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Santulli G, Varzideh F, Forzano I, Wilson S, Salemme L, de Donato A, Lombardi A, Rainone A, Nunziata L, Jankauskas SS, Tesorio T, Guerra G, Kansakar U, Mone P. Functional and Clinical Importance of SGLT2-inhibitors in Frailty: From the Kidney to the Heart. Hypertension 2023; 80:1800-1809. [PMID: 37403685 PMCID: PMC10529735 DOI: 10.1161/hypertensionaha.123.20598] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 07/06/2023]
Abstract
SGLT2 (sodium-glucose cotransporter 2) enables glucose and sodium reabsorption in the kidney. SGLT2-inhibitors (also known as gliflozins, which include canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin) act by increasing glycosuria, thereby reducing glycemia. These drugs are critical to reach and keep glycemic control, a crucial feature, especially in patients with comorbidities, like frail individuals. Several studies evaluated the effects of SGLT2-inhibitors in different settings beyond diabetes, revealing that they are actually pleiotropic drugs. We recently evidenced the favorable effects of SGLT2-inhibition on physical and cognitive impairment in frail older adults with diabetes and hypertension. In the present overview, we summarize the latest clinical and preclinical studies exploring the main effects of SGLT2-inhibitors on kidney and heart, emphasizing their potential beneficial actions in frailty.
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Affiliation(s)
- Gaetano Santulli
- Department of Medicine, Einstein College, New York, USA
- Naples University “Federico II”
| | | | | | - Scott Wilson
- Department of Medicine, Einstein College, New York, USA
| | | | | | | | | | | | | | | | | | - Urna Kansakar
- Department of Medicine, Einstein College, New York, USA
| | - Pasquale Mone
- Department of Medicine, Einstein College, New York, USA
- Department of Medicine, Molise University
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Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D’Angelo M, Da Ros S, D’Andrea F, D’Andrea A, D’Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Del Giudice C, Dell’Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Bella G, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi RM, Inserra CA, Iori E, Izzo A, La Rosa G, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Picano E, Carerj S. Stress Echocardiography in Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging. J Cardiovasc Echogr 2023; 33:125-132. [PMID: 38161775 PMCID: PMC10756319 DOI: 10.4103/jcecho.jcecho_48_23] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 01/03/2024] Open
Abstract
Background The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand the volumes of activity, modalities and stressors used during stress echocardiography (SE) in Italy. Methods We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved through an electronic survey based on a structured questionnaire, uploaded on the SIECVI website. Results Data were obtained from 228 echocardiographic laboratories, and SE examinations were performed in 179 centers (80.6%): 87 centers (47.5%) were in the northern regions of Italy, 33 centers (18.4%) were in the central regions, and 61 (34.1%) in the southern regions. We annotated a total of 4057 SE. We divided the SE centers into three groups, according to the numbers of SE performed: <10 SE (low-volume activity, 40 centers), between 10 and 39 SE (moderate volume activity, 102 centers) and ≥40 SE (high volume activity, 37 centers). Dipyridamole was used in 139 centers (77.6%); exercise in 120 centers (67.0%); dobutamine in 153 centers (85.4%); pacing in 37 centers (21.1%); and adenosine in 7 centers (4.0%). We found a significant difference between the stressors used and volume of activity of the centers, with a progressive increase in the prevalence of number of stressors from low to high volume activity (P = 0.033). The traditional evaluation of regional wall motion of the left ventricle was performed in all centers, with combined assessment of coronary flow velocity reserve (CFVR) in 90 centers (50.3%): there was a significant difference in the centers with different volume of SE activity: the incidence of analysis of CFVR was significantly higher in high volume centers compared to low - moderate - volume (32.5%, 41.0% and 73.0%, respectively, P < 0.001). The lung ultrasound (LUS) was assessed in 67 centers (37.4%). Furthermore for LUS, we found a significant difference in the centers with different volume of SE activity: significantly higher in high volume centers compared to low - moderate - volume (25.0%, 35.3% and 56.8%, respectively, P < 0.001). Conclusions This nationwide survey demonstrated that SE was significantly widespread and practiced throughout Italy. In addition to the traditional indication to coronary artery disease based on regional wall motion analysis, other indications are emerging with an increase in the use of LUS and CFVR, especially in high-volume centers.
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Affiliation(s)
- Quirino Ciampi
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Mauro Pepi
- Cardiology Division, Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Francesco Antonini-Canterin
- Department of Rehabilitative Cardiology, Rehabilitative Hospital High Speciality, Motta di Livenza, TV, Italy
| | - Andrea Barbieri
- Department of Biomedical, Metabolic and Neural Sciences, Cardiology Division, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Agata Barchitta
- Semi Intensive Care Department, Padova University Hospital, Padova, Italy
| | | | - Sofia Miceli
- Geriatric Division, University Hospital Renato Dulbecco, Catanzaro, Italy
| | - Vito Maurizio Parato
- Cardiology Division, Madonna del Soccorso Hospital, San Benedetto del Tronto, AP, Italy
| | - Antonio Tota
- Cardiology Division, Polyclinic Hospital, Bari, Italy
| | - Giuseppe Trocino
- Non Invasive Cardiac Imaging Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Massimiliana Abbate
- Cardiology Vanvitelli Division, AORN dei Colli, Monaldi Hospital, Napoli, Italy
| | - Maria Accadia
- Cardiology Division, Del Mare Hospital, Ponticelli, NA, Italy
| | - Rossella Alemanni
- Cardiac Surgery Division, Casa Sollievo Della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | | | | | - Maurizio Anselmi
- Cardiology Division, Fracastoro Hospital, San Bonifacio, VR, Italy
| | - Iolanda Aquila
- Cardiology Division, University Hospital Mater Domini, Catanzaro, Italy
| | - Simona Aramu
- Cardiology Division, San Martino Hospital, Oristano, Italy
| | - Enrico Avogadri
- Department of Rehabilitative Cardiology, SS Trinità Hospital, Fossano, CN, Italy
| | | | - Luigi Badano
- Department of Medicine and Surgery, University MIlano-Bicocca, Integrated Cardiovascular Diagnosi Unit, Istituto Auxologico Italiano, IRCCS, Italy
| | - Anna Balducci
- Pediatric Cardiology Division, Polyclinico S. Orsola-Malpighi IRCCS Hospital, Bologna, Italy
| | | | | | | | - Valentina Barletta
- Cardiology 2 Division, Cardiac Vascular Thoracic Department, Pisa University Hospital, Pisa, Italy
| | - Daniele Barone
- Cardiology Division, S. Andrea Hospital, La Spezia, Pisa, Italy
| | - Francesco Becherini
- Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | | | | | | | | | | | - Massimo Bolognesi
- Center for Internal Medicine and Sports Cardiology, Local Health Unit of Romagna, Cesena, FC, Italy
| | - Stefano Bongiovi
- Cardiology Division, Immacolata Concezione Civil Hospital, Piove di Sacco, PD, Italy
| | - Renato Maria Bragato
- Echocardiography and Emergency Cardiovascular Care Division, Humanitas Clinical and Research Centre, Rozzano, Italy
| | - Gabriele Braggion
- Cardiology Division, Santa Maria Regina Degli Angeli Hospital, Adria, RO, Italy
| | | | - Francesca Bursi
- Department of Health Sciences, Cardiology Division, University of Milan, San Paolo Hospital, ASST Santi Paolo e Carlo, Milano, Italy
| | | | - Matteo Cameli
- Cardiology Division, Polyclinic Le Scotte Hospital, Siena, Italy
| | - Antonella Canu
- Cardiology Division, Santissima Annunziata Hospital, Siena, Italy
| | - Mariano Capitelli
- Internal Medicine Division, Pavullo Hospital, Pavullo nel Frignano, MO, Italy
| | | | - Rosa Carbonara
- Cardiology Division, Maugeri Institute IRCCS, Bari, Italy
| | - Maria Carbone
- Emergency Medicine Division, St. Anna and St. Sebastiano Hospital, Caserta, Italy
| | - Marco Carbonella
- Cardiology Division, SS Maria Addolorata Hospital, Eboli, SA, Italy
| | - Nazario Carrabba
- Cardiology Division, Careggi University Hospital, Firenze, Italy
| | - Grazia Casavecchia
- Cardiology Division, University Hospital Ospedali Riuniti, Foggia, Italy
| | - Margherita Casula
- Cardiology Division, Nostra Signora di Bonaria Hospital, San Gavino Monreale, SU, Italy
| | - Elena Chesi
- Neonatology Division, S. Maria Nuova Hospital, Reggio Emilia, Italy
| | - Sebastiano Cicco
- Department of Precision and Regenerative Medicine and Ionian Area, Unit of Internal Medicine “G. Baccelli” and Unit of Hypertension “A.M. Pirrelli”, University of Bari Aldo Moro Medical School, AUOC Policlinico di Bari, Bari, Italy
| | - Rodolfo Citro
- Echocardiography Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | | | - Paolo Colonna
- Cardiology Division, Polyclinic Hospital, Bari, Italy
| | - Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Pietro Cortesi
- Cardioncology Division, IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori”, Meldola, FC, Italy
| | | | | | - Fabiana Cozza
- Cardiology Division, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Umberto Cucchini
- Cardiology Division, San Bassiano Hospital, Bassano Del Grappa, VI, Italy
| | - Myriam D’Angelo
- Cardiology Division, Bonino Pulejo IRCCS Hospital, Messina, Italy
| | - Santina Da Ros
- Division of Cardiology, Riuniti Padova Sud Hospital, Monselice, PD, Italy
| | | | | | - Francesca D’Auria
- Vascular - Endovascular Surgery Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Giovanni De Caridi
- Vascular Surgery Division, University Hospital Polyclinic G. Martino, University of Messina, Messina, Italy
| | - Stefania De Feo
- Cardiology Division, P Pederzoli Hospital, Peschiera del Garda, VR, Italy
| | | | - Simona De Vecchi
- Cardiology Division, Major University Hospital of Charity, Novara, Italy
| | | | - Luca Dell’Angela
- Cardiology Division, Gorizia-Monfalcone Hospital, Gorizia, Italy
| | | | - Ilaria Dentamaro
- Cardiology Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | - Paola Destefanis
- Cardiology Division, San Luigi Gonzaga University Hospital, Orbassano, Italy
| | - Gianluca Di Bella
- Cardiology Division, University Hospital Polyclinic G. Martino, University of Messina, Messina, Italy
| | | | | | | | - Angelo Di Gioia
- Cardiology Division, St. Giuliano Hospital, Giugliano in Campania, NA, Italy
| | | | | | - Concetta Di Nora
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Giovanni Di Salvo
- Pediatric Cardiology and Congenital Heart Disease Division, Padova University Hospital, Padova, Italy
| | - Claudio Dodi
- Cardiology Division, San Antonino Clinic, Piacenza, Italy
| | - Sarah Dogliani
- Cardiology Division, SS. Annunziata Civil Hospital, Savigliano, Italy
| | - Federica Donati
- Pascia Center, Polyclinic, University Hospital Modena Polyclinic, Modena, Italy
| | - Melissa Dottori
- Cardiology Division, Marche University Hospital, Ancona, Italy
| | - Giuseppe Epifani
- Internal Medicine Division, Camberlingo Hospital, Francavilla Fontana, BR, Italy
| | - Iacopo Fabiani
- Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Francesca Ferrara
- Internal Medicine Division, University Hospital Modena Polyclinic, Modena, Italy
| | - Luigi Ferrara
- Cardiology Division, Villa Dei Fiori Clinic, Acerra, Italy
| | | | - Gemma Filice
- Cardiology Division, Annunziata Hospital, Cosenza, Italy
| | - Maria Fiorino
- Cardiology Division, ARNAS Civico Hospital, Cremona, Italy
| | - Davide Forno
- Cardiology Division, Maria Vittoria Hospital, Torino, Italy
| | | | | | - Giuseppe Gigantino
- Cardiology Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Mauro Giorgi
- Cardiology Division, Molinette Hospital - Città della Salute e della Scienza, Torino, Italy
| | | | | | | | | | - Anna Holzl
- Internal Medicine Division, Quisisana Clinic, Italy
| | - Alessandra Iaiza
- Cardiac Surgery Division, San Camillo-Fornalinini Hospital, Roma, Italy
| | - Andrea Iannaccone
- Internal Medicine Division, Ordine Mauriziano Hospital, Torino, Italy
| | - Federica Ilardi
- Cardiology Division, Federico II University Hospital, Napoli, Italy
| | - Egidio Imbalzano
- Internal Medicine Division, University Hospital Polyclinic G. Martino, University of Messina, Messina, Italy
| | | | | | - Emilio Iori
- Cardiology Division, New Civil Hospital, Sassuolo, Italy
| | - Annibale Izzo
- Cardiology Division, St. Anna and St. Sebastiano Hospital, Caserta, Italy
| | | | | | | | - Laura Lanzoni
- Cardiology Division, Sacro Cuore Don Calabria IRCCS Hospital, Verona, Italy
| | | | - Elisa Leiballi
- Cardiology and Rehabilitative Division, Azienda Sanitaria Friuli Occidentale (ASFO), Health Care, Sacile (Pd), Italy
| | | | - Carmenita Lo Conte
- Cardiology Division, St. Ottone Frangipane Hospital, Ariano Irpino, AV, Italy
| | - Maria Lo Monaco
- Cardiology Division, Humanitas Gavazzeni Hospital, Bergamo, Italy
| | - Antonella Lombardo
- Cardiology Division, Fondazione Policlinico A. Gemelli-IRCCS, Università Cattolica, Roma, Italy
| | | | - Paola Lusardi
- Cardiology and Cardiac Surgery Division, Maria Pia Hospital, Torino, Italy
| | - Antonio Magnante
- Cardiology Division, Madonna delle Grazie Hospital, Matera, Italy
| | - Alessandro Malagoli
- Division of Cardiology, Nephro Cardiovascular Department, Baggiovara Hospital, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | | | - Fiore Manganelli
- Cardiology Division, St. Giuseppe Moscati Hospital, Avellino, Italy
| | - Francesca Mantovani
- Cardiology Division, Azienda USL- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Valeria Marchese
- Cardiology Division, St. Maria della Speranza Hospital, Battipaglia, SA, Italy
| | - Lina Marinacci
- Cardiology Division, Civil Hospital, Città di Castello, Italy
| | - Roberto Mattioli
- Cardiology Division, IRCCS Multimedica Hospital, Sesto San Giovanni, Italy
| | - Civelli Maurizio
- Cardiology Division, European Institute of Oncology, Milano, Italy
| | - Giuseppe Antonio Mazza
- Pediaric Cardiology Division, Regina Margherita Hospital - Città Della Salute e Della Scienza, Torino, Italy
| | - Stefano Mazza
- Cardiology Division, Maggiore St. Andrea Hospital, Vercelli, Italy
| | - Marco Melis
- Cardiology Division, Brotzu Hospital, Cagliari, Italy
| | - Giulia Meloni
- Center for Prevention, Diagnosis and Therapy of Arterial Hypertension and Cardiovascular Complications, St. Camillo Hospital, Sassari, Italy
| | - Elisa Merli
- Cardiology Division, Degli Infermi Hospital, Faenza, RA, Italy
| | - Alberto Milan
- Internal Medicine 4 Division, Molinette Hospital - Città della Salute e Della Scienza, Torino, Italy
| | | | - Antonella Monaco
- Cardiology Outpatient Clinic, Cardiology Outpatient Clinic, Civitanova Marche, MC, Italy
| | - Ines Monte
- Cardiology Division, University Hospital Polyclinic “G.Rodolico-S. Marco”, University of Catania, Catania, Italy
| | | | - Antonella Moreo
- De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Fabio Mori
- Non-invasive Cardiovascular Diagnostic Division, Careggi University Hospital, Firenze, Italy
| | - Sofia Morini
- Cardiology Division, Riuniti della Valdichiana Hospital, Montepulciano, SI, Italy
| | - Claudio Moro
- Cardiology Division, Pio XI Hospital, Desio, MB, Italy
| | | | - Francesco Negri
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Carmelo Nipote
- Cardiology Division, Civil Hospital, Sant’Agata di Militello, ME, Italy
| | - Fulvio Nisi
- Anesthesia and Intensive Care Division, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Silvio Nocco
- Cardiology Division, Sirai Hospital, Carbonia, CI, Italy
| | - Luigi Novello
- Geriatric Division, Valdagno Hospital, Arzignano, VI, Italy
| | - Luigi Nunziata
- Cardiology Division, St. Maria della Pietà Hospital, Nola, NA, Italy
| | | | - Antonello Parodi
- Cardiology Division, Padre Antero Micone Hospital, Genova, Italy
| | | | - Guido Pastorini
- Cardiology Division, Regina Montis Regalis Hospital, Mondovì, CN, Italy
| | - Rita Pavasini
- Cardiology Division, University Hospital of Ferrara, Italy
| | - Daisy Pavoni
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Chiara Pedone
- Cardiology Division, Maggiore Hospital, Bologna, Italy
| | | | | | | | - Valeria Pergola
- Cardiology Division, Padova University Hospital, Padova, Italy
| | | | | | - Chiara Pezzullo
- Cardiology Division, G.B. Grassi Hospital, Lido di Ostia, Italy
| | - Gerardo Piacentini
- Fetal and Neonatal Cardiology Unit - Fatebenefratelli Isola Tiberina Gemelli Isola Hospital, Roma, Italy
| | - Elisa Picardi
- Cardiology Division, Civic Hospital, Chivasso, Italy
| | - Giovanni Pinna
- Neonatology and Neonatal Intensive Care Division, San Camillo-Fornalinini Hospital, Roma, Italy
| | | | - Alfredo Pizzuti
- Cardiology Outpatient Clinic, Koelliker Hospital, Torino, Italy
| | - Matteo Maria Poggi
- Interdisciplinary Internal Medicine Division, Careggi University Hospital, Firenze, Italy
| | - Alfredo Posteraro
- Cardiology Division, St. Giovanni Evangelista Hospital, Tivoli, Italy
| | | | - Debora Rampazzo
- Cardiology Division, Madonna della Navicella Hospital, Chioggia, Italy
| | - Carlo Ratti
- Cardiology Division, St. Maria Bianca Hospital, Mirandola, Italy
| | | | - Fabrizio Ricci
- Cardiology Division, Ss. Annunziata Hospital, Chieti, Italy
| | - Caterina Ricci
- Cardiology Outpatient Clinic, Casa della Salute “Regina Margherita”, Castelfranco Emilia, MO, Italy
| | | | | | - Chiara Rovera
- Cardiology Division, Civic Hospital, Chivasso, Italy
| | | | | | - Nicola Sacchi
- Medical Division, St. Agostino Hospital, Castiglione del Lago, PG, Italy
| | | | - Francesca Sani
- Cardiology Division, St. Giovanni di Dio Hospital, Firenze, Italy
| | - Chiara Sartori
- Cardiology Division, Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Virginia Scarabeo
- Cardiology Division, Camposampiero Hospital, Camposampiero, PD, Italy
| | - Angela Sciacqua
- Geriatric Division, University Hospital Renato Dulbecco, Catanzaro, Italy
| | - Antonio Scillone
- Intensive Cardiac Rehabilitation Unit, Villa del Sole Clinic, Cosenza, Italy
| | | | - Alfredo Scorza
- Cardiology Division, Riuniti Anzio-Nettuno Hospital, Anzio, RM, Italy
| | | | | | - Walter Serra
- Cardiology Division, University Hospital, Parma, Italy
| | | | | | - Domenico Sirico
- Pediatric Cardiology and Congenital Heart Disease Division, Padova University Hospital, Padova, Italy
| | - Marco Solari
- Cardiology Division, St. Giuseppe Hospital, Empoli, FI, Italy
| | | | - Laura Stefani
- Sports Medicine Division, Careggi University Hospital, Firenze, Italy
| | - Antonio Strangio
- Cardiology Division, St. Giovanni di Dio Hospital, Crotone, Italy
| | - Francesca Chiara Surace
- Pediatric Cardiac Surgery and Cardiology Division, Marche University Hospital, Ancona, Italy
| | - Gloria Tamborini
- Cardiology Division, Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Nicola Tarquinio
- Internal Medicine Division, IRCCS INRCA Hospital, Osimo AN, Italy
| | | | | | - Bertrand Tchana
- Pediatric Cardiology Division, University Hospital, Parma, Italy
| | | | - Monica Tinto
- Cardiology Division, Mater Salutis Hospital, Legnago, VR, Italy
| | - Daniela Torzillo
- Internal Medicine Division, L. Sacco Hospital, University of Milan, Italy
| | - Antonio Totaro
- Department of Cardiovascular Sciences, Responsible Research Hospital, Campobasso, Italy
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | | | - Federica Troisi
- Cardiology Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | - Maurizio Tusa
- Cardiology Division, St. Donato Polyclinic, San Donato Milanese, Milan, Italy
| | | | - Vincenzo Varasano
- Internal and Emergency Medicine Division, Civil Hospital, Policoro MT, Italy
| | - Amedeo Venezia
- Geriatric Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | | | - Bruno Villari
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | | | - Jessica Zannoni
- Cardiology Division, St. Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Concetta Zito
- Cardiology Division, University Hospital Polyclinic G. Martino, University of Messina, Messina, Italy
| | | | - Eugenio Picano
- CNR, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy
| | - Scipione Carerj
- Cardiology Division, University Hospital Polyclinic G. Martino, University of Messina, Messina, Italy
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Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D’Angelo M, Ros SD, D’Andrea F, D’Andrea A, D’Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Giudice CD, Dell’Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi R, Inserra CA, Iori E, Izzo A, Rosa GL, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Di Bella G, Carerj S. Organization and Activity of Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging. J Cardiovasc Echogr 2023; 33:1-9. [PMID: 37426716 PMCID: PMC10328129 DOI: 10.4103/jcecho.jcecho_16_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 07/11/2023] Open
Abstract
Background The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy. Methods We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website. Results Data were obtained from 228 echocardiographic laboratories: 112 centers (49%) in the northern, 43 centers (19%) in the central, and 73 (32%) in the southern regions. During the month of observation, we collected 101,050 transthoracic echocardiography (TTE) examinations performed in all centers. As concern other modalities there were performed 5497 transesophageal echocardiography (TEE) examinations in 161/228 centers (71%); 4057 stress echocardiography (SE) examinations in 179/228 centers (79%); and examinations with ultrasound contrast agents (UCAs) in 151/228 centers (66%). We did not find significant regional variations between the different modalities. The usage of picture archiving and communication system (PACS) was significantly higher in the northern (84%) versus central (49%) and southern (45%) centers (P < 0.001). Lung ultrasound (LUS) was performed in 154 centers (66%), without difference between cardiology and noncardiology centers. The evaluation of left ventricular (LV) ejection fraction was evaluated mainly using the qualitative method in 223 centers (94%), occasionally with the Simpson method in 193 centers (85%), and with selective use of the three-dimensional (3D) method in only 23 centers (10%). 3D TTE was present in 137 centers (70%), and 3D TEE in all centers where TEE was done (71%). The assessment of LV diastolic function was done routinely in 80% of the centers. Right ventricular function was evaluated using tricuspid annular plane systolic excursion in all centers, using tricuspid valve annular systolic velocity by tissue Doppler imaging in 53% of the centers, and using fractional area change in 33% of the centers. When we divided into cardiology (179, 78%) and noncardiology (49, 22%) centers, we found significant differences in the SE (93% vs. 26%, P < 0.001), TEE (85% vs. 18%), UCA (67% vs. 43%, P < 0001), and STE (87% vs. 20%, P < 0.001). The incidence of LUS evaluation was similar between the cardiology and noncardiology centers (69% vs. 61%, P = NS). Conclusions This nationwide survey demonstrated that digital infrastructures and advanced echocardiography modalities, such as 3D and STE, are widely available in Italy with a notable diffuse uptake of LUS in the core TTE examination, a suboptimal diffusion of PACS recording, and conservative use of UCA, 3D, and strain. There are significant differences between northern and central-southern regions and echocardiographic laboratories that pertain to the cardiac unit. This inhomogeneous distribution of technology represents one of the main issues that must be solved to standardize the practice of echocardiography.
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Affiliation(s)
- Quirino Ciampi
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Mauro Pepi
- Cardiology Division, Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | | | - Andrea Barbieri
- Department of Biomedical, Cardiology Division, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Agata Barchitta
- Semi Intensive Care Department, Semi-Intensive Care Unit, Padova University Hospital, Padova, Italy
| | | | - Sofia Miceli
- Geriatric Division, University Hospital Mater Domini, Catanzaro, Italy
| | - Vito Maurizio Parato
- Cardiology Division, Madonna del Soccorso Hospital, San Benedetto del Tronto, AP, Italy
| | - Antonio Tota
- Cardiology Division, Polyclinic Hospital, Bari, Italy
| | - Giuseppe Trocino
- Non Invasive Cardiac Imaging Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Massimiliana Abbate
- Cardiology Vanvitelli Division, AORN dei Colli, Monaldi Hospital, Napoli, Italy
| | - Maria Accadia
- Cardiology Division, Del Mare Hospital, Ponticelli, NA, Italy
| | - Rossella Alemanni
- Cardiac Surgery Division, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | | | | | - Maurizio Anselmi
- Cardiology Division, Fracastoro Hospital, San Bonifacio, VR, Italy
| | - Iolanda Aquila
- Cardiology Division, University Hospital Mater Domini, Catanzaro, Italy
| | - Simona Aramu
- Cardiology Division, San Martino Hospital, Oristano, Italy
| | - Enrico Avogadri
- Department of Cardiology, SS Trinità Hospital, Fossano, CN, Italy
| | | | - Luigi Badano
- Integrated Cardiovascular Diagnostic Division, Auxologico San Luca IRCCS Hospital, Milano, Italy
| | - Anna Balducci
- Pediatric Cardiology Division, Polyclinico S. Orsola-Malpighi IRCCS Hospital, Bologna, Italy
| | | | | | | | - Valentina Barletta
- Cardiology 2 Department, Cardiac Vascular Thoracic Department, Pisa University Hospital, Pisa, Italy
| | - Daniele Barone
- Cardiology Division, S. Andrea Hospital, La Spezia, Italy
| | - Francesco Becherini
- Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | | | | | | | | | | | - Massimo Bolognesi
- Center for Internal Medicine and Sports Cardiology, Local Health Unit of Romagna, Cesena, FC, Italy
| | - Stefano Bongiovi
- Cardiology Division, Immacolata Concezione Civil Hospital, Piove di Sacco, PD, Italy
| | - Renato Maria Bragato
- Echocardiography and Emergency Cardiovascular Care Division, Humanitas Clinical and Research Centre, Rozzano, MI, Italy
| | - Gabriele Braggion
- Cardiology Division, Santa Maria Regina degli Angeli Hospital, Adria, RO, Italy
| | | | - Francesca Bursi
- Department of Health Science, Cardiology Division, University of Milan, San Paolo Hospital, ASST Santi Paolo e Carlo, Milano, Italy
| | | | - Matteo Cameli
- Cardiology Division, Polyclinic Le Scotte Hospital, Siena, Italy
| | - Antonella Canu
- Cardiology Division, Santissima Annunziata Hospital, Sassari, Italy
| | - Mariano Capitelli
- Internal Medicine Division, Pavullo Hospital, Pavullo Nel Frignano, MO, Italy
| | | | - Rosa Carbonara
- Cardiology Division, Maugeri Institute IRCCS, Bari, Italy
| | - Maria Carbone
- Emergency Medicine Division, St Anna and St Sebastiano Hospital, Caserta, Italy
| | - Marco Carbonella
- Cardiology Division, SS Maria Addolorata Hospital, Eboli, SA, Italy
| | - Nazario Carrabba
- Cardiology Division, Careggi University Hospital, Firenze, Italy
| | - Grazia Casavecchia
- Cardiology Division, University Hospital Ospedali Riuniti, Foggia, Italy
| | - Margherita Casula
- Cardiology Division, Nostra Signora di Bonaria Hospital, San Gavino Monreale, SU, Italy
| | - Elena Chesi
- Neonatology Division, S. Maria Nuova Hospital, Reggio Emilia, Italy
| | - Sebastiano Cicco
- Department of Precision and Regenerative Medicine and Ionian Area, Unit of Internal Medicine “G. Baccelli” and Unit of Hypertension “A.M. Pirrelli”, University of Bari Aldo Moro Medical School, AUOC Policlinico di Bari, Bari, Italy
| | - Rodolfo Citro
- Echocardiography Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | | | - Paolo Colonna
- Cardiology Division, Polyclinic Hospital, Bari, Italy
| | - Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Pietro Cortesi
- Cardioncology Division, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, FC, Italy
| | | | | | - Fabiana Cozza
- Cardiology Division, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Umberto Cucchini
- Cardiology Division, San Bassiano Hospital, Bassano Del Grappa, VI, Italy
| | - Myriam D’Angelo
- Cardiology Division, Bonino Pulejo IRCCS Hospital, Messina, Italy
| | - Santina Da Ros
- Division of Cardiology, Riuniti Padova Sud Hospital, Monselice, PD, Italy
| | | | | | - Francesca D’Auria
- Vascular - Endovascular Surgery Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Giovanni De Caridi
- Vascular Surgery Division, University Hospital Polyclinic G.Martino, University of Messina, Messina, Italy
| | - Stefania De Feo
- Cardiology Division, P Pederzoli Hospital, Peschiera del Garda, VR, Italy
| | | | - Simona De Vecchi
- Cardiology Division, Major University Hospital of Charity, Novara, Italy
| | | | - Luca Dell’Angela
- Cardiology Division, Gorizia-Monfalcone Hospital, Gorizia, Italy
| | | | - Ilaria Dentamaro
- Cardiology Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | - Paola Destefanis
- Cardiology Division, San Luigi Gonzaga University Hospital, Orbassano, Italy
| | - Maria Di Fulvio
- Cardiology-ICCU Division, Ss. Annunziata Hospital, Chieti, Italy
| | | | | | - Angelo Di Gioia
- Cardiology Division, St Giuliano Hospital, Giugliano in Campania, NA, Italy
| | | | | | - Concetta Di Nora
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Giovanni Di Salvo
- Pediatric Cardiology and Congenital Heart Disease Division, Padova University Hospital, Padova, Italy
| | - Claudio Dodi
- Cardiology Division, San Antonino Clinic, Piacenza, Italy
| | - Sarah Dogliani
- Cardiology Division, SS. Annunziata Civil Hospital, Savigliano, CN, Italy
| | | | - Melissa Dottori
- Cardiology Division, Marche University Hospital, Ancona, Italy
| | - Giuseppe Epifani
- Internal Medicine Division, Camberlingo Hospital, Francavilla Fontana, BR, Italy
| | - Iacopo Fabiani
- Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Francesca Ferrara
- Internal Medicine Division, University Hospital Modena Polyclinic, Modena, Italy
| | - Luigi Ferrara
- Cardiology Division, Villa Dei Fiori Clinic, Acerra, NA, Italy
| | | | - Gemma Filice
- Cardiology Division, Annunziata Hospital, Cosenza, Italy
| | - Maria Fiorino
- Cardiology Division, ARNAS Civico Hospital, Palermo, Italy
| | - Davide Forno
- Cardiology Division, Maria Vittoria Hospital, Torino, Italy
| | | | | | - Giuseppe Gigantino
- Cardiology Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Mauro Giorgi
- Cardiology Division, Molinette Hospital - Città della Salute e della Scienza, Torino, Italy
| | | | | | | | | | - Anna Holzl
- Internal Medicine Division, Quisisana Clinic, Ferrara, Italy
| | - Alessandra Iaiza
- Cardiac Surgery Division, San Camillo-Fornalinini Hospital, Roma, Italy
| | - Andrea Iannaccone
- Internal Medicine Division, Ordine Mauriziano Hospital, Torino, Italy
| | - Federica Ilardi
- Cardiology Division, Federico II University Hospital, Napoli, Italy
| | - Egidio Imbalzano
- Internal Medicine Division, University Hospital Polyclinic G.Martino, University of Messina, Messina, Italy
| | | | | | - Emilio Iori
- Cardiology Division, New Civil Hospital, Sassuolo, MO, Italy
| | - Annibale Izzo
- Cardiology Division, St Anna and St Sebastiano Hospital, Caserta, Italy
| | | | | | | | - Laura Lanzoni
- Cardiology Division, Sacro Cuore Don Calabria IRCCS Hospital, Verona, Italy
| | | | - Elisa Leiballi
- Cardiological and Cardio Oncological Rehabilitation Department, Sacile (PN) CRO (PN) Hospital, Sacile (PN), Italy
| | | | - Carmenita Lo Conte
- Cardiology Division, St Ottone Frangipane Hospital, Ariano Irpino, AV, Italy
| | - Maria Lo Monaco
- Cardiology Division, Humanitas Gavazzeni Hospital, Bergamo, Italy
| | - Antonella Lombardo
- Cardiology Division, Fondazione Policlinico A. Gemelli-IRCCS, Università Cattolica, Roma, Italy
| | | | - Paola Lusardi
- Cardiology and Cardiac Surgery Division, Maria Pia Hospital, Torino, Italy
| | - Antonio Magnante
- Cardiology Division, Madonna delle Grazie Hospital, Matera, Italy
| | - Alessandro Malagoli
- Division of Cardiology, Nephro-Cardiovascular Department, Baggiovara Hospital, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | | | - Fiore Manganelli
- Cardiology Division, St Giuseppe Moscati Hospital, Avellino, Italy
| | - Francesca Mantovani
- Cardiology Division, Azienda USL- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Valeria Marchese
- Cardiology Division, St Maria della Speranza Hospital, Battipaglia, SA, Italy
| | - Lina Marinacci
- Cardiology Division, Civil Hospital, Città di Castello, PG, Italy
| | - Roberto Mattioli
- Cardiology Division, IRCCS Multimedica Hospital, Sesto San Giovanni, MI, Italy
| | - Civelli Maurizio
- Cardiology Division, European Institute of Oncology, Milano, Italy
| | - Giuseppe Antonio Mazza
- Pediaric Cardiology Division, Regina Margherita Hospital - Città della Salute e della Scienza, Torino, Italy
| | - Stefano Mazza
- Cardiology Division, Maggiore St Andrea Hospital, Vercelli, Italy
| | - Marco Melis
- Cardiology Division, Brotzu Hospital, Cagliari, Italy
| | - Giulia Meloni
- Center for Prevention, Diagnosis and Therapy of Arterial Hypertension and Cardiovascular Complications, St Camillo Hospital, Sassari, Italy
| | - Elisa Merli
- Cardiology Division, Degli Infermi Hospital, Faenza, RA, Italy
| | - Alberto Milan
- Internal Medicine 4 Department, Molinette Hospital - Città della Salute e della Scienza, Torino, Italy
| | | | - Antonella Monaco
- Cardiology Outpatient Clinic, Cardiology Outpatient Clinic, Civitanova Marche, MC, Italy
| | - Ines Monte
- Cardiology Division, University Hospital Polyclinic “G.Rodolico-S. Marco”, University of Catania, Catania, Italy
| | | | - Antonella Moreo
- De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Fabio Mori
- Non-invasive Cardiovascular Diagnostic Division, Careggi University Hospital, Firenze, Italy
| | - Sofia Morini
- Cardiology Division, Riuniti della Valdichiana Hospital, Montepulciano, SI, Italy
| | - Claudio Moro
- Cardiology Division, Pio XI Hospital, Desio, MB, Italy
| | | | - Francesco Negri
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Carmelo Nipote
- Cardiology Division, Civil Hospital, Sant’Agata di Militello, ME, Italy
| | - Fulvio Nisi
- Anesthesia and Intensive Care Division, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Silvio Nocco
- Cardiology Division, Sirai Hospital, Carbonia, CI, Italy
| | - Luigi Novello
- Geriatric Division, Valdagno Hospital, Arzignano, VI, Italy
| | - Luigi Nunziata
- Cardiology Division, St Maria della Pietà Hospital, Nola, NA, Italy
| | | | - Antonello Parodi
- Cardiology Division, Padre Antero Micone Hospital, Genova, Italy
| | | | - Guido Pastorini
- Cardiology Division, Regina Montis Regalis Hospital, Mondovì, CN, Italy
| | - Rita Pavasini
- Cardiology Division, St Anna University Hospital, Ferrara, Italy
| | - Daisy Pavoni
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Chiara Pedone
- Cardiology Division, Maggiore Hospital, Bologna, Italy
| | | | | | | | - Valeria Pergola
- Cardiology Division, Padova University Hospital, Padova, Italy
| | | | | | - Chiara Pezzullo
- Cardiology Division, G.B. Grassi Hospital, Lido di Ostia, RM, Italy
| | - Gerardo Piacentini
- Fetal and Neonatal Cardiology Unit - Fatebenefratelli Isola Tiberina Gemelli Isola Hospital, Roma, Italy
| | - Elisa Picardi
- Cardiology Division, Civic Hospital, Chivasso, TO, Italy
| | - Giovanni Pinna
- Neonatology and Neonatal Intensive Care Division, San Camillo-Fornalinini Hospital, Roma, Italy
| | | | - Alfredo Pizzuti
- Cardiology Outpatient Clinic, Koelliker Hospital, Torino, Italy
| | - Matteo Maria Poggi
- Interdisciplinary Internal Medicine Division, Careggi University Hospital, Firenze, Italy
| | - Alfredo Posteraro
- Cardiology Division, St Giovanni Evangelista Hospital, Tivoli, RM, Italy
| | | | - Debora Rampazzo
- Cardiology Division, Madonna della Navicella Hospital, Chioggia, VE, Italy
| | - Carlo Ratti
- Cardiology Division, St Maria Bianca Hospital, Mirandola, MO, Italy
| | - Sara Rettegno
- Cardiology Division, Hospital, Moncalieri, TO, Italy
| | - Fabrizio Ricci
- Cardiology Division, Ss. Annunziata Hospital, Chieti, Italy
| | - Caterina Ricci
- Cardiology Outpatient Clinic, Casa della Salute “Regina Margherita”, Castelfranco Emilia, MO, Italy
| | | | | | - Chiara Rovera
- Cardiology Division, Civic Hospital, Chivasso, TO, Italy
| | | | | | - Nicola Sacchi
- Medical Division, St Agostino Hospital, Castiglione del Lago, PG, Italy
| | | | - Francesca Sani
- Cardiology Division, St Giovanni di Dio Hospital, Firenze, Italy
| | - Chiara Sartori
- Cardiology Division, Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Virginia Scarabeo
- Cardiology Division, Camposampiero Hospital, Camposampiero, PD, Italy
| | - Angela Sciacqua
- Geriatric Division, University Hospital Mater Domini, Catanzaro, Italy
| | - Antonio Scillone
- Intensive Cardiac Rehabilitation Unit, Villa del Sole Clinic, Cosenza, Italy
| | | | - Alfredo Scorza
- Cardiology Division, Riuniti Anzio-Nettuno Hospital, Anzio, RM, Italy
| | | | | | - Walter Serra
- Cardiology Division, University Hospital, Parma, Italy
| | | | | | - Domenico Sirico
- Pediatric Cardiology and Congenital Heart Disease Division, Padova University Hospital, Padova, Italy
| | - Marco Solari
- Cardiology Division, St Giuseppe Hospital, Empoli, FI, Italy
| | | | - Laura Stefani
- Sports Medicine Division, Careggi University Hospital, Firenze, Italy
| | - Antonio Strangio
- Cardiology Division, St Giovanni di Dio Hospital, Crotone, Italy
| | - Francesca Chiara Surace
- Pediatric Cardiac Surgery and Cardiology Division, Marche University Hospital, Ancona, Italy
| | - Gloria Tamborini
- Cardiology Division, Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Nicola Tarquinio
- Internal Medicine Division, IRCCS INRCA Hospital, Osimo AN, Italy
| | | | | | - Bertrand Tchana
- Pediatric Cardiology Division, University Hospital, Parma, Italy
| | | | - Monica Tinto
- Cardiology Division, Mater Salutis Hospital, Legnago, VR, Italy
| | - Daniela Torzillo
- Internal Medicine Division, L. Sacco Hospital, University of Milan, Italy
| | - Antonio Totaro
- Cardiology Division, Gemelli Molise Hospital, Campobasso, Italy
| | | | - Federica Troisi
- Cardiology Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | - Maurizio Tusa
- Cardiology Division, St Donato Polyclinic, San Donato Milanese MI, Italy
| | | | - Vincenzo Varasano
- Internal and Emergency Medicine Division, Civil Hospital, Policoro MT, Italy
| | - Amedeo Venezia
- Geriatric Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | | | - Bruno Villari
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | | | - Jessica Zannoni
- Cardiology Division, St Donato Polyclinic, San Donato Milanese MI, Italy
| | - Concetta Zito
- Cardiology Division, University Hospital Polyclinic G.Martino, University of Messina, Messina, Italy
| | - Antonello Zugaro
- Department of Cardiology, Intensive Care Unit, St Salvatore Hospital, L’Aquila, Italy
| | - Gianluca Di Bella
- Cardiology Division, University Hospital Polyclinic G.Martino, University of Messina, Messina, Italy
| | - Scipione Carerj
- Cardiology Division, University Hospital Polyclinic G.Martino, University of Messina, Messina, Italy
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4
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Nunziata L, Ambrosino S, Carbone L, Ruggiero V, Laezza A, Prisco A, Nardiello V, Miele R, Terracciano F, Falato S, Granata F, Maresca G, Volpicelli M, Muto C, Capasso M, Caliendo L. P120 A STRANGE HEART MURMUR. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.117] [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
An 38–year–old man was referred to our hospital for chest pain. He was a smoker but had no other cardiovascular risk factors and had no history of relevant diseases. On cardiovascular examination, a rough grade IV/V systolic murmur was present at the mesocardium. His electrocardiogram showed sinus tachycardia and complete right branch block. On laboratory tests, cardiac biomarkers were negative. A transthoracic echocardiogram showed left ventricle cavity–sized at the upper limits with preserved systolic function and mild concentric hypertrophy. The aortic root was ectatic with tricuspid valve and mild regurgitation. In addition, there was a great spheric cavity in the region of the right sinus of Valsalva that was communicating with the aortic lumen with turbulent flow inside. The Pulmonary Trunk was dilated and there was a strange turbulent flow within it that extended towards the aortic valve. A chest computed tomography (CT) scan was performed in emergency which ruled out an aortic dissection and revealed the presence of an aneurysm of the right sinus of Valsalva. The following day, a transesophageal echocardiogram was performed which confirmed the aneurysm of the right sinus Valsalva and the presence of systodiastolic flow between it and the right ventricular outflow compatible with a fistula. For this reason, the patient was transferred to the Cardiac Surgery Department of another hospital. He underwent cardiac surgery of resection of aneurysmatic tissue, direct suture of the fistula by the combined transaortic / transpulmonary route and reductive plastic surgery of the pulmonary trunk. Aneurysms of sinus of Valsalva are rare cardiac anomalies, which may be either acquired or congenital. A congenital lack of continuity between the aortic media and annulus fibrosis may initiate aneurysm formation. Acquired aneurysms may result from trauma, endocarditis, syphilis, Behcet, Marfan’s syndrome and senile–type dilatation. In our case, the etiology of the aneurysm is not well understood. It could be a congenital aneurysm that has fissured over time creating a fistula with the right ventricular outflow. This fistula caused a significant left–to–right shunt resulting in haemodynamic changes such as pulmonary trunk dilation. We report this case because the concomitant presence of an aneurysm of the right Valsalva sinus and a fistula between it and the right ventricular outflow represents an extremely rare and poorly described event in the literature.
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Affiliation(s)
- L Nunziata
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - S Ambrosino
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - L Carbone
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - V Ruggiero
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - A Laezza
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - A Prisco
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - V Nardiello
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - R Miele
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - F Terracciano
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - S Falato
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - F Granata
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - G Maresca
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - M Volpicelli
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - C Muto
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - M Capasso
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
| | - L Caliendo
- P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA; P.O. SAN LEONARDO DI CASTELLAMMARE DI STABIA – ASL NAPOLI 3 SUD, NOLA; P.O. SANTA MARIA DELLA PIETA‘ DI NOLA – ASL NAPOLI 3 SUD, NOLA
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Russo V, Silverio A, Scudiero F, Attena E, D'Andrea A, Nunziata L, Parodi G, Celentani D, Varbella F, Albani S, Musumeci G, Di Micco P, Di Maio M. Preadmission Statin Therapy and Clinical Outcome in Hospitalized Patients With COVID-19: An Italian Multicenter Observational Study. J Cardiovasc Pharmacol 2021; 78:e94-e100. [PMID: 34173802 PMCID: PMC8253374 DOI: 10.1097/fjc.0000000000001041] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/29/2021] [Indexed: 12/30/2022]
Abstract
ABSTRACT Statin therapy has been recently suggested as possible adjuvant treatment to improve the clinical outcome in patients with coronavirus disease 2019 (COVID-19). The aim of this study was to describe the prevalence of preadmission statin therapy in hospitalized patients with COVID-19 and to investigate its potential association with acute distress respiratory syndrome (ARDS) at admission and in-hospital mortality. We retrospectively recruited 467 patients with laboratory-confirmed COVID-19 admitted to the emergency department of 10 Italian hospitals. The study population was divided in 2 groups according to the ARDS diagnosis at admission and in-hospital mortality. A multivariable regression analysis was performed to assess the risk of ARDS at admission and death during hospitalization among patients with COVID-19. A competing risk analysis in patients taking or not statins before admission was also performed. ARDS at admission was reported in 122 cases (26.1%). There was no statistically significant difference for clinical characteristics between patients presenting with and without ARDS. One hundred seven patients (18.5%) died during the hospitalization; they showed increased age (69.6 ± 13.1 vs. 66.1 ± 14.9; P = 0.001), coronary artery disease (23.4% vs. 12.8%; P = 0.012), and chronic kidney disease (20.6% vs. 11.1%; P = 0.018) prevalence; moreover, they presented more frequently ARDS at admission (48.6% vs. 19.4%; P < 0.001). At multivariable regression model, statin therapy was not associated neither with ARDS at admission nor with in-hospital mortality. Preadmission statin therapy does not seem to show a protective effect in severe forms of COVID-19 complicated by ARDS at presentation and rapidly evolving toward death.
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Affiliation(s)
- Vincenzo Russo
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”—Monaldi and Cotugno Hospital, Naples, Italy
| | - Angelo Silverio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy;
| | - Fernando Scudiero
- Cardiology Unit, Health Authority Bergamo East, Seriate (Bergamo), Italy;
| | - Emilio Attena
- Division of Cardiology, San Giuliano Hospital, Naples, Italy;
| | - Antonello D'Andrea
- Cardiology and Intensive Care Unit, Umberto I Hospital, Nocera Inferiore, Italy;
| | | | - Guido Parodi
- Clinical and Interventional Cardiology, Sassari University Hospital, Sassary, Italy;
| | | | | | | | | | - Pierpaolo Di Micco
- Medicine Unit, Division of Cardiology, Fatebenefratelli Hospital of Naples, Naples, Italy; and
| | - Marco Di Maio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (Salerno), Italy;
- Division of Cardiology, Maria SS. Addolorata Hospital, Eboli (Salerno), Italy.
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Russo V, Di Maio M, Mottola FF, Pagnano G, Attena E, Verde N, Di Micco P, Silverio A, Scudiero F, Nunziata L, Fele N, D'Andrea A, Parodi G, Albani S, Scacciatella P, Nigro G, Severino S. Clinical characteristics and prognosis of hospitalized COVID-19 patients with incident sustained tachyarrhythmias: A multicenter observational study. Eur J Clin Invest 2020; 50:e13387. [PMID: 32813877 PMCID: PMC7460920 DOI: 10.1111/eci.13387] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/03/2020] [Accepted: 08/17/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Little is still known about the prognostic impact of incident arrhythmias in hospitalized patients with COVID-19. The aim of this study was to evaluate the incidence and predictors of sustained tachyarrhythmias in hospitalized patients with COVID-19, and their potential association with disease severity and in-hospital mortality. MATERIALS AND METHODS This was a retrospective multicenter observation study including consecutive patients with laboratory confirmed COVID-19 admitted to emergency department of ten Italian Hospitals from 15 February to 15 March 2020. The prevalence and the type of incident sustained arrhythmias have been collected. The correlation between the most prevalent arrhythmias and both baseline characteristics and the development of ARDS and in-hospital mortality has been evaluated. RESULTS 414 hospitalized patients with COVID-19 (66.9 ± 15.0 years, 61.1% male) were included in the present study. During a median follow-up of 28 days (IQR: 12-45), the most frequent incident sustained arrhythmia was AF (N: 71; 17.1%), of which 50 (12.1%) were new-onset and 21 (5.1%) were recurrent, followed by VT (N: 14, 3.4%) and supraventricular arrhythmias (N: 5, 1.2%). Incident AF, both new-onset and recurrent, did not affect the risk of severe adverse events including ARDS and death during hospitalization; in contrast, incident VT significantly increased the risk of in-hospital mortality (RR: 2.55; P: .003). CONCLUSIONS AF is the more frequent incident tachyarrhythmia; however, it not seems associated to ARDS development and death. On the other hand, incident VT is a not frequent but independent predictor of in-hospital mortality among hospitalized COVID-19 patients.
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Affiliation(s)
- Vincenzo Russo
- Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli'-Monaldi Hospital, Naples, Italy
| | - Marco Di Maio
- Cardiology Division, "Maria S.S. Addolorata" Hospital, ASL Salerno, Salerno, Italy
| | - Filiberto Fausto Mottola
- Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli'-Monaldi Hospital, Naples, Italy
| | | | - Emilio Attena
- Medicine Unit, Division of Cardiology, San Giuliano Hospital, Naples, Italy
| | - Nicoletta Verde
- Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli'-Monaldi Hospital, Naples, Italy
| | | | - Angelo Silverio
- Cardiology Division, Cardiovascular and Thoracic Department, University Hospital "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy
| | | | | | - Nunzia Fele
- Cardiology Unit, Cotugno Hospital, Naples, Italy
| | - Antonello D'Andrea
- Division of Cardiology and Intensive Care Unit, Umberto I Hospital, Nocera Inferiore, Italy
| | - Guido Parodi
- Clinical and Interventional Cardiology, Sassari University Hospital, Sassary, Italy
| | - Stefano Albani
- Cardiology Department, Aosta Valley Health Authority, Aosta, Italy
| | | | - Gerardo Nigro
- Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli'-Monaldi Hospital, Naples, Italy
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Russo V, Carbone A, Mottola FF, Mocerino R, Verde R, Attena E, Verde N, Di Micco P, Nunziata L, Santelli F, Nigro G, Severino S. Effect of Triple Combination Therapy With Lopinavir-Ritonavir, Azithromycin, and Hydroxychloroquine on QT Interval and Arrhythmic Risk in Hospitalized COVID-19 Patients. Front Pharmacol 2020; 11:582348. [PMID: 33132915 PMCID: PMC7578422 DOI: 10.3389/fphar.2020.582348] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 07/11/2020] [Accepted: 09/11/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction No data are provided about the effect of triple combination therapy with Lopinavir/Ritonavir (LPN/RTN), hydroxychloroquine (HQ) and azithromycin (AZT) on corrected QT (QTc) interval and arrhythmic risk, in COVID-19 patients. This study aims to describe the incidence of extreme QTc interval prolongation among COVID-19 patients on this experimental treatment and to identify the clinical features associated with extreme QTc prolongation. Materials and Methods Data of 87 COVID-19 patients, treated with triple combination including LPN/RTN, HQ and AZT, were analyzed. QT interval was obtained by the tangent method and corrected for heart rate using Bazett’s formula. Extreme QTc interval prolongation was considered an absolute QTc interval ≥ 500 ms or an increase in QTc intervals of 60 ms or greater (ΔQTc ≥ 60 ms) compared with baseline. Results Hypertension (66.7%) and diabetes (25.3%) were the most prevalent cardiovascular comorbidities. Twenty patients (23%) showed extreme QTc interval prolongation; no clinical, electrocardiographic or pharmacological characteristics have been associated to extreme QTc prolongation, except the history of ischemic stroke (P= 0,007). One torsade de pointes (TdP) in patient with QTc extreme prolongation (QTc: 560 ms) after 5 days of therapy was recorded. Conclusions We observed a high incidence of extreme QTc interval prolongation among COVID-19 patients on triple combination therapy. Since the incidence of malignant arrhythmias seems to be not negligible, a careful electrocardiographic monitoring would be advisable.
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Affiliation(s)
- Vincenzo Russo
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli"-Monaldi Hospital, Naples, Italy
| | - Andreina Carbone
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli"-Monaldi Hospital, Naples, Italy
| | - Filiberto Fausto Mottola
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli"-Monaldi Hospital, Naples, Italy
| | | | | | - Emilio Attena
- Italy Medicine Unit, Division of Cardiology, San Giuliano Hospital, Naples, Naples, Italy
| | - Nicoletta Verde
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli"-Monaldi Hospital, Naples, Italy
| | - Pierpaolo Di Micco
- Department of Cardiology, Fatebenefratelli Hospital of Naples, Naples, Italy
| | | | - Francesco Santelli
- Department of Political Sciences, University of Naples Federico II, Naples, Italy
| | - Gerardo Nigro
- Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli"-Monaldi Hospital, Naples, Italy
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Abstract
Aims and background Pancreatic resections for neoplastic diseases have a high risk of severe intra- and postoperative complications and are associated with high mortality rates. They should be performed as a rule in centers specializing in this type of surgery. However, it is becoming increasingly likely that such tumors may have to be treated in surgery units which are not specifically dedicated to pancreatic surgery. The aim of this study was to assess the improvements in clinical results in a non-specialized general surgery setting in the light of the most recent progress in surgical techniques, drug treatments and nutritional support. Methods and study design We analyzed 48 patients with pancreatic cancer treated in our institution over the period from 1980 to 1998: 36 had cancer of the head of the pancreas, 5 of the ampulla, 1 in the second duodenal portion, and 6 of the body-tail. The operations performed consisted of 13 Whipple pancreaticoduodenectomies with cutting and stapling of the distal pancreatic stump at the level of the isthmus, 4 left pancreasectomies, 2 local resections of the ampulla, 21 palliative operations, and 2 exploratory laparotomies. Results and conclusions The patients were submitted to follow-up including clinical examinations, blood-chemistry tests, and instrumental investigations. The mean survival was 18 months in the cases where radical surgery was performed, compared to 11 months after palliative surgery. We conclude that an improved prognosis can obtain after pancreatic resection. This is attributable to a more accurate preoperative staging and to the aid of the various forms of nutritional support and pharmacological prophylaxis currently available.
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Affiliation(s)
- Fulvio Freda
- Second University of Naples, School of Medicine, Department of Anesthesiology, Surgical Sciences and Emergency, Italy
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Freda F, Procaccini E, Ruggiero R, Antropoli M, Manganiello A, Nunziata L, Petronella P, Lo Schiavo F. Solid-Cystic Pseudopapillary Tumor of Pancreas: Description of two Cases and Literature Review. Tumori 2018; 93:522-5. [DOI: 10.1177/030089160709300523] [Citation(s) in RCA: 2] [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 authors report the cases of two young female patients aged 17 and 27 years who underwent surgery for a rare tumor of the pancreas, Frantz's tumor or solid-cystic pseudopapillary tumor. Solid-cystic pseudopapillary tumor of the pancreas is a rare tumor, accounting for 2.7% of pancreatic exocrine tumors. About 90% of these tumors occur in young women and they can reach very large dimensions. Due to their rareness and behavior, they are often associated with diagnostic and therapeutic problems. In most cases surgical treatment is curative and neither chemotherapy nor radiotherapy should be added. In the few cases where surgery is not possible, radiotherapy can be used because these tumors appear to be radiosensitive.
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Affiliation(s)
- Fulvio Freda
- Department of Gerontology, Geriatry and Metabolic Diseases, Department of General and Oncological Specialistic Surgery, Second University of Naples, School of Medicine, Naples, Italy
| | - Eugenio Procaccini
- Department of Gerontology, Geriatry and Metabolic Diseases, Department of General and Oncological Specialistic Surgery, Second University of Naples, School of Medicine, Naples, Italy
| | - Roberto Ruggiero
- Department of Gerontology, Geriatry and Metabolic Diseases, Department of General and Oncological Specialistic Surgery, Second University of Naples, School of Medicine, Naples, Italy
| | - Massimo Antropoli
- Department of Gerontology, Geriatry and Metabolic Diseases, Department of General and Oncological Specialistic Surgery, Second University of Naples, School of Medicine, Naples, Italy
| | - Amelia Manganiello
- Department of Gerontology, Geriatry and Metabolic Diseases, Department of General and Oncological Specialistic Surgery, Second University of Naples, School of Medicine, Naples, Italy
| | - Luigi Nunziata
- Department of Gerontology, Geriatry and Metabolic Diseases, Department of General and Oncological Specialistic Surgery, Second University of Naples, School of Medicine, Naples, Italy
| | - Pasquale Petronella
- Department of Gerontology, Geriatry and Metabolic Diseases, Department of General and Oncological Specialistic Surgery, Second University of Naples, School of Medicine, Naples, Italy
| | - Francesco Lo Schiavo
- Department of Gerontology, Geriatry and Metabolic Diseases, Department of General and Oncological Specialistic Surgery, Second University of Naples, School of Medicine, Naples, Italy
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D'Andrea A, Naeije R, Grünig E, Caso P, D'Alto M, Di Palma E, Nunziata L, Riegler L, Scarafile R, Cocchia R, Vriz O, Citro R, Calabrò R, Russo MG, Bossone E. Echocardiography of the Pulmonary Circulation and Right Ventricular Function. Chest 2014; 145:1071-1078. [DOI: 10.1378/chest.12-3079] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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D’Andrea A, Riegler L, Nunziata L, Scarafile R, Gravino R, Salerno G, Amarelli C, Maiello C, Limongelli G, Di Salvo G, Caso P, Bossone E, Calabrò R, Pacileo G, Russo MG. Right heart morphology and function in heart transplantation recipients. J Cardiovasc Med (Hagerstown) 2013; 14:648-58. [DOI: 10.2459/jcm.0b013e32835ec634] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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D’Andrea A, Gravino R, Salerno G, Padalino R, Riegler L, Scarafile R, Pezzullo E, Nunziata L, Romano M, Limongelli G, Bossone E, Pacileo G, Caso P, Russo MG, Calabrò R. La stretta correlazione tra la funzione ventricolare destra valutata all’ecografia tridimensionale e la capacità funzionale nei pazienti con cardiomiopatia dilatativa. J Cardiovasc Echogr 2011. [DOI: 10.1016/j.jcecho.2011.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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13
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D'Andrea A, Riegler L, Golia E, Cocchia R, Scarafile R, Salerno G, Pezzullo E, Nunziata L, Citro R, Cuomo S, Caso P, Di Salvo G, Cittadini A, Russo MG, Calabrò R, Bossone E. Range of right heart measurements in top-level athletes: the training impact. Int J Cardiol 2011; 164:48-57. [PMID: 21737163 DOI: 10.1016/j.ijcard.2011.06.058] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [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: 03/22/2011] [Revised: 06/06/2011] [Accepted: 06/09/2011] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To explore the full range of right heart dimensions and the impact of long-term intensive training in athletes. BACKGROUND Although echocardiography has been widely used to distinguish the athlete's heart from pathologic left ventricular (LV) hypertrophy, only few reports have described right ventricular (RV) and right atrial (RA) adaptations to extensive physical exercise. METHODS 650 top-level athletes [395 endurance- (ATE) and 255 strength-trained (ATS); 410 males (63.1%); mean age 28.4 ± 10.1; 18-40 years] and 230 healthy age- and sex-comparable controls underwent a transthoracic echocardiographic exam. Along with left heart parameters, right heart measurements included: RV end-diastolic diameters at the basal and mid-cavity level; RV base-to-apex length; RV proximal and distal outflow tract diameters; RA long and short diameters; and RA area. Tricuspid annular plane systolic excursion and RV tissue Doppler systolic peak velocity were assessed as indexes of RV systolic function. Pulmonary artery systolic pressure (PASP) was estimated from the peak tricuspid regurgitant velocity. RESULTS ATS showed increased sum of wall thickness and relative wall thickness, whereas left atrial volume, LV end-diastolic volume, LV stroke volume and PASP were significantly higher in ATE. RV and RA measurements were all significantly greater in ATE than in ATS and controls. ATE also showed improved early diastolic RV function, whereas RV systolic indexes were comparable among groups. On multivariate analysis, type and duration of training (p<0.01), PASP (p<0.01) and LV stroke volume (p<0.001) were the only independent predictors of the main RV and RA dimensions in athletes. CONCLUSIONS This study delineates the upper limits of RV and RA dimensions in highly-trained athletes. Right heart measurements were all significantly greater in elite endurance-trained athletes than in age- and sex-matched strength athletes and controls. This should be considered as a "physiologic phenomenon" when evaluating athletes for sports eligibility.
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Comenale Pinto S, Ancona R, Caso P, Severino S, Nunziata L, Roselli T, Calabro R, Stoylen A, Aase S, Bjastad T, Langeland S, Rabben SI, Heimdal A, Gerard O, Ejlersen JA, May O, Ting P, Choy J, Sonnenberg B, Becher H, Asplund E, Gustafsson U, Ronn F, Jensen S, Karp K, Waldenstrom A, Jaussaud J, Barandon L, Reant P, Calderon J, Duplaa C, Leroux L, Dos Santos P, Roudaut R, Couffinhal T, Lafitte S, Dhutia NM, Cole G, Willson K, Pabari P, Rueckert D, Parker KH, Hughes AD, Francis DP, Seo JS, Kim DH, Jung YJ, Kang JH, Seo DJ, Song JM, Kang DH, Song JK, Cameli M, Lisi M, Padeletti M, Bernazzali S, Tsoulpas C, Maccherini M, Ballo P, Mondillo S. Moderated Posters session III: Novel techniques of analysis * Friday 10 December 2010, 10:00-11:00. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Markovic J, Hjelmgren O, Bech-Hanssen O, Corazzini A, Faricelli S, Carrideo M, Gravina M, Barnabei L, Ippedico R, Tonti G, Gallina S, Di Giammarco G, De Caterina R, Ancona R, Comenale Pinto S, Caso P, Severino S, Cavallaro C, Vecchione F, D'onofrio A, Nunziata L, Roselli T, Calabro R, Bezgin T, Can MM, Tanboga H, Tokgoz HC, Sonmez K, Saglam M, Kaymaz C, Cho JS, Yoon HJ, Cho EJ, Park CS, Jung HO, Jeon HK. Oral session IV: Novel techniques in evolution of right ventricular function * Thursday 9 December 2010, 16:30-18:00. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Kuznetsov VA, Kozhurina AO, Plusnin AV, Szulik M, Sredniawa B, Streb W, Lenarczyk R, Stabryla-Deska J, Sedkowska A, Kowalski O, Kalarus Z, Kukulski T, Katova TM, Nesheva A, Simova I, Hristova K, Kostova V, Boiadjiev L, Dimitrov N, Papamichalis Michalis MP, Sitafidis George SG, Dimopoulos Basilios BD, Kelepesis Glafkos GK, Economou Dimitrios DE, Skoularigis John JS, Triposkiadis Filippos FT, Attenhofer Jost CH, Pfyffer M, Naegeli B, Levis P, Faeh-Gunz A, Brunner-Larocca HP, Velasco Del Castillo MS, Cacicedo A, Onaindia JJ, Gonzalez Ruiz J, Subinas A, Alarcon JA, Quintana O, Rodriguez I, Laraudogoitia E, Lam YY, Henein MY, Mazzone A, Vianello A, Perlini S, Corciu AI, Cappelli S, Cerillo A, Chiappino D, Berti S, Glauber M, Herrmann S, Niemann M, Stoerk S, Strotmann J, Voelker W, Ertl G, Weidemann F, Yong ZY, Boerlage - Van Dijk K, Koch KT, Vis MM, Bouma BJ, Henriques JPS, Cocchieri R, De Mol BAJM, Piek JJ, Baan J, Keenan NGJ, Cueff C, Cimadevilla C, Brochet E, Lepage L, Detaint D, Iung B, Vahanian A, Messika-Zeitoun D, Otsuka T, Suzuki M, Yoshikawa H, Hashimoto G, Osaki T, Tsuchida T, Matsuyama M, Yamashita H, Ozaki S, Sugi K, Garcia Alonso CJ, Vallejo Camazon N, Ferrer Sistach E, Camara ML, Lopez Ayerbe J, Bosch Carabante C, Espriu Simon M, Gual Capllonch F, Bayes Genis A, Deswarte G, Vanesson C, Polge AS, Huchette D, Modine T, Marboeuf P, Lamblin N, Bauters C, Deklunder G, Le Tourneau T, Agricola A, Gullace M, Stella S, D'amato R, Slavich M, Oppizzi M, Ancona M, Margonato A, Le Ven F, Etienne Y, Jobic Y, Frachon I, Castellant P, Fatemi M, Blanc JJ, Muratori M, Montorsi P, Maffessanti F, Gripari P, Teruzzi G, Ghulam Ali S, Fusini L, Celeste F, Pepi M, Goebel B, Haugaa K, Meyer K, Otto S, Lauten A, Jung C, Edvardsen T, Figulla HR, Poerner TC, Aksoy H, Okutucu S, Evranos B, Aytemir K, Kaya EB, Kabakci G, Tokgozoglu L, Ozkutlu H, Oto A, Valeur N, Pedersen HH, Videbaek R, Hassager C, Svendsen JH, Kober L, Tigen MK, Karaahmet T, Gurel E, Pala S, Dundar C, Basaran Y, Caldararu CI, Ene E, Dorobantu M, Vatasescu RG, Tigen MK, Karaahmet T, Gurel E, Dundar C, Basaran Y, Tigen MK, Karaahmet T, Gurel E, Dundar C, Pala S, Basaran Y, Tigen MK, Pala S, Karaahmet T, Dundar C, Gurel E, Basaran Y, Cikes M, Bijnens B, Gasparovic H, Siric F, Velagic V, Lovric D, Samardzic J, Ferek-Petric B, Milicic D, Biocina B, Kjaergaard J, Ghio S, St John Sutton M, Hassager C, Moreau O, Kervio G, Thebault C, Leclercq C, Donal E, Mornos C, Rusinaru D, Petrescu L, Cozma D, Ionac A, Pescariu S, Dragulescu SI, Petrovic MZ, Vujisic-Tesic B, Milasinovic G, Petrovic MT, Nedeljkovic I, Zamaklar-Trifunovic D, Calovic Z, Jelic V, Boricic M, Petrovic I, Kuchynka P, Palecek T, Simek S, Nemecek E, Horak J, Hulinska D, Schramlova J, Vitkova I, Aster V, Linhart A, Paluszkiewicz L, Guersoy D, Ozegowski S, Spiliopoulos S, Koerfer R, Tenderich G, Gaggl M, Heinze G, Sunder-Plassmann G, Graf S, Zehetmayer M, Voigtlaender T, Mannhalter C, Paschke E, Fauler G, Mundigler G, Tesic M, Trifunovic D, Djordjevic-Dikic A, Petrovic O, Nedeljkovic I, Petrovic M, Boricic M, Beleslin B, Vujisic-Tesic B, Ostojic M, Trifunovic D, Tesic M, Vujisic-Tesic B, Petrovic O, Petrovic M, Nedeljkovic I, Boricic M, Draganic G, Ostojic M, Correia CE, Rodrigues B, Santos LF, Moreira D, Gama P, Nunes L, Nascimento C, Dionisio O, Santos O, Prinz C, Oldenburg O, Bitter T, Piper C, Horstkotte D, Faber L, Nemes A, Gavaller H, Csanady M, Forster T, Calcagnino M, O'mahony C, Tsovolas K, Lambiase PD, Elliott P, Olezac AS, Bensaid A, Nahum J, Teiger E, Dubois-Rande JL, Gueret P, Lim P, Prinz C, Langer C, Oldenburg O, Horstkotte D, Faber L, Kansal M, Surapaneni P, Sengupta PP, Lester SJ, Ommen SR, Ressler SW, Hurst RT, Monivas Palomero V, Mingo Santos S, Mitroi C, Garcia Lunar I, Garcia Pavia P, Gonzalez Mirelis J, Ruiz Bautista L, Castro Urda V, Toquero Ramos J, Fernandez Lozano I, Sommer A, Poulsen SH, Mogensen J, Thuesen L, Egeblad H, Montisci R, Ruscazio M, Vacca A, Garau P, Tuveri F, Soro C, Matthieu A, Meloni L, Kosmala W, Przewlocka-Kosmala M, Wojnalowicz A, Mysiak A, Marwick TH, Yotti R, Ripoll C, Bermejo J, Benito Y, Mombiela T, Rincon D, Barrio A, Banares R, Fernandez-Aviles F, Tomaszewski A, Kutarski A, Tomaszewski M, Ticulescu R, Vriz O, Sparacino L, Popescu BA, Ginghina C, Nicolosi GL, Carerj S, Antonini-Canterin F, Agricola E, Slavich M, Stella S, Ancona M, Oppizzi M, Bertoglio L, Melissano G, Margonato A, Chiesa R, Garcia Blas S, Iglesias Del Valle D, Lopez Fernandez T, Gomez De Diego JJ, Monedero Martin MC, Dominguez FJ, Moreno Yanguela M, Lopez Sendon JL, Adhya S, Murgatroyd FD, Monaghan M, Spinarova L, Meluzin J, Hude P, Krejci J, Podrouzkova H, Pesl M, Panovsky R, Dusek L, Orban M, Korinek J, Hammerstingl C, Schwiekendik M, Nickenig G, Momcilovic D, Lickfett L, Beladan CC, Calin A, Rosca M, Popescu BA, Muraru D, Voinea F, Popa E, Matei F, Curea F, Ginghina C, Di Salvo G, Pacileo G, Gala S, Castaldi B, D'aiello AF, Mormile A, Baldini L, Russo MG, Calabro R, Halvorsen PS, Dahle G, Bugge JF, Bendz B, Aaberge L, Rein KA, Fiane A, Bergsland J, Fosse E, Aakhus S, Koopman LP, Chahal N, Slorach C, Hui W, Sarkola T, Manlhiot C, Bradley TJ, Jaeggi ET, Mccrindle BW, Mertens L, Di Salvo G, Pacileo G, Castaldi B, Gala S, Baldini L, D'aiello FA, Mormilw A, Rea A, Russo MG, Calabro R, Calin A, Rosca M, O'Connor K, Romano G, Magne J, Beladan CC, Ginghina C, Pierard L, Lancellotti P, Popescu BA, Arita T, Ando K, Isotani A, Soga Y, Iwabuchi M, Nobuyoshi M, Hammerstingl C, Momcilovic D, Wiesen M, Nickenig G, Skowasch D, Mornos C, Cozma D, Rusinaru D, Ionac A, Pescariu S, Dragulescu SI, Niemann M, Breunig F, Beer M, Herrmann S, Strotmann J, Hu K, Voelker W, Ertl G, Wanner C, Weidemann F, Morel MA, Bernard YF, Descotes-Genon V, Meneveau N, Schiele F, Vitarelli A, Bernardi M, Scarno A, Caranci F, Padella V, Dettori O, Capotosto L, Vitarelli M, De Cicco V, Bruno P, Bajraktari G, Lindqvist P, Gustafsson U, Holmgren A, Henein MY, Hassan M, Said K, Baligh E, Farouk H, Osama D, Elmahdy MF, Elfaramawy A, Sorour K, Luckie M, Zaidi A, Fitzpatrick A, Khattar RS, Schwartz J, Huttin O, Popovic B, Zinzius PY, Christophe C, Marcon O, Groben L, Juilliere Y, Chabot F, Selton-Suty C, Krastev B, Kinova ETK, Zlatareva NIZ, Goudev ARG, Teske AJ, De Boeck BW, Mohames Hoesein FA, Van Driel V, Loh P, Cramer MJ, Doevendans PA, Dillenburg F, Mertens L, Abd El Salam KM, Ho EMM, Hall M, Hemeryck L, Bennett K, Scott K, King G, Murphy RT, Mahmud A, Brown AS, Dalen H, Thorstensen A, Romundstad PR, Aase SA, Stoylen A, Vatten L, Bochenek T, Wita K, Tabor Z, Doruchowska A, Lelek M, Trusz-Gluza M, Hamodraka E, Paraskevaidis I, Karamanou A, Michalakeas C, Vrettou H, Kapsali E, Tsiapras D, Lekakis I, Anastasiou-Nana M, Kremastinos D, Sirugo L, Bottari VE, Licciardi S, Blundo A, Atanasio A, Monte IP, Park CS, Kim JH, Cho JS, Kim MJ, Cho EJ, Ihm SH, Jung HO, Jeon HK, Youn HJ, Kim KS, Fontana A, Taravella L, Zambon A, Trocino G, Giannattasio C, Kalinin A, Alekhin M, Bahs G, Lejnieks A, Kalvelis A, Kalnins A, Shipachovs P, Zakharova E, Blumentale G, Trukshina M, Biering-Sorensen T, Mogelvang R, Haahr-Pedersen S, Schnohr P, Sogaard P, Skov Jensen J, Gargani L, Agoston G, Capati E, Badano L, Moreo A, Costantino MF, Caputo ML, Mondillo S, Sicari R, Picano E, Malev EG, Timofeev EV, Reeva SV, Zemtsovsky EV, Piazza R, Enache R, Roman-Pognuz A, Muraru D, Popescu BA, Leiballi E, Pecoraro R, Antonini-Canterin F, Ginghina C, Nicolosi GL, Sadeghian H, Lotfi_Tokaldany M, Rezvanfard M, Kasemisaeid A, Majidi S, Montazeri M, Saber-Ayad M, Nassar YS, Farhan A, Moussa A, El-Sherif A, Cooper RM, Somauroo JD, Shave RE, Williams KL, Forster J, George C, Bett T, Gaze DC, George KP, Mansencal N, Dupland A, Caille V, Perrot S, Bouferrache K, Vieillard-Baron A, Jouffroy R, Cioroiu SG, Alexe OS, Bobescu E, Rus H, Schiano Lomoriello V, Esposito R, Santoro A, Raia R, Farina F, Ippolito R, Galderisi M, Aburawi EH, Malcus P, Thuring A, Maxedius A, Pesonen E, Nair SV, Joyce E, Lee L, Shrimpton J, Newman E, James PR, Jurcut C, Caraiola S, Jurcut RO, Giusca S, Nitescu D, Amzulescu MS, Copaci I, Popescu BA, Tanasescu C, Ginghina C, Silva Marques J, Silva D, Ferreira F, Ferreira PC, Almeida AG, Martim Martins J, Lopes MG, Bergenzaun L, Chew M, Ersson A, Gudmundsson P, Ohlin H, Borowiec A, Dabrowski R, Wozniak J, Jasek S, Chwyczko T, Kowalik I, Musiej-Nowakowska E, Szwed H, Wen YL, Tian J, Yan L, Cheng H, Yang H, Luo B, Wang J, Kozman H, Villarreal D, Liu K, Karavidas A, Tsiachris D, Lazaros G, Matzaraki V, Xylomenos G, Levendopoulos G, Arapi S, Perpinia A, Matsakas E, Pyrgakis V, Liu YW, Su CT, Tsai WC, Huang JW, Hung KY, Chen JH, Larsson M, Kremer F, Kouznetsova T, Bjallmark A, Lind B, Brodin LA, D'hooge J, Santoro A, Caputo M, Antonelli G, Lisi M, Giacomin E, Mondillo S, Moustafa S, Alharthi M, Kansal M, Deng Y, Chandrasekaran K, Mookadam F, Hayashi SY, Bjallmark A, Larsson M, Nascimento MM, Lindholm B, Lind B, Seeberger A, Nowak J, Riella MC, Brodin LA, Theodosis A, Fousteris E, Tsiaousis G, Krommydas A, Margetis P, Katidis Z, Beldekos D, Argirakis S, Melidonis A, Foussas S, Khaleva O, Onyshchenko O, Lukaschuk E, Sherwi N, Nikitin N, Cleland JGF, Risum N, Jons C, Olsen NT, Valeur N, Kronborg MB, Jensen MT, Fritz-Hansen T, Bruun NE, Hojgaard MV, Sogaard P, Petrini J, Yousry M, Rickenlund A, Liska J, Franco-Cereceda A, Hamsten A, Eriksson P, Caidahl K, Eriksson MJ, Elmstedt N, Lind B, Ferm-Widlund K, Westgren M, Brodin LA, Szymczyk E, Kasprzak JD, Wozniakowski B, Rotkiewicz A, Szymczyk K, Stefanczyk L, Michalski B, Lipiec P, Ring L, Eller T, Deegan P, Rusk R, Urbano Moral JA, Arias JA, Kuvin JT, Patel AR, Pandian NG, Bellsham-Revell H, Bell AJ, Miller O, Greil GF, Simpson J, Moustafa S, Kansal M, Alharthi M, Deng Y, Chandrasekaran K, Mookadam F, Ancona R, Comenale Pinto S, Caso P, Severino S, Nunziata L, Roselli T, Calabro R, Dussault C, Donal E, Lafitte S, Habib G, Reant P, Derumeaux G, Thibault H, Gueret P, Lim P, Kaladaridis A, Agrios IA, Pamboucas CP, Mesogitis SM, Vasiladiotis NV, Bramos DB, Toumanidis STT, Martiniello AR, Santangelo G, Caso P, Pedrizzetti G, Tonti G, Cioppa C, Cavallaro M, Calvi V, Chianese R, Calabro R. Poster session I * Thursday 9 December 2010, 08:30-12:30. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Petronella P, Scorzelli M, Manganiello A, Nunziata L, Ferretti M, Campitiello F, Santoriello A, Freda F, Canonico S. Our experience of total mesorectal excision for rectal cancers. Hepatogastroenterology 2010; 57:482-486. [PMID: 20698213] [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: 05/29/2023]
Abstract
BACKGROUND/AIMS The total mesorectal excision (TME) for rectal tumours was introduced in 1982 by Heald et al. and has led both to a 5% de crease of local recurrences 5 and 10 years after the operation when compared with cases treated with conventional surgery, and to an increase of survival up to five years estimated in 80% of all cases. In Italy TME was firstly introduced for distal rectal carcinomas about 20 years ago, and has shown the same rate of local recurrences reported by Heald. The aim of our work is to highlight TME advantages and demonstrate how this more demanding and longer lasting method has an acceptable risk for the surgery of rectal tumours. METHODOLOGY We have compared two groups of patients operated for rectal carcinoma; the first, "historical control group" (no TME, including 46 patients) was treated with the standard surgery technique, while the second group (TME, 47 patients) underwent the total mesorectal excision technique. 14 of non TME patients belonged to Dukes stage A, 20 to stage B and 12 to C; whereas in the TME group 16 patients belonged to Dukes stage A, 23 to B and 8 to C. The patients of both groups undergone the exams of follow up (blood test, hepatic ultrasonography, abdominal CT, thorax Ro); the follow up pattern included periodic controls with a check-up every three and six months, from one to five years. RESULTS Postoperative complications in both groups do not show important differences in rates, although, the first group (no TME) had 11 cases with postoperative complications confronted with the 8 cases of the second group (TME). The complications taken into consideration were: anastomotic bleeding (3 patients no TME, 6% vs 1 patients TME, 2%), intestinal obstruction (1 patient no TME, 2% vs 1 patient TME, 2%), parietal infection (4 patients no TME, 9% vs 3 patients TME, 6%), anastomotic fistulae (2 patients no TME, 4% vs 2 patients TME, 4%), retention of urine and vesicular disorder (1 patient no TME, 2% vs 1 patient TME, 2%). Tumours closer to the anus have shown more complications compared with tumours at higher levels. As a matter of fact, 9 cases of no TME and TME patients with low located tumours have undergone complications compared with the 3 cases of no TME and TME patients with tumours being more distant from the anus; the rest 7 cases belonged to the middle rectum. A higher rate of local recurrences was noticed in the no TME group: 6 (13%) compared with the TME group: 3 (6%). Other tardy complications taken into consideration were: hepatic metastasis (5 patients no TME, 11% vs 4 patients TME, 8%), pulmonary metastasis (3, 6% of the no TME vs 2, 4% of the TME), anastomotic stenosis (4, 9% of the no TME vs 2, 4% of the TME), impotence (2, 4% of the no TME vs 1, 2% of the TME). We also noticed that most of the tardy complications in the TME group belonged to Dukes stage C. CONCLUSION From our experience, we concluded that, in TME patients, complications are lower than in no TME patients; the site of the tumour affects the appearance of complications which are more frequently in distal localizations. An important result is the minor incidence of local recurrences after TME, which brings us to the conclusion that TME can be considered a valid method with an acceptable risk for the surgery of rectal tumour.
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Affiliation(s)
- Pasquale Petronella
- Second University of the Study of Naples, School of Medicine, Department of Gerontology, Geriatry and Metabolic Diseases, U.O. of Geriatric Surgery, Piazza Miraglia, 5, 80138 Naples, Italy.
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Freda F, Fabbrocile G, Antropoli M, Manganiello A, Nunziata L, Petronella P. [Sentinel node in the surgical treatment of the breast cancer. Technique and clinical experience]. MINERVA CHIR 2005; 60:235-41. [PMID: 16166922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
AIM It is very important to confirm the reliability of the sentinel node (SN) technique in breast cancer surgery, since it can avoid useless traumas, wide mutilations, prolongation of the operation. The aim of the study is to give a contribution to evaluate the real value of SN as regards axillary lymph nodes, in breast cancer, in order to limit axillary lymphadenectomy (AL). METHODS The search of LS was made in 42 patients (using Patent Blue alone in 5 cases, with radioisotope in 25 cases and with both techniques in 12 cases); their mean age was 62 years and they were suffering from not multicentric infiltrating carcinoma of the breast, with a diameter less than the 2.5 cm and no evidence of axillary gland at clinical examination. All the patients underwent histologic examination of SN and AL was carried out, whatever was the histologic result of SN. RESULTS Lymphoscintigraphy identified the SN in 96% of the cases (1 case with no identification in a patient with a previous excisional biopsy), with the Patent Blue in 80% of the cases and with the combined technique in 100% of the cases. The average number of SN obtained was 3 and the number of removed lymph nodes in AL was 25. The metastasization of SN was verified in 10 cases, in 3 of them the SN turned out to be the only one interested by metastasis. In 1 case the intraoperative examination was negative and the postoperative one was positive. The percentage of false-negative was 5% (1 case with lymphoscintigraphy and 1 case with Patent Blue). These findings show that in about 70% of the patients AL could be avoided since axillary lymph nodes were without metastases. The predictive role of SN, particularly with lymphoscintigraphy, proved to be reliable with a very reduced number of false-negative. CONCLUSIONS In our opinion, the SN technique can be considered reliable but it could be used in routine practice when all false-positive can be avoided, since even if not very numerous they represent the principal obstacle to its application.
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Affiliation(s)
- F Freda
- Dipartimento di Scienze Anestesiologiche, Chirurgiche e dell'Emergenza, Seconda Università degli Studi di Napoli, Naples
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Petronella P, Freda F, Nunziata L, Manganiello A, Antropoli M. Spigelian hernia: a rare lateral ventral hernia. Chir Ital 2004; 56:727-30. [PMID: 15553447] [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: 05/01/2023]
Abstract
The authors take a treated clinical case as a starting point to consider lateral ventral hernia, generally referred to as "Spigelian hernia". Such hernias are rare (1-2% of all hernias), with a slightly higher incidence in the female sex. Obesity and multiparous status are known to be predisposing factors. Instrumental tests of great importance in terms of specificity and definition such as ultrasonography and computed tomography are available, in cases of diagnostic doubt, for a pathology that in any case has to be detected early in order to avoid possible complications. The treatment is essentially surgical. A personal variant of the surgical repair technique is described with the use of prosthetic material, which guarantees a better result in terms of strength and resistance compared to simple repair surgery.
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Affiliation(s)
- Pasquale Petronella
- Seconda Università degli Studi di Napoli, Facoltà di Medicina e Chirurgia, V Divisione di Chirurgia Generale e Tecniche Speciali
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Petronella P, Freda F, Nunziata L, Antropoli M, Manganiello A, Cutolo PP, D'Amodio AS. Prostaglandin E1 versus lumbar sympathectomy in the treatment of peripheral arterial occlusive disease: randomised study of 86 patients. Nutr Metab Cardiovasc Dis 2004; 14:186-192. [PMID: 15553595 DOI: 10.1016/s0939-4753(04)80003-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM The aim of this study was to compare the effects of a pharmacological and a surgical vasodilatatory therapy in the treatment of chronic arterial diseases of the lower limbs. METHODS AND RESULTS After giving their informed consent, 40 patients were randomised to receive a slow (approximately 2-hour) infusion of 40 microg of prostaglandin E1 twice daily for 28 days (group A), and 46 were randomised to undergo lumbar sympathectomy, including the second and third ganglion. Twenty-four (60%) of the patients in group A experienced complete remission, seven (17.5%) were partial responders, and nine (22.5%) failed to respond. Of the 46 patients in group B, 29 (63%) experienced complete remission, seven (15.2%) were partial responders, and 10 (21.7%) failed to respond. CONCLUSIONS Broadly similar results were obtained with the two types of treatment, both of which are indicated mainly in Fontaine stages IIB and III (non-advanced), particularly when revascularising therapy is impossible or excessively risky. The two strategies can be advantageously combined with direct revascularisation surgery and may therefore constitute a first-line approach favouring subsequent therapy.
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Affiliation(s)
- P Petronella
- Department of Anesthesiology, Surgical Sciences and Emergencies, School of Medicine, Second University of Naples, Naples, Italy.
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Antropoli M, Freda F, Apicella A, Nunziata L, Cutolo PP, Antropoli C, Petronella P. [Peritoneal multicystic mesothelioma: unusual case of localization in the left lobe of the liver]. Chir Ital 2002; 54:897-902. [PMID: 12613343] [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: 03/01/2023]
Abstract
Peritoneal multicystic mesothelioma is a very rare clinical condition. This neoplastic variant has a high incidence of recurrence after surgical resection. It usually occurs in middle-aged women with a previous history of gynaecological surgery and presents with the symptoms of an abdominal or pelvic mass. The case reported here is that of a 58-year-old woman, characterised first by a left liver-lobe tumour and then by a subsequent episode of emission of cystic matter from an abdominal fistula. The relevant literature is reviewed and the clinical aspects and treatment of this disease are discussed.
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Affiliation(s)
- Massimo Antropoli
- V Divisione di Chirurgia Generale e Tecniche Chirurgiche Speciali, Seconda Università degli Studi di Napoli
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Abstract
BACKGROUND Cancer is one of the most common acquired causes of venous thromboembolism. AIM To evaluate haemostasis disorders in patients with non-metastatic gastric cancer. PATIENTS AND METHODS We studied 11 patients with non-metastatic gastric cancer (9 males and 2 females, median age 54 years) and 20 healthy subjects (15 males and 5 females, median age 48 years) control. We measured prothrombin time, activated partial thromboplastin time, coagulation time, clot lysis time, fibrinogen, clotting factors (II, VII, VIII, IX, X), C protein, S protein, AT III, activated protein C resistance, prothrombin 1+2 fragment, tissue plasminogen activator and D-Dimer in all subjects. RESULTS Fibrinogen plasma levels were significantly higher in patients with non-metastatic gastric cancer than in control group (505+/-24 mg/dl vs 336+/-30 mg/dl, p<0.001). We also found a significant increase in prothrombin 1+2 fragment plasma concentration compared with controls (3.8+/-0.6 nM vs 0.83+/-0.09 nM, p<0.001). Plasma D-dimer levels were 20-fold higher in patients with non-metastatic gastric cancer compared with controls (9.57+/-0.4 ng/dl vs 0.4+/-0.05 ng/dl, p<0.001). Also tissue plasminogen activator was significantly higher in gastric cancer patients than in controls (20.8+/-2.32 ng/ml vs 9.1+/-1.37 ng/ml, p<0.01). Finally clot lysis time was significantly accelerated in gastric cancer patients compared with control subjects (81+/-37 min vs 233+/-74 min, p<0.01). CONCLUSIONS Patients with non-metastatic gastric cancer are at risk for thrombotic events due to the combined increase in fibrinogen plasma levels and thrombin formation.
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Affiliation(s)
- P Di Micco
- Division of General Medicine and Hepatology, Second University of Naples, Italy.
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Magli A, De Marco R, Di Maio S, Nunziata L, Villani S, Calace PL. A case of Parinaud's syndrome in a boy with delayed puberty. Ophthalmologica 1991; 202:132-7. [PMID: 1923305 DOI: 10.1159/000310190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The authors describe a case of Parinaud's syndrome in a 14-year-old boy with delayed puberty. The neurological examination and the neuroradiological work-up excluded the presence of cerebral pathological processes except for a pituitary microadenoma. As the sole presence of the microadenoma cannot justify gonadotropin deficiency, the authors in this case favor a form of isolated gonadotropin deficiency, and they suggest that the elevation paralysis can be put in the range of median line defects, such as labiopalatoschisis and hypoplasia of the olfactory bulbs, frequently associated with isolated hypogonadotropic hypogonadism.
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Affiliation(s)
- A Magli
- Department of Ophthalmology, University of Naples, Italy
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Fiorillo A, Farina V, DiMaio S, Ciriaco M, Nunziata L, Scippa L, D'Agostino N. Myocardial dysfunction in two hypothyroid twins with thalassaemia major. Acta Paediatr Scand 1989; 78:455-7. [PMID: 2741689 DOI: 10.1111/j.1651-2227.1989.tb11110.x] [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)
- A Fiorillo
- Department of Paediatrics, II Faculty of Medicine, University of Naples, Italy
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