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Badagliacca R, Mercurio V, Romeo E, Correale M, Masarone D, Papa S, Tocchetti C, Agostoni P. Beta-blockers in pulmonary arterial hypertension: Time for a second thought? Vascul Pharmacol 2022; 144:106974. [DOI: 10.1016/j.vph.2022.106974] [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] [Received: 12/06/2021] [Revised: 02/19/2022] [Accepted: 02/26/2022] [Indexed: 11/29/2022]
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Di Terlizzi V, Barone R, Manuppelli V, Correale M, Casavecchia G, Goffredo G, Pellegrino P, Puteo A, Ieva R, Di Biase M, Brunetti N, Iacoviello M. P237 INFLUENCE OF HEART RATE ON LEFT AND RIGHT VENTRICULAR LONGITUDINAL STRAIN IN PATIENTS WITH CHRONIC HEART FAILURE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Myocardial deformation evaluated by two–dimensional speckle tracking echocardiography (STE) is a useful tool to evaluate both left and right ventricular function. However, there are no conclusive data about the relationship between strain measures and heart rate (HR).
Aim of the Study
To analyse changes in left (LV) and right ventricular (RV) longitudinal strain associated with variations of HR in patients with and without chronic heart failure (CHF). Methods. We enrolled 45 patients. Of the 38 patients diagnosed with CHF, 21 were carrying an ICD (Group 1), and 17 an ICD with CRT (Group 2). Group 3 included 7 participants without CHF with sinus node dysfunction that were carrying a pacemaker. The frequency of atrial stimulation was increased to 90 beats/min and an echocardiogram was performed at each increase of 10 beats/min. Global LV and RV longitudinal strain (LVGLS and RVGLS, respectively) and RV free wall longitudinal strain (RVfwLS) were calculated at each HR, together with other echocardiographic parameters. Worsening or improvement of strain measures was defined as a relative change from baseline of 10%.
Results
The reproducibility of strain measurements was assessed in all the images obtained at the different HRs for 19 of the study participants. A high degree of reproducibility was observed for LVGLS (ICC = 0.96; 95% CI, 0.93 – 0.97) as well as for RVGLS (ICC = 0.91; 95%CI, 0.86 – 0.94) and RVfwLS (ICC = 0.91; 95%CI, 0.85 – 0.94). When analysed as continuous variables, significant reductions in LVGLS were detected at higher HRs, whereas improvements in both RVGLS and RVfwLS were observed (left panels of the figure). Patients with worsening of LVGLS (76% overall) were more likely to present lower baseline LV function and maximum relative changes of LVGLS correlated significantly with the E/e’ ratios (r = –0.56; p < 0.001). Only few patients (18% for RVGLS and 16% for RVfwLS) exhibited HR–related worsening of RV strain measures, which was associated with lower levels of baseline RV function and higher pulmonary systolic pressures. Finally, 21 (47%) and 25 (56%) of the participants responded with improvements in RVGLS and RVfwLS, respectively. Right panels of the figure show the trend of left and right measures in the different groups.
Conclusions
Our findings revealed heterogeneous RV and LV responses to increases in HR. These findings might ultimately be used to optimize cardiac functionality at rest in patients diagnosed with CHF.
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Affiliation(s)
| | | | | | | | | | | | | | | | - R Ieva
- POLICLINICO RIUNITI, FOGGIA
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De Gennaro L, Donadeo V, Ruggero M, Tota F, Sergio M, De Laura D, Cavallari D, Resta M, Ricci G, Licurgo L, Buquicchio F, Corriero F, Citarelli G, Parisi G, Campanella C, Mancini L, Locuratolo N, Sublimi Saponetti L, Rutigliano D, Palumbo V, Basso P, Correale M, Brunetti N, Iacoviello M, Caldarola P. C23 HOW TO IMPROVE ADHERENCE TO ESC HF GUIDELINES THE PONTE (PDTA FOR INTEGRATED FOLLOW–UP TERRITORY HOSPITAL OF THE PATIENT WITH CARDIAC HEART FAILURE) PROJECT. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.022] [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
Background
A careful and integrated follow up after hospitalization for heart failure (HF) may represent a feasible strategy to optimize the adherence to ESC guidelines and reduce the occurrence of adverse events (mortality, re–hospitalizations).
Methods
A strict integration between hospital and local health district proximity office cardiologist through an integrated clinical data sharing software has been implemented in Apulia region, Italy, in order to optimize the management of the HF patient after an hospitalization: the PONTE (PDTA FOR INTEGRATED FOLLOW–UP TERRITORY HOSPITAL OF THE PATIENT WITH CARDIAC HEART FAILURE) (bridge) project. As until December 2021, 1200 patients with HF have been enrolled in the project, both with reduced (HFrEF) and preserved ejection fraction (HFpEF). Adherence to ESC HF guidelines in HFrEF patients before vs after December 2020 was compared.
Results
In the HFrEF population (56%) the mean age was 63 years, 38% were hypertensive, 15% diabetic, 40% had ischemic heart disease, 42% were previously treated with coronary angioplasty, 56% had an ICD/CRT, 22% had atrial fibrillation. Mean NYHA class was 2.2, mean LVEF 30%, mean NT–proBNP values 4027 pg/mL, mean serum creatinine 1 mg/dL, 91% were taking beta–blockers (BB), 86% mineral corticoid receptor antagonists (MRA), 98% ACE–inhibitors/angiotensin–receptor–antagonists/neprilysin and angiotensin receptor antagonists (ACE/ARB/ARNI), and 13% ARNI. Compared to patients enrolled before 2020, ARNI prescription increased in 2021 (60% vs 13%, p < 0.001); in 30% ARNI were prescribed in hospital before discharge. Furthermore, in 10% of the population (most diabetics), sodium glucose cotransporter type 2 inhibitors (SGLT2i) have been prescribed as indicated by the latest ESC 2021 guidelines.
Conclusions
The implementation the PONTE project shows an improved adherence to ESC HF guidelines.
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Affiliation(s)
- L De Gennaro
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - V Donadeo
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - M Ruggero
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - F Tota
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - M Sergio
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - D De Laura
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - D Cavallari
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - M Resta
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - G Ricci
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - L Licurgo
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - F Buquicchio
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - F Corriero
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - G Citarelli
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - G Parisi
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - C Campanella
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - L Mancini
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - N Locuratolo
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | | | - D Rutigliano
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - V Palumbo
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - P Basso
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - M Correale
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - N Brunetti
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - M Iacoviello
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
| | - P Caldarola
- OSPEDALE SAN PAOLO BARI, BARI; OSPEDALE SAN PAOLO, BARI; SAN PAOLO, BARI
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Barone R, Goffredo G, Di Terlizzi V, Correale M, Casavecchia G, Ieva R, Cuculo A, Brunetti N, Iacoviello M. P243 RELEVANCE OF RENAL RESISTANCE INDEX INCREASE AFTER CORONARY ANGIOGRAPHY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Renal resistance index is a Doppler derived measure which is able to reflect the pathophysiological background of Cardiorenal Syndrome (CS). There are no data about the influence of the intravascular administration of contrast media on RRI and its relationship with worsening of renal function (WRF).
Aim of the Study
To evaluate changes in renal resistance index (RRI) after coronary angiography in patients with and without WRF. METHODS We enrolled 115 patients (mean age 64 years, 73% males, 84% hypertensive, 43% diabetic, 30% with acute coronary syndrome, 21% affected by chronic heart failure, CHF, with a mean left ventricular ejection fraction, LVEF, of 51±11) with suspected coronary artery disease, stable angina, or acute coronary syndromes who have been referred for coronary angiography (with or without pre–existing renal impairment). Renal arterial echo–color Doppler was used to calculate RRI before and 48 hours after coronary angiography. WRF was defined as an increase of creatinine >0.3 mg/dl and of at least 25% from baseline 24–48 hours after coronary angiography.
Results
Fourteen (12%) among the enrolled patients showed WRF. As expected, a significant increase of creatinine serum levels was observed in patients with WRF (from 1.14±0.40 to 1.71±0.49, p < 0.001) but not those without (from 0.89±0.27 to 0.92±0.28, p n.s.) WRF. On the other hand, RRI significantly increased both in patients with (from 72.8±4.3 to 76.4±5.2, p < 0.05) and without (from 63.1±7.2 to 65.4±7.1, p < 0.05). However, both at baseline and after angiography, patients with WRF showed RRI values significantly greater when compared with those without. At ROC curve analyses for WRF, the baseline and after angiography RRI sowed similar AUC (0.88 and 0.90, respectively) and for both RRI values the best cut–off was 70% (sensitivity of 79% and 93% and Specificity of 93% and 82%, respectively). As shown in the figure, the high predictive accuracy of RRI values was due to the fact that, although increased after angiography, the proportion of patients without WRF and with RRI>70% remained very low.
Conclusion
After coronary angiography RRI significantly increase both in patients with and without WRF. However, a larger proportion of patients with WRF present a critically increased RRI, i.e. equal or above 70%, before and after angiography probably because reflecting the pathophysiological background underlying the progression of cardiorenal syndrome.
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Affiliation(s)
| | | | | | | | | | - R Ieva
- POLICLINICO RIUNITI, FOGGIA
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Diomede N, Terazzi E, Correale M, Di Terlizzi V, Barone R, Manuppelli V, Brunetti N, Iacoviello M. P235 CLINICAL AND INSTRUMENTAL CORRELATES OF LEFT AND RIGHT ATRIAL TWO–DIMENSIONAL STRAIN MEASUREMENTS IN PATIENTS WITH HEART FAILURE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
The two–dimensional strain obtained through Speckle Tracking Imaging (STI) represents an innovative, rapid and semi–automatic echocardiographic method to study systolic and diastolic function. By analyzing the deformation of cardiac segments, it provides an indirect index of myocardial contractility and relaxation of left and right ventricles, but also of both left and right atria.
Purpose of the Study
The aim of this study was to evaluate the clinical and instrumental correlates of the different measures of right and left atrial strain in a group of patients with chronic heart failure (CHF). Method. We enrolled 165 out patients with CHF (63 ± 14 years, 76% male, 39 ± 11% ejection fraction). All patients underwent a cardiological examination, ECG and echocardiogram. The echocardiographic images were analyzed using an innovative software (TomTec, Philips) able to semi–automatically analyze both the ventricular and atrial strain. For each patient, both for the left atrium (LA) and the right atrium (RA), the measures related to all atrial functional phases were calculated: reservoir (r), conduit (cd) and contraction (ct).
Results
At univariate and multivariate logistic regression models, the main determinants of atrial strain measurements were evaluated. As shown in the Table, both for the RA and LA the reservoir and conduit were more closely associated with ventricular systolic function and age. LA contraction was associated only with E/e‘ and heart rate, whereas for the RA one there was no independent statistical association with the parameters studied.
Conclusions
The Strain parameters that evaluate right and left atrial function have an independent association with different clinical and instrumental variables. These results support the hypothesis that the reservoir and conduit measurements express a different physiological and pathophysiological substrate than the contraction measures.
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Affiliation(s)
- N Diomede
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - E Terazzi
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - M Correale
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - V Di Terlizzi
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - R Barone
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - V Manuppelli
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - N Brunetti
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - M Iacoviello
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
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Terazzi E, Diomede N, Correale M, Di Terlizzi V, Barone R, Manuppelli V, Brunetti N, Iacoviello M. P233 ASSOCIATIONS BETWEEN LEFT AND RIGHT ATRIAL BIDIMENSIONAL STRAIN AND HEART FAILURE PROGRESSION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Two dimensional speckle tracking is an innovative echocardiographic method which analyses myocardial deformation thus allowing the evaluation of both atrial and ventricular function. Recently, new software are available to measure it by semiautomatic analyses.
Aim of the Study
To evaluate the association between left and right atrial Strain and the occurrence of clinical events related to the heart failure (HF) progression. Method. We enrolled 165 outpatients with chronic HF (76% males, NYHA 2.2 ± 0.69, ejection fraction 39±11%). All underwent a clinical and echocardiographic evaluation. An innovative software (TomTec, Philips) was used to analyse the images in order to semi–automatically calculate of atrial Strain. For each patient all the measures relative to the different phases of atrial deformation were considered both for the left atrium (LA) and the right one (RA), i.e. reservoir (r), conduit (cd) and contraction (ct). During the follow–up, we defined the HF progression as hospitalization due to HF worsening and/or heart transplantation and/or cardiovascular death.
Results
During a median follow–up of 5 months, at least one event related to HF progression occurred in 22 patients: all underwent at least one hospitalization, 7 patients died because of cardiovascular reasons and 2 underwent heart transplantation. At Cox univariate analysis, LASr (HR: 0,93; 95%CI: 0,88–0,97, p: 0.004; C–index 0,7), LAScd (HR: 1,09; 95%CI: 1,01–1,19; p: 0,023; C–index: 0,64), RASr (HR: 0,95; 95%CI: 0,90–0,99; p: 0,031; C–index: 0,68), RAScd (HR: 1,08; 95%CI: 1,01–1,15; p: 0,021; C–index: 0,67), but not LASct (HR: 1,04; 95%CI: 0,99–1,09; p 0,094; C–index 0,62) and RASct (HR: 1,02; 95%CI: 0,96–1,09; p: 0,61; C–index: 0,55), were significantly associated to HF progression. LASr and RASr showed the higher accuracy in predicting the events by the estimation of C index. At ROC curve analysis, for LASr the best cut–off was 16.1% (Sensitivity 83%, Specificity 56%) and for RASr 17.3% (Sensitivity 79%, Specificity 60%). Figure shows Kaplan–Meier curves for the considered end–point according with these cut–offs.
Conclusions
The preliminary results of this study have showed the association between LA and RA Strain variables and the HF progression. The prosecution of this study will be finalised to demonstrate the prognostic independent and incremental significance.
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Affiliation(s)
- E Terazzi
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - N Diomede
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - M Correale
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - V Di Terlizzi
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - R Barone
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - V Manuppelli
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - N Brunetti
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
| | - M Iacoviello
- CARDIOLOGIA UNIVERSITARIA – OSPEDALI RIUNITI DI FOGGIA, FOGGIA
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Goffredo G, Barone R, Di Terlizzi V, Correale M, Casavecchia G, Ieva R, Cuculo A, Brunetti N, Iacoviello M. P216 RENAL RESISTANCE INDEX IS INDEPENDENTLY ASSOCIATED WITH THE WORSENING OF RENAL FUNCTION AFTER CORONARY ANGIOGRAPHY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.208] [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
Background
The term Cardiorenal Syndrome (CS) has been recently introduced to indicate the close relationship between cardiovascular and renal diseases, which are able to reciprocally influence the each other progression. In this setting the renal resistance index (RRI) has been demonstrated to be a useful parameter able to detect patients at higher risk of CS. However, there are no data about its role in predicting worsening of renal function (WRF) mediated by the intravascular administration of contrast.
Aim of the Study
To evaluate the role of RRI in predicting WRF after coronary angiography. METHODS We enrolled 115 patients (mean age 64 years, 73% males, 84% hypertensive, 43% diabetic, 30% with acute coronary syndrome, 21% affected by chronic heart failure, CHF, with a mean left ventricular ejection fraction, LVEF, of 51±11) with suspected coronary artery disease, stable angina, or acute coronary syndromes who have been referred for coronary angiography (with or without pre–existing renal impairment). All patients underwent medical examination, electrocardiogram, echocardiographic and chemical evaluation, and renal arterial echo–color Doppler used to calculate RRI. WRF was defined as an increase of creatinine >0.3 mg/dl and of at least 25% from baseline 24–48 hours after coronary angiography.
Results
After coronary angiography, 14 (12%) of the enrolled patients showed WRF. As shown in the Table, at univariate regression analysis baseline RRI was associated with WRF as well as age, peripheral artery disease, CHF, atrial fibrillation, NYHA class, LVEF, mitral regurgitation (MR), central venous pressure (CVP), tricuspid regurgitation (TR), estimated glomerular filtration rate (GFR). In a multivariate forward stepwise regression model, including all univariate predictors, history of CHF, high CVP and RRI were the only parameters significantly associated with WRF.
Conclusion
Our findings demonstrate that in patients undergoing coronary angiography, history of CHF, high CVP and RRI are independent predictors of WRF. RRI, but not GFR, is independently associated with WRF probably because providing additional relevant information about cardiorenal pathophysiological factors reflecting the hemodynamic status and kidney flow reserve.
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Affiliation(s)
| | | | | | | | | | - R Ieva
- POLICLINICO RIUNITI, FOGGIA
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Mazzeo P, Correale M, Magnesa M, Fortunato M, Mallardi A, Leopizzi A, Tricarico L, Mennella R, Iacoviello M, Brunetti ND. Right ventricle function improvement after six month of therapy with Sacubitril/Valsartan in a real-life population of patients with chronic heart failure with reduced ejection fraction. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.384] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Observational studies have demonstrated that treatment with sacubitril/valsartan may improve left ventricular (LV) systolic and diastolic function in subjects with reduced LV ejection fraction (LVEF) in real-world studies. Subjects with heart failure and reduced EF (HFrEF), however, are also characterized by an impaired right ventricular (RV) function. We therefore aimed to evaluate whether also RV function may improve after S/V therapy and possible predictors of RV improvement could be identified at echocardiography and tissue Doppler imaging.
Methods
Fifty consecutive patients (67 ± 8 years, LVEF 28 ± 6%, male 86%) with chronic HFrEF and NYHA class II-III were followed up for 6 months after therapy with S/V. L&RV function was assessed at baseline and after 6 months of therapy.
Results
After 6-month therapy with S/V a significant improvement was shown in the following echocardiography parameters assessing RV function: PAsP(31 ± 11vs 35 ± 10mmHg,p < 0.001),
TAPSE(19 ± 3vs18 ± 3mm,p < 0.001),RVFAC(38 ± 7 vs 34 ± 6 mm,p < 0.001), RVS’(12 ± 2vs10 ± 2cm/sec,p < 0.001), RVFWGLS(-20 ± 5vs-18 ± 5%,p < 0.001), RV4ChGLS (-16 ± 5vs-14 ± 5%,p < 0.001). At multivariable analysis improvement in RVFWGLS was associated to baseline levels of RV S’ (r 0.75, p < 0.01) and RAV (r–0.32,p < 0.05).
Conclusions
In a real-world scenario, 6-month therapy with S/V was associated with an improved RV function in HFrEF. RV function improvement may be predicted by assessing baseline RV S’ and right atrial volume values.
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Affiliation(s)
- P Mazzeo
- University of Foggia, Foggia, Italy
| | - M Correale
- University Hospital Ospedali Riuniti, Foggia, Italy
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9
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Magnesa M, Correale M, Correale M, Correale M, Mazzeo P, Mazzeo P, Mazzeo P, Fortunato M, Fortunato M, Fortunato M, Leopizzi A, Leopizzi A, Leopizzi A, Mallardi A, Mallardi A, Mallardi A, Tricarico L, Tricarico L, Tricarico L, Mennella R, Mennella R, Mennella R, Iacoviello M, Iacoviello M, Iacoviello M, Brunetti ND, Brunetti ND, Brunetti ND. Left atrial functional reverse remodeling assessed by speckle tracking echocardiography in a real-life population of patients with chronic heart failure after therapy with sacubitril/valsartan. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.050] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Left atrial (LA) enlargement has been demonstrated to be a predictor of adverse cardiovascular outcomes, such as atrial fibrillation (AF), heart failure (HF), and cardiovascular death (1). Previous studies showed left atrial structural reverse remodeling (LARR), defined as >15% reduction in LA end-systolic volume index (LAESVi) (2), can be achieved after therapy with Sacubitril/Valsartan (S/V) in real-world settings. On the other hand, LA functional reverse remodeling is not well defined.
Purpose
We sought to investigate the association between left atrial (LA) structural and functional remodelling in patients with chronic heart failure after therapy with S/V.
Methods
Patients with chronic HF, LV dysfunction (EF < 35%), NYHA class II-III were followed up between September 2019 and March 2020. All patients underwent clinical and echocardiography follow up at baseline and after 6 months of therapy with S/V. Measures of LA structure [LA end-systolic volume index (LAESVi)] and function [left atrial ejection fraction (LAEF), peak atrial longitudinal strain (PALS), LA conduit strain, and peak atrial contraction strain (PACS)] were calculated. We divided our population into two subgroups based on whether reverse remodeling was achieved (LARR+) or not (LARR-).
Results
Forty-seven consecutive outpatients (mean age 66 ± 8 years; 85% males) were enrolled in the study. At follow-up visit, a positive LARR was found in nearly half of patients treated with S/V, resulting in line with previous studies (3). Furthermore, global PALS was significantly improved in both groups compared to baseline (15 ± 7 vs 19 ± 8 %, p < 0.001), but the LARR+ group showed an improvement that was twice higher (55 ± 66 vs 25 ± 26, p = 0.039), supporting the potential role of PALS as marker of functional LARR.
Conclusions
Treatment with S/V in patients with systolic dysfunction is associated with an improvement in LA structural and functional remodelling in a real-world scenario. Therefore, PALS could be the benchmark for the assessment of left atrial functional reverse remodeling.
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Affiliation(s)
- M Magnesa
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - M Correale
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - M Correale
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - M Correale
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - P Mazzeo
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - P Mazzeo
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - P Mazzeo
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - M Fortunato
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - M Fortunato
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - M Fortunato
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - A Leopizzi
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - A Leopizzi
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - A Leopizzi
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - A Mallardi
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - A Mallardi
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - A Mallardi
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - L Tricarico
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - L Tricarico
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - L Tricarico
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - R Mennella
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - R Mennella
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - R Mennella
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - M Iacoviello
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - M Iacoviello
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - M Iacoviello
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - ND Brunetti
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - ND Brunetti
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
| | - ND Brunetti
- UTIC Universitaria Ospedali Riuniti OO.RR , Foggia, Italy
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10
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Pezzuto B, Badagliacca R, Muratori M, Farina S, Bussotti M, Correale M, Bonomi A, Vignati C, Sciomer S, Papa S, Palazzo Adriano E, Agostoni P. ROLE OF CARDIOPULMONARY EXERCISE TEST IN THE PREDICTION OF HEMODYNAMIC IMPAIRMENT IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION. Pulm Circ 2022; 12:e12044. [PMID: 35506106 PMCID: PMC9052996 DOI: 10.1002/pul2.12044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/22/2021] [Accepted: 01/14/2022] [Indexed: 11/25/2022] Open
Abstract
Periodic repetition of right heart catheterization (RHC) in pulmonary arterial hypertension (PAH) can be challenging. We evaluated the correlation between RHC and cardiopulmonary exercise test (CPET) aiming at CPET use as a potential noninvasive tool for hemodynamic burden evaluation. One hundred and forty‐four retrospective PAH patients who had performed CPET and RHC within 2 months were enrolled. The following analyses were performed: (a) CPET parameters in hemodynamic variables tertiles; (b) position of hemodynamic parameters in the peak end‐tidal carbon dioxide pressure (PETCO2) versus ventilation/carbon dioxide output (VE/VCO2) slope scatterplot, which is a specific hallmark of exercise respiratory abnormalities in PAH; (c) association between CPET and a hemodynamic burden score developed including mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), cardiac index, and right atrial pressure. VE/VCO2 slope and peak PETCO2 significantly varied in mPAP and PVR tertiles, while peak oxygen uptake (peak VO2) and O2 pulse varied in the tertiles of all hemodynamic parameters. PETCO2 versus VE/VCO2 slope showed a strong hyperbolic relationship (R2 = 0.7627). Patients with peak PETCO2 > median (26 mmHg) and VE/VCO2 slope < median (44) presented lower mPAP and PVR (p < 0.005) than patients with peak PETCO2 < median and VE/VCO2 slope > median. Multivariate analysis individuated peak VO2 (p = 0.0158) and peak PETCO2 (p = 0.0089) as hemodynamic score independent predictors; the formula 11.584 − 0.0925 × peak VO2 − 0.0811 × peak PETCO2 best predicts the hemodynamic score value from CPET data. A significant correlation was found between estimated and calculated scores (p < 0.0001), with a precise match for patients with mild‐to‐moderate hemodynamic burden (76% of cases). The results of the present study suggest that CPET could allow to estimate the hemodynamic burden in PAH patients.
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Affiliation(s)
- B Pezzuto
- Centro Cardiologico Monzino IRCCS Milan Italy
| | - R Badagliacca
- Department of Cardiovascular and Respiratory Sciences Sapienza University of Rome Italy
| | - M Muratori
- Centro Cardiologico Monzino IRCCS Milan Italy
| | - S Farina
- Centro Cardiologico Monzino IRCCS Milan Italy
| | - M Bussotti
- Cardiac Rehabilitation Department IRCCS Istituti Clinici Scientifici Maugeri Milan Italy
| | - M Correale
- University Hospital Ospedali Riuniti Foggia Italy
| | - A Bonomi
- Centro Cardiologico Monzino IRCCS Milan Italy
| | - C Vignati
- Centro Cardiologico Monzino IRCCS Milan Italy
| | - S Sciomer
- Department of Cardiovascular and Respiratory Sciences Sapienza University of Rome Italy
| | - S Papa
- Department of Cardiovascular and Respiratory Sciences Sapienza University of Rome Italy
| | - E Palazzo Adriano
- Cardiac Rehabilitation Department IRCCS Istituti Clinici Scientifici Maugeri Milan Italy
| | - P Agostoni
- Centro Cardiologico Monzino IRCCS Milan Italy
- Department of Clinical Sciences and Community Health University of Milan Milan Italy
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11
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Mandoli G, Pastore M, Giannoni A, Benfari G, Dini F, Correale M, Carluccio E, Guaricci A, Citro R, Novo G, Pasquini A, Degiovanni A, Santoro C, Malagoli A, Cameli M. Deformation imaging by strain in chronic heart failure over sacubitril/valsartan: a multicenter echocardiographic registry (DISCOVER) ARNI. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0793] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sacubitril/valsartan changed the treatment of heart failure with reduced ejection fraction (HFrEF), due to the positive effects morbidity and mortality partly mediated by left ventricular reverse remodeling (LVRR). The aim of this multicenter study was to identify echocardiographic predictors of LVRR after sacubitril/valsartan administration.
Methods
Patients with HFrEF requiring therapy with sacubitril/valsartan from 13 Italian centers were included. Echocardiographic indexes including speckle tracking echocardiography (STE) were used to predict LVRR (defined as LV end-systolic volume reduction and ejection fraction [LVEF] improvement >10% at follow-up) at 6 months follow-up as the primary endpoint. Changes in symptoms (NYHA class) and neurohormonal activations (N-terminal-pro-brain natriuretic peptide [NTproBNP]) were also evaluated as secondary endpoints. Patients with poor acoustic windows and missing data were excluded.
Results
The final population consisted of 341 patients (mean age: 65±10 years; 18% female, median LVEF 30% [interquartile range:25; 34]. At 6 months follow-up, cardiac dimensions and function, including left heart STE parameters, improved (Table 1). Moreover, 82 (24%) patients showed early complete response (LVRR and LVEF ≥35%), 55 (16%) early incomplete response (LVRR and LVEF <35%), 204 (60%) no response (no LVRR and LVEF <35%) after 6 months of sacubitril/valsartan. Among patients with ischemic etiology, 68% (108) did not develop LV RR. Age, sex, general characteristics, baseline NYHA class and NT-pro BNP did not significantly differ between the groups.Conversely, baseline LV dimensions and LVEF showed significant differences between the groups (p<0.0001). Also, STE parameters were considerably better in group 1 compared to group 2 and 3 both at baseline and follow-up. Non-ischemic etiology, a lower left atrial volume index and a higher global longitudinal strain were all independent predictors of LVRR at multivariable logistic analysis (all p<0.01). With ROC and spline curves, LV GLS >−9.3% showed a good accuracy in predicting LV RR (Figure 1). LA strain was the best predictor of positive changes in NYHA class and NT-proBNP (all p<0.05).
Conclusions
STE parameters at baseline could be useful to predict LVRR and early clinical response to sacubitril-valsartan, and thus could be used as a guide for treatment in patients with HFrEF.
Funding Acknowledgement
Type of funding sources: None. Table 1Figure 1
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Affiliation(s)
- G.E Mandoli
- University of Siena, Department of Medical Biotechnologies, Division of Cardiology, Siena, Italy
| | - M.C Pastore
- University of Siena, Department of Medical Biotechnologies, Division of Cardiology, Siena, Italy
| | - A Giannoni
- Fondazione Toscana Gabriele Monasterio, Cardiology and Cardiovascular Medicine Department, Pisa, Italy
| | - G Benfari
- University of Verona, Division of Cardiology, Department of Medicine, Verona, Italy
| | - F.L Dini
- Major Hospital, Centro Medico Sant'Agostino, Milano, Italy, Milano, Italy
| | - M Correale
- University Hospital Ospedali Riuniti, Cardiology Department, Foggia, Italy
| | - E Carluccio
- Hospital Santa Maria Della Misericordia, Cardiology and Cardiovascular Pathophysiology - Heart Failure Unit, Perugia, Italy
| | - A.I Guaricci
- Polyclinic Hospital of Bari, University Cardiology Unit, Cardiothoracic Department, Bari, Italy
| | - R Citro
- AOU San Giovanni di Dio e Ruggi dAragona, Cardio-Thoracic-Vascular Department, Salerno, Italy
| | - G Novo
- University Hospital Paolo Giaccone, Division of Cardiology, Department ProMISE, Palermo, Italy
| | - A Pasquini
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Department of Cardiovascular and Thoracic Sciences, Rome, Italy
| | - A Degiovanni
- Hospital Maggiore Della Carita, Department of Thoracic, Heart and Vascular Diseases, Novara, Italy
| | - C Santoro
- Federico II University Hospital, Department of Advanced Biomedical Science, Naples, Italy
| | - A Malagoli
- University of Modena & Reggio Emilia, Division of Cardiology, Nephro-Cardiovascular Department, Baggiovara Hospital, Modena, Italy
| | - M Cameli
- University of Siena, Department of Medical Biotechnologies, Division of Cardiology, Siena, Italy
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12
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Paolillo S, Salvioni E, Perrone Filardi P, Bonomi A, Sinagra G, Gentile P, Gargiulo P, Scoccia A, Cosentino N, Gugliandolo P, Badagliacca R, Lagioia R, Correale M, Frigerio M, Perna E, Piepoli M, Re F, Raimondo R, Minà C, Clemenza F, Bussotti M, Limongelli G, Gravino R, Passantino A, Magrì D, Parati G, Caravita S, Scardovi AB, Arcari L, Vignati C, Mapelli M, Cattadori G, Cavaliere C, Corrà U, Agostoni P. Corrigendum to "Long-term prognostic role of diabetes mellitus and glycemic control in heart failure patients with reduced ejection fraction: Insights from the MECKI Score database" [Int J Cardiol. 2020 Oct 15; 317: 103-110. PMID: 32360652]. Int J Cardiol 2021; 333:252. [PMID: 33640418 DOI: 10.1016/j.ijcard.2021.02.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- S Paolillo
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy; Mediterranea Cardiocentro, Naples, Italy
| | - E Salvioni
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - P Perrone Filardi
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy
| | - A Bonomi
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - G Sinagra
- Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy
| | - P Gentile
- Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy
| | - P Gargiulo
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy
| | - A Scoccia
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - N Cosentino
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | | | - R Badagliacca
- Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, "Sapienza", Rome University, Rome, Italy
| | - R Lagioia
- Division of Cardiology, "S. Maugeri" Foundation, IRCCS, Institute of Cassano Murge, Bari, Italy
| | - M Correale
- Department of Cardiology, University of Foggia, Foggia, Italy
| | - M Frigerio
- Dipartimento Cardiologico "A. De Gasperis", Ospedale Cà Granda - A.O. Niguarda, Milano, Italy
| | - E Perna
- Dipartimento Cardiologico "A. De Gasperis", Ospedale Cà Granda - A.O. Niguarda, Milano, Italy
| | - M Piepoli
- UOC Cardiologia, G da Saliceto Hospital, Piacenza, Italy
| | - F Re
- Cardiology Division, Cardiac Arrhythmia Center and Cardiomyopathies Unit, San Camillo-Forlanini Hospital, Roma, Italy
| | - R Raimondo
- Fondazione Salvatore Maugeri, IRCCS, Istituto Scientifico di Tradate, Italy
| | - C Minà
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation IRCCS - ISMETT, Palermo, Italy
| | - F Clemenza
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation IRCCS - ISMETT, Palermo, Italy
| | - M Bussotti
- Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy
| | - G Limongelli
- Cardiologia SUN, Ospedale Monaldi (Azienda dei Colli), Seconda Università di Napoli, Napoli, Italy
| | - R Gravino
- Cardiologia SUN, Ospedale Monaldi (Azienda dei Colli), Seconda Università di Napoli, Napoli, Italy
| | - A Passantino
- Division of Cardiology, "S. Maugeri" Foundation, IRCCS, Institute of Cassano Murge, Bari, Italy
| | - D Magrì
- Department of Clinical and Molecular Medicine, Azienda Ospedaliera Sant'Andrea, "Sapienza" Università degli Studi di Roma, Roma, Italy
| | - G Parati
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy
| | - S Caravita
- San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy; Department of Management, Information and Production Engineering, University of Bergamo, Dalmine, BG, Italy
| | - A B Scardovi
- Cardiology Division, Santo Spirito Hospital, Roma, Italy
| | - L Arcari
- Cardiology Division, Santo Spirito Hospital, Roma, Italy
| | - C Vignati
- Centro Cardiologico Monzino, IRCCS, Milano, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Milano, Italy
| | - M Mapelli
- Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - G Cattadori
- Unità Operativa Cardiologia Riabilitativa, Multimedica IRCCS, Milano, Italy
| | | | - U Corrà
- Fondazione Salvatore Maugeri, IRCCS, Istituto Scientifico di Veruno, Italy
| | - P Agostoni
- Centro Cardiologico Monzino, IRCCS, Milano, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Milano, Italy.
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13
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Badagliacca R, D'Alto M, Ghio S, Greco A, Papa S, Romeo E, Casu G, Corda M, Paciocco P, D'Agostino C, Galgano G, Stolfo D, Correale M, Naeije R, Vizza C. Determinants of pulmonary vascular resistance reduction with upfront oral therapy in idiopathic pulmonary arterial hypertension: relevance in risk assessment. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2283] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In pulmonary arterial hypertension (PAH) upfront oral therapy represents the standard of care for naive patients at low and intermediate risk. However little is known about associated changes in risk assessment and prediction of low risk status achievement.
Purpose
To evaluate determinants of PVR reduction in patients treated with upfront oral therapy and to create a score to predict PVR reduction after upfront oral treatment and compared its additive value on top of the European and REVEAL scoring system in predicting treatment response.
Methods
One-hundred-eighty-one consecutive naive PAH patients treated with upfront therapy at 11 italian centers were retrospectively evaluated. Evaluation included clinical, hemodynamic and simple echocardiographic parameters, together with European and REVEAL 2.0 risk scores.
Results
At the time of diagnosis, the majority of the patients was idiopathic PAH (80.6%), female (66.3%), at intermediate risk, 71.8% and 55.2%, respectively, according to the European (average method) and the REVEAL 2.0 risk scores. Ambrisentan-Tadalafil was the most frequent combination used (62%). The median PVR reduction obtained after 180 days (IQR 79–394) was −40.4% (IQR −25.8; −45.3).
Age ≥60 years, male-sex, baseline mPAP 48 mmHg associated with low CI (<2.5 l/min/m2), and RV/LV ratio >1 associated with low TAPSE (<18 mm) emerged as independent predictors of poor PVR reduction, defined as the lower tertile of PVR changes (−25.8%). A treatment response score was created deriving weighted integers from the beta coefficient.
At second evaluation 78 (43.1%) patients achieved or remained at European-derived low risk status, while 63 (34.8%) considering the REVEAL 2.0 score.
Multivariate analysis for the prediction of treatment failure, defined as the absence of low-risk status at follow-up, demonstrated the incremental prognostic power of the models incorporating the treatment response score (≥3) on top of the European and REVEAL 2.0 scores, improving risk discrimination by 63.2% (IDI index 0.056) and 36.8% (IDI index 0.080), respectively.
Conclusions
A significant proportion of PAH patients treated with upfront oral combination are not able to achieve a low-risk status. The treatment response score helps clinicians in predicting treatment failure at the time of diagnosis.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - M D'Alto
- AORN Ospedali dei Colli - Monaldi Hospital, Naples, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - A Greco
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - S Papa
- Sapienza University of Rome, Rome, Italy
| | - E Romeo
- AORN Ospedali dei Colli - Monaldi Hospital, Naples, Italy
| | - G Casu
- San Francesco Hospital, Nuoro, Italy
| | - M Corda
- AO Brotzu Hospital, Cagliari, Italy
| | - P Paciocco
- University of Milan-Bicocca, Milan, Italy
| | | | - G Galgano
- Regional General Hospital F. Miulli, Acquaviva Delle Fonti, Italy
| | - D Stolfo
- University Hospital Riuniti, Trieste, Italy
| | - M Correale
- AORN Ospedali dei Colli - Monaldi Hospital, Naples, Italy
| | - R Naeije
- Free University of Brussels (VUB), Brussels, Belgium
| | - C.D Vizza
- Sapienza University of Rome, Rome, Italy
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14
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Correale M, Abbate I, Gargano G, Catino A, Dragone CD, Musci MD, Serio G, Paradiso A, De Lena M. Analytical and clinical evaluation of a new tumor marker in breast cancer: CA 27.29. Int J Biol Markers 2020; 7:43-6. [PMID: 1583347 DOI: 10.1177/172460089200700106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 11/16/2022]
Abstract
Evaluation of a radioimmunoassay for a new tumor marker, named CA 27.29, recently proposed for use in breast cancer patients, is reported in this study. After considering the analytical performance, the clinical study was directed to a control group of 66 apparently healthy subjects (Controls), a group of 25 women with benign breast disease (BBD) and a group of 164 breast cancer patients divided into primary before any treatment (M-), in follow-up with no evidence of disease (NED) and presence of metastases (M+). When compared to CA 15.3, our results showed similar sensitivity of both markers with a slightly lower specificity for CA 27.29. In some cases, however, CA 27.29 elevation appears earlier than CA 15.3 as a sign of metastases. We thus propose their associated use.
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Affiliation(s)
- M Correale
- Clinical Chemistry Lab.-RIA Unit, Bari, Italy
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15
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Mione R, Aimo G, Bombardieri E, Cianetti A, Correale M, Barioli P, Barichello M, Terrone C, Massaron S, Seregni E, Marzano D, Abbate I, Pagliarulo A, Gion M. Preliminary Results of Clinical Evaluation of the Free/Total Prostate-Specific Antigen Ratio in a Multicentric Study. Tumori 2018; 82:543-9. [PMID: 9061061 DOI: 10.1177/030089169608200606] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background The free/total (F/T) prostate-specific antigen (PSA) ratio is probably the most promising tool proposed to increase the specificity of PSA in the diagnosis of prostate cancer. The aim of the present study was to evaluate the clinical value of the F/T ratio in 138 patients with benign hyperplasia, 101 with untreated prostate cancer, and 176 apparently healthy men. Methods We used a new immunometric assay of free PSA (FPSA-RIACT, CIS Diagnostici, Italy) which has shown good analytical performance; sample handling and storage under routine conditions did not affect the antigen stability. Results The diagnostic efficiency of the F/T ratio was significantly better than that of total PSA. In patients with total PSA ranging from 4 to 10 ng/ml, at a specificity level of 95% total PSA showed a sensitivity of 7%, whereas the sensitivity of F/T increased to 70%. Using the F/T ratio as a decision tool in association with total PSA and considering all cases candidate to biopsy (total PSA greater than 3.79 ng/ml corresponding to the 95% level), we demonstrated a 35% reduction of total biopsies that would have been required on the basis of total PSA alone. Conclusions The determination of the percentage of F/T serum PSA significantly improves the specificity of the marker, particularly in the 4-10 ng/ml dose range where unnecessary prostate biopsies can be reduced.
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Affiliation(s)
- R Mione
- Center for the Study of Biological Markers of Malignancy, Regional General Hospital, Venezia, Italy.
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16
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Correale M, Arnberg H, Blockx P, Bombardieri E, Castelli M, Encabo G, Gion M, Klapdor R, Martin M, Nilsson S. Clinical Profile of a New Monoclonal Antibody-Based Immunoassay for Tissue Polypeptide Antigen. Int J Biol Markers 2018; 9:231-8. [PMID: 7836801 DOI: 10.1177/172460089400900405] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our preliminary evaluation of a new monoclonal antibody-based assay for tissue polypeptide antigen (TPA) has shown it to be clinically equivalent to the polyclonal antibody-based assay for TPA. The new assay (TPA-M) employs three monoclonal antibodies to epitopes on cytokeratins 8, 18 and 19. This multicenter, multinational study included 266 patients with newly diagnosed carcinomas of the lung, breast, large bowel and urinary bladder. TPA values from the two assays were compared with three other cytokeratin markers (TPS, CYFRA 21–1 and TPACyk) and with the established reference markers for these malignancies (CEA and NSE for lung, CA 15–3 for breast, CEA and CA 19–9 for colorectal tumors). Analysis of receiver operating characteristic (ROC) curves in lung, colorectal and bladder cancer showed similar sensitivities for the two assays, ranging from 50% to 80% with a specificity of 95%. In breast cancer all the markers studied showed poor sensitivity. However, TPA determination by either method could discriminate advanced stage (stages III and IV) from early stage disease (stages 0 to II). TPA showed similar discriminating ability in bladder cancer. On the basis of the results obtained in our patient series, it seems that of the cytokeratin markers studied, TPA and TPA-M are the most sensitive and offer a wide range of clinical applications.
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17
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Correale M, Abbate I, Dragone CD, Tedone T, Musci MD, Gargano G, Catino AM, Bafunno AM, Grossi B. Behaviour of Four Serum Tumor Markers in Pregnant Women. Int J Biol Markers 2018; 8:198-9. [PMID: 8277213 DOI: 10.1177/172460089300800311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Gion M, Mione R, Becciolini A, Balzi M, Correale M, Piffanelli A, Giovannini G, Saccani Jotti G, Fontanesi M. Relationship between Cytosol Tps, Tpa and Cell Proliferation. Int J Biol Markers 2018; 9:109-14. [PMID: 7930761 DOI: 10.1177/172460089400900208] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 11/16/2022]
Abstract
The serological tumor marker tissue polypeptide antigen (TPA) and the more recently identified tissue-specific polypeptide antigen (TPS) have been reported to be indicators of the proliferation rate of the tumor. In the present investigation we compared the cytosol level of the two markers with the proliferative activity of the tumor measured using the 3H-thymidine labelling index. The preliminary results presented here show that higher TLI is associated with lower cytosol levels of both TPA and TPS. TPA and TPS in the cytosol were significantly associated. These findings are in agreement with the previously demonstrated association between high TPA cytosol levels and better prognosis in breast cancer. Further studies are ongoing in order to: 1. confirm these findings in a larger patient series; 2. investigate any possible prognostic indication provided by TPS; 3. evaluate any possible biological meaning of the negative association between TPA/ TPS and TLI in the cytosol of breast cancer.
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Affiliation(s)
- M Gion
- Center for the Study of Biological Markers of Malignancy, General Hospital, Venezia, Italy
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Bombardieri E, Seregni E, Bogni A, Ardit S, Belloli S, Busetto A, Caniello B, Castelli M, Cianetti A, Correale M. Evaluation of Cytokeratin 19 Serum Fragments (Cyfra 21–1) in Patients with Lung Cancer: Results of a Multicenter Trial. Int J Biol Markers 2018; 9:89-95. [PMID: 7523547 DOI: 10.1177/172460089400900205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recently, a new immunometric assay (Cyfra 21–1) was developed to measure serum concentrations of a soluble fragment of cytokeratin subunit 19. With this method, supplied by Boehringer Mannheim (EIA Test Cyfra 21–1), an Italian multicenter trial was performed in patients with lung cancer. Cyfra 21–1 serum levels were determined in 568 normal subjects (blood donors), 607 patients with non-malignant diseases (491 respiratory diseases) and 730 patients with malignancies. In the latter group 584 had lung cancer. All these 584 patients had pathologically confirmed disease; 314 were epidermoid tumors, 166 adenocarcinomas, 88 small cell cancers and 16 large cell cancers. In the 568 healthy blood donors the mean Cyfra 21–1 value was 0.91 ng/ml (SD 0.47 ng/ml; range 0.05–2.90 ng/ml). A threshold of 1.9 ng/ml was chosen as the upper limit of normality. High levels of Cyfra21–1 were observed in patients with chronic hepatitis (positivity rate: 17/51–33.3%) and with pancreatitis (positivity rate 5/16 - 31.3%). In 114 out of 491 (23.2%) patients with respiratory diseases Cyfra 21–1 showed values greater than 1.9 ng/ml. The overall sensitivity (all stages) of Cyfra 21–1 in lung cancer was 65.6% (383/584). When the histology was considered the highest positivity rates were found in patients with squamous cell tumors (226/314; 72%) followed by adenocarcinomas (105/166; 63%). In patients with SCLC the global sensitivity was 52.3% (46/88). Higher sensitivity of Cyfra 21–1 was observed from stage I to stage IV (53.9% vs 85.7%; Chisquare: p < 0.01). When comparing patients in whom curative resections were possible (up to stage IIIa) with patients suffering from inoperable tumors, a significant difference in Cyfra 21–1 positivies was found (59% vs 81.5%; Chi square p < 0.01).
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20
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Pelizzola D, Gion M, Paradiso A, Dittadi R, Correale M, Mione R, Piffanelli A. Cathepsin D versus Other Prognostic Factors in Breast Cancer. Results and Controversies of a Multicenter Study on 2575 Cases. Int J Biol Markers 2018; 11:139-47. [PMID: 8915708 DOI: 10.1177/172460089601100301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was the survey of cathepsin D determination in a large group of patients enrolled at several centers, under the coordination of the Italian Committee for Quality Control in the Oncological Laboratory. Cathepsin D was measured with the same method-ology, under control of an intra and interlaboratory quality control program, in order to verify the comparability of cathepsin D results from different institutions and to analyze the frequency of cathepsin D positive cases in subgroups of patients stratified according to other prognostic parameters. This retrospective study included 2575 patients with primary breast cancer evaluat-ed in 10 institutions. Cytosol from tumor tissue was the substrate for biochemical cathepsin D, estrogen receptor and progesterone receptor determination, with an interlaboratory quality control survey provided by the E.O.R.T.C. Receptor Group and the Italian Committee for Quality Control in the Oncological Laboratory. The results of the present study can be summarized as follows: 1) Cathepsin D is independent of menopausal status; 2) In spite of standardization of tissue handling and assay methods, different results may be obtained by different institutions. It is therefore essential that each laboratory calculates its own positive/negative cutoff values prior to any routine clinical use of the parameter. This should be a serious consideration when a multicenter study is planned.
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Affiliation(s)
- D Pelizzola
- Cattedra di Medicina Nucleare, Università di Ferrara, Italy
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21
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Correale M, Pagliarulo A, Donatuti G, Sturdà F, Capobianco AM, Stigliani V, Rizzello M, Circhietta S, Pignatelli F, Leone L, Frusciante V, Modoni S, Schittulli F. Preliminary Clinical Evaluation of free/total PSA Ratio by the IMMULITE® system. Int J Biol Markers 2018; 11:24-8. [PMID: 8740638 DOI: 10.1177/172460089601100105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 11/16/2022]
Abstract
The role of free (F) and complexed serum PSA is now under investigation. In the present study, we evaluated the clinical significance of F-PSA and F/Total (T) PSA ratio in a preliminary series of samples from 88 patients with prostate cancer (PC), 113 with benign prostatic disease (BPD), and 98 with non-prostatic disease (NP). We used the F-PSA and third generation T-PSA (DPC, Los Angeles, USA) chemiluminescent enzyme immunometric assays with the IMMULITE automated system. At the 10 ng/ml cutoff for T-PSA levels, we obtained a sensitivity of 83% with a specificity of 100% in NP and 80% in BPD. The addition of the FIT ratio –rather than F-PSA levels – was useful to better discriminate PC and BPD in the cases erroneously classified by T-PSA alone: 44/68 samples (65%) were correctly diagnosed. Moreover, the FIT ratio was particularly effective in the critical T-PSA range between 4.1-9.9 ng/ml; 26/40 cases (65%) were correctly evaluated. In conclusion, the FIT ratio seems to be an interesting auxiliary test to T-PSA, to be reserved for selected cases where additional diagnostic information is necessary.
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Affiliation(s)
- M Correale
- Clinical Chemistry Laboratory-RIA Unit, Oncology Institute, Bari, Italy
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22
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Iacovazzi PA, Guerra V, Elba S, Sportelli F, Manghisi OG, Correale M. Are 90K/MAC-2BP Serum Levels Correlated with Poor Prognosis in HCC Patients? Preliminary Results. Int J Biol Markers 2018; 18:222-6. [PMID: 14535594 DOI: 10.1177/172460080301800311] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In this study we assessed the prognostic significance of 90K/MAC-2BP serum levels in a group of 40 hepatocellular carcinoma patients. This glycoprotein is a new, interesting serum marker that reflects the immune reaction of the host against certain viral infections and tumors such as breast, ovarian and pancreatic cancer. Hepatocellular carcinoma (HCC) is one of the most widespread tumors in the world. AFP is currently the most useful marker for HCC, in spite of its poor diagnostic sensitivity. In this study 40 cirrhotic HCC patients were enrolled. The prevalence of viral hepatic infections in this group was 73% for HCV, 8% for HBV, and 8% for both viruses. Thirteen percent of the patients showed non-virus-related liver damage. 90K serum levels were assayed by an ELISA kit and AFP levels by a chemiluminescent enzyme immunometric system. The overall survival curves were estimated by the Kaplan-Meier method, taking into account age, sex, 90K and AFP serum levels. Statistical analysis showed a highly significant influence on overall survival of age below 70 years and 90K serum levels below the cutoff of 14 ng/mL. Serum AFP (≤20 ng/mL) had positive prognostic value only when it was associated with 90K levels (p<0.02, log-rank).
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Affiliation(s)
- P A Iacovazzi
- Clinical Laboratory Unit, IRCCS "S. De Bellis", Castellana Grotte (Bari), Italy.
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D'Alto M, Romeo E, Argiento P, Paciocco G, Correale M, Lo Giudice F, Prediletto R, Corda M, Ghio S, Vizza C. P2613Initial combination therapy with ambrisentan and tadalafil for pulmonary arterial hypertension: clinical effect and haemodynamic changes. A multicenter retrospective analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Guastafierro F, Santoro F, Tarantino N, Ieva R, Centola A, Correale M, Di Biase M, Brunetti N. P4518In-hospital complications among Takotsubo Cardiomyopathy patients. Preliminary data from a prospective multicenter registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Corrado A, Correale M, Mansueto N, Monaco I, Carriero A, Mele A, Colia R, Di Biase M, Cantatore FP. Nailfold capillaroscopic changes in patients with idiopathic pulmonary arterial hypertension and systemic sclerosis-related pulmonary arterial hypertension. Microvasc Res 2017; 114:46-51. [PMID: 28619664 DOI: 10.1016/j.mvr.2017.06.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 05/10/2017] [Accepted: 06/09/2017] [Indexed: 01/12/2023]
Abstract
Pulmonary arterial hypertension (PAH) represents one of the main clinical expressions of the vascular changes in systemic sclerosis (SSc). Lung microvascular changes can play a role in the pathogenesis of idiopathic PAH (IPAH) also. The aim of this study is to investigate the presence of capillaroscopic abnormalities in patients with IPAH and to evaluate the differences in capillary nailfold changes between patients with IPAH and patients with SSc with and without PAH. METHODS 39 SSc patients (19 with PAH - SSc-PAH and 20 without - SSc-noPAH), 21 subjects with IPAH and 20 healthy subjects were recruited. PAH was diagnosed by right heart catheterization. Nailfold videocapillaroscopy was performed (NVC) in all recruited subjects; capillary quantitative parameters (loops length and width, capillary density, neoangiogenesis) were evaluated and a semiquantitative scoring was used (normal, minor or major abnormalities for healthy controls and IPAH subjects and specific patterns - early, active and late - for SSc subjects) to define microvascular alterations. RESULTS The presence of capillaroscopic abnormalities was detected in 38,1% subjects with IPAH; particularly, compared to healthy controls, capillary density was significantly lower (7,5±1,65loops/mm vs 9±1,37loops/mm p<0,05) and mean capillary width was significantly higher (21±13μm vs 17±3μm p<0,05). A more severe NVC pattern (active/late) was described. SSc-PAH patients compared to SSc-noPAH patients (73,2% vs 50% respectively, p<0,05), with a significantly lower capillary density (5,64±1,9loops/mm vs 6,5±1,3loops/mm p<0,05) and a significantly higher capillary width (55±7μm vs 35±8μm - p<0,05) and mean number of neoangiogenesis (N/mm) (1±0,33 vs 0,2±0,22 respectively p<0,05). CONCLUSIONS These data, beyond to confirm the role of microvascular damage in SSc-related PAH, support the hypothesis of systemic microvascular involvement in IPAH also, which can be detected by NVC, although further studies are needed to establish whether the changes in the systemic microcirculation are causal or consequential to PAH.
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Affiliation(s)
- A Corrado
- Rheumatology Clinic, Department of Medical and Surgical Sciences - University of Foggia, Foggia, Italy
| | - M Correale
- Cardiology Clinic, Department of Medical and Surgical Sciences - University of Foggia, Foggia, Italy
| | - N Mansueto
- Rheumatology Clinic, Department of Medical and Surgical Sciences - University of Foggia, Foggia, Italy
| | - I Monaco
- Cardiology Clinic, Department of Medical and Surgical Sciences - University of Foggia, Foggia, Italy
| | - A Carriero
- Rheumatology Clinic, Department of Medical and Surgical Sciences - University of Foggia, Foggia, Italy
| | - A Mele
- Rheumatology Clinic, Department of Medical and Surgical Sciences - University of Foggia, Foggia, Italy
| | - R Colia
- Rheumatology Clinic, Department of Medical and Surgical Sciences - University of Foggia, Foggia, Italy
| | - M Di Biase
- Cardiology Clinic, Department of Medical and Surgical Sciences - University of Foggia, Foggia, Italy
| | - F P Cantatore
- Rheumatology Clinic, Department of Medical and Surgical Sciences - University of Foggia, Foggia, Italy.
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Misciagna G, Del Pilar Díaz M, Caramia DV, Bonfiglio C, Franco I, Noviello MR, Chiloiro M, Abbrescia DI, Mirizzi A, Tanzi M, Caruso MG, Correale M, Reddavide R, Inguaggiato R, Cisternino AM, Osella AR. Effect of a Low Glycemic Index Mediterranean Diet on Non-Alcoholic Fatty Liver Disease. A Randomized Controlled Clinici Trial. J Nutr Health Aging 2017; 21:404-412. [PMID: 28346567 DOI: 10.1007/s12603-016-0809-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Non-Alcoholic Fatty Liver Disease (NAFLD) is currently the most common form of liver disease worldwide affecting all ages and ethnic groups and it has become a consistent threat even in young people. Our aim was to estimate the effect of a Low Glycemic Index Mediterranean Diet (LGIMD) on the NAFLD score as measured by a Liver Ultrasonography (LUS). DESIGN NUTRIzione in EPAtologia (NUTRIEPA) is a population-based Double-Blind RCT. Data were collected in 2011 and analyzed in 2013-14. SETTING/PARTICIPANTS 98 men and women coming from Putignano (Puglia, Southern Italy) were drawn from a previous randomly sampled population-based study and identified as having moderate or severe NAFLD. INTERVENTION The intervention strategy was the assignment of a LGIMD or a control diet. OUTCOME MEASURES The main outcome measure was NAFLD score, defined by LUS. RESULTS After randomization, 50 subjects were assigned to a LGIMD and 48 to a control diet. The study lasted six months and all participants were subject to monthly controls/checks. Adherence to the LGIMD as measured by Mediterranean Adequacy Index (MAI) showed a median of 10.1. A negative interaction between time and LGIMD on the NAFLD score (-4.14, 95% CI -6.78,-1.49) was observed, and became more evident at the sixth month (-4.43, 95%CI -7.15, -1.71). A positive effect of the interaction among LGIMD, time and age (Third month: 0.07, 95% CI 0.02, 0.12; Sixth month: 0.08, 95% CI 0.03,0.13) was also observed. CONCLUSIONS LGIMD was found to decrease the NAFLD score in a relatively short time. Encouraging those subjects who do not seek medical attention but still have NAFLD to follow a LGIMD and other life-style interventions, may reduce the degree of severity of the disease. Dietary intervention of this kind, could also form the cornerstone of primary prevention of Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease.
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Affiliation(s)
- G Misciagna
- Alberto Rubén Osella, PhD, Laboratory of Epidemiology and Biostatistics, IRCCS Saverio de Bellis, Via Turi 27, 70013 Castellana Grotte (BA), Italy, Tel: +39 0804994655, Fax: +39 0804994650, e-mail:
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Targher G, Dauriz M, Laroche C, Temporelli PL, Hassanein M, Seferovic PM, Drozdz J, Ferrari R, Anker S, Coats A, Filippatos G, Crespo‐Leiro MG, Mebazaa A, Piepoli MF, Maggioni AP, Tavazzi L, Crespo‐Leiro M, Anker S, Coats A, Ferrari R, Filippatos G, Maggioni A, Mebazaa A, Piepoli M, Amir O, Chioncel O, Dahlström U, Jimenez JD, Drozdz J, Erglis A, Fazlibegovic E, Fonseca C, Fruhwald F, Gatzov P, Goncalvesova E, Hassanein M, Hradec J, Kavoliuniene A, Lainscak M, Logeart D, Merkely B, Metra M, Otljanska M, Seferovic P, Kostovska ES, Temizhan A, Tousoulis D, Andarala M, Ferreira T, Fiorucci E, Gracia G, Laroche C, Pommier C, Taylor C, Cuculici A, Gaulhofer C, Casado EP, Szymczyk E, Ramani F, Mulak G, Schou IL, Semenka J, Stojkovic J, Mehanna R, Mizarienne V, Auer J, Ablasser K, Fruhwald F, Dolze T, Brandner K, Gstrein S, Poelzl G, Moertl D, Reiter S, Podczeck‐Schweighofer A, Muslibegovic A, Vasilj M, Fazlibegovic E, Cesko M, Zelenika D, Palic B, Pravdic D, Cuk D, Vitlianova K, Katova T, Velikov T, Kurteva T, Gatzov P, Kamenova D, Antova M, Sirakova V, Krejci J, Mikolaskova M, Spinar J, Krupicka J, Malek F, Hegarova M, Lazarova M, Monhart Z, Hassanein M, Sobhy M, El Messiry F, El Shazly A, Elrakshy Y, Youssef A, Moneim A, Noamany M, Reda A, Dayem TA, Farag N, Halawa SI, Hamid MA, Said K, Saleh A, Ebeid H, Hanna R, Aziz R, Louis O, Enen M, Ibrahim B, Nasr G, Elbahry A, Sobhy H, Ashmawy M, Gouda M, Aboleineen W, Bernard Y, Luporsi P, Meneveau N, Pillot M, Morel M, Seronde M, Schiele F, Briand F, Delahaye F, Damy T, Eicher J, Groote P, Fertin M, Lamblin N, Isnard R, Lefol C, Thevenin S, Hagege A, Jondeau G, Logeart D, Le Marcis V, Ly J, Coisne D, Lequeux B, Le Moal V, Mascle S, Lotton P, Behar N, Donal E, Thebault C, Ridard C, Reynaud A, Basquin A, Bauer F, Codjia R, Galinier M, Tourikis P, Stavroula M, Tousoulis D, Stefanadis C, Chrysohoou C, Kotrogiannis I, Matzaraki V, Dimitroula T, Karavidas A, Tsitsinakis G, Kapelios C, Nanas J, Kampouri H, Nana E, Kaldara E, Eugenidou A, Vardas P, Saloustros I, Patrianakos A, Tsaknakis T, Evangelou S, Nikoloulis N, Tziourganou H, Tsaroucha A, Papadopoulou A, Douras A, Polgar L, Merkely B, Kosztin A, Nyolczas N, Nagy AC, Halmosi R, Elber J, Alony I, Shotan A, Fuhrmann AV, Amir O, Romano S, Marcon S, Penco M, Di Mauro M, Lemme E, Carubelli V, Rovetta R, Metra M, Bulgari M, Quinzani F, Lombardi C, Bosi S, Schiavina G, Squeri A, Barbieri A, Di Tano G, Pirelli S, Ferrari R, Fucili A, Passero T, Musio S, Di Biase M, Correale M, Salvemini G, Brognoli S, Zanelli E, Giordano A, Agostoni P, Italiano G, Salvioni E, Copelli S, Modena M, Reggianini L, Valenti C, Olaru A, Bandino S, Deidda M, Mercuro G, Dessalvi CC, Marino P, Di Ruocco M, Sartori C, Piccinino C, Parrinello G, Licata G, Torres D, Giambanco S, Busalacchi S, Arrotti S, Novo S, Inciardi R, Pieri P, Chirco P, Galifi MA, Teresi G, Buccheri D, Minacapelli A, Veniani M, Frisinghelli A, Priori S, Cattaneo S, Opasich C, Gualco A, Pagliaro M, Mancone M, Fedele F, Cinque A, Vellini M, Scarfo I, Romeo F, Ferraiuolo F, Sergi D, Anselmi M, Melandri F, Leci E, Iori E, Bovolo V, Pidello S, Frea S, Bergerone S, Botta M, Canavosio F, Gaita F, Merlo M, Cinquetti M, Sinagra G, Ramani F, Fabris E, Stolfo D, Artico J, Miani D, Fresco C, Daneluzzi C, Proclemer A, Cicoira M, Zanolla L, Marchese G, Torelli F, Vassanelli C, Voronina N, Erglis A, Tamakauskas V, Smalinskas V, Karaliute R, Petraskiene I, Kazakauskaite E, Rumbinaite E, Kavoliuniene A, Vysniauskas V, Brazyte‐Ramanauskiene R, Petraskiene D, Stankala S, Switala P, Juszczyk Z, Sinkiewicz W, Gilewski W, Pietrzak J, Orzel T, Kasztelowicz P, Kardaszewicz P, Lazorko‐Piega M, Gabryel J, Mosakowska K, Bellwon J, Rynkiewicz A, Raczak G, Lewicka E, Dabrowska‐Kugacka A, Bartkowiak R, Sosnowska‐Pasiarska B, Wozakowska‐Kaplon B, Krzeminski A, Zabojszcz M, Mirek‐Bryniarska E, Grzegorzko A, Bury K, Nessler J, Zalewski J, Furman A, Broncel M, Poliwczak A, Bala A, Zycinski P, Rudzinska M, Jankowski L, Kasprzak J, Michalak L, Soska KW, Drozdz J, Huziuk I, Retwinski A, Flis P, Weglarz J, Bodys A, Grajek S, Kaluzna‐Oleksy M, Straburzynska‐Migaj E, Dankowski R, Szymanowska K, Grabia J, Szyszka A, Nowicka A, Samcik M, Wolniewicz L, Baczynska K, Komorowska K, Poprawa I, Komorowska E, Sajnaga D, Zolbach A, Dudzik‐Plocica A, Abdulkarim A, Lauko‐Rachocka A, Kaminski L, Kostka A, Cichy A, Ruszkowski P, Splawski M, Fitas G, Szymczyk A, Serwicka A, Fiega A, Zysko D, Krysiak W, Szabowski S, Skorek E, Pruszczyk P, Bienias P, Ciurzynski M, Welnicki M, Mamcarz A, Folga A, Zielinski T, Rywik T, Leszek P, Sobieszczanska‐Malek M, Piotrowska M, Kozar‐Kaminska K, Komuda K, Wisniewska J, Tarnowska A, Balsam P, Marchel M, Opolski G, Kaplon‐Cieslicka A, Gil R, Mozenska O, Byczkowska K, Gil K, Pawlak A, Michalek A, Krzesinski P, Piotrowicz K, Uzieblo‐Zyczkowska B, Stanczyk A, Skrobowski A, Ponikowski P, Jankowska E, Rozentryt P, Polonski L, Gadula‐Gacek E, Nowalany‐Kozielska E, Kuczaj A, Kalarus Z, Szulik M, Przybylska K, Klys J, Prokop‐Lewicka G, Kleinrok A, Aguiar CT, Ventosa A, Pereira S, Faria R, Chin J, De Jesus I, Santos R, Silva P, Moreno N, Queirós C, Lourenço C, Pereira A, Castro A, Andrade A, Guimaraes TO, Martins S, Placido R, Lima G, Brito D, Francisco A, Cardiga R, Proenca M, Araujo I, Marques F, Fonseca C, Moura B, Leite S, Campelo M, Silva‐Cardoso J, Rodrigues J, Rangel I, Martins E, Correia AS, Peres M, Marta L, Silva GF, Severino D, Durao D, Leao S, Magalhaes P, Moreira I, Cordeiro AF, Ferreira C, Araujo C, Ferreira A, Baptista A, Radoi M, Bicescu G, Vinereanu D, Sinescu C, Macarie C, Popescu R, Daha I, Dan G, Stanescu C, Dan A, Craiu E, Nechita E, Aursulesei V, Christodorescu R, Otasevic P, Seferovic P, Simeunovic D, Ristic A, Celic V, Pavlovic‐Kleut M, Lazic JS, Stojcevski B, Pencic B, Stevanovic A, Andric A, Iric‐Cupic V, Jovic M, Davidovic G, Milanov S, Mitic V, Atanaskovic V, Antic S, Pavlovic M, Stanojevic D, Stoickov V, Ilic S, Ilic MD, Petrovic D, Stojsic S, Kecojevic S, Dodic S, Adic NC, Cankovic M, Stojiljkovic J, Mihajlovic B, Radin A, Radovanovic S, Krotin M, Klabnik A, Goncalvesova E, Pernicky M, Murin J, Kovar F, Kmec J, Semjanova H, Strasek M, Iskra MS, Ravnikar T, Suligoj NC, Komel J, Fras Z, Jug B, Glavic T, Losic R, Bombek M, Krajnc I, Krunic B, Horvat S, Kovac D, Rajtman D, Cencic V, Letonja M, Winkler R, Valentincic M, Melihen‐Bartolic C, Bartolic A, Vrckovnik MP, Kladnik M, Pusnik CS, Marolt A, Klen J, Drnovsek B, Leskovar B, Anguita MF, Page JG, Martinez FS, Andres J, Genis A, Mirabet S, Mendez A, Garcia‐Cosio L, Roig E, Leon V, Gonzalez‐Costello J, Muntane G, Garay A, Alcade‐Martinez V, Fernandez SL, Rivera‐Lopez R, Puga‐Martinez M, Fernandez‐Alvarez M, Serrano‐Martinez J, Crespo‐Leiro M, Grille‐Cancela Z, Marzoa‐Rivas R, Blanco‐Canosa P, Paniagua‐Martin M, Barge‐Caballero E, Cerdena IL, Baldomero IFH, Padron AL, Rosillo SO, Gonzalez‐Gallarza RD, Montanes OS, Manjavacas AI, Conde AC, Araujo A, Soria T, Garcia‐Pavia P, Gomez‐Bueno M, Cobo‐Marcos M, Alonso‐Pulpon L, Cubero JS, Sayago I, Gonzalez‐Segovia A, Briceno A, Subias PE, Hernandez MV, Cano MR, Sanchez MG, Jimenez JD, Garrido‐Lestache EB, Pinilla JG, Villa BG, Sahuquillo A, Marques RB, Calvo FT, Perez‐Martinez M, Gracia‐Rodenas M, Garrido‐Bravo IP, Pastor‐Perez F, Pascual‐Figal D, Molina BD, Orus J, Gonzalo FE, Bertomeu V, Valero R, Martinez‐Abellan R, Quiles J, Rodrigez‐Ortega J, Mateo I, ElAmrani A, Fernandez‐Vivancos C, Valero DB, Almenar‐Bonet L, Sanchez‐Lazaro I, Marques‐Sule E, Facila‐Rubio L, Perez‐Silvestre J, Garcia‐Gonzalez P, Ridocci‐Soriano F, Garcia‐Escriva D, Pellicer‐Cabo A, Fuente Galan L, Diaz JL, Platero AR, Arias J, Blasco‐Peiro T, Julve MS, Sanchez‐Insa E, Aured‐Guallar C, Portoles‐Ocampo A, Melin M, Hägglund E, Stenberg A, Lindahl I, Asserlund B, Olsson L, Dahlström U, Afzelius M, Karlström P, Tengvall L, Wiklund P, Olsson B, Kalayci S, Temizhan A, Cavusoglu Y, Gencer E, Yilmaz M, Gunes H. In‐hospital and 1‐year mortality associated with diabetes in patients with acute heart failure: results from the
ESC‐HFA
Heart Failure Long‐Term Registry. Eur J Heart Fail 2016; 19:54-65. [DOI: 10.1002/ejhf.679] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/24/2016] [Accepted: 09/20/2016] [Indexed: 12/28/2022] Open
Affiliation(s)
- Giovanni Targher
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University and Azienda Ospedaliera Universitaria Integrata of Verona Verona Italy
| | - Marco Dauriz
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University and Azienda Ospedaliera Universitaria Integrata of Verona Verona Italy
| | - Cécile Laroche
- EURObservational Research Programme European Society of Cardiology Sophia‐Antipolis France
| | | | | | | | | | - Roberto Ferrari
- Department of Cardiology and LTTA Centre, University Hospital of Ferrara and Maria Cecilia Hospital, GVM Care & Research E.S: Health Science Foundation Cotignola Italy
| | - Stephan Anker
- Innovative Clinical Trials, Department of Cardiology & Pneumology University Medical Center Göttingen (UMG) Göttingen Germany
| | - Andrew Coats
- Monash University Australia and University of Warwick Coventry UK
| | | | - Maria G. Crespo‐Leiro
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Complexo Hospitalario Universitario A Coruna CHUAC La Coruna Spain
| | - Alexandre Mebazaa
- Inserm 942, Hôpital Lariboisière Université Paris Diderot Paris France
| | - Massimo F. Piepoli
- Department of Cardiology Polichirurgico Hospital G. da Saliceto Piacenza Italy
| | - Aldo Pietro Maggioni
- EURObservational Research Programme European Society of Cardiology Sophia‐Antipolis France
- ANMCO Research Center Florence Italy
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care & Research E.S. Health Science Foundation Cotignola Italy
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Correale M, Totaro A, Passero T, Abruzzese S, Musaico F, Ferraretti A, Ieva R, Di Biase M, Brunetti ND. Treatment with atorvastatin is associated with a better prognosis in chronic heart failure with systolic dysfunction: results from The Daunia Heart Failure Registry. Neth Heart J 2013; 21:408-16. [PMID: 23712465 PMCID: PMC3751026 DOI: 10.1007/s12471-013-0430-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Few works have evaluated the effect of statins on left ventricular dysfunction in patients with chronic heart failure (CHF), by using tissue Doppler imaging (TDI). We therefore aimed to investigate whether atorvastatin treatment may influence prognosis and myocardial performance evaluated by TDI in subjects with CHF. METHODS Five hundred thirty-two consecutive CHF outpatients enrolled in a local registry, the Daunia Heart Failure Registry, were prospectively analysed. 195 patients with CHF and left ventricular ejection fraction (LVEF) ≤40 %, either in treatment with atorvastatin (N: 114) or without statins (N: 81), underwent TDI examination. Adverse events were evaluated during follow-up. RESULTS The atorvastatin group showed a lower incidence of adverse events (cardiac death: 0 % vs 7 %, p < 0.01), and better TDI performance (E/E' 15 ± 5.7 vs 18 ± 8.3, p < 001) than controls. Ischaemic CHF patients in treatment with atorvastatin also showed a lower incidence of adverse events (death: 10 % vs 26 %, p < 0.05; sustained ventricular arrhythmias: 5 % vs 19 %, p < 0.05, cardiac death: 0 vs 8 %, p < 0.05) and better TDI performance (E/E' ratio: 15.00 ± 5.68 vs 19.72 ± 9.14, p < 0.01; St: 353.70 ± 48.96 vs 303.33 ± 68.52 msec, p < 0.01) than controls. The association between atorvastatin and lower rates of cardiac death remained statistically significant even after correction in a multivariable analysis (RR 0.83, 95 % CI 0.71-0.96, p < 0.05 in CHF with LVEF ≤40 %; RR 0.77, 95 % CI 0.62-0.95, p < 0.05 in ischaemic CHF with LVEF ≤40 %). CONCLUSIONS Treatment with atorvastatin in outpatients with systolic CHF is associated with fewer cardiac deaths, and a better left ventricular performance, as assessed by TDI.
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Affiliation(s)
- M Correale
- Department of Cardiology, University of Foggia, "Ospedali Riuniti" OO.RR, viale L Pinto, 1, 71100, Foggia, Italy,
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Correale M, Brunetti ND, Totaro A, Ferraretti A, Passero T, De Rosa F, Musaico F, Salvemini G, Di Martino L, Di Biase M. Peak myocardial acceleration during isovolumic relaxation time predicts the occurrence of re-hospitalization in chronic heart failure: data from the daunia heart failure registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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D'Amato N, Correale M, D'Agostino C, Di Biase M. A fibrous ring and a subaortic fibrous process conforming a tunnel obstruction in patient with recurrent pulmonary edema. Minerva Cardioangiol 2011; 59:617-618. [PMID: 22134473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Correale M, D’Amato N, D’Agostino C, Di Biase M. Massive pulmonary embolism and atrial mass attached to permanent transvenous lead. Neth Heart J 2011; 19:196-7. [DOI: 10.1007/s12471-011-0087-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Correale M, Ieva R, Manuppelli V, Rinaldi A, Di Biase M. Controversies in echocardiography: 2D vs 3D vs 4D. Minerva Cardioangiol 2009; 57:443-455. [PMID: 19763067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In the latest years several manuscripts have showed some new possible advantages of the three-dimensional (3D) echocardiography in daily practice. 3D echocardiography allows imaging and analysis of cardiovascular structures as they move in time and space, thus creating possibility for creation of 4D datasets (3D and real-time). Real-time three-dimensional echocardiography (RT3DE) is a major innovation in the history of cardiovascular ultrasound. Advances in computer and transducer technologies, especially the fully-sampled matrix array transducer, have permitted real-time 3D image acquisition and display. The aim of this manuscript is to give a brief review of the development of the 3D echocardiography and of comparison of two-dimensional echocardiography versus 3D echocardiography and RT3DE.
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Affiliation(s)
- M Correale
- Department of Cardiology, University of Foggia, Foggia, Italy.
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Chiloiro M, Riezzo G, Chiarappa S, Correale M, Guerra V, Amati L, Noviello MR, Jirillo E. Relationship among fatty liver, adipose tissue distribution and metabolic profile in moderately obese children: an ultrasonographic study. Curr Pharm Des 2009; 14:2693-8. [PMID: 18991688 DOI: 10.2174/138161208786264197] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We examined the relationship between moderate obesity and glucose metabolism, insulin sensitivity and suspected fatty liver in children. We measured body mass index (BMI), z-score BMI, caliper skinfold thickness, waist and hip circumference in 94 participants (mean age 9.7 +/-2.2 years). Fasting blood glucose, insulin, HOMA score, lipid profile and transaminases (ALT, AST) were measured. Fatty liver and skinfold thickness were evaluated by means of ultrasound. The z-score BMI was 2.01 +/-0.39 (mean +/- SD), and the duration of obesity was 4.3+/-3.03 years. A positive correlation was found between caliper and US skinfold thickness for tricipital (r= 0.33; p= 0.003) and sovrailiac skinfold (r= 0.34; p=0.003). Fatty liver was diagnosed in 64% of children and it was positively related to anthropometric measurements. The three sub-groups--group 0 (normal US liver and normal transaminases); group 1 (US fatty liver and normal transaminases); group 2 (US fatty liver and elevated transaminases)--showed a difference concerning z-score BMI, insulin and HOMA parameters (Tukey test: z score BMI group 1 vs group 0 and 2 vs group 0; serum insulin: group 2 vs group 1 and group 2 vs group 0; HOMA IR: group 2 vs group 1 and group 2 vs group 0). Moderately obese children with steatosis exhibited a clear increase of insulin and insulin resistance which represents indices of a future metabolic syndrome. In addition, it is important to perform a liver ultrasound since transaminases seems to be not adequate for the diagnosis of fatty liver.
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Affiliation(s)
- M Chiloiro
- Radiology Unit, IRCCS S de Bellis, Via Turi, 70013 Castellana Grotte, BA, Italy.
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Correale M, Ieva R, Rinaldi M, Rinaldi G, Di Biase M. Multidisciplinary approach in a case of successful surgical treatment of a voluminous intracardiac fungal mass in an infant: reply. European Journal of Echocardiography 2008. [DOI: 10.1093/ejechocard/jen118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Caroppo E, Iacovazzi P, Correale M, D’Amato G. Detection of 90K/MAC-2BP in the Seminal Plasma of Infertile Males With Accessory Gland Infection and Effect of Quinolones Treatment on its Secretion. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.554] [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: 11/30/2022]
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Valentini AM, Iacovazzi PA, Correale M, Pirrelli M, Armentano R, Iacobelli S, Tinari N, Iurisci I, Caruso ML. Immunohistochemical and Serological 90K / Mac-2BP Detection in Hepatocellular Carcinoma Patients: Different Behaviour of Two Monoclonal Antibodies. Med Chem 2005; 1:185-9. [PMID: 16787313 DOI: 10.2174/1573406053175229] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To clarify the biological role of the 90K/Mac-2BP glycoprotein, we evaluated the ability of two MAbs SP-2 and 1A4.22, to reveal this glycoprotein in both serum and tissue from hepatocellular carcinoma (HCC) patients. Tissue expression of 90K was detected by the immunohistochemical method in 20 HCC patients, while the 90K serum level was assessed by the ELISA assay in 13 HCC patients. MAb SP-2 was reactive only in serum, with a mean value of 12.8+/- 6.7 microg/ml . On the contrary, MAb 1A4.22 revealed immunoreactivity both in 92% of sera and in 60% of neoplastic samples. Positive staining was seen only in the epithelial cells and was cytoplasmic and granular in all instances. The mean 90K serum level assayed with MAb 1A4.22 was 29.4 +/- 13.7 microg/ml. Patients with a 90K serum level <or= 30 microg/ml had positive tissue samples in 71% of cases versus 20% of patients with a serum level > 30 microg/ml. Moreover, a possible poor prognostic role was observed for negative 90K in tissue. Our results suggest that only MAb 1A4.22 could demonstrate 90K glycoprotein expression in paraffin-embedded tissue and that this MAb could have a diagnostic and prognostic role in both sera and tissues from HCC patients.
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Affiliation(s)
- A M Valentini
- Department of Pathology, Scientific Institute for Digestive Diseases ,S de Bellis Castellana Grotte (BA), Italy.
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Chimienti G, Russo F, Lamanuzzi BL, Nardulli M, Messa C, Di Leo A, Correale M, Giannuzzi V, Pepe G. Helicobacter pylori is associated with modified lipid profile: impact on Lipoprotein(a). Clin Biochem 2003; 36:359-65. [PMID: 12849867 DOI: 10.1016/s0009-9120(03)00063-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Helicobacter pylori is a controversial risk factor for atherosclerosis. We investigated whether the bacterium persistent inflammation or the expression of the cytotoxin-associated gene A (CagA) may affect serum lipids as well as Lipoprotein(a). DESIGN AND METHODS Two hundred-eleven healthy volunteers were evaluated for lipids and Lipoprotein(a). Helicobacter pylori was characterized by Urea Breath Test and IgG-anti-CagA. apo(a) Kringle-IV polymorphism was genotyped. RESULTS Prevalence of the infection was 72%; 43% of subjects expressed CagA reactivity. Infected subjects showed increased levels of cholesterol, LDL-cholesterol, and cholesterol/HDL-cholesterol atherogenic index. Association with the Helicobacter pylori CagA(-) strains persisted after the adjustment for covariates. Significant difference between infected and uninfected subjects was found in Lipoprotein(a) levels. This difference did not arise from the Kringle-IV genotype. CONCLUSIONS The infection per se significantly modified serum lipid and Lipoprotein(a) concentrations. CagA does not seem to be a reliable marker of pathogenicity for the atherogenic complications of H. pylori infection.
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Affiliation(s)
- G Chimienti
- Department of Biochemistry and Molecular Biology, University of Bari, Bari, Italy
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Caroppo E, Niederberger C, Iacovazzi PA, Correale M, Palagiano A, D'Amato G. Human chorionic gonadotropin free beta-subunit in the human seminal plasma: a new marker for spermatogenesis? Eur J Obstet Gynecol Reprod Biol 2003; 106:165-9. [PMID: 12551786 DOI: 10.1016/s0301-2115(02)00231-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED In the past 20 years, several factors were detected in the human seminal plasma and proposed as markers for spermatogenesis. Human chorionic gonadotropin (hCG) and its beta-subunit were therefore investigated, and their seminal levels were found to be higher than those detected in the serum and to correlate with sperm parameters. OBJECTIVE We designed a retrospective study to determine the suitability of hCG free beta-subunit concentration in the seminal plasma of fertile and infertile male patients as marker of spermatogenesis. STUDY DESIGN A total of 79 infertile male patients were divided into four groups by their semen analysis results (group 1 [n=8]: azoospermia; group 2 [n=21]: severe oligozoospermia; group 3 [n=40]: oligoasthenospermia (OAS); group 4 [n=10]: asthenospermia) and 10 healthy volunteers of proven fertility were evaluated. RESULTS The hCG free beta-subunit levels in the seminal plasma were found to be significantly higher (P<0.0001) in the control group in respect to those assayed in the infertile patients and showed a correlation with sperm count (r=0.5) and total motile sperm density (r=0.5). Twenty-five patients were on treatment with oral Mesterolone (100mg daily) plus Tamoxifen (20mg daily) for 3-6 months. Apart from a significant improvement (P<0.05) in sperm morphology, no significant changes in sperm count and motility were observed after the treatment in all the patients. In the seminal plasma of 10 patients who showed a significant increase in sperm count, hCG free beta-subunit levels were found to be significantly higher compared to those detected in the remaining patients (P<0.01). In all patients, these levels remained unchanged after the treatment. CONCLUSIONS The evidence regarding the positive correlation between hCG free beta-subunit levels in the seminal plasma and sperm concentration is consistent with the previous results regarding hCG levels. A previous study demonstrated that testosterone levels in seminal plasma correlated with sperm concentrations; from the same evidence regarding hCG we hypothesize that seminal plasma testosterone and hCG levels are correlated. Thus, hCG may play a paracrine role in the intratesticular regulation of testosterone secretion.
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Affiliation(s)
- E Caroppo
- Operative Unit of Pathophysiology of Human Reproduction, IRCCS "S. De Bellis", Via della Resistenza, 70013 Grotte Castellana (Ba), Italy.
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Reshkin SJ, Tedone T, Correale M, Mangia A, Casavola V, Paradiso A. Association of pS2 (TFF1) release with breast tumour proliferative rate: in vitro and in vivo studies. Cell Prolif 2003; 32:107-18. [PMID: 10535357 PMCID: PMC6726325 DOI: 10.1046/j.1365-2184.1999.32230107.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Although cytosolic expression of the protein pS2 (TFF1) is considered to be a marker of oestrogen receptor (OR) function, there exists some clinical data to suggest an inverse relationship of cytosolic pS2 to tumour proliferation. Although secreted from breast cancer cells, the relationship of pS2 secretion to tumour natural history has been little studied. The mechanisms and kinetics of pS2 release and its relation to tumour cell proliferation were studied in a human breast cancer cell line MCF-7 and verified in a preliminary clinical study. Stimulation by stripped serum or oestradiol resulted in parallel increases of proliferation and pS2 release in both time course and dose-response experiments. Direct pharmacological alterations of proliferation were followed by identical changes in pS2 release. The relationship between serum pS2 levels and tumour proliferative activity when analysed as a function of steroid status showed a slope of 0.56 in OR+ vs. 0.19 in OR- tumours. It is concluded that pS2 release from breast cancer cells is associated with their proliferation and measurement of serum pS2 levels might be a good predictor of tumour proliferative state and could permit noninvasive monitoring of this tumour parameter.
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Affiliation(s)
- S J Reshkin
- Department of General and Environmental Physiology, University of Bari, Italy.
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Iacovazzi PA, Trisolini A, Barletta D, Elba S, Manghisi OG, Correale M. Serum 90K/MAC-2BP glycoprotein in patients with liver cirrhosis and hepatocellular carcinoma: a comparison with alpha-fetoprotein. Clin Chem Lab Med 2001; 39:961-5. [PMID: 11758611 DOI: 10.1515/cclm.2001.155] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Glycoprotein 90K/MAC-2BP is a member of the scavenger receptor cystein-rich protein superfamily, which is thought to be involved in immune surveillance, defending the body against pathogens and cancer. 90K serum levels are elevated in patients with cancer of various origins and in viral infections, such as human immunodeficiency virus and hepatitis C virus (HCV). Because in patients with HCV-related cirrhosis the incidence of hepatocellular carcinoma (HCC) is high, in the present paper we examined, by means of an enzyme-linked immunosorbent assay, the 90K serum levels in 103 patients with liver cirrhosis, and in 69 with HCC, and compared them to alpha-fetoprotein, the reference tumor marker for this neoplasm. Serum levels of 90K (cut-off 14 microg/ml) were elevated both in cirrhosis (39%) and HCC (46%) compared to controls (14.1 microg/ml vs. 10.6 microg/ml in cirrhosis, and 14.8 microg/ml vs. 9.1 microg/ml in HCC, p < or = 0.001). There was a significant association with the presence of anti-HCV antibodies. 90K was found to be a non-specific tumor marker which is complementary to alpha-fetoprotein on the basis of its probable different biological significance. In fact, 74% of HCC patients had at least one positive marker. Combined use of 90K and alpha-fetoprotein could improve the sensitivity of a single test in the diagnosis of HCC.
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Affiliation(s)
- P A Iacovazzi
- Clinical Laboratory Unit, IRCCS Gastroenterology Institute S. De Bellis, Castellana Grotte (Bari), Italy.
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Abstract
BACKGROUND Hyperinsulinaemia has been associated with many common diseases in developed countries, such as ischaemic heart disease and colon cancer. Gall stones are also very prevalent in these countries but little is known about the association between insulin and gall stones. AIMS To study the relationships between insulin and the incidence of gall stones in a sample of the general population. SUBJECTS AND METHODS Between May 1985 and June 1986, systematic sampling from the electoral register of Castellana, a small town in southern Italy, yielded 2472 subjects who had their gall bladder checked for gall stones by ultrasonography. Between May 1992 and June 1993, 1962 of the 2235 subjects without gall stones at the first examination agreed to a further ultrasound examination. A total of 101 subjects with newly diagnosed gall stones and 303 randomly chosen controls entered the study. Serum insulin was determined by radioimmunoassay, and concentrations of cholesterol, cholesterol high density lipoprotein (HDL), glucose, and triglycerides by standard enzymatic colorimetric methods. Unconditional multiple logistic regression was used to study the association between insulin and gall stones, controlling for the most common confounding factors. RESULTS In individuals with no clinical diagnosis of diabetes and serum glucose <7 mmol/l, insulin was associated with gall stones. This association persisted even after controlling for sex, age, body mass index, and serum glucose. The risk of gall stones in the highest quintile of serum insulin was 2.66 (95% confidence interval 1.04-6.72; chi(2) test for trend, p=0.03). The association of insulin with gall stones persisted when total and HDL cholesterol were entered in the logistic regression models, and only slightly decreased when serum triglycerides were included in the model. CONCLUSIONS The results of the study indicate that hyperinsulinaemia may play an important role in the aetiology of gall stones even in individuals without diabetes and with normal serum glucose levels.
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Affiliation(s)
- G Misciagna
- Laboratorio di Epidemiologia, IRCCS "S de Bellis", Ospedale Gastroenterologico, Castellana, Bari, Italy
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Sonnante AM, Correale M, Linsalata M, Di Leo A, Guerra V. Circulating Levels of Matrix Metalloproteinase-9 in Patients with Colorectal Cancer. Scand J Gastroenterol 2000; 35:671-2. [PMID: 10912671 DOI: 10.1080/003655200750023679] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Bonfitto P, Valenza M, Castellana G, Gentile F, Lombardi P, Ricco G, Lamorgese V, Correale M, Lippolis A. Bronchial infection and systemic steroid therapy in a sample of patients with acute exacerbation of chronic bronchitis (AECB). Respir Med 2000. [DOI: 10.1016/s0954-6111(00)90192-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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44
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Correale M, Giannuzzi V, Iacovazzi PA, Valenza MA, Lanzillotta S, Abbate I, Quaranta M, Caruso ML, Elba S, Manghisi OG. Serum 90K/MAC-2BP glycoprotein levels in hepatocellular carcinoma and cirrhosis. Anticancer Res 1999; 19:3469-72. [PMID: 10629637] [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: 02/15/2023]
Abstract
90K/MAC-2BP glycoprotein is a serum tumour marker, member of the scavenger receptor cysteine rich (SRCR) protein superfamily, involved in different immunological mechanisms. In the present study, we determined 90K serum levels by a sandwich enzyme immunoassay using the same monoclonal antibody in 11 chronic active hepatitis (CAH), 48 liver cirrhosis and 36 hepatocellular carcinoma (HCC). In comparison, the same samples were also tested for AFP. According to a cut-off point of 14 micrograms/mL for the 90K, established as 100% of specificity in 50 controls, we observed increasing positivities from CAH to cirrhosis and then to HCC (27%, 50% and 78%, respectively). In cirrhotic patients 90K levels were associated with the presence of anti-HCV antibodies, but not with the degree of liver compromise. Finally, 90K sensitivity was higher than AIFP in all groups of hepatic patients. However, further investigations are needed before proposing 90K as a clinical useful tumour marker in the progression from cirrhosis to HCC.
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Affiliation(s)
- M Correale
- IRCCS Gastroenterology Institute S. De Bellis, Castellana Grotte, Bari, Italy
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45
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Abbate I, D'Introno A, Cardo G, Marano A, Addabbo L, Musci MD, Pagliarulo A, Correale M, Quaranta M. Comparison of nuclear matrix protein 22 and bladder tumor antigen in urine of patients with bladder cancer. Anticancer Res 1998; 18:3803-5. [PMID: 9854500] [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: 02/09/2023]
Abstract
Recently, two new tumor markers for bladder cancer have been introduced: NMP22 test and BTA TRAK assay. This study was designed to evaluate the urinary values of these two proteins using quantitative enzyme immunoassays in well microplates. Urine samples from 47 healthy subjects, 26 with benign genitourinary disorders and 109 patients with a histological diagnosis of bladder cancer were collected. The specificity, the positive predictive value, the negative predictive value and the efficiency were established for NMP 22 and BTA, and the cut off values were fixed at a specificity of 95% in the benign disease group (12 U/ml and 23 U/ml respectively). We observed a very high concordance between the two urinary tumor markers (73%), although the overall sensitivity of BTA in bladder cancer patients seems to be better than that of NMP22 (62% vs 54% respectively), especially in the superficial disease group (36% for BTA and 14% for NMP22).
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Affiliation(s)
- I Abbate
- Oncology Institute of Bari, Italy
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46
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Tedone T, Correale M, Barbarossa G, Casavola V, Paradiso A, Reshkin SJ. Release of the aspartyl protease cathepsin D is associated with and facilitates human breast cancer cell invasion. FASEB J 1997; 11:785-92. [PMID: 9271363 DOI: 10.1096/fasebj.11.10.9271363] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [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: 02/05/2023]
Abstract
Data concerning the hormone sensitivity of the release and role of the aspartyl protease cathepsin D in tumor proliferative and invasive processes have been contradictory. To clarify the mechanisms of its release and role we first studied the contribution of estradiol and stripped serum to the time course and kinetics of cathepsin D release, proliferation, and invasion in parallel in the MCF-7 in vitro breast cancer cell culture model. Both estradiol and stripped serum independently stimulated both proliferation and cathepsin D release. However, the dose-response of estradiol and stripped serum-dependent stimulated release were similar to those for invasion and differed from those for proliferation: cathepsin D release and invasion were first stimulated at a stripped serum concentration more than 10-fold lower than that which initiated proliferation and had half stimulation constants almost 10-fold lower than those for proliferation. These results demonstrate that cathepsin D release is not related in any direct way to proliferation. The effect of the reduction of cathepsin D activity or release on in vitro invasion was also measured: both the inhibition of secreted cathepsin D activity by a specific inhibitor, diazoacetyl-DL-Nle-OMe, and the reduction of cathepsin D release by antisense oligonucleotides against its translation start site reduced cellular in vitro invasion without affecting proliferation. Cathepsin D release and activity are concluded to be directly involved in the process of invasion.
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Affiliation(s)
- T Tedone
- Laboratory of Experimental Oncology, Oncology Institute of Bari, Italy
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47
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Casamassima A, Marinaccio L, Fanciullo F, Correale M, Petroni S, Wiesel S, Simone G, Marzullo A, Caponio MA, Falco G. [Secretory IgA of the cervical mucus in neoplastic and nonneoplastic conditions of the uterine cervix]. Minerva Ginecol 1997; 49:7-12. [PMID: 9162888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In 39 women affected by cervical intraepithelial neoplasia (CIN) concentration of the cervical mucus secretory IgA (sIgA) was significantly higher than in 414 controls matched for age, reproductive status and smoking habit (196 healthy women; 109 with "specific" and "aspecific" cervicitis or cervico-vaginitis; 51 with benign epithelial disorders of the cervix; 40 with adenomatous cervical polyp and 18 with early invasive exocervical squamous carcinoma). CIN carried the highest proportion of cases with sIgA detectable or beyond the cut-off value and sIgA concentration was inversely related to CIN grade. Present data confirm our preliminary investigation on the cervical total IgA and explain that any increased levels of these IgA are induced by the secretory and not serum fraction of this immunoglobulin. We still don't know the exact meaning and value of the present results. It is only possible to suppose that they are the expression of a vigorous local immune activation adverse to CIN, which is elevated for as long as the architecture of cervical glandular epithelia is preserved.
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Affiliation(s)
- A Casamassima
- Unità di Laboratorio Analisi, IRCCS Oncologico, Bari
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Correale M, Reshkin S, Tedone T, Abbate I, Mangia A, Schittulli F, Paradiso A. Cytokeratins and proliferation in breast cancer patients. Int J Oncol 1996; 9:1007-12. [PMID: 21541608 DOI: 10.3892/ijo.9.5.1007] [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: 11/05/2022] Open
Abstract
Tissue polypeptide antigen (TPA) was studied in 242 sera and 165 tumor cell cytosols (both evaluations in 67 cases) of breast cancer patients, for which proliferative activity, determined by the TLI technique, was also available. The TPA serum and tumor cell cytosol median values (utilized for measure analysis as cut-off) were 70 U/1 and 377 U/mg cytosol protein, respectively. High serum TPA levels were associated with unfavourable clinicopathological characteristics whereas a higher tumor cell cytosol TPA level was associated with better cytohistological tumor differentiation. Furthermore, no overall correlation was found between serum and tumor cell cytosol TPA levels or between their levels and TLI. When analyzing cases in which serum and tumor cell cytosol TPA values were higher than 100 U/l and 500 U/mg cytosol protein, respectively (n = 28), serum TPA was positively associated with TLI (slope = 12.3 r = 0.55, p < 0.01), while cytosolic TPA resulted negatively associated with TLI (slope = -87.4 r = 0.41, p < 0.01). Finally, a strong inverse relationship between cytosolic and serum TPA (p < 0.0005) became evident. We suggest that TPA could represent a serum marker for tumor cell proliferation in specific patient subgroups with original high serum and/or cytosol TPA expression.
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Affiliation(s)
- M Correale
- ONCOL INST BARI,EXPTL & CLIN ONCOL LAB,I-70126 BARI,ITALY
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Tedone T, Correale M, Paradiso A, Reshkin SJ. Differential responsiveness of proliferation and cytokeratin release to stripped serum and oestrogen in the human breast cancer cell line, MCF-7. Eur J Cancer 1996; 32A:849-56. [PMID: 9081365 DOI: 10.1016/0959-8049(95)00660-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In vitro research into hormone sensitivity and the relation to proliferation of cytokeratin release from cancer cells is scarce. Therefore, we examined the stimulation of proliferation and the release of cytokeratins in a breast cancer cell culture model. Cell growth was stimulated by 17 beta-oestradiol (10(-11) M), stripped serum (10%) and by the two together. Cytokeratin release was stimulated only by stripped serum, oestradiol having no effect. After long incubation periods (> 12 h), cytokeratin release also commenced in the control and oestradiol treatments. Release rate versus time analysis suggested that there are two different release processes. Cytokeratin release was first stimulated at a stripped serum concentration approximately 100 times lower than that which initiated proliferation. Pharmacological alteration of proliferation with cordyceptin resulted in growth changes without alterations in cytokeratin release. We conclude that cytokeratin release in these cells is unrelated to proliferation, independent of oestrogen action and probably in some way related to growth factor receptor function.
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Affiliation(s)
- T Tedone
- Laboratory of Experimental Oncology, Oncology Institute of Bari, Italy
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50
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