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Shenouda R, Vancheri S, Maria Bassi E, Nicoll R, Sobhi M, El Sharkawy E, Wester P, Vancheri F, Henein MY. The relationship between carotid and coronary calcification in patients with coronary artery disease. Clin Physiol Funct Imaging 2021; 41:271-280. [PMID: 33583121 DOI: 10.1111/cpf.12694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/28/2021] [Accepted: 02/11/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Atherosclerosis is a multi-system pathology with heterogeneous involvement. We aimed to investigate the relationship between the presence and severity of carotid and coronary calcification in a group of patients with coronary artery disease. METHODS Sixty-three patients presenting with unstable angina or positive stress test for myocardial ischaemia were enrolled in this study. All patients underwent CT scanning of the carotid and coronary arteries using the conventional protocol and Agatston scoring system. Risk factors for atherosclerosis were also analyzed for correlation with the extent of arterial calcification. RESULTS Total coronary artery calcium score (CAC) was several times higher than total carotid calcium score (1274 (1018) vs 6 (124), p = 0·0001, respectively). The left carotid calcium score correlated strongly with the right carotid calcium score (rho = 0·69, p < 0·0001). The total CAC score correlated modestly with the total carotid calcium score (rho = 0·34, p = 0·007), in particular with left carotid score (rho = 0·38, p = 0·002), but not with the right carotid score. The left coronary calcium score correlated with the right coronary calcium score (rho = 0·35, p = 0·004), left carotid calcium score (rho = 0·33, p = 0·007) and left carotid calcium score at the bifurcation (rho = 0·34, p = 0·006). While hypertension correlated with carotid calcium score, diabetes and dyslipidaemia correlated with left CAC score. CONCLUSION In patients with coronary disease, the carotid calcification pattern appeared to be similar between the right and left system in contrast to that of the coronary arteries. CAC correlated only modestly with the carotid score, despite being significantly higher. Hypertension was related to carotid calcium score while diabetes and dyslipidaemia correlated with coronary calcification.
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Affiliation(s)
- Rafik Shenouda
- International Cardiac Centre - ICC, Alexandria, Egypt.,Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - Sergio Vancheri
- Radiology Department, I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | | | - Rachel Nicoll
- Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - Mohammed Sobhi
- International Cardiac Centre - ICC, Alexandria, Egypt.,Cardiology Department, Faculty of medicine, Alexandria University, Sharqi, Egypt
| | - Eman El Sharkawy
- International Cardiac Centre - ICC, Alexandria, Egypt.,Cardiology Department, Faculty of medicine, Alexandria University, Sharqi, Egypt
| | - Per Wester
- Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | | | - Michael Y Henein
- Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
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Gnecchi M, Moretti F, Bassi EM, Leonardi S, Totaro R, Perotti L, Zuccaro V, Perlini S, Preda L, Baldanti F, Bruno R, Visconti LO. Myocarditis in a 16-year-old boy positive for SARS-CoV-2. Lancet 2020; 395:e116. [PMID: 32593338 PMCID: PMC7316465 DOI: 10.1016/s0140-6736(20)31307-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Massimiliano Gnecchi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Molecular Medicine, Cardiology Unit, University of Pavia, Pavia, Italy.
| | - Francesco Moretti
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Molecular Medicine, Cardiology Unit, University of Pavia, Pavia, Italy
| | | | - Sergio Leonardi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Molecular Medicine, Cardiology Unit, University of Pavia, Pavia, Italy
| | - Rossana Totaro
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Luciano Perotti
- Anaesthesia and Resuscitation Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Zuccaro
- Infectious Diseases I Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Perlini
- Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Lorenzo Preda
- Radiology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Infectious Diseases I Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
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Raineri C, Pavesi C, Turco A, Ghio S, Scelsi L, Valentini A, Bassi EM, Dusi V, Petracci B, Savastano S, Sanzo A, Vicentini A, Rordorf R, Oltrona Visconti L, De Ferrari GM. P2867Late gadolinium enhancement at cardiac magnetic resonance accurately predicts arrhythmias in patients with non-ischemic cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Raineri
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Pavesi
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Turco
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - L Scelsi
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Valentini
- Institute of Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - E M Bassi
- Institute of Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - V Dusi
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - B Petracci
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Savastano
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Sanzo
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Vicentini
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - R Rordorf
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - L Oltrona Visconti
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G M De Ferrari
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
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Fronza M, Raineri C, Valentini A, Bassi EM, Scelsi L, Buscemi ML, Turco A, Castelli G, Ghio S, Visconti LO. Relationship between electrocardiographic findings and Cardiac Magnetic Resonance phenotypes in patients with Hypertrophic Cardiomyopathy. Int J Cardiol Heart Vasc 2016; 11:7-11. [PMID: 28616518 PMCID: PMC5462632 DOI: 10.1016/j.ijcha.2016.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/09/2016] [Accepted: 02/21/2016] [Indexed: 12/31/2022]
Abstract
Background Q waves and negative T waves are common electrocardiographic (ECG) abnormalities in patients with Hypertrophic Cardiomyopathy (HCM). Several studies correlated ECG findings with presence and extent of fibrosis and hypertrophy; however, their significance remains incompletely clarified. Our study aimed to explain the mechanism behind Q and negative T waves by comparing their positions on a 12-lead ECG with phenotypes observed at Late Gadolinium Enhancement (LGE) Cardiac Magnetic Resonance (CMR). Methods 12-lead ECG and LGE-CMR were performed in 88 consecutive patients with HCM (42 SD 16 years, 65 males). Using Delta Thickness ratio (DT ratio), and “global” and “parietal” LGE at CMR, the extent and distribution of myocardial hypertrophy and fibrosis were studied in correlation with ECG abnormalities. Results Q waves in different leads were not associated with “parietal” LGE score. Lateral Q waves correlated with an increased DT ratio Inferior Septum/Lateral wall (p = 0.01). A similar correlation between inferior Q waves and an increased DT Ratio Anterior wall/Inferior wall was of borderline statistical significance (p = 0.06). As expected, ECG signs of LV hypertrophy related to a raised Left Ventricular Mass Index (LVMI) (p < 0.0001) and mean wall thickness (p = 0.01). Depolarization disturbances, including negative T waves in lateral (p = 0.044) and anterior (p = 0.031) leads correlated with “parietal” LGE scores while QT dispersion (p = 0.0001) was associated with “global” LGE score. Conclusion In HCM patients, Q waves are generated by asymmetric hypertrophy rather than by myocardial fibrosis, while negative T waves result from local LGE distribution at CMR.
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Affiliation(s)
- Matteo Fronza
- Division of Cardiology, Fondazione I.R.C.C.S. Policlinico S Matteo, Pavia, Italy
| | - Claudia Raineri
- Division of Cardiology, Fondazione I.R.C.C.S. Policlinico S Matteo, Pavia, Italy
| | - Adele Valentini
- Institute of Radiology, University of Pavia School of Medicine, Pavia, Italy
| | - Emilio Maria Bassi
- Institute of Radiology, University of Pavia School of Medicine, Pavia, Italy
| | - Laura Scelsi
- Division of Cardiology, Fondazione I.R.C.C.S. Policlinico S Matteo, Pavia, Italy
| | - Maria Laura Buscemi
- Division of Cardiology, Fondazione I.R.C.C.S. Policlinico S Matteo, Pavia, Italy
| | - Annalisa Turco
- Division of Cardiology, Fondazione I.R.C.C.S. Policlinico S Matteo, Pavia, Italy
| | - Grazia Castelli
- Division of Cardiology, Fondazione I.R.C.C.S. Policlinico S Matteo, Pavia, Italy
| | - Stefano Ghio
- Division of Cardiology, Fondazione I.R.C.C.S. Policlinico S Matteo, Pavia, Italy
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Della Valle V, Bassi EM, Calliada F. Migration of calcium deposits into subacromial-subdeltoid bursa and into humeral head as a rare complication of calcifying tendinitis: sonography and imaging. J Ultrasound 2015; 18:259-63. [PMID: 26261476 DOI: 10.1007/s40477-015-0163-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 02/25/2015] [Indexed: 11/28/2022] Open
Abstract
Calcifying tendinitis of the shoulder is a common condition characterized by the deposition of calcium, predominantly hydroxyapatite crystals, in the rotator cuff. A rare complication of this condition is the migration of calcium deposits from tendons, usually the supraspinatus, into the subacromial-subdeltoid bursa or into the humeral greater tuberosity. These complications are responsible for intense acute shoulder pain and functional disability. Patient anamnesis and clinical symptoms must be considered to make the diagnosis, but imaging, particularly sonography, is often necessary, showing a typical presentation related to the locations of calcium deposits. We present sonographic and other imaging features of subacromial-subdeltoid bursitis and humeral osteitis related to the migration of calcium.
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Affiliation(s)
- Valeria Della Valle
- IRCCS Foundation, San Matteo Medical Center, Institute of Radiology, University of Pavia, Viale Camillo Golgi 19, 27100 Pavia, Italy
| | - Emilio Maria Bassi
- IRCCS Foundation, San Matteo Medical Center, Institute of Radiology, University of Pavia, Viale Camillo Golgi 19, 27100 Pavia, Italy
| | - Fabrizio Calliada
- IRCCS Foundation, San Matteo Medical Center, Institute of Radiology, University of Pavia, Viale Camillo Golgi 19, 27100 Pavia, Italy
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Abstract
Cardiac metastases are rare, but more common than primary cardiac tumours, and metastatic melanoma involves heart or pericardium in greater than 50% of the cases, although cardiac metastasis are rarely diagnosed ante mortem because of the lack of symptoms. A multimodality approach may help to obtain a more timely diagnosis and in some cases a quicker and better diagnosis can enable a surgical resection to prevent cardiac failure or to reduce the tumour before chemotherapy. We present a case of a patient with cardiac metastasis as first evidence of a malignant melanoma: in this case the patient underwent echocardiography, cardiac magnetic resonance and computed tomography. This case underlines the importance of advanced diagnostic techniques, such as cardiac magnetic resonance, not only for the detection of cardiac masses, but also for a better anatomic definition and tissue characterization, to enable a quick and accurate diagnosis which can be followed by appropriate treatment.
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Affiliation(s)
- Adriana Villa
- Department of Radiology, IRCCS S. Matteo, Pavia, Italy
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Abstract
A biloma is an encapsulated collection of bile located in the abdomen. It occurs spontaneously or secondary to traumatic or iatrogenic injury to the biliary system. The patient's medical history, symptoms and diagnostic imaging findings suggest the diagnosis, but a definitive diagnosis is provided by drainage and biochemical analysis of the fluid. We report a case of a patient admitted with acute abdominal pain in the right hypochondrium caused by a spontaneous biloma. This is a rare condition, and the reason for the onset was not identified. We discuss the role of the various diagnostic imaging techniques, particularly that of ultrasound.
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Affiliation(s)
- V Della Valle
- Department of Radiology, IRCCS Policlinico San Matteo Pavia, University of Pavia, Piazzale Golgi 1, 27100 Pavia, Italy
| | - E Eshja
- Department of Radiology, IRCCS Policlinico San Matteo Pavia, University of Pavia, Piazzale Golgi 1, 27100 Pavia, Italy
| | - E M Bassi
- Department of Radiology, IRCCS Policlinico San Matteo Pavia, University of Pavia, Piazzale Golgi 1, 27100 Pavia, Italy
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