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Rigattieri S, Cristiano E, Tempestini F, Pittorino L, Cesario V, Casenghi M, Giovannelli F, Tommasino A, Barbato E, Berni A. Acute Kidney Injury in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: The Role of Vascular Access Site. J Clin Med 2024; 13:2367. [PMID: 38673640 PMCID: PMC11051292 DOI: 10.3390/jcm13082367] [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: 02/21/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Background: in patients undergoing percutaneous coronary interventions (PCI), radial access should be favoured over femoral access as it reduces the risk of vascular complications and bleeding. Furthermore, a preventive role of radial access in the occurrence of acute kidney injury (AKI), mainly mediated by the reduction of bleeding and cholesterol crystal embolization into renal circulation, has been investigated in several studies, yielding conflicting results. Methods: we designed a retrospective study to appraise the effect of the use of a vascular access site on the occurrence of AKI in a cohort of 633 patients with acute myocardial infarction treated by PCI at our centre from 2018 to 2020. Results: after propensity score adjustment, radial access was associated with a reduced, albeit statistically not significant, incidence of AKI (14.7% vs. 21.0%; p = 0.06) and major bleeding (12.5% vs. 18.7%; p = 0.04) as compared to femoral access. At multivariate analysis, femoral access was an independent predictor of AKI, together with in-hospital occurrence of BARC 3-5 bleeding, Killip class >1 at presentation, female gender, baseline eGFR <60 mL/min, and baseline haemoglobin <12 g/dL. Conclusions: although limited by the observational design, our study supports the hypothesis that radial access may exert a protective role on the occurrence of AKI in patients with acute myocardial infarction undergoing PCI.
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Affiliation(s)
- Stefano Rigattieri
- Cardiology Division, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy; (E.C.); (F.T.); (L.P.); (V.C.); (M.C.); (F.G.); (A.T.); (E.B.); (A.B.)
| | - Ernesto Cristiano
- Cardiology Division, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy; (E.C.); (F.T.); (L.P.); (V.C.); (M.C.); (F.G.); (A.T.); (E.B.); (A.B.)
- Department of Electrophysiology, Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Federica Tempestini
- Cardiology Division, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy; (E.C.); (F.T.); (L.P.); (V.C.); (M.C.); (F.G.); (A.T.); (E.B.); (A.B.)
| | - Luca Pittorino
- Cardiology Division, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy; (E.C.); (F.T.); (L.P.); (V.C.); (M.C.); (F.G.); (A.T.); (E.B.); (A.B.)
| | - Vincenzo Cesario
- Cardiology Division, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy; (E.C.); (F.T.); (L.P.); (V.C.); (M.C.); (F.G.); (A.T.); (E.B.); (A.B.)
| | - Matteo Casenghi
- Cardiology Division, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy; (E.C.); (F.T.); (L.P.); (V.C.); (M.C.); (F.G.); (A.T.); (E.B.); (A.B.)
| | - Francesca Giovannelli
- Cardiology Division, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy; (E.C.); (F.T.); (L.P.); (V.C.); (M.C.); (F.G.); (A.T.); (E.B.); (A.B.)
| | - Antonella Tommasino
- Cardiology Division, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy; (E.C.); (F.T.); (L.P.); (V.C.); (M.C.); (F.G.); (A.T.); (E.B.); (A.B.)
| | - Emanuele Barbato
- Cardiology Division, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy; (E.C.); (F.T.); (L.P.); (V.C.); (M.C.); (F.G.); (A.T.); (E.B.); (A.B.)
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Berni
- Cardiology Division, Sant’Andrea University Hospital, Via di Grottarossa 1035, 00189 Rome, Italy; (E.C.); (F.T.); (L.P.); (V.C.); (M.C.); (F.G.); (A.T.); (E.B.); (A.B.)
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
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Rojas JI, Gracia F, Parciak T, Alonso R, Becker J, Treviño-Frenk I, Alonso-Serena M, Giunta D, Abad P, Carnero-Contentti E, Carrá A, Correa-Díaz EP, Correale J, Cristiano E, Flores J, Fruns M, Galleguillos L, Garcea O, Hamuy F, Lana-Peixoto M, Navas C, Pappais-Alvarenga R, Patrucco L, Rivera V, Tenembaum S, Ysrraelit MC, Peeters LM. [Core data set for real world data in multiple sclerosis: customization for latin america from a global task force recommendation]. Rev Neurol 2024; 78:185-197. [PMID: 38502167 DOI: 10.33588/rn.7807.2023326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
INTRODUCTION The primary objective of the core data set is to reduce heterogeneity and promote harmonization among data sources in EM, thereby reducing the time needed to execute real life data collection efforts. Recently, a group led by the Multiple Sclerosis Data Alliance has developed a core data set for collecting real-world data on multiple sclerosis (MS) globally. Our objective was to adapt this global data set to the needs of Latin America, so that it can be implemented by the registries already developed and in the process of development in the region. MATERIAL AND METHODS A working group was formed regionally, the core data set created globally was adapted (translation process into Spanish, incorporation of regional variables and consensus on variables to be used). Consensus was obtained through the remote Delphi methodology of a round of questionnaires and remote discussion of the core data set variables. RESULTS A total of 25 professionals from Latin America carried out the adaptation process between November 2022 and July 2023. Agreement was established on a core data set of nine categories and 45 variables, version 2023 to suggest its implementation in developed or developing registries, and MS cohorts in the region. CONCLUSION The core data set seeks to harmonize the variables collected by registries and cohorts in MS in Latin America in order to facilitate said collection and allow collaboration between sources. Its implementation will facilitate real life data collection and collaboration in the region.
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Affiliation(s)
- J I Rojas
- Hospital Alemán, Buenos Aires, Argentina
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
| | - F Gracia
- Hospital Santo Tomás, Panamá, República de Panamá
| | - T Parciak
- Universidad Hasselt, Diepenbeek, Bélgica
| | - R Alonso
- Hospital J. M. Ramos Mejía, Buenos Aires, Argentina
- Universidad de Buenos Aires, Buenos Aires, Argentina
- Sanatorio Güemes, Buenos Aires, Argentina
| | - J Becker
- Universidad Pontificia de Rio Grande do Sul, Porto Alegre, Brasil
| | - I Treviño-Frenk
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | | | - D Giunta
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - P Abad
- Hospital Metropolitano de Quito, Quito, Ecuador
| | | | - A Carrá
- Hospital Británico, Buenos Aires, Argentina
- Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - E P Correa-Díaz
- Hospital Carlos Andrade Marín. Universidad Central del Ecuador, Quito, Ecuador
| | | | - E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
| | - J Flores
- Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
| | - M Fruns
- Clínica Las Condes , Santiago de Chile, Chile
| | - L Galleguillos
- Clinica Alemana, Santiago de Chile, Chile
- Universidad del Desarrollo, Santiago de Chile, Chile
| | - O Garcea
- Hospital J. M. Ramos Mejía, Buenos Aires, Argentina
- Universidad de Buenos Aires, Buenos Aires, Argentina
| | - F Hamuy
- Hospital IMT, Asunción, Paraguay
| | - M Lana-Peixoto
- Universidad Federal de Minas Gerais, Belo Horizonte, Brasil
| | - C Navas
- Clínica Universitaria Colombia, Bogotá, Colombia
| | | | - L Patrucco
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
| | - V Rivera
- Universidad de Medicina Baylor, Houston, EE.UU
| | - S Tenembaum
- Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
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Ali H, Cristiano E, Lupo P, Foresti S, DE Ambroggi G, DE Lucia C, Turturiello D, Paganini EM, Bessi R, Farghaly AA, Nicolì L, Cappato R. Oral mexiletine for ventricular tachyarrhythmias treatment in implantable cardioverter-defibrillator patients: a systematic review of the literature. Minerva Cardiol Angiol 2023; 71:622-630. [PMID: 36305779 DOI: 10.23736/s2724-5683.22.06176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION To evaluate the clinical outcomes of oral mexiletine (oMXT) to treat ventricular tachyarrhythmias (VTAs) in the era of implantable cardioverter-defibrillator (ICD) technology. EVIDENCE ACQUISITION A systematic search was conducted using PubMed, Embase and Cochrane databases following the PRISMA guidelines to collect literature data reporting oMXT efficacy and safety outcomes in treating VTAs in ICD recipients. EVIDENCE SYNTHESIS Final analysis included four studies accounting for a total of 91 patients with recurrent VTAs treated with oMXT. Amiodarone therapy was initially attempted in most patients (91.2%), while catheter ablation was performed in one-third of patients. VTA recurrences were observed in 55/91 patients (60.4%) during oMXT treatment compared to 91/91 (100%) before treatment (P<0.001). Appropriate therapies occurred in 55/88 ICD patients (62.5%) during oMXT treatment compared to 80/88 (90.9%) before treatment (P<0.001). After oMXT introduction, there was a significant reduction of the individual burden of VTA episodes and appropriate ICD therapies per patient, showing Hedges'g values of -1.103 (P=0.002) and -1.474 (P=0.008), respectively. Safety analysis showed a sample-weighted overall side-effect rate of 30%, while 21% of patients required drug reduction or discontinuation. Aggregated meta-regression analysis of the included studies and remote literature revealed a linear correlation between oMXT dosage and the overall side effects rate (r2 = 0.48; P=0.014). CONCLUSIONS Oral mexiletine provides an adjunctive treatment to manage VTAs and reduces appropriate therapies in ICD patients with moderate efficacy and acceptable safety profiles. These observations await confirmation through randomised clinical trials.
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Affiliation(s)
- Hussam Ali
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy -
| | - Ernesto Cristiano
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Pierpaolo Lupo
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Sara Foresti
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Guido DE Ambroggi
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Carmine DE Lucia
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Dario Turturiello
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Edoardo M Paganini
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Riccardo Bessi
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Ahmad A Farghaly
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
- Department of Cardiovascular Medicine, Faculty of Medicine, University of Assiut, Assiut, Egypt
| | - Leoluca Nicolì
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Riccardo Cappato
- Arrhythmia and Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
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Ali H, Lupo P, Foresti S, De Ambroggi G, Anderson RH, De Lucia C, Turturiello D, Paganini EM, Bessi R, Contrafatto I, Farghaly AAA, Cristiano E, Cappato R. Catheter-induced right bundle branch block: Practical implications for the cardiac electrophysiologist. J Cardiovasc Electrophysiol 2023; 34:2316-2329. [PMID: 37655997 DOI: 10.1111/jce.16050] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/23/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
The right bundle branch (RBB), due to its endocardial course, is susceptible to traumatic block caused by "bumping" during right-heart catheterization. In the era of cardiac electrophysiology, catheter-induced RBB block (CI-RBBB) has become a common phenomenon observed during electrophysiological studies and catheter ablation procedures. While typically transient, it may persist for the entire procedure time. Compared to pre-existing RBBB, the transient nature of CI-RBBB allows for comparative analysis relative to the baseline rhythm. Furthermore, unlike functional RBBB, it occurs at similar heart rates, making the comparison of conduction intervals more reliable. While CI-RBBB can provide valuable diagnostic information in various conditions, it is often overlooked by cardiac electrophysiologists. Though it is usually a benign and self-limiting conduction defect, it may occasionally lead to diagnostic difficulties, pitfalls, or undesired consequences. Avoidance of CI-RBBB is advised in the presence of baseline complete left bundle branch block and when approaching arrhythmic substrates linked to the right His-Purkinje-System, such as fasciculo-ventricular pathways, bundle branch reentry, and right-Purkinje focal ventricular arrhythmias. This article aims to provide a comprehensive practical review of the electrophysiological phenomena related to CI-RBBB and its impact on the intrinsic conduction system and various arrhythmic substrates.
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Affiliation(s)
- Hussam Ali
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Pierpaolo Lupo
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Sara Foresti
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Guido De Ambroggi
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Robert H Anderson
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - Carmine De Lucia
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Dario Turturiello
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Edoardo Maria Paganini
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Riccardo Bessi
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Igino Contrafatto
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
- Cardiac Electrophysiology, Salus Hospital, Reggio Emilia, Italy
| | - Ahmad Abdelrady Abdelsalam Farghaly
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
- Cardiovascular Department, Assiut University, Assiut, Egypt
| | - Ernesto Cristiano
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Riccardo Cappato
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
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Francia P, Ocaña-Franco P, Cristiano E, Falasconi G, Adduci C, Soto-Iglesias D, Penela D, Sclafani M, Martì-Almor J, Musumeci B, Autore C, Berruezo A. Substrates of Scar-Related Ventricular Arrhythmia in Patients With Hypertrophic Cardiomyopathy: A Cardiac Magnetic Resonance Study. JACC Cardiovasc Imaging 2023; 16:1359-1362. [PMID: 37204386 DOI: 10.1016/j.jcmg.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 03/03/2023] [Accepted: 03/23/2023] [Indexed: 05/20/2023]
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Ali H, Ambroggi GD, Contrafatto I, Bessi R, Lupo P, Foresti S, Cristiano E, Cappato R. Catheter ablation of left atrial tachycardia adjacent to a septal closure device: A multifaceted challenge? Pacing Clin Electrophysiol 2023; 46:1230-1234. [PMID: 36788778 DOI: 10.1111/pace.14674] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023]
Abstract
Catheter ablation (CA) of left atrial tachycardia adjacent to implanted septal closure devices represents a multifaceted challenge. We describe the case of a 57-year-old patient with remote percutaneous closure of atrial septal defect who underwent successful CA of left atrial tachycardia adjacent to the septal device using a transaortic approach and RF energy. Besides the technical difficulties and associated risks, interference between the device and applied RF parameters may limit ablation efficiency. Further research is required to evaluate the safety, efficacy, and optimal energy type/parameters when ablating arrhythmias adjacent to these devices.
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Affiliation(s)
- Hussam Ali
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Guido De Ambroggi
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Igino Contrafatto
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
- Electrophysiology Department, Salus Hospital, Reggio Emilia, Italy
| | - Riccardo Bessi
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Pierpaolo Lupo
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Sara Foresti
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Ernesto Cristiano
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Riccardo Cappato
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
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Celentano E, Ignatiuk B, Cristiano E, Bia E, Lo Monaco M, de Groot NM. Are three-dimensional mapping systems useful for left bundle branch area pacing? HeartRhythm Case Rep 2023; 9:465-468. [PMID: 37492049 PMCID: PMC10363463 DOI: 10.1016/j.hrcr.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Affiliation(s)
- Eduardo Celentano
- Humanitas Gavazzeni, Bergamo, Italy
- Lowlands Institute for Bioelectric Medicine, Unit Translational Electrophysiology, Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | | | | | | | - Natasja M.S. de Groot
- Lowlands Institute for Bioelectric Medicine, Unit Translational Electrophysiology, Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Ali H, Lupo P, Cristiano E, Nicolì L, Foresti S, De Ambroggi G, Anderson RH, De Lucia C, Turturiello D, Paganini EM, Bessi R, Farghaly AAA, Butera G, Cappato R. Chiari network for the interventional cardiologist: A hidden enemy at the heart gate - A systematic review of the literature. Int J Cardiol 2023; 375:23-28. [PMID: 36587656 DOI: 10.1016/j.ijcard.2022.12.046] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND This study aimed to collect and analyze the literature data regarding Chiari network (CN) and other right atrium (RA) remnants comprising the Eustachian and Thebesian valves (EV, ThV) as a potential entrapment site during different percutaneous cardiac procedures (PCP). METHODS AND RESULTS A systematic search was conducted using Pubmed and Embase databases following the PRISMA guidelines to obtain available data concerning PCP associated with entrapment of inserted materials within CN-EV-ThV. The final analysis included 41 patients who underwent PCP with reported material entrapment within these RA remnants. The PCP was atrial septal defect (ASD)/patent foramen ovale (PFO) closure, catheter ablation, and pacemaker/defibrillator implantation in 44%, 22%, and 17% of patients, respectively. The entrapped materials were ASD/PFO devices, multipolar electrophysiology catheters, passive-fixation pacing leads, and J-guidewires in about 30%, 20%, 15%, and 10% of patients, respectively. Intraprocedural transthoracic, transoesophageal and intracardiac echocardiography showed sensitivity to reveal these structures of 20%, ∼95%, and 100%, respectively. A percutaneous approach successfully managed 70% of patients, while cardiovascular surgery was required in 20% and three patients died (7.3%). CONCLUSIONS CN and other RA remnants may cause entrapment of various devices or catheters during PCP requiring right heart access. The percutaneous approach, guided by intraprocedural imaging, appears safe and effective in managing most patients. Prevention includes recognizing these anatomical structures at baseline cardiac imaging and intraprocedural precautions. Further studies are needed to analyze the actual incidence of this condition, its clinical impact and appropriate management.
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Affiliation(s)
- Hussam Ali
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy.
| | - Pierpaolo Lupo
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Ernesto Cristiano
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Leoluca Nicolì
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Sara Foresti
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Guido De Ambroggi
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Robert H Anderson
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Carmine De Lucia
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Dario Turturiello
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Edoardo Maria Paganini
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Riccardo Bessi
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Ahmad Abdelrady Abdelsalam Farghaly
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy; Cardiovascular Department, Assiut University, Assiut, Egypt
| | - Gianfranco Butera
- Department of Paediatric Cardiology, Cardiac Surgery and Heart Lung Transplantation, ERN GUARD HEART: Bambin Gesù Hospital and Research Institute, IRCCS, Rome, Italy; Department of Paediatric and Adult Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Riccardo Cappato
- Arrhythmia & Electrophysiology Centre, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
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Ali H, De Lucia C, Cristiano E, Lupo P, Foresti S, De Ambroggi G, Turturiello D, Paganini EM, Bessi R, Farghaly AAA, Francia P, Cappato R. A Single-lead ECG algorithm to differentiate right from left manifest accessory pathways: A reappraisal of the P-Delta interval. J Cardiovasc Electrophysiol 2023; 34:598-606. [PMID: 36640425 DOI: 10.1111/jce.15818] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Despite numerous ECG algorithms being developed to localize the site of manifest accessory pathways (AP), they often require stepwise multiple-lead analysis with variable accuracy, limitations, and reproducibility. The study aimed to develop a single-lead ECG algorithm incorporating the P-Delta interval (PDI) as an adjunct criterion to discriminate between right and left manifest AP. METHODS Consecutive WPW patients undergoing electrophysiological study (EPS) were retrospectively recruited and split into a derivation and validation group (1:1 ratio). Sinus rhythm ECG analysis in lead V1 was performed by three independent investigators blinded to the EPS results. Conventional ECG parameters and PDI were assessed through the global cohort. RESULTS A total of 140 WPW patients were included (70 for each group). A score-based, single-lead ECG algorithm was developed through derivation analysis incorporating the PDI, R/S ratio, and QRS onset polarity in lead V1. The validation group analysis confirmed the proposed algorithm's high accuracy (95%), which was superior to the previous ones in predicting the AP side (p < 0.05). A score of ≤+1 was 96.5% accurate in predicting right AP while a score of ≥+2 was 92.5% accurate in predicting left AP. The new algorithm maintained optimal performance in specific subgroups of the global cohort showing an accuracy rate of 90%, 92%, and 96% in minimal pre-excitation, posteroseptal AP, and pediatric patients, respectively. CONCLUSIONS A novel single-lead ECG algorithm incorporating the PDI interval with previous conventional criteria showed high accuracy in differentiating right from left manifest AP comprising pediatric and minimal pre-excitation subgroups in the current study.
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Affiliation(s)
- Hussam Ali
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Carmine De Lucia
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Ernesto Cristiano
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy.,Department of Clinical and Molecular Medicine, Division of Cardiology, St. Andrea Hospital, Sapienza University, Rome, Italy
| | - Pierpaolo Lupo
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Sara Foresti
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Guido De Ambroggi
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Dario Turturiello
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Edoardo Maria Paganini
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Riccardo Bessi
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
| | - Ahmad Abdelrady Abdelsalam Farghaly
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy.,Cardiovascular Department, Assiut University, Assiut, Egypt
| | - Pietro Francia
- Department of Clinical and Molecular Medicine, Division of Cardiology, St. Andrea Hospital, Sapienza University, Rome, Italy
| | - Riccardo Cappato
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
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10
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Grimaldi MC, Rosato E, D’Angelo A, Cristiano E, Marchitti S, Volpe M, Rubattu S, Romaniello A. The prognostic role of the echocardiographic tricuspid annular plane systolic excursion/systolic pulmonary arterial pressure (TAPSE/sPAP) ratio and its relationship with NT-proANP plasma level in systemic sclerosis. Front Cardiovasc Med 2023; 9:1021048. [PMID: 36733829 PMCID: PMC9887033 DOI: 10.3389/fcvm.2022.1021048] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Abstract
Background The tricuspid annular plane systolic excursion/systolic pulmonary arterial pressure (TAPSE/sPAP) ratio is an echocardiographic estimation of the right ventricle to pulmonary artery (RV/PA) coupling, with a validated prognostic role in different clinical settings. Systemic sclerosis (SSc) patients without evident cardiovascular involvement frequently display subtle RV impairment. The amino-terminal atrial natriuretic peptide (NT-proANP) plasma level relates to SSc disease progression and mortality. We aimed to assess the prognostic value of the TAPSE/sPAP ratio and its relationship with NT-proANP plasma level in SSc patients without overt cardiovascular involvement. Methods We retrospectively analysed 70 SSc consecutive patients, with no clinical evidence of cardiovascular involvement or pulmonary hypertension (PH), and 30 healthy controls (HC) in a retrospective, single-centre study. All SSc patients underwent recurrent clinical and echocardiographic assessments and NT-proANP plasma level was assessed at baseline. SSc-related cardiovascular events and deaths were extracted during a 6-year follow-up. The complete work-up for the diagnosis, treatment and management of PH performed along the 6 years of follow-up referred to the 2015 European Society of Cardiology guidelines. Results Systemic sclerosis patients showed lower TAPSE/sPAP ratio at baseline compared to HC [SSc median value = 0.71 mm/mmHg, (IQR 0.62-0.88) vs. HC median value = 1.00 mm/mmHg, (IQR 0.96-1.05); p < 0.001]. Multivariable Cox analysis revealed TAPSE/sPAP ratio as an independent predictor for SSc-related cardiovascular events [HR = 3.436 (95% CI 1.577-7.448); p = 0.002] and mortality [HR = 3.653 (95% CI 1.712-8.892); p = 0.014]. The value of TAPSE/sPAP ratio < 0.7 mm/mmHg was identified as an optimal cut-off for predicting adverse outcomes (p < 0.001) by receiver operating characteristic (ROC) analyses. NT-proANP level significantly related to TAPSE/sPAP ratio (r = 0.52, p < 0.001). TAPSE/sPAP ratio combined with NT-proANP showed an overall significant prognostic role in this SSc population, confirmed by Kaplan-Meier analysis (Log rank p < 0.001). Conclusion The TAPSE/sPAP ratio, as an index of RV/PA coupling, is an affordable predictor of cardiovascular events and mortality in SSc and, combined with NT-proANP level, may improve the clinical phenotyping and prognostic stratification of SSc patients.
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Affiliation(s)
- Maria Chiara Grimaldi
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy,Department of Cardiovascular and Pneumological Sciences, Catholic University of Sacred Heart, Rome, Italy,Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy,*Correspondence: Maria Chiara Grimaldi,
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Adriano D’Angelo
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Ernesto Cristiano
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Simona Marchitti
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy,San Raffaele Pisana Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Speranza Rubattu
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli, Italy
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11
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Tempestini F, Cristiano E, Pala B, Tifi P, Magrì D, Marcoccia A, Romaniello A. 728 GALECTINE-3 AND SST2 IN SYSTEMIC SCLEROSIS: AN EARLY DETECTION OF PULMONARY VASCULAR INVOLVEMENT IS REALLY POSSIBLE? Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Introduction
Pulmonary arterial hypertension (PAH) is a rare form of pulmonary hypertension (PH) that may also be associated with connective tissue diseases (CTD). In particular, PAH may affect from 5 to 19% of patients with systemic sclerosis (SSc), leading to a significant prognostic worsening. The current challenge is an early detection of PAH in such patients, in order to provide an early referral to PH centers to supply specific therapies as soon as possible. In the latest ESC guidelines for PH, cardiopulmonary exercise testing (CPET) has been included in the diagnostic algorithm for patients with unexplained exertional dyspnoea and/or suspected PH. Patients with PAH show a typical pattern, with a low end-tidal partial pressure of carbon dioxide (PETCO2), high ventilatory equivalent for carbon dioxide (VE/VCO2), low oxygen pulse (VO2/ HR) and low peak oxygen uptake (VO2). CPET may identify patients with SSc at low risk of PAH, to avoid unnecessary right heart catheterization (RHC). However, CPET is not available in all centers. So, we designed a preliminary study to identify new biomarkers that correlate with CPET's parameters.
Material and Methods
We enrolled 62 SSc patients [53 females, median age 52 years] with no other comorbidities and asymptomatic for dyspnea or other symptoms. 56% and 44% of them presented limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc), respectively.
For all patients we performed serum analysis for sST2, Galectine-3, pro-ANP, BNP and IL6, diagnostic imaging with echocardiography and cardiac MRI, CPET and pulmonary functionality test (PFT).
Results
All patients presented normal echocardiographic and RMI imaging findings.
Galectin-3, sST2, pro-ANP, BNP and IL6 presented respectively the following median value: 13.45 ng/mL [11.78; 18.70], 23.25 ng/mL [13.04; 43.35], 1897 fmol/ml [1487; 2445], 12.18 pg/mL [9.34; 15.01]. Both Galectin-3 and sST2 showed a linear correlation with VE/VCO2 slope with R 0.339 (P-value 0.018) and 0.355 (P-value 0.013) respectively. After linear regression analysis, Galectin-3 and sST2 were overall statistically significant with R2 of 0.115 and 0.126, F of 5.97 and 6.62 and P-value of 0.018 and 0.013, respectively. It was found that Galectin-3 and SST2 significantly predicted VE/VCO2 slope with β = 0.364 [0,064; 0,665] for Galectin-3 and 0.137 [0,030; 0,244] for SST2.
All other CPET parameters did not show correlation with the biomarkers.
Conclusion
Our preliminary results suggest that Galectine-3 and sST2 may be useful biomarkers for predicting increasing VE/VCO2 slope. Future analysis may confirm the role of these new biomarkers for early detection of pulmonary vascular involvement in SSc patients to allow an early referral and treatment and, conversely, to avoid unnecessary RHC.
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Affiliation(s)
- Federica Tempestini
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Ernesto Cristiano
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Barbara Pala
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Priscilla Tifi
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Damiano Magrì
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
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12
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Cacioli G, Polizzi V, Ciabatti M, Cristiano E, Pergolini A, Distefano G, Della Monica PL, Comisso M, Piazza V, Sbaraglia F, Musumeci F. 677 PREDICTION OF RIGHT VENTRICULAR FAILURE AFTER LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION: ROLE OF VASODILATOR CHALLENGE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Pulmonary artery pulsatility index (PAPi) is an indicator of right ventricular (RV) function and an independent predictor of right ventricular failure (RVF) following left ventricular assist device (LVAD) implantation. Administration of vasodilator challenge during right heart catheterization (RHC) could reduce RV workload allowing a better assessment of its functional reserve.
Patients undergoing LVAD implantation at our Institution between May 2013 and August 2021 were enrolled. Only patients who had undergone RHC and vasodilator challenge with sodium nitroprusside were analyzed. We collected all available clinical, instrumental, and haemodynamic parameters, at baseline and after nitroprusside infusion and evaluated potential associations with post-LVAD RVF. Of the 54 patients analyzed, 19 (35%) developed RVF after LVAD implantation. Fractional area change (FAC) (OR: 0.647, CI: 0.481–0.871; P = 0.004), pulmonary artery systolic pressure (PASP)(OR: 0.856, CI: 0.761–0.964; P=0.010), and post-sodium nitroprusside (NTP) PAPi (OR: 0.218, CI: 0.073–0.653; P = 0.006) were independent predictors of post-LVAD RVF. The model combining FAC, PASP, and post-NTP PAPi demonstrated a predictive accuracy of 90.7%. Addition of post-NTP PAPi significantly increased the predictive accuracy of the European Registry for Patients with Mechanical Circulatory Support right-sided heart failure risk score [79.4 vs. 70.4%; area under the curve (AUC): 0.841 vs. 0.724, P = 0.022] and the CRITT score (79.6% vs. 74%; AUC: 0.861 vs. 0.767 P = 0.033).
Post-NTP PAPi has observed to be an independent predictor of RVF following LVAD implantation. Dynamic assessment of PAPi using a vasodilator challenge may represent a method of testing RV functional reserve in candidates for LVAD implantation. Larger and prospective studies are needed to confirm this hypothesis.
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Affiliation(s)
- Giulio Cacioli
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Vincenzo Polizzi
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | | | - Ernesto Cristiano
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, Sapienza University , Rome
| | - Amedeo Pergolini
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Giada Distefano
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | | | - Marina Comisso
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Vito Piazza
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Fabio Sbaraglia
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Francesco Musumeci
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
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13
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Tifi P, Pala B, Tempestini F, Cristiano E, Bocci A, Rosato E, Salerno G, Romaniello A. 729 BIOMARKERS FOR EARLY DIAGNOSIS OF CARDIAC INVOLVEMENT IN SYSTEMIC SCLEROSIS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Introduction
Systemic Sclerosis (SSc) is an autoimmune disease characterized by microvascular damage, immune system dysregulation and fibrosis of skin and internal organs. It is reported that asymptomatic involvement of the heart was found in 70% of SSc patients. The role of biomarkers in the early detection of fibrosis and vascular damage in SSc is not yet completely defined. Serum levels of sST2, Galectin 3, ANP, IL6 are a potential marker of cardiac involvement. In patients with chronic heart failure elevated levels of galectin-3 (>17.8 ng/ml) are a marker of worse prognosis. Moreover, a previous study reported a possible role of galectin-3 as an independent predictor of all-cause and cardiovascular mortality in SSc.
Material and Methods
We enrolled 62 SSc patients (53 females, median age 52 years) who fulfilled inclusion criteria.
35 patients had limited cutaneous SSc and 27 diffuse cutaneous SSc.
30 Healthy Controls (HC) were also enrolled [20 females; median age 50 years].
All SSc patients had normal echocardiographic and cardiac MRI findings.
Results
In SSc patients, the median Galectin value was 16.7 ng/ml, significantly higher than HC median (10,7 ng/Ml).
sST2 and IL-6 median value was 30 ng/mL and 12,3 pg/mL respectively, which resulted significantly higher than the median value of HC patient (21,55 ng/mL and 4,5 pg/mL respectively).
Therefore, there was a significant difference in biomarkers levels in the SSc group compared with controls.
Conclusion
These data suggest that these biomarkers can help identify a subgroup of SSc patients, with normal echocardiographic and RMN findings, who are at risk of developing heart involvement. In fact, all patients are scheduled for yearly echocardiographic re-evaluation as ESC guidelines recommend for earlier detection of pulmonary arterial hypertension (PAH), a leading cause of death in systemic sclerosis (SSc).
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Affiliation(s)
- Priscilla Tifi
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Barbara Pala
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Federica Tempestini
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Ernesto Cristiano
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Alessandro Bocci
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, School Of Medicine And Psychology, Sapienza University , Rome , Italy
| | - Edoardo Rosato
- Department Of Translational And Precision Medicine, Scleroderma Unit, Sapienza University Of Rome , Italy
| | - Gerardo Salerno
- Divison Of Neuroscience, Mental Health And Sensory Organs (Nesmos), School Of Medicine And Psychology, Sapienza University Of Rome , Italy
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14
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Turturiello D, Cristiano E, De Lucia C, Bessi R, Paganini E, Lupo P, Deambroggi G, Foresti S, Ali H, Cappato R. 952 SAFETY OF CLASS IC ANTIARRHYTHMIC DRUGS IN CORONARY ARTERY DISEASE PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Introduction
Class IC antiarrhythmic drugs (AADs) currently represent a cornerstone in the therapy of atrial fibrillation (AF). They also play an important role in the treatment of idiopathic ventricular arrhythmias. Following the results of the CAST study flecainide and by extension the other class IC AADs were contraindicated in patients with ischemic and structural heart disease, because of their proarrhythmic effect and the consequent increase in mortality observed in the study.
Recent studies, carried out on patients with chronic coronary heart disease, have shown a good safety profile for this class of drugs.
Methods
The aim of our study was to evaluate the mortality and the mortality rate in patients affected by ischaemic heart disease who take Class IC AADs. A systematic review and meta-analysis was conducted using Pubmed and Embase databases, following the PRISMA guidelines, to collect literature data reporting Class IC AADs safety in patients affected by coronary artery disease.
Results
The final analysis included four studies accounting for a total of 3643. In the Classe IC AADs group the events (all cause death) were observed in 104/1170 patients, while in the control group were observed in 338/2473 patients, showing an ODDS ratio of 1.431 (IC 0.748-2.740), p value 0.279 (TABLE 1A). The event rate per year was 5,5% in the CLASS IC AADs group and 5,1 in the control group, with an ODDS ratio of 1.524 (IC 0.807-2.879), p value 0.194 (TABLE 1B).
Conclusion
Class IC AADs doesn't increase the overall mortality and mortality rate in patient affected by icheamic heart disease. These observations await confirmation through randomised clinical trial.
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15
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Ali H, De Ambroggi G, Lupo P, Foresti S, Cristiano E, Farghaly AAA, Cappato R. Transient baseline rhythm changes unmasking an uncommon arrhythmic substrate. J Cardiovasc Electrophysiol 2022; 33:2663-2666. [PMID: 36251261 DOI: 10.1111/jce.15706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/27/2022] [Accepted: 10/09/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Hussam Ali
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Italy
| | - Guido De Ambroggi
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Italy
| | - Pierpaolo Lupo
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Italy
| | - Sara Foresti
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Italy
| | - Ernesto Cristiano
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Italy
| | - Ahmad Abdelrady Abdelsalam Farghaly
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Italy.,Cardiovascular Department, Assiut University, Assiut, Egypt
| | - Riccardo Cappato
- Arrhythmia & Electrophysiology Center, IRCCS MultiMedica, Sesto San Giovanni, Italy
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16
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Rigattieri S, Cristiano E, Tempestini F, Lo Monaco M, Cava F, Bongiovanni M, Tifi P, Berni A, Volpe M. Lipoprotein(a) and the risk of recurrent events in patients with acute myocardial infarction treated by percutaneous coronary intervention. Minerva Cardiol Angiol 2022:S2724-5683.22.06213-5. [PMID: 36321889 DOI: 10.23736/s2724-5683.22.06213-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The role of Lipoprotein(a) (Lp[a]) in risk stratification following an acute myocardial infarction (AMI) is still debated. We aimed to investigate whether elevated Lp(a) levels in patients with AMI treated by percutaneous coronary intervention (PCI) are associated with worse outcomes. METHODS We designed a retrospective registry including patients with AMI undergoing PCI. The occurrence of major adverse cardiac and cerebrovascular events (MACCE), defined as death from cardiovascular causes, recurrent myocardial infarction, unplanned coronary revascularization and stroke, was assessed at follow up and compared between patients with high (≥ 30 mg/dl) and low (< 30 mg/dl) Lp(a) levels. Cox proportional hazard analysis was performed in order to assess independent predictors of MACCE. RESULTS During a 3-year period (2018-2020) we identified 634 patients with AMI treated by PCI and known Lp(a) blood levels; follow up visits were performed in 414 patients (median length 29 months [19-38]). Median Lp(a) level was 18 mg/dl [8-42]. The incidence of MACCE was significantly higher in high as compared to low Lp(a) group (log-rank p=0.018). The following independent predictors were identified at multivariate Cox regression: Lp(a) ≥30 mg/dl (HR 1.82 [95% CI 1.04-3.19], peripheral artery disease (HR 4.62 [95% CI 2.50-8.54]), number of diseased coronary vessels (HR 1.51 [95% 1.03-2.24] and presence of a coronary chronic total occlusion at coronary angiography (HR 3.46 [95% CI 1.77-6.76]). CONCLUSIONS In this study, Lp(a) values ≥30 mg/dl were associated to worse outcomes in patients with AMI receiving PCI. Lp(a) could represent a useful tool to identify patients at high risk of recurrent events.
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Affiliation(s)
- Stefano Rigattieri
- Cardiology Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy -
| | - Ernesto Cristiano
- Cardiology Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Federica Tempestini
- Cardiology Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maria Lo Monaco
- Cardiology Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Francesco Cava
- Cardiology Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Martina Bongiovanni
- Cardiology Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Priscilla Tifi
- Cardiology Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Andrea Berni
- Cardiology Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Massimo Volpe
- Cardiology Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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17
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Cacioli G, Polizzi V, Ciabatti M, Cristiano E, Pergolini A, Distefano G, Lilla Della Monica P, Comisso M, Piazza V, Sbaraglia F, Musumeci F. Prediction of right ventricular failure after left ventricular assist device implantation: role of vasodilator challenge. Eur Heart J Acute Cardiovasc Care 2022; 11:629-639. [PMID: 35866303 DOI: 10.1093/ehjacc/zuac085] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 01/01/2023]
Abstract
AIMS Pulmonary artery pulsatility index (PAPi) is an indicator of right ventricular (RV) function and an independent predictor of right ventricular failure (RVF) following left ventricular assist device (LVAD) implantation. Administration of vasodilator challenge during right heart catheterization (RHC) could reduce RV workload allowing a better assessment of its functional reserve. METHODS AND RESULTS Patients undergoing LVAD implantation at our Institution between May 2013 and August 2021 were enrolled. Only patients who had undergone RHC and vasodilator challenge with sodium nitroprusside were analyzed. We collected all available clinical, instrumental, and haemodynamic parameters, at baseline and after nitroprusside infusion and evaluated potential associations with post-LVAD RVF. Of the 54 patients analyzed, 19 (35%) developed RVF after LVAD implantation. Fractional area change (FAC) (OR: 0.647, CI: 0.481-0.871; P = 0.004), pulmonary artery systolic pressure (PASP) (OR: 0.856, CI: 0.761-0.964; P = 0.010), and post-sodium nitroprusside (NTP) PAPi (OR: 0.218, CI: 0.073-0.653; P = 0.006) were independent predictors of post-LVAD RVF. The model combining FAC, PASP, and post-NTP PAPi demonstrated a predictive accuracy of 90.7%. Addition of post-NTP PAPi significantly increased the predictive accuracy of the European Registry for Patients with Mechanical Circulatory Support right-sided heart failure risk score [79.4 vs. 70.4%; area under the curve (AUC): 0.841 vs. 0.724, P = 0.022] and the CRITT score (79.6% vs. 74%; AUC: 0.861 vs. 0.767 P = 0.033). CONCLUSION Post-NTP PAPi has observed to be an independent predictor of RVF following LVAD implantation. Dynamic assessment of PAPi using a vasodilator challenge may represent a method of testing RV functional reserve in candidates for LVAD implantation. Larger and prospective studies are needed to confirm this hypothesis.
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Affiliation(s)
- Giulio Cacioli
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Vincenzo Polizzi
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | | | - Ernesto Cristiano
- Division of Cardiology, Department of Clinical and Molecular Medicine; School of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Amedeo Pergolini
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Giada Distefano
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | | | - Marina Comisso
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Vito Piazza
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Fabio Sbaraglia
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Francesco Musumeci
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
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18
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Francia P, Silvetti G, Cosentino P, Cristiano E, Adduci C, Tini G, Musumeci MB, Volpe M, Autore C. Relation of delayed intrinsicoid deflection of the QRS complex to sudden cardiac death in patients with hypertrophic cardiomyopathy. Int J Cardiol 2022; 366:42-47. [PMID: 35780930 DOI: 10.1016/j.ijcard.2022.06.066] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/15/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022]
Abstract
AIMS Predictors of sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM) do not include ECG variables. Intrinsicoid deflection (ID) represents the early ventricular depolarization on surface ECG. Delayed ID (DID) has been associated with sudden cardiac arrest (SCA) in the community. In a cohort of consecutive patients with HCM, we assessed whether DID predicts SCA or its surrogates. METHODS We reviewed ECG, clinical and follow-up data of 344 consecutive HCM patients. DID (ID ≥50 ms) was classified as lateral (leads I or aVL), inferior (leads II, III or aVF), and precordial (leads V5 or V6). The endpoint was a combination of SCD, resuscitated SCA or appropriate ICD intervention. RESULTS The SCA group was composed by 2 secondary prevention ICD recipients and 23 patients that reached the endpoint during follow-up (108 ± 73 months). SCA patients had more frequently massive LV hypertrophy (LVH) or end-stage HCM. ECG indexes of LVH were comparable between SCA and controls. SCA patients were more likely to have DID on ECG lateral leads I/aVL (72% vs 44%; p = 0.008). A non significant trend was observed for inferior and V5/V6 leads. DID I/aVL was associated with SCA in multivariate analysis after correction for massive LVH and end-stage disease (HR: 2.86; 95%CI: 1.14-7.13; p = 0.02). CONCLUSIONS In HCM patients DID is associated with increased risk of SCA. Its prognostic value extends beyond that of LVH. If confirmed in prospective studies, the prognostic power of this ECG marker could be used to refine risk prediction.
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Affiliation(s)
- Pietro Francia
- Division Cardiology, Department of Clinical and Molecular Medicine, St. Andrea Hospital, Sapienza University, Rome, Italy
| | - Giacomo Silvetti
- Division Cardiology, Department of Clinical and Molecular Medicine, St. Andrea Hospital, Sapienza University, Rome, Italy
| | - Pietro Cosentino
- Division Cardiology, Department of Clinical and Molecular Medicine, St. Andrea Hospital, Sapienza University, Rome, Italy
| | - Ernesto Cristiano
- Division Cardiology, Department of Clinical and Molecular Medicine, St. Andrea Hospital, Sapienza University, Rome, Italy
| | - Carmen Adduci
- Division Cardiology, Department of Clinical and Molecular Medicine, St. Andrea Hospital, Sapienza University, Rome, Italy
| | - Giacomo Tini
- Division Cardiology, Department of Clinical and Molecular Medicine, St. Andrea Hospital, Sapienza University, Rome, Italy
| | - Maria Beatrice Musumeci
- Division Cardiology, Department of Clinical and Molecular Medicine, St. Andrea Hospital, Sapienza University, Rome, Italy
| | - Massimo Volpe
- Division Cardiology, Department of Clinical and Molecular Medicine, St. Andrea Hospital, Sapienza University, Rome, Italy
| | - Camillo Autore
- Division Cardiology, Department of Clinical and Molecular Medicine, St. Andrea Hospital, Sapienza University, Rome, Italy.
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19
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Pala B, Romaniello A, Cristiano E, D'Angelo A, Grimaldi MC, Figliuzzi I, Tonelli E, Volpe M. Overview of mitral valve replacement versus mitral valve repair due to ischemic papillary muscle rupture: A meta-analysis inspired by a case report. Cardiol J 2022; 29:680-690. [PMID: 35621090 PMCID: PMC9273235 DOI: 10.5603/cj.a2022.0046] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 02/15/2022] [Accepted: 05/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background Papillary muscle rupture (PMR) is an infrequent but catastrophic complication after myocardial infarction (MI). Surgical procedure is considered the optimal treatment, despite high risk. However, the gold standard technique is still a major dilemma. Therefore, a meta-analysis was carried out to assess and provide an overview comparing mitral valve replacement (MVR) and mitral valve repair (MVr) for PMR post-MI. Methods A systematic literature search was performed. Data were extracted and verified using a standardized data extraction form. Meta-analysis was realized mainly using RevMan 5.4 software. Results From four observational studies 1640 patients were identified; 81% underwent MVR and 19% MVr. Operative mortality results were significantly higher in MVR group than the MVr group. MVR was performed under emergency conditions and patients admitted in cardiogenic shock or who required the use of mechanical cardiac support underwent MVR. MVr had shorter time of hospitalization and similar incidence of postoperative complications than MVR. No significant differences existed between the two procedures regarding cardiopulmonary bypass time. Conclusions Mitral valve repair appears to be a viable alternative to MVR for post-MI PMR, given that it has lower operative mortality, shorter time of hospitalization and similar incidence of short-term postoperative complications than MVR. However, it needs to be pointed out that MVR was associated with the most critical clinical condition following PMR. There is uncertainty regarding the overall survival and improvement of the quality of life between the procedures. Nevertheless, further completed investigation is required.
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Affiliation(s)
- Barbara Pala
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy..
| | - Antonella Romaniello
- Division of Cardiology, Sant' Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Ernesto Cristiano
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Adriano D'Angelo
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Maria Chiara Grimaldi
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Ilaria Figliuzzi
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Euclide Tonelli
- Department of Cardiac Surgery, Sant 'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Massimo Volpe
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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20
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Anabtawi A, Holyoak M, He J, Cristiano E, Polineni D, Graves L. Trabecular bone score in people with cystic fibrosis. Osteoporos Int 2022; 33:1137-1145. [PMID: 35013769 DOI: 10.1007/s00198-021-06290-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 12/22/2021] [Indexed: 10/19/2022]
Abstract
UNLABELLED People with cystic fibrosis (CF) are at increased risk of fractures. Our study found that low trabecular bone score (TBS) (a measure of bone strength) may help identify people with CF at risk of fractures especially when combined with bone density measured by DXA, age, hemoglobin A1c, and transplant status. INTRODUCTION People with cystic fibrosis (CF) are at increased risk of fractures. This study aims to evaluate the association of trabecular bone score (TBS) with fractures in CF. METHODS A cross-sectional study of adults with CF who completed bone density between 2009 and 2019. TBS was applied to lumbar spine studies. RESULTS A total of 202 people with CF were included. A history of fracture was present in 36 (17.8%) subjects. Patients with history of fractures had higher hemoglobin A1c (A1C) (7.8 ± 2.7% vs. 6.7 ± 1.7%, p = 0.024), lower femoral neck (FN) Z/T-score (- 1.05 ± 1.08 vs. - 0.44 ± 1.08, p = 0.012), and lower TBS (1.36 ± 0.13 vs. 1.40 ± 0.11, p = 0.05) compared to those without. Lung transplant recipients had a higher prevalence of fractures (50% vs. 14.1%, p < 0.001). The odds ratio (95%CI) of having a fracture for subjects with TBS (≤ 1.2 vs. > 1.2) stratified by FN Z/T-score (≤ - 2.0 or > - 2.0) was 3.88 (0.92, 16.35), p = 0.07. ROC analysis showed TBS was significantly associated with fractures (p < 0.05); however, FN BMD was superior. A model combining FN BMD, age, A1c, transplant, and TBS improved ROC compared to FN BMD + age (0.837 vs. 0.779, p = 0.031). CONCLUSIONS TBS ≤ 1.2 may identify people with CF at high risk of fractures. A model combining FN BMD, age, A1c, transplant, and TBS was significantly associated with fractures compared to FN BMD + age. Future studies are needed to evaluate the prediction of fractures in people with CF using clinical and bone parameters.
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Affiliation(s)
- A Anabtawi
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail stop 2024, Kansas City, KS, 66160, USA.
| | - M Holyoak
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail stop 2024, Kansas City, KS, 66160, USA
| | - J He
- Department of Biostatistics and Data Science, Medical Center, University of Kansas, Kansas City, KS, USA
| | - E Cristiano
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail stop 2024, Kansas City, KS, 66160, USA
| | - D Polineni
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Medical Center, University of Kansas, Kansas City, KS, USA
| | - L Graves
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail stop 2024, Kansas City, KS, 66160, USA
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21
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Cristiano E, Cava F, Monaco ML, Tempestini F, Giovannelli F, Tommasino A, Zardi D, Berni A, Volpe M. 494 Glycoprotein IIB/IIIA inhibitors may modulate the clinical benefit of radial access as compared to femoral access in primary percutaneous coronary intervention: a meta-regression and a meta-analysis of randomized trials. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab134.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aims
Several randomized controlled trials (RCTs) consistently reported better clinical outcomes with radial as compared to femoral access for primary percutaneous coronary intervention (PCI). Nevertheless, heterogeneous use of potent antiplatelet drugs, such as Gp IIb/IIIa inhibitors (GPI), across different studies could have biased the results in favour of radial access. We performed an updated meta-analysis and meta-regression of RCTs in order to appraise whether the use of GPI had an impact on pooled estimates of clinical outcomes according to vascular access.
Methods and results
We computed pooled estimates by the random effects model for the following outcomes: mortality, major adverse cardiovascular events (death, myocardial infarction, stroke, and target vessel revascularization), and major bleedings. Additionally, we performed meta-regression analysis to investigate the impact of GPI use on pooled estimates of clinical outcomes. We analysed 14 randomized controlled trials and 11 090 patients who were treated by radial (5497) and femoral access (5593), respectively. Radial access was associated with better outcomes for mortality [risk difference 0.01 (0.00, 0.01), P = 0.03], MACE [risk difference 0.01 (0.00, 0.02), P = 0.003], and major bleedings [risk difference 0.01 (0.00, 0.02), P = 0.02]. At meta-regression, we observed a significant correlation of mortality with both GPI use (P = 0.011) and year of publication (P = 0.0073), whereas no correlation was observed with major bleedings.
Conclusions
In this meta-analysis, the use of radial access for primary PCI was associated with better clinical outcomes as compared to femoral access. However, the effect size on mortality was modulated by GPI rate, with greater benefit of radial access in studies with larger use of these drugs.
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Affiliation(s)
| | - Francesco Cava
- Interventional Cardiology Unit, Sant’Andrea Hospital, Rome, Italy
| | - Maria Lo Monaco
- Interventional Cardiology Unit, Sant’Andrea Hospital, Rome, Italy
| | | | | | | | - Domenico Zardi
- Interventional Cardiology Unit, Sant’Andrea Hospital, Rome, Italy
| | - Andrea Berni
- Interventional Cardiology Unit, Sant’Andrea Hospital, Rome, Italy
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza Universityof Rome, Rome, Italy
| | - Massimo Volpe
- Interventional Cardiology Unit, Sant’Andrea Hospital, Rome, Italy
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza Universityof Rome, Rome, Italy
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22
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Arcari L, Limite LR, Adduci C, Sclafani M, Tini G, Palano F, Cosentino P, Cristiano E, Cacciotti L, Russo D, Rubattu S, Volpe M, Autore C, Musumeci MB, Francia P. Novel Imaging and Genetic Risk Markers in Takotsubo Syndrome. Front Cardiovasc Med 2021; 8:703418. [PMID: 34485402 PMCID: PMC8415918 DOI: 10.3389/fcvm.2021.703418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 04/30/2021] [Accepted: 07/26/2021] [Indexed: 12/22/2022] Open
Abstract
Takotsubo syndrome (TTS) is an increasingly recognized condition burdened by significant acute and long-term adverse events. The availability of novel techniques expanded the knowledge on TTS and allowed a more accurate risk-stratification, potentially guiding clinical management. The present review aims to summarize the recent advances in TTS prognostic evaluation with a specific focus on novel imaging and genetic markers. Parametric deformation analysis by speckle-tracking echocardiography, as well as tissue characterization by cardiac magnetic resonance imaging T1 and T2 mapping techniques, currently appear the most clinically valuable applications. Notwithstanding, computed tomography and nuclear imaging studies provided limited but promising data. A genetic predisposition to TTS has been hypothesized, though available evidence is still not sufficient. Although a genetic predisposition appears likely, further studies are needed to fully characterize the genetic background of TTS, in order to identify genetic markers that could assist in predicting disease recurrences and help in familial screening.
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Affiliation(s)
- Luca Arcari
- Cardiology Unit, Mother Giuseppina Vannini Hospital, Rome, Italy
| | - Luca Rosario Limite
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carmen Adduci
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Matteo Sclafani
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Giacomo Tini
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Francesca Palano
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Pietro Cosentino
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Ernesto Cristiano
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Luca Cacciotti
- Cardiology Unit, Mother Giuseppina Vannini Hospital, Rome, Italy
| | - Domitilla Russo
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Speranza Rubattu
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Massimo Volpe
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Camillo Autore
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Maria Beatrice Musumeci
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Pietro Francia
- Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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23
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Cava F, Cristiano E, Musumeci MB, Savio C, Germani A, Monaco ML, Petrucci S, Torrisi MR, Autore C, Rubattu S, Piane M. TNNI3 and KCNQ1 co-inherited variants in a family with hypertrophic cardiomyopathy and long QT phenotypes: A case report. Mol Genet Metab Rep 2021; 27:100743. [PMID: 33777698 PMCID: PMC7985525 DOI: 10.1016/j.ymgmr.2021.100743] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/26/2021] [Accepted: 03/04/2021] [Indexed: 10/27/2022] Open
Abstract
QTc prolongation is reported in patients with hypertrophic cardiomyopathy (HCM). However, the causes of the QTc interval increase remain unclear. The main contribution to QTc prolongation in HCM is attributed to the myocardial hypertrophy and related structural damage. In a 24-year-old male proband, affected by HCM and long QTc, we identified by Next Generation Sequencing a pathogenic variant in gene TNNI3 co-inherited with a damaging variant in KCNQ1 gene. This evidence suggests the possibility that QTc interval prolongation and its dispersion in HCM could be associated not only to the severity of left ventricular hypertrophy but also to the co-inheritance of pathogenic variants related to both long QT Syndrome (LQTS) and HCM. Although the simultaneous presence of pathogenic variants in genes related to different heart diseases is extremely rare, counseling and genetic testing appear crucial for the clinical diagnosis. Screening of LQTS genes should be considered in HCM patients to clarify the origin of long QTc, to provide more information about the clinical presentation and to evaluate the incidence of the co-existence of LQTS/HCM gene variants that could occur more frequently than so far reported.
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Affiliation(s)
- Francesco Cava
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, "Sapienza" University of Rome, Rome 00189, Italy
| | - Ernesto Cristiano
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, "Sapienza" University of Rome, Rome 00189, Italy
| | - Maria Beatrice Musumeci
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, "Sapienza" University of Rome, Rome 00189, Italy
| | - Camilla Savio
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, "Sapienza" University of Rome, Rome 00189, Italy
| | - Aldo Germani
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, "Sapienza" University of Rome, Rome 00189, Italy.,Sant'Andrea University Hospital, Rome 00100, Italy
| | - Maria Lo Monaco
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, "Sapienza" University of Rome, Rome 00189, Italy
| | - Simona Petrucci
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, "Sapienza" University of Rome, Rome 00189, Italy.,Sant'Andrea University Hospital, Rome 00100, Italy
| | - Maria Rosaria Torrisi
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, "Sapienza" University of Rome, Rome 00189, Italy.,Sant'Andrea University Hospital, Rome 00100, Italy
| | - Camillo Autore
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, "Sapienza" University of Rome, Rome 00189, Italy
| | - Speranza Rubattu
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, "Sapienza" University of Rome, Rome 00189, Italy.,IRCCS Neuromed, Pozzilli, IS 86077, Italy
| | - Maria Piane
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, "Sapienza" University of Rome, Rome 00189, Italy.,Sant'Andrea University Hospital, Rome 00100, Italy
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24
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Cristiano E, Patrucco L, Ysrraelit MC, Alonso R, Balbuena ME, Ballario C, Barboza AG, Bestoso S, Burgos M, Cáceres FJ, Carrá A, Carnero-Contentti E, Deri N, Fernández-Liguori N, Garcea O, Hryb JP, Jacobo M, Kohler E, Luetic GG, Mainella C, Menichini ML, Míguez J, Nofal PG, Piedrabuena R, Rugilo C, Saladino ML, Silva BA, Silva E, Sinay V, Tavolini D, Tkachuk VA, Villa A, Vrech C, Rojas JI. [Argentinean consensus guidelines on the identification and clinical care of secondary progressive multiple sclerosis]. Rev Neurol 2021; 72:23-32. [PMID: 33378076 DOI: 10.33588/rn.7201.2020379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The identification, diagnosis, follow-up, and treatment of patients with secondary progressive multiple sclerosis (SPMS) show significant differences between health care professionals in Argentina. AIM To provide consensus recommendations on the management of patients with SPMS in Argentina to optimize patient care. DEVELOPMENT A panel of expert neurologists from Argentina dedicated to the diagnosis and care of multiple sclerosis patients gathered during 2019 and 2020 to carry out a consensus recommendation on the diagnosis and treatment of SPMS patients in Argentina. To achieve consensus, the methodology of 'formal consensus-RAND/UCLA method' was used. Recommendations were established based on published evidence and the expert opinion. Recommendations focused on how to define SPMS and how to follow SPMS patients. CONCLUSION The recommendations of this consensus guidelines attempt to optimize the care of SPMS patients in Argentina.
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Affiliation(s)
- E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
| | - L Patrucco
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M C Ysrraelit
- Instituto de Investigaciones Neurológicas Dr. Raúl Carrea (FLENI), Buenos Aires, Argentina
| | - R Alonso
- Hospital Ramos Mejía. Universidad de Buenos Aires, Buenos Aires, Argentina.,Hospital Universitario Sanatorio Güemes, Buenos Aires, Argentina
| | - M E Balbuena
- Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | | | - A G Barboza
- Hospital Central de Mendoza, Mendoza, Argentina
| | - S Bestoso
- Hospital Escuela de Corrientes. Universidad Nacional del Nordeste, Corrientes, Argentina
| | - M Burgos
- Hospital San Bernardo, Salta, Argentina
| | - F J Cáceres
- Instituto de Neurociencias de Buenos Aires (INEBA), Buenos Aires, Argentina
| | - A Carrá
- Hospital Británico, Buenos Aires, Argentina.,Fundación Favaloro/INECO, Buenos Aires, Argentina
| | | | - N Deri
- Hospital General de Agudos Juan A. Fernández, Buenos Aires, Argentina.,Centro de Investigaciones Diabaid, Buenos Aires, Argentina
| | - N Fernández-Liguori
- Hospital Universitario Sanatorio Güemes, Buenos Aires, Argentina.,Hospital Enrique Tornu, Buenos Aires, Argentina
| | - O Garcea
- Hospital Ramos Mejía. Universidad de Buenos Aires, Buenos Aires, Argentina
| | - J P Hryb
- Hospital Carlos G. Durand, Buenos Aires, Argentina
| | - M Jacobo
- Red Integral Asistencial al Paciente con Esclerosis Múltiple (RIAPEM), Santiago del Estero, Argentina
| | - E Kohler
- Fundación Sinapsis, Santa Rosa, Argentina
| | - G G Luetic
- Instituto de Neurociencias de Rosario, Rosario, Argentina
| | - C Mainella
- Hospital Español de Rosario, Rosario, Argentina
| | - M L Menichini
- Sanatorio Británico, Rosario, Argentina.,Hospital Provincial del Centenario, Rosario, Argentina
| | - J Míguez
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - P G Nofal
- Hospital de Clínicas Nuestra Señora del Carmen, San Miguel de Tucumán, Argentina
| | - R Piedrabuena
- Instituto Lennox, Córdoba, Argentina.,Clínica Reina Fabiola, Córdoba, Argentina
| | - C Rugilo
- Hospital Británico de Buenos Aires, Buenos Aires, Argentina.,Hospital Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - M L Saladino
- Instituto de Neurociencias de Buenos Aires (INEBA), Buenos Aires, Argentina
| | - B A Silva
- Hospital Ramos Mejía. Universidad de Buenos Aires, Buenos Aires, Argentina
| | - E Silva
- Predigma. Centro de Medicina Preventiva, Posadas, Argentina
| | - V Sinay
- Fundación Favoloro/INECO, Buenos Aires, Argentina
| | - D Tavolini
- Hospital Provincial del Centenario, Rosario, Argentina.,INECO Neurociencias Oroño, Rosario, Argentina
| | - V A Tkachuk
- Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - A Villa
- Hospital J. M. Ramos Mejía, Buenos Aires, Argentina
| | - C Vrech
- Sanatorio Allende, Córdoba, Argentina
| | - J I Rojas
- Hospital Universitario de CEMIC, Buenos Aires, Argentina.,Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
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25
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Cava F, Cristiano E, Lo Monaco M, Musumeci MB, Savio C, Petrucci S, Rubattu SD, Piane M, Autore C. 370 The CO-existence of KCNQ1 and TNNI3 genes mutations supports the genetic origin of QTC abnormalities in hypertrophic cardiomyopathy. Eur Heart J Suppl 2020. [DOI: 10.1093/eurheartj/suaa201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Hypertrophic cardiomyopathy (HCM) and Long QT Syndrome (LQTS) are inherited diseases characterized by a wide genetic heterogeneity. Based on the separate incidence of these pathologies and on the absence of linkage, the occurrence of both diseases in the same individual has an incidence of about 1/250000. We describe a rare case report of a 24 years-old patient with maternal familiarity for type 1 LQTS (mother carrier of KCNQ1 c.1781G>A) and paternal familiarity for HCM (father carrier of TNNI3 c.592C>G mutation) who inherited both gene mutations and was diagnosed with HCM and LQTS later in adolescence, after clinical and genetic evaluations.
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Affiliation(s)
- Francesco Cava
- Dipartimento di Medicina Clinica e Molecolare, Università la Sapienza, Roma
| | - Ernesto Cristiano
- Dipartimento di Medicina Clinica e Molecolare, Università la Sapienza, Roma
| | - Maria Lo Monaco
- Dipartimento di Medicina Clinica e Molecolare, Università la Sapienza, Roma
| | | | - Camilla Savio
- Dipartimento di Medicina Clinica e Molecolare, Università la Sapienza, Roma
- UOC Genetica Medica e Diagnostica Cellulare Avanzata, Ospedale S. Andrea, Università la Sapienza, Roma
| | - Simona Petrucci
- Dipartimento di Medicina Clinica e Molecolare, Università la Sapienza, Roma
- UOC Genetica Medica e Diagnostica Cellulare Avanzata, Ospedale S. Andrea, Università la Sapienza, Roma
| | - Speranza Donatella Rubattu
- Dipartimento di Medicina Clinica e Molecolare, Università la Sapienza, Roma
- IRCCS Neuromed, Pozzilli (IS)
| | - Maria Piane
- Dipartimento di Medicina Clinica e Molecolare, Università la Sapienza, Roma
- UOC Genetica Medica e Diagnostica Cellulare Avanzata, Ospedale S. Andrea, Università la Sapienza, Roma
| | - Camillo Autore
- Dipartimento di Medicina Clinica e Molecolare, Università la Sapienza, Roma
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Cristiano E, Patrucco L, Rojas JI, Nuñez S. Estimating the risk of COVID-19 in multiple sclerosis patients in Buenos Aires, Argentina. Mult Scler Relat Disord 2020; 44:102307. [PMID: 32563927 PMCID: PMC7833342 DOI: 10.1016/j.msard.2020.102307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/13/2020] [Indexed: 11/27/2022]
Affiliation(s)
- E Cristiano
- Centro de Esclerosis Múltiple Buenos Aires, Argentina
| | - L Patrucco
- Hospital Italiano Buenos Aires, Argentina.
| | - J I Rojas
- Centro de Esclerosis Múltiple, CEMIC, Argentina
| | - S Nuñez
- Infectious Diseases Unit Sanatorio Güemes, Buenos Aires Argentina
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Marrodan M, Bensi C, Pappolla A, Rojas JI, Gaitán MI, Ysrraelit MC, Negrotto L, Fiol MP, Patrucco L, Cristiano E, Farez MF, Correale J. Disease activity impacts disability progression in primary progressive multiple sclerosis. Mult Scler Relat Disord 2020; 39:101892. [PMID: 31846866 DOI: 10.1016/j.msard.2019.101892] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/15/2019] [Accepted: 12/10/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although solid information on the natural history of primary progressive multiple sclerosis (PPMS) is available, evidence regarding impact of disease activity on PPMS progression remains controversial. OBJECTIVE To describe the clinical characteristics, presence or absence of MRI activity, and natural history of a PPMS cohort from two referral centers in Argentina and assess whether clinical and/or radiological disease activity correlated with disability worsening. METHODS Retrospective study conducted at two MS clinics in Buenos Aires, Argentina, through comparative analysis of patients with and without evidence of disease activity. RESULTS Clinical and/or radiologic activity was presented in 56 (31%) of 178 patients. When stratified by age at onset, we found that for every 10 years of increase in age at onset, risk of reaching EDSS scores of 4 and 6 increased by 26% and 31%, respectively (EDSS 4: HR 1.26, CI 95%: 1.06-1.50; EDSS 6: HR 1.31, CI 95%: 1.06-1.62). Patients who presented clinical exacerbations reached EDSS scores of 6, 7 and 8 faster than those without associated exacerbations (p = 0.009, p = 0.016 and p = 0.001, respectively). Likewise, patients who presented gadolinium-enhancing lesions during the course of disease reached EDSS scores of 7 earlier (p = 0.002). CONCLUSION Older age at onset and presence of clinical and/or radiological disease activity correlated with accelerated disability progression in this cohort of PPMS patients.
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Affiliation(s)
- M Marrodan
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - C Bensi
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - A Pappolla
- Department of Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - J I Rojas
- Department of Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Centro de Esclerosis Múltiple de Buenos Aires, Buenos Aires, Argentina
| | - M I Gaitán
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - M C Ysrraelit
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - L Negrotto
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - M P Fiol
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - L Patrucco
- Department of Neurology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Centro de Esclerosis Múltiple de Buenos Aires, Buenos Aires, Argentina
| | - E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires, Buenos Aires, Argentina
| | - M F Farez
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina; Center for Biostatistics, Epidemiology and Public Health (CEBES). Fleni, Buenos Aires, Argentina
| | - J Correale
- Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
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Rojas J, Sanchez F, Caro F, Miguez J, Patrucco L, Funes J, Cristiano E. Brain volume loss and no evidence of disease activity over 3 years in multiple sclerosis patients under interferon beta 1a subcutaneous treatment. J Clin Neurosci 2019; 59:175-178. [DOI: 10.1016/j.jocn.2018.10.095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/28/2018] [Accepted: 10/24/2018] [Indexed: 12/24/2022]
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Cristiano E, De Vita A, Villano A, Mencarelli E, Melita V, Manfredonia L, Stazi A, Bisignani A, Lanza GA, Crea F. P1696Effect of remote ischemic preconditioning on vascular dilator function in patient undergoing invasive coronary procedure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1696] [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: 11/12/2022] Open
Affiliation(s)
- E Cristiano
- Catholic University of the Sacred Heart, Rome, Italy
| | - A De Vita
- Catholic University of the Sacred Heart, Rome, Italy
| | - A Villano
- Catholic University of the Sacred Heart, Rome, Italy
| | - E Mencarelli
- Catholic University of the Sacred Heart, Rome, Italy
| | - V Melita
- Catholic University of the Sacred Heart, Rome, Italy
| | - L Manfredonia
- Catholic University of the Sacred Heart, Rome, Italy
| | - A Stazi
- Catholic University of the Sacred Heart, Rome, Italy
| | - A Bisignani
- Catholic University of the Sacred Heart, Rome, Italy
| | - G A Lanza
- Catholic University of the Sacred Heart, Rome, Italy
| | - F Crea
- Catholic University of the Sacred Heart, Rome, Italy
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Sosa PS, Colla-Machado PE, Cristiano E. [Pisa syndrome associated with codeine]. Rev Neurol 2018; 67:73-74. [PMID: 29971761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- P S Sosa
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - E Cristiano
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Pappolla A, Miquelini L, Zurrú-Ganen MC, Pigretti S, Silveira F, Patrucco L, Cristiano E. WITHDRAWN: Ischemic stroke as initial manifestation of Takayasu's arteritis. Interdisciplinary Neurosurgery 2018. [DOI: 10.1016/j.inat.2018.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Pappolla A, Christiansen S, Garcia-Rivello H, Zurru-Ganen MC, Patrucco L, Cristiano E. [Primary lymphoma of the anterior pituitary in an immunocompetent patient]. Rev Neurol 2017; 65:238-239. [PMID: 28849868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- A Pappolla
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - S Christiansen
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | - L Patrucco
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - E Cristiano
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Pappolla A, Zurru-Ganen MC, Pigretti SG, Balian NR, Michelangelo H, Cristiano E. [Reversible posterior leukoencephalopathy syndrome with isolated involvement of the brainstem and spinal cord]. Rev Neurol 2017; 64:525-526. [PMID: 28555459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- A Pappolla
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - S G Pigretti
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - N R Balian
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - H Michelangelo
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - E Cristiano
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Colla-Machado PE, Pigretti SG, Luzzi AA, Balian NR, Cristiano E, Zurru-Ganen MC. [Is endovenous thrombolysis safety and efficacy in ischemic stroke comparable between patients aged over and above 80 years? Experience from an Argentinean cohort]. Rev Neurol 2017; 64:347-352. [PMID: 28368081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Enrollment of patients aged above 80 years in trials assessing endovenous thrombolysis (rt-PA) was scarce. The goal of this study is to compare safety and efficacy of endovenous rt-PA between patients aged above 80 and those below 80 years. PATIENTS AND METHODS A cohort of patients who received rt-PA was prospectively followed. Length of hospital stay, bleeding incidence, in-hospital mortality and 90 days' clinical outcome was compared between patients aged above 80 and those below 80 years. RESULTS Of 1996 patients admitted at our hospital with ischemic stroke between October 2005 and January 2016, 180 received rt-PA (9%). Mean age was 77 ± 10 years, being 55% of the women. Comparing patients aged above 80 with those below 80 years, in the latter the length of hospital stay was longer with a median length of 15 days (IQR: 6-19) vs 7 days (IQR: 4-12; p = 0.001) and 90 days' clinical outcome was worse (modified Rankin scale 0-1 of 24% vs 41%; p = 0.001). Admission ASPECTS score, bleeding incidence and in-hospital mortality showed no significant differences between both groups. Patients aged over 80 arrived to the hospital earlier (97 ± 34 vs 113 ± 45 min; p = 0.01), however door-to-needle time was longer. CONCLUSIONS Endovenous thrombolysis in patients aged above 80 years was safe, although its efficacy in assuring a better clinical outcome was not as pronounced as in patients below 80 years.
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Affiliation(s)
| | - S G Pigretti
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - A A Luzzi
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - N R Balian
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - E Cristiano
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Rojas JI, Sanchez F, Patrucco L, Miguez J, Besada C, Cristiano E. Brain structural changes in patients in the early stages of multiple sclerosis with depression. Neurol Res 2017; 39:596-600. [DOI: 10.1080/01616412.2017.1298279] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J. I. Rojas
- Multiple Sclerosis Center of Buenos Aires, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - F. Sanchez
- Multiple Sclerosis Center of Buenos Aires, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Laboratory of Immunomodulators – Laboratory of Tumor Immunopharmacology, School of Medicine, Center for Pharmacological and Botanical Studies (CEFYBO), University of Buenos Aires – National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - L. Patrucco
- Multiple Sclerosis Center of Buenos Aires, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - J. Miguez
- Multiple Sclerosis Center of Buenos Aires, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - C. Besada
- Neuroradiology Department, Hospital Italiano de Buenos Aires, Argentina
| | - E. Cristiano
- Multiple Sclerosis Center of Buenos Aires, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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36
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Rojas JI, Patrucco L, MIguez J, Sinay V, Cassara FP, Cáceres F, Liguori NF, Saladino ML, Deri N, Jaacks G, Marcilla MP, Arrigoni MI, Correale J, Fiol M, Ysrraelit MC, Carrá A, Curbelo MC, Martinez A, Steinberg J, Bestoso S, Hryb JP, Di Pace JL, Perassolo MB, Contentti EC, Caride A, Lopez PA, Martinez C, Reich E, Giunta D, Cristiano E. Gender ratio trends over time in multiple sclerosis patients from Argentina. J Clin Neurosci 2017; 38:84-86. [PMID: 28087187 DOI: 10.1016/j.jocn.2016.12.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 12/26/2016] [Indexed: 11/19/2022]
Abstract
Several studies in multiple sclerosis (MS) suggest a trend of increasing disease frequency in women during the last decades. A direct comparison of gender ratio trends among MS populations from Argentina remains to be carried out. The objective of the study was to compare gender ratio trends, over a 50-year span in MS populations from Argentina. METHODS multicenter study that included patients from 14 MS Centers of Argentina. Patients with definite MS with birth years ranging from 1940 to 1989 were included. Gender ratios were calculated by five decades based on year of birth and were adjusted for the F/M born-alive ratio derived from the Argentinean national registry of births. The F/M ratios were calculated using a multivariate logistic regression per five decades by the year of birth approach. Analyses were performed using Stata 10.1. RESULTS 1069 patients were included. Gender ratios showed a significant increase from the first to the last decade in the whole MS sample (from 1.8 to 2.7; p value for trend=0.023). The Gender ratio did not show differences considering MS subtype. CONCLUSION our study showed a modest increase of the F/M ratio (from 1.8 to 2.7) over time among patients affected by MS in Argentina.
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Affiliation(s)
- J I Rojas
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina.
| | - L Patrucco
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - J MIguez
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - V Sinay
- Instituto de Neurociencias Fundación Favaloro (INCyT), Argentina
| | - F Pagani Cassara
- Instituto de Neurociencias Fundación Favaloro (INCyT), Argentina
| | - F Cáceres
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina
| | | | - M L Saladino
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina
| | - N Deri
- Centro de Investigación DIABAID, Argentina
| | - G Jaacks
- Centro de Investigación DIABAID, Argentina
| | | | | | - J Correale
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M Fiol
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M C Ysrraelit
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - A Carrá
- Hospital Británico Buenos Aires, Argentina
| | | | - A Martinez
- Hospital Británico Buenos Aires, Argentina
| | | | - S Bestoso
- Hospital Escuela "José F. De San Martín", Corrientes, Argentina
| | - J P Hryb
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - J L Di Pace
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - M B Perassolo
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | | | - A Caride
- Hospital Alemán, Buenos Aires, Argentina
| | - P A Lopez
- Hospital Alemán, Buenos Aires, Argentina
| | | | - E Reich
- Hospital Julio Mendez, Buenos Aires, Argentina
| | - D Giunta
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
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Garcia Basalo MM, Fernandez MC, Ojea Quintana M, Rojas JI, Garcia Basalo MJ, Bogliotti E, Campora N, Fernandez M, Berrios W, Cristiano E, Golimstok A. ALBA Screening Instrument (ASI): A brief screening tool for Lewy Body Dementia. Arch Gerontol Geriatr 2017; 70:67-75. [PMID: 28088604 DOI: 10.1016/j.archger.2017.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/18/2016] [Accepted: 01/02/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Early detection of neurodegenerative diseases is essential for treatment and proper care of these patients. Screening tools available today are effective for several types of dementia. However, there is no one specific for Lewy Body Dementia (LBD). OBJECTIVES The aim of this paper is to present a tool for early detection of LBD, accessible even for non-medical staff. METHODS We stratified subjects (MMSE>20) into four groups: health controls (HC), Mild Cognitive Impairment (MCI), LBD and other dementias (Alzheimer and vascular). All subjects (age range 50-90) were examined with a comprehensive neuropsychological and neuropsychiatric evaluation, as well as neuroimaging to differentiate diagnosis between groups, fulfilling corresponding criteria. Both neurologists and neuropsychologists were blind to the performance on clinical evaluations and ASI, respectively. The sensitivity and specificity of the instrument were determined to differentiate LBD from other groups. RESULTS We evaluated 427 subjects, 91 HC, 140 with MCI and 196 with dementia. In the dementia group, 75 were diagnosed with LBD and 121 with other dementias. ASI total score was 12.7±0.4 for LBD, 2.9±0.2 for HC, 5±0.7 for MCI, and 5.4±2.6 for other causes of dementia. ROC curve analysis showed a sensitivity of 90.7% and a specificity of 93.6% stands, with 9 as the cutoff with better test performance compared against other groups. CONCLUSION ASI is a brief screening tool for LBD with high sensitivity and specificity and useful even for non-medical staff.
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Affiliation(s)
- M M Garcia Basalo
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - M C Fernandez
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina; Lewy Body Association Argentina (ALBA), Argentina
| | - M Ojea Quintana
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina; Lewy Body Association Argentina (ALBA), Argentina
| | - J I Rojas
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - M J Garcia Basalo
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina; Lewy Body Association Argentina (ALBA), Argentina
| | - E Bogliotti
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - N Campora
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - M Fernandez
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - W Berrios
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - E Cristiano
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina
| | - A Golimstok
- Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina; Lewy Body Association Argentina (ALBA), Argentina.
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Cristiano E, Patrucco L, Miguez J, Giunta D, Correale J, Fiol M, Ysrraelit M, Cáceres F, Liguori NF, Saladino M, Garcea O, Silva B, Alonso R, Carrá A, Curbelo M, Martinez A, Steinberg J, Giachello S, Melcom M, Rojas J. Increasing prevalence of multiple sclerosis in Buenos Aires, Argentina. Mult Scler Relat Disord 2016; 9:91-4. [DOI: 10.1016/j.msard.2016.07.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/05/2016] [Accepted: 07/08/2016] [Indexed: 12/23/2022]
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Cristiano E, Patrucco L, Miguez J, Giunta D, Peroni J, Rojas JI. Increasing incidence of multiple sclerosis among women in Buenos Aires: a 22 year health maintenance organization based study. Neurol Sci 2016; 37:1621-6. [PMID: 27338941 DOI: 10.1007/s10072-016-2637-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 11/16/2015] [Accepted: 06/14/2016] [Indexed: 01/18/2023]
Abstract
Studies in multiple sclerosis (MS) suggest a trend of increasing disease prevalence and incidence, and especially, a disproportional increase in the incidence of multiple sclerosis in women. The objective of this study was to evaluate the incidence of MS over 22 years and to determine the ratio in incidence of men to women in a health maintenance organization from Buenos Aires, Argentina. The population was made up of all members of a hospital-based HMO affiliated between January 1992 and December 2013. Each person was followed contributing time at risk. Cases with definite diagnosis of MS were included. Incidence density was calculated with 95 % confidence intervals and compared between women and men. 165,456 subjects were followed for a total of 1,488,575 person-years, of whom 42 developed MS. Incidence density was 3/100,000 person-years (95 % CI 2.1-3.5/100,000 person-years). During this period (1992-2013), the incidence rate in women increased from 1/100,000 (95 % CI 0.8-1.6) to 4.9/100,000 (95 % CI 4.1-5.4) (p < 0.001), while in men the incidence ranged from 1.4/100,000 (95 % CI 1-1.7) to 1.8 (1.3-2.1) (p = 0.16). Incidence density during the study period increased significantly in women but not in men. This is the first report of this phenomenon in Latin America region.
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Affiliation(s)
- E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Italian Hospital of Buenos Aires, Gascón 450, C1181ACH, Buenos Aires, Argentina.
| | - L Patrucco
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Italian Hospital of Buenos Aires, Gascón 450, C1181ACH, Buenos Aires, Argentina
| | - J Miguez
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Italian Hospital of Buenos Aires, Gascón 450, C1181ACH, Buenos Aires, Argentina
| | - D Giunta
- Clinical Research Section, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - J Peroni
- Clinical Research Section, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - J I Rojas
- Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Italian Hospital of Buenos Aires, Gascón 450, C1181ACH, Buenos Aires, Argentina
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Rojas JI, Patrucco L, MIguez J, Sinay V, Cassara FP, Cáceres F, Liguori NF, Saladino ML, Deri N, Jaacks G, Marcilla MP, Arrigoni MI, Correale J, Fiol M, Ysrraelit MC, Carrá A, Curbelo MC, Martinez A, Steinberg J, Bestoso S, Hryb JP, Di Pace JL, Perassolo MB, Carnero Contentti E, Caride A, Lopez PA, Martinez C, Reich E, Cristiano E. Disease onset in familial and sporadic multiple sclerosis in Argentina. Mult Scler Relat Disord 2016; 6:54-56. [PMID: 27063623 DOI: 10.1016/j.msard.2016.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 12/28/2015] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
Abstract
UNLABELLED The present study was carried out to assess if there is an anticipation of age at onset in younger generations of familial multiple sclerosis (FMS) vs. sporadic MS (SMS) in Argentina. METHODS multicenter study that included patients from 14 MS Centers of Argentina. Patients were considered as FMS if they had in their family at least one relative of first or second degree diagnosed with MS; otherwise, patients were considered to have SMS. We compared the age at onset between familial and sporadic cases as well as the age at onset between relatives from different generations in FMS vs. SMS. RESULTS 1333 patients were included, 97 of them were FMS (7.3%). A lower age at onset in the younger generations of FMS cases was found compared with older generations of FMS as well as. SMS cases (24.1±3.7 years vs. 30.3±5.7 years, and 32.4±9.4 respectively; p<0.001). No differences were observed between older generations of FMS vs. SMS cases (p=0.12). CONCLUSION we observed an anticipation of age at onset of MS in younger generations of patients with FMS vs. older generations of FMS and SMS.
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Affiliation(s)
- J I Rojas
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina.
| | - L Patrucco
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - J MIguez
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - V Sinay
- Instituto de Neurociencias, Fundación Favaloro, Argentina
| | | | - F Cáceres
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina
| | - N Fernandez Liguori
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina; Multiple Sclerosis Section Hospital E.Tornú, Buenos Aires, Argentina
| | - M L Saladino
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina; Multiple Sclerosis Section Hospital E.Tornú, Buenos Aires, Argentina
| | - N Deri
- Centro de Investigación DIABAID, Argentina
| | - G Jaacks
- Centro de Investigación DIABAID, Argentina
| | | | | | - J Correale
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M Fiol
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M C Ysrraelit
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - A Carrá
- Hospital Británico Buenos Aires, Argentina
| | | | - A Martinez
- Hospital Británico Buenos Aires, Argentina
| | | | - S Bestoso
- Hospital Escuela "José F. De San Martín", Corrientes, Argentina
| | - J P Hryb
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - J L Di Pace
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - M B Perassolo
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | | | - A Caride
- Hospital Alemán, Buenos Aires, Argentina
| | - P A Lopez
- Hospital Alemán, Buenos Aires, Argentina
| | - C Martinez
- Private Office, Private Office, Argentina
| | - E Reich
- Hospital Julio Mendez, Buenos Aires, Argentina
| | - E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
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Valiensi S, Martin F, Cristiano E, Izbizky G. Subjective assessment of the presence of reverie and some features of emotional phenomena in the dreams of pregnant women. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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42
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Cabana Cal M, Valiensi S, Campora N, Tanzi M, Ojea Quintana M, Turner F, Garcia Basalo M, Garcia Basalo M, Cristiano E, Golimstok A. Impact of obstructive sleep apnea syndrome on cognitive function in patients with dementia with Lewy Bodies (LBD). J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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43
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Cabana Cal M, Valiensi S, Campora N, Cabana Cal M, Tanzi M, Garcia Basalo M, Ojea Quintana M, Turner F, Cristiano E, Golimstok A. Impact of sleep characteristics on cognitive performance in Mild Cognitive Impairment (MCI). J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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44
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45
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Bergamaschi R, Montomoli C, Mallucci G, Lugaresi A, Izquierdo G, Grand'Maison F, Duquette P, Shaygannejad V, Alroughani R, Grammond P, Boz C, Iuliano G, Zwanikken C, Petersen T, Lechner-Scott J, Hupperts R, Butzkueven H, Pucci E, Oreja-Guevara C, Cristiano E, Pia Amato MP, Havrdova E, Fernandez-Bolanos R, Spelman T, Trojano M. BREMSO: a simple score to predict early the natural course of multiple sclerosis. Eur J Neurol 2015; 22:981-9. [DOI: 10.1111/ene.12696] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 01/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
- R. Bergamaschi
- Inter-Department Multiple Sclerosis Research Centre; Neurological Institute IRCCS Mondino; Pavia Italy
| | - C. Montomoli
- Unit of Biostatistics and Clinical Epidemiology; Department of Public Health; University of Pavia; Pavia Italy
| | - G. Mallucci
- Inter-Department Multiple Sclerosis Research Centre; Neurological Institute IRCCS Mondino; Pavia Italy
| | - A. Lugaresi
- MS Centre; Department of Neuroscience and Imaging; University ‘G. d'Annunzio’; Chieti Italy
| | - G. Izquierdo
- Hospital Universitario Virgen Macarena; Sevilla Spain
| | | | | | - V. Shaygannejad
- Al-Zahra Hospital; Isfahan University of Medical Sciences; Isfahan Iran
| | | | | | - C. Boz
- Karadeniz Technical University; Trabzon Turkey
| | - G. Iuliano
- Ospedali Riuniti di Salerno; Salerno Italy
| | - C. Zwanikken
- University Hospital Nijmegen; Nijmegen The Netherlands
| | - T. Petersen
- Aarhus University Hospital; Aarhus C Denmark
| | | | | | - H. Butzkueven
- Department of Neurology; Box Hill Hospital; Monash University; Box Hill Vic. Australia
| | - E. Pucci
- Ospedale di Macerata; Salerno Italy
| | | | | | - M. P. Pia Amato
- Department NEUROFARBA; Section of Neurosciences; University of Florence; Florence Italy
| | | | | | - T. Spelman
- University of Melbourne; Melbourne Australia
| | - M. Trojano
- Department of Basic Medical Sciences; Neuroscience and Sense Organs; University of Bari; Bari Italy
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Valiensi S, Maggi S, Leon P, Cristiano E, Lucero C. Polysomnographic characteristics of sleep in old age patients. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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47
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Ketzoian C, Hackembruch H, Melcon M, Melcon C, Bartoloni L, Cristiano E, Durán J, Kuntz Grzesiuk A, Dadalti Fragoso Y, Bidin Brooks J, Díaz V, Romero García K, Cabera Gómez J, Abad P, Macías Islas M, Gracia F, Hamuy Díaz de Bedoya V, Córdoba Ruiz M, Oehninger C, Soto A. Association between multiple sclerosis prevalence and environmental and genetic factors in Latin America and the Caribbean: An ecological study. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rojas J, Patrucco L, Besada C, Funes J, Cristiano E. Diferencias en la tasa de atrofia global y regional y del volumen lesional entre género en esclerosis múltiple. Neurologia 2013; 28:389-93. [DOI: 10.1016/j.nrl.2012.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 08/02/2012] [Accepted: 10/04/2012] [Indexed: 10/27/2022] Open
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Rojas J, Patrucco L, Besada C, Funes J, Cristiano E. Sex-related differences in atrophy and lesion load in multiple sclerosis patients. Neurología (English Edition) 2013. [DOI: 10.1016/j.nrleng.2012.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Patrucco L, Rojas JI, Miguez JS, Cristiano E. Application of the McDonald 2010 criteria for the diagnosis of multiple sclerosis in an Argentinean cohort of patients with clinically isolated syndromes. Mult Scler 2013; 19:1297-301. [DOI: 10.1177/1352458513475492] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The International Panel on Diagnosis of Multiple Sclerosis has proposed new magnetic resonance imaging (MRI) criteria for the diagnosis of multiple sclerosis (MS) in patients with clinically isolated syndrome (CIS). We aimed to evaluate these new criteria in a cohort of patients from Buenos Aires, Argentina. Methods: Patients with CIS, in whom MRI was performed within three months of onset of symptoms, were included between January 2005–June 2010. Poser or McDonald 2005 criteria were used as gold standard diagnostic criteria for MS. MRI was assessed by a blind evaluator identifying recently diagnostic MS criteria. New criteria sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were determined. Results: Altogether 101 patients were included. Of these, 86 patients converted to MS (McDonald 2005/Poser) during the follow-up. The mean follow-up time was 7.3±3.2 years (range 1.8–11 years). Sensitivity was 84%, specificity 80%, PPV 96%, NPV 46% and accuracy 82%. The sub-analysis applied only to non-European descendants (mestizos, natives and zambos) showed a high level of accuracy for these new diagnostic criteria in this local ethnic/genetic population (sensitivity 77%, specificity 72%, PPV 94%, NPV 38%). Conclusions: This study assessing McDonald 2010 criteria in a Latin-American population may contribute to its international validation.
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Affiliation(s)
- L Patrucco
- Department of Neurology, MS Clinic, Hospital Italiano de Buenos Aires, Argentina
| | - JI Rojas
- Department of Neurology, MS Clinic, Hospital Italiano de Buenos Aires, Argentina
| | - JS Miguez
- Department of Neurology, MS Clinic, Hospital Italiano de Buenos Aires, Argentina
| | - E Cristiano
- Department of Neurology, MS Clinic, Hospital Italiano de Buenos Aires, Argentina
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