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Pasceri V, Pelliccia F, Mehran R, Dangas G, Porto I, Radico F, Biancari F, D'Ascenzo F, Saia F, Luzi G, Bedogni F, Amat Santos IJ, De Marzo V, Dimagli A, Mäkikallio T, Stabile E, Blasco-Turrión S, Testa L, Barbanti M, Tamburino C, Fabiocchi F, Chilmeran A, Conrotto F, Costa G, Stefanini G, Spaccarotella C, Macchione A, La Torre M, Bendandi F, Juvonen T, Wańha W, Wojakowski W, Benedetto U, Indolfi C, Hildick-Smith D, Zimarino M. Risk Score for Prediction of Dialysis After Transcatheter Aortic Valve Replacement. J Am Heart Assoc 2024; 13:e032955. [PMID: 38533944 DOI: 10.1161/jaha.123.032955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/08/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Dialysis is a rare but serious complication after transcatheter aortic valve replacement. We analyzed the large multicenter TRITAVI (transfusion requirements in transcatheter aortic valve implantation) registry in order to develop and validate a clinical score assessing this risk. METHODS AND RESULTS A total of 10 071 consecutive patients were enrolled in 19 European centers. Patients were randomly assigned (2:1) to a derivation and validation cohort. Two scores were developed, 1 including only preprocedural variables (TRITAVIpre) and 1 also including procedural variables (TRITAVIpost). In the 6714 patients of the derivation cohort (age 82±6 years, 48% men), preprocedural factors independently associated with dialysis and included in the TRITAVIpre score were male sex, diabetes, prior coronary artery bypass graft, anemia, nonfemoral access, and creatinine clearance <30 mL/min per m2. Additional independent predictors among procedural features were volume of contrast, need for transfusion, and major vascular complications. Both scores showed a good discrimination power for identifying risk for dialysis with C-statistic 0.78 for TRITAVIpre and C-statistic 0.88 for TRITAVIpost score. Need for dialysis increased from the lowest to the highest of 3 risk score groups (from 0.3% to 3.9% for TRITAVIpre score and from 0.1% to 6.2% for TRITAVIpost score). Analysis of the 3357 patients of the validation cohort (age 82±7 years, 48% men) confirmed the good discrimination power of both scores (C-statistic 0.80 for TRITAVIpre and 0.81 for TRITAVIpost score). Need for dialysis was associated with a significant increase in 1-year mortality (from 6.9% to 54.4%; P=0.0001). CONCLUSIONS A simple preprocedural clinical score can help predict the risk of dialysis after transcatheter aortic valve replacement.
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Affiliation(s)
| | | | | | | | - Italo Porto
- Chair of Cardiovascular Disease, Department of Internal Medicine and Specialties University of Genoa Italy
- Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genoa Italy
| | | | - Fausto Biancari
- Department of Medicine South Karelia Central Hospital, University of Helsinki Lappeenranta Finland
| | - Fabrizio D'Ascenzo
- Department of Internal Medicine Città della Salute e della Scienza Turin Italy
| | - Francesco Saia
- Department of Cardiothoracic Vascular Surgery University Hospital Bologna Italy
| | - Giampaolo Luzi
- Cardiovascular Department Azienda Ospedaliera Regionale "San Carlo" Potenza Italy
| | - Francesco Bedogni
- Department of Cardiology IRCCS Policlinico San Donato, San Donato Milanese Milan Italy
| | - Ignacio J Amat Santos
- CIBERCV, Interventional Cardiology Hospital Clínico Universitario de Valladolid Valladolid Spain
| | - Vincenzo De Marzo
- Chair of Cardiovascular Disease, Department of Internal Medicine and Specialties University of Genoa Italy
- Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genoa Italy
- Department of Cardiology ASL2 Abruzzo Chieti Italy
| | - Arnaldo Dimagli
- Department of Cardiothoracic Surgery Weill Cornell Medicine New York NY
| | - Timo Mäkikallio
- Department of Medicine South Karelia Central Hospital, University of Helsinki Lappeenranta Finland
| | - Eugenio Stabile
- Cardiovascular Department Azienda Ospedaliera Regionale "San Carlo" Potenza Italy
| | - Sara Blasco-Turrión
- CIBERCV, Interventional Cardiology Hospital Clínico Universitario de Valladolid Valladolid Spain
| | - Luca Testa
- Department of Cardiology IRCCS Policlinico San Donato, San Donato Milanese Milan Italy
| | | | - Corrado Tamburino
- Division of Cardiology A.O.U. Policlinico "G. Rodolico-San Marco" Catania Italy
| | - Franco Fabiocchi
- Centro Cardiologico Monzino, IRCCS Milan Italy
- Galeazzi-Sant'Ambrogio Hospital, I.R.C.C.S Milan Italy
| | - Ahmed Chilmeran
- Department of Cardiology Royal Sussex County Hospital Brighton UK
| | - Federico Conrotto
- Department of Internal Medicine Città della Salute e della Scienza Turin Italy
| | - Giuliano Costa
- Division of Cardiology A.O.U. Policlinico "G. Rodolico-San Marco" Catania Italy
| | | | | | - Andrea Macchione
- Chair of Cardiovascular Disease, Department of Internal Medicine and Specialties University of Genoa Italy
- Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genoa Italy
| | - Michele La Torre
- Department of Internal Medicine Città della Salute e della Scienza Turin Italy
| | - Francesco Bendandi
- Department of Cardiothoracic Vascular Surgery University Hospital Bologna Italy
| | - Tatu Juvonen
- Heart and Lung Center, Helsinki University Central Hospital University of Helsinki Finland
| | - Wojciech Wańha
- Division of Cardiology and Structural Heart Diseases Medical University of Silesia Katowice Poland
| | - Wojtek Wojakowski
- Division of Cardiology and Structural Heart Diseases Medical University of Silesia Katowice Poland
| | - Umberto Benedetto
- Department of Cardiac Surgery University "G. d'Annunzio" Chieti Italy
| | - Ciro Indolfi
- Division of Cardiology University Magna Graecia Catanzaro Italy
| | | | - Marco Zimarino
- Department of Cardiology ASL2 Abruzzo Chieti Italy
- Department of Neuroscience, Imaging and Clinical Sciences 'G. D'Annunzio' University of Chieti-Pescara Italy
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Cortese F, Costantino MF, Tarsia G, Luzi G. Complete right bundle branch block in young: understanding its clinical significance and the diagnosis implications. Eur J Prev Cardiol 2024:zwae109. [PMID: 38477363 DOI: 10.1093/eurjpc/zwae109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/12/2024] [Indexed: 03/14/2024]
Affiliation(s)
| | | | | | - Giampaolo Luzi
- Cardiac Surgery Unit, Department of Cardiovascular Science, San Carlo Hospital, Potenza, Italy
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Costantino MF, Stolfi L, D'Addeo G, Cappabianca G, Cortese F, Fiorilli R, Biscione C, Matera A, Tarsia G, Lopizzo A, Mannarini A, Stabile E, Luzi G. [Single-center retrospective observational study on predictors of residual mitral regurgitation 1 year after MitraClip® implantation]. G Ital Cardiol (Rome) 2024; 25:106-111. [PMID: 38270366 DOI: 10.1714/4187.41759] [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: 01/26/2024]
Abstract
BACKGROUND The extent of residual mitral regurgitation (MR) (1+ vs ≥2+) has a notable impact on the outcome of MitraClip (MC) repair of significant functional MR. In this retrospective single-center study, we evaluated the predictors of MI ≥2+ at 1 year in one of our case series. METHODS Overall, 58 patients with moderate severe functional MR underwent MC implantation; of these, 48 patients had instrumental clinical follow-up for 1 year. RESULTS At 1 year, 10 patients died (mortality 17.2%). In the remaining 48 patients, the incidence of rehospitalization was 8.3%, and the incidence of MR grade 1+ and ≥2+ was 54.1% (n = 26) and 45.9% (n = 22), respectively. In patients with MR ≥2+, clinical and instrumental outcomes were worse than in patients with MR 1+. The height of the posterior leaflet and the extent of immediate postprocedural MR were independent predictors of MR ≥2+. CONCLUSIONS Percutaneous repair with MC of moderate/severe functional MR has favorable 1-year outcomes in terms of mortality and rehospitalizations. The best results are achieved in patients with residual MR 1+. Echocardiographic parameters are independent predictors of residual MR ≥2+.
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Affiliation(s)
| | - Luisiana Stolfi
- Dipartimento Cardiovascolare, Azienda Ospedaliera "San Carlo", Potenza
| | - Gianpaolo D'Addeo
- Dipartimento Cardiovascolare, Azienda Ospedaliera "San Carlo", Potenza
| | | | - Francesca Cortese
- Unità di Cardiologia, Presidio Ospedaliero "Madonna delle Grazie", Matera
| | - Rosario Fiorilli
- Dipartimento Cardiovascolare, Azienda Ospedaliera "San Carlo", Potenza
| | - Carmine Biscione
- Dipartimento Cardiovascolare, Azienda Ospedaliera "San Carlo", Potenza
| | - Antonella Matera
- Dipartimento Cardiovascolare, Azienda Ospedaliera "San Carlo", Potenza
| | | | - Agostino Lopizzo
- Dipartimento Cardiovascolare, Azienda Ospedaliera "San Carlo", Potenza
| | - Antonia Mannarini
- Unità di Cardiologia, Azienda Ospedaliera Universitaria Policlinico di Bari, Bari
| | - Eugenio Stabile
- Dipartimento Cardiovascolare, Azienda Ospedaliera "San Carlo", Potenza
| | - Giampaolo Luzi
- Dipartimento Cardiovascolare, Azienda Ospedaliera "San Carlo", Potenza
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Innelli P, Lopizzo T, Paternò G, Bruno N, Radice RP, Bertini P, Marabotti A, Luzi G, Stabile E, Di Fazio A, Pittella G, Paternoster G. Dipeptidyl Amino-Peptidase 3 (DPP3) as an Early Marker of Severity in a Patient Population with Cardiogenic Shock. Diagnostics (Basel) 2023; 13:1350. [PMID: 37046568 PMCID: PMC10093224 DOI: 10.3390/diagnostics13071350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/29/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023] Open
Abstract
Dipeptidyl amino-peptidase 3 (DPP3) is an aminopeptidase that is released into circulation upon cell death. DPP3 is involved in the degradation of angiotensins, enkephalines, and endomorphines. It has been shown that circulating DPP3 (cDPP3) plasma concentration increases in cardiogenic shock (CS) patients and correlates with high mortality risk. Cardiogenic shock is a life-threatening syndrome associated with organ hypoperfusion. One of the common causes of CS is acute myocardial infarction (AMI). This study aimed to investigate if cDPP3 levels are associated with CS severity and the need for ventilation in patients suffering from CS. Fifteen patients with CS were included in this study. Six patients were invasively ventilated. The values of cDPP3 were higher in ventilated patients than in non-ventilated patients at admission, 3 h, and 24 h after admission in the intensive care unit. Patients with pulmonary hypertension at admission also showed high cDPP3 values at all time points. Furthermore, high cDPP3 levels were associated with reduced stroke volume. Our results suggest that cDPP3 could predict CS progression and guide therapy escalation.
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Affiliation(s)
- Pasquale Innelli
- Acute Cardiac Care Unit, San Carlo Hospital, 85100 Potenza, Italy
| | - Teresa Lopizzo
- Clinical Pathology and Microbiology, San Carlo Hospital, 85100 Potenza, Italy
| | - Giovanni Paternò
- Acute Cardiac Care Unit, San Carlo Hospital, 85100 Potenza, Italy
| | - Noemi Bruno
- Cardiac Intesive Care, San Camillo Forlanini, 00152 Rome, Italy
| | | | - Pietro Bertini
- Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy
| | - Alberto Marabotti
- Intensive Care Unit and Regional, ECMO Referral Centre, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
| | - Giampaolo Luzi
- Cardiac Surgery, San Carlo Hospital, 85100 Potenza, Italy
| | - Eugenio Stabile
- Acute Cardiac Care Unit, San Carlo Hospital, 85100 Potenza, Italy
| | - Aldo Di Fazio
- Regional Complex Intercompany Institute of Legal Medicine, San Carlo Hospital, 85100 Potenza, Italy
| | - Giuseppe Pittella
- Cardiac Resuscitation, Cardiovascular Anesthesia and Intensive Care, San Carlo Hospital, 85100 Potenza, Italy
| | - Gianluca Paternoster
- Cardiac Resuscitation, Cardiovascular Anesthesia and Intensive Care, San Carlo Hospital, 85100 Potenza, Italy
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Abstract
Carotid artery stenting (CAS) is a valid alternative to conventional carotid endarterectomy for treatment of carotid artery stenosis. Distal embolization of atherosclerotic debris causing cerebrovascular accidents during CAS has been the most significant concern limiting widespread application of CAS technology. A variety of embolic protection devices (EPDs) with different mechanism of action, have been designed to minimize the risk of major embolization causing stroke and their use is recommended by current guidelines. Two general types of EPDs are available: proximal protection devices (PPDs) and distal protection devices (DPDs). However, there is no convincing clinical evidence of the clinical superiority of one device over another. This review will examine the different types of available devices and also innovative devices and techniques, including strengths and weaknesses of each, and present the available evidence and rationale for their routine use during CAS.
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Affiliation(s)
- Vincenzo Fioretti
- Division of Cardiology, Cardiovascular Department, San Carlo Regional Hospital, Potenza, Italy
| | - Donato Gerardi
- Division of Cardiology, Cardiovascular Department, San Carlo Regional Hospital, Potenza, Italy
| | - Giampaolo Luzi
- Division of Cardiac Surgery, Cardiovascular Department, San Carlo Regional Hospital, Potenza, Italy
| | - Eugenio Stabile
- Division of Cardiology, Cardiovascular Department, San Carlo Regional Hospital, Potenza, Italy -
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Cortese F, Costantino MF, Stabile E, D'Addeo G, Bochicchio A, Luzi G. [An atrial myxoma with a significant coronary vascularization]. G Ital Cardiol (Rome) 2022; 23:876-877. [PMID: 36300391 DOI: 10.1714/3900.38827] [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: 06/16/2023]
Affiliation(s)
- Francesca Cortese
- Unità di Cardiologia, Presidio Ospedaliero "Giovanni Paolo II", Policoro (MT)
| | | | - Eugenio Stabile
- Dipartimento Cardiovascolare, Istituto di Cardiologia, Ospedale San Carlo, Potenza
| | - Giampaolo D'Addeo
- Dipartimento Cardiovascolare, Istituto di Cardiologia, Ospedale San Carlo, Potenza
| | - Angela Bochicchio
- Dipartimento Cardiovascolare, Istituto di Cardiologia, Ospedale San Carlo, Potenza
| | - Giampaolo Luzi
- Dipartimento di Cardiochirurgia, Ospedale San Carlo, Potenza
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Innelli P, Prestipino F, Manzan E, Telesca M, D‘Ascoli R, Paternoster G, Stabile E, Luzi G. C14 A PROMISING SURGICAL TECHNIQUE IN PATIENTS WITH ATRIAL FUNCTIONAL MITRAL REGURGITATION: HYPER–DOWN–SIZING ANNULOPLASTY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objective
Atrial functional mitral valve regurgitation is a less common form of functional mitral regurgitation with normal leaflet motion and morphology, preserved dimension and function of left ventricle, associated with atrial fibrillation ad/or left atrial dilatation. Several factors are involved into the etiology, such as mitral annular dilation and insufficient leaflet remodeling, atriogenic leaflet tethering, loss of annular saddle shape and contractility, changes in heart rate.
Methods
Eleven consecutive patients with atrial functional mitral regurgitation, mean age 65 ± 12 years, normal left ventricle dimension and ejection fraction greater than 50% underwent mitral valve repair via right mini–thoracotomy in case of isolated mitral and tricuspid valve surgery or via median sternotomy in case of combined procedures. Concomitant procedures include tricuspid valve repair in 1 patient and coronary artery bypass in 5 patients. All patients presented an increased dimension of left atrium (mean left atrial volume: 90 ± 23 ml); mitral annular dimension was investigated with trans–esophageal echocardiography before operation. In all patients was implanted a downsized complete rigid annuloplasty ring with asymmetrical design of two sizes smaller respect to measured intercommissural distance. Clinical outcomes of patients and echocardiographic findings related to mitral regurgitation recurrence and left ventricle function were followed in the time.
Results
At discharge, any patient present a residual mitral regurgitation greater than mild, mean trans–mitral gradient was 2.5 ±2.1 mmHg. During the follow–up period of 24 ± 5 months, the New York Heart Association functional class significantly improved from 2.5 ± 0.4 to 1.5 ± 2.1. In three patients occurred cardiac rhythm disturbances requiring hospital stay, only one patient developed a greater than mild mitral regurgitation, reoperation was not becessary in any case. Left atrial volume decreased from 90 ± 23 ml to 58 ± 30 ml.
Conclusions
Mitral annuloplasty with downsized ring is a safe and effective procedure in patient with atrial functional mitral regurgitation in the same way of patient with functional mitral regurgitation due to ventricular dilation and tethering. The comforting clinical and echocardiographic outcome in our small group of patient encourage future studies in this particular group of patients.
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Affiliation(s)
- P Innelli
- TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC TERAPIA INTENSIVA CARDIOCHIRURGICA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - F Prestipino
- TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC TERAPIA INTENSIVA CARDIOCHIRURGICA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - E Manzan
- TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC TERAPIA INTENSIVA CARDIOCHIRURGICA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - M Telesca
- TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC TERAPIA INTENSIVA CARDIOCHIRURGICA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - R D‘Ascoli
- TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC TERAPIA INTENSIVA CARDIOCHIRURGICA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - G Paternoster
- TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC TERAPIA INTENSIVA CARDIOCHIRURGICA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - E Stabile
- TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC TERAPIA INTENSIVA CARDIOCHIRURGICA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - G Luzi
- TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC TERAPIA INTENSIVA CARDIOCHIRURGICA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
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D‘Ascoli R, Manzan E, Prestipino F, Innelli P, Cristiano A, Costantino M, Stabile E, Luzi G. P81 SIMULTANEOUS TRANS–APICAL AORTIC AND MITRAL VALVE IMPLANTATION IN A PATIENT WITH A DEGENERATED MITRAL BIOPROSTHESIS AND SEVERE AORTIC STENOSIS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Transcatheter Valve–in–Valve implantation has shown promising results in high–risk patients suffering from structural valve deterioration (SVD) of a previously implanted heart valve bioprosthesis. This is a case of a 82–year–old man, with history of multiple previous mitral valve replacement, admitted to the hospital for heart failure. During diagnostic work out he was diagnosed with a severe aortic stenosis and structural degeneration of a mitral valve bioprostheses Epic 29mm, St Jude Medical, (Inc, St Paul, Minn, USA). The heart team defined the patient at high surgical risk profile and was therefore scheduled for a simultaneous mitral and aortic transcatheter valve implantation. Through a double trans–apical approach (Figure A and B), the patient underwent two balloon expandable valves (Sapien 3, Edwards Lifesciences, Irvine, CA, USA) deployment in native aortic (Figure C) and mitral bioprosthesis (Figure D), respectively. Final angiography showed lack of aortic (Figure E) and left atrial (Figure E) regurgitation. The procedure was uneventful as well as the following hospital stay. Post–procedural transesophageal echocardiography confirmed the absence of paravalvular leakage nor aortic or mitral regurgitation. The patient was discharged at home on day 7. Simultaneous transapical transcatheter aortic and mitral valve replacement is technically feasible with the current available technology and can be a possible alternative in patients with high surgical risk.
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Affiliation(s)
- R D‘Ascoli
- UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - E Manzan
- UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - F Prestipino
- UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - P Innelli
- UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - A Cristiano
- UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - M Costantino
- UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - E Stabile
- UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
| | - G Luzi
- UOC CARDIOCHIRURGIA AOR OSPEDALE SAN CARLO, POTENZA; TERAPIA INTENSIVA CARDIOLOGICA UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA; UOC CARDIOLOGIA AOR OSPEDALE SAN CARLO, POTENZA
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Cortese F, Costantino MF, Luzi G, Di Marino S, Giordano P, Monitillo F. Vitamin D and cardiovascular disease risk. A literature overview. Mol Biol Rep 2022; 49:8925-8942. [PMID: 35364717 DOI: 10.1007/s11033-022-07373-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/15/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Atherosclerosis and cerebro and cardiovascular disease associated represent the major cause of morbidity and mortality worldwide. Recently, vitamin D deficiency has been considered a new potential risk factor of these conditions. METHODS AND RESULTS In this reviw we briefly describe the biological role of vitamin D, analyze the pathophysiological associations between cardiovascular disease and vitamin D, summarize and synthesize the evidence from literature about the association between vitamin D and cardiovascular disease. RESULTS Vit D is an essential vitamin for bone metabolism and homeostasis. The maintenance of optimal blood levels contributes to the correct homeostasis by influencing different metabolic processes, including those underlying cardiovascular diseases. However, the evidence does not support vitamin D routine administration for the prevention and treatment of cardiovascular disease and intake to achieve specific cardiovascular effects. Evidence shows that maintaining optimal levels of vitamin D, ensures cardiovascular protection.
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Affiliation(s)
- Francesca Cortese
- Cardiology Unit, Azienda Sanitaria Locale di Matera, Viale Salerno, 74015, Policoro, Italy.
| | | | - Giampaolo Luzi
- Cardiac Surgery Unit, Department of Cardiovascular Science, San Carlo Hospital, Potenza, Italy
| | - Serena Di Marino
- Department of Cardiology, "Valle D'Itria" Hospital, Martina Franca, Taranto, Italy
| | - Paola Giordano
- Department of Pediatrics, Ospedale Pediatrico Giovanni XXIII, "Aldo Moro" University of Bari, Bari, Italy
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Prestipino F, D'Ascoli R, Nagy Á, Paternoster G, Manzan E, Luzi G. Mini-thoracotomy in redo mitral valve surgery: safety and efficacy of a standardized procedure. J Thorac Dis 2021; 13:5363-5372. [PMID: 34659803 PMCID: PMC8482333 DOI: 10.21037/jtd-21-667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022]
Abstract
Background Re-operative mitral valve surgery is sometimes burdened by a greater technical difficulty and a higher complications rate than the first operation. Minimally invasive cardiac surgery has become routine, and it could significantly reduce the surgical risk in redo surgery. The objective of our retrospective observational study is to assess the results of cardiac reoperations in patients with mitral valve disease approached trough a 5–7 cm right mini-thoracotomy. Methods From February 2017 to December 2019, 65 patients underwent re-operative mitral valve surgery in our institution. Cardiopulmonary bypass (CPB) was started by cannulation of the femoral and jugular vein and femoral artery or alternatively right axillary artery. Patients enrolled had a mean age of 66.6±11.5 years. Patients were divided into three groups based on the procedure adopted: external aortic cross-clamp (EAC), EndoAortic balloon occlusion (EABO) and ventricular fibrillation (VF). Major complications were evaluated and compared with a propensity matched population of patients undergoing elective isolated mitral valve surgery via right minithoracotomy (MVS). Results The average time between last operation and reoperation was 7.1±3.4 years. Fourteen patients (21%) underwent mitral valve repair and 51 patients (78%) underwent mitral valve replacement; 9 patients (14%) received tricuspid valve surgery. There was no statistically significant difference in CPB time between the groups. Seven patients (11%) had a postoperative renal failure, 5 patients (8%) underwent surgical reopening for bleeding; incidence of post-operative stroke and pace-maker implantation was 3% for both. No deaths were registered during in-hospital stay and at 30-days echocardiographic control all patients respect the criterions of device success according with MVARC. Propensity matched patients of group redo had a longer CPB time (100.8±42.7 versus 72.8±16.7 min, P<0.001) and cross-clamp time (71.9±30.7 versus 59±10.7 min, P<0.001) respect to first operation mitral valve surgery patients. Conclusions Minimally invasive mitral valve redo surgery is a safe procedure. Less invasive techniques in redo surgery could minimize morbidity and mortality without prolonging the duration of CPB.
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Affiliation(s)
| | | | - Ádám Nagy
- Károly Rácz School of PhD Studies, Semmelweis University, Budapest, Hungary
| | - Gianluca Paternoster
- Cardiac Anaesthesia and Cardiac-Intesive Care, AOR San Carlo Hospital, Basilicata, Italy
| | - Erica Manzan
- Cardiac Surgery Unit, AOR San Carlo Hospital, Basilicata, Italy
| | - Giampaolo Luzi
- Cardiac Surgery Unit, AOR San Carlo Hospital, Basilicata, Italy
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D'Onofrio A, Tessari C, Cibin G, Lorenzoni G, Martinelli GL, Solinas M, Gerosa G, Gregori D, Alamanni F, Polvani G, Massetti M, Eusanio MD, Merlo M, Vendramin I, Mangino D, Mignosa C, Russo C, Rinaldi M, De Paulis R, Pacini D, Luzi G, Antona C, Salvador L, Musumeci F, Maselli D, Colli A, Portoghese M, Alfieri O, De Filippo CM. Clinical and Hemodynamic Outcomes of Rapid-Deployment Aortic Bioprostheses. Semin Thorac Cardiovasc Surg 2021; 34:453-461. [PMID: 33979664 DOI: 10.1053/j.semtcvs.2021.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 11/11/2022]
Abstract
Aim of this retrospective, multicenter study was to evaluate early and mid-term clinical and hemodynamic results of patients who underwent surgical aortic valve replacement (SAVR) with Intuity rapid-deployment bioprostheses (RDB) (Edwards Lifesciences, Irvine, CA). We analyzed data from the Italian Registry of Intuity Valve (INTU-ITA registry) that is a national, real-world and independent from the industry registry. Preoperative variables were defined according to EuroSCORE and postoperative outcomes according to Valve Academic Research Consortium (VARC). Survival distribution was evaluated using the Kaplan-Meier approach. A Cox-Proportional Hazard Model was employed to assess the effect of the covariates on patients' survival. The registry included 1687 patients from 23 centers (June 2012-September 2019). Aortic cross clamp time for isolated SAVR was 55 minutes (IQR: 45-70 minute). Postoperative pace-maker rate was 6.3%. At discharge transaortic peak and mean gradients were: 18 mm Hg (IQR: 14-23 mm Hg) and 10 mmHg (IQR: 8-13 mm Hg), respectively. Indexed effective orifice area was 1.10 cm2/m2 (IQR: 0.91-1.31 cm2/m2) and the incidence of severe patient-prosthesis mismatch was 0.6%. Hemodynamic data for all valve sizes remained stable during follow-up. Thirty-day overall mortality was 1.8% (30 patients), and at follow-up it was 5.3% (89 patients). Kaplan-Meier overall survival was 95.5% (94.3-96.7%); 90.7% (88.3-93.1%); 86.4% (82.6-90.4%) at 1, 3, and 5 years, respectively. Serum creatinine (HR: 1.36; 95%CI: 1.04-1.81; p = 0.0397) and cross-clamp time (HR: 1.01; 95%CI: 1.002-1.017; p = 0.0077) were identified as independent predictors of mortality. According to our data from the INTU-ITA registry, SAVR with RDB provides good early clinical and hemodynamic results that are confirmed at follow-up.
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Affiliation(s)
| | - Chiara Tessari
- Division of Cardiac Surgery, University of Padova, Padova, Italy
| | - Giorgia Cibin
- Division of Cardiac Surgery, University of Padova, Padova, Italy
| | | | | | - Marco Solinas
- Division of Cardiac Surgery, Ospedale del Cuore "G. Pasquinucci", Massa
| | - Gino Gerosa
- Division of Cardiac Surgery, University of Padova, Padova, Italy
| | | | - Dario Gregori
- Division of Biostatistics, University of Padova, Padova, Italy
| | - Francesco Alamanni
- Departments of Cardiac Surgery, Centro Cardiologico Monzino, Milan, Italy
| | - Gianluca Polvani
- Departments of Cardiac Surgery, Centro Cardiologico Monzino, Milan, Italy
| | - Massimo Massetti
- Departments of Cardiac Surgery, Policlinico Universitario Agostino Gemelli, Catholic University, Rome, Italy
| | | | - Maurizio Merlo
- Departments of Cardiac Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Igor Vendramin
- Departments of Cardiac Surgery, S. Maria della Misericordia Hospital - University of Udine, Udine, Italy
| | - Domenico Mangino
- Departments of Cardiac Surgery, L'Angelo Hospital, Mestre-Venezia, Italy
| | - Carmelo Mignosa
- Departments of Cardiac Surgery, G.B. Morgagni Hospital, Catania, Italy
| | - Claudio Russo
- Departments of Cardiac Surgery, Niguarda Hospital, Milan, Italy
| | - Mauro Rinaldi
- Departments of Cardiac Surgery, University Hospital of Turin, Turin, Italy
| | | | - Davide Pacini
- Departments of Cardiac Surgery, University Hospital of Bologna, Bologna, Italy
| | - Giampaolo Luzi
- Departments of Cardiac Surgery, San Carlo Hospital, Potenza, Italy
| | - Carlo Antona
- Departments of Cardiac Surgery, Sacco Hospital, Milan, Italy
| | - Loris Salvador
- Departments of Cardiac Surgery, San Bortolo Hospital, Vicenza, Italy
| | | | - Daniele Maselli
- Departments of Cardiac Surgery, S. Anna Hospital, Catanzaro, Italy
| | - Andrea Colli
- Departments of Cardiac Surgery, University Hospital of Pisa, Pisa, Italy
| | - Michele Portoghese
- Departments of Cardiac Surgery, Santissima Annunziata Hospital, Sassari, Italy
| | - Ottavio Alfieri
- Departments of Cardiac Surgery, San Raffaele University Hospital, Milano, Italy
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12
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D'Onofrio A, Tessari C, Lorenzoni G, Cibin G, Martinelli G, Alamanni F, Polvani G, Solinas M, Massetti M, Merlo M, Vendramin I, Di Eusanio M, Mignosa C, Mangino D, Russo C, Rinaldi M, Pacini D, Salvador L, Antona C, Maselli D, De Paulis R, Luzi G, Alfieri O, De Filippo CM, Portoghese M, Musumeci F, Colli A, Gregori D, Gerosa G. Minimally Invasive vs Conventional Aortic Valve Replacement With Rapid-Deployment Bioprostheses. Ann Thorac Surg 2020; 111:1916-1922. [PMID: 33039363 DOI: 10.1016/j.athoracsur.2020.06.150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/13/2020] [Accepted: 06/29/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The aim of this multicenter retrospective study was to compare early and midterm clinical and hemodynamic results of aortic valve replacement with rapid-deployment bioprostheses performed through conventional full-sternotomy vs mini-sternotomy. METHODS Data from the Italian multicenter registry of aortic valve replacement with rapid-deployment bioprostheses (INTU-ITA registry) were analyzed. Patients were divided into 2 groups: full sternotomy (FS) and ministernotomy (MS). Primary endpoint was the comparison of early and midterm mortality. Secondary endpoints were: comparison of intraoperative variables, complications, and hemodynamic performance. A propensity score weighting approach was used for data analysis. RESULTS A total of 1057 patients were analyzed: 435 (41.2%) and 622 (58.8%) in group FS and MS, respectively. Thirty-day mortality was 1.6% and 0.6% in FS and MS groups, respectively (P = .074). cardiopulmonary bypass time was 78.5 minutes and 83 minutes in FS and MS groups, respectively (P = .414). In the overall cohort, the incidence of intraoperative complications and of device success was 3.8% (40 patients) and 95.9% (1014 patients), respectively, with no significant differences between groups. Survival at 1, 3, and 5 years was 94.1%, 98.1%, 88.5% and 91.8%, 85.2%, and 84.8% in FS and MS groups, respectively (P = .412). The 2 groups showed similar postoperative gradients (median mean gradient, FS: 10.0 mm Hg, MS: 11.0 mm Hg; P = .170) and also similar incidence of patient-prosthesis mismatch (FS: 7%, MS: 6.4%, P = .647). CONCLUSIONS According to our data, rapid-deployment bioprostheses allow the performance of minimally invasive aortic valve replacement with similar surgical times and similar clinical and hemodynamic outcomes to conventional surgery and should be considered the first choice in these procedures.
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Affiliation(s)
- Augusto D'Onofrio
- Department of Cardiac Surgery, University Hospital of Padova, Padova, Italy.
| | - Chiara Tessari
- Department of Cardiac Surgery, University Hospital of Padova, Padova, Italy
| | - Giulia Lorenzoni
- Department of Cardiac Surgery, University Hospital of Padova, Padova, Italy
| | - Giorgia Cibin
- Department of Cardiac Surgery, University Hospital of Padova, Padova, Italy
| | | | - Francesco Alamanni
- Department of Cardiac Surgery, Centro Cardiologico Monzino, Milan, Italy
| | - Gianluca Polvani
- Department of Cardiac Surgery, Centro Cardiologico Monzino, Milan, Italy
| | - Marco Solinas
- Department of Cardiac Surgery, Ospedale del Cuore "G. Pasquinucci", Massa, Italy
| | - Massimo Massetti
- Department of Cardiac Surgery, Policlinico Universitario Agostino Gemelli, Catholic University, Rome, Italy
| | - Maurizio Merlo
- Department of Cardiac Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Igor Vendramin
- Department of Cardiac Surgery, S. Maria della Misericordia Hospital, University of Udine, Udine, Italy
| | | | - Carmelo Mignosa
- Department of Cardiac Surgery, G.B. Morgagni Hospital, Catania, Italy
| | - Domenico Mangino
- Department of Cardiac Surgery, L'Angelo Hospital, Mestre-Venezia, Italy
| | - Claudio Russo
- Department of Cardiac Surgery, Niguarda Hospital, Milan, Italy
| | - Mauro Rinaldi
- Department of Cardiac Surgery, University Hospital of Turin, Turin, Italy
| | - Davide Pacini
- Department of Cardiac Surgery, University Hospital of Bologna, Bologna, Italy
| | - Loris Salvador
- Department of Cardiac Surgery, San Bortolo Hospital, Vicenza, Italy
| | - Carlo Antona
- Department of Cardiac Surgery, Sacco Hospital, Milan, Italy
| | - Daniele Maselli
- Department of Cardiac Surgery, S. Anna Hospital, Catanzaro, Italy
| | | | - Giampaolo Luzi
- Department of Cardiac Surgery, San Carlo Hospital, Potenza, Italy
| | - Ottavio Alfieri
- Department of Cardiac Surgery, San Raffaele University Hospital, Milano, Italy
| | | | - Michele Portoghese
- Department of Cardiac Surgery, Santissima Annunziata Hospital, Sassari, Italy
| | | | - Andrea Colli
- Department of Cardiac Surgery, University Hospital of Pisa, Pisa, Italy
| | - Dario Gregori
- Department of Cardiac Surgery, University Hospital of Padova, Padova, Italy
| | - Gino Gerosa
- Department of Cardiac Surgery, University Hospital of Padova, Padova, Italy
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Prestipino F, D'Ascoli R, Miele M, Luzi G. Anomalous coronary sinus: A predictor of challenging redo mitral surgery. J Card Surg 2019; 34:348-349. [PMID: 30868639 DOI: 10.1111/jocs.14017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 02/11/2019] [Accepted: 02/27/2019] [Indexed: 11/28/2022]
Abstract
In the spectrum of congenital heart diseases, anomalies involving the venous coronary sinus have received relatively little attention, although they are often associated with major congenital defects, such as atrioventricular septal defects. In cases of mitral surgery in patients with these conditions, it is mandatory to keep the problem in mind and to respect the coronary sinus when approaching the left atrium and the mitral valve.
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Affiliation(s)
- Filippo Prestipino
- Cardiac Surgery Unit, Department of Cardiovascular Science, San Carlo Hospital, Potenza, Italy
| | - Riccardo D'Ascoli
- Cardiac Surgery Unit, Department of Cardiovascular Science, San Carlo Hospital, Potenza, Italy
| | - Mario Miele
- Cardiac Surgery Unit, Department of Cardiovascular Science, San Carlo Hospital, Potenza, Italy
| | - Giampaolo Luzi
- Cardiac Surgery Unit, Department of Cardiovascular Science, San Carlo Hospital, Potenza, Italy
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14
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Prestipino F, Manzan E, Miele M, D’Ascoli R, Luzi G. EP10 DIRECT AORTIC CROSS-CLAMPING IN REDO MITRAL VALVE SURGERY VIA RIGHT MINI-THORACOTOMY. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549946.17100.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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15
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Prestipino F, Manzan E, Miele M, D’Ascoli R, Luzi G. EP25 OPTIMAL OPERATIVE PLANNING AND HIGH-EXPERIENCE ARE PREDICTORS OF GOOD OUTCOMES IN PATIENTS UNDERGOING TRANS-APICAL VALVE IMPLANTATION. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549992.68680.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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16
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Manzan E, Prestipino F, Miele M, D’ascoli R, Luzi G. EP31 RAPID-DEPLOYMENT VERSUS TRANSCATHETER AORTIC VALVE. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549999.76303.b8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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17
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Paternoster G, Vitiello M, Pittella G, Dielo C, Luzi G. RF77 IGM-ENRICHED-IMMUNOGLOBULINS ASSOCIATED WITH EMIC 2 FILTER IN TREATMENT OF EARLY SEPTIC SHOCK AFTER CARDIAC SURGERY. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550093.65932.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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18
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Tessari C, D’Onofrio A, Diena M, Solinas M, Alamanni F, Massetti M, Livi U, Di Eusanio M, Mignosa C, Russo C, Rinaldi M, Di Bartolomeo R, Luzi G, Antona C, De Paulis R, Salvador L, Maselli D, Portoghese M, Alfieri O, De Filippo C, Bortolotti U, Musumeci F, Gerosa G. OC21 EARLY OUTCOMES OF MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT WITH RAPID DEPLOYMENT BIOPROSTHESES. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549887.95122.c8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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19
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Miele M, Manzan E, Prestipino F, D’Ascoli R, Luzi G. VD01 A CASE OF “VERY” SIMULTANEOUS TRANSAPICAL TRANSCATHETER AORTIC AND MITRAL VALVE IMPLANTATION. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549939.92443.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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20
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D’Onofrio A, Tessari C, Filippini C, Diena M, Solinas M, Alamanni F, Massetti M, Livi U, Di Eusanio M, Mignosa C, Russo C, Rinaldi M, Di Bartolomeo R, Luzi G, Antona C, De Paulis R, Salvador L, Maselli D, Portoghese M, Alfieri O, De Filippo C, Bortolotti U, Musumeci F, Gerosa G. OC09 CLINICAL AND HEMODYNAMIC OUTCOMES AFTER AORTIC VALVE REPLACEMENT WITH RAPID-DEPLOYMENT BIOPROSTHESES. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549901.50273.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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21
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Sirianni MC, Luzi G, Iavarone C, Papaluca M, Fiorilli M, Messinetti S, Aiuti F. Inhibition of Leukocyte Migration by a Human Colon Cancer Extract. Tumori 2018; 67:163-7. [PMID: 7025399 DOI: 10.1177/030089168106700301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The direct leucocyte migration inhibition test in capillary tubes was used to test 10 patients with colonic adenocarcinoma against KCl soluble extracts of an allogenic colon cancer and an allogenic normal colon fragment. Inhibition was consistently found with the cancer extract but not with the normal tissue extract. None of the control group of patients affected by other tumors, intestinal and liver disorders showed a migration inhibition in response to the colonic tumor extract. Our findings strongly suggest the presence of a tumor-associated antigen in the cancer extract.
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D’Onofrio A, Salizzoni S, Filippini C, Agrifoglio M, Alfieri O, Chieffo A, Tarantini G, Gabbieri D, Savini C, Immè S, Ribichini F, Cugola D, Raviola E, Loi B, Pompei E, Cappai A, Cassese M, Luzi G, Aiello M, Santini F, Rinaldi M, Gerosa G. Transapical aortic valve replacement is a safe option in patients with poor left ventricular ejection fraction: results from the Italian Transcatheter Balloon-Expandable Registry (ITER)†. Eur J Cardiothorac Surg 2017; 52:874-880. [DOI: 10.1093/ejcts/ezx227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 05/29/2017] [Indexed: 12/13/2022] Open
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Agudo JR, Luzi G, Han J, Hwang M, Lee J, Wierschem A. Detection of particle motion using image processing with particular emphasis on rolling motion. Rev Sci Instrum 2017; 88:051805. [PMID: 28571429 DOI: 10.1063/1.4983054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Image-processing has been used in granular systems for detecting particle positions and motion near optically accessible surfaces like sediment flow and bedload transport. We review the image-processing techniques used for single and multiple particles. To enhance reliability in particle recognition, tools like Canny edge and Hough transform are intensively used. We show exemplarily how they can be applied to detect not only particle positions but also rotatory motion. The different steps are described in detail and the algorithm is applied to different examples, which are discussed in view of the obtained accuracy.
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Affiliation(s)
- J R Agudo
- Institute of Fluid Mechanics, FAU Busan Campus, University of Erlangen-Nuremberg, 618-230 Busan, South Korea
| | - G Luzi
- Institute of Fluid Mechanics, FAU Busan Campus, University of Erlangen-Nuremberg, 618-230 Busan, South Korea
| | - J Han
- Institute of Fluid Mechanics, FAU Busan Campus, University of Erlangen-Nuremberg, 618-230 Busan, South Korea
| | - M Hwang
- Institute of Fluid Mechanics, FAU Busan Campus, University of Erlangen-Nuremberg, 618-230 Busan, South Korea
| | - J Lee
- Institute of Fluid Mechanics, FAU Busan Campus, University of Erlangen-Nuremberg, 618-230 Busan, South Korea
| | - A Wierschem
- Institute of Fluid Mechanics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), D-91058 Erlangen, Germany
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Cottini M, Pergolini A, Zampi G, Buffa V, Pino PG, Polizzi V, Ranocchi F, Luzi G, Montalto A, Musumeci F. Posterior wall as atypical localization of left atrial myxoma : Diagnosis and management. Herz 2016; 42:390-394. [PMID: 27752714 DOI: 10.1007/s00059-016-4480-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 08/06/2016] [Accepted: 08/07/2016] [Indexed: 10/20/2022]
Abstract
Atrial myxomas are the most common benign cardiac neoplasms. Although the majority occur in the left atrium (LA) and are attached to the interatrial septum (75-80 % of cases), they can arise from any part of the LA and the cardiac chambers. We report the case of a 65-year-old woman who presented with features of worsening dyspnea and persistent headache. During transthoracic echocardiography, a suspected cardiac myxoma was found arising from the posterior wall of the LA.
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Affiliation(s)
- M Cottini
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy.
| | - A Pergolini
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - G Zampi
- Department of Heart and Vessels, Cardiac Unit, Belcolle Hospital, 01100, Viterbo, Italy
| | - V Buffa
- Department of Cardiovascular Science, Radiology Unit, S. Camillo-Forlanini Hospital, Rome, Italy
| | - P G Pino
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - V Polizzi
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - F Ranocchi
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - G Luzi
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - A Montalto
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
| | - F Musumeci
- Department of Cardiovascular Science, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00149, Rome, Italy
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Pergolini A, Zampi G, Tinti MD, Polizzi V, Pino PG, Pontillo D, Musumeci F, Luzi G. Combined venoarterial extracorporeal membrane oxygenation and transcatheter aortic valve implantation for the treatment of acute aortic prosthesis dysfunction in a high-risk patient. Rev Port Cardiol 2016; 35:445.e1-4. [PMID: 27402446 DOI: 10.1016/j.repc.2015.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 10/16/2015] [Indexed: 11/19/2022] Open
Abstract
We describe the case of a patient with acute bioprosthesis dysfunction in cardiogenic shock, in whom hemodynamic support was provided by venoarterial extracorporeal membrane oxygenation, and successfully treated by transcatheter aortic valve implantation.
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Affiliation(s)
- Amedeo Pergolini
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Giordano Zampi
- Department of Cardiology, Belcolle Hospital, Viterbo, Italy.
| | - Maria Denitza Tinti
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Vincenzo Polizzi
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Paolo Giuseppe Pino
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Daniele Pontillo
- Department of Cardiomyopathies and Heart Failure, Belcolle Hospital, Montefiascone Facility, Montefiascone (VT), Italy
| | - Francesco Musumeci
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Giampaolo Luzi
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
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Taniguchi Y, Takahashi Y, Toba T, Yamada S, Yokoi K, Kobayashi S, Okajima S, Shimane A, Kawai H, Yasaka Y, Smanio P, Oliveira MA, Machado L, Cestari P, Medeiros E, Fukuzawa S, Okino S, Ikeda A, Maekawa J, Ichikawa S, Kuroiwa N, Yamanaka K, Igarashi A, Inagaki M, Patel K, Mahan M, Ananthasubramaniam K, Mouden M, Yokota S, Ottervanger J, Knollema S, Timmer J, Jager P, Padron K, Peix A, Cabrera L, Pena Bofill V, Valera D, Rodriguez Nande L, Carrillo Hernandez R, Mena Esnard E, Fernandez Columbie Y, Bertella E, Baggiano A, Mushtaq S, Segurini C, Loguercio M, Conte E, Beltrama V, Petulla' M, Andreini D, Pontone G, Guzic Salobir B, Dolenc Novak M, Jug B, Kacjan B, Novak Z, Vrtovec M, Mushtaq S, Pontone G, Bertella E, Conte E, Segurini C, Volpato V, Baggiano A, Formenti A, Pepi M, Andreini D, Ajanovic R, Husic-Selimovic A, Zujovic-Ajanovic A, Mlynarski R, Mlynarska A, Golba K, Sosnowski M, Ameta D, Goyal M, Kumar D, Chandra S, Sethi R, Puri A, Dwivedi SK, Narain VS, Saran RK, Nekolla S, Rischpler C, Nicolosi S, Langwieser N, Dirschinger R, Laugwitz K, Schwaiger M, Goral JL, Napoli J, Forcada P, Zucchiatti N, Damico A, Damico A, Olivieri D, Lavorato M, Dubesarsky E, Montana O, Salgado C, Jimenez-Heffernan A, Ramos-Font C, Lopez-Martin J, Sanchez De Mora E, Lopez-Aguilar R, Manovel A, Martinez A, Rivera F, Soriano E, Maroz-Vadalazhskaya N, Trisvetova E, Vrublevskaya O, Abazid R, Kattea M, Saqqah H, Sayed S, Smettei O, Winther S, Svensson M, Birn H, Jorgensen H, Botker H, Ivarsen P, Bottcher M, Maaniitty T, Stenstrom I, Saraste A, Pikkarainen E, Uusitalo V, Ukkonen H, Kajander S, Bax J, Knuuti J, Choi T, Park H, Lee C, Lee J, Seo Y, Cho Y, Hwang E, Cho D, Sanchez Enrique C, Ferrera C, Olmos C, Jimenez - Ballve A, Perez - Castejon MJ, Fernandez C, Vivas D, Vilacosta I, Nagamachi S, Onizuka H, Nishii R, Mizutani Y, Kitamura K, Lo Presti M, Polizzi V, Pino P, Luzi G, Bellavia D, Fiorilli R, Madeo A, Malouf J, Buffa V, Musumeci F, Rosales S, Puente A, Zafrir N, Shochat T, Mats A, Solodky A, Kornowski R, Lorber A, Boemio A, Pellegrino T, Paolillo S, Piscopo V, Carotenuto R, Russo B, Pellegrino S, De Matteis G, Perrone-Filardi P, Cuocolo A, Piscopo V, Pellegrino T, Boemio A, Carotenuto R, Russo B, Pellegrino S, De Matteis G, Petretta M, Cuocolo A, Amirov N, Ibatullin M, Sadykov A A, Saifullina G, Ruano R, Diego Dominguez M, Rodriguez Gabella T, Diego Nieto A, Diaz Gonzalez L, Garcia-Talavera J, Sanchez Fernandez P, Leen A, Al Younis I, Zandbergen-Harlaar S, Verberne H, Gimelli A, Veltman C, Wolterbeek R, Bax J, Scholte A, Mooney D, Rosenblatt J, Dunn T, Vasaiwala S, Okuda K, Nakajima K, Nystrom K, Edenbrandt L, Matsuo S, Wakabayashi H, Hashimoto M, Kinuya S, Iric-Cupic V, Milanov S, Davidovic G, Zdravkovic V, Ashikaga K, Yoneyama K, Akashi Y, Shugushev Z, Maximkin D, Chepurnoy A, Volkova O, Baranovich V, Faibushevich A, El Tahlawi M, Elmurr A, Alzubaidi S, Sakrana A, Gouda M, El Tahlawi R, Sellem A, Melki S, Elajmi W, Hammami H, Okano M, Kato T, Kimura M, Funasako M, Nakane E, Miyamoto S, Izumi T, Haruna T, Inoko M, Massardo T, Swett E, Fernandez R, Vera V, Zhindon J, Fernandez R, Swett E, Vera V, Zhindon J, Alay R, Massardo T, Ohshima S, Nishio M, Kojima A, Tamai S, Kobayashi T, Murohara T, Burrell S, Van Rosendael A, Van Den Hoogen I, De Graaf M, Roelofs J, Kroft L, Bax J, Scholte A, Rjabceva I, Krumina G, Kalvelis A, Chanakhchyan F, Vakhromeeva M, Kankiya E, Koppes J, Knol R, Wondergem M, Van Der Ploeg T, Van Der Zant F, Lazarenko SV, Bruin VS, Pan XB, Declerck JM, Van Der Zant FM, Knol RJJ, Juarez-Orozco LE, Alexanderson E, Slart R, Tio R, Dierckx R, Zeebregts C, Boersma H, Hillege H, Martinez-Aguilar M, Jordan-Rios A, Christensen TE, Ahtarovski KA, Bang LE, Holmvang L, Soeholm H, Ghotbi AA, Andersson H, Ihlemann N, Kjaer A, Hasbak P, Gulya M, Lishmanov YB, Zavadovskii K, Lebedev D, Stahle M, Hellberg S, Liljenback H, Virta J, Metsala O, Yla-Herttuala S, Saukko P, Knuuti J, Saraste A, Roivainen A, Thackeray J, Wang Y, Bankstahl J, Wollert K, Bengel F, Saushkina Y, Evtushenko V, Minin S, Efimova I, Evtushenko A, Smishlyaev K, Lishmanov Y, Maslov L, Okuda K, Nakajima K, Kirihara Y, Sugino S, Matsuo S, Taki J, Hashimoto M, Kinuya S, Ahmadian A, Berman J, Govender P, Ruberg F, Miller E, Piriou N, Pallardy A, Valette F, Cahouch Z, Mathieu C, Warin-Fresse K, Gueffet J, Serfaty J, Trochu J, Kraeber-Bodere F, Van Dijk J, Mouden M, Ottervanger J, Van Dalen J, Jager P, Zafrir N, Ofrk H, Vaturi M, Shochat T, Hassid Y, Belzer D, Sagie A, Kornowski R, Kaminek M, Metelkova I, Budikova M, Koranda P, Henzlova L, Sovova E, Kincl V, Drozdova A, Jordan M, Shahid F, Teoh Y, Thamen R, Hara N, Onoguchi M, Hojyo O, Kawaguchi Y, Murai M, Udaka F, Matsuzawa Y, Bulugahapitiya DS, Avison M, Martin J, Liu YH, Wu J, Liu C, Sinusas A, Daou D, Sabbah R, Bouladhour H, Coaguila C, Aguade-Bruix S, Pizzi M, Romero-Farina G, Candell-Riera J, Castell-Conesa J, Patchett N, Sverdlov A, Miller E, Daou D, Sabbah R, Bouladhour H, Coaguila C, Smettei O, Abazid R, Boulaamayl El Fatemi S, Sallam L, Snipelisky D, Park J, Ray J, Shapiro B, Kostkiewicz M, Szot W, Holcman K, Lesniak-Sobelga A, Podolec P, Clerc O, Possner M, Liga R, Vontobel J, Mikulicic F, Graeni C, Benz D, Herzog B, Gaemperli O, Kaufmann P. Poster Session 1: Sunday 3 May 2015, 08:30-18:00 * Room: Poster Area. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev051] [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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Sirianni MC, Luzi G, Mezzaroma I, Scano G, Ragona G, Soddu S, Ensoli B, Aiuti F. A critical immunological and serological evaluation of patients with HTLV-III/LAV-related disorders. Antibiot Chemother (1971) 2015; 38:141-50. [PMID: 2821880 DOI: 10.1159/000414228] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M C Sirianni
- Department of Allergy and Clinical Immunology, University of Rome, La Sapienza, Italy
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Polizzi V, Giuseppe PP, Luzi G, Bellavia D, Fiorilli R, Chialastri C, Madeo A, Presti ML, Malouf J, Buffa V, Musumeci F. AORTIC ANNULUS SIZING FOR TRANSAPICAL HEART VALVE IMPLANTATION: AN AGREEMENT ANALISYS OF DIFFERENT THREE-DIMENSIONAL TRANSOESOPHAGEAL ECHOCARDIOGRAPHIC MODALITIES AND CARDIAC COMPUTED TOMOGRAPHY SCAN. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61311-0] [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: 11/25/2022]
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Pergolini A, Zampi G, Tinti MD, Vallone A, Pino PG, Musumeci F, Luzi G. Idiopathic ascending aortitis as a rare cause of supravalvular aortic stenosis. Heart Lung Vessel 2015; 7:81-2. [PMID: 25861594 PMCID: PMC4381826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Amedeo Pergolini
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Giordano Zampi
- Department of Cardiology, Belcolle Hospital, Viterbo, Italy
| | - Maria Denitza Tinti
- Department Heart and Great Vessels "A. Reale", Policlinico Umberto I, "La Sapienza", Rome, Italy
| | - Andrea Vallone
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Paolo Giuseppe Pino
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Francesco Musumeci
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Giampaolo Luzi
- Department of Cardiovascular Science, "S. Camillo-Forlanini" Hospital, Rome, Italy
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Goirigolzarri Artaza J, Gallego Delgado M, Jaimes Castellanos C, Cavero Gibanel M, Pastrana Ledesma M, Alonso Pulpon L, Gonzalez Mirelis J, Al Ansi RZ, Sokolovic S, Cerin G, Szychta W, Popa BA, Botezatu D, Benea D, Manganiello S, Corlan A, Jabour A, Igual Munoz B, Osaca Asensi J, Andres La Huerta A, Maceira Gonzalez A, Estornell Erill J, Cano Perez O, Sancho-Tello M, Alonso Fernandez P, Sepulveda Sanchez P, Montero Argudo A, Palombo C, Morizzo C, Baluci M, Kozakova M, Panajotu A, Karady J, Szeplaki G, Horvath T, Tarnoki D, Jermendy A, Geller L, Merkely B, Maurovich-Horvat P, Moustafa S, Mookadam F, Youssef M, Zuhairy H, Connelly M, Prieur T, Alvarez N, Ashikhmin Y, Drapkina O, Boutsikou M, Demerouti E, Leontiadis E, Petrou E, Karatasakis G, Kozakova M, Morizzo C, Bianchi V, Marchi B, Federico G, Palombo C, Chatzistamatiou E, Moustakas G, Memo G, Konstantinidis D, Mpampatzeva Vagena I, Manakos K, Traxanas K, Vergi N, Feretou A, Kallikazaros I, Goto M, Uejima T, Itatani K, Pedrizzetti G, Mada R, Daraban A, Duchenne J, Voigt J, Chiu DYY, Green D, Johnstone L, Sinha S, Kalra P, Abidin N, Sikora-Frac M, Zaborska B, Maciejewski P, Bednarz B, Budaj A, Nemes A, Sasi V, Gavaller H, Kalapos A, Domsik P, Katona A, Szucsborus T, Ungi T, Forster T, Ungi I, Pluchinotta F, Arcidiacono C, Saracino A, Carminati M, Bussadori C, Dahlslett T, Karlsen S, Grenne B, Sjoli B, Bendz B, Skulstad H, Smiseth O, Edvardsen T, Brunvand H, Vereckei A, Szelenyi Z, Szenasi G, Santoro C, Galderisi M, Niglio T, Santoro M, Stabile E, Rapacciuolo A, Spinelli L, De Simone G, Esposito G, Trimarco B, Hubert S, Jacquier A, Fromonot J, Resseguier C, Tessier A, Guieu R, Renard S, Haentjiens J, Lavoute C, Habib G, Menting ME, Koopman L, Mcghie J, Rebel B, Gnanam D, Helbing W, Van Den Bosch A, Roos-Hesselink J, Shiino K, Yamada A, Sugimoto K, Takada K, Takakuwa Y, Miyagi M, Iwase M, Ozaki Y, Hayashi T, Itatani K, Inuzuka R, Shindo T, Hirata Y, Shimizu N, Miyaji K, Henri C, Dulgheru R, Magne J, Kou S, Davin L, Nchimi A, Oury C, Pierard L, Lancellotti P, Kovalyova O, Honchar O, Tengku W, Ketaren A, Mingo Santos S, Monivas Palomero V, Restrepo Cordoba A, Rodriguez Gonzalez E, Goirigolzarri Artaza J, Sayago Silva I, Garcia Lunar I, Mitroi C, Cavero Gibanel M, Segovia Cubero J, Ryu S, Park J, Kim S, Choi J, Goh C, Byun Y, Choi J, Westholm C, Johnson J, Jernberg T, Winter R, Rio P, Moura Branco L, Galrinho A, Pinto Teixeira P, Viveiros Monteiro A, Portugal G, Pereira-Da-Silva T, Afonso Nogueira M, Abreu J, Cruz Ferreira R, Mazzone A, Botto N, Paradossi U, Chabane A, Francini M, Cerone E, Baroni M, Maffei S, Berti S, Ghattas A, Shantsila E, Griffiths H, Lip G, Galli E, Guirette Y, Daudin M, Auffret V, Mabo P, Donal E, Fabiani I, Conte L, Scatena C, Barletta V, Pratali S, De Martino A, Bortolotti U, Naccarato A, Di Bello V, Falanga G, Alati E, Di Giannuario G, Zito C, Cusma' Piccione M, Carerj S, Oreto G, Dattilo G, Alfieri O, La Canna G, Generati G, Bandera F, Pellegrino M, Alfonzetti E, Labate V, Guazzi M, Cengiz B, Sahin ST, Yurdakul S, Kahraman S, Bozkurt A, Aytekin S, Borges IP, Peixoto E, Peixoto R, Peixoto R, Marcolla V, Venkateshvaran A, Sola S, Dash PK, Thapa P, Manouras A, Winter R, Brodin L, Govind SC, Mizariene V, Verseckaite R, Bieseviciene M, Karaliute R, Jonkaitiene R, Vaskelyte J, Arzanauskiene R, Janenaite J, Jurkevicius R, Rosner S, Orban M, Nadjiri J, Lesevic H, Hadamitzky M, Sonne C, Manganaro R, Carerj S, Cusma-Piccione M, Caprino A, Boretti I, Todaro M, Falanga G, Oreto L, D'angelo M, Zito C, Le Tourneau T, Cueff C, Richardson M, Hossein-Foucher C, Fayad G, Roussel J, Trochu J, Vincentelli A, Cavalli G, Muraru D, Miglioranza M, Addetia K, Veronesi F, Cucchini U, Mihaila S, Tadic M, Lang R, Badano L, Polizzi V, Pino P, Luzi G, Bellavia D, Fiorilli R, Chialastri C, Madeo A, Malouf J, Buffa V, Musumeci F, Gripari P, Tamborini G, Bottari V, Maffessanti F, Carminati C, Muratori M, Vignati C, Bartorelli A, Alamanni F, Pepi M, Polymeros S, Dimopoulos A, Spargias K, Karatasakis G, Athanasopoulos G, Pavlides G, Dagres N, Vavouranakis E, Stefanadis C, Cokkinos D, Pradel S, Mohty D, Magne J, Darodes N, Lavergne D, Damy T, Beaufort C, Aboyans V, Jaccard A, Mzoughi K, Zairi I, Jabeur M, Ben Moussa F, Ben Chaabene A, Kamoun S, Mrabet K, Fennira S, Zargouni A, Kraiem S, Jovanova S, Arnaudova-Dezjulovic F, Correia CE, Cruz I, Marques N, Fernandes M, Bento D, Moreira D, Lopes L, Azevedo O, Keramida K, Kouris N, Kostopoulos V, Psarrou G, Giannaris V, Olympios C, Marketou M, Parthenakis F, Kalyva N, Pontikoglou C, Maragkoudakis S, Zacharis E, Patrianakos A, Roufas K, Papadaki H, Vardas P, Dominguez Rodriguez F, Monivas Palomero V, Mingo Santos S, Arribas Rivero B, Cuenca Parra S, Zegri Reiriz I, Vazquez Lopez-Ibor J, Garcia-Pavia P, Szulik M, Streb W, Wozniak A, Lenarczyk R, Sliwinska A, Kalarus Z, Kukulski T, Nemes A, Domsik P, Kalapos A, Forster T, Serra W, Lumetti F, Mozzani F, Del Sante G, Ariani A, Corros C, Colunga S, Garcia-Campos A, Diaz E, Martin M, Rodriguez-Suarez M, Leon V, Fidalgo A, Moris C, De La Hera J, Kylmala MM, Rosengard-Barlund M, Groop PH, Lommi J, Bruin De- Bon H, Bilt Van Der I, Wilde A, Brink Van Den R, Teske A, Rinkel G, Bouma B, Teixeira R, Monteiro R, Garcia J, Silva A, Graca M, Baptista R, Ribeiro M, Cardim N, Goncalves L, Duszanska A, Skoczylas I, Kukulski T, Polonski L, Kalarus Z, Choi JH, Park J, Ahn J, Lee J, Ryu S, Ahn J, Kim D, Lee H, Przewlocka-Kosmala M, Mlynarczyk J, Rojek A, Mysiak A, Kosmala W, Pellissier A, Larochelle E, Krsticevic L, Baron E, Le V, Roy A, Deragon A, Cote M, Garcia D, Tournoux F, Yiangou K, Azina C, Yiangou A, Zitti M, Ioannides M, Ricci F, Dipace G, Aquilani R, Radico F, Cicchitti V, Bianco F, Miniero E, Petrini F, De Caterina R, Gallina S, Jardim Prista Monteiro R, Teixeira R, Garcia J, Baptista R, Ribeiro M, Cardim N, Goncalves L, Chung H, Kim J, Joung B, Uhm J, Pak H, Lee M, Lee K, Ragab A, Abdelwahab A, Yazeed Y, El Naggar W, Spahiu K, Spahiu E, Doko A, Liesting C, Brugts J, Kofflard M, Kitzen J, Boersma E, Levin MD, Coppola C, Piscopo G, Rea D, Maurea C, Caronna A, Capasso I, Maurea N, Azevedo O, Tadeu I, Lourenco M, Portugues J, Pereira V, Lourenco A, Nesukay E, Kovalenko V, Cherniuk S, Danylenko O, Nemes A, Domsik P, Kalapos A, Lengyel C, Varkonyi T, Orosz A, Forster T, Castro M, Abecasis J, Dores H, Madeira S, Horta E, Ribeiras R, Canada M, Andrade M, Mendes M, Morosin M, Piazza R, Leonelli V, Leiballi E, Pecoraro R, Cinello M, Dell' Angela L, Cassin M, Sinagra G, Nicolosi G, Wierzbowska-Drabik K, Hamala P, Kasprzak J, O'driscoll J, Rossato C, Gargallo-Fernandez P, Araco M, Sharma S, Sharma R, Jakus N, Baricevic Z, Ljubas Macek J, Skoric B, Skorak I, Velagic V, Separovic Hanzevacki J, Milicic D, Cikes M, Deljanin Ilic M, Ilic S, Kocic G, Pavlovic R, Stoickov V, Ilic V, Nikolic L, Generati G, Bandera F, Pellegrino M, Alfonzetti E, Labate V, Guazzi M, Labate V, Bandera F, Generati G, Pellegrino M, Donghi V, Alfonzetti E, Guazzi M, Zakarkaite D, Kramena R, Aidietiene S, Janusauskas V, Rucinskas K, Samalavicius R, Norkiene I, Speciali G, Aidietis A, Kemaloglu Oz T, Ozpamuk Karadeniz F, Akyuz S, Unal Dayi S, Esen Zencirci A, Atasoy I, Osken A, Eren M, Fazendas PR, Caldeira D, Stuart B, Cruz I, Rocha Lopes L, Almeida AR, Sousa P, Joao I, Cotrim C, Pereira H, Fazendas PR, Caldeira D, Stuart B, Cruz I, Rocha Lopes L, Almeida AR, Joao I, Cotrim C, Pereira H, Sinem Cakal S, Elif Eroglu E, Baydar O, Beytullah Cakal B, Mehmet Vefik Yazicioglu M, Mustafa Bulut M, Cihan Dundar C, Kursat Tigen K, Birol Ozkan B, Ali Metin Esen A, Yagasaki H, Kawasaki M, Tanaka R, Minatoguchi S, Houle H, Warita S, Ono K, Noda T, Watanabe S, Minatoguchi S, Cho EJ, Park SJ, Lim HJ, Chang SA, Lee SC, Park SW, Cho EJ, Park SJ, Lim HJ, Chang SA, Lee SC, Park SW, Mornos C, Cozma D, Ionac A, Mornos A, Popescu I, Ionescu G, Pescariu S, Melzer L, Faeh-Gunz A, Seifert B, Attenhofer Jost CH, Storve S, Haugen B, Dalen H, Grue J, Samstad S, Torp H, Ferrarotti L, Maggi E, Piccinino C, Sola D, Pastore F, Marino P, Ranjbar S, Karvandi M, Hassantash S, Karvandi M, Ranjbar S, Tierens S, Remory I, Bala G, Gillis K, Hernot S, Droogmans S, Cosyns B, Lahoutte T, Tran N, Poelaert J, Al-Mallah M, Alsaileek A, Nour K, Celeng C, Horvath T, Kolossvary M, Karolyi M, Panajotu A, Kitslaar P, Merkely B, Maurovich Horvat P, Aguiar Rosa S, Ramos R, Marques H, Portugal G, Pereira Da Silva T, Rio P, Afonso Nogueira M, Viveiros Monteiro A, Figueiredo L, Cruz Ferreira R. Poster session 6. Eur Heart J Cardiovasc Imaging 2014; 15:ii235-ii264. [PMCID: PMC4453635 DOI: 10.1093/ehjci/jeu271] [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: 08/13/2023] Open
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Di Rosa R, Pietrosanti M, Luzi G, Salemi S, D'Amelio R. Polyclonal intravenous immunoglobulin: an important additional strategy in sepsis? Eur J Intern Med 2014; 25:511-6. [PMID: 24877856 DOI: 10.1016/j.ejim.2014.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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: 03/15/2014] [Accepted: 05/04/2014] [Indexed: 10/25/2022]
Abstract
Sepsis syndrome is characterized by a systemic inflammatory response to infection potentially leading to acute organ failure and rapid decline to death. Polyclonal intravenous immune globulin, a blood product derived from human donor blood, in addition to antiinfective activities, also exerts a broad antiinflammatory and immunomodulating effect. Intravenous immunoglobulin (IVIg) has been proposed as adjuvant therapy for sepsis even though the clinical studies demonstrating their efficacy and safety are relatively small. Several systematic reviews and meta-analyses of intravenous immunoglobulin treatment in sepsis have been performed. As a result of heterogeneity across studies and inconsistencies in results, the majority have concluded that more evidence, coming from large, well-conducted randomized controlled trials (RCTs), is required. Moreover the appropriate timing of administration and the identification of specific clinical settings represent a key factor to maximizing their beneficial effect. The authors, in this revision, review the basic mechanisms of action of IVIg, the rationale for their use, and their clinical applications.
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Affiliation(s)
- R Di Rosa
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
| | - M Pietrosanti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - G Luzi
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - S Salemi
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - R D'Amelio
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, S. Andrea University Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
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Kalcik M, Gursoy M, Astarcioglu M, Gokdeniz T, Karakoyun S, Cakal B, Yesin M, Kahveci G, Yildiz M, Ozkan M, Cresti A, Cesareo F, Guerrini F, Capati E, Miracapillo G, Severi S, Ternacle J, Lellouche N, Gallet R, Deux JF, Dubois-Rande JL, Teiger E, Lim P, Polizzi V, Pino P, Luzi G, Fiorilli R, Buffa V, Visconti C, Bellavia D, Violini R, Musumeci F, Saura Espin D, Oliva Sandoval M, Gonzalez Carrillo J, Caballero Jimenez L, Espinosa Garcia M, Garcia Navarro M, Lopez Ruiz M, Valdes Chavarri M, De La Morena Valenzuela G. Oral Abstract session * Imaging in structural interventions: 13/12/2013, 08:30-10:00 * Location: Bursa. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet222] [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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Arduini M, Luzi G, Affronti G, Epicoco G. Intra-abdominal versus free-loop portion Doppler analysis of the umbilical artery: the importance of the choice. Minerva Ginecol 2011; 63:333-338. [PMID: 21747341] [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: 05/31/2023]
Abstract
AIM The aim of this study was to assess the variations in Doppler indexes along the length of the cord from the intra-abdominal portion (IAP) to the free loop portion (FLP) of the umbilical artery (UA). METHODS UA blood flow velocities were measured at the IAP and FLP in 100 low-risk singleton pregnancies. The peak systolic velocity (PSV), end-diastolic velocity, pulsatility index (PI), resistance index (RI), PS/ED ratio and Delta value (Δ) were calculated. at each site of sampling and were compared. RESULTS PI and RI of the IAP were greater versus the FLP. UA blood velocities increased with gestational age and the PSV at the IAP showed different development compared to other sites, increasing from 20 to 30-32 weeks and then decreasing until term. The PSV value was greater in the IAP from 20 until 36 weeks. There were not significant differences in EDV values between the two sites. The Δ PI in IAP remained constantly greater than ~0.2 at all gestational ages. CONCLUSION UA Doppler parameters vary significantly at different locations, showing the greater value in the IAP. The IAP site is in a fixed anatomical position, therefore potentially reproducible. This potential advantage is very important in cases of severe growth restriction and in monoamniotic twins.
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Affiliation(s)
- M Arduini
- Unit of Obstetrics and Gynecology, S. Maria della Misericordia Hospital, Perugia, Italy.
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Loforte A, Luzi G, Montalto A, Ranocchi F, Polizzi V, Sbaraglia F, Della Monica PL, Menichetti A, Musumeci F. Video-Assisted Minimally Invasive Mitral Valve Surgery External Aortic Clamp versus Endoclamp Techniques. Innovations�(Phila) 2010; 5:413-8. [DOI: 10.1177/155698451000500606] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective Video-assisted minimally invasive mitral valve surgery can be performed through different approaches. The aim of the study was to report our early results and compare the external transthoracic aortic clamping with the endoaortic balloon occlusion techniques according to our experience. Methods Between January 2000 and March 2010, 138 patients (103 women, aged 58.4 ± 10.2 years) underwent video-assisted mitral valve surgery through a right thoracotomy. Cardiopulmonary bypass was instituted by femoral arterial and bicaval cannulation with active venous drainage and normothermia; cardioplegic arrest achieved with intermittent blood cardioplegia. In group A (93 patients, 68 women, aged 58.8 ± 7.8 years, 72 MV replacement, 21 MV repair), aortic clamping was achieved using the external transthoracic aortic clamp. In group B (45 patients, 35 women, aged 58.1 ± 11.4 years, 33 MV replacement, 12 MV repair), aortic clamping was achieved with endoaortic balloon occlusion. Results Intraoperative procedure-associated problems were experienced in one patient (0.7%) in group A (one conversion to sternotomy for pleural adhesions and bad exposure). At a mean follow-up of 36 ± 18 months, 135 patients (97.8%) were in New York Heart Association class I to II, with satisfactory echocardiographic follow-up. In group A, two patients had noncardiac-related deaths. No perioperative deaths were observed in both groups. There were four (2.8%) transient ischemic attacks and one (0.7%) peripheral ischemic event (group A) during the early postoperative period. Mitral valve repair patients had a 5-year freedom from reoperation of 100% in both groups. There was no significant difference between the two groups regarding preoperative variables, such as age, sex, New York Heart Association class, and left ventricular ejection fraction (P ≥ 0.05). Postoperative levels of myocardial cytonecrosis enzymes (MB fraction, creatine kinase, and troponine I) as well as operative time, extracorporeal circulation, and aortic cross-clamping times or ventilation and intensive care unit times were not significantly different between the two groups (P ≥ 0.05). More microembolic events were observed in group A than in group B (total 143.4 ± 30.6 per patient vs 78.9 ± 28.6 per patient) by means of continuous automated intraoperative transcranial Doppler evaluations (P < 0.05) applied to part of population. Conclusions Both techniques proved safe and comparable with low risk of morbidity and mortality. Patients undergoing endoclamp technique resulted to be less subject to embolism.
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Affiliation(s)
- Antonio Loforte
- Department of Cardiac Surgery and Transplantation, San Camillo Hospital, Rome, Italy
| | - Giampaolo Luzi
- Department of Cardiac Surgery and Transplantation, San Camillo Hospital, Rome, Italy
| | - Andrea Montalto
- Department of Cardiac Surgery and Transplantation, San Camillo Hospital, Rome, Italy
| | - Federico Ranocchi
- Department of Cardiac Surgery and Transplantation, San Camillo Hospital, Rome, Italy
| | - Vincenzo Polizzi
- Department of Cardiac Surgery and Transplantation, San Camillo Hospital, Rome, Italy
| | - Fabio Sbaraglia
- Department of Cardiac Surgery and Transplantation, San Camillo Hospital, Rome, Italy
| | | | - Antonio Menichetti
- Department of Cardiac Surgery and Transplantation, San Camillo Hospital, Rome, Italy
| | - Francesco Musumeci
- Department of Cardiac Surgery and Transplantation, San Camillo Hospital, Rome, Italy
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Francia A, Luzi G, Morreale M, Vanacore N. Can Immune Disorders Influence Therapeutical Approach in Treatment of Epilepsy among Neurologists? A First Co-Operative National Recognition in Italy. Int J Immunopathol Pharmacol 2010; 23:1267-9. [DOI: 10.1177/039463201002300432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Functional disturbances of the immune system have been detected more often among persons affected by epilepsy than in the general population. In the February-July period of 2007 a specific questionnaire on the relationship between epilepsy and immunological response was sent to 27 specialized Centres for Epilepsy in nine Italian regions. 15,388 epileptic patients attended twenty-seven Centers during this six-month period. 3.3% (n=502) of these patients suffered an immune disease. This is the first national survey on the relationship between epilepsy and immunological response in current clinical practice.
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Affiliation(s)
| | - G. Luzi
- Faculty of Medicine and Psychology, “Sapienza” University, Rome
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Barbati S, Grenga L, Luzi G, Paolozzi L, Ghelardini P. Prokaryotic division interactome: setup of an assay for protein–protein interaction mutant selection. Res Microbiol 2010; 161:118-26. [DOI: 10.1016/j.resmic.2010.01.001] [Citation(s) in RCA: 2] [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] [Received: 11/05/2009] [Revised: 12/16/2009] [Accepted: 01/04/2010] [Indexed: 10/19/2022]
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Loforte A, Montalto A, Ranocchi F, Casali G, Luzi G, Monica PLD, Sbaraglia F, Polizzi V, Distefano G, Musumeci F. Heartmate II axial-flow left ventricular assist system: management, clinical review and personal experience. J Cardiovasc Med (Hagerstown) 2009; 10:765-71. [DOI: 10.2459/jcm.0b013e32832d495e] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Affiliation(s)
- R. Guidetti
- Institute of Gynaecology and Obstetrics, University of Perugia, Italy
| | - E. Simonazzi
- Institute of Gynaecology and Obstetrics, University of Perugia, Italy
| | - F. Gori
- Institute of Gynaecology and Obstetrics, University of Perugia, Italy
| | - A. Chiodi
- Institute of Gynaecology and Obstetrics, University of Perugia, Italy
| | - G. Luzi
- Institute of Gynaecology and Obstetrics, University of Perugia, Italy
| | - G. C. Di Renzo
- Institute of Gynaecology and Obstetrics, University of Perugia, Italy
| | - E. V. Cosmi
- Institute of Gynaecology and Obstetrics, University of Perugia, Italy
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Loforte A, Montalto A, Ranocchi F, Casali G, Luzi G, Della Monica P, Sbaraglia F, Polizzi V, Distefano G, Musumeci F. Long-Term Mechanical Support With the HeartMate II LVAS. Transplant Proc 2009; 41:1357-9. [DOI: 10.1016/j.transproceed.2009.03.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Luzi G, Laganà B, Salemi S, Di Rosa R. Are glucocorticoids a consistent risk factor for infections in rheumatoid arthritis patients under treatment with methotrexate and etanercept? Clin Ter 2009; 160:121-123. [PMID: 19452100] [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: 05/27/2023]
Abstract
OBJECTIVE To evaluate the incidence of infections in subjects with rheumatoid arthritis (RA), treated with an anti-TNFalpha blocker during one year follow-up. The aim of the study was focused to evaluate the number of infectious episodes in two groups of patients treated with etanercept (ETN) plus methotrexate (MTX) or ETN plus MTX and glucocorticoid drugs (GCs/prednisone) for a 12 months period. MATERIALS AND METHODS Sixty-nine out of 122 RA patients treated with an anti-TNFalpha drug (ETN) were included in an outpatient control system within the Immunology Department Sapienza-University of Rome-II; School of Medicine. RA patients were studied during the first year after ETN introduction. Particularly 20 RA patients have been included in a subgroup. For these 20 patients infections have been monitored for 2 years: 12 months before and 12 months after ETN treatment starting. RESULTS According to drugs administration protocols, after a careful screening aiming to exclude latent tuberculosis infection, 20 patients have been treated with ETN (10 of them received treatment in association to MTX, while 10 were given a GCs therapy plus MTX). During the one-year ETN treatment period, 7 infections have been described in the group treated with ETN, MTX and GCs and no infection in the group treated with ETN and MTX. After analysing the infection number in the two groups of patients, in the year preceding biological treatment no significant change arose. CONCLUSIONS The risk of infections in subjects treated with the biological drug ETN is well known. Our data show that after one year therapy the [ETN+MTX+GCs] group is marked by a greater frequency of infectious episodes compared to the subjects treated with ETN plus MTX. Therefore, the additional infectious risk appears to be related to steroid therapy itself, though infections were not serious.
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Affiliation(s)
- G Luzi
- II School of Medicine, Sapienza University of Rome, A.O. Sant'Andrea, Rome, Italy.
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Luzi G, Bongiorno F, Paparo Barbaro S, Bruno G. Intravenous IgG: biological modulating molecules. J BIOL REG HOMEOS AG 2009; 23:1-9. [PMID: 19321040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Intravenous IgG has been adopted as treatment for various immune-related diseases, including immune thrombocytopenic purpura, autoimmune neuropathies, systemic lupus erythematosus, Guillain-Barré syndrome, myasthenia gravis, Kawasaki disease, skin blistering diseases. The intravenous administration of exogenously pooled human immunoglobulin was originally licensed as antibody replacement therapy in patients with primary immunodeficiencies, but in the last thirty years, despite a current lack of institutional approval, off-label IVIgG treatment of a consistent number of disorders has shown to be a useful approach with good clinical results. The mechanism of action of IVIgG is complex and is not fully understood. The current understanding and development in the immune modulant action of IVIgG has three basic mechanisms: 1) F(ab')2 mediated actions; 2) interaction of IgGFc molecule with Fc receptors (FcgammaR); 3) actions mediated by complement fractions binding within the Fc molecular structure. The mode of action of IVIgG involves expression and function of Fc receptors, idiotype network, complement and cytokine network, T and B cell differentiation, modulation of antigen-presenting cells (APC). The therapeutic action of IVIgG is also related to natural antibodies in maintaining immune homeostasis. In addition, IVIgG interaction through V regions with complementary V regions of antibodies may provide a rational basis for selection of various immune repertoires. Since there is a significant gap between the institutional approval and the use of IVIgG in various clinical conditions, for which there is no adequate testing or for which a small number of records does not allow a rigorous statistical approach, several public and private institutions (mostly insurance companies) and research centres have developed guidelines for evaluating a rational and deontological approach in various pathological situations where IVIgG is used. Mathematical models based on non-linear differential equations may represent another potentially useful system to better understand an IVIgG targeted use in individual subjects.
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Arena S, Canonico S, Luzi G, Brusco G, Affronti G. Use of Misoprostol Prior to Operative Hysteroscopy in Premenopausal Women: A Placebo-Controlled Trial. J Minim Invasive Gynecol 2008. [DOI: 10.1016/j.jmig.2008.09.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Casali G, Luzi G, Vicchio M, Lilla della Monica P, Minardi G, Musumeci F. Echocardiographic Follow-Up after Implanting 17-mm Regent Mechanical Prostheses. Asian Cardiovasc Thorac Ann 2008; 16:208-11. [DOI: 10.1177/021849230801600306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to evaluate midterm echocardiographic results and changes in quality of life after aortic valve replacement with 17-mm St. Jude Medical Regent mechanical prostheses in patients with aortic valve stenosis. The study population was 34 women and 2 men, aged 31–83 years. Echocardiographic follow-up was 100% complete at 4.1 ± 1.8 years. Hospital mortality was 5.6%. Actuarial 5-year survival was 88.5% ± 0.067%. Postoperative echocardiography showed significant regression of left ventricular mass index and significant reductions of peak gradient, mean gradient and mean effective orifice area index. All survivors were interviewed using the 36-item Short Form Health Survey questionnaire. Scores obtained in 7 of the 8 domains of the test were significantly higher than preoperative values. In our experience, implantation of this prosthesis allowed regression of left ventricular mass index and improved the perceived quality of life.
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Affiliation(s)
- Giovanni Casali
- Department of Cardiology and Cardiovascular Surgery, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Giampaolo Luzi
- Department of Cardiology and Cardiovascular Surgery, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Mariano Vicchio
- Department of Cardiology and Cardiovascular Surgery, S. Camillo-Forlanini Hospital, Rome, Italy
| | | | - Giovanni Minardi
- Department of Cardiology and Cardiovascular Surgery, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Francesco Musumeci
- Department of Cardiology and Cardiovascular Surgery, S. Camillo-Forlanini Hospital, Rome, Italy
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Luzi G, Montalto A, Polizzi V, D'Alessandro CC, Vicchio M, Musumeci F. Best site on right ventricle for open-chest biventricular pacing. Asian Cardiovasc Thorac Ann 2007; 15:427-31. [PMID: 17911073 DOI: 10.1177/021849230701500514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/15/2022]
Abstract
Cardiac resynchronization therapy is effective in patients with a low ejection fraction and left bundle branch block, but 20%-30% do not respond despite selection of the optimal site for pacing on the left ventricle. We investigated whether optimizing the site for placement of the pacing lead on the right ventricle could further improve left ventricular function during cardiac resynchronization in 19 patients (mean age, 63 +/- 5 years) undergoing coronary artery bypass with post-ischemic dilated myocardiopathy (ejection fraction, 25.8% +/- 2%) and left bundle branch block. The hemodynamic response to pacing was tested with the right ventricular lead positioned at the interventricular septum, atrioventricular junction, acute margin, and the pulmonary trunk. Biventricular stimulation improved left ventricular function. When the right ventricular lead was sited at the interventricular septum, a significant improvement in all hemodynamic parameters compared to the other sites was obtained. Biventricular pacing is important to optimize cardiac resynchronization. Although further studies are needed to confirm these findings, accurate lead placement is recommended for cardiac resynchronization therapy in patients with poor cardiac function and left bundle branch block.
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Affiliation(s)
- Giampaolo Luzi
- Department of Cardiac Surgery, San Camillo Hospital, Rome, Italy.
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Romanelli M, Ribiani E, Burnelli L, Luzi G, Affronti G, Di Renzo GC. [Pharmacological induction of labour: benefits and risks]. Minerva Ginecol 2007; 59:347-355. [PMID: 17923826] [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: 05/25/2023]
Abstract
AIM Induction of labour is a very common practice in modern obstetrics. The most used method is based on the use of topical prostaglandins. In this study we aimed to analyse the results of pharmacological induction of labour through the use of dinoprostone, comparing the intracervical gel (Prepidil 0.5 mg) and the vaginal insert (Propess 10 mg). METHODS An observational longitudinal study was conducted, in which all patients treated with prostaglandins from January 1, 2003 to June 30, 2006 were included, for a total of 852 cases. The intracervical gel was applied on 32.5% of pregnant women (277 patients) while the vaginal insert to 56.2% (479 patients); in 11.3% of the cases (96 patients) both preparations were administered, one after the other. RESULTS In 2/3 of the total (568 patients), the induction led to vaginal delivery, in contrast to 284 cases in which the practice showed negative results: in 270 women (31.7%) a cesarean section was practiced. Adverse events occurred only in 1.8% of cases (16 patients); the most frequent adverse reaction was uterine hypertonus in 1.8% of cases, which was in any case resolved with removal of the vaginal insert or injection of a tocolytic drug (atosiban). CONCLUSION Induction through prostaglandins is an effective and safe method to get cervical maturation. Its success is influenced by Bishop score. In the case of unfit cervix, vaginal insert seems to get better results than intracervical gel. The relation between risks and benefits is certainly better in the latter.
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Affiliation(s)
- M Romanelli
- Struttura Complessa di Ostetricia e Ginecologia, Centro di Medicina Perinatale e della Riproduzione, Università degli Studi di Perugia, Perugia, Italy
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Minardi G, Manzara C, Pulignano G, Luzi G, Maselli D, Casali G, Musumeci F. Rest and Dobutamine stress echocardiography in the evaluation of mid-term results of mitral valve repair in Barlow's disease. Cardiovasc Ultrasound 2007; 5:17. [PMID: 17386112 PMCID: PMC1845153 DOI: 10.1186/1476-7120-5-17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Accepted: 03/26/2007] [Indexed: 11/10/2022] Open
Abstract
Background Surgical "anatomical" repair is the most frequent technique used to correct mitral regurgitation due to severe myxomatous valve disease. Debate, however, persists on the efficacy of this technique, as well as on the durability of the repaired valve, and on its functioning and hemodynamics under stress conditions. Thus, a basal and Dobutamine echocardiographic (DSE) study was carried out to evaluate these parameters at mid-term follow-up. Methods and Results Twenty patients selected for the study (12 men and 8 women, mean age 60 ± 9 years) underwent pre- and post-operative transthoracic echocardiography (TTE) and intra-operative transesophageal echocardiography (TEE). At mid-term follow-up (20 ± 5 months) all patients underwent rest TTE and DSE (3 min. dose increments up to 40 microg/Kg/min protocol). Pre-discharge and one-month TTE showed absence of MR in 11 pts., trivial or mild MR in 9 pts. and normal mitral valve area and gradients. Mid-term TTE showed decrease in left atrial and ventricular dimension, in pulmonary artery pressure (sPAP) and grade of MR. During DSE a significant increase in mitral valve area, maximum and mean gradients, sPAP, heart rate and cardiac output and a decrease in systolic annular diameter and left ventricular volume were found; in 6 pts. a transient left ventricular outflow tract obstruction was observed. Conclusion Basal and Dobutamine stress echocardiography proved to be valuable tools for evaluation of mid-term results of mitral valve repair. In our study population, the surgical technique employed had a favourable impact on several cardiac parameters, evaluated by these methods.
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Affiliation(s)
- Giovanni Minardi
- Division of Cardiology, Department of Cardiology and Cardiovascular Surgery, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | - Carla Manzara
- Division of Cardiology, Department of Cardiology and Cardiovascular Surgery, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | - Giovanni Pulignano
- Division of Cardiology, Department of Cardiology and Cardiovascular Surgery, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | - Giampaolo Luzi
- Division of Cardiovascular Surgery, Department of Cardiology and Cardiovascular Surgery, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | - Daniele Maselli
- Division of Cardiovascular Surgery, Department of Cardiology and Cardiovascular Surgery, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | - Giovanni Casali
- Division of Cardiovascular Surgery, Department of Cardiology and Cardiovascular Surgery, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
| | - Francesco Musumeci
- Division of Cardiovascular Surgery, Department of Cardiology and Cardiovascular Surgery, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
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Di Renzo G, Mignosa M, Gerli S, Burnelli L, Luzi G, Clerici G, Taddei F, Marinelli D, Bragetti B, Mezzetti D, Della Torre B, Fantauzzi A, Lungarotti M. Reply. Am J Obstet Gynecol 2006. [DOI: 10.1016/j.ajog.2005.07.006] [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: 10/25/2022]
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Abati S, Cargnel M, Ottolina P, Scala A, Luzi G, Strohmenger L. P14 Characteristics of a cohort of patients suffering from halitosis and effect of a short-term treatment. Oral Dis 2005. [DOI: 10.1111/j.1601-0825.2005.01105_37.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pierdominici M, Mazzetta F, Caprini E, Marziali M, Digilio MC, Marino B, Aiuti A, Amati F, Russo G, Novelli G, Pandolfi F, Luzi G, Giovannetti A. Biased T-cell receptor repertoires in patients with chromosome 22q11.2 deletion syndrome (DiGeorge syndrome/velocardiofacial syndrome). Clin Exp Immunol 2003; 132:323-31. [PMID: 12699424 PMCID: PMC1808695 DOI: 10.1046/j.1365-2249.2003.02134.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Chromosome 22q11.2 deletion (del22q11.2) syndrome (DiGeorge syndrome/velocardiofacial syndrome) is a common syndrome typically consisting of congenital heart disease, hypoparathyroidism, developmental delay and immunodeficiency. Although a broad range of immunologic defects have been described in these patients, limited information is currently available on the diversity of the T-cell receptor (TCR) variable beta (BV) chain repertoire. The TCRBV repertoires of nine patients with del22q11.2 syndrome were determined by flow cytometry, fragment size analysis of the third complementarity determining region (CDR3 spectratyping) and sequencing of V(D)J regions. The rate of thymic output and the phenotype and function of peripheral T cells were also studied. Expanded TCRBV families were detected by flow cytometry in both CD4+ and CD8+ T cells. A decreased diversity of TCR repertoires was also demonstrated by CDR3 spectratyping, showing altered CDR3 profiles in the majority of TCRBV families investigated. The oligoclonal nature of abnormal peaks detected by CDR3 spectratyping was confirmed by the sequence analysis of the V(D)J regions. Thymic output, evaluated by measuring TCR rearrangement excision circles (TRECs), was significantly decreased in comparison with age-matched controls. Finally, a significant up-regulation in the percentage, but not in the absolute count, of activated CD4+ T cells (CD95+, CCR5+, HLA-DR+), IFN-gamma - and IL-2-expressing T cells was detected. These findings suggest that the diversity of CD4 and CD8 TCRBV repertoires is decreased in patients with del22q11.2 syndrome, possibly as a result of either impaired thymic function and/or increased T-cell activation.
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Affiliation(s)
- M Pierdominici
- Laboratory of Cell Biology, Istituto Superiore di Sanità, Rome, Italy
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Muscaritoli M, Fanfarillo F, Luzi G, Sirianni MC, Iebba F, Laviano A, Russo M, Aiuti F, Rossi Fanelli F. Impaired nutritional status in common variable immunodeficiency patients correlates with reduced levels of serum IgA and of circulating CD4+ T lymphocytes. Eur J Clin Invest 2001; 31:544-9. [PMID: 11422405 DOI: 10.1046/j.1365-2362.2001.00838.x] [Citation(s) in RCA: 13] [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: 01/14/2023]
Abstract
BACKGROUND Common variable immunodeficiency (CVI) is a primary defect of the immune system. Infections, persistent diarrhoea and malabsorption may result in malnutrition, which may in turn contribute to increased morbidity. In this paper, the prevalence of malnutrition in CVI was evaluated. PATIENTS AND METHODS Forty CVI patients (20 male, 20 female, aged 17-75 years) underwent anthropometric measurements from which body mass index, arm fat and muscle area were calculated. Body mass index values < 18.5 and arm fat and muscle area values < 10th percentile were considered indicative of malnutrition. Patients were divided into four groups according to circulating CD4+ T cells (lower or greater than 300 microL(-1)) and serum immunoglobulin A (IgA) levels (detectable and undetectable). RESULTS Body mass index < 18.5, arm fat and muscle area < 10th percentile were observed in 23%, 58% and 44%, respectively, of patients. Lower values of body mass index, arm fat and muscle area were more frequent in patients with low CD4+ cells and undetectable IgA. Low arm fat values were more frequent in patients with diarrhoea (P = 0.03). Infectious episodes were more frequent in undetectable IgA than in detectable IgA patients (P = 0.04). CONCLUSIONS Anthropometric measurements revealed an increased rate of malnutrition in CVI patients, particularly in those with low CD4+ and undetectable IgA, suggesting that selected CVI subjects could be considered for standard or specialized nutritional support.
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Affiliation(s)
- M Muscaritoli
- Department of Clinical Medicine, University La Sapienza, Rome, Italy.
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