1
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Bellino M, Piscione F. Spontaneous coronary artery dissection: do we need different tailored strategies? Int J Cardiol 2023; 375:7-8. [PMID: 36621576 DOI: 10.1016/j.ijcard.2022.12.054] [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] [Received: 12/21/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023]
Affiliation(s)
- M Bellino
- Department of Medicine, Surgery and Dentistry; University of Salerno, Baronissi, Salerno, Italy
| | - F Piscione
- Department of Medicine, Surgery and Dentistry; University of Salerno, Baronissi, Salerno, Italy.
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2
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Polito MV, D'Auria F, Vitulano G, Cogliani FM, Conti V, Ciccarelli M, Esposito I, Punzi L, Manzo V, Bonadies D, Filippelli A, Piscione F, Galasso G. P2795The role of SIRT1 activity in patients with chronic heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M V Polito
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - F D'Auria
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - G Vitulano
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - F M Cogliani
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - V Conti
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - M Ciccarelli
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - I Esposito
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - L Punzi
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - V Manzo
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - D Bonadies
- Department of Cardiology, A.O.U. “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
| | - A Filippelli
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - F Piscione
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - G Galasso
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
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3
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D'Auria F, Vitulano G, Polito M, Cogliani F, Bonadies D, Citro R, Gigantino A, Piscione F, Iaccarino G, Ciccarelli M. P2794The increased level of GRK2 correlates with preserved exercise capacity in patients with HF. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2794] [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: 11/13/2022] Open
Affiliation(s)
- F D'Auria
- University of Salerno, Salerno, Italy
| | | | - M Polito
- University of Salerno, Salerno, Italy
| | | | | | - R Citro
- AOU S. Giovanni e Ruggi, Salerno, Italy
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4
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Silverio A, Baldi C, Di Maio M, Bonadies D, Verolino G, Esposito L, Cogliani FM, Fierro G, Di Muro MR, De Rosa R, Giudice P, Citro R, Piscione F, Galasso G. P2648Predictors of outcome in heart failure patients with functional mitral regurgitation undergoing mitraclip treatment. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Silverio
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - C Baldi
- Department of Cardiology, A.O.U. “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
| | - M Di Maio
- Division of Cardiology, Department of Cardiothoracic and Respiratory Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, A.O.R.N. “Ospedali dei Colli”, Naples, Italy
| | - D Bonadies
- Department of Cardiology, A.O.U. “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
| | - G Verolino
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - L Esposito
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - F M Cogliani
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - G Fierro
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - M R Di Muro
- Department of Cardiology, A.O.U. “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
| | - R De Rosa
- Chair of Cardiology, J.W. Goethe University Hospital of Frankfurt, Frankfurt, Germany
| | - P Giudice
- Department of Cardiology, A.O.U. “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
| | - R Citro
- Department of Cardiology, A.O.U. “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
| | - F Piscione
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - G Galasso
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
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5
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Silverio A, De Rosa R, Baldi C, Di Maio M, Prota C, Radano I, Herrmann E, Rey J, Citro R, Piscione F, Galasso G. P5098Percutaneous repair of functional mitral regurgitation in heart failure patients: a meta-analysis of 23 studies on mitraclip implantation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Silverio
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - R De Rosa
- Chair of Cardiology, J.W. Goethe University Hospital of Frankfurt, Frankfurt, Germany
| | - C Baldi
- Department of Cardiology, A.O.U. “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
| | - M Di Maio
- Division of Cardiology, Department of Cardiothoracic and Respiratory Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, A.O.R.N. “Ospedali dei Colli”, Naples, Italy
| | - C Prota
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - I Radano
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - E Herrmann
- Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany
| | - J Rey
- Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany
| | - R Citro
- Department of Cardiology, A.O.U. “San Giovanni di Dio e Ruggi D'Aragona”, Salerno, Italy
| | - F Piscione
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
| | - G Galasso
- University of Salerno. Department of Medicine and Surgery, Salerno, Italy
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6
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De Rosa R, Polito M, Benvenga R, De Angelis E, Piscione F, Galasso G. Micrornas and Cardiovascular Diseases: From Bench to Bedside. Transl Med UniSa 2018; 17:12-18. [PMID: 30050875 PMCID: PMC6056249] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
MicroRNAs (microRNAs or miRs) are small, non-coding RNAs that control gene expression by binding to and repressing specific mRNA target and have emered as powerful regulators of many biological processes. Understanding miRNAs-biology and functions may be pivotal to get a better insight into pathophysiological mechanisms responsible for a large number of morbid conditions and may lay the foundations for the development of novel therapeutic interventions. Moreover, besides their intracellular functions, miRs are present in the human circulation in a remarkably stable cell-free form, and their plasmatic levels have been proposed as biomarkers for several pathological conditions. The present review aims to summarize the current evidences with regard to biological role of miRNAs in cardiovascular system and their involvement in the pathogenesis of cardiovascular diseases including atherosclerosis, heart failure and pathological heart and vascular remodelling and to highlight their potential use as novel biomarkers and as therapeutic targets in cardiac and vascular diseases.
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Affiliation(s)
- R. De Rosa
- Department of Cardiology, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, IT
| | - M.V. Polito
- Department of Cardiology, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, IT
| | - R. Benvenga
- Department of Cardiology, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, IT
| | - E. De Angelis
- Department of Cardiology, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, IT
| | - F. Piscione
- Department of Cardiology, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, IT
| | - G. Galasso
- Department of Cardiology, San Giovanni di Dio e Ruggi d’Aragona University Hospital, Salerno, IT
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7
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De Rosa R, Palmerini T, Belmonte M, De Servi S, Calabro P, Capodanno D, Toso A, Genereux P, Galasso G, Piscione F. P3690Impact of high on-treatment platelet reactivity on 1-year clinical outcome in elderly patients with NSTE-ACS undergoing percutaneous coronary intervention- insights from the GEPRESS study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3690] [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: 11/13/2022] Open
Affiliation(s)
- R. De Rosa
- University of Salerno, Cardiology, Salerno, Italy
| | | | - M. Belmonte
- University of Salerno, Cardiology, Salerno, Italy
| | - S. De Servi
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - P. Calabro
- AO dei Colli-Monaldi Hospital, Naples, Italy
| | | | - A. Toso
- Prato Hospital, Prato, Italy
| | - P. Genereux
- Columbia University Medical Center, New York, United States of America
| | - G. Galasso
- University of Salerno, Cardiology, Salerno, Italy
| | - F. Piscione
- University of Salerno, Cardiology, Salerno, Italy
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8
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Podda GM, Grossi E, Palmerini T, Buscema M, Femia EA, Della Riva D, de Servi S, Calabrò P, Piscione F, Maffeo D, Toso A, Palmieri C, De Carlo M, Capodanno D, Genereux P, Cattaneo M. Prediction of high on-treatment platelet reactivity in clopidogrel-treated patients with acute coronary syndromes. Int J Cardiol 2017; 240:60-65. [PMID: 28343766 DOI: 10.1016/j.ijcard.2017.03.074] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 01/05/2017] [Revised: 03/01/2017] [Accepted: 03/15/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND About 40% of clopidogrel-treated patients display high platelet reactivity (HPR). Alternative treatments of HPR patients, identified by platelet function tests, failed to improve their clinical outcomes in large randomized clinical trials. A more appealing alternative would be to identify HPR patients a priori, based on the presence/absence of demographic, clinical and genetic factors that affect PR. Due to the complexity and multiplicity of these factors, traditional statistical methods (TSMs) fail to identify a priori HPR patients accurately. The objective was to test whether Artificial Neural Networks (ANNs) or other Machine Learning Systems (MLSs), which use algorithms to extract model-like 'structure' information from a given set of data, accurately predict platelet reactivity (PR) in clopidogrel-treated patients. METHODS A complete set of fifty-nine demographic, clinical, genetic data was available of 603 patients with acute coronary syndromes enrolled in the prospective GEPRESS study, which showed that HPR after 1month of clopidogrel treatment independently predicted adverse cardiovascular events in patients with Syntax Score >14. Data were analysed by MLSs and TSMs. ANNs identified more variables associated PR at 1month, compared to TSMs. RESULTS ANNs overall accuracy in predicting PR, although superior to other MLSs was 63% (95% CI 59-66). PR phenotype changed in both directions in 35% of patients across the 3 time points tested (before PCI, at hospital discharge and at 1month). CONCLUSIONS Despite their ability to analyse very complex non-linear phenomena, ANNs or MLS were unable to predict PR accurately, likely because PR is a highly unstable phenotype.
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Affiliation(s)
- G M Podda
- Unità di Medicina III, ASST Santi Paolo e Carlo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - E Grossi
- Centro Diagnostico Italiano, Milano, Italy
| | - T Palmerini
- Dipartimento Cardiovascolare, Policlinico S. Orsola, Bologna, Italy
| | - M Buscema
- Semeion Research Centre, Roma, Italy
| | - E A Femia
- Unità di Medicina III, ASST Santi Paolo e Carlo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy
| | - D Della Riva
- Dipartimento Cardiovascolare, Policlinico S. Orsola, Bologna, Italy
| | - S de Servi
- Unità Coronarica IRCCS Policlinico San Matteo, Pavia, Italy
| | - P Calabrò
- Divisione di Cardiologia, Seconda Università di Napoli, Napoli, Italy
| | - F Piscione
- Dipartimento di Medicina e Chirurgia, Schola Medica Salernitana, Università di Salerno, Salerno, Italy
| | - D Maffeo
- Unità di Cardiologia, Servizio di Emodinamica, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy
| | - A Toso
- Divisione di Cardiologia, Ospedale Santo Stefano, Prato, Italy
| | - C Palmieri
- Ospedale del Cuore, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - M De Carlo
- Dipartimento Cardiotoracico e Vascolare, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - D Capodanno
- Ospedale Ferrarotto, Università di Catania, Catania, Italy
| | - P Genereux
- The Cardiovascular Research Foundation, New York, NY, USA
| | - M Cattaneo
- Unità di Medicina III, ASST Santi Paolo e Carlo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano, Italy.
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9
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Galasso G, Mirra M, De Luca G, Piscione F. Bivalirudin in Patients Undergoing PCI: State of Art and Future Perspectives. Transl Med UniSa 2016; 14:54-63. [PMID: 27326396 PMCID: PMC4912339] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Acute coronary syndrome (ACS) represents the most common cause of death worldwide. Percutaneous coronary intervention (PCI) is the management of choice in patients with ACS and occurrence of intra-procedural thrombotic complications are an independent predictor of mortality and other major adverse cardiovascular events in patients undergoing PCI. According to current guideline, anticoagulation therapy is indicated during PCI in order to reduce the risk of thrombotic complications such as stent thrombosis. Among currently available anticoagulant drugs, bivalirudin demonstrates a lower incidence of bleeding risk, despite it is associated with an increased risk of stent thrombosis. The aim of this paper is to discuss the pharmacology of bivalirudin and the clinical evidences of its use in patients undergoing PCI for ACS.
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Affiliation(s)
- G Galasso
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy.,()
| | - M Mirra
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - G De Luca
- Division of Cardiology, AOU Maggiore della Carità-Eastern Piedmont University, Novara, Italy
| | - F Piscione
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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10
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d'Avenia M, Citro R, De Marco M, Veronese A, Rosati A, Visone R, Leptidis S, Philippen L, Vitale G, Cavallo A, Silverio A, Prota C, Gravina P, De Cola A, Carletti E, Coppola G, Gallo S, Provenza G, Bossone E, Piscione F, Hahne M, De Windt LJ, Turco MC, De Laurenzi V. A novel miR-371a-5p-mediated pathway, leading to BAG3 upregulation in cardiomyocytes in response to epinephrine, is lost in Takotsubo cardiomyopathy. Cell Death Dis 2015; 6:e1948. [PMID: 26512958 PMCID: PMC4632305 DOI: 10.1038/cddis.2015.280] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/31/2015] [Accepted: 08/05/2015] [Indexed: 02/08/2023]
Abstract
Molecular mechanisms protecting cardiomyocytes from stress-induced death, including tension stress, are essential for cardiac physiology and defects in these protective mechanisms can result in pathological alterations. Bcl2-associated athanogene 3 (BAG3) is expressed in cardiomyocytes and is a component of the chaperone-assisted autophagy pathway, essential for homeostasis of mechanically altered cells. BAG3 ablation in mice results in a lethal cardiomyopathy soon after birth and mutations of this gene have been associated with different cardiomyopathies including stress-induced Takotsubo cardiomyopathy (TTC). The pathogenic mechanism leading to TTC has not been defined, but it has been suggested that the heart can be damaged by excessive epinephrine (epi) spillover in the absence of a protective mechanism. The aim of this study was to provide more evidence for a role of BAG3 in the pathogenesis of TTC. Therefore, we sequenced BAG3 gene in 70 TTC patients and in 81 healthy donors with the absence of evaluable cardiovascular disease. Mutations and polymorphisms detected in the BAG3 gene included a frequent nucleotide change g2252c in the BAG3 3′-untranslated region (3′-UTR) of Takotsubo patients (P<0.05), resulting in loss of binding of microRNA-371a-5p (miR-371a-5p) as evidenced by dual-luciferase reporter assays and argonaute RNA-induced silencing complex catalytic component 2/pull-down assays. Moreover, we describe a novel signaling pathway in cardiomyocytes that leads to BAG3 upregulation on exposure to epi through an ERK-dependent upregulation of miR-371a-5p. In conclusion, the presence of a g2252c polymorphism in the BAG3 3′-UTR determines loss of miR-371a-5p binding and results in an altered response to epi, potentially representing a new molecular mechanism that contributes to TTC pathogenesis.
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Affiliation(s)
- M d'Avenia
- Department of Pharmacy (DIFARMA), University of Salerno, Fisciano, Italy.,Biouniversa s.r.l., c/o University of Salerno, Fisciano, Italy.,Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - R Citro
- 'Cuore' Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - M De Marco
- Department of Pharmacy (DIFARMA), University of Salerno, Fisciano, Italy.,Biouniversa s.r.l., c/o University of Salerno, Fisciano, Italy
| | - A Veronese
- Dipartimento di Scienze Mediche, Orali e Biotecnologiche, CeSI, Universita' 'G. D'Annunzio' di Chieti e Pescara, Pescara, Italy
| | - A Rosati
- Department of Pharmacy (DIFARMA), University of Salerno, Fisciano, Italy.,Biouniversa s.r.l., c/o University of Salerno, Fisciano, Italy
| | - R Visone
- Dipartimento di Scienze Mediche, Orali e Biotecnologiche, CeSI, Universita' 'G. D'Annunzio' di Chieti e Pescara, Pescara, Italy
| | - S Leptidis
- Faculty of Health, Medicine and Life Sciences, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - L Philippen
- Faculty of Health, Medicine and Life Sciences, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - G Vitale
- 'Cuore' Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - A Cavallo
- 'Cuore' Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - A Silverio
- 'Cuore' Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - C Prota
- 'Cuore' Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - P Gravina
- Department of Laboratory Medicine, 'Tor Vergata' University, Rome, Italy
| | - A De Cola
- Dipartimento di Scienze Mediche, Orali e Biotecnologiche, CeSI, Universita' 'G. D'Annunzio' di Chieti e Pescara, Pescara, Italy
| | - E Carletti
- Dipartimento di Scienze Mediche, Orali e Biotecnologiche, CeSI, Universita' 'G. D'Annunzio' di Chieti e Pescara, Pescara, Italy
| | - G Coppola
- Transfusional Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - S Gallo
- Transfusional Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - G Provenza
- Division of Cardiology San Francesco d'Assisi, Hospital of Oliveto Citra, Salerno, Italy
| | - E Bossone
- 'Cuore' Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - F Piscione
- 'Cuore' Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - M Hahne
- Institut de Genetique Moleculaire de Montpellier, CNRS UMR5535, Montpellier, France
| | - L J De Windt
- Faculty of Health, Medicine and Life Sciences, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - M C Turco
- Biouniversa s.r.l., c/o University of Salerno, Fisciano, Italy.,Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - V De Laurenzi
- Biouniversa s.r.l., c/o University of Salerno, Fisciano, Italy.,Dipartimento di Scienze Mediche, Orali e Biotecnologiche, CeSI, Universita' 'G. D'Annunzio' di Chieti e Pescara, Pescara, Italy
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11
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Mirra M, Vitulano G, Virtuoso N, Tufano N, D’Auria F, De Angelis S, Giudice R, Lambiase A, Gigantino A, Piscione F. Heart Failure in a Dedicated Outpatient Clinic: Results after 58 Month Follow-Up. Can it be Enough? Transl Med UniSa 2014; 11:59-62. [PMID: 25674552 PMCID: PMC4309658] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Incidence of chronic heart failure (HF) is rapidly increasing, approaching a 10 per 1000 rate after 65 years of age. In the last decades, despite pharmacological, interventional and supportive innovations, HF prognosis remained poor, with about 30% of death within one year from the diagnosis. Current guidelines recommend for these patients management programs providing follow-up through dedicated outpatient clinic. Limits of these programs are represented by great difficulties in getting patients adherence, being still too elevated the rate of abandonments. In this paper, we analyzed the impact of 58 months of activity in our dedicated to heart failure outpatient clinic on mortality, hospitalization and abandonment rate. 477 HF patients (346 M, 72.5%, mean age 69.6 years) were enrolled. Mean follow-up and visit were 18.2 and 2.6 months respectively. Total mortality rate was 11.5%, 4% of patients per year. Total hospitalizations for acute HF were 212 and, among all patients left in follow-up, the number of hospitalizations for acute de-compensation significantly decreased from 0.49/patient/year before enrollment to 0.29/patient/year during follow-up (p=0.015). Patients who abandoned outpatient clinic were 94 (19%, 1 abandonment every 23 days), mostly observed over the first months of activity. In conclusion, our patients experienced a major decrease in rates of acute de-compensation and need of in-hospital admissions.
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Affiliation(s)
- M Mirra
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - G Vitulano
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - N Virtuoso
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - N Tufano
- Department of Emergency, University Hospital of Salerno, Salerno, Italy
| | - F D’Auria
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - S De Angelis
- Department of Emergency, University Hospital of Salerno, Salerno, Italy
| | - R Giudice
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - A Lambiase
- Department of Medical and Surgical Cardiology, University Hospital of Salerno, Salerno, Italy. ()
| | - A Gigantino
- Department of Medical and Surgical Cardiology, University Hospital of Salerno, Salerno, Italy. ()
| | - F Piscione
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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Wang Y, Gong X, Su Y, Cui J, Shu X, Perge P, Kovacs A, Liptai C, Apor A, Nagy K, Geller L, Szeplaki G, Merkely B, Goebel B, Hamadanchi A, Schmidt-Winter C, Otto S, Jung C, Figulla H, Poerner T, Rotzak R, Aharonovich A, Geva Y, Rozenman Y, Capotosto L, D'angeli I, Azzano A, Placanica A, Mukred K, Rinaldi E, Ashurov R, Tanzilli G, Mangieri E, Vitarelli A, Lesevic H, Karl M, Rosner S, Ott I, Sonne C, Borges IP, Peixoto E, Peixoto R, Peixoto R, Marcolla V, Citro R, Baldi C, Provenza G, Di Maio M, Silverio A, Prota C, Di Muro MR, Bossone E, Giudice P, Piscione F, Muratori M, Fusini L, Gripari P, Tamborini G, Ghulam Ali S, Salvi L, Bartorelli A, Agrifoglio M, Alamanni F, Pepi M, Fusini L, Tamborini G, Muratori M, Cefalu' C, Bottari V, Gripari P, Ghulam Ali S, Andreini D, Pontone G, Pepi M. MODERATED POSTER SESSION: Imaging in interventional cardiology: Wednesday 3 December 2014, 09:00-16:00 * Location: Moderated Poster area. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu242] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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De Luca L, Bolognese L, Valgimigli M, Ceravolo R, Danzi GB, Piccaluga E, Rakar S, Cremonesi A, Bovenzi FM, Abbate R, Andreotti F, Bolognese L, Biondi-Zoccai G, Bovenzi FM, Capodanno D, Caporale R, Capranzano P, Carrabba N, Casella G, Cavallini C, Ceravolo R, Colombo P, Conte MR, Cordone S, Cremonesi A, Danzi GB, Del Pinto M, De Luca G, De Luca L, De Servi S, Di Lorenzo E, Di Pasquale G, Esposito G, Farina R, Fiscella A, Formigli D, Galli S, Giudice P, Gonzi G, Greco C, Grieco NB, La Vecchia L, Lazzari M, Lettieri C, Lettino M, Limbruno U, Lupi A, Macchi A, Marini M, Marzilli M, Montinaro A, Musumeci G, Navazio A, Olivari Z, Oltrona Visconti L, Oreglia JA, Ottani F, Parodi G, Pasquetto G, Patti G, Perkan A, Perna GP, Piccaluga E, Piscione F, Prati F, Rakar S, Ravasio R, Ronco F, Rossini R, Rubboli A, Saia F, Sardella G, Satullo G, Savonitto S, Sbarzaglia P, Scorcu G, Signore N, Tarantini G, Terrosu P, Testa L, Tubaro M, Valente S, Valgimigli M, Varbella F, Vatrano M. ANMCO/SICI-GISE paper on antiplatelet therapy in acute coronary syndrome. Eur Heart J Suppl 2014. [DOI: 10.1093/eurheartj/suu030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Campanile A, Sozzi FB, Consonni D, Piscione F, Sganzerla P, Indolfi C, Stabile A, Migliorini A, Antoniucci D, Ferraresi R, Boccuzzi G, Danzi GB. Primary PCI for the treatment of ectatic infarct-related coronary artery. Minerva Cardioangiol 2014; 62:327-333. [PMID: 24825102] [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: 06/03/2023]
Abstract
AIM There is lack of information on the outcome of patients treated with primary angioplasty for lesions located in an ectatic coronary artery segment in the setting of acute myocardial infarction. The aim of this study was to analyse the 2-year follow-up of this specific patient population. METHODS By means of a systematic review of the databases and cine-films of 5912 primary angioplasties performed in eight Italian cardiac centers we identified 101 patients with infarct-related coronary artery ectasia. Ectasia was defined as a dilatation exceeding the 1.5-fold of normal adjacent segment and was classified according to its severity. The primary end point was the composite rate of cardiac death, recurrence of acute myocardial infarction and a new revascularisation at 2-year. RESULTS The procedure was successful in 70.3% of cases, unsuccessful or complicated in 29.7%. The primary endpoint was met in 6.9% of cases during hospitalization (95% CI: 2.0-11.8), in 17.8% (95% CI: 10.3-25.3) at 1 year, and in 38.5% (95% CI: 29.0-48.0) at 2 years. Nine patients had a stent thrombosis: 3 acute and 6 sub-acute. A statistically significant correlation between the dimensions of the stent and stent thrombosis was observed (P=0.005). CONCLUSION In subjects undergoing primary angioplasty for acute myocardial infarction the rate of patients treated on lesions located in an ectatic coronary artery segment is very small (1.7%). The procedural success was low, whereas the rate of events at follow-up was quit high reflecting the complexity of this disease.
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Affiliation(s)
- A Campanile
- Department of Adult Intensive Care Unit Royal Brompton Hospital, London, UK -
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Niglio T, Galasso G, Piccolo R, Di Gioia G, Strisciuglio T, Esposito G, Trimarco B, Piscione F. New perspectives for transcatheter aortic valve implantation: more than a "simple" alternative to surgery. Minerva Cardioangiol 2014; 62:193-203. [PMID: 24686997] [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: 06/03/2023]
Abstract
To date, the gold standard of aortic stenosis treatment is surgical valve replacement. However, in inoperable or high risk patients a valid alternative is transcatheter aortic valve implantation (TAVI). Several trials showed feasibility, efficacy and safety of TAVI, with a tailored strategy for these patients on the basis of their clinical and anatomical conditions. The selection of valve type (CoreValve® or Edwards Sapien®) and transcatheter approach (transfemoral, transapical, subclavian or direct aortic approach) is an important step in the management of aortic stenosis. However, mortality is high and it is mainly related to non-cardiac reasons, given the high clinical risk profile of these patients. Moreover, the less invasive approach, the faster recovery, the reduced morbidity and the improved psychological tolerance, typical of TAVI, suggest that this technique could be used in a broader spectrum of cases, becoming a valid therapeutic alternative even in patients with severe aortic stenosis with a low surgical risk or asymptomatics. The identification of aortic stenosis patients by the medical community and their assessment over time, before they become candidates only for "extreme" strategies, remains the main challenge.
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Affiliation(s)
- T Niglio
- Department of Advanced Biomedical Sciences Federico II University, Naples, Italy -
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Mirra M, Di Maio M, Vitulano G, Prota C, Polito MV, Poto S, Pierro L, Piscione F. Management of atrial fibrillation in patients undergoing percutaneous coronary intervention. Transl Med UniSa 2014; 9:33-7. [PMID: 24809033 PMCID: PMC4012373] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 03/24/2014] [Indexed: 11/18/2022] Open
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia, occurring in 1-2% of overall population, involving more than 6 millions of European people. It is associated to a reduced quality of life and an increased morbidity and mortality. The Framingham study showed the link between angina and AF. The same risk factors, such as hypertension, diabetes and obesity promote both AF and coronary artery disease (CAD). About 1/4 of AF patients develop a CAD and, in this setting, about 1/5 undergoes a percutaneous coronary intervention (PCI). In patients with both AF and CAD, the optimal medical strategy is challenging and it is still debated in cardiological community, since patients treated by dual (two antiplatelets drugs ore one antiplatelets drug and an oral anticoagulant drug) or triple therapy (two antiplatelets drugs and an oral anticoagulant drug) are exposed to divergent risk of bleeding or thromboembolic and ischemic complications. Aim of this paper is to focus the attention on the different problems arising from the presence of AF in patients undergoing PCI, such as the risk of stroke, bleeding and stent thrombosis.
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Affiliation(s)
- M Mirra
- Deparment of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - M Di Maio
- Deparment of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - G Vitulano
- Deparment of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - C Prota
- Deparment of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - MV Polito
- Deparment of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - S Poto
- Deparment of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - L Pierro
- Deparment of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - F Piscione
- Deparment of Medicine and Surgery, University of Salerno, Salerno, Italy
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Piccolo R, Niglio T, Di Gioia G, D'Anna C, De Rosa R, Strisciuglio T, Trimarco B, Piscione F, Galasso G. Radial versus femoral approach in patients undergoing percutaneous coronary intervention for acute coronary syndrome: meta-analysis and trial sequential analysis of randomized trials. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.111] [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: 11/13/2022] Open
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Piccolo R, Di Gioia G, Niglio T, D'Anna C, De Rosa R, Strisciuglio T, Piscione F, Trimarco B, Galasso G. Do changes in high on-treatment platelet reactivity predict cardiovascular events in patients undergoing percutaneous coronary intervention? A meta-regression analysis of 30 randomized clinical trials. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4860] [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: 11/12/2022] Open
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Galderisi M, Rapacciuolo A, Esposito R, Versiero M, Schiano-Lomoriello V, Santoro C, Piscione F, de Simone G. Site-dependency of the E/e' ratio in predicting invasive left ventricular filling pressure in patients with suspected or ascertained coronary artery disease. Eur Heart J Cardiovasc Imaging 2013; 14:555-561. [DOI: 10.1093/ehjci/jes216] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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De Marco M, Falco A, Basile A, Rosati A, Festa M, d'Avenia M, Pascale M, Dal Piaz F, Bisogni R, Barcaroli D, Coppola G, Piscione F, Gigantino A, Citro R, De Rosa R, Vitulano G, Virtuoso N, Manganelli F, Palermo E, Siano F, Rosato G, Hahne M, Tiberti C, De Laurenzi V, Turco MC. Detection of soluble BAG3 and anti-BAG3 antibodies in patients with chronic heart failure. Cell Death Dis 2013; 4:e495. [PMID: 23412388 PMCID: PMC3734839 DOI: 10.1038/cddis.2013.8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Jovanovic I, Giga V, Tesic M, Paunovic I, Kostic J, Dobric M, Dikic M, Stepanovic J, Belesiln B, Djordjevic-Dikic A, Lindqvist P, Henein M, Soderberg S, Gonzalez M, Tossavainen E, Djordjevic-Dikic A, Tesic M, Stepanovic J, Giga V, Kostic J, Trifunovic D, Jovanovic I, Paunovic I, Stanic S, Beleslin B, Koutsogiannis N, Moulias A, Xanthopoulou I, Mavronasiou E, Kakkavas A, Davlouros P, Alexopoulos D, Barbier P, Cefalu' C, Gripari P, Pontone G, Andreini D, Pepi M, Duncan AM, Snow T, Barker S, Davies S, Di Mario C, Moat N, Serra W, Chetta A, Marangio E, Reverberi C, Cattabiani MA, Ardissino D, Sahlen A, Hakansson F, Shahgaldi K, Manouras A, Norman M, Winter R, Johnson J, Fawzi S, Rafla SM, El Atroush H, Farouk K, Wilson C, Hilde J, Skjoerten I, Melsom M, Humerfelt S, Hansteen V, Hisdal J, Steine K, Rees P, Hutchings S, Magnino C, Omede' P, Avenatti E, Chiarlo M, Presutti D, Bucca C, Moretti C, Gaita F, Veglio F, Milan A, Kostic J, Tesic M, Stepanovic J, Giga V, Paunovic I, Marinkovic A, Jovanovic I, Beleslin B, Ostojic M, Djordjevic Dikic A, Najjar E, Winter R, Gunyeli E, Shahgaldi K, Manouras A, Rodriguez Munoz DA, Moya Mur J, Baguda JDJ, Lazaro Rivera C, Navas Tejedor P, Jimenez Nacher J, Castillo Orive M, Fernandez-Golfin C, Zamorano Gomez J, Satendra M, Sargento L, Sousa C, Lousada N, Palma Reis R, Said K, Shehata A, Ashour Z, El-Tobgi S, Li Kam Wa M, Pabari P, Perry S, Kyriacou A, Manisty C, Francis D, Kusmierczyk-Droszcz B, Kowalik E, Niewiadomska J, Lech A, Hoffman P, Patrianakos A, Kalogerakis A, Zacharaki A, Nyktari E, Psathakis E, Parthenakis F, Vardas P, Stefani L, Milicia M, Bartolini A, Gori N, Tempesti G, Toncelli L, Vono M, Di Tante V, Pedri S, Galanti G, Zhong L, Huang F, Le T, Chen Q, Gao F, Tan R, Anwar A, Nosir Y, Alasnig M, Llemit M, Alhagoly A, Chamsi-Pasha H, Trifunovic D, Ostojic M, Stankovic S, Vujisic-Tesic B, Petrovic M, Nedeljkovic I, Beleslin B, Djordjevic-Dikic A, Banovic M, Tesic M, Orii M, Hirata K, Tanimoto T, Ishibashi K, Yamano T, Ino Y, Yamaguchi T, Kubo T, Imanishi T, Akasaka T, Giesecke A, Ripsweden J, Shahgaldi K, Guyeli E, Winter R, Hristova K, Vasilev D, Pavlov P, Katova T, Simova I, Kostova V, Wada T, Hirata KH, Kubo T, Shiono Y, Ishibashi K, Tanimoto T, Ino Y, Yamaguchi T, Imanishi TI, Akasaka T, Martirosyan M, Adamyan K, Chilingaryan A, Negrea S, Alexandrescu C, Civaia F, Bourlon F, Dreyfus G, Malev E, Kim G, Omelchenko M, Mitrofanova L, Zemtsovsky E, Santoro A, Costantino F, Dores E, Tarsia G, Di Natale M, Innelli P, Schiano Lomoriello V, De Stefano F, Galderisi M, Lee SP, Ahn H, Hwang H, Kim H, Kim Y, Kim K, Kim K, Sohn D, Ahn H, Calin A, Popescu B, Rosca M, Beladan C, Enache R, Gurzun M, Calinescu C, Calin C, Ginghina C, Rafla S, Hamdy S, Lotfi M, Elneklawy M, Mordi I, Spratt J, Sonecki P, Stanton T, Mcculloch A, Goodfield N, Tzemos N, Ghulam Ali S, Fusini L, Tamborini G, Celeste F, Gripari P, Muratori M, Maffessanti F, Mirea O, Alamanni F, Pepi M, Demirkan B, Guray Y, Guray U, Ege M, Kisacik H, Sasmaz H, Korkmaz S, Petrovic-Nagorni S, Zdravkovic-Ciric S, Nagorni A, Stanojevic D, Jankovic-Tomasevic R, Atanaskovic V, Mitic V, Szymanski C, Magne J, Rusinaru D, Fournier A, Mezghani S, Peltier M, Touati G, Tribouilloy C, Huttin O, Khachab H, Voilliot D, Schwartz J, Zinzius P, Lemoine S, Carillo S, Popovic B, Juilliere Y, Selton-Suty C, Kimura K, Takenaka K, Ebihara A, Uno K, Morita H, Nakajima T, Motoyoshi Y, Komori T, Yatomi Y, Nagai R, Mihaila S, Mincu R, Rimbas R, Badiu C, Vinereanu D, Igual Munoz B, Maceira Gonzalez A, Domingo Valero D, Estornell Erill J, Giner Blasco J, Arnau Vives M, Molina Aguilar P, Navarro Manchon J, Zorio Grima E, Miglioranza M, Sant'anna R, Rover M, Mantovani A, Lessa J, Haertel J, Salgado Filho P, Kalil R, Leiria T, Risum N, Sogaard P, Fritz Hansen T, Bruun N, Kisslo J, Velazquez E, Jons C, Olsen N, Azevedo O, Lourenco M, Machado I, Pereira V, Medeiros R, Pereira A, Quelhas I, Lourenco A, Rangel I, Goncalves A, Sousa C, Correia A, Pinho T, Madureira A, Martins E, Silva-Cardoso J, Macedo F, Maciel M, Kinova E, Zlatareva N, Goudev A, Rogge B, Cramariuc D, Lonnebakken M, Rieck A, Gohlke-Baerwolf C, Chambers J, Boman K, Gerdts E, Florescu M, Mihalcea D, Enescu O, Suran B, Mincu R, Patrascu N, Magda L, Cinteza M, Vinereanu D, Bruno R, Cogo A, Bartesaghi M, Thapa K, Duo E, Basnyat B, Ghiadoni L, Picano E, Sicari R, Pratali L, Jensen-Urstad K, Nordin A, Bjornadal L, Svenungsson E, King GJ, Murphy R, Almuntaser I, Mc Loughlin B, Livingston A, Nevin S, Clarke J, De Sousa CC, Rangel I, Martins E, Correia A, Nadais G, Silveira F, Silva Cardoso J, Goncalves A, Macedo F, Maciel M, Lindqvist P, Henein M, Hornsten R, Rasmunsson J, Hedstrom M, Alm C, Filali T, Jedaida B, Lahidheb D, Gommidh M, Mahfoudhi H, Hajlaoui N, Dahmani R, Fehri W, Haouala H, Shin SH, Woo S, Kim D, Park K, Kwan J, Brambila CA, Gabrielli L, Bijnens B, Marin J, Sitges I, Grazioli G, Pare C, Mont L, Brugada J, Sitges M, Pica S, Ghio S, Raineri C, Camporotondo R, Rordorf R, Previtali M, Landolina M, Valentini A, Turco A, Visconti L, Stuart B, Santos A, Cruz I, Caldeira D, Cotrim C, Fazendas P, Joao I, Almeida A, Pereira H, Goncalves A, Pinho T, Sousa C, Rangel I, Correia A, Madureira A, Macedo F, Zamorano JL, Maciel M, Driessen M, Kort E, Leiner T, Cramer M, Sieswerda G, Chamuleau S, Kim D, Choi Y, Park H, Kim H, Shin J, Song J, Kang D, Song J, Parisi V, Galasso G, Festa G, Piccolo R, Rengo G, De Rosa R, Pagano G, Iacotucci P, Leosco D, Piscione F, Bellsham-Revell H, Nedjati-Gilani S, Yao C, Pushparajah K, Penney G, Simpson J, Lopez Melgar B, Sanchez Sanchez V, Rodriguez Garcia J, Coma Samartin R, Martin Asenjo R, Fernandez Casares S, Lopez-Guarch CJ, Diaz Anton B, Mayordomo Gomez S, Lombera Romero F, Yamada S, Okada K, Iwano H, Nishino H, Nakabachi M, Yokoyama S, Kaga S, Mikami T, Tsutsui H, Stoebe S, Tarr A, Pfeiffer D, Hagendorff A, Klitsie L, Roest A, Kuipers I, Van Der Hulst A, Hazekamp M, Blom N, Ten Harkel A, Hagendorff A, Stoebe S, Tarr A, Gelbrich G, Loeffler M, Pfeiffer D, Badran H, Elnoamany M, Soltan G, Ezat M, Elsedi M, Abdelfatah R, Yacoub M, Kydd A, Khan F, Mccormick L, Gopalan D, Virdee M, Dutka D, Ruiz Ortiz M, Mesa D, Delgado M, Romo E, Morenate M, Baeza F, Castillo F, Lopez Granados A, Del Prado JA, De Lezo JS, Kilickiran Avci B, Yurdakul S, Sahin S, Ermis E, Dilekci B, Aytekin S, Turhan S, Gerede D, Hural R, Ozcan O, Candemir B, Erol C, Saha SK, Kiotsekoglou A, Gopal A, Govind S, Lindqvist P, Soderberg S, Kawata T, Daimon M, Sekita G, Miyazaki S, Ichikawa R, Maruyama M, Suzuki H, Daida H, Persic V, Lovric D, Jurin H, Pehar Pejcinovic V, Baricevic Z, Pezo Nikolic B, Ivanac Vranesic I, Separovic Hanzevacki J, Ahn H, Cho G, Lee S, Kim H, Kim Y, Sohn D, Igual Munoz B, Estornell Erill J, Gonzalez AM, Bel Minguez A, Perez Guillen M, Donate Bertolin L, Monmeneu Menadas J, Lopez Lereu P, La Huerta AA, Argudo AM, Igual Munoz B, Gonzalez AM, Valero DD, La Huerta AA, Fernandez PA, Ferrer JM, Rueda Soriano J, Buendia Sanchez F, Estornell Erill J, Carrasco J, Carvalho MS, De Araujo Goncalves P, Sousa P, Dores H, Marques H, Pereira Machado F, Gaspar A, Aleixo A, Mota Carmo M, Roquette J, Vassiliadis IV, Despotopoulos E, Kaitozis O, Tekedis C, Al-Mallah M, Nour K, Tomaszewski A, Kutarski A, Brzozowski W, Tomaszewski M, Oleszczak K, Tong J, Bian Y, Yang F, Li P, Chen L, Shen X, Xu Y, Yan L, Kilickiran Avci B, Yurdakul S, Sahin S, Ermis E, Dilekci B, Aytekin S, Hristova K, Marinov R, Georgiev S, Kaneva A, Lasarov S, Mitev P, Katova T, Pilosoff V, Ikonomidis I, Tzortzis S, Triantafyllidi H, Paraskevaidis I, Trivilou P, Papadakis I, Papadopoulos C, Pavlidis G, Anastasiou-Nana M, Lekakis J. Poster session: Aortic stenosis. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Galasso G, Niglio T, De Luca S, De Biase C, Parisi V, Piscione F. Impact of bivalirudin and Genous stent in patients with acute myeloid leukemia undergoing emergency percutaneous coronary angioplasty for acute coronary syndrome [corrected]. Leukemia 2012; 26:2300-1. [PMID: 22466223 DOI: 10.1038/leu.2012.93] [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: 11/09/2022]
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De Rosa R, Piccolo R, Cassese S, Petretta A, D'Andrea C, D'Anna C, Piscione F, Chiariello M. Coronary flow reserve evaluation: basics, techniques and clinical applications. Minerva Cardioangiol 2011; 59:569-580. [PMID: 19946255] [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: 05/28/2023]
Abstract
Coronary flow reserve is a useful physiologic parameter providing information on coronary stenoses severity. To date, the gold standard to evaluate coronary flow reserve consists of fractional flow reserve (FFR) measurement, assessed with a pressure-wire. The FFR has a high lesion specificity, due to insensitivity to patient hemodynamic status and to coronary microvascular resistance; it shows low inter- and intraindividual variability and a well-defined, bound cut-off range values (0.75-0.80). Several reports confirmed that FFR has high reproducibility and feasibility in patients with either single- or multi-vessel coronary artery disease, or with both stable and instable coronary artery disease and that is significantly associated with patient outcome. More recently, the FFR has been used as a sensitive marker of successful percutaneous coronary intervention, since postprocedural FFR value strongly predicts patients event-free survival rate after angioplasty. Moreover, it has been demonstrated that abnormal FFR ratios can be also associated with diffused atherosclerotic coronary artery disease in the absence of unique angiographically detectable stenoses requiring revascularization. There are strong evidences supporting that the FFR provides crucial functional information that could be related with morphological endovascular ultrasound findings, with the possibility to achieve same information in a cheaper, easier and more available manner. This review will focus on the current available literature regarding coronary flow reserve quantification and its clinical validation, suggesting and highlighting its current and future clinical applications.
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Affiliation(s)
- R De Rosa
- Clinical Medicine Department, Federico II University Hospital, Naples, Italy
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Graham J, Cantor W, Tan M, Yan A, Le May M, Jolly S, Piscione F, Di Mario C, Scheller B, Armstrong P, Madan M, Halvorsen S, Fernandez-Aviles F, Goodman S. 718 Radial versus femoral access for percutaneous coronary intervention in ST-elevation myocardial infarction patients treated with fibrinolysis: A patient-level meta-analysis of the randomized early routine invasive clinical trials. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.593] [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: 10/15/2022] Open
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Petrillo G, Cirillo P, Leosco D, Maresca F, Piscione F, Chiariello M. Percutaneous coronary intervention in a patient with acute non-ST-elevation myocardial infarction and haemophilia A: a 'genous' experience. Haemophilia 2011; 17:e245-6. [PMID: 20609013 DOI: 10.1111/j.1365-2516.2010.02355.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pabari PA, Kyriacou A, Moraldo M, Unsworth B, Baruah R, Sutaria N, Hughes A, Mayet J, Francis DP, Uejima T, Loboz K, Antonini-Canterin F, Polombo C, Carerj S, Hughes A, Vinereanu D, Evangelista A, Leftheriotis G, Fraser AG, Kiotsekoglou A, Govindan M, Govind SC, Saha SK, Camm AJ, Azcarate PM, Castano S, Rodriguez-Manero M, Arraiza M, Levy B, Barba J, Rabago G, Bastarrika G, Nemes A, Takacs R, Varkonyi T, Gavaller H, Baczko I, Forster T, Wittmann T, Papp JG, Lengyel C, Varro A, Tumasyan LR, Adamyan KG, Savu O, Mieghem T, Dekoninck P, Gucciardo L, Jurcut R, Giusca S, Popescu BA, Ginghina C, Deprest J, Voigt JU, Versiero M, Galderisi M, Esposito R, Rapacciuolo A, Esposito G, Raia R, Morgillo T, Piscione F, De Simone G, Oraby MA, Maklady FA, Mohamed EM, Eraki AZ, Zaliaduonyte-Peksiene D, Tamuleviciute E, Janenaite J, Marcinkeviciene J, Mizariene V, Bucyte S, Vaskelyte J, Trifunovic D, Nedeljkovic I, Popovic D, Ostojic M, Vujisic-Tesic B, Petrovic M, Stankovic S, Sobic-Saranovic D, Banovic M, Dikic-Djordjevic A, Savino K, Lilli A, Grikstaite E, Giglio V, Bordoni E, Maragoni G, Cavallini C, Ambrosio G, Nedeljkovic I, Ostojic M, Vujisic-Tesic B, Jakovljevic B, Petrovic M, Trifunovic D, Beleslin B, Nedeljkovic M, Banovic M, Petrovic O, Moral S, Rodriguez-Palomares J, Descalzo M, Marti G, Pineda V, Mahia P, Gutierrez L, Gonzalez-Alujas T, Evangelista A, Garcia-Dorado D, Schnell F, Donal E, Thebault C, Bernard A, Corbineau H, Le Breton H, Kochanowski J, Scislo P, Piatkowski R, Roik M, Marchel M, Kosior D, Opolski G, Lesniak-Sobelga AM, Wicher-Muniak E, Kostkiewicz M, Olszowska M, Suchon E, Klimeczek P, Banys P, Pasowicz M, Tracz W, Podolec P, Moral S, Rodriguez-Palomares J, Descalzo M, Pineda V, Mahia P, Gutierrez L, Gonzalez-Alujas T, Laynez A, Evangelista A, Garcia-Dorado D, Hoefsten DE, Loegstrup BB, Norager B, Moller JE, Flyvbjerg A, Egstrup K, Streb W, Szulik M, Nowak J, Markowicz-Pawlus E, Duszanska A, Sedkowska A, Kalarus Z, Kukulski T, Spinelli L, Morisco C, Assante 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Anastasiou-Nana M, Maceira Gonzalez AM, Ripoll C, Cosin-Sales J, Igual B, Salazar J, Belloch V, Cosin-Aguilar J, Pennell DJ, Masaki M, Pulido JN, Yuasa T, Gillespie S, Afessa B, Brown DR, Mankad SV, Oh JK, Gurghean AL, Mihailescu AM, Tudor I, Homentcovschi C, Muraru M, Bruckner IV, Correia CE, Rodrigues B, Moreira D, Santos LF, Gama P, Dionisio O, Cabral C, Santos O, Bombardini T, Gherardi S, Arpesella G, Valente S, Calamai I, Pasanisi E, Sansoni S, Picano E, Szymanski P, Dobrowolski P, Lipczynska M, Klisiewicz A, Hoffman P, Stepowski D, Kurtz B, Grezis-Soulie G, Savoure A, Anselme F, Bauer F, Castillo J, Herszkowicz N, Ferreira C, Goscinska A, Mizia-Stec K, Gasior Z, Mizia M, Haberka M, Chmiel A, Poborski W, Azevedo O, Quelhas I, Guardado J, Fernandes M, Miranda CS, Gaspar P, Lourenco A, Medeiros R, Almeida J, L Bennani S, Algalarrondo V, Dinanian S, Guiader J, Juin C, Adams D, Slama MS, Onaindia JJ, Quintana O, Velasco S, Astigarraga E, Cacicedo A, Gonzalez J, Rodriguez I, Sadaba M, Eneriz M, Laraudogoitia Zaldumbide E, Nunez-Gil I, Luaces M, Zamorano J, Garcia Rubira JC, Vivas D, Ibanez B, Marcos Alberca P, Fernandez Golfin C, Alonso J, Macaya C, Silva Marques J, Almeida AG, Carvalho V, Jorge C, Silva D, Gato Varela M, Martins S, Brito D, Lopes MG, Tripodi E, Miserrafiti B, Montemurro V, Scali R, Tripodi P, Marchel M, Kochanowski J, Piatkowski R, Scislo P, Winkler A, Madej A, Hausmanowa-Petrusewicz I, Opolski G, Fijalkowski M, Koprowski A, Jaguszewski M, Galaska R, Taszner M, Rynkiewicz A, Citro R, Rigo F, Provenza G, Ciampi Q, Patella MM, D'andrea A, Antonini-Canterin F, Vriz O, Astarita C, Bossone E, Heggemann F, Walter TH, Kaelsch TH, Sueselbeck T, Papavassiliu TH, Borggrefe M, Haghi D, Monk-Hansen T, Have Dall C, Bisgaard Christensen S, Snoer M, Gustafsson F, Rasmusen H, Prescott E, Finocchiaro G, Pinamonti B, Merlo M, Barbati G, Di Lenarda A, Bussani R, Sinagra G, Butz T, Faber L, Lang CN, Meissner A, Plehn G, Yeni H, Langer C, Horstkotte D, Trappe HJ, Gu X, Gu XY, He YH, Li ZA, Han JC, Chen J, Gaudron P, Niemann M, Herrmann S, Hu K, Bijnens B, Hillenbrand H, Beer M, Ertl G, Weidemann F, Mazzone A, Mariani M, Foffa I, Vianello A, Del Ry S, Bevilacqua S, Andreassi MG, Glauber M, Berti S, Kochanowski J, Scislo P, Piatkowski R, Grabowski M, Roik M, Postula M, Marchel M, Kosior D, Opolski G, Dragulescu A, Van Arsdell G, Al-Radi O, Caldarone C, Mertens L, Lee KJ, Unsworth B, Casula RP, Yadav H, Baruah R, Cherian A, Sutaria N, Hughes AD, Mayet J, Francis DP, Vitarelli A, D'orazio S, Nguyen BL, Iorio G, Battaglia D, Caranci F, Padella V, Capotosto L, Alessandroni L, Barilla F, Cardin C, Hascoet S, Saudron M, Caudron G, Arnaudis B, Acar P, Sun MM, Shu XH, Pan CZ, Fang XY, Kong DH, Fang F, Zhang Q, Chan YS, Xie JM, Yip WK, Lam YY, Sanderson JE, Yu CM, Rosca M, O' Connor K, Romano G, Magne J, Calin A, Popescu BA, Muraru D, Pierard L, Ginghina C, Lancellotti P, Roushdy A, Elfiky I, El Shahid G, Elfiky A, El Sayed M, Wierzbowska-Drabik K, Chrzanowski L, Kapusta A, Plonska-Goscinak E, Krzeminska-Pakula M, Kurpesa M, Rechcinski T, Trzos E, Kasprzak JD, Ersboll MK, Valeur N, Mogensen UM, Andersen M, Moller JE, Hassager C, Sogaard P, Kober LV, Kloeckner M, Hayat D, Nahum J, Dussault C, Lellouche N, Elbaz N, Dubois-Rande JL, Gueret P, Lim P, Demopoulos A, Hatzigeorgiou G, Leontiades E, Motsi A, Karatasakis G, Athanassopoulos G, Zycinski P, Chrzanowski L, Wierzbowska-Drabik K, Kasprzak J, Vazquez Alvarez MC, Medrano Lopez C, Camino Lopez M, Granja S, Zunzunegui Martinez JL, Maroto Alvaro E, Tsai WC, Chen JY, Liu YW, Lin CC, Tsai LM, Silva Marques J, Gomes DC, Robalo Martins S, Gois MR, Ribeiro S, Nunes Diogo A, Almeida AG, Lopes MG, Zito C, Sengupta P, Di Bella G, Cusma-Piccione M, Oreto G, Caracciolo G, Longordo C, Lentini S, Carerj S, Kinova E, Zlatareva N, Goudev A, Papagiannis N, Mpouki M, Papagianni A, Vorria M, Mpenetos G, Lytra D, Papadopoulou E, Sgourakis P, Malakos J, Kyriazis J, Saha SK, Kodali V, Toole R, Govind SC, Kiotsekoglou A, Gopal AS, Celutkiene J, Rudys A, Grabauskiene V, Glaveckaite S, Sadauskiene E, Lileikiene Z, Bickauskaite N, Ciburiene E, Skorniakov V, Laucevicius A, Attenhofer Jost CH, Pfyffer M, Lindquist R, Santos JLF, Coelho ORC, Mady CM, Picard MHP, Salemi VMC, Funk L, Butz T, Lang CN, Prull MW, Plehn G, Yeni H, Meissner A, Trappe HJ, Tsai WC, Liu YW, Shih JY, Lin CC, Huang YY, Tsai LM, Lancellotti P, Donal E, Magne J, O'connor K, Moonen M, Pierard LA, Cozma DC, Mornos C, Ionac A, Petrescu L, Dragulescu D, Dan R, Popescu I, Dragulescu SI, Von Lueder TG, Hodt A, Gjerdalen GF, Andersen TE, Solberg EE, Steine K, Savu O, Van Mieghem T, Dekoninck P, Gucciardo L, Jurcut R, Giusca S, Popescu BA, Ginghina C, Deprest J, Voigt JU, Rostek M, Pikto-Pietkiewicz W, Dluzniewski M, Antoniewicz A, Poletajew S, Borowka A, Pasierski T, Malyutina SK, Ryabikov M, Ragino J, Ryabikov A, Sitia S, Tomasoni L, Atzeni F, Gianturco L, Sarzi-Puttini P, De Gennaro Colonna V, Turiel M, Uejima T, Loboz K, Vriz O, Polombo C, Carerj S, Hughes A, Vinereanu D, Gutierrez FR, Lefhtheriotis G, Fraser AG, Hurst RT, Nelson MR, Mookadam F, Thota V, Emani U, Al Harthi M, Stepanek J, Cha S, Lester SJ, Ho EMM, Hemeryck L, Hall M, Scott K, Bennett K, Mahmud A, Daly C, King G, Murphy RT, Brown AS, Teske AJ, D'Hooge J, Claus P, Rademakers F, Voigt JU, Santos L, Cortez-Dias N, Silva D, Silva Marques J, Ribeiro S, Goncalves S, Almeida Ribeiro M, Robalo Martins S, Bordalo E Sa A, Lopes MG, Teske AJ, D'Hooge J, Claus P, Rademakers F, Voigt JU, Magnino C, Marcos-Alberca P, Milan A, Nunez-Gil I, Almeria C, Caniadas V, Rodrigo JL, Perez De Isla L, Macaya C, Zamorano JL, Gustafsson U, Larsson M, Bjallmark A, Lindqvist P, Brodin L, Waldenstrom A, Roosens B, Hernot S, Droogmans S, Van Camp G, Lahoutte T, Lancellotti P, Cosyns B, Ho EMM, Scott K, Hemeryck L, Hall M, Bennett K, Mahmud A, Daly C, King G, Murphy RT, Brown AS, Rao CM, Aguglia D, Casciola G, Imbesi C, Marvelli A, Sgro M, Benedetto D, Tripepi R, Zoccali C, Benedetto FA, Muraru D, Badano LP, Cardillo M, Del Mestre L, Gianfagna P, Proclemer A, Tschernich HD, Mora B, Base E, Weber U, Dumfarth J, Mukherjee C, Skaltsiotis HS, Kaladaridis AK, Bramos DB, Kottis GK, Antoniou AA, Agrios IA, Takos DT, Vasiladiotis NV, Pamboucas KP, Toumanidis STT, Shim A, Kasprzak JD, Lipec P, Michalski B, Wozniakowski B, Stefanczyk L, Rotkiewicz A, Cameli M, Lisi M, Padeletti M, Bigio E, Bernazzali S, Tsoulpas C, Maccherini M, Henein M, Mondillo S, Garcia Lunar I, Mingo Santos S, Monivas Palomero V, Mitroi C, Beltran Correas P, Ruiz Bautista L, Muniz Lozano A, Gonzalez Gonzalez M, Pabari PA, Stegemann B, Willson K, Kyriacou A, Moraldo M, Mayet J, Hughes A, Francis DP, Zeppellini R, Iavernaro A, Zadro M, Carasi M, De Domenico R, Rigo T, Artuso E, Erente G, Ramondo A, Le TT, Huang FQ, Gu Y, Tan RS. Poster session II * Thursday 9 December 2010, 14:00-18:00. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Piscione F, Piccolo R, Cassese S. Direct stenting should be attempted by default whenever possible. Heart 2010. [DOI: 10.1136/hrt.2010.202309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dimova I, Hlushchuk R, Makanya A, Djonov V, Theurl M, Schgoer W, Albrecht K, Beer A, Patsch JR, Schratzberger P, Mahata S, Kirchmair R, Didie M, Christalla P, Rau T, Eschenhagen T, Schumacher U, Lin Q, Zenke M, Zimmmermann W, Hoch M, Fischer P, Stapel B, Missol-Kolka E, Erschow S, Scherr M, Drexler H, Hilfiker-Kleiner D, Diebold I, Petry A, Kennel P, Djordjevic T, Hess J, Goerlach A, Castellano J, Aledo R, Sendra J, Costales P, Badimon L, Llorente-Cortes V, Dworatzek E, Mahmoodzadeh S, Regitz-Zagrosek V, Posa A, Varga C, Berko A, Veszelka M, Szablics P, Vari B, Pavo I, Laszlo F, Brandenburger M, Wenzel J, Bogdan R, Richardt D, Reppel M, Hescheler J, Terlau H, Dendorfer A, Heijman J, Rudy Y, Westra R, Volders P, Rasmusson R, Bondarenko V, Ertas Gokhan MD, Ural Ertan MD, Karaoz Erdal PHD, Aksoy Ayca PHD, Kilic Teoman MD, Kozdag Guliz MD, Vural Ahmet MD, Ural Dilek MD, Poulet C, Christ T, Wettwer E, Ravens U, Van Der Pouw Kraan C, Schirmer S, Fledderus J, Moerland P, Leyen T, Piek J, Van 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Pena E, Badimon L, Kobus K, Czyszek J, Kozlowska-Wiechowska A, Milkiewicz P, Milkiewicz M, Madonna R, Montebello E, Geng Y, De Caterina R, Chin-Dusting J, Michell D, Skilton M, Dixon J, Dart A, Moore X, Hlushchuk R, Ehrbar M, Reichmuth P, Heinimann N, Djonov V, Hewing B, Stangl V, Stangl K, Laule M, Baumann G, Ludwig A, Widmer-Teske R, Mueller A, Stieger P, Tillmanns H, Braun-Dullaeus R, Sedding D, Troidl K, Eller L, Benli I, Apfelbeck H, Schierling W, Troidl C, Schaper W, Schmitz-Rixen T, Hinkel R, Trenkwalder T, Pfosser A, Globisch F, Stachel G, Lebherz C, Bock-Marquette I, Kupatt C, Seyler C, Duthil-Straub E, Zitron E, Scholz E, Thomas D, Gierten J, Karle C, Fink R, Padro T, Lugano R, Garcia-Arguinzonis M, Badimon L, Schuchardt M, Pruefer J, Toelle M, Pruefer N, Jankowski V, Jankowski J, Zidek W, Van Der Giet M, Pena E, Arderiu G, Badimon L, Fransen P, Van Hove C, Michiels C, Van Langen J, Bult H, Quarck R, Wynants M, Alfaro-Moreno E, Rosario Sepulveda M, Wuytack F, Van Raemdonck D, Meyns B, Delcroix M, Christofi F, Wijetunge S, Sever P, Hughes A, Ohanian J, Forman S, Ohanian V, Wijetunge S, Hughes A, Gibbons C, Ohanian J, Ohanian V, Costales P, Aledo R, Vernia S, Das A, Shah V, Casado M, Badimon L, Llorente-Cortes V, Fransen P, Van Hove C, Van Langen J, Bult H, Bielenberg W, Daniel J, Tillmanns H, Sedding D, Daniel JM, Hersemeyer K, Schmidt-Woell T, Kaetzel D, Tillmans H, Sedding D, Kanse S, Tuncay E, Kandilci H, Zeydanli E, Sozmen N, Akman D, Yildirim S, Turan B, Nagy N, Acsai K, Farkas A, Papp J, Varro A, Toth A, Viero C, Mason S, Williams A, Marston S, Stuckey D, Dyer E, Song W, El Kadri M, Hart G, Hussain M, Faltinova A, Gaburjakova J, Urbanikova L, Hajduk M, Tomaskova B, Antalik M, Zahradnikova A, Steinwascher P, Jaquet K, Muegge A, Ferrantini C, Coppini R, Wang G, Zhang M, Cerbai E, Tesi C, Poggesi C, Ter Keurs H, Kettlewell S, Smith G, Workman A, Acsai K, Lenaerts I, Holemans P, Sokolow S, Schurmans S, Herchuelz A, Sipido K, Antoons G, Wehrens X, Li N, Respress JR, De Almeida A, Van Oort R, Bussek A, Lohmann H, Christ T, Wettwer E, Ravens U, Saes M, Muegge A, Jaquet K, Messer A, Copeland O, Leung M, Marston S, Matthes F, Steinbrecher J, Salinas-Riester G, Opitz L, Hasenfuss G, Lehnart S, Caracciolo G, Eleid M, Carerj S, Chandrasekaran K, Khandheria B, Sengupta P, Riaz I, Tyng L, Dou Y, Seymour A, Dyer C, Griffin S, Haswell S, Greenman J, Yasushige S, Amorim P, Nguyen T, Schwarzer M, Mohr F, Doenst T, Popin Sanja S, Lalosevic D, Capo I, Momcilov Popin T, Astvatsatryan A, Senan M, Astvatsatryan A, Senan M, Shafieian G, Goncalves N, Falcao-Pires I, Henriques-Coelho T, Moreira-Goncalves D, Leite-Moreira A, Bronze Carvalho L, Azevedo J, Andrade M, Arroja I, Relvas M, Morais G, Seabra M, Aleixo A, Winter J, Brack K, Ng G, Zabunova M, Mintale I, Lurina D, Narbute I, Zakke I, Erglis A, Astvatsatryan A, Senan M, Marcinkevics Z, Kusnere S, Abolins A, Aivars J, Rubins U, Nassar Y, Monsef D, Hamed G, Abdelshafy S, Chen L, Wu Y, Wang J, Cheng C, Sternak M, Khomich T, Jakubowski A, Szafarz M, Szczepanski W, Mateuszuk L, Szymura-Oleksiak J, Chlopicki S, Sulicka J, Strach M, Kierzkowska I, Surdacki A, Mikolajczyk T, Balwierz W, Guzik T, Grodzicki T, Dmitriev V, Oschepkova E, Polovitkina O, Titov V, Rogoza A, Shakur R, Metcalfe S, Bradley J, Demyanets S, Kaun C, Kastl S, Pfaffenberger S, Huk I, Maurer G, Huber K, Wojta J, Eriksson O, Aberg M, Siegbahn A, Prnjavorac B, Niccoli G, Sgueglia G, Conte M, Giubilato S, Cosentino N, Ferrante G, Crea F, Dmitriev V, Oschepkova E, Polovitkina O, Titov V, Ilisei D, Leon M, Mitu F, Kyriakakis E, Philippova M, Cavallari M, Bochkov V, Biedermann B, De Libero G, Erne P, Resink T, Titov V, Bakogiannis C, Antoniades C, Tousoulis D, Demosthenous M, Psarros C, Sfyras N, Channon K, Stefanadis C, Del Turco S, Navarra T, Basta G, De Caterina R, Carnicelli V, Frascarelli S, Zucchi R, Kostareva A, Malashicheva A, Sjoberg G, Gudkova A, Semernin E, Shlyakhto E, Sejersen T, Cucu N, Anton M, Stambuli D, Botezatu A, Arsene C, Lupeanu E, Anton G, Beer A, Theurl M, Schgoer W, Albrecht K, Patsch J, Huber E, Schratzberger P, Kirchmair R, Lande C, Cecchettini A, Tedeschi L, Trivella M, Citti L, Chen B, Ma Y, Yang Y, Ma X, Liu F, Hasanzad M, Rejali L, Fathi M, Minassian A, Mohammad Hassani R, Najafi A, Sarzaeem M, Sezavar S, Akhmedov A, Klingenberg R, Yonekawa K, Lohmann C, Gay S, Maier W, Neithard M, Luescher T, Xie X, Ma Y, Yang Y, Fu Z, Li X, Ma X, Liu F, Chen B, Kevorkov A, Verduci L, Mercatanti A, Cremisi F, Pitto L, Wonnerth A, Katsaros K, Zorn G, Kaun C, Weiss T, Huber K, Maurer G, Wojta J, De Rosa R, Galasso G, Piscione F, Santulli G, Iaccarino G, Piccolo R, Luciano R, Chiariello M, Szymanski M, Schoemaker R, Van Veldhuisen D, Van Gilst W, Hillege H, Rizzo S, Basso C, Thiene G, Valente M, Rickelt S, Franke W, Bartoloni G, Bianca S, Giurato E, Barone C, Ettore G, Bianca I, Eftekhari P, Wallukat G, Bekel A, Heinrich F, Fu M, Briedert M, Briand J, Roegel J, Rizzo S, Pilichou K, Basso C, Thiene G, Korkmaz S, Radovits T, Pali S, Hirschberg K, Zoellner S, Loganathan S, Karck M, Szabo G, Bartoloni G, Pucci A, Pantaleo J, Martino S, Pelosi G, Matteucci M, Kusmic C, Vesentini N, Piccolomini F, Viglione F, Trivella M, L'abbate A, Slavikova J, Chottova Dvorakova M, Kummer W, Campanile A, Spinelli L, Santulli G, Ciccarelli M, De Gennaro S, Assante Di Panzillo E, Trimarco B, Iaccarino G, Akbarzadeh Najar R, Ghaderian S, Tabatabaei Panah A, Vakili H, Rezaei Farimani A, Rezaie G, Beigi Harchegani A, Falcao-Pires I, Hamdani N, Gavina C, Van Der Velden J, Niessen H, Stienen G, Leite-Moreira A, Paulus W, Goncalves N, Falcao-Pires I, Moura C, Lamego I, Eloy C, Niessen H, Areias J, Leite-Moreira A, Bonda T, Dziemidowicz M, Hirnle T, Dmitruk I, Kaminski K, Musial W, Winnicka M, Villar A, Merino D, Ares M, Pilar F, Valdizan E, Hurle M, Nistal J, Vera V, Toelle M, Van Der Giet M, Zidek W, Jankowski J, Astvatsatryan A, Senan M, Karuppasamy P, Chaubey S, Dew T, Sherwood R, Desai J, John L, Marber M, Kunst G, Cipolletta E, Santulli G, Attanasio A, Del Giudice C, Campiglia P, Illario M, Iaccarino G, Berezin A, Koretskaya E, Bishop E, Fearon I, Heger J, Warga B, Abdallah Y, Meyering B, Schlueter K, Piper H, Euler G, Lavorgna A, Cecchetti S, Rio T, Coluzzi G, Carrozza C, Conti E, Crea F, Andreotti F, Berezin A, Glavatskiy A, Uz O, Kardesoglu E, Yiginer O, Bas S, Ipcioglu O, Ozmen N, Aparci M, Cingozbay B, Ivanes F, Hillaert M, Susen S, Mouquet F, Doevendans P, Jude B, Montalescot G, Van Belle E, Leon M, Ilisei D, Mitu F, Castellani C, Angelini A, De Boer O, Van Der Loos C, Gerosa G, Thiene G, Van Der Wal A, Dumitriu I, Baruah P, Kaski J, Maytham O, D Smith J, Rose M, Cappelletti A, Pessina A, Mazzavillani M, Calori G, Margonato A, De Rosa R, Galasso G, Piscione F, Cassese S, Piccolo R, Luciano R, D'anna C, Chiariello M, Niccoli G, Ferrante G, Leo A, Giubilato S, Silenzi A, Baca' M, Biasucci L, Crea F, Baller D, Gleichmann U, Holzinger J, Bitter T, Horstkotte D, Bakogiannis C, Antoniades C, Antonopoulos A, Tousoulis D, Miliou A, Triantafyllou C, Channon K, Stefanadis C, Masson W, Siniawski D, Sorroche P, Casanas L, Scordo W, Krauss J, Cagide A, Schuchardt M, Toelle M, Huang T, Wiedon A, Van Der Giet M, Chin-Dusting J, Lee S, Walker K, Dart A, O'dea K, Skilton M, Perez Berbel P, Arrarte Esteban V, Garcia Valentin M, Sola Villalpando M, Lopez Vaquero C, Caballero L, Quintanilla Tello M, Sogorb Garri F, Duerr G, Elhafi N, Bostani T, Swieny L, Kolobara E, Welz A, Roell W, Dewald O, Kaludercic N, Takimoto E, Nagayama T, Chen K, Shih J, Kass D, Di Lisa F, Paolocci N, Vinet L, Pezet M, Briec F, Previlon M, Rouet-Benzineb P, Hivonnait A, Charpentier F, Mercadier J, Villar A, Cobo M, Llano M, Montalvo C, Exposito V, Nistal J, Hurle M, Ruifrok W, Meems L. Saturday, 17 July 2010. Cardiovasc Res 2010. [DOI: 10.1093/cvr/cvq174] [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: 11/14/2022] Open
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Piscione F, Cassese S. "Pro-healing" coronary stent before undeferrable major non-cardiac surgery. Heart 2010; 96:715; author reply 715. [PMID: 20424156 DOI: 10.1136/hrt.2009.188698] [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] [Indexed: 11/03/2022] Open
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Piscione F, Piccolo R, Cassese S, Galasso G, D'Andrea C, De Rosa R, Chiariello M. Is direct stenting superior to stenting with predilation in patients treated with percutaneous coronary intervention? results from a meta-analysis of 24 randomised controlled trials. Heart 2010; 96:588-94. [DOI: 10.1136/hrt.2009.183277] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Piscione F, Cassese S, Galasso G, Rapacciuolo A, De Rosa R, Piccolo R, D'Andrea C, Chiariello M. Coronary stenting early before non-cardiac surgery: is the endothelial progenitor cell capturing coronary stent a solution? Minerva Cardioangiol 2010; 58:147-152. [PMID: 20145601] [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: 05/28/2023]
Abstract
The authors report, for the first time, immediate and mid-term outcome of early antiplatelet therapy discontinuation followed by uneventful non-cardiac surgery and endovascular aortic repair, few days after successful deployment of an endothelial progenitor cell capturing coronary stent, in three consecutive patients.
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Affiliation(s)
- F Piscione
- Department of Clinical Medicine, Federico II University, Naples, Italy
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Ciccarelli M, Santulli G, Campanile A, Galasso G, Cervèro P, Altobelli GG, Cimini V, Pastore L, Piscione F, Trimarco B, Iaccarino G. Endothelial alpha1-adrenoceptors regulate neo-angiogenesis. Br J Pharmacol 2007; 153:936-46. [PMID: 18084315 DOI: 10.1038/sj.bjp.0707637] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND AND PURPOSE Intact endothelium plays a pivotal role in post-ischaemic angiogenesis. It is a phenomenon finely tuned by activation and inhibition of several endothelial receptors. The presence of alpha(1)-adrenoceptors on the endothelium suggests that these receptors may participate in regenerative phenomena by regulating the responses of endothelial cells involved in neo-angiogenesis. EXPERIMENTAL APPROACH We evaluated the expression of the subtypes of the alpha(1)-adrenoceptor in isolated endothelial cells harvested from Wistar-Kyoto (WKY) rats. We explored the possibility these alpha(1)-adrenoceptors may influence the pro-angiogenic phenotype of endothelial cells in vitro. In vivo, we used a model of hindlimb ischaemia in WKY rats, to assess the effects of alpha(1) adrenoceptor agonist or antagonist on angiogenesis in the ischaemic hindlimb by laser Doppler blood flow measurements, digital angiographies, hindlimb perfusion with dyed beads and histological evaluation. KEY RESULTS In vitro, pharmacological antagonism of alpha(1)-adrenoceptors in endothelial cells from WKY rats by doxazosin enhanced, while stimulation of these adrenoceptors with phenylephrine, inhibited endothelial cell proliferation and DNA synthesis, ERK and retinoblastoma protein (Rb) phosphorylation, cell migration and tubule formation. In vivo, we found increased alpha(1)-adrenoceptor density in the ischaemic hindlimb, compared to non-ischaemic hindlimb, suggesting an enhanced alpha(1)-adrenoceptor tone in the ischaemic tissue. Treatment with doxazosin (0.06 mg kg(-1) day(-1) for 14 days) did not alter systemic blood pressure but enhanced neo-angiogenesis in the ischaemic hindlimb, as measured by all our assays. CONCLUSIONS Our findings support the hypothesis that the alpha(1)-adrenoceptors in endothelial cells provide a negative regulation of angiogenesis.
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Affiliation(s)
- M Ciccarelli
- Division of Internal Medicine, Department of Clinical Medicine & Cardiovascular Sciences, Federico II University of Naples, Naples, Italy
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Di Tommaso L, Monaco M, Piscione F, Sarno G, Iannelli G. Endovascular Stent Grafts as a Safe Secondary Option for Paraanastomotic Abdominal Aortic Aneurysm. Eur J Vasc Endovasc Surg 2007; 33:91-3. [PMID: 16798027 DOI: 10.1016/j.ejvs.2006.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Accepted: 05/08/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe our experience of endovascular repair of para-anastomotic aortic aneurysm. METHODS AND RESULTS From March 2001 to December 2004 we identified 6 patients with a para-anastomotic aortic aneurysms following previous open repair of abdominal aortic aneurysm. All patients were treated with endovascular surgery under epidural anaesthesia. There were no major complications, surgical conversions or deaths. Four patients received a bifurcated aortic stent-graft, and two an aorto-uniliac stent-graft followed by a femoro-femoral bypass. At follow-up (mean 26.1+/-10.2 months) there were no deaths, endoleaks or graft migrations observed. CONCLUSION Endovascular surgery, avoiding general anesthesia and re-laparotomy, is the ideal technique for treatment of this complication resulting from failed primary conventional AAA repair.
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Affiliation(s)
- L Di Tommaso
- Department of Cardiac Surgery, University Federico II of Naples, Italy.
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Tommaso LD, Monaco M, Piscione F, Sarno G, Iannelli G. Letter to editor re: endovascular repair of para-anastomotic aortic aueurysms. Eur J Vasc Endovasc Surg 2006; 33:256; author reply 256-7. [PMID: 17137803 DOI: 10.1016/j.ejvs.2006.10.013] [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] [Subscribe] [Scholar Register] [Received: 10/17/2006] [Accepted: 10/25/2006] [Indexed: 10/23/2022]
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Iannelli G, Monaco M, Di Tommaso L, Piscione F, Stassano P, Mainenti PP, Laurino S, Spampinato N. Endovascular vs. Open Surgery of Abdominal Aortic Aneurysm in High-Risk Patients: A Single Center Experience. Thorac Cardiovasc Surg 2005; 53:291-4. [PMID: 16208615 DOI: 10.1055/s-2005-837680] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 10/25/2022]
Abstract
BACKGROUND We compared two groups of high-risk patients with abdominal aortic aneurysm to assess the safety and efficacy of endovascular repair vs. open surgery. METHODS From January 1998 to July 2003, sixty-two high-risk patients were divided into two groups: group A consisted of 28 (46 %) open surgery patients and group B consisted of 34 (54 %) patients who underwent endovascular repair. RESULTS Four patients (14.3 %) in the open surgery group died, while no deaths occurred in the endovascular group ( p < 0.05). There were 14 complications in 8 patients of the open surgery group versus 2 complications in 2 patients of the endovascular group ( p = 0.01). At follow-up there were 4 (16.6 %) deaths in group A and 3 (8.8 %) in the endovascular group ( p = n. s.). CONCLUSIONS While the use of endovascular repair in patients who are physiologically fit for open surgical repair remains controversial, we believe that patients with multiple or advanced comorbidities, i.e. high-risk patients, can benefit from the endografting procedure.
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Affiliation(s)
- G Iannelli
- Department of Cardiac Surgery, University of Naples Federico II, Naples, Italy.
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Lenzen MJ, Boersma E, Bertrand ME, Maier W, Moris C, Piscione F, Sechtem U, Stahle E, Widimsky P, de Jaegere P, Scholte op Reimer WJM, Mercado N, Wijns W. Management and outcome of patients with established coronary artery disease: the Euro Heart Survey on coronary revascularization. Eur Heart J 2005; 26:1169-79. [PMID: 15802360 DOI: 10.1093/eurheartj/ehi238] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS The purpose of the Euro Heart Survey Programme of the European Society of Cardiology is to evaluate to which extent clinical practice endorses existing guidelines as well as to identify differences in population profiles, patient management, and outcome across Europe. The current survey focuses on the invasive diagnosis and treatment of patients with established coronary artery disease (CAD). METHODS AND RESULTS Between November 2001 and March 2002, 7769 consecutive patients undergoing invasive evaluation at 130 hospitals (31 countries) were screened for the presence of one or more coronary stenosis >50% in diameter. Patient demographics and comorbidity, clinical presentation, invasive parameters, treatment options, and procedural techniques were prospectively entered in an electronic database (550 variables+29 per diseased coronary segment). Major adverse cardiac events (MACE) were evaluated at 30 days and 1 year. Out of 5619 patients with angiographically proven coronary stenosis (72% of screened population), 53% presented with stable angina while ST elevation myocardial infarction (STEMI) was the indication for coronary angiography in 16% and non-ST segment elevation myocardial infarction or unstable angina in 30%. Only medical therapy was continued in 21%, whereas mechanical revascularization was performed in the remainder [percutaneous coronary intervention (PCI) in 58% and coronary artery bypass grafting (CABG) in 21%]. Patients referred for PCI were younger, were more active, had a lower risk profile, and had less comorbid conditions. CABG was performed mostly in patients with left main lesions (21%), two- (25%), or three-vessel disease (67%) with 4.1 diseased segments, on average. Single-vessel PCI was performed in 82% of patients with either single- (45%), two- (33%), or three-vessel disease (21%). Stents were used in 75% of attempted lesions, with a large variation between sites. Direct PCI for STEMI was performed in 410 cases, representing 7% of the entire workload in the participating catheterization laboratories. Time delay was within 90 min in 76% of direct PCI cases. In keeping with the recommendations of practice guidelines, the survey identified under-use of adjunctive medication (GP IIb/IIIa receptor blockers, statins, and angiotensin-converting enzyme-inhibitors). Mortality rates at 30 days and 1 year were low in all subgroups. MACE primarily consisted of repeat PCI (12%). CONCLUSION The current Euro Heart Survey on coronary revascularization was performed in the era of bare metal stenting and provides a global European picture of the invasive approach to patients with CAD. These data will serve as a benchmark for the future evaluation of the impact of drug-eluting stents on the practice of interventional cardiology and bypass surgery.
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Affiliation(s)
- M J Lenzen
- Department of Cardiology, Erasmus MC, Thoraxcenter, Rotterdam, The Netherlands
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Amato B, Iuliano GP, Markabauoi AK, Piscitelli V, Masone S, Compagna R, Esposito G, Piscione F. Endovascular procedures in critical leg ischemia of elderly patients. Acta Biomed 2005; 76 Suppl 1:11-5. [PMID: 16450500] [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] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
PURPOSE Purpose of this study was to evaluate angiographic and clinical results of popliteal, infrapopliteal, and multi-level disease percutaneous transluminal angioplasty (PTA) in over-80 years old patients with chronical clitical leg ischemia. In fact such patients with extensive peripheral vascular disease and critical limb ischemia (CLI) are generally poor surgical candidates. METHODS Between 1998 and 2003, 37 elderly patients aged 80-89 years old (mean age 83.3) with critical leg ischemia were treated with PTA. All patients were at high surgical risk. 31/37 (81.5%) patients had chronic non-healing wounds, and 14/37 (37%) had multi-level disease of superficial femoral, popliteal and crural arteries. One hundred and two lesions were treated by angioplasty. Immediate angiographic and 1 year clinical results were retrospectively analyzed. RESULTS The overall procedural success rate was 32/37 (84.2%). There were three major complications (7.9%), but no deaths, and three technical failures, all were of infrapopliteal lesions. After 1 year, 27 patients could be followed, five patients died during the first year of unrelated causes. Twenty-three patients (85.2%), were clinically re-occluded within 1 year, but complete and partial wound healing was achieved in 80% (16/20) and rest pain improvement in 57% (4/7), so that overall limb salvage was 74% (20/27). CONCLUSIONS Elderly patients with multi-level CCLI have a short patency term following angioplasty of 14.8% after 1 year. Nevertheless, this temporary vascular patency enables wound healing or improvement in 74% of these patients, thus such endovascular interventions are recommended in this age group.
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Affiliation(s)
- B Amato
- Dpt. of General and Geriatric Surgery, University of Naples "Federico II", Italy
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Piscione F, Perrone-Filardi P, De Luca G, Prastaro M, Indolfi C, Golino P, Dellegrottaglie S, Chiariello M. Low dose dobutamine echocardiography for predicting functional recovery after coronary revascularisation. Heart 2001; 86:679-86. [PMID: 11711467 PMCID: PMC1730003 DOI: 10.1136/heart.86.6.679] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To evaluate the effects of chronic coronary occlusion on the accuracy of low dose dobutamine echocardiography in predicting recovery of dysfunctional myocardium after revascularisation. DESIGN Retrospective study. SETTING Tertiary referral centre. PATIENTS 53 consecutive patients with >/= 70% stenosis of the left anterior descending coronary artery (LAD) and regional ventricular dysfunction (group 1, non-occluded LAD; group 2, occluded LAD) who underwent dobutamine echocardiography. INTERVENTIONS 26 patients underwent coronary artery bypass grafting and 27 had percutaneous transluminal coronary angioplasty. MAIN OUTCOME MEASURES Baseline studies before revascularisation included cross sectional echocardiography at rest and during dobutamine infusion (5-10 microgram), and coronary angiography. The dobutamine study was performed mean (SD) 35 (28) days before revascularisation. Echocardiography at rest was repeated 90 (48) days after revascularisation. RESULTS Of 296 dysfunctional segments, 63 in group 1 (43%; 63/146) and 69 in group 2 (46%; 69/150) (NS) improved at follow up. Mean (SD) regional wall motion score index decreased from 1.97 (0.48) (95% confidence interval (CI) 1.01 to 2.93) before revascularisation to 1.74 (0.52) (95% CI 0.70 to 2.78) at follow up in group 1 (p = 0.001), and from 2.12 (0.41) (95% CI 1.30 to 2.98) to 1.88 (0.36) (95% CI 1.16 to 2.60) in group 2 (p = 0.0006). In group 1, sensitivity (87% v 52%; p < 0.0001), negative predictive value (88% v 65%; p = 0.001), and accuracy (77% v 64%; p = 0.01) were all significantly higher than in group 2, despite the angiographic evidence of collaterals in patients with occluded vessels. CONCLUSIONS Dobutamine echocardiography shows reduced sensitivity in predicting recovery of dysfunctional myocardium supplied by totally occluded vessels. Thus caution should be used in selecting such patients for revascularisation on the basis of a viability assessment made in this way.
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Affiliation(s)
- F Piscione
- Division of Cardiology, Federico II University, Via Sergio Pansini 5, I-80131 Naples, Italy
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Pace L, Filardi PP, Cuocolo A, Prastaro M, Acampa W, Dellegrottaglie S, Storto G, Della Morte AM, Piscione F, Chiariello M, Salvatore M. Diagnostic accuracy of low-dose dobutamine echocardiography in predicting post-revascularisation recovery of function in patients with chronic coronary artery disease: relationship to thallium-201 uptake. Eur J Nucl Med 2001; 28:1616-23. [PMID: 11702102 DOI: 10.1007/s002590100608] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
It is known that contractile reserve may be blunted if perfusion and coronary flow reserve are reduced. Thus, it is conceivable that the predictive accuracy of dobutamine echocardiography may differ according to perfusion tracer uptake. The aim of this study was therefore to assess the relationship between the level of thallium-201 uptake and the accuracy of dobutamine echocardiography in identifying reversible dysfunction. Sixty-nine patients (age 59+/-8 years, ejection fraction 40%+/-11%) with chronic coronary artery disease scheduled for coronary revascularisation were studied. All patients underwent rest 201Tl single-photon emission tomography and two-dimensional echocardiography at rest and during low-dose dobutamine infusion on the same day before revascularisation and repeated echocardiography at least 30 days thereafter. At follow-up, recovery of function was observed in 49% of 339 dysfunctional segments. The percentage of segments with post-revascularisation recovery of function and the percentage with contractile reserve increased in parallel with 201Tl uptake both in the total group of segments (chi2=35.5, P<0.0001 and chi2=35.9, P<0.0001, respectively) and among the 183 akinetic segments (chi2=44.4, P<0.0001 and chi2=14.6, P<0.05, respectively). The dysfunctional segments were divided into three groups according to 201Tl uptake: (a) uptake <65%, (b) uptake between 65% and 79%, (c) uptake >80%. The positive predictive value increased significantly with the level of 201Tl uptake, and was suboptimal (46%) in akinetic segments with severely reduced 201Tl uptake. The negative predictive value decreased significantly with 201Tl uptake, and it was less than suboptimal (29%) in akinetic segments with normal tracer uptake. Sensitivity was lower in the subset of akinetic segments (42%-63%) than in all dyssynergic segments (63%-76%), whereas specificity was very high in akinetic segments (80%-84%). It is concluded that the accuracy of low-dose dobutamine echocardiography in predicting reversibility of regional dysfunction varies considerably according to 201Tl uptake at rest and to the severity of regional dysfunction.
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Affiliation(s)
- L Pace
- Dipartimento di Scienze Biomorfologiche e Funzionali, Università Federico II, Napoli, Italy.
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40
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Piscione F, Barbato E, Galasso G, Chiariello M. [Diabetes and ischemic cardiopathy]. Ital Heart J Suppl 2001; 2:980-9. [PMID: 11675835] [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] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Diabetes represents an independent risk factor for coronary artery disease (CAD), and the prognosis in terms of survival rates is worse for diabetic patients who have CAD with respect to those with CAD but no diabetes. An acute coronary event represents a cause of death in more than 30% of diabetics. Experimental studies suggested that the increased incidence of myocardial infarction in diabetics is due to an increased risk of developing atherosclerotic plaque with subsequent ulceration and intracoronary thrombus formation. Structural abnormalities of the coronary vessel wall were associated with an abnormal pattern of coronary flow and of coagulation abnormalities: all these abnormalities explain the epidemiological evidence of widespread and severe vascular atherosclerotic disease in diabetics. Due to the extreme complexity of ischemic vascular disease in patients with diabetes, an optimal therapeutic strategy is based on the correction of elevated blood glucose and lipid levels, of blood pressure, of platelet and coagulation abnormalities and of any other risk factor. Both percutaneous and surgical myocardial revascularization have been proved equally effective for CAD treatment in diabetes, even though a recent randomized trial has shown a significantly improved outcome after surgical revascularization. More recently the characterization of the advanced glycation end-product receptor opened new perspectives in the treatment of the complications of diabetes, and gave a new impact to the need of further investigations, through new randomized trials, of the best therapeutic options for diabetic patients.
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Affiliation(s)
- F Piscione
- Cattedra di Cardiologia Università degli Studi Federico II Via S. Pansini, 5 80131 Napoli.
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41
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Capozzolo C, Piscione F, De Luca G, Cioppa A, Mazzarotto P, Leosco D, Golino P, Indolfi C, Chiariello M. Direct coronary stenting: effect on coronary blood flow, immediate and late clinical results. Catheter Cardiovasc Interv 2001; 53:464-73. [PMID: 11514995 DOI: 10.1002/ccd.1204] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Direct stenting (DS) was attempted in 99 coronary lesions in 94 patients while standard stenting (SS) was attempted in 113 lesions in 103 patients matched for clinical characteristics, stenosis type, and location and stent type. The angiographic result was also evaluated according to TIMI frame count method (TFC) before and after procedure. A clinical follow-up was performed 1 year after the procedure. Before the procedure, TIMI grade 3 flow was detected in 42 cases (42.4%), grade 2 in 40 cases (40.4%), grade 1 in 5 cases (5.1%), and grade 0 in 12 cases (12.1%) in the DS group; these data were similar in SS group. After the procedure, TIMI grade flow was 3 in 90 cases (92.8%) in DS group and in 87 (77.0%) in SS group (P < 0.005); grade 2 was observed in 7 case (7.2%) in DS group and in 25 (22.1%) in SS group (P < 0.005). Major adverse cardiac events during hospitalization and at follow-up were similar in two groups. Radiation exposure time and procedure costs per lesion were significantly reduced in DS group compared to SS group (10.1 +/- 8 min vs. 13.9 +/- 4.7 min, P < 0.001; and 1901 +/- 687 Euro vs. 2352 +/- 743 Euro, P < 0.001, respectively). This study confirms that, in selected patients, direct stenting is a safe and successful procedure, allowing a significant reduction in radiation exposure time and procedural costs compared to standard stenting technique. The angiographic success is confirmed by the improvement in TFC in all cases.
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Affiliation(s)
- C Capozzolo
- Division of Cardiology, Federico II University, Naples, Italy
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42
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Pace L, Perrone-Filardi P, Storto G, Della Morte AM, Dellegrottaglie S, Prastaro M, Crisci T, Ponticelli MP, Piscione F, Chiariello M, Salvatore M. Prediction of improvement in global left ventricular function in patients with chronic coronary artery disease and impaired left ventricular function: rest thallium-201 SPET versus low-dose dobutamine echocardiography. Eur J Nucl Med 2000; 27:1740-6. [PMID: 11189934 DOI: 10.1007/s002590000374] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Accurate assessment of myocardial viability permits selection of patients who would benefit from myocardial revascularization. Currently, rest-redistribution thallium-201 scintigraphy and low-dose dobutamine echocardiography are among the most used techniques for the identification of viable myocardium. Thirty-one consecutive patients (all men, mean age 60 +/- 8 years) with chronic coronary artery disease and reduced left ventricular ejection fraction (31% +/- 7%) were studied. Rest 201Tl single-photon emission tomography (SPET), low-dose dobutamine echocardiography and radionuclide angiography were performed before revascularization. Radionuclide angiography and echocardiography were repeated after revascularization. An a/dyskinetic segment was considered viable on 201Tl SPET when tracer uptake was >65%, while improvement on low-dose dobutamine echocardiography was considered a marker of viability. Increase in global ejection fraction was considered significant at > or = 5%. In identifying viable segments, rest 201Tl SPET showed higher sensitivity than low-dose dobutamine echocardiography (72% vs 53%, P<0.05), while specificity was not significantly different (86% vs 88%). In 17 patients, global ejection fraction increased > or = 5% (group 1) while in 14 it did not (group 2). A higher number of a/dyskinetic segments were viable on 201Tl SPET in group 1 than in group 2 (2.6 +/- 1.9 vs 0.6 +/- 1.2, P < 0.005), while no significant differences were observed on low-dose dobutamine echocardiography (1.7 +/- 1.6 vs 1.1 +/- 1.6). A significant correlation was found between the number of a/dyskinetic segments viable on 201Tl SPET and post-revascularization changes in ejection fraction (r = 0.52, P < 0.05), but such a correlation was not observed for low-dose dobutamine echocardiography. Using as the cut-off the presence of at least one viable a/dyskinetic segment, rest 201Tl SPET had a higher sensitivity (82% vs 53%, P = 0.07) and showed a trend towards higher accuracy and specificity (77% vs 58%, and 71% vs 64%, respectively) as compared with low-dose dobutamine echocardiography. In conclusion, these findings suggest that when severely reduced global function is present, rest 201Tl SPET evaluation of viability is more accurate than low-dose dobutamine echocardiography for the identification of patients who will benefit most from revascularization.
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Affiliation(s)
- L Pace
- Cattedra di Medicina Nucleare, Istituto di Scienze Biomorfologiche e Funzionali, Facoltà di Medicina, Università Federico II, Napoli, Italy
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43
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Losi MA, Betocchi S, Briguori C, Piscione F, Manganelli F, Ciampi Q, Stabile G, Chiariello M. Dual chamber pacing in hypertrophic cardiomyopathy: influence of atrioventricular delay on left ventricular outflow tract obstruction. Cardiology 2000; 89:8-13. [PMID: 9452150 DOI: 10.1159/000006736] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The impact of the duration of atrioventricular (AV) delay on obstruction in hypertrophic cardiomyopathy was evaluated in 12 patients by cardiac catheterization, and in 8 of them also by Doppler echocardiography. The AV delay was programmed in random order at 125, 100 and 75 ms in the invasive study and at 120, 100 and 80 ms after pacemaker implantation. The arterial pressure did not changed throughout the studies, whereas the gradient decreased significantly by reducing the AV delay value; the greater gradient reduction was obtained, in both studies, with the AV delay set between 75 or 80 and 100 ms. QRS duration increased significantly by reducing the AV delay during both studies. The widest QRS was not associated with the smallest gradient in all patients. Changes in gradients were similar during the invasive and noninvasive protocols.
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Affiliation(s)
- M A Losi
- Department of Cardiology and Cardiac Surgery, University Federico II School of Medicine, Naples, Italy
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44
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Piscione F, Mazzarotto P, Capozzolo C, Galasso G, Spinazzola A, Sarno G, Guerrera L, Chiariello M. [Is there an ideal stent for each type of coronary lesion?]. Cardiologia 1999; 44 Suppl 1:469-73. [PMID: 12497954] [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] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- F Piscione
- Divisione di Cardiologia, Università degli Studi Federico II, Via Sergio Pansini, 5, 80131 Napoli.
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Maier W, Enderlin MF, Bonzel T, Danchin N, Heyndrickx G, Mühlberger V, Neuhaus KL, Piscione F, Reifart N, Antoni J, Ogurol Y, Wischnewsky MB, Meier B. Audit and quality control in angioplasty in Europe: procedural results of the AQUA Study 1997: assessment of 250 randomly selected coronary interventions performed in 25 centres of five European countries. AQUA Study Group, Nucleus Clinical Issues, Working Group Coronary Circulation, of the European Society of Cardiology. Eur Heart J 1999; 20:1261-70. [PMID: 10456827 DOI: 10.1053/euhj.1998.1307] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS Percutaneous transluminal coronary angioplasty (PTCA) has become the most widely used major intervention in western medicine. However, there is disparate use of this technique among different European countries and the U.S.A. In an attempt at quality assurance, the working group Coronary Circulation of the European Society of Cardiology has carried out a study on appropriateness, necessity, and performance of PTCA in Europe. The present paper reports on the procedural results of this survey. METHODS In a multicentre case-control study in Europe, 750 patients (544 men, 206 women) with documented vascular disease of the From the countries participating in the European Registry of Coronary Intervention, the three countries with the highest absolute PTCA volume (Germany, France, and the United Kingdom) and two randomly selected countries (Belgium and Italy) were chosen for investigation. In these countries, five centres were selected at random according to the following criteria: one centre with >1000, three centres with 300-1000, and one centre with <300 procedures per year. In each of these, 10 cases from the first half of 1997 were randomly identified and all pertinent documentation was collected. RESULTS In 250 cases, 325 stenoses were addressed as target lesions. Single vessel disease was present in 41%. History included stable angina in 49%, unstable angina in 32%, atypical chest pain in 6%, no anginal pain in 12%, and acute/subacute myocardial infarction in 13%. The percentage of patients with either positive stress test and/or unstable angina, acute/subacute infarction, previous infarction (within 6 months) or coronary revascularization amounted to 98%. Single vessel intervention accounted for 90%. In 41% balloon-only angioplasty was performed and in 54% at least one stent was implanted with considerable variation among countries. The use of other new devices amounted to only 3%. In 92%, the operators documented a successful procedure. Major complications (myocardial infarction, emergency bypass surgery, or death) were found in 4.8%. CONCLUSIONS Based on scrutinized hospital and operator data, the present study revealed a satisfactorily high percentage of justifiable indications, an adequate procedural success rate, and an acceptably low complication rate. Further analysis by an expert panel will address appropriateness, necessity, and procedural performance of the individual cases.
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Affiliation(s)
- W Maier
- Department of Cardioloy, University Hospital, Bern, Switzerland
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46
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Windecker S, Maier-Rudolph W, Bonzel T, Heyndrickx G, Lablanche JM, Morice MC, Mühlberger V, Neuhaus KL, Piscione F, van den Brand M, Wijns W, Meier B. Interventional cardiology in Europe 1995. Working Group Coronary Circulation of the European Society of Cardiology. Eur Heart J 1999; 20:484-95. [PMID: 10365285 DOI: 10.1053/euhj.1998.1356] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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47
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Spadaro P, Violini R, Marzocchi A, Antoniucci D, Piscione F, Marrozzini C, Valenti R, Cioppa A, Colombo A, di Mario C. Multicenter evaluation of the XT modular coronary stent: clinical and angiographic results. GIORNALE ITALIANO DI CARDIOLOGIA 1999; 29:241-5. [PMID: 10231668] [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] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND In the past few years, the indications for stent implantation have broadened, along with a larger number of available designs. The Bard XT stent is a new modular stent with an original structure and design. METHODS To evaluate the new Bard XT stent, we studied its use in a multicenter experience in 163 patients, with a total of 168 lesions and 180 implanted units. RESULTS Despite the predominance of complex lesions, the procedural success rate was 98%, with only a 2% failure of stent implantation. There was only one death (no-reflow phenomenon in a rescue primary PTCA in a patient in cardiogenic shock) without other major periprocedural complications. Centralized QCA showed a statistically significant increase of MLD (from 0.73 +/- 0.43 mm to 2.71 +/- 0.40 mm, p < 0.0001) and DS reduction (from 73.8 +/- 15.1% pre-treatment to 7.8 +/- 0.4% after stent implantation; p < 0.0001). Aspirin and ticlopidine were routinely administered after the procedure. Thirty-day follow-up reported only one case of subacute stent thrombosis (in the first day), treated with re-PTCA. CONCLUSIONS In a group of patients with complex lesions, we obtained a high rate of success with a low incidence of complications. The Bard XT stent had a high-performance profile with normalization of vessel diameter and angiographic results similar to the ones obtained with the "slotted tube" stents.
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Affiliation(s)
- P Spadaro
- Servizio di Emodinamica, AO Monaldi, Napoli
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48
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Pace L, Perrone-Filardi P, Mainenti P, Prastaro M, Vezzuto P, Varrone A, Crisci T, Cuocolo A, Dellegrottaglie S, Piscione F, Chiariello M, Salvatore M. Combined evaluation of rest-redistribution thallium-201 tomography and low-dose dobutamine echocardiography enhances the identification of viable myocardium in patients with chronic coronary artery disease. Eur J Nucl Med 1998; 25:744-50. [PMID: 9662597 DOI: 10.1007/s002590050278] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to evaluate whether combined evaluation by discriminant analysis of rest-redistribution thallium-201 tomography and low-dose dobutamine echocardiography enhances the accuracy in identifying viable myocardium in patients with chronic coronary artery disease. Rest-redistribution 201Tl has high sensitivity but low specificity in identifying viable myocardium, while the opposite is true for low-dose dobutamine echocardiography. Forty-six patients underwent low-dose dobutamine echocardiography and rest-redistribution 201Tl tomography on the same day. Rest echocardiography was repeated at least 30 days (mean 40+/-20) after myocardial revascularization. Discriminant analysis was applied to the results of 201Tl tomography and dobutamine echocardiography to classify a/dyskinetic segments as viable or non-viable. In 92 a/dyskinetic segments that were revascularized, rest-redistribution 201Tl tomography yielded an accuracy of 75%, while the accuracy of dobutamine echocardiography was 70% (P<0.05). When discriminant analysis was used, the combined evaluation gave an accuracy of 83% (P<0.05 vs both tests). These findings demonstrate that low-dose dobutamine echocardiography and 201Tl imaging are useful and complementary techniques for identifying viable myocardium in patients with chronic coronary artery disease. Combined evaluation by discriminant analysis significantly improves accuracy, although the cost-effectiveness of such an approach remains to be determined.
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Affiliation(s)
- L Pace
- Cattedra di Medicina Nucleare, Istituto di Scienze Radiologiche, Facoltà di Medicina, Università "Federico II", Napoli, Italy
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49
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Pace L, Perrone-Filardi P, Mainenti PP, Prastaro M, Cuocolo A, Varrone A, Vezzuto P, Crisci T, Soricelli A, Piscione F, Chiariello M, Salvatore M. Effects of myocardial revascularization on regional thallium-201 uptake and systolic function in regions with reverse redistribution on tomographic thallium-201 imaging at rest in patients with chronic coronary artery disease. J Nucl Cardiol 1998; 5:153-60. [PMID: 9588667 DOI: 10.1016/s1071-3581(98)90198-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 02/07/2023]
Abstract
OBJECTIVES There is growing evidence that myocardial segments with reverse redistribution are viable in patients with chronic coronary artery disease. The aim of this study was to assess the effects of myocardial revascularization on systolic function and thallium-201 uptake in such segments. METHODS Rest-redistribution thallium-201 tomography before and after myocardial revascularization was performed in 47 patients with chronic coronary artery disease. Regional function was evaluated by two-dimensional echocardiography before and after revascularization according to a 3-point scale (1 = normal, 2 = hypokinetic, 3 = a/dyskinetic). Improvement of dysfunctional segments was defined when systolic function score decreased > or =1 after revascularization. Reverse redistribution was defined as >8% decrease in relative thallium-201 uptake between rest and redistribution images. RESULTS Reverse redistribution was found in 27 (57%) of 47 patients, corresponding to 60 (11%) of 564 myocardial segments. Of such segments, 24 (40%) had normal systolic function, 19 (32%) were hypokinetic, and 17 (28%) were a/dyskinetic. Thirty-six segments underwent myocardial revascularization, and reverse redistribution was no longer present in 86% of them subsequent to the procedure. Of 26 dyssynergic segments with reverse redistribution subjected to revascularization, 18 (69%) improved at follow-up. CONCLUSIONS The findings of the present study indicate that reverse redistribution is a reversible phenomenon and is often associated with improvement of systolic function following revascularization in patients with chronic coronary artery disease.
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Affiliation(s)
- L Pace
- Cattedra di Medicina Nucleare, Istituto di Scienze Radiologiche, Facoltà di Medicina e Chirurgia, Università Federico II, Napoli, Italy
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50
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Briguori C, Betocchi S, Losi MA, Manganelli F, Piscione F, Pace L, Boccalatte M, Gottilla R, Salvatore M, Chiariello M. Noninvasive evaluation of left ventricular diastolic function in hypertrophic cardiomyopathy. Am J Cardiol 1998; 81:180-7. [PMID: 9591902 DOI: 10.1016/s0002-9149(97)00870-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Diastolic dysfunction is common in hypertrophic cardiomyopathy (HC). Previous studies suggest that Doppler transmitral flow velocity profiles, and the left atrial (LA) M-mode echogram can be used noninvasively to evaluate left ventricular (LV) diastolic function. However, this has not been proved in HC. In this study we determined the relation of Doppler transmitral flow velocity profiles and the LA M-mode echograms to invasive indexes of LV diastolic function in patients with HC. We studied 25 patients with HC, while off drugs, and calculated LA global and active fractional shortening and the slope of both early and late displacement of the posterior aortic wall during LA emptying by M-mode echocardiography. We calculated peak velocity of early (E) and atrial (A) filling, E to A ratio, and E-wave deceleration time by pulsed Doppler echocardiography, and simultaneous radionuclide angiography, LV pressures, time constant of isovolumic relaxation tau, and the constant of chamber stiffness k by cardiac catheterization. The time constant of isovolumic relaxation tau correlated with the slope of early posterior aortic wall displacement (r = 0.59; p <0.01). LV end-diastolic pressure correlated with global LA fractional shortening (r = -0.75; p <0.001); the constant of chamber stiffness k correlated with active LA fractional shortening (r = -0.53; p <0.02). In a subset of 13 patients, in whom echocardiography and cardiac catheterization were performed simultaneously, similar results were found. LA M-mode recordings provide a more reliable noninvasive assessment of diastolic function in HC than mitral Doppler indexes.
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Affiliation(s)
- C Briguori
- The Department of Cardiology and Cardiac Surgery, Federico II University School of Medicine, Naples, Italy
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