61 results on '"S Del Pace"'
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2. Prognostic impact of cerebral embolism in patients with active infective endocarditis and therapeutic strategies. A retrospective real world study in a surgical centre
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V Scheggi, S Menale, B Tonietti, J Giovacchini, C Bigiarini, S Del Pace, N Zoppetti, B Alterini, P L Stefano, and N Marchionni
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Cardiology and Cardiovascular Medicine - Abstract
Purpose Infective endocarditis still has high mortality and invalidating complications, such as cerebral embolism. The best strategies to prevent and to manage neurologic complications remain uncertain. This study aimed to identify predictors of septic cerebral embolism and to evaluate the role of surgery in these patients, in a real-world surgical center. Methods We retrospectively analyzed 551 consecutive patients admitted to our department with a definite diagnosis of non-device-related infective endocarditis; of these, 126 (23%) presented a neurologic complication. Results Cerebral embolism was significantly more frequent in patients with large vegetations (p=0.001), mitral valve infection (p=0.001), and Staphylococcus aureus infection (p=0.025). At multivariable analysis, only vegetation length was an independent predictor of cerebral embolism (HR 1.057, 95% CI 1.025–1.091, p 0.001), with a best predictive threshold of 10 mm at ROC curve analysis (AUC 0.54, p=0.001). Patients with neurologic complications were more often excluded from surgery despite an indication to it (16% vs 8%, p=0.001). If eligible, they were treated within two weeks from diagnosis in similar proportion as patients without cerebral embolism with similar survival rate. Predictors of mortality were hemorrhagic lesions (p=0.018), a GCS Conclusions The present study highlights the prognostic value of clinical functional presentation and the safety of cardiac surgery, when feasible, in patients with septic cerebral embolism. Funding Acknowledgement Type of funding sources: None.
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- 2022
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3. P293 MULTI–DIMENSIONAL EVALUATION IN PATIENTS WITH AORTIC STENOSIS CANDIDATE FOR CARDIAC SURGERY
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F Bonanni, S Caciolli, M Berteotti, A Grasso Granchietti, N Cenni, V Tozzetti, E Marchi, M Bandini, C Servoli, G Grandi, S Del Pace, M Gabriele, and P Stefano
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Cardiology and Cardiovascular Medicine - Abstract
In patients with severe aortic stenosis, the presence of left ventricular systolic dysfunction is one of the main predictors of adverse events after valve replacement surgery. However, more and more patients are being referred for surgery early and have preserved systolic function at the time of surgery. Within this category, global longitudinal strain (GLS) has been proposed as a marker of ventricular remodeling after cardiac surgery. Our study aims to identify the variation of Global longitudinal strain (GLS) in patients undergoing aortic valve replacement and any differences compared to classes of diastolic dysfunction. Methods From June 2020 to June 2022 we analyzed patients with severe aortic stenosis with an indication for cardiac surgery treatment admitted to the cardiac surgery department of our AOU. All patients underwent an echocardiogram immediately before surgery and in the early postoperative period (mean 7 days). In all cases, the GLS of the left ventricle was calculated and patients were divided into four classes according to the degree of diastolic dysfunction (0–III) according to the most recent international guidelines. The data were analyzed with SPSS 28 software. Analysis of variance was performed with a t–test and ANOVA test. Results In the final analysis, 63 patients were included, with a mean age of 70.5±8.2%, of whom 28 were women (44.4%) and 35 were men (55.6%). In 12 patients (19%) ischaemic heart disease with an indication for coronary revascularization was also present. The mean preoperative ejection fraction was 59±9.5%. The mean GLS values before surgery were 15.26±4.3% vs. early postoperative 12.52±2.6%, p Conclusions In our case series, patients with severe aortic stenosis undergoing aortic valve replacement with or without myocardial revascularization show a significant early reduction in GLS regardless of the degree of diastolic dysfunction. An extension of follow–up is needed to assess any differences in the intervention‘s benefit in different diastolic dysfunction subgroups.
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- 2023
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4. Characteristics, management, and outcomes of patients with left-sided infective endocarditis complicated by heart failure:a substudy of the ESC-EORP EURO-ENDO (European infective endocarditis) registry
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Bohbot, Yohann, Habib, Gilbert, Laroche, Cécile, Stöhr, Elisabeth, Chirouze, Catherine, Hernandez-Meneses, Marta, Melissopoulou, Maria, Mutlu, Bülent, Scheggi, Valentina, Branco, Luísa, Olmos, Carmen, Reyes, Graciela, Pazdernik, Michal, Iung, Bernard, Sow, Rouguiatou, Mirocevic, Maja, Lancellotti, Patrizio, Tribouilloy, Christophe, P Gale, C, Beleslin, B, Budaj, A, Chioncel, O, Dagres, N, Danchin, N, Emberson, J, Erlinge, D, Glikson, M, Gray, A, Kayikcioglu, M, P Maggioni, A, K Nagy, V, Nedoshivin, A, A-S, Petronio, Roos-Hesselink, J, Wallentin, L, Zeymer, U, Habib, G, Lancellotti, P, Cosyns, B, Donal, E, Erba, P, Iung, B, A Popescu, B, Prendergast, B, Tornos, P, Andarala, M, Berle, C, Brunel-Lebecq, A, Fiorucci, E, Laroche, C, Missiamenou, V, Taylor, C, N Ali Tatar-Chentir, N, Al-Mallah, M, M Astrom Aneq, Athanassopoulos, G, P Badano, L, Benyoussef, S, E Calderon Aranda, M Cardim, N, K-L, Chan, Cruz, I, Edvardsen, T, Goliasch, G, Hagendorff, A, Hristova, K, Kamp, O, D-H, Kang, Kong, W, Matskeplishvili, S, Meshaal, M, Mirocevic, M, N Neskovic, A, Pazdernik, M, Plonska-Gosciniak, E, Raissouni, M, Ronderos, R, E Sade, L, Sadeghpour, A, Sambola, A, Sengupta, S, Separovic-Hanzevacki, J, Takeuchi, M, Tucay, E, C Tude Rodrigues, A, Varga, A, Vaskelyte, J, Yamagata, K, Yiangou, K, Zaky, H, Granada, I, Mahia, M, Ressi, S, Nacinovich, F, Iribarren, A, P Fernandez Oses, Avegliano, G, Filipini, E, Obregon, R, Bangher, M, Dho, J, Cartasegna, L, L Plastino, M, Novas, V, Shigel, C, Reyes, G, M De Santos, Gastaldello, N, M Granillo Fernandez, Potito, M, Streitenberger, G, Velazco, P, H Casabé, J, Cortes, C, Guevara, E, Salmo, F, Seijo, M, Weidinger, F, Heger, M, Brooks, R, Stöllberger, C, C-Y, Ho, Perschy, L, Puskas, L, Binder, C, Rosenhek, R, Schneider, M, M-P, Winter, Hoffer, E, Melissopoulou, M, Lecoq, E, Legrand, D, Jacquet, S, Massoz, M, Pierard, L, Marchetta, S, Dulgheru, R, D'Emal, C, Oury, C, Droogmans, S, Kerkhove, D, Plein, D, Soens, L, Weytjens, C, Motoc, A, Roosens, B, Lemoine, I, Rodrigus, I, Paelinck, B, Amsel, B, Unger, P, Konopnicki, D, Beauloye, C, Pasquet, A, L Vanoverschelde, J, Pierard, S, Vancraeynest, D, Sinnaeve, F, L Andrade, J, Staszko, K, R Dos Santos Monteiro, H Miglioranza, M, L Shuha, D, Alcantara, M, Cravo, V, Fazzio, L, Felix, A, Iso, M, Musa, C, P Siciliano, A, F Villaca Filho, Rodrigues, A, Vilela, F, Braga, J, Silva, R, Rodrigues, D, Silva, L, Morhy, S, Fischer, C, Vieira, M, Afonso, T, Abreu, J, N Falcao, S, A Moises, V, Gouvea, A, J Mancuso, F, C Souza, A, Y Silva, C, João, G, S Abboud, C, R Bellio de Mattos Barretto, Ramos, A, Arnoni, R, E Assef, J, J Della Togna, D, D Le Bihan, Miglioli, L, P Romero Oliveira, A, R Tadeu Magro Kroll, Cortez, D, L Gelape, C, M D, C Peirira Nunes, C De Abreu Ferrari, T, Hay, K, V, Le, Page, M, Poulin, F, Sauve, C, Serri, K, Mercure, C, Beaudoin, J, Pibarot, P, A Sebag, I, G Rudski, L, Ricafort, G, Barsic, B, Krajinovic, V, Vargovic, M, Lovric, D, Reskovic-Luksic, V, Vincelj, J, S Jaksic Jurinjak, Yiannikourides, V, Ioannides, M, Pofaides, C, Masoura, V, Pudich, J, Linhart, A, Siranec, M, Marek, J, Blechova, K, Kamenik, M, Pelouch, R, Coufal, Z, Mikulica, M, Griva, M, Jancova, E, Mikulcova, M, Taborsky, M, Precek, J, Jecmenova, M, Latal, J, Widimsky, J, Butta, T, Machacek, S, Vancata, R, Spinar, J, Holicka, M, F Pow Chon Long, Anzules, N, A Bajana Carpio, Largacha, G, Penaherrera, E, Moreira, D, Mahfouz, E, Elsafty, E, Soliman, A, Zayed, Y, Aboulenein, J, Abdel-Hay, M, Almaghraby, A, Abdelnaby, M, Ahmed, M, Hammad, B, Saleh, Y, Zahran, H, Elgebaly, O, Saad, A, Ali, M, Zeid, A, R El Sharkawy, A Al Kholy, Doss, R, Osama, D, Rizk, H, Elmogy, A, Mishriky, M, Assayag, P, S El Hatimi, Hubert, S, J-P, Casalta, Gouriet, F, Arregle, F, Cammilleri, S, Tessonnier, L, Riberi, A, Botelho-Nevers, E, Gagneux-Brunon, A, Pierrard, R, Tulane, C, Campisi, S, J-F, Fuzellier, Detoc, M, Mehalla, T, Boutoille, D, S Lecompte, A, Lefebvre, M, Pattier, S, O Al Habash, Asseray-Madani, N, Biron, C, Brochard, J, Caillon, J, Cueff, C, T Le Tourneau, Lecomte, R, M Magali Michel, M, Orain, J, Delarue, S, M Le Bras, J-F, Faucher, Aboyans, V, Beeharry, A, Durox, H, Lacoste, M, Magne, J, Mohty, D, David, A, Pradel, V, Sierra, V, Neykova, A, Bettayeb, B, Elkentaoui, S, Tzvetkov, B, Landry, G, Strady, C, Ainine, K, Baumard, S, Brasselet, C, Tassigny, C, Valente-Pires, V, Lefranc, M, Hoen, B, Lefevre, B, Curlier, E, Callier, C, Fourcade, N, Jobic, Y, Ansard, S, R Le Berre, F Le Ven, M-C, Pouliquen, Prat, G, P Le Roux, Bouchart, F, Savoure, A, Alarcon, C, Chapuzet, C, Gueit, I, Tribouilloy, C, Bohbot, Y, Peugnet, F, Gun, M, Duval, X, Lescure, X, Ilic-Habensus, E, Sadoul, N, Selton-Suty, C, Alla, F, Goehringer, F, Huttin, O, Chevalier, E, Garcia, R, V Le Marcis, Tattevin, P, Flecher, E, Revest, M, Chirouze, C, Bouiller, K, Hustache-Mathieu, L, Klopfenstein, T, Moreau, J, Fournier, D, A-S, Brunel, Lim, P, Oliver, L, Ternacle, J, Moussafeur, A, Chavanet, P, Piroth, L, Salmon-Rousseau, A, Buisson, M, Mahy, S, Martins, C, Gohier, S, Axler, O, Baumann, F, Lebras, S, Piper, C, Guckel, D, Börgermann, J, Horstkotte, D, Winkelmann, E, Brockmeier, B, Grey, D, Nickenig, G, Schueler, R, Öztürk, C, Stöhr, E, Hamm, C, Walther, T, Brandt, R, A-C, Frühauf, T Hartung, C, Hellner, C, Wild, C, Becker, M, Hamada, S, Kaestner, W, Stangl, K, Knebel, F, Baldenhofer, G, Brecht, A, Dreger, H, Isner, C, Pfafflin, F, Stegemann, M, Zahn, R, Fraiture, B, Kilkowski, C, A-K, Karcher, Klinger, S, Tolksdorf, H, Tousoulis, D, Aggeli, C, Sideris, S, Venieri, E, Sarri, G, Tsiapras, D, Armenis, I, Koutsiari, A, Floros, G, Grassos, C, Dragasis, S, Rallidis, L, Varlamos, C, Michalis, L, Naka, K, Bechlioulis, A, Kotsia, A, Lakkas, L, Pappas, K, Papadopoulos, C, Kiokas, S, Lioni, A, Misailidou, S, Barbetseas, J, Bonou, M, Kapelios, C, Tomprou, I, Zerva, K, Manolis, A, Hamodraka, E, Athanasiou, D, Haralambidis, G, Samaras, H, Poulimenos, L, Nagy, A, Bartykowszki, A, Gara, E, Mungulmare, K, Kasliwal, R, Bansal, M, Ranjan, S, Bhan, A, Kyavar, M, Maleki, M, F Noohi Bezanjani, Alizadehasl, A, Boudagh, S, Ghavidel, A, Moradnejad, P, R Pasha, H, Ghadrdoost, B, Gilon, D, Strahilevitz, J, Wanounou, M, Israel, S, D'Agostino, C, Colonna, P, L De Michele, Fumarola, F, Stante, M, Marchionni, N, Scheggi, V, Alterini, B, S Del Pace, Stefano, P, Sparano, C, Ruozi, N, Tenaglia, R, Muraru, D, Limbruno, U, Cresti, A, Baratta, P, Solari, M, Giannattasio, C, Moreo, A, B De Chiara, B Lopez Montero, Musca, F, A Orcese, C, Panzeri, F, Spano, F, F Russo, C, Alfieri, O, M De Bonis, Chiappetta, S, B Del Forno, Ripa, M, Scarpellini, P, C Tassan Din, Castiglioni, B, Pasciuta, R, Carletti, S, Ferrara, D, Guffanti, M, Iaci, G, Lapenna, E, Nisi, T, Oltolini, C, Busnardo, E, Pajoro, U, Agricola, E, Meneghin, R, Schiavi, D, Piscione, F, Citro, R, M Benvenga, R, Greco, L, Soriente, L, Radano, I, Prota, C, Bellino, M, D Di Vece, Santini, F, Salsano, A, M Olivieri, G, Turrini, F, Messora, R, Tondi, S, Olaru, A, Agnoletto, V, Grassi, L, Leonardi, C, Sansoni, S, S Del Ponte, M Actis Dato, G, A De Martino, Ohte, N, Kikuchi, S, Wakami, K, Aonuma, K, Seo, Y, Ishizu, T, Machino-Ohtsuka, T, Yamamoto, M, Iida, N, Nakajima, H, Nakagawa, Y, Izumi, C, Amano, M, Miyake, M, Takahashi, K, Shiojima, I, Miyasaka, Y, Maeba, H, Suwa, Y, Taniguchi, N, Tsujimoto, S, Kitai, T, Ota, M, Yuda, S, Sasaki, S, Hagiwara, N, Yamazaki, K, Ashihara, K, Arai, K, Saitou, C, Saitou, S, Suzuki, G, Shibata, Y, Watanabe, N, Nishino, S, Ashikaga, K, Kuriyama, N, Mahara, K, Okubo, T, Fujimaki, H, Shitan, H, Yamamoto, H, Abe, K, Terada, M, Takanashi, S, Sata, M, Yamada, H, Kusunose, K, Saijo, Y, Seno, H, Yuichiro, O, Onishi, T, Sera, F, Nakatani, S, Mizuno, H, Sengoku, K, W Park, S, K Eun Kyoung, L Ga Yeon, J-W, Hwang, Jin-Oh, C, S-J, Park, Sang-Chol, L, Sung-A, C, Y Jang, S, Heo, R, Lee, S, J-M, Song, Jung, E, Plisiene, J, Dambrauskaite, A, Gruodyte, G, Jonkaitiene, R, Mizariene, V, Atkocaityte, J, Zvirblyte, R, Sow, R, Codreanu, 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Butt, M, F Khanzada, M, Saghir, T, Wahid, A, Hryniewiecki, T, Szymanski, P, Marzec, K, Misztal-Ogonowska, M, Kosmala, W, Przewlocka-Kosmala, M, Rojek, A, Woznicka, K, Zachwyc, J, Lisowska, A, Kaminska, M, D Kasprzak, J, Kowalczyk, E, F Strzecka, D, Wejner-Mik, P, Trabulo, M, Freitas, P, Ranchordas, S, Rodrigues, G, Pinto, P, Queiros, C, Azevedo, J, Marques, L, Seabra, D, Branco, L, Cruz, M, Galrinho, A, Moreira, R, Rio, P, T Timoteo, A, Selas, M, Carmelo, V, B Duque Neves, Pereira, H, Guerra, A, Marques, A, Pintassilgo, I, C Tomescu, M, N-M, Trofenciuc, Andor, M, Bordejevic, A, S Branea, H, Caruntu, F, A Velcean, L, Mavrea, A, F Onel, M, Parvanescu, T, Pop, D, L Pop-Moldovan, A, I Puticiu, M, Cirin, L, M Citu, I, A Cotoraci, C, Darabantiu, D, Farcas, R, Marincu, I, Ionac, A, Cozma, D, Mornos, C, Goanta, F, Popescu, I, Beyer, R, Mada, R, Rancea, R, Tomoaia, R, Rosianu, H, Stanescu, C, Kobalava, Z, Karaulova, J, Kotova, E, Milto, A, Pisaryuk, A, Povalyaev, N, Sorokina, M, Alrahimi, J, Elshiekh, A, Jamiel, A, Ahmed, A, Attia, N, Putnikovic, B, Dimic, A, Ivanovic, B, Matic, S, Trifunovic, D, Petrovic, J, Kosevic, D, Stojanovic, I, Petrovic, I, Dabic, P, Milojevic, P, Srdanovic, I, Susak, S, Velicki, L, Vulin, A, Kovacevic, M, Redzek, A, Stefanovic, M, C Yeo, T, W Kf Kong, K Poh, K, Vilacosta, I, Ferrera, C, Olmos, C, M Abd El-Nasser, F Calvo Iglesias, Blanco-Gonzalez, E, M Bravo Amaro, Lopez-Rodriguez, E, J Lugo Adan, N Germinas, A, Pazos-Lopez, P, M Pereira Loureiro, T Perez, M, Raposeiras-Roubin, S, S Rasheed Yas, M-M, Suarez-Varela, F Vasallo Vidal, Garcia-Dorado, D, Fernandez-Hidalgo, N, Gonzalez-Alujas, T, Lozano, J, Maisterra, O, Pizzi, N, Rios, R, Bayes-Genis, A, L Pedro Botet, Vallejo, N, Llibre, C, Mateu, L, Nunez, R, Quesada, D, Berastegui, E, D Bosch Portell, J Aboal Vinas, X Albert Bertran, R Brugada Tarradellas, P Loma-Osorio Ricon, C Tiron de Llano, A Arnau, M, Bel, A, Blanes, M, Osa, A, Anguita, M, Carrasco, F, C Castillo, J, L Zamorano, J, L Moya Mur, 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Amiens-Picardie, CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), EURObservational Research Programme, European Society of Cardiology, Careggi University Hospital [Florence, Italie], Hospital de Alta Complejidad El Cruce 'Nestor Kirchner', Florencio Varela, Buenos Aires, Centre Hospitalier Universitaire de Liège (CHU-Liège), Maria Cecilia Hospital [Cotignola], Anthea Hospital [Bari, Italy], Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Bohbot, Yohann, Habib, Gilbert, Laroche, Cécile, Stöhr, Elisabeth, Chirouze, Catherine, Hernandez-Meneses, Marta, Melissopoulou, Maria, Mutlu, Bülent, Scheggi, Valentina, Branco, Luísa, Olmos, Carmen, Reyes, Graciela, Pazdernik, Michal, Iung, Bernard, Sow, Rouguiatou, Mirocevic, Maja, Lancellotti, Patrizio, Tribouilloy, Christophe, Agricola, Eustachio, Cardiology, ACS - Heart failure & arrhythmias, Neurosurgery, Graduate School, Radiotherapy, ACS - Atherosclerosis & ischemic syndromes, Clinical sciences, Cardio-vascular diseases, Medical Imaging, Bohbot Y., Habib G., Laroche C., Stohr E., Chirouze C., Hernandez-Meneses M., Melissopoulou M., Mutlu B., Scheggi V., Branco L., et al., Bohbot, Y, Habib, G, Laroche, C, Stohr, E, Chirouze, C, Hernandez-Meneses, M, Melissopoulou, M, Mutlu, B, Scheggi, V, Branco, L, Olmos, C, Reyes, G, Pazdernik, M, Iung, B, Sow, R, Mirocevic, M, 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Aggeli, C, Sideris, S, Venieri, E, Sarri, G, Tsiapras, D, Armenis, I, Koutsiari, A, Floros, G, Grassos, C, Dragasis, S, Rallidis, L, Varlamos, C, Michalis, L, Naka, K, Bechlioulis, A, Kotsia, A, Lakkas, L, Pappas, K, Papadopoulos, C, Kiokas, S, Lioni, A, Misailidou, S, Barbetseas, J, Bonou, M, Kapelios, C, Tomprou, I, Zerva, K, Manolis, A, Hamodraka, E, Athanasiou, D, Haralambidis, G, Samaras, H, Poulimenos, L, Nagy, A, Bartykowszki, A, Gara, E, Mungulmare, K, Kasliwal, R, Bansal, M, Ranjan, S, Bhan, A, Kyavar, M, Maleki, M, Bezanjani, F, Alizadehasl, A, Boudagh, S, Ghavidel, A, Moradnejad, P, Pasha, H, Ghadrdoost, B, Gilon, D, Strahilevitz, J, Wanounou, M, Israel, S, D'Agostino, C, Colonna, P, De Michele, L, Fumarola, F, Stante, M, Marchionni, N, Alterini, B, Del Pace, S, Stefano, P, Sparano, C, Ruozi, N, Tenaglia, R, Muraru, D, Limbruno, U, Cresti, A, Baratta, P, Solari, M, Giannattasio, C, Moreo, A, De Chiara, B, Lopez Montero, B, Musca, F, Orcese, C, Panzeri, F, Spano, F, Russo, C, 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Fujimaki, H, Shitan, H, Yamamoto, H, Abe, K, Terada, M, Takanashi, S, Sata, M, Yamada, H, Kusunose, K, Saijo, Y, Seno, H, Yuichiro, O, Onishi, T, Sera, F, Nakatani, S, Mizuno, H, Sengoku, K, Park, S, Kyoung, K, Yeon, L, Hwang, J, Jin-Oh, C, Sang-Chol, L, Sung-A, C, Jang, S, Heo, R, Lee, S, Song, J, Jung, E, Plisiene, J, Dambrauskaite, A, Gruodyte, G, Jonkaitiene, R, Mizariene, V, Atkocaityte, J, Zvirblyte, R, Codreanu, A, Staub, T, Michaux, C, De la Vega, E, Jacobs-Orazi, L, Mallia Azzopardi, C, Xuereb, R, Piscopo, T, Farrugia, J, Fenech, M, Pllaha, E, Vella, C, Borg, D, Casha, R, Grib, L, Raevschi, E, Grejdieru, A, Kravcenco, D, Prisacari, E, Samohvalov, E, Samohvalov, S, Sceglova, N, Panfile, E, Cardaniuc, L, Corcea, V, Feodorovici, A, Gaina, V, Girbu, L, Jimbei, P, Balan, G, Cardaniuc, I, Benesco, I, Marian, V, Sumarga, N, Bozovic, B, Bulatovic, N, Lakovic, P, Music, L, Budde, R, Wahadat, A, Gamela, T, Meijers, T, Van Melle, J, Deursen, V, Crijns, H, Bekkers, S, Cheriex, E, Gilbers, M, Kietselaer, B, Knackstedt, C, Lorusso, R, Schalla, S, Streukens, S, Chamuleau, S, Cramer, M, Teske, A, Van der Spoel, T, Wind, A, Lokhorst, J, Liesbek, O, Van Heusden, H, Tanis, W, Van der Bilt, I, Vriend, J, De Lange-van Bruggen, H, Karijodikoro, E, Riezebos, R, van Dongen, E, Schoep, J, Stolk, V, Offstad, J, Beitnes, J, Helle-Valle, T, Skulstad, H, Skardal, R, Qamar, N, Furnaz, S, Ahmed, B, Butt, M, Khanzada, M, Saghir, T, Wahid, A, Hryniewiecki, T, Szymanski, P, Marzec, K, Misztal-Ogonowska, M, Kosmala, W, Przewlocka-Kosmala, M, Rojek, A, Woznicka, K, Zachwyc, J, Lisowska, A, Kaminska, M, Kasprzak, J, Kowalczyk, E, Strzecka, D, Wejner-Mik, P, Trabulo, M, Freitas, P, Ranchordas, S, Rodrigues, G, Pinto, P, Queiros, C, Azevedo, J, Marques, L, Seabra, D, Cruz, M, Galrinho, A, Moreira, R, Rio, P, Timoteo, A, Selas, M, Carmelo, V, Duque Neves, B, Pereira, H, Guerra, A, Marques, A, Pintassilgo, I, Tomescu, M, Trofenciuc, N, Andor, M, Bordejevic, A, Branea, H, Caruntu, F, Velcean, L, Mavrea, A, Onel, M, Parvanescu, T, Pop, D, Pop-Moldovan, A, Puticiu, M, Cirin, L, Citu, I, Cotoraci, C, Darabantiu, D, Farcas, R, Marincu, I, Ionac, A, Cozma, D, Mornos, C, Goanta, F, Popescu, I, Beyer, R, Mada, R, Rancea, R, Tomoaia, R, Rosianu, H, Stanescu, C, Kobalava, Z, Karaulova, J, Kotova, E, Milto, A, Pisaryuk, A, Povalyaev, N, Sorokina, M, Alrahimi, J, Elshiekh, A, Jamiel, A, Ahmed, A, Attia, N, Putnikovic, B, Dimic, A, Ivanovic, B, Matic, S, Trifunovic, D, Petrovic, J, Kosevic, D, Stojanovic, I, Petrovic, I, Dabic, P, Milojevic, P, Srdanovic, I, Susak, S, Velicki, L, Vulin, A, Kovacevic, M, Redzek, A, Stefanovic, M, Yeo, T, Poh, K, Vilacosta, I, Ferrera, C, Abd El- Nasser, M, Calvo Iglesias, F, Blanco-Gonzalez, E, Bravo Amaro, M, Lopez-Rodriguez, E, Lugo Adan, J, Germinas, A, Pazos-Lopez, P, Pereira Loureiro, M, Perez, M, Raposeiras-Roubin, S, Rasheed Yas, S, Suarez-Varela, M, Vasallo Vidal, F, Garcia-Dorado, D, Fernandez-Hidalgo, N, Gonzalez-Alujas, T, Lozano, J, Maisterra, O, Pizzi, N, Rios, R, Bayes-Genis, A, Pedro Botet, L, Vallejo, N, Llibre, C, Mateu, L, Nunez, R, Quesada, D, Berastegui, E, Bosch Portell, D, Aboal Vinas, J, Albert Bertran, X, Brugada Tarradellas, R, Loma-Osorio Ricon, P, Tiron de Llano, C, Arnau, M, Bel, A, Blanes, M, Osa, A, Anguita, M, Carrasco, F, Castillo, J, Zamorano, J, Moya Mur, J, Alvaro, M, Fernandez-Golfin, C, Monteagudo, J, Navas Elorza, E, Farinas Alvarez, M, Aguero Balbin, J, Zarauza, J, Gutierrez-Diez, J, Arminanzas, C, Arnaiz de las Revillas, F, Arnaiz Garcia, A, Cobo Belaustegui, M, Fernandez Sampedro, M, Gutierrez Cuadra, M, Garcia Cuello, L, Gonzalez Rico, C, Rodriguez-Alvarez, R, Goikoetxea, J, Montejo, M, Miro, J, Almela, M, Ambrosioni, J, Moreno, A, Quintana, E, Sandoval, E, Tellez, A, Tolosana, J, Vidal, B, Falces, C, Fuster, D, Garcia-de-la-Maria, C, Llopis, J, Marco, F, Ruiz-Zamora, I, Bardaji Ruiz, A, Sanz Girgas, E, Garcia-Pardo, G, Guillen Marzo, M, Rodriguez Oviedo, A, Villares Jimenez, A, Abid, L, 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Male ,Congestive heart failure ,Survival ,SURGERY ,IMPACT ,Hospital mortality ,Infective endocarditi ,Sağlık Bilimleri ,Cardiovascular ,Clinical Medicine (MED) ,Endocarditis, Bacterial/complications ,PROGNOSTIC-FACTORS ,KALP VE KALP DAMAR SİSTEMLERİ ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Early surgery ,Klinik Tıp (MED) ,Prospective Studies ,Registries ,PREDICTORS ,ComputingMilieux_MISCELLANEOUS ,Outcome ,RISK ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Klinik Tıp ,DEATH ,Middle Aged ,Tıp ,Heart Failure/complications ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Medicine ,Female ,EURO-ENDO ,Cardiology and Cardiovascular Medicine ,Kardiyoloji ,Kardiyoloji ve Kardiyovasküler Tıp ,NATIVE VALVE ENDOCARDITIS ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Endocarditis/complications ,Health Sciences ,Humans ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,Retrospective Studies ,Internal Medicine Sciences ,MORTALITY ,MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,Dahili Tıp Bilimleri ,ADULTS ,Infective endocarditis ,CLINICAL MEDICINE ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,CARDIAC & CARDIOVASCULAR SYSTEMS - Abstract
International audience; AIMS: To evaluate the current management and survival of patients with left-sided infective endocarditis (IE) complicated by congestive heart failure (CHF) in the ESC-EORP European Endocarditis (EURO-ENDO) registry. METHODS AND RESULTS: Among the 3116 patients enrolled in this prospective registry, 2449 (mean age: 60 years, 69% male) with left-sided (native or prosthetic) IE were included in this study. Patients with CHF (n~=~698, 28.5%) were older, with more comorbidity and more severe valvular damage (mitro-aortic involvement, vegetations >10\,mm and severe regurgitation/new prosthesis dehiscence) than those without CHF (all p\,≤q\,0.019). Patients with CHF experienced higher 30-day and 1-year mortality than those without (20.5% vs. 9.0% and 36.1% vs. 19.3%, respectively) and CHF remained strongly associated with 30-day (odds ratio[OR] 2.37, 95% confidence interval [CI] [1.73-3.24; p\,10\,mm, severe valvular regurgitation and/or new prosthetic dehiscence, perivalvular complication, and prosthetic IE (OR 0.22, 95% CI 0.12-0.38; p\
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- 2022
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5. Socio-Economic Variations Determine the Clinical Presentation, Aetiology and Outcome of Infective Endocarditis: a Prospective Cohort Study from the ESC-EORP EURO-ENDO (European Infective Endocarditis) Registry
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Sengupta, Shantanu P, Prendergast, Bernard, Laroche, Cécile, Furnaz, Shumaila, Ronderos, Ricardo, Almaghraby, Abdallah, Asch, Federico M, Blechova, Kamila, Zaky, Hosam, Strahilevitz, Jacob, Dworakowski, Rafal, Miyasaka, Yoko, Sebag, Igal, Izumi, Chisato, Axler, Olivier, Jamiel, Abdulrahman, Philip, Mary, Campos Vieira, Marcelo Luiz, Lancellotti, Patrizio, Habib, Gilbert, P Gale, C, Beleslin, B, Budaj, A, Chioncel, O, Dagres, N, Danchin, N, Emberson, J, Erlinge, D, Glikson, M, Gray, A, Kayikcioglu, M, P Maggioni, A, K Nagy, V, Nedoshivin, A, A-S, Petronio, Roos-Hesselink, J, Wallentin, L, Zeymer, U, Habib, G, Lancellotti, P, Cosyns, B, Donal, E, Erba, P, Iung, B, A Popescu, B, Prendergast, B, Tornos, P, Andarala, M, Berle, C, Brunel-Lebecq, A, Fiorucci, E, Laroche, C, Missiamenou, V, Taylor, C, N Ali Tatar-Chentir, N, Al-Mallah, M, M Astrom Aneq, Athanassopoulos, G, P Badano, L, Benyoussef, S, E Calderon Aranda, M Cardim, N, K-L, Chan, Cruz, I, Edvardsen, T, Goliasch, G, Hagendorff, A, Hristova, K, Kamp, O, D-H, Kang, Kong, W, Matskeplishvili, S, Meshaal, M, Mirocevic, M, N Neskovic, A, Pazdernik, M, Plonska-Gosciniak, E, Raissouni, M, Ronderos, R, E Sade, L, Sadeghpour, A, Sambola, A, Sengupta, S, Separovic-Hanzevacki, J, Takeuchi, M, Tucay, E, C Tude Rodrigues, A, Varga, A, Vaskelyte, J, Yamagata, K, Yiangou, K, Zaky, H, Granada, I, Mahia, M, Ressi, S, Nacinovich, F, Iribarren, A, P Fernandez Oses, Avegliano, G, Filipini, E, Obregon, R, Bangher, M, Dho, J, Cartasegna, L, L Plastino, M, Novas, V, Shigel, C, Reyes, G, M De Santos, Gastaldello, N, M Granillo Fernandez, Potito, M, Streitenberger, G, Velazco, P, H Casabé, J, Cortes, C, Guevara, E, Salmo, F, Seijo, M, Weidinger, F, Heger, M, Brooks, R, Stöllberger, C, C-Y, Ho, Perschy, L, Puskas, L, Binder, C, Rosenhek, R, Schneider, M, M-P, Winter, Hoffer, E, Melissopoulou, M, Lecoq, E, Legrand, D, Jacquet, S, Massoz, M, Pierard, L, Marchetta, S, Dulgheru, R, D Emal, C, Oury, C, Droogmans, S, Kerkhove, D, Plein, D, 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C Castillo, J, L Zamorano, J, L Moya Mur, J, Alvaro, M, Fernandez-Golfin, C, M Monteagudo, J, E Navas Elorza, C Farinas Alvarez, M, J Aguero Balbin, Zarauza, J, F Gutierrez-Diez, J, Arminanzas, C, F Arnaiz de Las Revillas, A Arnaiz Garcia, M Cobo Belaustegui, M Fernandez Sampedro, M Gutierrez Cuadra, L Garcia Cuello, C Gonzalez Rico, Rodriguez-Alvarez, R, Goikoetxea, J, Montejo, M, M Miro, J, Almela, M, Ambrosioni, J, Moreno, A, Quintana, E, Sandoval, E, Tellez, A, M Tolosana, J, Vidal, B, Falces, C, Fuster, D, Garcia-de-la-Maria, C, Hernandez-Meneses, M, Llopis, J, Marco, F, Ruiz-Zamora, I, A Bardaji Ruiz, E Sanz Girgas, Garcia-Pardo, G, M Guillen Marzo, A Rodriguez Oviedo, A Villares Jimenez, Abid, L, Hammami, R, Kammoun, S, S Mourali, M, F Mghaieth Zghal, M Ben Hlima, Boudiche, S, Ouali, S, Zakhama, L, Antit, S, Slama, I, Gulel, O, Sahin, M, Karacaglar, E, Kucukoglu, S, Cetinarslan, O, S Yasar, U, Canpolat, U, Mutlu, B, Atas, H, Dervishova, R, Ileri, C, Alhashmi, J, Tahir, J, Zarger, P, Baslib, F, Woldman, S, Menezes, L, Primus, C, Uppal, R, Bvekerwa, I, Chandrasekaran, B, Kopanska, A, Chambers, J, Hancock, J, Klein, J, Rajani, R, P Ursi, M, Cannata, S, Dworakowski, R, Fife, A, Breeze, J, Browne-Morgan, M, Gunning, M, Streather, S, M Asch, F, Zemedkun, M, Alyavi, B, Uzokov, J, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), 2011–21, Abbott Vascular, 2009–18, Amgen, 2016–19, Edwards, 2014–16, Gedeon Richter, 2009–12, Menarini Group, 2011–14, MSD, 2014–20, Novartis Pharma, 2014–16, ResMed Foundation, 2009–11, Sanofi, 2009–21, Servier, 2019–22, Vifor Pharma, 2014–21, AstraZeneca, 2009–18, Bayer AG, 2009–19, Boehringer Ingelheim, 2009–12, Boston Scientific, Bristol Myers Squibb, 2011–19, Pfizer Alliance, 2011–20, Daiichi Sankyo Company, 2014–17, Eli Lilly and Company, Sengupta, S, Prendergast, B, Laroche, C, Furnaz, S, Ronderos, R, Almaghraby, A, Asch, F, Blechova, K, Zaky, H, Strahilevitz, J, Dworakowski, R, Miyasaka, Y, Sebag, I, Izumi, C, Axler, O, Jamiel, A, Philip, M, Vieira, M, Lancellotti, P, Habib, G, Gale, C, Beleslin, B, Budaj, A, Chioncel, O, Dagres, N, Danchin, N, Emberson, J, Erlinge, D, Glikson, M, Gray, A, Kayikcioglu, M, Maggioni, A, Nagy, V, Nedoshivin, A, Petronio, A, Roos-Hesselink, J, Wallentin, L, Zeymer, U, Cosyns, B, Donal, E, Erba, P, Iung, B, Popescu, B, Tornos, P, Andarala, M, Berle, C, Brunel-Lebecq, A, Fiorucci, E, Missiamenou, V, Taylor, 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M, Lecoq, E, Legrand, D, Jacquet, S, Massoz, M, Pierard, L, Marchetta, S, Dulgheru, R, D'Emal, C, Oury, C, Droog-Mans, S, Kerkhove, D, Plein, D, Soens, L, Weytjens, C, Motoc, A, Roosens, B, Lemoine, I, Rodrigus, I, Paelinck, B, Am-Sel, B, Unger, P, Konopnicki, D, Beauloye, C, Pasquet, A, Vanoverschelde, J, Pierard, S, Vancraeynest, D, Sinnaeve, F, Andrade, J, Staszko, K, Dos Santos Monteiro, R, Miglioranza, M, Shuha, D, Alcantara, M, Cravo, V, Fazzio, L, Felix, A, Iso, M, Musa, C, Siciliano, A, Villaca Filho, F, Rodrigues, A, Vilela, F, Braga, J, Silva, R, Rodrigues, D, Silva, L, Morhy, S, Fischer, C, Afonso, T, Abreu, J, Falcao, S, Moises, V, Gou-Vea, A, Mancuso, F, Souza, A, Silva, C, Joao, G, Abboud, C, Bellio de Mattos Barretto, R, Ramos, A, Arnoni, R, Assef, J, Della Togna, D, Le Bihan, D, Miglioli, L, Romero Oliveira, A, Tadeu Magro Kroll, R, Cortez, D, Gelape, C, Peirira Nunes, M, De Abreu Ferrari, T, Hay, K, Le, V, Page, M, Poulin, F, Sauve, C, Serri, K, Mercure, C, Beaudoin, J, Pibarot, P, Rudski, L, Ricafort, G, Barsic, B, Krajinovic, V, Vargovic, M, Lovric, D, Reskovic-Luksic, V, Vincelj, J, Jaksic Jurinjak, S, Yiannikourides, V, Ioannides, M, Pofaides, C, Masoura, V, Pudich, J, Linhart, A, Siranec, M, Marek, J, Kamenik, M, Pelouch, R, Coufal, Z, Mikulica, M, Griva, M, Jancova, E, Mikulcova, M, Taborsky, M, Precek, J, Jecmenova, M, Latal, J, Widimsky, J, Butta, T, Machacek, S, Vancata, R, Spinar, J, Holicka, M, Pow Chon Long, F, Anzules, N, Bajana Carpio, A, Largacha, G, Penaherrera, E, Moreira, D, Mahfouz, E, Elsafty, E, Soliman, A, Zayed, Y, Aboulenein, J, Abdel-Hay, M, Abdelnaby, M, Ahmed, M, Hammad, B, Saleh, Y, Zahran, H, El-Gebaly, O, Saad, A, Ali, M, Zeid, A, El Sharkawy, R, Al Kholy, A, Doss, R, Osama, D, Rizk, H, Elmogy, A, Mishriky, M, Assayag, P, El Hatimi, S, Hubert, S, Casalta, J, Gouriet, F, Arregle, F, Cammilleri, S, Tessonnier, L, Riberi, A, Botelho-Nevers, E, Gagneux-Brunon, A, Pierrard, R, Tulane, C, Campisi, S, Fuzellier, J, Detoc, M, Mehalla, T, Boutoille, D, Lecompte, A, Lefebvre, M, Pattier, S, Al Habash, O, Asseray-Madani, N, Biron, C, Brochard, J, Caillon, J, Cueff, C, Le Tourneau, T, Lecomte, R, Magali Michel, M, Orain, J, Delarue, S, Le Bras, M, Faucher, J, Aboyans, V, Bee-Harry, A, Durox, H, Lacoste, M, Magne, J, Mohty, D, David, A, Pradel, V, Sierra, V, Neykova, A, Bettayeb, B, Elkentaoui, S, Tzvetkov, B, Landry, G, Strady, C, Ainine, K, Baumard, S, Brasselet, C, Tassigny, C, Valente-Pires, V, Lefranc, M, Hoen, B, Lefevre, B, Curlier, E, Callier, C, Fourcade, N, Jobic, Y, Ansard, S, Le Berre, R, Le Ven, F, Pouliquen, M, Prat, G, Le Roux, P, Bouchart, F, Savoure, A, Alarcon, C, Chapuzet, C, Gueit, I, Tribouilloy, C, Bohbot, Y, Peugnet, F, Gun, M, Duval, X, Lescure, X, Ilic-Habensus, E, Sadoul, N, Selton-Suty, C, Alla, F, Goehringer, F, Huttin, O, Chevalier, E, Garcia, R, Le Marcis, V, Tattevin, P, Flecher, E, Revest, M, Chirouze, C, Bouiller, K, Hustache-Mathieu, L, Klopfenstein, T, Moreau, J, Fournier, D, Brunel, A, Lim, P, Oliver, L, Ternacle, J, Moussafeur, A, Chavanet, P, Piroth, L, Salmon-Rousseau, A, Buisson, M, Mahy, S, Martins, C, Go-Hier, S, Baumann, F, Lebras, S, Piper, C, Guckel, D, Borgermann, J, Horstkotte, D, Winkelmann, E, Brockmeier, B, Grey, D, Nick-Enig, G, Schueler, R, Ozturk, C, Stohr, E, Hamm, C, Walther, T, Brandt, R, Fruhauf, A, Hartung, C, Hellner, C, Wild, C, Becker, M, Hamada, S, Kaestner, W, Stangl, K, Knebel, F, Baldenhofer, G, Brecht, A, Dreger, H, Isner, C, Pfafflin, F, Stegemann, M, Zahn, R, Fraiture, B, Kilkowski, C, Karcher, A, Klinger, S, Tolksdorf, H, Tousoulis, D, Aggeli, C, Sideris, S, Venieri, E, Sarri, G, Tsiapras, D, Armenis, I, Koutsiari, A, Floros, G, Grassos, C, Dragasis, S, Rallidis, L, Varlamos, C, Michalis, L, Naka, K, Bechlioulis, A, Kotsia, A, Lakkas, L, Pappas, K, Papadopoulos, C, Kiokas, S, Lioni, A, Misailidou, S, Bar-Betseas, J, Bonou, M, Kapelios, C, Tomprou, I, Zerva, K, Manolis, A, Hamodraka, E, Athanasiou, D, Haralambidis, G, Samaras, H, Poulimenos, L, Nagy, A, Bartykowszki, A, Gara, E, Mungulmare, K, Kasliwal, R, Bansal, M, Ranjan, S, Bhan, A, Kyavar, M, Maleki, M, Noohi Bezanjani, F, Alizadehasl, A, Boudagh, S, Ghavidel, A, Morad-Nejad, P, Pasha, H, Ghadrdoost, B, Gilon, D, Wanounou, M, Israel, S, D'Agostino, C, Colonna, P, De Michele, L, Fumarola, F, Stante, M, Mar-Chionni, N, Scheggi, V, Alterini, B, Del Pace, S, Stefano, P, Sparano, C, Ruozi, N, Tenaglia, R, Muraru, D, Limbruno, U, Cresti, A, Baratta, P, Solari, M, Giannattasio, C, Moreo, A, De Chiara, B, Lopez Montero, B, Musca, F, Orcese, C, Panzeri, F, Spano, F, Russo, C, Alferi, O, De Bonis, M, Chiappetta, S, Del Forno, B, Ripa, M, Scarpellini, P, Tassan Din, C, Castiglioni, B, Pasci-Uta, R, Carletti, S, Ferrara, D, Guffanti, M, Iaci, G, Lapenna, E, Nisi, T, Oltolini, C, Busnardo, E, Pajoro, U, Agricola, E, Meneghin, R, Schiavi, D, Piscione, F, Citro, R, Benvenga, R, Greco, L, Soriente, L, Radano, I, Prota, C, Bellino, M, Di Vece, D, Santini, F, Salsano, A, Olivieri, G, Turrini, F, Messora, R, Tondi, S, Olaru, A, Agnoletto, V, Grassi, L, Leonardi, C, Sansoni, S, Del Ponte, S, Actis Dato, G, De Martino, A, Ohte, N, Kikuchi, S, Wakami, K, Aonuma, K, Seo, Y, Ishizu, T, Machino-Ohtsuka, T, Yamamoto, M, Iida, N, Nakajima, H, Nakagawa, Y, Amano, M, Miyake, M, Takahashi, K, Shiojima, I, Maeba, H, Suwa, Y, Taniguchi, N, Tsujimoto, S, Kitai, T, Ota, M, Yuda, S, Sasaki, S, Hagiwara, N, Yamazaki, K, Ashihara, K, Arai, K, Saitou, C, Saitou, S, Suzuki, G, Shibata, Y, Watanabe, N, Nishino, S, Ashikaga, K, Kuriyama, N, Mahara, K, Okubo, T, Fujimaki, H, Shi-Tan, H, Yamamoto, H, Abe, K, Terada, M, Takanashi, S, Sata, M, Yamada, H, Kusunose, K, Saijo, Y, Seno, H, Yuichiro, O, Onishi, T, Sera, F, Nakatani, S, Mizuno, H, Sengoku, K, Park, S, Eun Kyoung, K, Ga Yeon, L, Hwang, J, Jin-Oh, C, Sang-Chol, L, Sung-A, C, Jang, S, Heo, R, Lee, S, Song, J, Jung, E, Plisiene, J, Dambrauskaite, A, Gruodyte, G, Jonkaitiene, R, Mizariene, V, Atkocaityte, J, Zvirblyte, R, Sow, R, Codreanu, A, Staub, T, Michaux, C, De la Vega, E, Jacobs-Orazi, L, Mallia Azzopardi, C, Xuereb, R, Pis-Copo, T, Farrugia, J, Fenech, M, Pllaha, E, Vella, C, Borg, D, Casha, R, Grib, L, Raevschi, E, Gre-Jdieru, A, Kravcenco, D, Prisacari, E, Samohvalov, E, Samohvalov, S, Sceglova, N, Panfle, E, Cardaniuc, L, Corcea, V, Feodorovici, A, Gaina, V, Girbu, L, Jimbei, P, Balan, G, Cardaniuc, I, Benesco, I, Marian, V, Sumarga, N, Bozovic, B, Bulatovic, N, Lakovic, P, Music, L, Budde, R, Waha-Dat, A, Gamela, T, Meijers, T, Van Melle, J, Deursen, V, Crijns, H, Bekkers, S, Cheriex, E, Gilbers, M, Kietselaer, B, Knackstedt, C, Lorusso, R, Schalla, S, Streukens, S, Chamuleau, S, Cramer, M, Teske, A, Van der Spoel, T, Wind, A, Lokhorst, J, Liesbek, O, Van Heusden, H, Tanis, W, Van der Bilt, I, Vriend, J, De Lange-Van Bruggen, H, Karijodikoro, E, Riezebos, R, van Dongen, E, Schoep, J, Stolk, V, Offstad, J, Beitnes, J, Helle-Valle, T, Skulstad, H, Skardal, R, Qamar, N, Ahmed, B, Butt, M, Khanzada, M, Saghir, T, Wahid, A, Hryniewiecki, T, Szymanski, P, Marzec, K, Misztal-Ogonowska, M, Kosmala, W, Przewlocka-Kosmala, M, Rojek, A, Woznicka, K, Zachwyc, J, Lisowska, A, Kamin-Ska, M, Kasprzak, J, Kowalczyk, E, Strzecka, D, Wejner-Mik, P, Trabulo, M, Freitas, P, Ranchordas, S, Rodrigues, G, Pinto, P, Queiros, C, Azevedo, J, Marques, L, Seabra, D, Branco, L, Cruz, M, Galrinho, A, Moreira, R, Rio, P, Timoteo, A, Selas, M, Carmelo, V, Duque Neves, B, Pereira, H, Guerra, A, Marques, A, Pintassilgo, I, Tomescu, M, Trofenciuc, N, Andor, M, Bordejevic, A, Branea, H, Caruntu, F, Velcean, L, Mavrea, A, Onel, M, Parvanescu, T, Pop, D, Pop-Moldovan, A, Puticiu, M, Cirin, L, Citu, I, Cotoraci, C, Darabantiu, D, Farcas, R, Marincu, I, Ionac, A, Cozma, D, Mornos, C, Goanta, F, Popescu, I, Beyer, R, Mada, R, Rancea, R, Tomoaia, R, Rosianu, H, Stanescu, C, Kobalava, Z, Karaulova, J, Ko-Tova, E, Milto, A, Pisaryuk, A, Povalyaev, N, Sorokina, M, Alrahimi, J, Elshiekh, A, Ahmed, A, Attia, N, Putnikovic, B, Dimic, A, Ivanovic, B, Matic, S, Trifunovic, D, Petrovic, J, Kosevic, D, Stojanovic, I, Petrovic, I, Dabic, P, Milojevic, P, Srdanovic, I, Susak, S, Velicki, L, Vulin, A, Kovacevic, M, Redzek, A, Stefanovic, M, Yeo, T, Poh, K, Vi-Lacosta, I, Ferrera, C, Olmos, C, Abd El-Nasser, M, Calvo Iglesias, F, Bianco-Gonzalez, E, Bravo Amaro, M, Lopez-Rodriguez, E, Lugo Adan, J, Germinas, A, Pazos-Lopez, P, Pereira Loureiro, M, Perez, M, Raposeiras-Roubin, S, Rasheed Yas, S, Suarez-Varela, M, Vasallo Vidal, F, Garcia-Dorado, D, Fernandez-Hidalgo, N, Gonzalez-Alujas, T, Lozano, J, Maisterra, O, Pizzi, N, Rios, R, Bayes-Genis, A, Pedro Botet, L, Vallejo, N, Llibre, C, Mateu, L, Nunez, R, Quesada, D, Berastegui, E, Bosch Portell, D, Aboal Vinas, J, Albert Bertran, X, Brugada Tar-Radellas, R, Loma-Osorio Ricon, P, Tiron de Llano, C, Arnau, M, Bel, A, Blanes, M, Osa, A, Anguita, M, Carrasco, F, Castillo, J, Zamorano, J, Moya Mur, J, Alvaro, M, Fernandez-Golfin, C, Monteagudo, J, Navas Elorza, E, Farinas Alvarez, M, Aguero Balbin, J, Zarauza, J, Gutierrez-Diez, J, Arminanzas, C, Arnaiz de las Revillas, F, Arnaiz Garcia, A, Cobo Belaustegui, M, Fernandez Sampedro, M, Gutierrez Cuadra, M, Garcia Cuello, L, Gonzalez Rico, C, Rodriguez-Alvarez, R, Goikoetxea, J, Montejo, M, Miro, J, Almela, M, Ambrosioni, J, Moreno, A, Quintana, E, Sandoval, E, Tellez, A, Tolosana, J, Vidal, B, Falces, C, Fuster, D, Garcia-De-la-Maria, C, Hernandez-Meneses, M, Llopis, J, Marco, F, Ruiz-Zamora, I, Bardaji Ruiz, A, Sanz Girgas, E, Garcia-Pardo, G, Guillen Marzo, M, Rodriguez Oviedo, A, Villares Jimenez, A, Abid, L, Ham-Mami, R, Kammoun, S, Mourali, M, Mghaieth Zghal, F, Ben Hlima, M, Boudiche, S, Ouali, S, Zakhama, L, Antit, S, Slama, I, Gulel, O, Sahin, M, Karacaglar, E, Kucukoglu, S, Cetinarslan, O, Sinan, U, Canpolat, U, Mutlu, B, Atas, H, Dervishova, R, Ileri, C, Alhashmi, J, Tahir, J, Zarger, P, Baslib, F, Woldman, S, Menezes, L, Primus, C, Uppal, R, Bvekerwa, I, Chandrasekaran, B, Kopanska, A, Chambers, J, Hancock, J, Klein, J, Rajani, R, Ursi, M, Cannata, S, Fife, A, Breeze, J, Browne-Morgan, M, Gunning, M, Streather, S, Zemedkun, M, Alyavi, B, and Uzokov, J
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Socioeconomic ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Endocarditis ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Health Policy ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Socio-economic ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,Endocarditi ,Cardiology and Cardiovascular Medicine ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology - Abstract
Aims Infective endocarditis (IE) is a life-threatening disease associated with high mortality and morbidity worldwide. We sought to determine how socioeconomic factors might influence its epidemiology, clinical presentation, investigation and management, and outcome, in a large international multicentre registry. Methods and results The EurObservational Programme (EORP) of the European Society of Cardiology EURO-ENDO (European Infective Endocarditis) registry comprises a prospective cohort of 3113 adult patients admitted for IE in 156 hospitals in 40 countries between January 2016 and March 2018. Patients were separated in three groups, according to World Bank economic stratification [group 1: high income (75.6%); group 2: upper-middle income (15.4%); group 3: lower-middle income (9.1%)]. Group 3 patients were younger [median age (interquartile range, IQR): group 1, 66 (53–75) years; group 2, 57 (41–68) years; group 3, 33 (26–43) years; P < 0.001] with a higher frequency of smokers, intravenous drug use, and human immunodeficiency virus infection (all P < 0.001) and presented later [median (IQR) days since symptom onset: group 1, 12 (3–35); group 2, 19 (6–54); group 3, 31 (12–62); P < 0.001] with a higher likelihood of developing congestive heart failure (13.6%, 11.1%, and 22.6%, respectively; P < 0.001) and persistent fever (9.8%, 14.2%, and 27.9%, respectively; P < 0.001). Among 2157 (69.3%) patients with theoretical indication for cardiac surgery, surgery was performed less frequently in group 3 patients (75.5%, 76.8%, and 51.3%, respectively; P < 0.001), who also demonstrated the highest mortality (15.0%, 23.0%, and 23.7%, respectively; P < 0.001). Conclusion Socioeconomic factors influence the clinical profile of patients presenting with IE across the world. Despite younger age, patients from the poorest countries presented with more frequent complications and higher mortality associated with delayed diagnosis and lower use of surgery.
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- 2022
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6. Spondylodiscitis and endocarditis, the strange couple
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S Del Pace, Pierluigi Stefàno, Valentina Scheggi, and Giacomo Virgili
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Spondylodiscitis ,medicine.medical_specialty ,business.industry ,General surgery ,medicine ,Endocarditis ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business - Abstract
Background The association between spondylodiscitis and infective endocarditis (IE) was first reported in 1965 but only a few data are available in the literature about this clinical picture. Early diagnosis of infective endocarditis as the source of spondylodiscitis is often difficult. The aim of this study was to evaluate the proportion of spondylodiscitis in patients with IE and to determine its clinical features. Methods We retrospectively analyzed 355 consecutive patients (127 women) admitted to our department with definite diagnosis of IE. Mean age was 65 years (SD 15.3). IE occurred on native valves in 223 patients (63%) and it involved the aortic valve in 191 cases (54%), mitral valve in 138 cases (39%) and tricuspid valve in 26 (7%). Spondylodiscitis occurred in 24 patients (7%). The diagnosis of spondylodiscitis was made on the basis of typical clinical and radiologic signs. Long-term follow-up was obtained by structured telephone interviews. Average duration of follow-up was three years. Primary endpoint was to establish clinical features of patients with IE complicated by spondylodiscitis. Results At univariable analysis spondylodiscitis was associated with male sex (p=0.043), diabetes (p=0.049), drug abuse (p=0.017) and enterococcus infection (p=0.043). At multivariable analysis diabetes (p=0.014) and drug abuse (p=0.006) were independently correlated with the presence of spondylodiscitis. Other clinical features were not associated with the presence of spondylodiscitis (age, BMI, chronic renal failure, paravalvular extension of infection, vegetation length, EuroScore 2, PCR and procalcitonin levels, type of valve infected). Mortality was similar between patients with and without spondylodiscitis. Conclusions The association of spondylodiscitis and infectious endocarditis should always be suspected, expecially in patients with a high risk profile. Hence, patients with spondylodiscitis should be submitted to echocardiography, mainly when the infective organism is an Enterococcus. Conversely, patients with IE should undergo screening for methasthatic infection. Funding Acknowledgement Type of funding source: None
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- 2020
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7. Machine learning analysis of factors influencing ischemic stroke after coronary artery bypass grafting
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Massimo Bonacchi, M La Meir, Sabina Caciolli, S Del Pace, Sandro Gelsomino, E.P Prifti, J. Maessen, and Orlando Parise
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medicine.medical_specialty ,medicine.anatomical_structure ,Bypass grafting ,business.industry ,Internal medicine ,Ischemic stroke ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Aims Ischemic Stroke (IS) is a devastating complication of coronary bypass (CABG) surgery, significantly increasing mortality, morbidity, cost, and the need for long-term care, and reducing the quality of life. With the aim of a learning-machine method, we investigated factors influencing the occurrence of IS after CABG. Methods and results We employed a statistical learning method – random forests – to examine which of various variables had the greatest impact on postoperative IS. A dataset including 16,255 consecutive patients undergoing isolated CABG between 1997 and 2017 In one Institution was examined. Along with demographic and clinical variables technical-related factors were included, encompassing surgical technique, number of touches on the aorta, cardiopulmonary bypass, total aortic clamping, use of the side-biting clamp, or number of proximal anastomoses. A ranking score based on the average percent increase in mean squared error and obtained for all variables was employed to quantify the importance of any variable in predicting IS. A total of 641 strokes occurred (3.9%). Total aortic clamp showed the highest incidence of stroke (n=570, 88.95% of total). Total aortic clamp had the highest score among all variables followed by previous stroke and carotid artery disease >50%. In contrast, other variables related to surgical technique showed low ranking scores in predicting IS. In patients undergoing CABG with the use of total aortic, a previous brain ischemic insult as well as age >75 years increase the risk of IS (fIGURE) Conclusions The use of total aortic clamp is the strongest predictor of stroke. A clamp-less technique is recommended whenever possible especially in older patients and those who experienced preoperative stroke or who had significant carotid stenosis. Importance of variables in predicting IS Funding Acknowledgement Type of funding source: None
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- 2020
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8. P5983Pre-operative physical performance as an independent predictor of in-hospital outcomes in older patients undergoing elective cardiac surgery
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Giulia Lucarelli, A Lo Forte, Pierluigi Stefàno, Anna Chiara Baroncini, S Del Pace, Niccolò Marchionni, E Carrassi, Alessandra Pratesi, Samuele Baldasseroni, Camilla Ghiara, Andrea Ungar, A J Marella, M. Di Bari, Francesco Orso, and Valter Campagnolo
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medicine.medical_specialty ,Older patients ,Hospital outcomes ,Physical performance ,business.industry ,Emergency medicine ,medicine ,Cardiology and Cardiovascular Medicine ,Independent predictor ,business ,Cardiac surgery - Abstract
Introduction Risk stratification of patients candidate to cardiac surgery is usually based on the Society of Thoracic Surgeons (STS) score or on the Euroscore II. However, these risk scores has limited predictive value in elderly patients. Purpose We conducted a study to determine whether the Short Physical Performance Battery (SPPB), a tool assessing physical performance, predicts hospital death and major morbidity, beyond STS risk score. The outcome was a composite end-point as defined by STS Major Morbidity or Operative Mortality (STS-MM) in STS Risk Model Outcomes: operative mortality, stroke, renal failure, prolonged mechanical ventilation, deep sternal wound infection, and reoperation. Methods In this prospective, single-center, cohort, hospital-based study, conducted at Careggi University Hospital, Florence, Italy, all patients aged 75+ years referred for an elective coronary aortic by-pass grafting, valvular surgery or combined cardiac surgery were evaluated pre-operatively. Assessment included SPPB, cognitive and functional status and evaluation of comorbidity. Patients receiving emergency/urgent cardiac surgery or a procedure not considered in the STS risk score calculator, who reported previous cardiac surgery or were clinically unstable were excluded. Participants were classified according to the STS-Predicted Risk Of Mortality (STS-PROM) as at low (8%). Results Out of 250 participants (females: 48.4%; mean age: 79.9 years), 148 (59.2%) were at low, 73 (29.2%) at intermediate and 29 (11.6%) at high risk, based on the STS-PROM. Mean±SEM SPPB score was 8.8±0.2, 7.1±0.4 and 6.0±0.7 in participants at low, intermediate, and high risk, respectively (p Figure 1 Conclusions SPPB predicts mortality and major morbidity in older patients undergoing elective cardiac surgery, in particular in those classified as low-risk with the STS risk score. Use of SPPB should therefore be recommended to improve preoperative risk stratification of older patients.
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- 2019
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9. Clinical presentation, aetiology and outcomes of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study
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Habib G., Erba P. A., Iung B., Donal E., Cosyns B., Laroche C., Popescu B. A., Prendergast B., Tornos P., Sadeghpour A., Oliver L., Vaskelyte J. -J., Sow R., Axler O., Maggioni A. P., Lancellotti P, C P Gale, B Beleslin, A Budaj, O Chioncel, N Dagres, N Danchin, J Emberson, D Erlinge, M Glikson, A Gray, M Kayikcioglu, A P Maggioni, V K Nagy, A Nedoshivin, A-S Petronio, J Roos-Hesselink, L Wallentin, U Zeymer, G Habib, P Lancellotti, B Cosyns, E Donal, P Erba, B Iung, B A Popescu, B Prendergast, P Tornos, M Andarala, C Berle, A Brunel-Lebecq, E Fiorucci, C Laroche, V Missiamenou, C Taylor, N N Ali Tatar-Chentir, M Al-Mallah, M Astrom Aneq, G Athanassopoulos, L P Badano, S Benyoussef, E Calderon Aranda, N M Cardim, K-L Chan, I Cruz, T Edvardsen, G Goliasch, A Hagendorff, K Hristova, O Kamp, D-H Kang, W Kong, S Matskeplishvili, M Meshaal, M Mirocevic, A N Neskovic, M Pazdernik, E Plonska-Gosciniak, M Raissouni, R Ronderos, L E Sade, A Sadeghpour, A Sambola, S Sengupta, J Separovic-Hanzevacki, M Takeuchi, E Tucay, A C Tude Rodrigues, A Varga, J Vaskelyte, K Yamagata, K Yiangou, H Zaky, I Granada, M Mahia, S Ressi, F Nacinovich, A Iribarren, P Fernandez Oses, G Avegliano, E Filipini, R Obregon, M Bangher, J Dho, L Cartasegna, M L Plastino, V Novas, C Shigel, G Reyes, M De Santos, N Gastaldello, M Granillo Fernandez, M Potito, G Streitenberger, P Velazco, J H Casabé, C Cortes, E Guevara, F Salmo, M Seijo, F Weidinger, M Heger, R Brooks, C Stöllberger, C-Y Ho, L Perschy, L Puskas, C Binder, R Rosenhek, M Schneider, M-P Winter, E Hoffer, M Melissopoulou, E Lecoq, D Legrand, S Jacquet, M Massoz, L Pierard, S Marchetta, R Dulgheru, C D Emal, C Oury, S Droogmans, D Kerkhove, D Plein, L Soens, C Weytjens, A Motoc, B Roosens, I Lemoine, I Rodrigus, B Paelinck, B Amsel, P Unger, D Konopnicki, C Beauloye, A Pasquet, J L Vanoverschelde, S Pierard, D Vancraeynest, F Sinnaeve, J L Andrade, K Staszko, R Dos Santos Monteiro, M H Miglioranza, D L Shuha, M Alcantara, V Cravo, L Fazzio, A Felix, M Iso, C Musa, A P Siciliano, F Villaca Filho, A Rodrigues, F Vilela, J Braga, R Silva, D Rodrigues, L Silva, S Morhy, C Fischer, M Vieira, T Afonso, J Abreu, S N Falcao, V A Moises, A Gouvea, F J Mancuso, A C Souza, C Y Silva, G João, C S Abboud, R Bellio de Mattos Barretto, A Ramos, R Arnoni, J E Assef, D J Della Togna, D Le Bihan, L Miglioli, A P Romero Oliveira, R Tadeu Magro Kroll, D Cortez, C L Gelape, M D C Peirira Nunes, T C De Abreu Ferrari, K Hay, V Le, M Page, F Poulin, C Sauve, K Serri, C Mercure, J Beaudoin, P Pibarot, I A Sebag, L G Rudski, G Ricafort, B Barsic, V Krajinovic, M Vargovic, D Lovric, V Reskovic-Luksic, J Vincelj, S Jaksic Jurinjak, V Yiannikourides, M Ioannides, C Pofaides, V Masoura, J Pudich, A Linhart, M Siranec, J Marek, K Blechova, M Kamenik, R Pelouch, Z Coufal, M Mikulica, M Griva, E Jancova, M Mikulcova, M Taborsky, J Precek, M Jecmenova, J Latal, J Widimsky, T Butta, S Machacek, R Vancata, J Spinar, M Holicka, F Pow Chon Long, N Anzules, A Bajana Carpio, G Largacha, E Penaherrera, D Moreira, E Mahfouz, E Elsafty, A Soliman, Y Zayed, J Aboulenein, M Abdel-Hay, A Almaghraby, M Abdelnaby, M Ahmed, B Hammad, Y Saleh, H Zahran, O Elgebaly, A Saad, M Ali, A Zeid, R El Sharkawy, A Al Kholy, R Doss, D Osama, H Rizk, A Elmogy, M Mishriky, P Assayag, S El Hatimi, S Hubert, J-P Casalta, F Gouriet, F Arregle, S Cammilleri, L Tessonnier, A Riberi, E Botelho-Nevers, A Gagneux-Brunon, R Pierrard, C Tulane, S Campisi, J-F Fuzellier, M Detoc, T Mehalla, D Boutoille, A S Lecompte, M Lefebvre, S Pattier, O Al Habash, N Asseray-Madani, C Biron, J Brochard, J Caillon, C Cueff, T Le Tourneau, R Lecomte, M M Magali Michel, J Orain, S Delarue, M Le Bras, J-F Faucher, V Aboyans, A Beeharry, H Durox, M Lacoste, J Magne, D Mohty, A David, V Pradel, V Sierra, A Neykova, B Bettayeb, S Elkentaoui, B Tzvetkov, G Landry, C Strady, K Ainine, S Baumard, C Brasselet, C Tassigny, V Valente-Pires, M Lefranc, B Hoen, B Lefevre, E Curlier, C Callier, N Fourcade, Y Jobic, S Ansard, R Le Berre, F Le Ven, M-C Pouliquen, G Prat, P Le Roux, F Bouchart, A Savoure, C Alarcon, C Chapuzet, I Gueit, C Tribouilloy, Y Bohbot, F Peugnet, M Gun, X Duval, X Lescure, E Ilic-Habensus, N Sadoul, C Selton-Suty, F Alla, F Goehringer, O Huttin, E Chevalier, R Garcia, V Le Marcis, P Tattevin, E Flecher, M Revest, C Chirouze, K Bouiller, L Hustache-Mathieu, T Klopfenstein, J Moreau, D Fournier, A-S Brunel, P Lim, L Oliver, J Ternacle, A Moussafeur, P Chavanet, L Piroth, A Salmon-Rousseau, M Buisson, S Mahy, C Martins, S Gohier, O Axler, F Baumann, S Lebras, C Piper, D Guckel, J Börgermann, D Horstkotte, E Winkelmann, B Brockmeier, D Grey, G Nickenig, R Schueler, C Öztürk, E Stöhr, C Hamm, T Walther, R Brandt, A-C Frühauf, C T Hartung, C Hellner, C Wild, M Becker, S Hamada, W Kaestner, K Stangl, F Knebel, G Baldenhofer, A Brecht, H Dreger, C Isner, F Pfafflin, M Stegemann, R Zahn, B Fraiture, C Kilkowski, A-K Karcher, S Klinger, H Tolksdorf, D Tousoulis, C Aggeli, S Sideris, E Venieri, G Sarri, D Tsiapras, I Armenis, A Koutsiari, G Floros, C Grassos, S Dragasis, L Rallidis, C Varlamos, L Michalis, K Naka, A Bechlioulis, A Kotsia, L Lakkas, K Pappas, C Papadopoulos, S Kiokas, A Lioni, S Misailidou, J Barbetseas, M Bonou, C Kapelios, I Tomprou, K Zerva, A Manolis, E Hamodraka, D Athanasiou, G Haralambidis, H Samaras, L Poulimenos, A Nagy, A Bartykowszki, E Gara, K Mungulmare, R Kasliwal, M Bansal, S Ranjan, A Bhan, M Kyavar, M Maleki, F Noohi Bezanjani, A Alizadehasl, S Boudagh, A Ghavidel, P Moradnejad, H R Pasha, B Ghadrdoost, D Gilon, J Strahilevitz, M Wanounou, S Israel, C d'Agostino, P Colonna, L De Michele, F Fumarola, M Stante, N Marchionni, V Scheggi, B Alterini, S Del Pace, P Stefano, C Sparano, N Ruozi, R Tenaglia, D Muraru, U Limbruno, A Cresti, P Baratta, M Solari, C Giannattasio, A Moreo, B De Chiara, B Lopez Montero, F Musca, C A Orcese, F Panzeri, F Spano, C F Russo, O Alfieri, M De Bonis, S Chiappetta, B Del Forno, M Ripa, P Scarpellini, C Tassan Din, B Castiglioni, R Pasciuta, S Carletti, D Ferrara, M Guffanti, G Iaci, E Lapenna, T Nisi, C Oltolini, E Busnardo, U Pajoro, E Agricola, R Meneghin, D Schiavi, F Piscione, R Citro, R M Benvenga, L Greco, L Soriente, I Radano, C Prota, M Bellino, D Di Vece, F Santini, A Salsano, G M Olivieri, F Turrini, R Messora, S Tondi, A Olaru, V Agnoletto, L Grassi, C Leonardi, S Sansoni, S Del Ponte, G M Actis Dato, A De Martino, N Ohte, S Kikuchi, K Wakami, K Aonuma, Y Seo, T Ishizu, T Machino-Ohtsuka, M Yamamoto, N Iida, H Nakajima, Y Nakagawa, C Izumi, M Amano, M Miyake, K Takahashi, I Shiojima, Y Miyasaka, H Maeba, Y Suwa, N Taniguchi, S Tsujimoto, T Kitai, M Ota, S Yuda, S Sasaki, N Hagiwara, K Yamazaki, K Ashihara, K Arai, C Saitou, S Saitou, G Suzuki, Y Shibata, N Watanabe, S Nishino, K Ashikaga, N Kuriyama, K Mahara, T Okubo, H Fujimaki, H Shitan, H Yamamoto, K Abe, M Terada, S Takanashi, M Sata, H Yamada, K Kusunose, Y Saijo, H Seno, O Yuichiro, T Onishi, F Sera, S Nakatani, H Mizuno, K Sengoku, S W Park, K Eun Kyoung, L Ga Yeon, J-W Hwang, C Jin-Oh, S-J Park, L Sang-Chol, C Sung-A, S Y Jang, R Heo, S Lee, J-M Song, E Jung, J Plisiene, A Dambrauskaite, G Gruodyte, R Jonkaitiene, V Mizariene, J Atkocaityte, R Zvirblyte, R Sow, A Codreanu, T Staub, C Michaux, E C L De la Vega, L Jacobs-Orazi, C Mallia Azzopardi, R G Xuereb, T Piscopo, J Farrugia, M Fenech, E Pllaha, C Vella, D Borg, R Casha, L Grib, E Raevschi, A Grejdieru, D Kravcenco, E Prisacari, E Samohvalov, S Samohvalov, N Sceglova, E Panfile, L Cardaniuc, V Corcea, A Feodorovici, V Gaina, L Girbu, P Jimbei, G Balan, I Cardaniuc, I Benesco, V Marian, N Sumarga, B Bozovic, N Bulatovic, P Lakovic, L Music, R Budde, A Wahadat, T Gamela, T Meijers, J P Van Melle, V M Deursen, H J Crijns, S C Bekkers, E C Cheriex, M Gilbers, B L Kietselaer, C Knackstedt, R Lorusso, S Schalla, S A Streukens, S Chamuleau, M-J Cramer, A Teske, T Van der Spoel, A Wind, J Lokhorst, O Liesbek, H Van Heusden, W Tanis, I Van der Bilt, J Vriend, H De Lange-van Bruggen, E Karijodikoro, R Riezebos, E van Dongen, J Schoep, V Stolk, J T Offstad, J O Beitnes, T Helle-Valle, H Skulstad, R Skardal, N Qamar, S Furnaz, B Ahmed, M H Butt, M F Khanzada, T Saghir, A Wahid, T Hryniewiecki, P Szymanski, K Marzec, M Misztal-Ogonowska, W Kosmala, M Przewlocka-Kosmala, A Rojek, K Woznicka, J Zachwyc, A Lisowska, M Kaminska, J D Kasprzak, E Kowalczyk, D F Strzecka, P Wejner-Mik, M Trabulo, P Freitas, S Ranchordas, G Rodrigues, P Pinto, C Queiros, J Azevedo, L Marques, D Seabra, L Branco, M Cruz, A Galrinho, R Moreira, P Rio, A T Timoteo, M Selas, V Carmelo, B Duque Neves, H Pereira, A Guerra, A Marques, I Pintassilgo, M C Tomescu, N-M Trofenciuc, M Andor, A Bordejevic, H S Branea, F Caruntu, L A Velcean, A Mavrea, M F Onel, T Parvanescu, D Pop, A L Pop-Moldovan, M I Puticiu, L Cirin, I M Citu, C A Cotoraci, D Darabantiu, R Farcas, I Marincu, A Ionac, D Cozma, C Mornos, F Goanta, I Popescu, R Beyer, R Mada, R Rancea, R Tomoaia, H Rosianu, C Stanescu, Z Kobalava, J Karaulova, E Kotova, A Milto, A Pisaryuk, N Povalyaev, M Sorokina, J Alrahimi, A Elshiekh, A Jamiel, A Ahmed, N Attia, B Putnikovic, A Dimic, B Ivanovic, S Matic, D Trifunovic, J Petrovic, D Kosevic, I Stojanovic, I Petrovic, P Dabic, P Milojevic, I Srdanovic, S Susak, L Velicki, A Vulin, M Kovacevic, A Redzek, M Stefanovic, T C Yeo, W Kf Kong, K K Poh, I Vilacosta, C Ferrera, C Olmos, M Abd El-Nasser, F Calvo Iglesias, E Blanco-Gonzalez, M Bravo Amaro, E Lopez-Rodriguez, J Lugo Adan, A N Germinas, P Pazos-Lopez, M Pereira Loureiro, M T Perez, S Raposeiras-Roubin, S Rasheed Yas, M-M Suarez-Varela, F Vasallo Vidal, D Garcia-Dorado, N Fernandez-Hidalgo, T Gonzalez-Alujas, J Lozano, O Maisterra, N Pizzi, R Rios, A Bayes-Genis, L Pedro Botet, N Vallejo, C Llibre, L Mateu, R Nunez, D Quesada, E Berastegui, D Bosch Portell, J Aboal Vinas, X Albert Bertran, R Brugada Tarradellas, P Loma-Osorio Ricon, C Tiron de Llano, M A Arnau, A Bel, M Blanes, A Osa, M Anguita, F Carrasco, J C Castillo, J L Zamorano, J L Moya Mur, M Alvaro, C Fernandez-Golfin, J M Monteagudo, E Navas Elorza, M C Farinas Alvarez, J Aguero Balbin, J Zarauza, J F Gutierrez-Diez, C Arminanzas, F Arnaiz de Las Revillas, A Arnaiz Garcia, M Cobo Belaustegui, M Fernandez Sampedro, M Gutierrez Cuadra, L Garcia Cuello, C Gonzalez Rico, R Rodriguez-Alvarez, J Goikoetxea, M Montejo, J M Miro, M Almela, J Ambrosioni, A Moreno, E Quintana, E Sandoval, A Tellez, J M Tolosana, B Vidal, C Falces, D Fuster, C Garcia-de-la-Maria, M Hernandez-Meneses, J Llopis, F Marco, I Ruiz-Zamora, A Bardaji Ruiz, E Sanz Girgas, G Garcia-Pardo, M Guillen Marzo, A Rodriguez Oviedo, A Villares Jimenez, L Abid, R Hammami, S Kammoun, M S Mourali, F Mghaieth Zghal, M Ben Hlima, S Boudiche, S Ouali, L Zakhama, S Antit, I Slama, O Gulel, M Sahin, E Karacaglar, S Kucukoglu, O Cetinarslan, U Y Sinan, U Canpolat, B Mutlu, H Atas, R Dervishova, C Ileri, J Alhashmi, J Tahir, P Zarger, F Baslib, S Woldman, L Menezes, C Primus, R Uppal, I Bvekerwa, B Chandrasekaran, A Kopanska, J Chambers, J Hancock, J Klein, R Rajani, M P Ursi, S Cannata, R Dworakowski, A Fife, J Breeze, M Browne-Morgan, M Gunning, S Streather, F M Asch, M Zemedkun, B Alyavi, J Uzokov, G., Habib, P. A., Erba, B., Iung, E., Donal, B., Cosyn, C., Laroche, B. A., Popescu, B., Prendergast, P., Torno, A., Sadeghpour, L., Oliver, J. -J., Vaskelyte, R., Sow, O., Axler, A. P., Maggioni, P, Lancellotti, P Gale, C, Beleslin, B, Budaj, A, Chioncel, O, Dagres, N, Danchin, N, Emberson, J, Erlinge, D, Glikson, M, Gray, A, Kayikcioglu, M, P Maggioni, A, K Nagy, V, Nedoshivin, A, Petronio, A-S, Roos-Hesselink, J, Wallentin, L, Zeymer, U, Habib, G, Lancellotti, P, Cosyns, B, Donal, E, Erba, P, Iung, B, A Popescu, B, Prendergast, B, Tornos, P, Andarala, M, Berle, C, Brunel-Lebecq, A, Fiorucci, E, Laroche, C, Missiamenou, V, Taylor, C, N Ali Tatar-Chentir, N, Al-Mallah, M, Astrom Aneq, M, Athanassopoulos, G, P Badano, L, Benyoussef, S, Calderon Aranda, E, M Cardim, N, Chan, K-L, Cruz, I, Edvardsen, T, Goliasch, G, Hagendorff, A, Hristova, K, Kamp, O, Kang, D-H, Kong, W, Matskeplishvili, S, Meshaal, M, Mirocevic, M, N Neskovic, A, Pazdernik, M, Plonska-Gosciniak, E, Raissouni, M, Ronderos, R, E Sade, L, Sadeghpour, A, Sambola, A, Sengupta, S, Separovic-Hanzevacki, J, Takeuchi, M, Tucay, E, C Tude Rodrigues, A, Varga, A, Vaskelyte, J, Yamagata, K, Yiangou, K, Zaky, H, Granada, I, Mahia, M, Ressi, S, Nacinovich, F, Iribarren, A, Fernandez Oses, P, Avegliano, G, Filipini, E, Obregon, R, Bangher, M, Dho, J, Cartasegna, L, L Plastino, M, Novas, V, Shigel, C, Reyes, G, De Santos, M, Gastaldello, N, Granillo Fernandez, M, Potito, M, Streitenberger, G, Velazco, P, H Casabé, J, Cortes, C, Guevara, E, Salmo, F, Seijo, M, Weidinger, F, Heger, M, Brooks, R, Stöllberger, C, Ho, C-Y, Perschy, L, Puskas, L, Binder, C, Rosenhek, R, Schneider, M, Winter, M-P, Hoffer, E, Melissopoulou, M, Lecoq, E, Legrand, D, Jacquet, S, Massoz, M, Pierard, L, Marchetta, S, Dulgheru, R, D Emal, C, Oury, C, Droogmans, S, Kerkhove, D, Plein, D, Soens, L, Weytjens, C, Motoc, A, Roosens, B, Lemoine, I, Rodrigus, I, Paelinck, B, Amsel, B, Unger, P, Konopnicki, D, Beauloye, C, Pasquet, A, L Vanoverschelde, J, Pierard, S, Vancraeynest, D, Sinnaeve, F, L Andrade, J, Staszko, K, Dos Santos Monteiro, R, H Miglioranza, M, L Shuha, D, Alcantara, M, Cravo, V, Fazzio, L, Felix, A, Iso, M, Musa, C, P Siciliano, A, Villaca Filho, F, Rodrigues, A, Vilela, F, Braga, J, Silva, R, Rodrigues, D, Silva, L, Morhy, S, Fischer, C, Vieira, M, Afonso, T, Abreu, J, N Falcao, S, A Moises, V, Gouvea, A, J Mancuso, F, C Souza, A, Y Silva, C, João, G, S Abboud, C, Bellio de Mattos Barretto, R, Ramos, A, Arnoni, R, E Assef, J, J Della Togna, D, Le Bihan, D, Miglioli, L, P Romero Oliveira, A, Tadeu Magro Kroll, R, Cortez, D, L Gelape, C, C Peirira Nunes, M D, C De Abreu Ferrari, T, Hay, K, Le, V, Page, M, Poulin, F, Sauve, C, Serri, K, Mercure, C, Beaudoin, J, Pibarot, P, A Sebag, I, G Rudski, L, Ricafort, G, Barsic, B, Krajinovic, V, Vargovic, M, Lovric, D, Reskovic-Luksic, V, Vincelj, J, Jaksic Jurinjak, S, Yiannikourides, V, Ioannides, M, Pofaides, C, Masoura, V, Pudich, J, Linhart, A, Siranec, M, Marek, J, Blechova, K, Kamenik, M, Pelouch, R, Coufal, Z, Mikulica, M, Griva, M, Jancova, E, Mikulcova, M, Taborsky, M, Precek, J, Jecmenova, M, Latal, J, Widimsky, J, Butta, T, Machacek, S, 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Landry, G, Strady, C, Ainine, K, Baumard, S, Brasselet, C, Tassigny, C, Valente-Pires, V, Lefranc, M, Hoen, B, Lefevre, B, Curlier, E, Callier, C, Fourcade, N, Jobic, Y, Ansard, S, Le Berre, R, Le Ven, F, Pouliquen, M-C, Prat, G, Le Roux, P, Bouchart, F, Savoure, A, Alarcon, C, Chapuzet, C, Gueit, I, Tribouilloy, C, Bohbot, Y, Peugnet, F, Gun, M, Duval, X, Lescure, X, Ilic-Habensus, E, Sadoul, N, Selton-Suty, C, Alla, F, Goehringer, F, Huttin, O, Chevalier, E, Garcia, R, Le Marcis, V, Tattevin, P, Flecher, E, Revest, M, Chirouze, C, Bouiller, K, Hustache-Mathieu, L, Klopfenstein, T, Moreau, J, Fournier, D, Brunel, A-S, Lim, P, Oliver, L, Ternacle, J, Moussafeur, A, Chavanet, P, Piroth, L, Salmon-Rousseau, A, Buisson, M, Mahy, S, Martins, C, Gohier, S, Axler, O, Baumann, F, Lebras, S, Piper, C, Guckel, D, Börgermann, J, Horstkotte, D, Winkelmann, E, Brockmeier, B, Grey, D, Nickenig, G, Schueler, R, Öztürk, C, Stöhr, E, Hamm, C, Walther, T, Brandt, R, Frühauf, A-C, T Hartung, C, Hellner, C, Wild, C, Becker, M, Hamada, S, Kaestner, W, Stangl, K, Knebel, F, Baldenhofer, G, Brecht, A, Dreger, H, Isner, C, Pfafflin, F, Stegemann, M, Zahn, R, Fraiture, B, Kilkowski, C, Karcher, A-K, Klinger, S, Tolksdorf, H, Tousoulis, D, Aggeli, C, Sideris, S, Venieri, E, Sarri, G, Tsiapras, D, Armenis, I, Koutsiari, A, Floros, G, Grassos, C, Dragasis, S, Rallidis, L, Varlamos, C, Michalis, L, Naka, K, Bechlioulis, A, Kotsia, A, Lakkas, L, Pappas, K, Papadopoulos, C, Kiokas, S, Lioni, A, Misailidou, S, Barbetseas, J, Bonou, M, Kapelios, C, Tomprou, I, Zerva, K, Manolis, A, Hamodraka, E, Athanasiou, D, Haralambidis, G, Samaras, H, Poulimenos, L, Nagy, A, Bartykowszki, A, Gara, E, Mungulmare, K, Kasliwal, R, Bansal, M, Ranjan, S, Bhan, A, Kyavar, M, Maleki, M, Noohi Bezanjani, F, Alizadehasl, A, Boudagh, S, Ghavidel, A, Moradnejad, P, R Pasha, H, Ghadrdoost, B, Gilon, D, Strahilevitz, J, Wanounou, M, Israel, S, D'Agostino, C, Colonna, P, De Michele, L, Fumarola, F, Stante, M, Marchionni, N, Scheggi, V, Alterini, B, Del Pace, S, Stefano, P, Sparano, C, Ruozi, N, Tenaglia, R, Muraru, D, Limbruno, U, Cresti, A, Baratta, P, Solari, M, Giannattasio, C, Moreo, A, De Chiara, B, Lopez Montero, B, Musca, F, A Orcese, C, Panzeri, F, Spano, F, F Russo, C, Alfieri, O, DE BONIS, Michele, Chiappetta, S, Del Forno, B, Ripa, M, Scarpellini, P, Tassan Din, C, Castiglioni, B, Pasciuta, R, Carletti, S, Ferrara, D, Guffanti, M, Iaci, G, Lapenna, E, Nisi, T, Oltolini, C, Busnardo, E, Pajoro, U, Agricola, E, Meneghin, R, Schiavi, D, Piscione, F, Citro, R, M Benvenga, R, Greco, L, Soriente, L, Radano, I, Prota, C, Bellino, M, Di Vece, D, Santini, F, Salsano, A, M Olivieri, G, Turrini, F, Messora, R, Tondi, S, Olaru, A, Agnoletto, V, Grassi, L, Leonardi, C, Sansoni, S, Del Ponte, S, M Actis Dato, G, De Martino, A, Ohte, N, Kikuchi, S, Wakami, K, Aonuma, K, Seo, Y, Ishizu, T, Machino-Ohtsuka, T, Yamamoto, M, Iida, N, Nakajima, H, Nakagawa, Y, Izumi, C, Amano, M, Miyake, M, Takahashi, K, Shiojima, I, Miyasaka, Y, Maeba, H, Suwa, Y, Taniguchi, N, Tsujimoto, S, Kitai, T, Ota, M, Yuda, S, Sasaki, S, Hagiwara, N, Yamazaki, K, Ashihara, K, Arai, K, Saitou, C, Saitou, S, Suzuki, G, Shibata, Y, Watanabe, N, Nishino, S, Ashikaga, K, Kuriyama, N, Mahara, K, Okubo, T, Fujimaki, H, Shitan, H, Yamamoto, H, Abe, K, Terada, M, Takanashi, S, Sata, M, Yamada, H, Kusunose, K, Saijo, Y, Seno, H, Yuichiro, O, Onishi, T, Sera, F, Nakatani, S, Mizuno, H, Sengoku, K, W Park, S, Eun Kyoung, K, Ga Yeon, L, Hwang, J-W, Jin-Oh, C, Park, S-J, Sang-Chol, L, Sung-A, C, Y Jang, S, Heo, R, Lee, S, Song, J-M, Jung, E, Plisiene, J, Dambrauskaite, A, Gruodyte, G, Jonkaitiene, R, Mizariene, V, Atkocaityte, J, Zvirblyte, R, Sow, R, Codreanu, A, Staub, T, Michaux, C, L De la Vega, E C, Jacobs-Orazi, L, Mallia Azzopardi, C, G Xuereb, R, Piscopo, T, Farrugia, J, Fenech, M, Pllaha, E, Vella, C, Borg, D, Casha, R, Grib, L, Raevschi, E, Grejdieru, A, Kravcenco, D, Prisacari, E, Samohvalov, E, Samohvalov, S, Sceglova, N, Panfile, E, Cardaniuc, L, Corcea, V, Feodorovici, A, Gaina, V, Girbu, L, Jimbei, P, Balan, G, Cardaniuc, I, Benesco, I, Marian, V, Sumarga, N, Bozovic, B, Bulatovic, N, Lakovic, P, Music, L, Budde, R, Wahadat, A, Gamela, T, Meijers, T, P Van Melle, J, M Deursen, V, J Crijns, H, C Bekkers, S, C Cheriex, E, Gilbers, M, L Kietselaer, B, Knackstedt, C, Lorusso, R, Schalla, S, A Streukens, S, Chamuleau, S, Cramer, M-J, Teske, A, Van der Spoel, T, Wind, A, Lokhorst, J, Liesbek, O, Van Heusden, H, Tanis, W, Van der Bilt, I, Vriend, J, De Lange-van Bruggen, H, Karijodikoro, E, Riezebos, R, van Dongen, E, Schoep, J, Stolk, V, T Offstad, J, O Beitnes, J, Helle-Valle, T, Skulstad, H, Skardal, R, Qamar, N, Furnaz, S, Ahmed, B, H Butt, M, F Khanzada, M, Saghir, T, Wahid, A, Hryniewiecki, T, Szymanski, P, Marzec, K, Misztal-Ogonowska, M, Kosmala, W, Przewlocka-Kosmala, M, Rojek, A, Woznicka, K, Zachwyc, J, Lisowska, A, Kaminska, M, D Kasprzak, J, Kowalczyk, E, F Strzecka, D, Wejner-Mik, P, Trabulo, M, Freitas, P, Ranchordas, S, Rodrigues, G, Pinto, P, Queiros, C, Azevedo, J, Marques, L, Seabra, D, Branco, L, Cruz, M, Galrinho, A, Moreira, R, Rio, P, T Timoteo, A, Selas, M, Carmelo, V, Duque Neves, B, Pereira, H, Guerra, A, Marques, A, Pintassilgo, I, C Tomescu, M, Trofenciuc, N-M, Andor, M, Bordejevic, A, S Branea, H, Caruntu, F, A Velcean, L, Mavrea, A, F Onel, M, Parvanescu, T, Pop, D, L Pop-Moldovan, A, I Puticiu, M, Cirin, L, M Citu, I, A Cotoraci, C, Darabantiu, D, Farcas, R, Marincu, I, Ionac, A, Cozma, D, Mornos, C, Goanta, F, Popescu, I, Beyer, R, Mada, R, Rancea, R, Tomoaia, R, Rosianu, H, Stanescu, C, Kobalava, Z, Karaulova, J, Kotova, E, Milto, A, Pisaryuk, A, Povalyaev, N, Sorokina, M, Alrahimi, J, Elshiekh, A, Jamiel, A, Ahmed, A, Attia, N, Putnikovic, B, Dimic, A, Ivanovic, B, Matic, S, Trifunovic, D, Petrovic, J, Kosevic, D, Stojanovic, I, Petrovic, I, Dabic, P, Milojevic, P, Srdanovic, I, Susak, S, Velicki, L, Vulin, A, Kovacevic, M, Redzek, A, Stefanovic, M, C Yeo, T, Kf Kong, W, K Poh, K, Vilacosta, I, Ferrera, C, Olmos, C, Abd El-Nasser, M, Calvo Iglesias, F, Blanco-Gonzalez, E, Bravo Amaro, M, Lopez-Rodriguez, E, Lugo Adan, J, N Germinas, A, Pazos-Lopez, P, Pereira Loureiro, M, T Perez, M, Raposeiras-Roubin, S, Rasheed Yas, S, Suarez-Varela, M-M, Vasallo Vidal, F, Garcia-Dorado, D, Fernandez-Hidalgo, N, Gonzalez-Alujas, T, Lozano, J, Maisterra, O, Pizzi, N, Rios, R, Bayes-Genis, A, Pedro Botet, L, Vallejo, N, Llibre, C, Mateu, L, Nunez, R, Quesada, D, Berastegui, E, Bosch Portell, D, Aboal Vinas, J, Albert Bertran, X, Brugada Tarradellas, R, Loma-Osorio Ricon, P, Tiron de Llano, C, A Arnau, M, Bel, A, Blanes, M, Osa, A, Anguita, M, Carrasco, F, C Castillo, J, L Zamorano, J, L Moya Mur, J, Alvaro, M, Fernandez-Golfin, C, M Monteagudo, J, Navas Elorza, E, C Farinas Alvarez, M, Aguero Balbin, J, Zarauza, J, F Gutierrez-Diez, J, Arminanzas, C, Arnaiz de Las Revillas, F, Arnaiz Garcia, A, Cobo Belaustegui, M, Fernandez Sampedro, M, Gutierrez Cuadra, M, Garcia Cuello, L, Gonzalez Rico, C, Rodriguez-Alvarez, R, Goikoetxea, J, Montejo, M, M Miro, J, Almela, M, Ambrosioni, J, Moreno, A, Quintana, E, Sandoval, E, Tellez, A, M Tolosana, J, Vidal, B, Falces, C, Fuster, D, Garcia-de-la-Maria, C, Hernandez-Meneses, M, Llopis, J, Marco, F, Ruiz-Zamora, I, Bardaji Ruiz, A, Sanz Girgas, E, Garcia-Pardo, G, Guillen Marzo, M, Rodriguez Oviedo, A, Villares Jimenez, A, Abid, L, Hammami, R, Kammoun, S, S Mourali, M, Mghaieth Zghal, F, Ben Hlima, M, Boudiche, S, Ouali, S, Zakhama, L, Antit, S, Slama, I, Gulel, O, Sahin, M, Karacaglar, E, Kucukoglu, S, Cetinarslan, O, Y Sinan, U, Canpolat, U, Mutlu, B, Atas, H, Dervishova, R, Ileri, C, Alhashmi, J, Tahir, J, Zarger, P, Baslib, F, Woldman, S, Menezes, L, Primus, C, Uppal, R, Bvekerwa, I, Chandrasekaran, B, Kopanska, A, Chambers, J, Hancock, J, Klein, J, Rajani, R, P Ursi, M, Cannata, S, Dworakowski, R, Fife, A, Breeze, J, Browne-Morgan, M, Gunning, M, Streather, S, M Asch, F, Zemedkun, M, Alyavi, B, Uzokov, J, Hôpital de la Timone [CHU - APHM] (TIMONE), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), University Medical Center Groningen [Groningen] (UMCG), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Université de Médecine Carol Davila, Guy's and St Thomas' Hospital [London], CHU Henri Mondor, Centre Hospitalier Universitaire de Liège (CHU-Liège), AstraZeneca, Bayer, Edwards Lifesciences, Servier, Abbott Vascular Int., Amgen Cardiovascular, Pfizer Alliance, Daiichi Sankyo Europe GmbH, Alliance Daiichi Sankyo Europe GmbH, Gedeon Richter Plc., Menarini Int. Op., Vifor, Boehringer Ingelheim, Boston Scientific Corporation, Bristol-Myers Squibb, Eli Lilly and Company, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, UCL - (SLuc) Service de pathologies cardiovasculaires intensives, UCL - (SLuc) Service de soins intensifs, Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Oxford University Hospitals NHS Trust, University of Oxford [Oxford], Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Bordeaux (UB), Research Center [Associazione Nazionale Medici Cardiologi Ospedalieri] (ANMCO Research Center), Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Service de cardiologie [Liège], CHU de Liège-Domaine Universitaire du Sart Tilman, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Exeter, Instituto Nacional de Tecnología Agropecuaria, Pergamino, Argentina, Laboratory of In Vivo Cellular and Molecular Imaging, Vrije Universiteit Brussel (VUB), Centre National de la Recherche Scientifique (CNRS), Division of Engineering and Applied Science, California Institute of Technology, California Institute of Technology (CALTECH), Departamento de Biologia de la Reproduccion, Universidad Autónoma Metropolitana Iztapalapa (UAMI), Universidade Federal de Itajubá, Departamento de Física [Coimbra] (DFC), Universidade de Coimbra [Coimbra], Section of Internal Medicine and Endocrine and Metabolic Sciences, Università degli Studi di Perugia (UNIPG), LIP-Coimbra & Department of Physics of the University of Coimbra, Service Hospitalier Frédéric Joliot (SHFJ), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Quebec Heart Institute/Laval Hospital, Université Laval [Québec] (ULaval)-Quebec Heart Institute, Institut Lavoisier de Versailles (ILV), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU AMU), CHU Saint-Etienne, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Service des maladies infectieuses et tropicales [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service de bactériologie et hygiène hospitalière [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Institut du thorax, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Maladies infectieuses et tropicales [CHU Limoges], CHU Limoges, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre Hospitalier Universitaire de Reims (CHU Reims), Anesthésie et réanimation en chirurgie cardiaque [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Normandie Université (NU), Service des maladies infectieuses et tropicales [Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Cardiology [Ospedali del Tigullio], Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Service des maladies infectieuses et réanimation médicale, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Laboratoire Chrono-environnement - CNRS - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), service de maladies infectieuses CHU J Minjoz Besancon, Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Département d'infectiologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Virologie et pathogenèse virale (VPV), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Institució Catalana de Recerca i Estudis Avançats (ICREA), Institute for Advanced Studies in Basic Sciences, affiliation inconnue, Dipartamento di Fisica 'E.R. Caianiello', Università degli Studi di Salerno (UNISA), The University of Tokyo, Northern Research Station, Forestry Commission, University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC), Instituto de Plasmas e Fusão Nuclear [Lisboa] (IPFN), Instituto Superior Técnico, Universidade Técnica de Lisboa (IST), Instituto de Investigaciones Marinas (CSIC), Faculté des Sciences Pharmaceutiques, EA 4529, Laboratoire de Biochimie, Université Paris-Sud - Paris 11 (UP11), Istituto di Virologia Vegetale, Università degli studi di Torino (UNITO), Universidad Nacional Autónoma de México (UNAM), Service de Chirurgie Cardiovasculaire, University Hospital of Cruces, Geneva University Hospital (HUG), Institut Jean Le Rond d'Alembert (DALEMBERT), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Preventive Medicine Unit, University Hospital Joan XXIII, IISPV, Rovira and Virgili University, Popescu, B, Maggioni, A, Gale, C, Nagy, V, Petronio, A, Ali Tatar-Chentir, N, Badano, L, Cardim, N, Chan, K, Kang, D, Neskovic, A, Sade, L, Tude Rodrigues, A, Plastino, M, Casabe, J, Stollberger, C, Ho, C, Winter, M, Emal, C, Vanoverschelde, J, Andrade, J, Miglioranza, M, Shuha, D, Siciliano, A, Falcao, S, Moises, V, Mancuso, F, Souza, A, Silva, C, Joao, G, Abboud, C, Assef, J, Della Togna, D, Romero Oliveira, A, Gelape, C, Peirira Nunes, M, De Abreu Ferrari, T, Sebag, I, Rudski, L, Casalta, J, Fuzellier, J, Lecompte, A, Magali Michel, M, Faucher, J, Pouliquen, M, Brunel, A, Borgermann, J, Ozturk, C, Stohr, E, Fruhauf, A, Hartung, C, Karcher, A, Pasha, H, Orcese, C, Russo, C, De Bonis, M, Benvenga, R, Olivieri, G, Actis Dato, G, Park, S, Hwang, J, Jang, S, Song, J, De la Vega, E, Xuereb, R, Van Melle, J, Deursen, V, Crijns, H, Bekkers, S, Cheriex, E, Kietselaer, B, Streukens, S, Cramer, M, Offstad, J, Beitnes, J, Butt, M, Khanzada, M, Kasprzak, J, Strzecka, D, Timoteo, A, Tomescu, M, Trofenciuc, N, Branea, H, Velcean, L, Onel, M, Pop-Moldovan, A, Puticiu, M, Citu, I, Cotoraci, C, Yeo, T, Poh, K, Germinas, A, Perez, M, Suarez-Varela, M, Arnau, M, Castillo, J, Zamorano, J, Moya Mur, J, Monteagudo, J, Farinas Alvarez, M, Gutierrez-Diez, J, Miro, J, Tolosana, J, Mourali, M, Yasar, U, Ursi, M, Asch, F, Clinical sciences, Cardio-vascular diseases, Cardiology, Medical Imaging, Cardiovascular Centre (CVC), Service de médecine nucléaire [Marseille], Imagerie MOléculaire pour applications THéranostiques personnalisées (IMOTHEP), Institut FRESNEL (FRESNEL), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)- Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC), MGSOG Scientific staff, MUMC+: MA Cardiologie (9), Cardiologie, RS: Carim - H01 Clinical atrial fibrillation, RS: CARIM - R2.01 - Clinical atrial fibrillation, RS: CARIM - R3.11 - Imaging, Promovendi CD, Fysiologie, MUMC+: MA Med Staf Artsass CTC (9), RS: CARIM - R1.06 - Genetic Epidemiology and Genomics of cardiovascular diseases, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H02 Cardiomyopathy, RS: CARIM - R2.02 - Cardiomyopathy, CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, RS: CARIM - R2.12 - Surgical intervention, RS: FdR IC Aansprakelijkheid, Graduate School, ACS - Heart failure & arrhythmias, Radiotherapy, CCA - Imaging and biomarkers, CCA - Cancer Treatment and Quality of Life, and ACS - Atherosclerosis & ischemic syndromes
- Subjects
Male ,SURGERY ,Embolism ,Infective endocarditi ,Infective endocarditis ,Registry ,Valve disease ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Africa, Northern ,Positron Emission Tomography Computed Tomography ,030212 general & internal medicine ,Hospital Mortality ,Prospective Studies ,Registries ,Prospective cohort study ,Abscess ,Aged, 80 and over ,medicine.diagnostic_test ,Middle Aged ,Staphylococcal Infections ,3. Good health ,Cardiac surgery ,Community-Acquired Infections ,Europe ,Treatment Outcome ,Positron emission tomography ,Echocardiography ,Heart Valve Prosthesis ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Female ,ECHOCARDIOGRAPHY ,Cardiology and Cardiovascular Medicine ,Adult ,medicine.medical_specialty ,Asia ,Prosthesis-Related Infections ,DIAGNOSIS ,03 medical and health sciences ,Fluorodeoxyglucose F18 ,Internal medicine ,Streptococcal Infections ,medicine ,MANAGEMENT ,Journal Article ,Humans ,Aged ,business.industry ,EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY ,Endocarditis, Bacterial ,South America ,medicine.disease ,Heart failure ,Etiology ,Radiopharmaceuticals ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Enterococcus - Abstract
Aims The EURO-ENDO registry aimed to study the management and outcomes of patients with infective endocarditis (IE). Methods and results Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. Conclusion Infective endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles.
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- 2019
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10. Markers of hypercoagulability and inflammation predict mortality in patients with heart failure
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Valerio Verdiani, Anna Maria Gori, Rossella Marcucci, M. Baldi, F. Giannotti, Rosanna Abbate, S. Del Pace, and Carlo Nozzoli
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Male ,medicine.medical_specialty ,Cardiac output ,Antithrombin III ,Cardiac Output, Low ,Fibrin Fibrinogen Degradation Products ,Risk Factors ,Internal medicine ,Natriuretic Peptide, Brain ,D-dimer ,medicine ,Humans ,Aged ,Subclinical infection ,Aged, 80 and over ,Inflammation ,biology ,Interleukin-6 ,Proportional hazards model ,business.industry ,C-reactive protein ,Hazard ratio ,Hematology ,Blood Coagulation Disorders ,medicine.disease ,Confidence interval ,Surgery ,C-Reactive Protein ,Heart failure ,Heart Function Tests ,biology.protein ,Cardiology ,Female ,business ,Biomarkers ,Peptide Hydrolases - Abstract
Summary. Background and aims: Plasma levels of inflammatory markers are increased in chronic heart failure (HF) and are also subclinical indicators of future HF. Inflammation is strictly correlated with clotting activation, but the association between inflammation, hypercoagulability and prognosis in HF has not been previously reported. Methods and results: Markers of inflammation (interleukin-6; IL-6, and C-reactive protein; CRP) and hypercoagulability (D-dimer; DD, and thrombin-antithrombin III complex; TAT) were prospectively assessed in 214 subjects with New York Heart Association (NYHA) functional class II–IV HF. During a median follow-up of 8.5 months, 32 patients had an event: 13 died and 19 were hospitalized because of worsening of HF. IL-6, DD and TAT levels were all significantly associated with increased risk of death after adjustment for other known HF prognostic factors (age, gender, traditional cardiovascular risk factors, NYHA class, systolic left ventricular function, renal failure, hemoglobin, serum sodium) in a Cox multivariate proportional hazard model (P = 0.003, P = 0.01 and P = 0.02, respectively). When these markers were added simultaneously to the known prognostic factors in a new Cox multivariate model, only DD levels were significant predictors of mortality (hazard ratio [95% confidence interval; CI]: 11 [2.7–45.1], P = 0.001). The Kaplan–Meier curve revealed a significantly better outcome in patients with DD below 450 ng mL−1. NT-pro-BNP was the only significant predictor of rehospitalization (HR [95% CI]: 5.3 [2.0–13.8], P
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- 2006
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11. O4.08: Predictive value of self-reported pre-operative and early post-operative physical performance status in older cardiac surgery patients
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M. Di Bari, V. Gamba, M. Taddei, S Del Pace, G. Guidarelli, Marco Chiostri, and Pierluigi Stefàno
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medicine.medical_specialty ,business.industry ,Physical performance ,Medicine ,Geriatrics and Gerontology ,Post operative ,business ,Gerontology ,Predictive value ,Pre operative ,Surgery ,Cardiac surgery - Published
- 2014
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12. Acute left ventricular dysfunction due to Tako-tsubo syndrome after induction of general anesthesia
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G, Consales, L, Campiglia, G, Michelagnoli, E, Gallerani, S, Rinaldi, S, Del Pace, and A R, De Gaudio
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Ventricular Dysfunction, Left ,Cholecystectomy, Laparoscopic ,Takotsubo Cardiomyopathy ,Acute Disease ,Humans ,Female ,Anesthesia, General ,Intraoperative Complications ,Aged - Abstract
Tako-tsubo cardiomyopathy is a recently described form of transient ventricular dysfunction that is not associated with coronary vessels obstruction, although its clinical manifestations are often similar to those of myocardial ischemia. This syndrome is possibly due to an excess of catecholamines, and it is associated with emotional and physical stress and surgery. However, the pathophysiological relation to anaesthesia has not yet been clarified. We report a case of Tako-tsubo cardiomyopathy that ensued immediately after induction of general anaesthesia for elective surgery in a patient submitted to laparoscopic cholecystectomy. The patient was first treated as if affected by myocardial ischemia, but a rapidly performed emergency coronary angiography showed normal epicardial coronary vessels with a significant reduction of left ventricular function. The coronary angiography ruled out the diagnosis of typical myocardial ischemia and allowed for the arrival at the correct diagnosis. The transient ventricular ballooning was attributed to the recently described Tako-tsubo syndrome. Prompt treatment allowed control of symptoms, and the patient was safely treated and discharged on day 15. Although it is difficult to identify the cause of this syndrome, it may be argued that, during general anaesthesia and particularly at induction, the imperfect control of catecholamine excess may induce cardiac damage in predisposed subjects.
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- 2007
13. [Acute pericarditis in pregnancy. Report of a case]
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F, Mecacci, P, La Torre, E, Parretti, A, Magrini, L, Falchi, G, Chiarello, G, Mello, and S, Del Pace
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Adult ,Pregnancy ,Acute Disease ,Pregnancy Complications, Cardiovascular ,Humans ,Pericarditis ,Female - Abstract
In this study the authors describe a case of acute pericarditis occurring at 26 weeks' gestation in a woman affected by Wolff-Parkinson-White Syndrome and with a history of Hodgkin's Lymphoma and autoimmune hypothyroidism. The patient was first admitted to the 4th Medical Pathology Unit of the University of Florence, where moderate pericardic effusion with no evidence of heart tamponade was documented by ultrasound scan. Subsequently the patient was cared for on outpatient basis at the Centre of Perinatal Medicine of the Department of Obstetrics and Gynaecology of the University of Florence. Since all examinations and tests aimed at defining the etiology of pericardial effusion were negative, an idiopathic acute pericarditis was diagnosed. The patient was given prednisone at a dose of 75 mg per day; owing to episodes of paroxystic atrial fibrillation, propaphenon was also administered intravenously to treat acute episodes and orally as prophylaxis. The patient underwent close control of both heart function (by means of ultrasound scans of the heart and dynamic EKG) and pregnancy (blood tests, ultrasound scans and Doppler velocimetry). At 36.5 weeks' gestation a healthy fetus was spontaneously delivered. Three months after delivery, the patient underwent an ultrasound scan that demonstrated the complete reabsorption of the effusion.
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- 2000
14. [Volume increase of the left leg and dyspnea as clinical manifestation of ruptured abdominal aorta aneurysm: problems of diagnostic assessment]
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A, Brancato, F, Gabriele, A, Alessi Innocenti, and S, Del Pace
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Male ,Leg ,Dyspnea ,Aortic Rupture ,Humans ,Aged ,Aortic Aneurysm, Abdominal - Abstract
The case of a 74-year-old man who presented with abdominal pain, worsening dyspnea and swelling of the left lower limb is described. Careful history taking and clinical examination enabled diagnosis of the rupture of an abdominal aortic aneurysm.
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- 1996
15. [Rational bases for the therapy of supraventricular tachycardias and their management]
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C, Rostagno, G, Bertini, L, Padeletti, A, Michelucci, S, Del Pace, and G F, Gensini
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Atrial Flutter ,Recurrence ,Atrial Fibrillation ,Tachycardia, Supraventricular ,Humans ,Wolff-Parkinson-White Syndrome ,Anti-Arrhythmia Agents - Abstract
Supraventricular arrhythmias are frequently encountered in clinical practice. Despite their common anatomical origin above the division of His' bundle into bundle branches, these arrhythmias have profoundly different electrophysiological mechanisms, clinical significances and responses to treatment. Although 12-lead surface ECG usually enables correct identification, facilitating treatment choice in the emergency room, electrophysiologic testing to determine the site of origin and the pathway of the arrhythmia may be necessary for the management of definitive treatment. Drug therapy is efficient for conversion to sinus treatment in 80-90% of patients with new onset arrhythmias. Class Ic antiarrhythmics (propafenone and flecainide) are particularly useful for atrial fibrillation, while adenosine and verapamil are the drugs of choice for reentry tachycardias. Atrial flutter is a noteworthy exception, and DC shock is often required to terminate the arrhythmia. The results of antiarrhythmic therapy for long term prevention of recurrences are often disappointing. Recent surgical and technological developments, in particular transcatheter ablation procedures, now allow definitive resolution of most reentrant arrhythmias, including preexcitation syndrome. This report discusses current concepts regarding the management of supraventricular arrhythmias.
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- 1993
16. Left Ventricular Diastolic Dysfunction Predicts Global Longitudinal Strain Recovery after Surgical Aortic Valve Replacement.
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Bonanni F, Caciolli S, Berteotti M, Grasso Granchietti A, Tozzetti V, Cenni N, Servoli C, Bandini M, Marchi E, Del Pace S, Stefano P, and Marchionni N
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Background and Objectives: In patients with severe aortic stenosis (AS), left ventricular systolic dysfunction is one of the main predictors of adverse events after surgical aortic valve replacement (SAVR). However, more patients undergo surgery earlier, often with preserved systolic function. In these cases, global longitudinal strain (GLS) has been proposed as a marker of ventricular remodeling post-surgery. This study aims to evaluate GLS variation in patients undergoing SAVR and explore differences across the diastolic dysfunction classes., Methods: From June 2020 to March 2023, patients with AS and preserved ejection fraction (EF) requiring SAVR were enrolled. Echocardiographic evaluations were conducted preoperatively, seven days post-surgery, and twelve months after surgery. Patients were divided into two groups based on the severity of diastolic dysfunction: Group A (grade I) and Group B (grades II-III)., Results: The final analysis included 108 patients (mean age 71.3 ± 7.2 years). Twenty-two patients (20.4%) also underwent coronary artery bypass grafting (CABG). The preoperative EF averaged 61.6 ± 6.03%, with no significant differences between groups. Preoperative GLS was 16 ± 4.3%, decreasing to 12.8 ± 3.4% postoperatively ( p < 0.0001). GLS was comparable between the groups preoperatively ( p = 0.185) and postoperatively (0.854). After twelve months, GLS improved in both groups (Group A: 17.7 ± 3.4%, Group B: 15.7 ± 3.2%, p < 0.0001), but only Group A showed significant improvement from preoperative values ( p = 0.018). SAVR improved GLS regardless of CABG intervention., Conclusions: SAVR in patients with preserved LVEF results in an early reduction in GLS, regardless of diastolic dysfunction. After twelve months, GLS improved significantly, with significant recovery only in patients with mild dysfunction.
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- 2024
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17. Atlas of Regional Left Ventricular Scar in Nonischemic Cardiomyopathies: Substrates and Etiologies.
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Del Franco A, Ruggieri R, Pieroni M, Ciabatti M, Zocchi C, Biagioni G, Tavanti V, Del Pace S, Leone O, Favale S, Guaricci AI, Udelson J, and Olivotto I
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Most acquired and inherited cardiomyopathies are characterized by regional left ventricular involvement and nonischemic myocardial scars, often with a disease-specific pattern. Irrespective of the etiology and pathophysiological mechanisms, myocardial disorders are invariably associated with cardiac fibrosis, which contributes to dysfunction and electrical instability. Accordingly, cardiac magnetic resonance plays a central role in the diagnostic work-up and prognostic risk stratification of cardiomyopathies, particularly with the increasing correlation between genetic background and specific disease phenotype. Starting from pattern and distribution of myocardial fibrosis at cardiac magnetic resonance, we provide a practical regional atlas of nonischemic myocardial scar to guide the diagnostic approach to nonischemic cardiomyopathies., Competing Interests: Dr Olivotto was supported by the European Union's 10.13039/100010661Horizon 2020 Research and Innovation Programme under Grant Agreement number: 777204: “SILICOFCM - In Silico trials for drug tracing the effects of sarcomeric protein mutations leading to familial cardiomyopathy”; by the Italian Ministry of Health (Left ventricular hypertrophy in aortic valve disease and hypertrophic cardiomyopathy: genetic basis, biophysical correlates and viral therapy models” (RF-2013-02356787); and by the EnteCassa di Risparmio di Firenze (bando 2016) “juvenile sudden cardiac death: just know and treat.” The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)
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- 2024
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18. Heparin-induced thrombocytopenia after cardiac surgery. A single-center, retrospective cohort study.
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Bevilacqua S, Stefàno P, Berteotti M, Del Pace S, Pieri M, Mandarano R, Rogolino A, Cesari F, Gori AM, Giusti B, and Marcucci R
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Background: Cardiac surgery is a high-risk setting for heparin-induced thrombocytopenia (HIT). However, large differences in its incidence, rate of thrombotic complications, and mortality have been reported in this context. Few studies address the pharmacologic management of HIT specifically in this setting., Objectives: To describe the incidence, outcomes, and management of patients with HIT in our cohort and to compare them with patients presenting platelet factor 4/heparin antibodies but without platelet-activating capacity., Methods: A retrospective observational study was conducted over a period of 10 years and 6 months on 13,178 cardiac operations in a single high-volume cardiac surgery center., Results: HIT was diagnosed in 0.22% of patients. HIT with associated thromboembolic complications occurred in 0.04% of cases. Two deaths at 30 days were registered, both in patients with associated thrombosis. The 4T score showed a 99.9% negative predictive value. The immunoglobulin G-specific chemiluminescence test positivity rate was highly predictive of HIT. Warfarin was often started early after surgery, and although it was rarely stopped when the diagnosis of HIT was made, no new thromboembolic complications subsequently occurred. Thrombocytopenia appeared to be a poor prognostic sign, whatever the cause., Conclusion: Although rare, HIT is characterized by high mortality in this setting, especially if thrombotic complications occur. Large multicentric studies or an international registry should be created to enhance the scientific evidence on HIT diagnosis and management in this context., (© 2024 The Author(s).)
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- 2024
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19. Post-procedural fever after transcatheter aortic valve implantation: a retrospective single-centre study.
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Scheggi V, Del Pace S, Fumagalli C, Meucci F, Nardi G, Di Muro FM, Menale S, Pisani E, Vitiello VS, Setti V, Valenti R, Cerillo A, Stefàno PL, Di Mario C, and Marchionni N
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- Humans, Retrospective Studies, Treatment Outcome, Risk Factors, Transcatheter Aortic Valve Replacement adverse effects
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- 2024
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20. Diagnostic delays in modern medicine. A case report.
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Ascione G, Scheggi V, and Del Pace S
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- Humans, Specialization, Delayed Diagnosis, Medicine
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Modern medicine has evolved toward ultra-specialization and sectoralization of medical specialties. This approach may provide an advantage for the quality of care of a single disease but implies the risk of not appropriately addressing comprehensive care. It may sometimes result in overall diagnostic delays due to the prescription of additional diagnostic tests, that could be appropriate considering the single specialist approach but do not consider the overall clinical context of the patient. We describe the case of a patient with multiple comorbidities, who experienced a multiple specialistic approach, without a holistic view.
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- 2024
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21. Infective endocarditis in octogenarians. A retrospective study in a single, high-volume surgical centre.
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Scheggi V, Menale S, Tonietti B, Giovacchini J, Del Pace S, Zoppetti N, Alterini B, Stefàno PL, and Marchionni N
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- Male, Aged, 80 and over, Humans, Female, Aged, Retrospective Studies, Octogenarians, Prognosis, Hospital Mortality, Endocarditis, Bacterial diagnosis, Endocarditis, Bacterial epidemiology, Endocarditis, Bacterial surgery, Endocarditis diagnosis, Endocarditis surgery, Endocarditis microbiology
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Background: Infective endocarditis (IE) is a severe disease associated with high morbidity and mortality. Little is known about the best management of elderly patients with IE. In these patients, surgery may be challenging. Our study aimed to describe IE's features in octogenarians and to identify the independent predictors of mortality, focusing on the prognostic impact of disability., Methods: We retrospectively analyzed 551 consecutive patients admitted to a single surgical centre with a definite diagnosis of non-device-related infective endocarditis; of these, 97 (17.6%) were older than 80 years., Results: In patients under eighty, males were mostly involved with a sex ratio exceeding 2:1. This ratio was inverted in older people, where the female gender represented 53.6% of the total. Enterococci (29.8 vs. 17.4%, p = 0.005) were significantly more frequent than in younger people. Comorbidities were more frequent in elderly patients; consequently, EuroSCORE II was higher (median ± IQR 16.4 ± 21.1 vs. 5.0 ± 10.3, p = 0.001). In octogenarians, IE was more frequently left-sided (97.9 vs. 89.8%, p = 0.011). Octogenarians were more often excluded from surgery despite indication (23.7 vs. 8.1%, p = 0.001) and had higher three-year mortality (45.3 vs. 30.6%, p = 0.005) than younger patients. In elderly patients, age did not independently predict mortality, while exclusion from surgery and a high grade of disability did., Conclusions: Octogenarians with IE have specific clinical and microbiological characteristics. Older patients are more often excluded from surgery, and the overall prognosis is poor. Age per se should not be a reason to deny surgery, while disability predicts futility., (© 2023. BioMed Central Ltd., part of Springer Nature.)
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- 2023
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22. Impact of cardiac surgery on left-sided infective endocarditis with intermediate-length vegetations.
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Scheggi V, Bohbot Y, Tribouilloy C, Trojette F, Di Lena C, Philip M, Hubert S, Menale S, Zoppetti N, Del Pace S, Stefàno PL, Habib G, and Marchionni N
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- Humans, Female, Middle Aged, Aged, Aged, 80 and over, Retrospective Studies, Hospitalization, Endocarditis complications, Endocarditis surgery, Cardiac Surgical Procedures adverse effects, Endocarditis, Bacterial complications, Endocarditis, Bacterial diagnosis, Endocarditis, Bacterial surgery
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Objective: The best strategy to manage patients with left-sided infective endocarditis (IE) and intermediate-length vegetations (10-15 mm) remains uncertain. We aimed to evaluate the role of surgery in patients with intermediate-length vegetations and no other European Society of Cardiology guidelines-approved surgical indication., Methods: We retrospectively enrolled 638 consecutive patients admitted to three academic centres (Amiens, Marseille and Florence University Hospitals) between 2012 and 2022 for left-sided definite IE (native or prosthetic) with intermediate-length vegetations (10-15 mm). We compared four clinical groups: medically (n=50) or surgically (n=345) treated complicated IE, medically (n=194) or surgically (n=49) treated uncomplicated IE., Results: Mean age was 67±14 years. Women were 182 (28.6%). The rate of embolic events on admission was 40% in medically treated and 61% in surgically treated complicated IE, 31% in medically treated and 26% in surgically treated uncomplicated IE. The analysis of all-cause mortality showed the lowest 5-year survival rate for medically treated complicated IE (53.7%). We found a similar 5-year survival rate for surgically treated complicated IE (71.4%) and medically treated uncomplicated IE (68.4%). The highest 5-year survival rate was observed in surgically treated uncomplicated IE group (82.4%, log-rank p<0.001). The analysis of the propensity score-matched cohort estimated an HR of 0.23 for uncomplicated IE treated surgically compared with medical therapy (p=0.005, 95% CI: 0.079 to 0.656)., Conclusions: Our results suggest that surgery is associated with lower all-cause mortality than medical therapy in patients with uncomplicated left-sided IE with intermediate-length vegetations even in the absence of other guideline-based indications., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2023
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23. Lower extremity performance predicts length of hospital stay in older candidates to elective cardiac surgery.
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Baldasseroni S, Di Bari M, Stefàno P, Pratesi A, Mossello E, Ungar A, Del Pace S, Orso F, Herbst A, Lucarelli G, Fumagalli C, Olivo G, and Marchionni N
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- Aged, Aged, 80 and over, Cohort Studies, Female, Humans, Length of Stay, Lower Extremity surgery, Male, Postoperative Complications epidemiology, Postoperative Complications etiology, Prospective Studies, Cardiac Surgical Procedures adverse effects
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Introduction: Prolonged hospital stay must be considered as risk factor for poor outcomes after cardiac surgery; different variables have been advocated as predictors of in-hospital stay. Nevertheless, most patients requiring prolonged hospital stay are frail older subjects; thus, we hypothesized a significant influence of pre-operative physical performance, as a frailty measure, on in-hospital stay after elective cardiac surgery., Methods: In a prospective, single-center, cohort study we enrolled patients aged 75+ years referred to our Division of Cardiac Surgery at Careggi University Hospital, for their first elective cardiac surgery. All participants were preoperatively evaluated by a team composed by a cardiac surgeon, a cardiologist, an anaesthesist, and a geriatrician to assess global cardiac surgery risk; lower extremity performance was measured with the Short Physical Performance Battery-SPPB., Results: A total of 518 patients were included in the study. Mean age was 79.5 ± 3.3 years; 256 (49.4%) were women. Isolated coronary by pass graft was performed in 37 patients (7.1%), isolated valve surgery in 115 (22.0%), and combined cardiac surgery procedures in 366 (70,9%). In a multivariable model, SPPB score was strongly associated with hospital length of stay both as continuous, categorized and dichotomous variable (p < 0.001; p = 0.002; p = 0.002 respectively) in all study population, and in subgroup of patients candidate to cardiac surgery considered by the Society of Thoracic Surgeons calculator score (p = 0.023; p = 0.056; p = 0.013 respectively)., Conclusions: Our findings support the use of pre-operative SPPB evaluation before elective cardiac surgery based on the independent ability to predict length of hospital stay., (Copyright © 2022 Elsevier Inc. All rights reserved.)
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- 2022
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24. Impact of septic cerebral embolism on prognosis and therapeutic strategies of infective endocarditis: a retrospective study in a surgical centre.
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Scheggi V, Menale S, Tonietti B, Bigiarini C, Giovacchini J, Del Pace S, Zoppetti N, Alterini B, Stefàno PL, and Marchionni N
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- Humans, Prognosis, Retrospective Studies, Risk Factors, Embolism complications, Endocarditis complications, Endocarditis diagnosis, Endocarditis surgery, Endocarditis, Bacterial complications, Endocarditis, Bacterial diagnosis, Endocarditis, Bacterial therapy, Intracranial Embolism etiology, Sepsis complications
- Abstract
Background: Infective endocarditis still has high mortality and invalidating complications, such as cerebral embolism. The best strategies to prevent and manage neurologic complications remain uncertain. This study aimed to identify predictors of cerebral septic embolism and evaluate the role of surgery in these patients in a real-world surgical centre., Methods: We retrospectively analyzed 551 consecutive patients admitted to our department with a definite diagnosis of non-device-related infective endocarditis; of these, 126 (23%) presented a neurologic complication., Results: Cerebral embolism was significantly more frequent in patients with large vegetations (p = 0.004), mitral valve infection (p = 0.001), and Staphylococcus aureus infection (p = 0.025). At multivariable analysis, only vegetation length was an independent predictor of cerebral embolism (HR per unit 1.057, 95% CI 1.025-1.091, p 0.001), with a best predictive threshold of 10 mm at ROC curve analysis (AUC 0.54, p = 0.001). Patients with neurologic complications were more often excluded from surgery despite an indication to it (16% vs 8%, p = 0.001). If eligible, they were treated within two weeks from diagnosis in similar proportions as patients without cerebral embolism with a similar survival rate. Predictors of mortality were hemorrhagic lesions (p = 0.018), a GCS < 14 (p = 0.001) or a severe degree of disability (p = 0.001) at presentation. The latter was the only independent predictor of mortality at multivariable analysis (HR 2.3, 95% CI 1.43-3.80, p = 0.001)., Conclusions: The present study highlights the prognostic value of functional presentation and the safety of cardiac surgery, when feasible, in patients with cerebral septic embolism., (© 2022. The Author(s).)
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- 2022
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25. Double-valve infective endocarditis: clinical features and prognostic impact-a retrospective study in a surgical centre.
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Scheggi V, Del Pace S, Ceschia N, Vanni F, Merilli I, Zoppetti N, Alterini B, Marchionni N, and Stefàno PL
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- Humans, Prognosis, Recurrence, Retrospective Studies, Endocarditis diagnosis, Endocarditis surgery, Endocarditis, Bacterial diagnosis, Endocarditis, Bacterial surgery
- Abstract
Most cases of infective endocarditis (IE) involve a single valve, and little is known concerning IE that simultaneously affects two valves. The involvement of more than one valve may imply more severe and extensive cardiac lesions. In these patients, surgery may be challenging. We aimed to determine the clinical characteristics, the therapeutic strategy, and the prognostic impact of double-valve IE (DVIE). We retrospectively included in the analysis that 440 consecutive patients with definite active IE in a single surgical centre. DVIE occurred in 75 of the total enrolled 440 patients (17%) and involved mostly the combination of mitral and aortic valves (N = 63, 84%). Most patients had double-native IE (N = 45, 60%). Staphylococci were less frequent in patients with double-valve than single-valve IE (SVIE). The proportion of patients undergoing valve repair among those treated surgically was higher for patients with DVIE than for SVIE (p < 0.03). Valve repair of at least one valve was associated with non-significant better survival than double replacement. DVIE was associated with higher all-cause mortality than SVIE (p < 0.013) and a higher relapse rate (p = 0.023). DVIE was not associated with a higher risk of composite non-fatal adverse events. DVIE represents a considerable proportion of overall cases of IE, mainly involving aortic and mitral valves, with a jet lesion on the mitral valve; Staphylococcus is significantly less frequent than in SVIE; DVIE is independently associated with higher mortality and relapse rate; finally, mitral valve repair is feasible in a considerable proportion of surgical cases., (© 2021. Springer Japan KK, part of Springer Nature.)
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- 2022
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26. Infective endocarditis in intravenous drug abusers: clinical challenges emerging from a single-centre experience.
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Scheggi V, Del Pace S, Ceschia N, Vanni F, Merilli I, Sottili E, Salcuni L, Zoppetti N, Alterini B, Cerillo A, Marchionni N, and Stefàno PL
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- Humans, Neoplasm Recurrence, Local, Retrospective Studies, Risk Factors, Drug Users, Endocarditis drug therapy, Endocarditis epidemiology, Endocarditis, Bacterial, Substance Abuse, Intravenous complications
- Abstract
Background: Intravenous drug abuse (IDA) is a known risk factor for infective endocarditis (IE) and is associated with frequent relapses, but its prognostic impact is still debated. The potential futility of surgery in this population is a further issue under discussion. We aimed to describe the clinical characteristics, the therapeutic strategy, and the prognosis associated with IDA in IE., Methods: We retrospectively analysed 440 patients admitted to a single surgical centre for definite active IE from January 2012 to December 2020., Results: Patients reporting IDA (N = 54; 12.2%) were significantly younger (p < 0.001) and presented fewer comorbidities (p < 0.001). IDA was associated with a higher proportion of relapses (27.8 vs. 3.3%, p < 0.001) and, at multivariable analysis, was an independent predictor of long-term mortality (HR 2.3, 95%CI 1.1-4.7, p = 0.015). We did not register multiple relapses in non-IDA patients. Among IDA patients, we observed 1 relapse after discharge in 9 patients, 2 relapses in 5 patients and 3 relapses in 1 patient. In IDA patients, neither clinical and laboratory variables nor the occurrence of even multiple relapses emerged as indicators of an adverse risk-benefit ratio of surgery in patients with surgical indication., Conclusions: IE secondary to IDA affects younger patients than those with IE not associated with IDA. Probably due to this difference, IE secondary to IDA is not associated with significantly higher mortality, whereas the negative, long-term prognostic impact of IDA emerges in multivariate analysis. Considering the good prognosis of patients with uncomplicated IE treated medically, surgery should be reserved to patients with a strict- guidelines-based indication. However, since there are no clear predictors of an unfavourable risk-benefit ratio of surgery in patients with surgical indication, all patients with a complicated IE should be operated, irrespective of a history of IDA., (© 2021. The Author(s).)
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- 2021
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27. Surgical Risk Factors for Ischemic Stroke Following Coronary Artery Bypass Grafting. A Multi-Factor Multimodel Analysis.
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Gelsomino S, Tetta C, Matteucci F, Del Pace S, Parise O, Prifti E, Dokollari A, Parise G, Micali LR, La Meir M, and Bonacchi M
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Background: Ischemic stroke after coronary artery bypass (CABG) has been often linked to aortic manipulation during surgery. Objectives: The objective of the study was to estimate the rate of postoperative ischemic stroke within 30 days from CABG by surgical risk factors alone or in combination. Methods: The multinomial propensity score for multiple treatments was used to create six models with a total of 16,255 consecutive patients undergoing isolated CABG. For each model, a different classification variable was used to stratify patients. Results: Balance achieved in all models was substantial, enabling unbiased estimation of the treatment estimand. Both off-pump techniques with (0.009; 95% CI 0.006-0.011) or without proximal anastomoses (0.005; 0.005-0.003), and surgery performed on the beating heart using cardiopulmonary bypass with (0.009; 0.006-0.011) or without proximal anastomoses (0.024; 0.021-0.029) showed a mean stroke estimate significantly lower than the other techniques. Off-pump surgery and on-pump surgery without an aortic cross-clamp yielded nearly equal incidences of stroke (0.012; 0.008-0.015 and 0.018; 0.012-0.023, respectively). Using an aortic cross-clamp significantly increased the stroke estimate (0.075; 0.061-0.088), whereas using a side-biting clamp did not (0.039; 0.033-0.044). The number of aortic touches (0.029; 0.026-0.031) and the number of proximal anastomoses (0.044; 0.035-0.047) did not significantly increase the incidence of stroke. Conclusions: Aortic cross-clamping was found to be the primary cause of post-CABG ischemic stroke. Instead, additional aortic manipulation from a side-biting clamp, on-pump surgery, multiple aortic touches, number of proximal anastomoses, and aortic cannulation were found not to increase the estimate of stroke significantly. Further research on this topic is warranted., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Gelsomino, Tetta, Matteucci, del Pace, Parise, Prifti, Dokollari, Parise, Micali, La Meir and Bonacchi.)
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- 2021
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28. Endocarditis with spondylodiscitis: clinical characteristics and prognosis.
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Del Pace S, Scheggi V, Virgili G, Caciolli S, Olivotto I, Zoppetti N, Merilli I, Ceschia N, Andrei V, Alterini B, Stefàno PL, and Marchionni N
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- Aged, Aged, 80 and over, Diabetes Mellitus epidemiology, Discitis diagnosis, Discitis microbiology, Endocarditis diagnosis, Endocarditis microbiology, Enterococcus pathogenicity, Female, Humans, Male, Middle Aged, Prevalence, Prognosis, Reinfection, Retrospective Studies, Risk Assessment, Risk Factors, Sex Factors, Substance-Related Disorders epidemiology, Time Factors, Discitis epidemiology, Endocarditis epidemiology
- Abstract
Background: The association of infective endocarditis (IE) with spondylodiscitis (SD) was first reported in 1965, but few data are available about this issue. This study aimed to evaluate the prevalence of SD in patients with IE, and to determine the clinical features and the prognostic impact of this association., Methods: We retrospectively analysed 363 consecutive patients admitted to our Department with non-device-related IE. Radiologically confirmed SD was revealed in 29 patients (8%). Long-term follow-up (average: 3 years) was obtained by structured telephone interviews; in 95 cases (13 of whom had been affected by SD), follow-up echocardiographic evaluation was also available., Results: At univariable analysis, the combination of IE with SD was associated with male gender (p = 0.017), diabetes (p = 0.028), drug abuse (p = 0.009), Streptococcus Viridans (p = 0.009) and Enterococcus (p = 0.015) infections. At multivariable analysis, all these factors independently correlated with presence of SD in patients with IE. Mortality was similar in patients with and without SD. IE relapses at 3 years were associated with the presence of SD (p = 0.003), Staphylococcus aureus infection (p < 0.001), and drug abuse (p < 0.001) but, at multivariable analysis, only drug abuse was an independent predictor of IE relapses (p < 0.001; HR 6.8, 95% CI 1.6-29). At echocardiographic follow-up, SD was not associated with worsening left ventricular systolic function or valvular dysfunction., Conclusions: The association of IE with SD is not rare. Hence, patients with IE should be screened for metastatic infection of the vertebral column, especially if they have risk factors for it. However, SD does not appear to worsen the prognosis of patients with IE, either in-hospital or long-term.
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- 2021
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29. Pre-operative physical performance as a predictor of in-hospital outcomes in older patients undergoing elective cardiac surgery.
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Baldasseroni S, Pratesi A, Stefàno P, Del Pace S, Campagnolo V, Baroncini AC, Lo Forte A, Marella AG, Ungar A, Di Bari M, and Marchionni N
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- Aged, Aged, 80 and over, Female, Hospitals, Humans, Italy epidemiology, Physical Functional Performance, Risk Assessment, Cardiac Surgical Procedures, Thoracic Surgery
- Abstract
Objective: Risk stratification of cardiac surgery patients is usually based on the Society of Thoracic Surgeons (STS) score, that has limited predictive value in older persons. We aimed assessing whether the Short Physical Performance Battery (SPPB) improves, beyond the STS score, assessment of hospital prognosis in older patients undergoing elective cardiac surgery., Methods: All patients aged 75+ years referred for elective cardiac surgery to Careggi University Hospital (Florence, Italy) from April 2013 to March 2017 were evaluated pre-operatively. Participants were classified according to the STS-Predicted Risk Of Mortality (STS-PROM): low (<4%), intermediate (4 to 8%), and high risk (>8%). Primary study outcomes were hospital mortality and STS-defined major morbidity. Length of hospital stay was an additional outcome., Results: Out of 235 participants (females: 46.5%; mean age: 79.6 years), 144 (61.3%) were at low, 67 (28.5%) at intermediate and 24 (10.2%) at high risk, based on the STS-PROM. SPPB (mean±SEM) was 8.8 ± 0.2, 7.0 ± 0.5, and 6.0 ± 0.8 in participants at low, intermediate, and high risk, respectively (p<0.001). The primary outcome occurred in 62 participants (26.4%). In low-risk participants, the SPPB score predicted the primary endpoint (adjusted OR 0.77, 95% CI 0.66-0.89 per each point increase; p<0.001) controlling for STS-Major Morbidity or Operative Mortality (STS-MM) score. This result was not observed in the intermediate-high risk group., Conclusions: SPPB predicts mortality and major morbidity in older patients undergoing elective cardiac surgery, classified as low risk with the STS risk score. The SPPB, applied preoperatively, might improve risk stratification in older patients undergoing elective cardiac surgery., (Copyright © 2020. Published by Elsevier B.V.)
- Published
- 2021
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30. Predictors of mortality and adverse events in patients with infective endocarditis: a retrospective real world study in a surgical centre.
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Scheggi V, Merilli I, Marcucci R, Del Pace S, Olivotto I, Zoppetti N, Ceschia N, Andrei V, Alterini B, Stefàno PL, and Marchionni N
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- Age Factors, Aged, Clinical Decision-Making, Conservative Treatment mortality, Endocarditis, Bacterial diagnosis, Endocarditis, Bacterial mortality, Female, Heart Valve Prosthesis Implantation mortality, Hospitalization, Humans, Male, Middle Aged, Postoperative Complications mortality, Postoperative Complications therapy, Predictive Value of Tests, Recurrence, Registries, Retrospective Studies, Risk Assessment, Risk Factors, Substance-Related Disorders mortality, Time Factors, Treatment Outcome, Conservative Treatment adverse effects, Endocarditis, Bacterial therapy, Heart Valve Prosthesis Implantation adverse effects, Postoperative Complications etiology, Substance-Related Disorders complications
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Purpose: Mortality in infective endocarditis (IE) is still high, and the long term prognosis remains uncertain. This study aimed to identify predictors of long-term mortality for any cause, adverse event rate, relapse rate, valvular and ventricular dysfunction at follow-up, in a real-world surgical centre., Methods: We retrospectively analyzed 363 consecutive episodes of IE (123 women, 34%) admitted to our department with a definite diagnosis of non-device-related IE. Median follow-up duration was 2.9 years. Primary endpoints were predictors of mortality, recurrent endocarditis, and major non-fatal adverse events (hospitalization for any cardiovascular cause, pace-maker implantation, new onset of atrial fibrillation, sternal dehiscence), and ventricular and valvular dysfunction at follow-up., Results: Multivariate analysis independent predictors of mortality showed age (HR per unit 1.031, p < 0.003), drug abuse (HR 3.5, p < 0.002), EUROSCORE II (HR per unit 1.017, p < 0.0006) and double valve infection (HR 2.3, p < 0.001) to be independent predictors of mortality, while streptococcal infection remained associated with a better prognosis (HR 0.5, p < 0.04). Major non-fatal adverse events were associated with age (HR 1.4, p < 0.022). New episodes of infection were correlated with S aureus infection (HR 4.8, p < 0.001), right-sided endocarditis (HR 7.4, p < 0.001), spondylodiscitis (HR 6.8, p < 0.004) and intravenous drug abuse (HR 10.3, p < 0.001). After multivariate analysis, only drug abuse was an independent predictor of new episodes of endocarditis (HR 8.5, p < 0.001). Echocardiographic follow-up, available in 95 cases, showed a worsening of left ventricular systolic function (p < 0.007); severe valvular dysfunction at follow-up was reported only in 4 patients, all of them had mitral IE (p < 0.03)., Conclusions: The present study highlights some clinical, readily available factors that can be useful to stratify the prognosis of patients with IE.
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- 2021
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31. Embolic risk stratification and prognostic impact of early surgery in left-sided infective endocarditis.
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Scheggi V, Alterini B, Olivotto I, Del Pace S, Zoppetti N, Tomberli B, Bartalesi F, Brandi L, Ceschia N, Andrei V, Suardi LR, Marchionni N, and Stefàno PL
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- Humans, Prognosis, Retrospective Studies, Risk Assessment, Risk Factors, Embolism, Endocarditis complications, Endocarditis surgery, Endocarditis, Bacterial complications, Endocarditis, Bacterial surgery
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Background: In patients with left-sided infective endocarditis (IE) and heart failure associated with large vegetations, early surgery prevents embolic events. However, optimal timing of surgery for other indications is still unresolved particularly when the presence of large vegetations represents the sole indication., Methods: We retrospectively analyzed 308 consecutive patients admitted to our department with definite left-sided IE. Of these patients, 243 (79%) underwent cardiac surgery (complicated IE), 34 patients with uncomplicated IE received medical treatment, 24 were not operated due to prohibitive general conditions and 7 refused surgery. Long-term follow-up was obtained by structured telephone interviews., Results: During the 6-year follow-up (average 121.8 weeks ± 76), patients not operated because of general conditions or refusal had the worst prognosis, while outcome in operated patients for complicated IE was comparable to that of uncomplicated IE treated medically. Early (<2 weeks from diagnosis) surgery was associated with better survival compared to delayed surgery (HR 0.58, p = 0.23). Embolic events were detected at admission in 38% of cases; Staphylococcus Aureus etiology and vegetation size were independently associated with embolism (OR 2.4, p = 0.01; OR 1, p=0.008 respectively)., Conclusions: Compared to uncomplicated medically-treated patients, complicated IE showed comparable survival when managed aggressively by surgical intervention, whereas a conservative approach was associated with an adverse prognosis. Staphylococcus Aureus infection and vegetation size were independent predictors of systemic embolism. Our data support aggressive surgical management of complicated IE patients and highlight the importance of etiological characterization in clinical decision-making., Competing Interests: Declaration of competing Interest None declared, (Copyright © 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)
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- 2020
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32. Comparison between three different equations for the estimation of glomerular filtration rate in predicting mortality after coronary artery bypass.
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Gelsomino S, Bonacchi M, Lucà F, Barili F, Del Pace S, Parise O, Johnson DM, and Gulizia MM
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- Aged, Coronary Artery Bypass adverse effects, Coronary Artery Bypass trends, Female, Humans, Male, Middle Aged, Mortality trends, Postoperative Complications diagnosis, Postoperative Complications etiology, Predictive Value of Tests, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic surgery, Retrospective Studies, Coronary Artery Bypass mortality, Glomerular Filtration Rate physiology, Postoperative Complications mortality, Renal Insufficiency, Chronic mortality
- Abstract
Background: This study was undertaken to compare the accuracy of chronic kidney disease-epidemiology collaboration (eGFR
CKD-EPI ) to modification of diet in renal disease (eGFRMDRD ) and the Cockcroft-Gault formulas of Creatinine clearance (CCG ) equations in predicting post coronary artery bypass grafting (CABG) mortality., Methods: Data from 4408 patients who underwent isolated CABG over a 11-year period were retrieved from one institutional database. Discriminatory power was assessed using the c-index and comparison between the scores' performance was performed with DeLong, bootstrap, and Venkatraman methods. Calibration was evaluated with calibration curves and associated statistics., Results: The discriminatory power was higher in eGFRCKD-EPI than eGFRMDRD and CCG (Area under Curve [AUC]:0.77, 0.55 and 0.52, respectively). Furthermore, eGFRCKD-EPI performed worse in patients with an eGFR ≤29 ml/min/1.73m2 (AUC: 0.53) while it was not influenced by higher eGFRs, age, and body size. In contrast, the MDRD equation was accurate only in women (calibration statistics p = 0.72), elderly patients (p = 0.53) and subjects with severe impairment of renal function (p = 0.06) whereas CCG was not significantly biased only in patients between 40 and 59 years (p = 0.6) and with eGFR 45-59 ml/min/1.73m2 (p = 0.32) or ≥ 60 ml/min/1.73m2 (p = 0.48)., Conclusions: In general, CKD-EPI gives the best prediction of death after CABG with unsatisfactory accuracy and calibration only in patients with severe kidney disease. In contrast, the CG and MDRD equations were inaccurate in a clinically significant proportion of patients.- Published
- 2019
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33. The duty of being a medical conservative. When in doubt, for the patient.
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Alderighi C, Del Pace S, and Rasoini R
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- Attitude of Health Personnel, Decision Making, Humans, Delivery of Health Care methods, Patient Care methods, Physicians organization & administration
- Abstract
Recently, John Mandrola et al. established the tenets of medical conservativism. We endorse this approach to patient care, and we believe that, in order to have this perspective incorporated into medical reasoning, the foundations for being medical conservatives should be taught since medical school. In this Perspective, through an analogy between medicine’s and criminal law’s approaches to uncertainty, we suggest that the precautionary principle of in dubio pro reo could be adapted to medicine as a decisional strategy for medical conservatives. This principle would represent a cognitive and decisional filter that allows physicians to counterbalance the currently widespread propensity toward interventions with a conservative and precautionary attitude.
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- 2019
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34. Impact of renal function impairment assessed by CKD EPI estimated glomerular filtration rate on early and late outcomes after coronary artery bypass grafting.
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Gelsomino S, Del Pace S, Parise O, Caciolli S, Matteucci F, Fradella G, Bonacchi M, Fusco S, Lucà F, and Marchionni N
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- Aged, Aged, 80 and over, Cohort Studies, Epidemiologic Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Renal Insufficiency epidemiology, Renal Insufficiency physiopathology, Renal Insufficiency surgery, Renal Insufficiency, Chronic epidemiology, Retrospective Studies, Treatment Outcome, Coronary Artery Bypass trends, Glomerular Filtration Rate physiology, Kidney physiopathology, Renal Insufficiency, Chronic physiopathology, Renal Insufficiency, Chronic surgery
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Background: We explore the association between short- and long- term adverse outcomes following coronary artery bypass grafting (CABG) and the degree of preoperative renal dysfunction classified on glomerular fraction estimated with Chronic Kidney Disease-Epidemiology Collaboration equation (eGFR
CKD-EPI ). We also try to identify cut-off values of eGFRCKD-EPI able to predict post-CABG unfavorable events and assess whether a reclassification with new thresholds is necessary., Methods: One-thousand-one-hundred-eighty-six consecutive patients undergoing CABG between 2005 and 2014 were categorized in 4 groups according to the eGFRCKD-EPI : Group 1 (≥60ml/min/1.73m2 ; n=1199), Group 2 (45-59ml/min/1.73m2 ; n=358), Group 3 (30-44ml/min/1.73m2 ; n=171) and Group 4 (≤29ml/min/1.73m2 ; n=126). Median follow-up was 66months [IQR 46-84]., Results: eGFRCKD-EPI ≤30ml/min/1.73m2 , ≤41ml/min/1.73m2 , ≤27ml/min/1.73m2 and ≤29ml/min/1.73m2 were strong predictors of early mortality (OR 5.88 [95% CI 2.59-11.25]), stroke (2.59 [1.43-3.71]), prolonged length of stay (3.49 [1.24-5.92]) and postoperative dialysis (3.68 [1.34-4.91]), respectively. In addition, eGFRCKD-EPI ≤26ml/min/1.73m2 , ≤25ml/min/1.73m2 , ≤35ml/min/1.73m2 and ≤29ml/min/1.73m2 predicted all-cause death (hazard ratio 2.74 [95% CI 2.10-3.92] cardiovascular death (sub-hazard ratio 2.11 [95% CI 1.42-3.90]), myocardial infarction (2.01 [1.32-3.70]) and heart failure (2.24 [1.41-3.93]), respectively. Analyses corrected by age and left ventricular ejection fraction confirmed these findings., Conclusions: In our experience, the use of the eGFRCKD-EPI equation led to categorization with a significantly lower number of patients at risk for post-CABG complications. This might have important clinical repercussions on allocation of healthcare resources and more targeted prevention and management of CABG complications., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)- Published
- 2017
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35. Tako-tsubo cardiomyopathy and coronary artery disease: a possible association.
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Parodi G, Citro R, Bellandi B, Del Pace S, Rigo F, Marrani M, Provenza G, Leoncini M, Salerno Uriarte JA, Bovenzi F, and Bossone E
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- Aged, Aged, 80 and over, Chi-Square Distribution, Coronary Angiography, Coronary Artery Disease diagnosis, Coronary Artery Disease mortality, Coronary Artery Disease therapy, Coronary Stenosis diagnosis, Coronary Stenosis mortality, Coronary Stenosis therapy, Female, Humans, Italy epidemiology, Male, Middle Aged, Multivariate Analysis, Patient Readmission, Prevalence, Prognosis, Proportional Hazards Models, Prospective Studies, Recurrence, Registries, Risk Factors, Takotsubo Cardiomyopathy diagnosis, Takotsubo Cardiomyopathy mortality, Takotsubo Cardiomyopathy therapy, Time Factors, Coronary Artery Disease epidemiology, Coronary Stenosis epidemiology, Takotsubo Cardiomyopathy epidemiology
- Abstract
Background: In the medical literature, several cases of Tako-tsubo cardiomyopathy (TTC) with coronary artery disease (CAD) have been reported, and in clinical practice, several typical TTC cases show relevant stenoses of the coronary arteries spatially unrelated to the dysfunctional myocardium., Objective: This study aimed to evaluate the prevalence, clinical characteristics, and outcome of patients with TTC and relevant CAD in a large multicenter database., Methods: In 26 centers, 450 patients admitted with a diagnosis of TTC underwent coronary angiography within 48 h of hospital admission and were included prospectively in the Tako-tsubo Italian Network Registry., Results: Overall, 43 (9.6%) patients had at least one relevant (≥50%) coronary stenosis not supplying the dysfunctional myocardium, whereas 407 patients (90.4%) had irrelevant stenosis or angiographically normal coronary arteries. TTC patients with relevant CAD were more likely to be older in age, to have diabetes, a familial history of CAD, and acute functional mitral regurgitation compared with those without relevant CAD. At the 6-month follow-up, the incidence of death, TTC recurrence, and rehospitalization rates in patients with and without relevant CAD were similar. On multivariable Cox analysis, an independent predictor of death was the Charlson Comorbidity Index, whereas the presence of CAD did not influence the mid-term outcome significantly., Conclusion: The presence of CAD is a rather common finding in a large proportion of patients with TTC. Thus, when the stenotic artery does not supply the dysfunctional myocardium or when the extent of dysfunctional myocardium is wider than the territory of distribution supplied by a single stenotic coronary artery, the presence of angiographically relevant CAD should not be considered an exclusion criterion for TTC.
- Published
- 2013
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36. [Epidemiology of Tako-tsubo cardiomyopathy: the Tuscany Registry for Tako-tsubo Cardiomyopathy ].
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Bellandi B, Salvadori C, Parodi G, Ebert AG, Petix N, Del Pace S, Boni A, Pestelli F, Fineschi M, Giomi A, Cresti A, Giuliani G, Venditti F, Querceto L, Gensini GF, Bolognese L, and Bovenzi F
- Subjects
- Aged, Electrocardiography, Female, Follow-Up Studies, Humans, Italy epidemiology, Male, Middle Aged, Prevalence, Prognosis, Prospective Studies, Registries, Risk Factors, Takotsubo Cardiomyopathy diagnosis, Takotsubo Cardiomyopathy epidemiology
- Abstract
Background: Tako-tsubo (stress) cardiomyopathy (TTC) is a recently described acute cardiac syndrome that mimics ST-segment elevation myocardial infarction. The TTC Tuscany Registry is an observational prospective multicenter registry established to define the prevalence, epidemiology and prognosis of TTC in the Tuscany area., Methods: From January 1 to December 31, 2009, 105 consecutive patients hospitalized in the 14 Cardiology Units of the Tuscany Region with a diagnosis of TTC, were enrolled in the registry. TTC diagnosis was made using the Mayo Clinic modified criteria. Clinical, instrumental, laboratory and 6-month follow-up data were collected. Results. TTC represented 1.2% of all myocardial infarctions in the Tuscany Region during 2009, and it was diagnosed in 0.6% of the angiographic exams performed during the same year. The data collected showed that TTC affects mainly the female gender (91%) in the post-menopausal period (70 ± 11 years), though 5% of patients were ≤50 years old. An antecedent stressful event was frequently detected (74%). The main clinical presentation was chest pain (86%), associated with ST-segment elevation (59%). Mean left ventricular ejection fraction on admission was 40 ± 9%, and was associated with apical (37%), midapical (49%) or midventricular (5%) wall motion abnormalities. Left ventricular ejection fraction recovered to 51 ± 9% in 7 ± 9 days. Heart failure was the most common complication in the acute phase (14%), and 4 patients presented with cardiogenic shock. No patient died during the index hospitalization. At 6-month follow-up, no patient had TTC recurrence, 9 patients were rehospitalized (7 for noncardiac disease) and 2 patients died of noncardiac causes., Conclusions: Our data, which represent the largest prospective series of patients with a diagnosis of TTC, show that the prevalence of TTC in Tuscany is similar that described in other national and international studies. Moreover, the data highlight that TTC may occur also in male patients and in patients aged <50 years. The mid-term prognosis is good, but the risk of acute complications related to heart failure cannot be neglected.
- Published
- 2012
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37. Anxiety trait in patients with stress-induced cardiomyopathy: a case-control study.
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Del Pace S, Parodi G, Bellandi B, Zampini L, Venditti F, Ardito M, Antoniucci D, and Gensini GF
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- Aged, Aged, 80 and over, Case-Control Studies, Coronary Angiography, Female, Humans, Male, Middle Aged, Myocardial Infarction complications, Prospective Studies, Psychological Tests, Anxiety Disorders complications, Takotsubo Cardiomyopathy complications
- Abstract
Background: Stress-induced Tako-tsubo cardiomyopathy (TTC) is an acute cardiac syndrome, mimics ST elevation myocardial infarction (STEMI), largely confined to postmenopausal women, frequently precipitated by a stressful event. The pathogenesis of TTC is still unknown. Some authors hypothesized a possible connection between TTC and anxiety disease, but no previous study analyzed the relationship between anxiety trait and TTC. This study sought to assess the potential role of anxiety trait in the development and clinical course of TTC., Methods: We included in the present prospective case-control study 50 consecutive patients admitted to our Hospital with a diagnosis of TTC according to the Mayo Clinic criteria. Fifty control patients with anterior STEMI matched for clinical characteristics such as age, gender, and hypertension were selected. During the hospitalization, all patients were asked to complete the Spielberger Trait Anxiety Inventory (STAI) scale for measuring self-reported trait anxiety (Trait-A). Outcome measures at follow-up were death, TTC recurrence, and rehospitalization., Results: The mean value of STAI scale was 46 ± 12 in TTC patients and 45 ± 14 in STEMI patients (p = 0.815). High-anxiety trait (STAI scale value ≥ 40) was documented in 30 (60%) TTC patients and in 26 (52%) STEMI patients (p = 0.387). At multivariate analysis, predictors of TTC were lower peak creatine kinase value (HR 0.999; 95% CI 0.998-0.999; p = 0.018) and an antecedent stressful trigger event (HR 45.487; 95% CI 6.471-319.759; p = 0.001), but anxiety trait was not. There were no differences in outcome measures between TTC patients with or without high-anxiety trait., Conclusion: In TTC patients, high-anxiety trait is a common finding but it is not significantly more frequent than in patients with STEMI. Moreover, a high-anxiety trait seems to be neither associated with a worse clinical outcome nor a predictor of TTC. Our study do not support the routine evaluation of anxiety trait in patients with TTC.
- Published
- 2011
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38. Natural history of tako-tsubo cardiomyopathy.
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Parodi G, Bellandi B, Del Pace S, Barchielli A, Zampini L, Velluzzi S, Carrabba N, Gensini GF, and Antoniucci D
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- Female, Follow-Up Studies, Humans, Italy epidemiology, Male, Prospective Studies, Recurrence, Survival Rate trends, Takotsubo Cardiomyopathy mortality, Takotsubo Cardiomyopathy physiopathology, Time Factors, Hospitalization statistics & numerical data, Takotsubo Cardiomyopathy etiology, Ventricular Function, Left physiology
- Abstract
Background: Stress-induced or tako-tsubo cardiomyopathy (TTC) is a rare acute cardiac syndrome characterized by transient left ventricular (LV) dysfunction of uncertain cause and outcome. This study sought to assess the long-term outcome of patients with TTC., Methods: One-hundred sixteen consecutive patients were prospectively included in the study and observed at long-term follow-up. Primary end points were death, TTC recurrence, and hospitalization from any cause., Results: Mean initial LV ejection fraction (LVEF) at admission was 36% ± 9%. Two patients died of refractory heart failure during hospitalization. Of the patients who were discharged alive all except one showed complete LV functional recovery. At follow-up (2.0 ± 1.3 years), only 64 (55%) patients were asymptomatic. Rehospitalization rate was high (25%), with chest pain (n = 6) and dyspnea (n = 5) as the most common causes. Only two patients had a recurrence of TTC. Eleven patients died (seven from cardiovascular cause). There was no significant difference in mortality (12% vs 7%; P = .284) and in the other clinical events between patients with and without severe LV dysfunction at presentation (LVEF ≤ 35%). Mortality observed in patients with TTC was compared with age and sex-specific mortality of the general population using the standardized mortality ratio (SMR) method. The SMR was 3.40 (95% CI, 1.83-6.34) in the TTC population. The only independent predictor of death at Cox analysis was Charlson comorbidity index (hazard ratio, 1.786; P = .0001), but the degree of initial LV dysfunction was not an independent predictor of death., Conclusions: The recurrence of TTC is rare, but recurrences of chest pain or dyspnea are common in patients with TTC and frequently lead to hospital readmission. Long-term mortality is higher as compared with the control general population and at least in part related to patients' comorbidities. Initial LV dysfunction severity does not seem to impact long-term event rates.
- Published
- 2011
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39. A 72-year-old man with intermittent fever, anemia and a history of coronary and peripheral artery disease.
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Del Pace S, Savino A, Rasoini R, Alderighi C, Acquafresca M, Innocenti AA, Pratesi C, and Gensini GF
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- Aged, Coronary Artery Disease, Endocarditis complications, Fever of Unknown Origin etiology, Humans, Male, Peripheral Arterial Disease, Anemia microbiology, Endocarditis microbiology, Fever of Unknown Origin microbiology, Pacemaker, Artificial adverse effects, Staphylococcal Infections complications, Staphylococcus intermedius isolation & purification
- Published
- 2010
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40. Abnormal response to mental stress in patients with Takotsubo cardiomyopathy detected by gated single photon emission computed tomography.
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Sciagrà R, Parodi G, Del Pace S, Genovese S, Zampini L, Bellandi B, Gensini GF, Pupi A, and Antoniucci D
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- Aged, Aged, 80 and over, Anger, Comorbidity, Female, Humans, Imagination, Male, Middle Aged, Motion, Myocardial Perfusion Imaging, Speech, Stroke Volume, Vasodilation, Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography, Stress, Psychological physiopathology, Sympathetic Nervous System physiopathology, Takotsubo Cardiomyopathy psychology
- Abstract
Purpose: Persistent abnormalities are usually not detected in patients with Takotsubo cardiomyopathy (TTC). Since sympathetically mediated myocardial damage has been proposed as a causative mechanism of TTC, we explored whether mental stress could evoke abnormalities in these patients., Methods: One month after an acute event, 22 patients fulfilling all TTC diagnostic criteria and 11 controls underwent resting and mental stress gated single photon emission computed tomography (SPECT). Perfusion, wall motion, transient ischaemic dilation (TID) and left ventricular (LV) ejection fraction (EF) were evaluated., Results: None of the controls showed stress-induced abnormalities. Mental stress evoked regional changes (perfusion defects and/or wall motion abnormality) in 16 TTC subjects and global abnormalities (LVEF fall >5% and/or TID >1.10) in 13; 3 had a completely negative response. TID, delta LVEF and delta wall motion score were significantly different in TTC vs control patients: 1.08 + or - 0.20 vs 0.95 + or - 0.11 (p < 0.05), -1.7 + or - 6% vs 4 + or - 5% (p < 0.02) and 2.5 (0, 4.25) vs 0 (0, 0) (p < 0.002), respectively., Conclusion: Mental stress may evoke regional and/or global abnormalities in most TTC patients. The abnormal response to mental stress supports the role of sympathetic stimulation in TTC. Mental stress could thus be helpful for TTC evaluation.
- Published
- 2010
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41. Acute infection-inflammation and coronary stent thrombosis: an observational study.
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Del Pace S, Boddi M, Rasoini R, Micheli S, Alderighi C, Caciolli S, Margheri M, Abbate R, and Gensini GF
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- Acute Disease, Aged, Aged, 80 and over, Angioplasty, Balloon, Coronary, Coronary Restenosis epidemiology, Coronary Thrombosis epidemiology, Female, Humans, Inflammation etiology, Italy epidemiology, Male, Middle Aged, Prevalence, Retrospective Studies, Risk Factors, Stroke Volume, Ventricular Function, Left, Coronary Restenosis etiology, Coronary Thrombosis etiology, Infections complications, Inflammation complications, Stents adverse effects
- Abstract
Coronary stent thrombosis (CST) is a major concern of interventional cardiology. Several risk factors for CST have been identified, but as a whole they do not explain the pathophysiology of CST. This study was designed to investigate whether acute infection-inflammation could facilitate the occurrence of CST. Forty-one patients, aged 66.6 +/- 11 years, consecutively admitted to our catheterization laboratory for acute, subacute or late CST, were retrospectively analysed. Transient acute infection-inflammation on admission for CST was diagnosed by predefined criteria. Prevalence of known risk factors for CST was also investigated. Twenty-one patients (51%) met predefined criteria for the occurrence of acute infection-inflammation. On admission, in these patients, levels of systemic humoral and cellular inflammatory markers were significantly higher than those of patients without recent or ongoing acute infection-inflammation (p < 0.05 for all). 62% of patients with acute infection-inflammation had less than two known risk factors for CST whereas only 37% patients without infection-inflammation showed less than two risk factors (p = 0.03) and showed more frequent interruption of antiplatelet treatment (17 vs. 2.4%, p = 0.02), mean longer stent length (20.5 +/- 4.8 vs. 16.5 +/- 5.1 mm, p = 0.02) and lower left ventricular ejection fraction before CST (42.9 +/- 14 vs. 47.3 +/- 11%, p = 0.02). In conclusion, acute infection-inflammation could play a role in facilitating the occurrence of CST in a subgroup with low risk profile for known risk factors. Our findings, if confirmed, could suggest new opportunities for prevention and treatment of CST.
- Published
- 2010
- Full Text
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42. Anomalous origin of circumflex arteries evaluated with MDCT.
- Author
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Bamoshmoosh M, Del Pace S, Fanfani F, and Santoro G
- Subjects
- Coronary Angiography instrumentation, Humans, Male, Middle Aged, Coronary Angiography methods, Coronary Vessel Anomalies diagnostic imaging, Tomography, X-Ray Computed
- Published
- 2010
- Full Text
- View/download PDF
43. Abnormal coronary reserve and left ventricular wall motion during cold pressor test in patients with previous left ventricular ballooning syndrome.
- Author
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Barletta G, Del Pace S, Boddi M, Del Bene R, Salvadori C, Bellandi B, Coppo M, Saletti E, and Gensini GF
- Subjects
- Aged, Aged, 80 and over, Echocardiography, Three-Dimensional, Epinephrine metabolism, Female, Humans, Microcirculation physiology, Middle Aged, Norepinephrine metabolism, Cold Temperature, Fractional Flow Reserve, Myocardial physiology, Takotsubo Cardiomyopathy physiopathology, Ventricular Dysfunction, Left physiopathology
- Abstract
Aims: To investigate whether and how cold pressor test (CPT) could affect myocardial perfusion and left ventricular (LV) function in patients with previous LV ballooning syndrome (LVBS)., Methods and Results: Cold pressor test (3 min hand immersion in ice-water) was performed in 17 women with previous LVBS and in 7 age- and risk factor-matched women with chest pain and normal coronary arteries. At baseline and peak CPT, global and regional LV function, and myocardial perfusion were quantitatively assessed by real-time three-dimensional echocardiography (RT3DE) and myocardial contrast (SonoVue, Bracco) 2D echocardiography (MCE), respectively (Philips iE33 machine, X3-1 and S5-1 probes). Data were analysed off-line (QLab 6.0 software). Peripheral venous catecholamines were assayed by high performance liquid chromatography with electrochemical detection. Cold pressor test induced similar haemodynamic changes and catecholamine increase in controls and LVBS patients. Left ventricular ejection fraction decreased and transient new mid-ventricular and apical motion abnormalities developed in LVBS patients only (quantitative RT3D analysis), without corresponding perfusion defects (MCE). At peak CPT, coronary blood flow and velocity increased (quantitative MCE analysis) in control subjects only., Conclusion: Cold pressor test induced LV wall motion abnormalities unmatched to regional coronary flow reduction in LVBS patients only. The reduced coronary reserve in response to CPT suggests microvascular dysfunction in LVBS patients.
- Published
- 2009
- Full Text
- View/download PDF
44. Tissue Doppler and strain imaging: a new tool for early detection of cardiac amyloidosis.
- Author
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Porciani MC, Lilli A, Perfetto F, Cappelli F, Massimiliano Rao C, Del Pace S, Ciaccheri M, Castelli G, Tarquini R, Romagnani L, Pastorini T, Padeletti L, and Bergesio F
- Subjects
- Aged, Case-Control Studies, Early Diagnosis, Female, Humans, Male, Amyloidosis diagnostic imaging, Echocardiography, Doppler, Heart Diseases diagnostic imaging
- Abstract
Using traditional echocardiography, the diagnosis of cardiac amyloidosis (CA) is often only possible in advanced stage when recommended therapies may have adverse effects. The aim of our study was to evaluate whether additional information can be derived from Tissue and strain Doppler imaging (TDI and SDI). Forty patients with systemic amyloidosis and 24 healthy subjects underwent traditional, tissue and strain Doppler echocardiography. Patients were classified having CA if mean wall thickness (mT), was half of the sum septum and posterior wall thickness, was > or =12 mm. The following parameters were evaluated: peak early diastolic velocity (Em) as index of ventricular relaxation, mitral E-wave to Em ratio (E/Em) as index of left ventricular (LV) filling pressure and mean LV strain peak curves (mSt) as global long-axis contraction index. In non cardiac amyloidosis (NCA), both Em and mSt were lower than in age matched controls (p < 0.01, p < 0.05, respectively) and higher than in CA (p < 0.01 and p < 0.01, respectively). Both Em and mSt were related to mT (p < 0.001). A significant (p < 0.01) nonlinear relation was observed between plasma terminal of pro B-natriuretic peptide and mT, Em, E/Em and mSt. TDI and SDI are able to detect amyloid myocardial involvement in such an early stage that cannot be evidenced by using traditional echocardiography.
- Published
- 2009
- Full Text
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45. Left bundle branch block as an electrocardiographic pattern at presentation of patients with Tako-tsubo cardiomyopathy.
- Author
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Parodi G, Salvadori C, Del Pace S, Bellandi B, Carrabba N, Gensini GF, and Antoniucci D
- Subjects
- Age Factors, Aged, Aged, 80 and over, Angina Pectoris etiology, Bundle-Branch Block etiology, Bundle-Branch Block mortality, Diagnosis, Differential, Female, Humans, Incidence, Male, Middle Aged, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Prospective Studies, Risk Assessment, Risk Factors, Takotsubo Cardiomyopathy complications, Takotsubo Cardiomyopathy mortality, Time Factors, Bundle-Branch Block diagnosis, Electrocardiography, Takotsubo Cardiomyopathy diagnosis
- Abstract
Background: Tako-tsubo cardiomyopathy (TTC) is a recently described clinical condition that may mimic acute myocardial infarction. The presence or new onset of left bundle branch block (LBBB) is associated with adverse outcome in patients with acute myocardial infarction., Objective: We sought to assess the incidence, clinical profile, and outcome of patients with TTC and LBBB at presentation., Methods and Results: From July 2003 to December 2006, 84 consecutive patients met the diagnostic criteria for TTC. LBBB was present in eight (9%) patients at presentation. Patients with LBBB tended to be older (77 +/- 11 years versus 72 +/- 10 years; P=0.186), and with a more frequent, but not statistically significant, history of hypertension (75 versus 53%; P=0.227), and chronic renal failure (25 versus 8%, P=0.117). Moreover, patients with LBBB showed a higher peak creatine kinase-MB value (76 +/- 32 U/I versus 21 +/- 31 U/I; P=0.005), and a lower, but not significantly, baseline left ventricular ejection fraction (30 +/- 13% versus 36 +/- 9%; P=0.107), as compared with patients without LBBB. Follow-up length was 12 +/- 10 months. The mortality rate was higher in patients with LBBB as compared with those without (25 and 3%; P=0.005). However, at Cox analysis the only independent predictor of death was age (P=0.042)., Conclusion: LBBB was documented at presentation in 9% of TTC patients. At long-term follow-up, TTC patients with LBBB showed increased unadjusted mortality. However, when adjusted for age, baseline characteristics, and concomitant diseases, LBBB did not appear to be an independent predictor of poor outcome in patients with TTC.
- Published
- 2009
- Full Text
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46. ACE insertion/deletion, but not -240A>T polymorphism, modulates the severity in heart failure.
- Author
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Fatini C, Sticchi E, Marcucci R, Said AA, Del Pace S, Verdiani V, Nozzoli C, Gensini GF, and Abbate R
- Subjects
- Adult, Aged, Female, Genotype, Humans, Male, Middle Aged, Natriuretic Peptide, Brain analysis, Peptide Fragments analysis, Gene Deletion, Heart Failure genetics, Mutagenesis, Insertional, Peptidyl-Dipeptidase A genetics, Polymorphism, Genetic
- Abstract
Objective: : ACE gene is reported to be a candidate gene in heart failure. The insertion/deletion (I/D) polymorphism has been observed to be a predictor of mortality in this disease, but no data are available concerning the role of ACE -240A>T polymorphism. In this study, we investigated the role of ACE I/D and -240A>T polymorphisms in influencing both severity and clinical outcomes in patients with heart failure, according to New York Heart Association (NYHA) class., Patients: : We studied 323 patients with heart failure (258 men/65 women; age, 70.8 +/- 11.5 years) followed-up for 11.9 +/- 6.6 months., Results: : The ACE D and -240T allele frequency significantly increased according to the NYHA functional class (P = 0.0002 and P < 0.0001, respectively).No significant difference in ACE polymorphism genotype distribution and allele frequency according to N-terminal pro-brain natriuretic peptide tertiles was observed. At multinomial regression analysis, ACE D but not -240T allele has been evidenced to be a significant and independent predictor of severity for both NYHA III and IV classes (P = 0.01 and P = 0.004, respectively). The ACE D allele prevalence was higher, even if not significantly in both death and rehospitalization groups in comparison with survivors and nonrehospitalized (P = 0.6 and P = 0.9, respectively). No difference in -240T allele frequency has been observed for the ACE -240A>T polymorphism, in relation to both death and rehospitalization (P = 0.1 and P = 0.6, respectively)., Conclusions: : This study suggests that ACE I/D polymorphism might represent a predisposing factor to severe heart failure, independently of well-known prognostic markers.
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- 2008
- Full Text
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47. A 48-year-old woman with dyspnoea on exertion, anemia and thrombocytopenia.
- Author
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Del Pace S, Alderighi C, Rasoini R, Alterini R, Micheli S, and Santoro G
- Subjects
- Comorbidity, Diagnosis, Differential, Dyspnea etiology, Emergency Service, Hospital, Female, Humans, Middle Aged, Ovarian Neoplasms complications, Physical Exertion, Anemia, Dyspnea physiopathology, Ovarian Neoplasms diagnosis, Thrombocytopenia
- Published
- 2008
- Full Text
- View/download PDF
48. Acute left ventricular dysfunction due to Tako-tsubo syndrome after induction of general anesthesia.
- Author
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Consales G, Campiglia L, Michelagnoli G, Gallerani E, Rinaldi S, Del Pace S, and De Gaudio AR
- Subjects
- Acute Disease, Aged, Cholecystectomy, Laparoscopic, Female, Humans, Intraoperative Complications therapy, Takotsubo Cardiomyopathy therapy, Ventricular Dysfunction, Left therapy, Anesthesia, General adverse effects, Intraoperative Complications etiology, Takotsubo Cardiomyopathy complications, Ventricular Dysfunction, Left etiology
- Abstract
Tako-tsubo cardiomyopathy is a recently described form of transient ventricular dysfunction that is not associated with coronary vessels obstruction, although its clinical manifestations are often similar to those of myocardial ischemia. This syndrome is possibly due to an excess of catecholamines, and it is associated with emotional and physical stress and surgery. However, the pathophysiological relation to anaesthesia has not yet been clarified. We report a case of Tako-tsubo cardiomyopathy that ensued immediately after induction of general anaesthesia for elective surgery in a patient submitted to laparoscopic cholecystectomy. The patient was first treated as if affected by myocardial ischemia, but a rapidly performed emergency coronary angiography showed normal epicardial coronary vessels with a significant reduction of left ventricular function. The coronary angiography ruled out the diagnosis of typical myocardial ischemia and allowed for the arrival at the correct diagnosis. The transient ventricular ballooning was attributed to the recently described Tako-tsubo syndrome. Prompt treatment allowed control of symptoms, and the patient was safely treated and discharged on day 15. Although it is difficult to identify the cause of this syndrome, it may be argued that, during general anaesthesia and particularly at induction, the imperfect control of catecholamine excess may induce cardiac damage in predisposed subjects.
- Published
- 2007
49. A new ATTR Phe64Ile mutation with late-onset multiorgan involvement.
- Author
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Tarquini R, Perfetto F, Bergesio F, Miliani A, Del Pace S, Frusconi S, Minuti B, Pelo E, and Torricelli F
- Subjects
- Aged, Amyloidosis, Familial pathology, Base Sequence, Cardiomyopathies genetics, Cardiomyopathies pathology, Codon genetics, DNA Mutational Analysis, Echocardiography, Exons genetics, Humans, Isoleucine genetics, Male, Molecular Sequence Data, Phenylalanine genetics, Amyloidosis, Familial genetics, Mutation, Missense, Prealbumin genetics
- Abstract
We describe a novel transthyretin mutation in which phenylalanine is replaced with isoleucine in exon 3 at codon 64: Phe64Ile. The mutation was found in an isolated patient and it was not possible to perform a family study. The phenotype included heart and peripheral nerve involvement associated with a possible gastrointestinal and renal involvement.
- Published
- 2007
- Full Text
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50. Cardiac resynchronization therapy: gender related differences in left ventricular reverse remodeling.
- Author
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Lilli A, Ricciardi G, Porciani MC, Perini AP, Pieragnoli P, Musilli N, Colella A, Del Pace S, Michelucci A, Turreni F, Sassara M, Achilli A, Barold SS, and Padeletti L
- Subjects
- Age Distribution, Aged, Comorbidity, Female, Humans, Italy epidemiology, Male, Middle Aged, Prevalence, Risk Factors, Sex Distribution, Survival Analysis, Survival Rate, Treatment Outcome, Ventricular Remodeling, Cardiac Output, Low mortality, Cardiac Output, Low prevention & control, Cardiac Pacing, Artificial mortality, Risk Assessment methods, Ventricular Dysfunction, Left mortality, Ventricular Dysfunction, Left prevention & control
- Abstract
Aim: Gender related differences in epidemiology, treatment, and prognosis of heart failure (HF) have been reported. We examined the sex influence in patients treated with cardiac resynchronization therapy (CRT)., Methods and Results: Out of 334 consecutive HF patients (19.7% women) who underwent CRT, 195 patients reached clinical and echocardiographic evaluation at six and 12 months and were selected for analysis. A reduction in left ventricular (LV) end-diastolic volume/m(2) (EDVi) and end systolic volume/m(2) (ESVi) was evident in the overall population at six months (P < 0.001) and from six to 12 months (P < 0.001). Compared to men, women showed significantly greater changes in LV volumes at mid (P < 0.05) and long-term (P < 0.001) follow-up and a significantly higher LV ejection fraction (EF) (40.8 +/- 12.3 vs 34.1 +/- 10.1, P < 0.01) at one year. Multiple regression analysis, including several demographic and clinical parameters, revealed that female gender is independently associated with greater reduction in LV ESVi. At the 12-month follow-up, the proportion of responders (defined in terms of ESV reduction by at least 10%) was higher in women than in men (76.1% vs 59.3%, P < 0.05)., Conclusions: CRT induced a gender specific LV remodeling response.
- Published
- 2007
- Full Text
- View/download PDF
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