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1. Progressive right ventricular dysfunction and exercise impairment in patients with heart failure and diabetes mellitus: insights from the T.O.S.CA. Registry

Author

Salzano, A, D'Assante, R, Iacoviello, M, Triggiani, V, Rengo, G, Cacciatore, F, Maiello, C, Limongelli, G, Masarone, D, Sciacqua, A, Perrone Filardi, P, Mancini, A, Volterrani, M, Vriz, O, Castello, R, Passantino, A, Campo, M, Modesti, Pa, De Giorgi, A, Arcopinto, M, Gargiulo, P, Perticone, M, Colao, A, Milano, S, Garavaglia, A, Napoli, R, Suzuki, T, Bossone, E, Marra, Am, Cittadini, A, Saccà, L, Monti, Mg, Matarazzo, M, Stagnaro, Fm, Piccioli, L, Lombardi, A, Panicara, V, Flora, M, Golia, L, Faga, V, Ruocco, A, Della Polla, D, Franco, R, Schiavo, A, Gigante, A, Spina, E, Sicuranza, M, Monaco, F, Apicella, M, Miele, C, Campanino, Ag, Mazza, L, Abete, R, Farro, A, Luciano, F, Polizzi, R, Ferrillo, G, De Luca, M, Crisci, G, Giardino, F, Barbato, M, Ranieri, B, Ferrara, F, Russo, V, Malinconico, M, Citro, R, Guastalamacchia, E, Leone, M, Giagulli, Va, Amarelli, C, Mattucci, I, Calabrò, P, Calabrò, R, D'Andrea, A, Maddaloni, V, Pacileo, G, Scarafile, R, Belfiore, A, Cimellaro, A, Casaretti, L, Paolillo, S, Favuzzi, Amr, Di Segni, C, Bruno, C, Vergani, E, Massaro, R, Grimaldi, F, Frigo, A, Sorrentino, Mr, Malandrino, D, Manfredini, R, Fabbian, F, Puzzo, A, Ragusa, L, Caliendo, L, Carbone, L, Frigiola, A, Generali, T, Giacomazzi, F, De Vincentiis, C, Ballotta, A, Garofalo, P, Malizia, G, Misiano, G, Israr, Mz, Bernieh, D, Cassambai, S, Yazaki, Y, Heaney, Lm, Eagle, Ka, Ventura, Ho, Bruzzese, D, Salzano, Andrea, D'Assante, Roberta, Iacoviello, Massimo, Triggiani, Vincenzo, Rengo, Giuseppe, Cacciatore, Francesco, Maiello, Ciro, Limongelli, Giuseppe, Masarone, Daniele, Sciacqua, Angela, Filardi, Pasquale Perrone, Mancini, Antonio, Volterrani, Maurizio, Vriz, Olga, Castello, Roberto, Passantino, Andrea, Campo, Michela, Modesti, Pietro A, De Giorgi, Alfredo, Arcopinto, Michele, Gargiulo, Paola, Perticone, Maria, Colao, Annamaria, Milano, Salvatore, Garavaglia, Agnese, Napoli, Raffaele, Suzuki, Toru, Bossone, Eduardo, Marra, Alberto M, Cittadini, Antonio, and Misiano, Gabriella

Subjects
Registrie, Heart Failure, Endocrinology, Diabetes and Metabolism, Ventricular Dysfunction, Right, Diabetes, Insulins, Socio-culturale, Stroke Volume, Insulin resistance, Diabete, Cardiopulmonary exercise test, Chronic heart failure, Diabetes, Insulin resistance, Right ventricle, TOSCA Registry, Chronic heart failure, Diabetes Mellitus, Type 2, TOSCA Registry, Exercise Test, Ventricular Function, Right, Humans, Insulin, Right ventricle, Registries, Cardiology and Cardiovascular Medicine, Cardiopulmonary exercise test, TOSCA, Human, LS4_7
Abstract

Background Findings from the T.O.S.CA. Registry recently reported that patients with concomitant chronic heart failure (CHF) and impairment of insulin axis (either insulin resistance—IR or diabetes mellitus—T2D) display increased morbidity and mortality. However, little information is available on the relative impact of IR and T2D on cardiac structure and function, cardiopulmonary performance, and their longitudinal changes in CHF. Methods Patients enrolled in the T.O.S.CA. Registry performed echocardiography and cardiopulmonary exercise test at baseline and at a patient-average follow-up of 36 months. Patients were divided into three groups based on the degree of insulin impairment: euglycemic without IR (EU), euglycemic with IR (IR), and T2D. Results Compared with EU and IR, T2D was associated with increased filling pressures (E/e′ratio: 15.9 ± 8.9, 12.0 ± 6.5, and 14.5 ± 8.1 respectively, p 2) in TD2 vs EU and IR patients was recorded (respectively, 15.8 ± 3.8 ml/Kg/min, 18.4 ± 4.3 ml/Kg/min and 16.5 ± 4.3 ml/Kg/min, p 2 in the T2D group (+ 13% increase in RV dimension, − 21% decline in TAPSE/PAPS ratio and − 20% decrease in peak VO2). Conclusion The higher risk of death and CV hospitalizations exhibited by HF-T2D patients in the T.O.S.CA. Registry is associated with progressive RV ventricular dysfunction and exercise impairment when compared to euglycemic CHF patients, supporting the pivotal importance of hyperglycaemia and right chambers in HF prognosis. Trial registration ClinicalTrials.gov identifier: NCT023358017

Published
2022
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2. Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry

Author

Cittadini A., Salzano A., Iacoviello M., Triggiani V., Rengo G., Cacciatore F., Maiello C., Limongelli G., Masarone D., Perticone F., Cimellaro A., Filardi P. P., Paolillo S., Mancini A., Volterrani M., Vriz O., Castello R., Passantino A., Campo M., Modesti P. A., de Giorgi A., Monte I. P., Puzzo A., Ballotta A., D'Assante R., Arcopinto M., Gargiulo P., Sciacqua A., Bruzzese D., Colao A., Napoli R., Suzuki T., Eagle K. A., Ventura H. O., Marra A. M., Bossone E., Sacca L., Monti M. G., Matarazzo M., Stagnaro F. M., Piccioli L., Lombardi A., Panicara V., Flora M., Golia L., Faga V., Ruocco A., della Polla D., Franco R., Schiavo A., Gigante A., Spina E., Sicuranza M., Monaco F., Apicella M., Miele C., Campanino A. G., Mazza L., Abete R., Farro A., Luciano F., Polizzi R., Ferrillo G., de Luca M., Crisci G., Giardino F., Barbato M., Ranieri B., Ferrara F., Russo V., Malinconico M., Citro R., Guastalamacchia E., Leone M., Giagulli V. A., Amarelli C., Mattucci I., Calabro P., Calabro R., D'Andrea A., Maddaloni V., Pacileo G., Scarafile R., Belfiore A., Casaretti L., Favuzzi A. M. R., Di Segni C., Bruno C., Vergani E., Massaro R., Grimaldi F., Frigo A., Campo M. R., Sorrentino M. R., Malandrino D., Manfredini R., Fabbian F., Ragusa L., Caliendo L., Carbone L., Frigiola A., Generali T., Giacomazzi F., de Vincentiis C., Garofalo P., Malizia G., Milano S., Misiano G., Israr M. Z., Bernieh D., Cassambai S., Yazaki Y., Heaney L. M., Cittadini, Antonio, Salzano, Andrea, Iacoviello, Massimo, Triggiani, Vincenzo, Rengo, Giuseppe, Cacciatore, Francesco, Maiello, Ciro, Limongelli, Giuseppe, Masarone, Daniele, Perticone, Francesco, Cimellaro, Antonio, Perrone Filardi, Pasquale, Paolillo, Stefania, Mancini, Antonio, Volterrani, Maurizio, Vriz, Olga, Castello, Roberto, Passantino, Andrea, Campo, Michela, Modesti, Pietro A, De Giorgi, Alfredo, Monte, Ines P, Puzzo, Alfonso, Ballotta, Andrea, D'Assante, Roberta, Arcopinto, Michele, Gargiulo, Paola, Sciacqua, Angela, Bruzzese, Dario, Colao, Annamaria, Napoli, Raffaele, Suzuki, Toru, Eagle, Kim A, Ventura, Hector O, Marra, Alberto M, Bossone, Eduardo, Cittadini, A., Salzano, A., Iacoviello, M., Triggiani, V., Rengo, G., Cacciatore, F., Maiello, C., Limongelli, G., Masarone, D., Perticone, F., Cimellaro, A., Filardi, P. P., Paolillo, S., Mancini, A., Volterrani, M., Vriz, O., Castello, R., Passantino, A., Campo, M., Modesti, P. A., de Giorgi, A., Monte, I. P., Puzzo, A., Ballotta, A., D'Assante, R., Arcopinto, M., Gargiulo, P., Sciacqua, A., Bruzzese, D., Colao, A., Napoli, R., Suzuki, T., Eagle, K. A., Ventura, H. O., Marra, A. M., Bossone, E., Sacca, L., Monti, M. G., Matarazzo, M., Stagnaro, F. M., Piccioli, L., Lombardi, A., Panicara, V., Flora, M., Golia, L., Faga, V., Ruocco, A., della Polla, D., Franco, R., Schiavo, A., Gigante, A., Spina, E., Sicuranza, M., Monaco, F., Apicella, M., Miele, C., Campanino, A. G., Mazza, L., Abete, R., Farro, A., Luciano, F., Polizzi, R., Ferrillo, G., de Luca, M., Crisci, G., Giardino, F., Barbato, M., Ranieri, B., Ferrara, F., Russo, V., Malinconico, M., Citro, R., Guastalamacchia, E., Leone, M., Giagulli, V. A., Amarelli, C., Mattucci, I., Calabro, P., Calabro, R., D'Andrea, A., Maddaloni, V., Pacileo, G., Scarafile, R., Belfiore, A., Casaretti, L., Favuzzi, A. M. R., Di Segni, C., Bruno, C., Vergani, E., Massaro, R., Grimaldi, F., Frigo, A., Campo, M. R., Sorrentino, M. R., Malandrino, D., Manfredini, R., Fabbian, F., Ragusa, L., Caliendo, L., Carbone, L., Frigiola, A., Generali, T., Giacomazzi, F., de Vincentiis, C., Garofalo, P., Malizia, G., Milano, S., Misiano, G., Israr, M. Z., Bernieh, D., Cassambai, S., Yazaki, Y., and Heaney, L. M.

Subjects
medicine.medical_specialty, Multiple hormonal and metabolic deficiency syndrome, Epidemiology, Prognosi, Anabolic deficiency, Socio-culturale, Heart failure, 030204 cardiovascular system & hematology, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, Insulin resistance, Diabetes mellitus, Internal medicine, Multiple hormonal, medicine, Clinical endpoint, Humans, 030212 general & internal medicine, Prospective Studies, Registries, TOSCA, LS4_7, Ejection fraction, business.industry, Hazard ratio, Metabolic deficiency syndrome, Heart failure • Anabolic deficiency • Multiple hormonal and metabolic deficiency syndrome • Hormones • Prognosis • TOSCA, Stroke Volume, medicine.disease, Prognosis, Hormone, Confidence interval, Heart failure, Anabolic deficiency, Multiple hormonal and metabolic deficiency syndrome, Hormones, Prognosis, TOSCA, Hormones, Hospitalization, Observational study, Cardiology and Cardiovascular Medicine, business
Abstract

Aims Recent evidence supports the occurrence of multiple hormonal and metabolic deficiency syndrome (MHDS) in chronic heart failure (CHF). However, no large observational study has unequivocally demonstrated its impact on CHF progression and outcome. The T.O.S.CA. (Trattamento Ormonale nello Scompenso CArdiaco; Hormone Treatment in Heart Failure) Registry has been specifically designed to test the hypothesis that MHDS affects morbidity and mortality in CHF patients. Methods and Results The T.O.S.CA. Registry is a prospective, multicentre, observational study involving 19 Italian centres. Thyroid hormones, insulin-like growth factor-1, total testosterone, dehydropianoandrosterone sulfate, insulin resistance, and the presence of diabetes were evaluated. A MHDS was defined as the presence of ≥2 hormone deficiencies (HDs). Primary endpoint was a composite of all-cause mortality and cardiovascular hospitalizations. Four hundred and eighty heart failure patients with ejection fraction ≤45% were enrolled. MHDS or diabetes was diagnosed in 372 patients (77.5%). A total of 271 events (97 deaths and 174 cardiovascular hospitalizations) were recorded, 41% in NO-MHDS and 62% in MHDS (P Conclusion MHDS is common in CHF and independently associated with increased all-cause mortality and cardiovascular hospitalization, representing a promising therapeutic target. Trial registration ClinicalTrials.gov identifier: NCT023358017

Published
2021

3. Determination of benzo[a]pyrene in oils intended for food preparation

Author

LE GROTTAGLIE, LAURA, NAVIGLIO, DANIELE, Scotti R., De Vita G., Sicuranza M., Le Grottaglie, L., Scotti, R., De Vita, G., Sicuranza, M., Naviglio, D., LE GROTTAGLIE, Laura, and Naviglio, Daniele

Subjects
Benzo[a]pyrene, Spectrofluorimeter, IPA, GPC, chromatography, Policyclic aromatic hydrocarbon, HPLC, Oil
Abstract

A procedure for the detn. of benzo[a]pyrene in vegetable oils based on preliminary sepn. by gel-permeation chromatog. (GPC) followed by reversed-phase HPLC is described. The GPC uses 1 g oil sample (sunflower, olive), glass column (450 x 25 mm) filled with 200-400 mesh styrene/divinylbenzene resin with exclusion limit 2 kDa, and elution with CH2Cl2/cyclohexane mixt. (3:7) at flow rate 5 mL/min. The eluate collected at 20-35 min is evapd. to dryness at 70°C, dissolved in acetonitrile, and analyzed by HPLC with Zorbax ODS C18 column (250 x 4.6 mm, 5 μm), gradient elution with acetonitrile/water mobile phase, and fluorometric detection at 280/410 nm. The method detection limit is 0.1 μg/kg and has accuracy sufficient to meet current regulatory requirements.

Published
2011

4. Ontogenesi dell'astroglia nell'encefalo di Chalcides chalcides

Author

FERRANDINO, IDA, GRIMALDI, MARIA CONSIGLIO, SICURANZA M, Ferrandino, Ida, Sicuranza, M, and Grimaldi, MARIA CONSIGLIO

Abstract

Dati relativi allo studio della componente astrogliale in Chalcides chalcides e della sua ontogenesi attraverso l’immunomarcatura della proteina acida gliofibrillare (GFAP), componente specifico dei gliofilamenti. Tale studio è stato effettuato su sezioni in paraffina di encefali di chalcides adulto e di embrioni a differenti stadi di sviluppo secondo la tabella di Dufaure ed Hubert (1961) relativa alla lacerta vivipara. Nell’encefalo di chalcides adulto la neuroglia presenta un’organizzazione abbastanza complessa: strutture GFAP(+) risultano distribuite lungo tutto l’encefalo, sia sotto forma di astrociti, localizzati soprattutto nel midollo allungato e nel cervelletto, che di glia radiale evidenziata in prossimità della cavità ventricolare, nel telencefalo e nel cervelletto. A differenza di quanto riportato nei Mammiferi, la glia radiale in questo rettile risulta pertanto ancora molto espressa dopo la nascita. Lo sviluppo di queste strutture appare però definito solo negli embrioni prossimi alla nascita. Nel I (stadio 28) e nel II (stadio 32-35) gruppo di embrioni si sono infatti rilevate rare positività all’anticorpo anti-GFAP, morfologicamente non riconducibili a strutture definite. Nel III gruppo di embrioni (stadio 36-38) invece appare ormai netta la distinzione delle varie regioni encefaliche e strutture GFAP(+) sono state osservate nel midollo allungato, nel cervelletto e nel telencefalo. E’ negli embrioni prossimi alla nascita (IV gruppo, stadio 39-40) che si sono evidenziate nettamente sia cellule astrocitiche che la stessa glia radiale pur non essendo ancora quantitativamente espresse come nell’adulto. L’ontogenesi dell’astroglia in chalcides appare quindi successiva alla formazione dei neuroni.

Published
2006

6. External DC Shocks of Symptomatic Supraventricular Tachycardia during Screw-In Leadless Pacemaker Implant: A Case Report.

Author

Liccardo M, Cipolletta E, Arezzi E, Sicuranza M, Rea M, Ricciardi P, and Napolitano G

Abstract

We present the case of a 64-year-old man who, during the implantation of an active-fixation leadless pacemaker (LP, Aveir VR, Abbott, USA), underwent several external defibrillation shocks up to 240 Joules, due to symptomatic sustained supraventricular tachycardia at 160 bpm. The shocks, delivered both before and after the screwing of the device in the low interventricular septum, did not cause any technical damage to the device, and no complications were observed. The device was then deployed successfully. To our knowledge, this is the first documented case of external cardioversion (ECV) in a patient with an active-fixation LP. The results suggest that ECV in these patients appears to be safe and feasible., (© 2025 Wiley Periodicals LLC.)

Published
2025
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7. Leadless implantation as alternative for pacemaker replacement in infiltrative breast cancer.

Author

D'Arienzo G, Sicuranza M, Ziccardi L, Di Biase M, and Brunetti ND

Subjects
Aged, 80 and over, Arrhythmias, Cardiac complications, Breast Neoplasms diagnosis, Carcinoma, Ductal, Breast diagnosis, Equipment Design, Female, Humans, Radiography, Thoracic, Ultrasonography, Mammary, Arrhythmias, Cardiac therapy, Breast Neoplasms complications, Carcinoma, Ductal, Breast complications, Pacemaker, Artificial
Published
2021
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8. Ventilatory power, a cardiopulmonary exercise testing parameter for the prediction of pulmonary hypertension at right heart catheterization.

Author

Correale M, Monaco I, Ferraretti A, Tricarico L, Sicuranza M, Gallotta AM, Formica ES, Acanfora G, Di Biase M, and Brunetti ND

Abstract

Background: Several cardiopulmonary exercise test (CPET) parameters (peak VO 2 , PetCO 2 and VE/VCO 2 ) emerged as tools for the prediction of pulmonary arterial hypertension (PAH). Less is known on ventilatory power (VP) in patients with suspect PAH., Aim: To ascertain possible correlations between VP derived at CPET and hemodynamic parameters at right heart catheterization (RHC) indicative of PH., Methods: Forty-seven consecutive outpatients with suspect of PAH were assessed by CPET and RHC; VP was defined as peak SBP divided by the minute ventilation-CO2 production slope at CPET and Diastolic Pressure Gradient (DPG), Trans-pulmonary Pressure Gradient (TPG), mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) at RHC were also assessed and compared with VP., Results: VP values were inversely related to mPAP (r -0.427, p 0.003), DPG (r -0.36, p 0.019), TPG (r: -0.43, p 0.004), and PVR (r -0.52, p 0.001). Correlations remained significant even after correction at multivariate analysis for age and gender. VP values below median identified subjects with mPAP ≥ 25 mmHg with an odds ratio of 4.5 (95% confidence interval 1.05-19.36, p < 0.05), an accuracy of 0.712 at ROC curve analysis (95% confidence interval 0.534-0.852, p < 0.05) and a positive predictive power 82%., Conclusions: In patients with suspected PAH, VP assessed at CPET might provide further information in predicting PAH at RHC. Correlations with PVR and DPG may be helpful in differentiating patients with isolated post-capillary PH from those with combined post-capillary and pre-capillary., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2020 The Authors.)

Published
2020
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9. Advanced heart failure: non-pharmacological approach.

Author

Correale M, Monaco I, Tricarico L, Bottigliero D, Sicuranza M, Del Forno B, Godeas G, Teri A, Maiorano A, Perulli R, Centola A, De Bonis M, Di Biase M, and Brunetti ND

Subjects
Aged, Aged, 80 and over, Atrial Fibrillation surgery, Female, Heart Failure mortality, Humans, Male, Mitral Valve Insufficiency surgery, Tachycardia, Ventricular surgery, Ablation Techniques methods, Cardiac Resynchronization Therapy methods, Heart Failure surgery, Heart Transplantation methods, Heart-Assist Devices, Transcatheter Aortic Valve Replacement methods
Abstract

Patients with advanced heart failure have poor prognosis despite traditional pharmacological therapies. The early identification of these subjects would allow them to be addressed on time in dedicated centers to select patients eligible for heart transplantation or ventricular assistance. In this article we will report the current management of these patients based on latest international guidelines, underlining some critical aspects, with reference to future perspectives.

Published
2019
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10. Perioperative autotransfusion systems in TKA are not necessary.

Author

Grimaldi NA, Sicuranza M, and Eck JC

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Intraoperative Care, Male, Middle Aged, Postoperative Care, Retrospective Studies, Arthroplasty, Replacement, Knee, Blood Transfusion, Autologous statistics & numerical data
Abstract

Perioperative autotransfusion is believed to reduce postoperative allogenic transfusion. A retrospective review of 128 patients undergoing total knee arthroplasty with preoperative hemoglobin < 14 g/dL was performed. Group 1 received an intraoperative tourniquet and postoperative autotransfusion. Group 2 received a tourniquet and hemovac drain postoperatively. Group 3 had a tourniquet only during cementing with no drain. Nine (17%) patients in group 1, 9 (19%) patients in group 2, and 4 (15%) patients in group 3 required transfusion. Perioperative autotransfusion does not decrease the need for allogenic transfusion when compared to similar patients at risk for transfusion because of preoperative hemoglobin level < 14 g/dL.

Published
2006
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11. Compressive neuropathies in the upper extremity of athletes.

Author

Sicuranza MJ and McCue FC 3rd

Subjects
Humans, Athletic Injuries etiology, Nerve Compression Syndromes etiology
Abstract

The physician responsible for the evaluation and treatment of athletes must include nerve compression injury in the differential diagnosis of upper extremity pain and dysfunction. Careful history and physical examination, along with selective objective testing, should be diagnostic. Treatment and prevention methods implemented under the supervision of knowledgeable trainers and coaches may allow for complete resolution of symptoms and, more importantly, prevent recurrence. Adolescents and novice athletes in many sports may be at the highest risk for this type of overuse injury.

Published
1992

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