It is cheap, widely available, non-invasive, and has high diagnostic sensitivity. However, this diagnostic tool may fail in rare cases due to misleading anatomical findings. We present an unusual flaw in the echographic AAA evaluation that should be considered during the diagnostic work-up.

Published
2023
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46. Long-term proactive management of psoriasis with calcipotriol and betamethasone dipropionate foam: an Italian consensus through a combined nominal group technique and Delphi approach.

Author

De Simone C, Dapavo P, Malagoli P, Martella A, Campanati A, Campione E, Errichetti E, Franchi C, Gambardella A, Megna M, Osti F, Ribero S, Zagni G, Calzavara-Pinton P, Fabbrocini G, Amoruso GF, Baglieri F, Biamonte AS, Bianchelli T, Bigi L, Bortoli J, Brunetti B, Buligan C, Cagni E, Calderoni O, Calzavara-Pinton P, Campanati A, Caputo A, Carrera CG, Carugno A, Chersi K, Cicchelli S, De Natale F, De Simone C, Dapavo P, Di Maria D, Errichetti E, Fabbrocini G, Ferrari AS, Fogli E, Forconi R, Franchi C, Galeazzi A, Gambardella A, Giovannini A, Giura MT, Iuculano M, Lazzaretti G, Leporati C, Magnanini M, Malagoli P, Marconi B, Martella A, Maruccia A, Megna M, Miglietta R, Minuti A, Mocci L, Modica S, Narcisi A, Odorici G, Osti F, Pazzaglia M, Peila R, Pertusi G, Pezza M, Pezzullo E, Puccia N, Raulo U, Ribero S, Rossi M, Rusignuolo S, Sapienza G, Savarese C, Scalisi M, Strippoli D, Stroppiana E, Tiberio R, Trischitta A, Tucci MG, Vaira F, Verrone A, Villa L, Zagni F, and Zoccali A

Subjects
Humans, Consensus, Betamethasone, Aerosols, Treatment Outcome, Recurrence, Drug Combinations, Dermatologic Agents therapeutic use, Psoriasis drug therapy
Abstract

Background: Although long-term management of psoriasis is paramount, this approach is challenging in clinical practice. In the recent PSO-LONG trial, a fixed-dose combination of betamethasone dipropionate (BD) and calcipotriol (Cal) foam applied twice a week on non-consecutive days for 52 weeks (proactive treatment) reduced the risk of relapse. However, the role of Cal/BD foam in the long-term management of psoriasis needs further clarifications. The ProActive Management (PAM) program, a nationwide Italian project, aims at reaching a consensus on the role of proactive management of psoriasis., Methods: A steering committee generated some statements through the nominal group technique (NGT). The statements were voted by an expert panel in an adapted Delphi voting process., Results: Eighteen statements were proposed, and the majority of them (14/18) reached a consensus during the Delphi voting. The need to provide long-term proactive topical treatment to reduce the risk of relapse for the treatment of challenging diseases sites or in patients where phototherapy or systemic therapies are contraindicated/ineffective was widely recognized. A consensus was reached about the possibility to associate the proactive treatment with systemic and biological therapies, without the need for dose intensification, thus favoring a prolonged remission. Moreover, the proactive treatment was recognized as more effective than weekend therapy in increasing time free from relapses. Approaches to improve adherence, on the other hand, need further investigation., Conclusions: The inclusion in guidelines of a proactive strategy among the effective treatment options will be a fundamental step in the evolution of a mild-moderate psoriasis therapeutic approach., (© 2022 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)

Published
2022
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47. Non Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients Scheduled for Electrical Cardioversion: A Real-Life Propensity Score Matched Study.

Author

Rago A, Pezzullo E, Malvezzi Caracciolo d'Aquino M, Scognamiglio G, Caso VM, Martone F, Attena E, Parisi V, D'Onofrio A, Golino P, Nigro G, and Russo V

Abstract

Aim: The aim of the present study was to assess the safety and effectiveness of non-vitamin K antagonist oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) in atrial fibrillation (AF) patients undergoing electrical cardioversion (EC)., Methods: A propensity score-matched analysis was performed in order to identify two homogeneous groups including AF patients on NOACs and VKAs treatment scheduled for EC. The primary safety endpoint was major bleeding. The composite of stroke, transient ischemic attack (TIA) and systemic embolism (SE) was the primary effectiveness endpoint. The discontinuation rate of anticoagulant therapy was assessed., Results: A total of 495 AF patients on NOACs therapy and scheduled for EC were compared to 495 VKAs recipients. No statistically significant differences in the incidence of both major bleeding (1.01% versus 1.4%; P = 0.5) and thromboembolic events (0.6% versus 0.8%; P = 0.7) were observed during a mean follow-up of 15 ± 3 months. The discontinuation rate of NOACs was significantly lower compared to VKAs (1.6% versus 3.6%, P =0.04)., Conclusion: We showed a safe and effective clinical profile of NOACs among AF patients scheduled for electrical cardioversion in real-life setting. Patients on NOACs therapy showed a lower discontinuation rate compared to those on VKAs., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Rago et al.)

Published
2021
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48. Sex-specific echocardiographic reference values: the women's point of view.

Author

Petitto M, Esposito R, Sorrentino R, Lembo M, Luciano F, De Roberto AM, La Mura L, Pezzullo E, Maffei S, Galderisi M, and Lancellotti P

Subjects
Adult, Age Factors, Cardiovascular Diseases physiopathology, Female, Heart Ventricles physiopathology, Humans, Male, Middle Aged, Predictive Value of Tests, Reference Values, Sex Factors, Young Adult, Cardiovascular Diseases diagnostic imaging, Echocardiography, Doppler standards, Echocardiography, Three-Dimensional standards, Heart Ventricles diagnostic imaging, Myocardial Contraction, Stroke Volume, Ventricular Function, Left, Women's Health
Abstract

: Clinical presentation, diagnosis and outcomes of cardiac diseases are influenced by the activity of sex steroid hormones. These hormonal differences explain the later development of heart diseases in women in comparison with men and the different clinical picture, management and prognosis. Echocardiography is a noninvasive and easily available technique for the analysis of cardiac structure and function. The aim of the present review is to underline the most important echocardiographic differences between sexes. Several echocardiographic studies have found differences in healthy populations between women and men. Sex-specific difference of some of these parameters, such as left ventricular (LV) linear dimensions and left atrial volume, can be explained on the grounds of smaller body size of women, but other parameters (LV volumes, stroke volume and ejection fraction, right ventricular size and systolic function) are specifically lower in women, even after adjusting for body size and age. Sex-specific differences of standard Doppler and Tissue Doppler diastolic indices remain controversial, but it is likely for aging to affect LV diastolic function more in women than in men. Global longitudinal strain appears to be higher in women during the childbearing age - a finding that also highlights a possible hormonal influence in women. All these findings have practical implications, and sex-specific reference values are necessary for the majority of echocardiographic parameters in order to distinguish normalcy from disease. Careful attention on specific cut-off points in women could avoid misinterpretation, inappropriate management and delayed treatment of cardiac diseases such as valvular disease and heart failure.

Published
2018
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49. The impact of age and gender on right ventricular diastolic function among healthy adults.

Author

D'Andrea A, Vriz O, Carbone A, Ferrara F, Di Maio M, Cocchia R, Tagliamonte G, Acri E, Driussi C, Pezzullo E, Citro R, Cittadini A, Calabrò R, Giovanna Russo M, and Bossone E

Subjects
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Cohort Studies, Echocardiography, Female, Heart Atria diagnostic imaging, Humans, Male, Middle Aged, Reference Values, Sex Factors, Systole, Young Adult, Diastole physiology, Heart Ventricles diagnostic imaging, Ventricular Function, Right physiology
Abstract

Background: Doppler echocardiography is ideally suited for assessment of diastolic function, being widely available, non-invasive, and less expensive than other techniques. However, data regarding age- and gender-matched reference values of right ventricular diastolic function are limited. This study aims to explore the physiologic variations of right ventricle (RV) diastolic function in a large cohort of healthy adults, and to investigate clinical and echocardiographic correlates., Methods: From June 2007 to February 2014, 1168 healthy Caucasian subjects [mean age 45.1±15.6 years, range 16-92; 555 (47.5%) men] underwent comprehensive transthoracic echocardiography (TTE) following current guidelines. The following RV main diastolic measurements were measured: peak early inflow velocity (E), annular both early (e') and atrial (a') velocities, E/e' ratio., Results: RV E/e' constantly increases with age in females, but do not change substantially in males. RV E/A constantly decreases with age in both genders. Stepwise multiple linear regression analysis underlined a close significant association of RV diastolic function with both right and left heart morphologic measurements (right atrial area, RV diameters, left atrial volume) and functional indexes (TAPSE, RV tissue Doppler peak systolic velocity, left ventricular E/Ee'), as well as with indexes of increased pulmonary resistance., Conclusion: Our data highlight the potential usefulness of different normal reference values according to the age and gender to correctly evaluate RV diastolic function. Differences in terms of demographic and anthropometric parameters could be useful to avoid potential misclassification of RV diastolic function when based on dichotomously suggested normal cut-off values., (Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)

Published
2017
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50. Cardiac damage in athlete's heart: When the "supernormal" heart fails!

Author

Carbone A, D'Andrea A, Riegler L, Scarafile R, Pezzullo E, Martone F, America R, Liccardo B, Galderisi M, Bossone E, and Calabrò R

Abstract

Intense exercise may cause heart remodeling to compensate increases in blood pressure or volume by increasing muscle mass. Cardiac changes do not involve only the left ventricle, but all heart chambers. Physiological cardiac modeling in athletes is associated with normal or enhanced cardiac function, but recent studies have documented decrements in left ventricular function during intense exercise and the release of cardiac markers of necrosis in athlete's blood of uncertain significance. Furthermore, cardiac remodeling may predispose athletes to heart disease and result in electrical remodeling, responsible for arrhythmias. Athlete's heart is a physiological condition and does not require a specific treatment. In some conditions, it is important to differentiate the physiological adaptations from pathological conditions, such as hypertrophic cardiomyopathy, arrhythmogenic dysplasia of the right ventricle, and non-compaction myocardium, for the greater risk of sudden cardiac death of these conditions. Moreover, some drugs and performance-enhancing drugs can cause structural alterations and arrhythmias, therefore, their use should be excluded., Competing Interests: Conflict-of-interest statement: No potential conflicts of interest exist.

Published
2017
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