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Pasceri V, Pelliccia F, Mehran R, Dangas G, Porto I, Radico F, Biancari F, D'Ascenzo F, Saia F, Luzi G, Bedogni F, Amat Santos IJ, De Marzo V, Dimagli A, Mäkikallio T, Stabile E, Blasco-Turrión S, Testa L, Barbanti M, Tamburino C, Fabiocchi F, Chilmeran A, Conrotto F, Costa G, Stefanini G, Spaccarotella C, Macchione A, La Torre M, Bendandi F, Juvonen T, Wańha W, Wojakowski W, Benedetto U, Indolfi C, Hildick-Smith D, Zimarino M. Risk Score for Prediction of Dialysis After Transcatheter Aortic Valve Replacement. J Am Heart Assoc 2024; 13:e032955. [PMID: 38533944 DOI: 10.1161/jaha.123.032955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/08/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Dialysis is a rare but serious complication after transcatheter aortic valve replacement. We analyzed the large multicenter TRITAVI (transfusion requirements in transcatheter aortic valve implantation) registry in order to develop and validate a clinical score assessing this risk. METHODS AND RESULTS A total of 10 071 consecutive patients were enrolled in 19 European centers. Patients were randomly assigned (2:1) to a derivation and validation cohort. Two scores were developed, 1 including only preprocedural variables (TRITAVIpre) and 1 also including procedural variables (TRITAVIpost). In the 6714 patients of the derivation cohort (age 82±6 years, 48% men), preprocedural factors independently associated with dialysis and included in the TRITAVIpre score were male sex, diabetes, prior coronary artery bypass graft, anemia, nonfemoral access, and creatinine clearance <30 mL/min per m2. Additional independent predictors among procedural features were volume of contrast, need for transfusion, and major vascular complications. Both scores showed a good discrimination power for identifying risk for dialysis with C-statistic 0.78 for TRITAVIpre and C-statistic 0.88 for TRITAVIpost score. Need for dialysis increased from the lowest to the highest of 3 risk score groups (from 0.3% to 3.9% for TRITAVIpre score and from 0.1% to 6.2% for TRITAVIpost score). Analysis of the 3357 patients of the validation cohort (age 82±7 years, 48% men) confirmed the good discrimination power of both scores (C-statistic 0.80 for TRITAVIpre and 0.81 for TRITAVIpost score). Need for dialysis was associated with a significant increase in 1-year mortality (from 6.9% to 54.4%; P=0.0001). CONCLUSIONS A simple preprocedural clinical score can help predict the risk of dialysis after transcatheter aortic valve replacement.
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Affiliation(s)
| | | | | | | | - Italo Porto
- Chair of Cardiovascular Disease, Department of Internal Medicine and Specialties University of Genoa Italy
- Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genoa Italy
| | | | - Fausto Biancari
- Department of Medicine South Karelia Central Hospital, University of Helsinki Lappeenranta Finland
| | - Fabrizio D'Ascenzo
- Department of Internal Medicine Città della Salute e della Scienza Turin Italy
| | - Francesco Saia
- Department of Cardiothoracic Vascular Surgery University Hospital Bologna Italy
| | - Giampaolo Luzi
- Cardiovascular Department Azienda Ospedaliera Regionale "San Carlo" Potenza Italy
| | - Francesco Bedogni
- Department of Cardiology IRCCS Policlinico San Donato, San Donato Milanese Milan Italy
| | - Ignacio J Amat Santos
- CIBERCV, Interventional Cardiology Hospital Clínico Universitario de Valladolid Valladolid Spain
| | - Vincenzo De Marzo
- Chair of Cardiovascular Disease, Department of Internal Medicine and Specialties University of Genoa Italy
- Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genoa Italy
- Department of Cardiology ASL2 Abruzzo Chieti Italy
| | - Arnaldo Dimagli
- Department of Cardiothoracic Surgery Weill Cornell Medicine New York NY
| | - Timo Mäkikallio
- Department of Medicine South Karelia Central Hospital, University of Helsinki Lappeenranta Finland
| | - Eugenio Stabile
- Cardiovascular Department Azienda Ospedaliera Regionale "San Carlo" Potenza Italy
| | - Sara Blasco-Turrión
- CIBERCV, Interventional Cardiology Hospital Clínico Universitario de Valladolid Valladolid Spain
| | - Luca Testa
- Department of Cardiology IRCCS Policlinico San Donato, San Donato Milanese Milan Italy
| | | | - Corrado Tamburino
- Division of Cardiology A.O.U. Policlinico "G. Rodolico-San Marco" Catania Italy
| | - Franco Fabiocchi
- Centro Cardiologico Monzino, IRCCS Milan Italy
- Galeazzi-Sant'Ambrogio Hospital, I.R.C.C.S Milan Italy
| | - Ahmed Chilmeran
- Department of Cardiology Royal Sussex County Hospital Brighton UK
| | - Federico Conrotto
- Department of Internal Medicine Città della Salute e della Scienza Turin Italy
| | - Giuliano Costa
- Division of Cardiology A.O.U. Policlinico "G. Rodolico-San Marco" Catania Italy
| | | | | | - Andrea Macchione
- Chair of Cardiovascular Disease, Department of Internal Medicine and Specialties University of Genoa Italy
- Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS Ospedale Policlinico San Martino Genoa Italy
| | - Michele La Torre
- Department of Internal Medicine Città della Salute e della Scienza Turin Italy
| | - Francesco Bendandi
- Department of Cardiothoracic Vascular Surgery University Hospital Bologna Italy
| | - Tatu Juvonen
- Heart and Lung Center, Helsinki University Central Hospital University of Helsinki Finland
| | - Wojciech Wańha
- Division of Cardiology and Structural Heart Diseases Medical University of Silesia Katowice Poland
| | - Wojtek Wojakowski
- Division of Cardiology and Structural Heart Diseases Medical University of Silesia Katowice Poland
| | - Umberto Benedetto
- Department of Cardiac Surgery University "G. d'Annunzio" Chieti Italy
| | - Ciro Indolfi
- Division of Cardiology University Magna Graecia Catanzaro Italy
| | | | - Marco Zimarino
- Department of Cardiology ASL2 Abruzzo Chieti Italy
- Department of Neuroscience, Imaging and Clinical Sciences 'G. D'Annunzio' University of Chieti-Pescara Italy
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Salizzoni S, Vairo A, Montefusco A, Alunni G, La Torre M, Agostini G, Pistono M, Faletti R, Rinaldi M, Vola M. A Mono-Leaflet, Low-Profile Transcatheter Mitral Prosthesis: First-in-Human Implantation. JACC Cardiovasc Interv 2023; 16:2918-2919. [PMID: 37943193 DOI: 10.1016/j.jcin.2023.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 11/10/2023]
Affiliation(s)
| | - Alessandro Vairo
- Cardiac Division, Città Della Salute e Della Scienza, Turin, Italy
| | | | - Gianluca Alunni
- Cardiac Division, Città Della Salute e Della Scienza, Turin, Italy
| | - Michele La Torre
- Cardiac Surgery Division, Città Della Salute e Della Scienza, Turin, Italy
| | - Giulia Agostini
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Massimo Pistono
- Division of Cardiac Rehabilitation of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS, Gattico-Veruno, Italy
| | - Riccardo Faletti
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Mauro Rinaldi
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Marco Vola
- Cardiac Surgery Division, University of Lyon, Lyon, France
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3
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Bruno F, Munoz Pousa I, Saia F, Vaira MP, Baldi E, Leone PP, Cabanas-Grandio P, Corcione N, Spinoni EG, Annibali G, Russo C, Ziacchi M, Caruzzo CA, Ferlini M, Lanzillo G, De Filippo O, Dusi V, Gallone G, Castagno D, Patti G, La Torre M, Musumeci G, Giordano A, Stefanini G, Salizzoni S, Conrotto F, Rinaldi M, Rordorf R, Abu-Assi E, Raposeiras-Roubin S, Biffi M, D'Ascenzo F, De Ferrari GM. Impact of Right Ventricular Pacing in Patients With TAVR Undergoing Permanent Pacemaker Implantation. JACC Cardiovasc Interv 2023; 16:1081-1091. [PMID: 37164607 DOI: 10.1016/j.jcin.2023.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 01/24/2023] [Accepted: 02/07/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Long-term right ventricular pacing (VP) has been related to negative left ventricular remodeling and heart failure (HF), but there is a lack of evidence regarding the prognostic impact on transcatheter aortic valve replacement (TAVR) patients. OBJECTIVES The aim of the PACE-TAVI registry is to evaluate the association of high percentage of VP with adverse outcomes in patients with pacemaker implantation after TAVR. METHODS PACE-TAVI is an international multicenter registry of all consecutive TAVR patients who underwent permanent pacemaker implantation for conduction disturbances in the first 30 days after the procedure. Patients were divided into 2 subgroups according to the percentage of VP (<40% vs ≥40%) at pacemaker interrogation. The primary endpoint was the composite of cardiovascular mortality or hospitalization for HF. RESULTS A total of 377 patients were enrolled, 158 with VP <40% and 219 with VP ≥40%. After multivariable adjustment, VP ≥40% was associated with a higher incidence of the primary endpoint (HR: 2.76; 95% CI: 1.39-5.51; P = 0.004), first HF hospitalization (HR: 3.37; 95% CI: 1.50-7.54; P = 0.003), and cardiovascular death (HR: 3.77; 95% CI: 1.02-13.88; P = 0.04), while the incidence of all-cause death was not significantly different (HR: 2.17; 95% CI: 0.80-5.90; P = 0.13). Patients with VP ≥ 40% showed a higher New York Heart Association functional class both at 1 year (P = 0.009) and at last available follow-up (P = 0.04) and a nonsignificant reduction of left ventricular ejection fraction (P = 0.18) on 1-year echocardiography, while patients with VP <40% showed significant improvement (P = 0.009). CONCLUSIONS In TAVR patients undergoing permanent pacemaker implantation, a high percentage of right VP at follow-up is associated with an increased risk for cardiovascular death and HF hospitalization. These findings suggest the opportunity to minimize right VP through dedicated algorithms in post-TAVR patients without complete atrioventricular block and to evaluate a more physiological VP modality in patients with persistent complete atrioventricular block.
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Affiliation(s)
- Francesco Bruno
- Division of Cardiology, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy.
| | - Isabel Munoz Pousa
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - Francesco Saia
- Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Matteo Pio Vaira
- Division of Cardiology, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Enrico Baldi
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | | - Nicola Corcione
- Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Rome, Italy
| | - Enrico Guido Spinoni
- Division of Cardiology, University of Eastern Piedmont, Maggiore Della Carità Hospital, Novara, Italy
| | - Gianmarco Annibali
- S.C. Cardiologia, Azienda Ospedaliera Ordine Mauriziano Umberto I, Turin, Italy
| | - Caterina Russo
- Division of Cardiology, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Matteo Ziacchi
- Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Carlo Alberto Caruzzo
- Division of Cardiology, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Marco Ferlini
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giuseppe Lanzillo
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Ovidio De Filippo
- Division of Cardiology, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Veronica Dusi
- Division of Cardiology, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Guglielmo Gallone
- Division of Cardiology, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Davide Castagno
- Division of Cardiology, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Giuseppe Patti
- Division of Cardiology, University of Eastern Piedmont, Maggiore Della Carità Hospital, Novara, Italy
| | - Michele La Torre
- Division of Cardiac Surgery, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Giuseppe Musumeci
- S.C. Cardiologia, Azienda Ospedaliera Ordine Mauriziano Umberto I, Turin, Italy
| | - Arturo Giordano
- Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Rome, Italy
| | - Giulio Stefanini
- IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
| | - Stefano Salizzoni
- Division of Cardiac Surgery, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Federico Conrotto
- Division of Cardiology, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Mauro Rinaldi
- Division of Cardiac Surgery, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Roberto Rordorf
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Emad Abu-Assi
- Servicio de Cardiología, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | | | - Mauro Biffi
- Cardiology Unit, Cardio-Thoracic-Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Cardiovascular and Thoracic Department, Città Della Salute e Della Scienza Hospital and University of Turin, Turin, Italy
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4
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Vairo A, Zaccaro L, Ballatore A, Airale L, D’Ascenzo F, Alunni G, Conrotto F, Scudeler L, Mascaretti D, Miccoli D, Torre ML, Rinaldi M, Pedrizzetti G, Salizzoni S, De Ferrari GM. Acute Modification of Hemodynamic Forces in Patients with Severe Aortic Stenosis after Transcatheter Aortic Valve Implantation. J Clin Med 2023; 12:jcm12031218. [PMID: 36769866 PMCID: PMC9917967 DOI: 10.3390/jcm12031218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/19/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Transcatheter aortic valve implantation (TAVI) is the established first-line treatment for patient with severe aortic stenosis not suitable for surgery. Echocardiographic evaluation of hemodynamic forces (HDFs) is a growing field, holding the potential to early predict improvement in LV function. A prospective observational study was conducted. Transthoracic echocardiography was performed before and after TAVI. HDFs were analyzed along with traditional left ventricular (LV) function parameters. Twenty-five consecutive patients undergoing TAVI were enrolled: mean age 83 ± 5 years, 74.5% male, mean LV Ejection Fraction (LVEF) at baseline 57 ± 8%. Post-TAVI echocardiographic evaluation was performed 2.4 ± 1.06 days after the procedure. HDF amplitude parameters improved significantly after the procedure: LV Longitudinal Forces (LF) apex-base [mean difference (MD) 1.79%; 95% CI 1.07-2.5; p-value < 0.001]; LV systolic LF apex-base (MD 2.6%; 95% CI 1.57-3.7; p-value < 0.001); LV impulse (LVim) apex-base (MD 2.9%; 95% CI 1.48-4.3; p-value < 0.001). Similarly, HDFs orientation parameters improved: LVLF angle (MD 1.5°; 95% CI 0.07-2.9; p-value = 0.041); LVim angle (MD 2.16°; 95% CI 0.76-3.56; p-value = 0.004). Conversely, global longitudinal strain and LVEF did not show any significant difference before and after the procedure. Echocardiographic analysis of HDFs could help differentiate patients with LV function recovery after TAVI from patients with persistent hemodynamic dysfunction.
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Affiliation(s)
- Alessandro Vairo
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
- Correspondence: (A.V.); (L.A.); Tel.: +39-011-6335511 (A.V.); +39-011-6336953 (L.A.); Fax: +39-011-6336015 (A.V.); +39-011-6336952 (L.A.)
| | - Lorenzo Zaccaro
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Andrea Ballatore
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Lorenzo Airale
- Internal Medicine and Hypertension Division, Department of Medical Sciences, Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy
- Correspondence: (A.V.); (L.A.); Tel.: +39-011-6335511 (A.V.); +39-011-6336953 (L.A.); Fax: +39-011-6336015 (A.V.); +39-011-6336952 (L.A.)
| | - Fabrizio D’Ascenzo
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Gianluca Alunni
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Federico Conrotto
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Luca Scudeler
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Daniela Mascaretti
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Davide Miccoli
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
| | - Michele La Torre
- Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza di Torino, University of Turin, 10126 Torino, Italy
| | - Mauro Rinaldi
- Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza di Torino, University of Turin, 10126 Torino, Italy
| | - Gianni Pedrizzetti
- Department of Engineering and Architecture, University of Trieste, 34127 Trieste, Italy
| | - Stefano Salizzoni
- Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza di Torino, University of Turin, 10126 Torino, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza Hospital, 10126 Turin, Italy
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5
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Bruno F, Elia E, D'Ascenzo F, Marengo G, Deharo P, Kaneko T, Cuisset T, Fauchier L, De Filippo O, Gallone G, Andreis A, Fortuni F, Salizzoni S, La Torre M, Rinaldi M, De Ferrari GM, Conrotto F. Valve-in-valve transcatheter aortic valve replacement or re-surgical aortic valve replacement in degenerated bioprostheses: A systematic review and meta-analysis of short and midterm results. Catheter Cardiovasc Interv 2022; 100:122-130. [PMID: 35485723 DOI: 10.1002/ccd.30219] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 03/03/2022] [Accepted: 04/15/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Despite limited to short and midterm outcomes, valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) has emerged as a valid alternative to re-surgical aortic valve replacement (re-SAVR) for high- and intermediate-risk patients with degenerated surgical bioprosthesis. METHODS All studies comparing multivariate adjustment between ViV TAVI and re-SAVR were screened. The primary end-points were all-cause and cardiovascular (CV) mortality at 30 days and at Midterm follow-up. Short-term complications were the secondary endpoints. RESULTS We obtained data from 11 studies, encompassing 8570 patients, 4224 undergoing ViV TAVI, and 4346 re-SAVR. Four studies included intermediate-risk patients and seven high-risk patients. 30-day all-cause and CV mortality were significantly lower in ViV (odds ratio [OR] 0.43, 95% confidence intervals [CIs] 0.29-0.64 and OR 0.44, 0.26-0.73 respectively), while after a mean follow-up of 717 (180-1825) days, there was no difference between the two groups (OR 1.04, 0.87-1.25 and OR 1.05, 0.78-1.43, respectively). The risk of stroke (OR 1.03, 0.59-1.82), MI (OR 0.70, 0.34-1.44), major vascular complications (OR 0.92, 0.50-1.67), and permanent pacemaker implantation (OR 0.67, 0.36-1.25) at 30 days did not differ, while major bleedings and new-onset atrial fibrillation were significantly lower in ViV patients (OR 0.41, 0.25-0.67 and OR 0.23, 0.12-0.42, respectively, all 95% CIs). CONCLUSIONS In high- and intermediate-risk patients with degenerated surgical bioprostheses, ViV TAVI is associated with reduced short-term mortality, compared with re-SAVR. Nevertheless, no differences were found in all-cause and CV mortality at midterm follow-up. PROSPERO CRD42021226488.
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Affiliation(s)
- Francesco Bruno
- Division of Cardiology, Department Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Edoardo Elia
- Division of Cardiology, Department Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Giorgio Marengo
- Division of Cardiology, Department Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Pierre Deharo
- Département de Cardiologie, CHU Timone, Marseille, France.,INSRRM, INRA, Aix Marseille University, Marseille, France
| | - Tsuyoshi Kaneko
- Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Thomas Cuisset
- Département de Cardiologie, CHU Timone, Marseille, France.,INSRRM, INRA, Aix Marseille University, Marseille, France
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Trousseau, Tours, France
| | - Ovidio De Filippo
- Division of Cardiology, Department Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Guglielmo Gallone
- Division of Cardiology, Department Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Alessandro Andreis
- Division of Cardiology, Department Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Federico Fortuni
- Division of Cardiology, Department Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Stefano Salizzoni
- Division of Cardiosurgery, Department of Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Michele La Torre
- Division of Cardiosurgery, Department of Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Mauro Rinaldi
- Division of Cardiosurgery, Department of Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Gaetano M De Ferrari
- Division of Cardiology, Department Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Federico Conrotto
- Division of Cardiology, Department Cardiovascular and Thoracic, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
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6
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Conrotto F, D'Ascenzo F, Franchin L, Bruno F, Mamas MA, Toutouzas K, Cuisset T, Leclercq F, Dumonteil N, Latib A, Nombela-Franco L, Schaefer A, Anderson RD, Marruncheddu L, Gallone G, De Filippo O, La Torre M, Rinaldi M, Omedè P, Salizzoni S, De Ferrari GM. Transcatheter Aortic Valve Implantation With or Without Predilation: A Meta-Analysis. J Invasive Cardiol 2022; 34:E104-E113. [PMID: 34995208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIMS To evaluate the impact of systematic predilation with balloon aortic valvuloplasty (BAV) on transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS We performed a systematic meta-analysis investigating patients undergoing TAVI with systematic BAV vs no BAV in RCT or in adjusted studies. Device success was the primary endpoint, while all-cause mortality, 30-day moderate/severe aortic regurgitation (AR), stroke, permanent pacemaker implantation (PPI) and acute kidney injury (AKI) were the secondary endpoints. Subanalysis according to design of the study (RCT and adjusted analysis) and to the type of valve (balloon-expandable [BE] vs self-expanding [SE]) were conducted. We obtained data from 15 studies, comprising 16,408 patients: 10,364 undergoing BAV prior to TAVI and 6,044 in which direct TAVI has been performed. At 30-day follow-up, BAV did not improve the rate of device success in the overall population (OR, 1.09; 95% CI, 0.90-1.31), both in SE (OR, 0.93; 95% CI, 0.60-1.45) and in BE (OR, 1.16; 95% CI, 0.88-1.52) valves. Between BAV and direct TAVI, no differences in secondary outcomes were observed neither in overall population nor according to valve type between BAV and direct TAVI strategies. All endpoints results were consistent between RCTs and adjusted studies except for postdilation rate that did not differ in observational studies (OR, 0.70; 95% CI, 0.47-1.04), while it was lower in BAV when only RCTs were included in the analysis (OR, 0.48; 95% CI, 0.24-0.97). CONCLUSIONS Direct TAVI is feasible and safe compared to predilation approach with similar device success rates and clinical outcomes. Direct TAVI could represent a first-choice approach in contemporary TAVI procedures.
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Affiliation(s)
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Medical Science, University of Turin, Corso Bramante 88/90, Turin, Italy.
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7
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Gallone G, Depaoli A, D'Ascenzo F, Tore D, Allois L, Bruno F, Casale M, Atzeni F, De Lio G, Bocchino PP, Piroli F, Angelini F, Angelini A, Scudeler L, De Lio F, Andreis A, Salizzoni S, La Torre M, Conrotto F, Rinaldi M, Fonio P, De Ferrari GM. Impact of computed-tomography defined sarcopenia on outcomes of older adults undergoing transcatheter aortic valve implantation. J Cardiovasc Comput Tomogr 2021; 16:207-214. [PMID: 34896066 DOI: 10.1016/j.jcct.2021.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/29/2021] [Accepted: 12/04/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The adoption of Computed tomography (CT)-defined sarcopenia to risk stratify transcatheter aortic valve implantation (TAVI) candidates remains limited by a lack of both standardized definition and evidence of independent value over currently adopted mortality prediction tools. METHODS 391 consecutive TAVI patients with pre-procedural CT scan were included (81 ± 6 years, 57.5% male, STS-PROM score 4.4 ± 3.6%) and abdominal muscle retrospectively quantified. The two definitions of radiologic sarcopenia previously adopted in TAVI studies were compared (psoas muscle area [PMA] at the L4 vertebra level: "PMA-sarcopenia"; indexed skeletal muscle area at the L3 vertebra level: "SMI-sarcopenia"). The primary endpoint was longer available-term all-cause mortality. Secondary endpoints were Valve Academic Research Consortium-2-defined in-hospital and 30-day outcomes. RESULTS SMI- and PMA-sarcopenia were present in 192 (49.1%) and 117 (29.9%) patients, respectively. After a median of 24 (12-30) months follow-up, 83 (21.2%) patients died. PMA-(adj-HR 1.81, 95%CI 1.12-2.93, p = 0.015), but not SMI-sarcopenia (adj-HR 1.23, 95%CI 0.76-2.00, p = 0.391), was associated with all-cause mortality independently of age, sex and in-study outcome predictors (atrial fibrillation, hemoglobin, history of peripheral artery disease, cancer and subcutaneous adipose tissue). PMA-defined sarcopenia provided additive prognostic value over current post-TAVI mortality risk estimators including STS-PROM (p = 0.001), Euroscore II (p = 0.025), Charlson index (p = 0.025) and TAVI2-score (p = 0.020). Device success, early safety, clinical efficacy and 30-day all-cause death were unaffected by sarcopenia status regardless of definition. CONCLUSIONS PMA-sarcopenia (but not SMI-sarcopenia) is predictive of 2 year mortality among TAVI patients. The prognostic information provided by PMA-sarcopenia is independent of the tools currently adopted to predict post-TAVI mortality in clinical practice.
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Affiliation(s)
- Guglielmo Gallone
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy.
| | - Alessandro Depaoli
- Radiology Unit, Department of Surgical Sciences, Città della Salute e della Scienza, Turin, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Davide Tore
- Radiology Unit, Department of Surgical Sciences, Città della Salute e della Scienza, Turin, Italy
| | - Luca Allois
- Radiology Unit, Department of Surgical Sciences, Città della Salute e della Scienza, Turin, Italy
| | - Francesco Bruno
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Maurizio Casale
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Francesco Atzeni
- Division of Cardiac Surgery, Department of Surgery, Città della Salute e della Scienza, Turin, Italy
| | - Giulia De Lio
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Pier Paolo Bocchino
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Francesco Piroli
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Filippo Angelini
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Andrea Angelini
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Luca Scudeler
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Francesca De Lio
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Alessandro Andreis
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Stefano Salizzoni
- Division of Cardiac Surgery, Department of Surgery, Città della Salute e della Scienza, Turin, Italy
| | - Michele La Torre
- Division of Cardiac Surgery, Department of Surgery, Città della Salute e della Scienza, Turin, Italy
| | - Federico Conrotto
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Mauro Rinaldi
- Division of Cardiac Surgery, Department of Surgery, Città della Salute e della Scienza, Turin, Italy
| | - Paolo Fonio
- Radiology Unit, Department of Surgical Sciences, Città della Salute e della Scienza, Turin, Italy
| | - Gaetano M De Ferrari
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
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8
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D'Ascenzo F, Bruno F, Baldetti L, De Filippo O, Marengo G, Breviario S, Melillo F, Thyregod HGH, Thiele H, Sondergaard L, Popma JJ, Kodali S, Franchin L, Annaratone M, Marruncheddu L, Gallone G, Crimi G, La Torre M, Rinaldi M, Omedè P, Conrotto F, Salizzoni S, De Ferrari GM. Aortic valve replacement vs. balloon-expandable and self-expandable transcatheter implantation: A network meta-analysis. Int J Cardiol 2021; 337:90-98. [PMID: 33974961 DOI: 10.1016/j.ijcard.2021.04.068] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/21/2021] [Accepted: 04/30/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Recently, observational data have raised concerns about safety of selfexpandable (SE) compared to balloon-expandable (BE) valves in TAVI, although potentially limited by patient selection bias. METHODS All Randomized Controlled Trials (RCTs) comparing BE vs. SE TAVI or/and vs. aortic valve replacement (AVR) were included and compared through Network Meta Analysis (NMA). All-cause and cardiovascular (CV) mortality were the primary endpoints, stroke, rates of permanent pacemaker implantation (PPI), moderate/severe paravalvular leak (PVL) and reintervention were the secondary endpoints. Results We obtained data from 11 RCTs, encompassing 9752 patients. After one and two years, no significant differences for allcause and CV mortality were observed. Compared to surgical bioprostheses, both BE and SE TAVI reduced the risk of acute kidney injury (OR 0.42; CI 95% 0.30-0.60 and OR 0.44; CI 95% 0.32-0.60), new-onset atrial fibrillation (OR 0.24; CI 95% 0.14-0.42 and OR 0.21; CI 95% 0.13-0.34) and major bleedings (OR 0.32; CI 95% 0.16-0.65 and OR 0.47; CI 95% 0.25-0.89). The BE prostheses reduced the risk of moderate/severe PVL at 30-day (OR 0.31; CI 95% 0.17-0.55) and of PPI both at 30-day (OR 0.51; CI 95% 0.33-0.79) and 1 year (OR 0.40; CI 95% 0.30-0.55) as compared to SE TAVI. Conclusions A TAVI strategy, independently from BE or SE prostheses, offers a midterm survival comparable to AVR. The BE prostheses are associated with a reduction of PPI and PVL compared to SE prostheses without any differences in all-cause and CV mortality during two years of follow up. PROSPERO ID CRD42020182407.
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Affiliation(s)
- Fabrizio D'Ascenzo
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy.
| | - Francesco Bruno
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
| | - Luca Baldetti
- Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Italy
| | - Ovidio De Filippo
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
| | - Giorgio Marengo
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
| | - Susanna Breviario
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
| | - Francesco Melillo
- Unit of echocardiography, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Holger Thiele
- Heart Center Leipzig, University of Leipzig, Germany
| | | | | | - Susheel Kodali
- Columbia University Medical Center (SKK), United States of America
| | - Luca Franchin
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
| | | | - Laura Marruncheddu
- Department of Clinical Internal, Anesthesiological and Cardiovascular Science, Sapienza University of Rome, Rome, Italy
| | - Guglielmo Gallone
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
| | | | - Michele La Torre
- Division of Cardiosurgery, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
| | - Mauro Rinaldi
- Division of Cardiosurgery, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
| | - Pierluigi Omedè
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
| | - Federico Conrotto
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
| | - Stefano Salizzoni
- Division of Cardiosurgery, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Italy
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9
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Toscano A, Capuano P, Bartoletti L, Trompeo AC, Salizzoni S, La Torre M, Rinaldi M, Brazzi L. Use of Pectoralis Type 2 Block (PECS II) for Awake Trans-subclavian Transcatheter Aortic Valve Replacement: First Experience in Two Cases. J Cardiothorac Vasc Anesth 2021; 36:1401-1405. [PMID: 33744110 DOI: 10.1053/j.jvca.2021.02.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Antonio Toscano
- Department of Anesthesia, Critical Care and Emergency, 'Città della Salute e della Scienza' hospital, Turin, Italy.
| | - Paolo Capuano
- Department of Anesthesia, Critical Care and Emergency, 'Città della Salute e della Scienza' hospital, Turin, Italy
| | - Lorenzo Bartoletti
- Department of Anesthesia, Critical Care and Emergency, 'Città della Salute e della Scienza' hospital, Turin, Italy
| | - Anna Chiara Trompeo
- Department of Anesthesia, Critical Care and Emergency, 'Città della Salute e della Scienza' hospital, Turin, Italy
| | - Stefano Salizzoni
- Department of cardiovascular and thoracic surgery, 'Città della Salute e della Scienza', Turin, Italy
| | - Michele La Torre
- Department of cardiovascular and thoracic surgery, 'Città della Salute e della Scienza', Turin, Italy
| | - Mauro Rinaldi
- Department of cardiovascular and thoracic surgery, 'Città della Salute e della Scienza', Turin, Italy
| | - Luca Brazzi
- Department of Anesthesia, Critical Care and Emergency, 'Città della Salute e della Scienza' hospital, Turin, Italy
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10
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Giordana F, Bruno F, Conrotto F, Saglietto A, D'Ascenzo F, Grosso Marra W, Dvir D, Webb J, D'Onofrio A, Camboni D, Grubitzsch H, Duncan A, Kaneko T, Toggweiler S, Latib A, Nerla R, Salizzoni S, La Torre M, Trompeo A, D'Amico M, Rinaldi M, De Ferrari G. Incidence, predictors and outcomes of valve-in-valve TAVI: A systematic review and meta-analysis. Int J Cardiol 2020; 316:64-69. [DOI: 10.1016/j.ijcard.2020.05.058] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/10/2020] [Accepted: 05/18/2020] [Indexed: 11/28/2022]
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11
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Vicchio TM, Aliquò F, Ruggeri RM, Ragonese M, Giuffrida G, Cotta OR, Spagnolo F, Torre ML, Alibrandi A, Asmundo A, Angileri FF, Esposito F, Polito F, Oteri R, Aguennouz MH, Cannavò S, Ferraù F. MicroRNAs expression in pituitary tumors: differences related to functional status, pathological features, and clinical behavior. J Endocrinol Invest 2020; 43:947-958. [PMID: 31939196 DOI: 10.1007/s40618-019-01178-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 12/31/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND MicroRNAs (miRNAs) are small non-coding RNA molecules that regulate gene expression at post-transcriptional level, having a role in many biological processes, such as control of cell proliferation, cell cycle, and cell death. Altered miRNA expression has been reported in many neoplasms, including pituitary adenomas (PAs). PURPOSE In this study, we aimed to evaluate the expression of 20 miRNAs involved in pathways relevant to pituitary pathophysiology, in PAs and normal pituitary tissue and to correlate their expression profile with clinical and pathological features. METHODS Pituitary tumor samples were obtained during transphenoidal surgery from patients with non-functioning (NFPA, n = 12) and functioning (n = 11, 5 GH-, 3 ACTH-, 3 PRL-omas) PAs. The expression of selected miRNAs in PAs and in normal pituitary was analyzed by RT-qPCR. miRNAs expression was correlated with demographic, clinical, and neuroradiological data and with histopathological features including pituitary hormones immunostaining, Ki-67 proliferation index, and p53 immunohistochemistry evaluation. RESULTS All evaluated miRNAs except miR-711 were expressed in both normal and tumor pituitary tissue. Seventeen miRNAs were significantly down-regulated in pituitary tumors compared to normal pituitary. miRNAs were differentially expressed in functioning PAs or in NFPAs, as in the latter group miR-149-3p (p = 0.036), miR-130a-3p (p = 0.014), and miR-370-3p (p = 0.026) were significantly under expressed as compared to functioning tumors. Point-biserial correlation analysis demonstrated a negative correlation between miR-26b-5p and Ki-67 (p = 0.031) and between miR-30a-5p and 'atypical' morphological features (p = 0.038) or cavernous sinus invasion (p = 0.049), while 508-5p was inversely correlated with clinical aggressiveness (p = 0.043). CONCLUSIONS In this study, we found a significant down-regulation of 17 miRNAs in PAs vs normal pituitary, with differential expression profile related to functional status and tumor aggressiveness.
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Affiliation(s)
- T M Vicchio
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - F Aliquò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - R M Ruggeri
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M Ragonese
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - G Giuffrida
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - O R Cotta
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - F Spagnolo
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - M L Torre
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
| | - A Alibrandi
- Department of Economics, University of Messina, Messina, Italy
| | - A Asmundo
- Department of Biomedical Sciences, Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - F F Angileri
- Department of Biomedical Sciences, Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - F Esposito
- Department of Biomedical Sciences, Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
| | - F Polito
- Department of Human Pathology of Adulthood and Childhood 'G. Barresi', University of Messina, UOC di Endocrinologia, Pad. H, 4° Piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - R Oteri
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M H Aguennouz
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - S Cannavò
- Unit of Endocrinology, University Hospital 'G. Martino', Messina, Italy
- Department of Human Pathology of Adulthood and Childhood 'G. Barresi', University of Messina, UOC di Endocrinologia, Pad. H, 4° Piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - F Ferraù
- Department of Human Pathology of Adulthood and Childhood 'G. Barresi', University of Messina, UOC di Endocrinologia, Pad. H, 4° Piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy.
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Menzà G, D'Ascenzo F, Attisani M, La Torre M, Verzini F, Rinaldi M, De Ferrari GM. Performing a PCI through a trifurcated aortic graft: a new challenging access route. Minerva Cardioangiol 2020; 68:373-375. [PMID: 32524809 DOI: 10.23736/s0026-4725.20.05258-5] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Gregorio Menzà
- Division of Cardiology, Department of Internal Medicine, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy -
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Internal Medicine, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Matteo Attisani
- Department of Surgical Sciences, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Michele La Torre
- Department of Surgical Sciences, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Fabio Verzini
- Unit of Vascular Surgery, Department of Surgical Sciences, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Mauro Rinaldi
- Department of Surgical Sciences, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy
| | - Gaetano M De Ferrari
- Division of Cardiology, Department of Internal Medicine, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy
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13
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Vergine G, Fabbri E, Conte ML, La Torre M, Dell'Omo V, Ronchi F. Letter to the Editor. J Paediatr Child Health 2020; 56:490-491. [PMID: 32173943 DOI: 10.1111/jpc.14838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 02/16/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Gianluca Vergine
- Department of Pediatrics, Infermi Hospital Rimini, ASL Romagna, Italy
| | - Elena Fabbri
- Department of Pediatrics, Infermi Hospital Rimini, ASL Romagna, Italy
| | - Maria L Conte
- Department of Pediatrics, Infermi Hospital Rimini, ASL Romagna, Italy
| | - Michele La Torre
- Department of Radiology, Infermi Hospital Rimini, ASL Romagna, Italy
| | - Valeria Dell'Omo
- Department of Pediatrics, Infermi Hospital Rimini, ASL Romagna, Italy
| | - Flavio Ronchi
- Department of Pediatrics, Family Pediatrician Rimini, ASL Romagna, Italy
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14
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Toscano A, Capuano P, Trompeo AC, La Torre M, D'Amico M, Rinaldi M, Brazzi L. Awake Thoracic Epidural Anesthesia in Transapical Transcatheter Aortic Valve Implantation. J Cardiothorac Vasc Anesth 2019; 34:311-312. [PMID: 31383597 DOI: 10.1053/j.jvca.2019.07.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/03/2019] [Accepted: 07/09/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Antonio Toscano
- Department of Anesthesia and Critical Care, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Paolo Capuano
- Department of Anesthesia and Critical Care, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Anna Chiara Trompeo
- Department of Anesthesia and Critical Care, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Michele La Torre
- Division of Cardiac Surgery, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Maurizio D'Amico
- Division of Cardiology, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Mauro Rinaldi
- Department of Cardiovascular and Thoracic Surgery, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Luca Brazzi
- Department of Anesthesia and Critical Care, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
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15
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Centofanti P, Attisani M, La Torre M, Ricci D, Boffini M, Baronetto A, Simonato E, Clerici A, Rinaldi M. Left Ventricular Unloading during Peripheral Extracorporeal Membrane Oxygenator Support: A Bridge To Life In Profound Cardiogenic Shock. J Extra Corpor Technol 2017; 49:201-205. [PMID: 28979045 PMCID: PMC5621585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 03/22/2017] [Indexed: 06/07/2023]
Abstract
A limit of peripheral veno-arterial Extracorporeal Membrane Oxigenator (VA-ECMO) is the inadequate unloading of the left ventricle. The increase of end-diastolic pressure reduces the possibility of a recovery and may cause severe pulmonary edema. In this study, we evaluate our results after implantation of VA-ECMO and Transapical Left Ventricular Vent (TLVV) as a bridge to recovery, heart transplantation or long-term left ventricular assit devices (LVAD). From 2011 to 2014, 24 consecutive patients with profound cardiogenic shock were supported by peripheral VA-ECMO as bridge to decision. In all cases, TLVV was implanted after a mean period of 12.2 ± 3.4 hours through a left mini-thoracotomy and connected to the venous inflow line of the VA-ECMO. Thirty-day mortality was 37.5% (9/24). In all patients, hemodynamics improved after TLVV implantation with an increased cardiac output, mixed venous saturation and a significant reduced heart filling pressures (p < .05). Recovery of the cardiac function was observed in 11 patients (11/24; 45.8%). Three patients were transplanted (3/24; 12.5%) and three patients (3/24; 12.5%) underwent LVAD implantation as destination therapy, all these patients were discharged from the hospital in good clinical conditions. In these critical patients, systematic TLVV improved hemodynamic seemed to provide better in hospital survival and chance of recovery, compared to VA-ECMO results in the treatment of cardiogenic shock reported in the literature . TLVV is a viable alternative to standard VA-ECMO to identify the appropriate long-term strategy (heart transplantation or long-term VAD) reducing the risk of treatment failure. A larger and multicenter experience is mandatory to validate these hypothesis.
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Affiliation(s)
| | - Matteo Attisani
- Division of Cardiac Surgery, University of Turin, Turin, Italy
| | | | - Davide Ricci
- Division of Cardiac Surgery, University of Turin, Turin, Italy
| | - Massimo Boffini
- Division of Cardiac Surgery, University of Turin, Turin, Italy
| | | | - Erika Simonato
- Division of Cardiac Surgery, University of Turin, Turin, Italy
| | - Alberto Clerici
- Division of Cardiac Surgery, University of Turin, Turin, Italy
| | - Mauro Rinaldi
- Division of Cardiac Surgery, University of Turin, Turin, Italy
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Ferraù F, Romeo PD, Puglisi S, Ragonese M, Torre ML, Scaroni C, Occhi G, De Menis E, Arnaldi G, Trimarchi F, Cannavò S. Analysis of GPR101 and AIP genes mutations in acromegaly: a multicentric study. Endocrine 2016; 54:762-767. [PMID: 26815903 DOI: 10.1007/s12020-016-0862-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/08/2016] [Indexed: 12/17/2022]
Abstract
This multicentric study aimed to investigate the prevalence of the G protein-coupled receptor 101 (GPR101) p.E308D variant and aryl hydrocarbon receptor interacting protein (AIP) gene mutations in a representative cohort of Italian patients with acromegaly. 215 patients with GH-secreting pituitary adenomas, referred to 4 Italian referral centres for pituitary diseases, have been included. Three cases of gigantism were present. Five cases were classified as FIPA. All the patients have been screened for germline AIP gene mutations and GPR101 gene p.E308D variant. Heterozygous AIP gene variants have been found in 7 patients (3.2 %). Five patients carried an AIP mutation (2.3 %; 4 females): 3 patients harboured the p.R3O4Q mutation, one had the p.R304* mutation and the last one the IVS3+1G>A mutation. The prevalence of AIP mutations was 3.3 % and 2.8 % when considering only the patients diagnosed when they were <30 or <40-year old, respectively. Furthermore, 2.0 % of the patients with a pituitary macroadenoma and 4.2 % of patients resistant to somatostatin analogues treatment were found to harbour an AIP gene mutation. None of the patients was found to carry the GPR101 p.E308D variant. The prevalence of AIP gene mutations among our sporadic and familial acromegaly cases was similar to that one reported in previous studies, but lower when considering only the cases diagnosed before 40 years of age. The GPR101 p.E308D change is unlikely to have a role in somatotroph adenomas tumorigenesis, since none of our sporadic or familial patients tested positive for this variant.
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Affiliation(s)
- Francesco Ferraù
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy.
| | - P D Romeo
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - S Puglisi
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - M Ragonese
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - M L Torre
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - C Scaroni
- Endocrinology Unit, Department of Medicine, Padova University Hospital, Padua, Italy
| | - G Occhi
- Department of Biology, University of Padova, Padua, Italy
| | - E De Menis
- Department of Internal Medicine, General Hospital of Montebelluna, Treviso, Italy
| | - G Arnaldi
- Department of Endocrinology and Metabolic Diseases, Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| | - F Trimarchi
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - S Cannavò
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Messina, UOC di Endocrinologia, Pad. H, 4° piano, AOU Policlinico Gaetano Martino, Via Consolare Valeria, 1, 98125, Messina, Italy
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17
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Centofanti P, Barbero C, D'Agata F, Caglio MM, Caroppo P, Cicerale A, Attisani M, La Torre M, Milan A, Contristano ML, Carlini E, Izzo G, Mortara P, Veglio F, Rinaldi M. Neurologic and cognitive outcomes after aortic arch operation with hypothermic circulatory arrest. Surgery 2016; 160:796-804. [DOI: 10.1016/j.surg.2016.02.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/04/2016] [Accepted: 02/04/2016] [Indexed: 11/17/2022]
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Salizzoni S, D'Onofrio A, Agrifoglio M, Colombo A, Chieffo A, Cioni M, Besola L, Regesta T, Rapetto F, Tarantini G, Napodano M, Gabbieri D, Saia F, Tamburino C, Ribichini F, Cugola D, Aiello M, Sanna F, Iadanza A, Pompei E, Stefàno P, Cappai A, Minati A, Cassese M, Martinelli GL, Agostinelli A, Fiorilli R, Casilli F, Reale M, Bedogni F, Petronio AS, Mozzillo RA, Bonmassari R, Briguori C, Liso A, Sardella G, Bruschi G, Fiorina C, Filippini C, Moretti C, D'Amico M, La Torre M, Conrotto F, Di Bartolomeo R, Gerosa G, Rinaldi M. Early and mid-term outcomes of 1904 patients undergoing transcatheter balloon-expandable valve implantation in Italy: results from the Italian Transcatheter Balloon-Expandable Valve Implantation Registry (ITER). Eur J Cardiothorac Surg 2016; 50:1139-1148. [PMID: 27406375 DOI: 10.1093/ejcts/ezw218] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 04/08/2016] [Accepted: 04/13/2016] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The aim of this multicentre study is to report the clinical experiences of all patients undergoing transcatheter aortic valve implantation (TAVI) with a balloon-expandable device in Italy. METHODS The Italian Transcatheter balloon-Expandable valve Registry (ITER) is a real-world registry that includes patients who have undergone TAVI with the Sapien (Edwards Lifesciences, Irvine, CA, USA) bioprosthesis in Italy since it became available in clinical practice. From 2007 to 2012, 1904 patients were enrolled to undergo TAVI in 33 Italian centres. Outcomes were classified according to the updated Valve Academic Research Consortium (VARC-2) definitions. A multivariable analysis was performed to identify independent predictors of all-cause mortality. RESULTS Mean age was 81.7 (SD:6.2) years, and 1147 (60.2%) patients were female. Mean Logistic EuroSCORE was 21.1% (SD:13.7). Transfemoral, transapical, transaortic and transaxillary TAVI was performed in 1252 (65.8%), 630 (33.1%), 18 (0.9%) and 4 (0.2%) patients, respectively. Operative mortality was 7.2% (137 patients). The VARC-2 outcomes were as follows: device success, 88.1%; disabling stroke, 1.0%; life-threatening and major bleeding 9.8 and 10.5%, respectively; major vascular complication, 9.7%; acute kidney injury, 8.2%; acute myocardial infarction ≤72 h, 1.5%. Perioperative pacemaker implantation was necessary in 116 (6.1%) patients. At discharge, the mean transprosthetic gradient was 10.7 (SD:4.5) mmHg. Incidence of postoperative mild, moderate or severe paravalvular leak was, respectively, 32.1, 5.0 and 0.4%. A total of 444/1767 (25.1%) deaths after hospital discharge were reported: of these, 168 (37.8%) were classified as cardiac death. Preoperative independent predictors of all-cause mortality were male gender (HR: 1.395; 95% CI:1.052-1.849); overweight, BMI 25-30 kg/m2 (HR: 0.775; 95% CI: 0.616-0.974); serum creatinine level (every 1 mg/dl increase; HR: 1.314; 95% CI:1.167-1.480); haemoglobin level (every 1 g/dl increase; HR: 0.905; 95% CI:0.833-0.984); critical preoperative state (HR: 2.282; 95% CI: 1.384-3.761); neurological dysfunction (HR: 1.552; 95% CI:1.060-2.272); atrial fibrillation (HR: 1.556; 95% CI:1.213-1.995); pacemaker rhythm (HR: 1.948; 95% CI:1.310-2.896); NYHA Class III or IV (HR: 1.800; 95% CI:1.205-2.689 or HR: 2.331; 95% CI:1.392-3.903, respectively). CONCLUSIONS TAVI with a balloon-expandable device in the 'real world' shows good mid-term outcomes in terms of survival, technical success, valve-related adverse events and haemodynamic performance.
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Affiliation(s)
| | - Augusto D'Onofrio
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Marco Agrifoglio
- Centro Cardiologico Monzino-Department of Clinical Sciences and Community, University of Milan, Milan, Italy
| | - Antonio Colombo
- Ospedale San Raffaele, Milano, Italy.,Casa di Cura Columbus, Milano, Italy
| | | | | | - Laura Besola
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Tommaso Regesta
- Divisione di Cardiochirurgia, IRCCS San Martino-IST, Genova, Italy
| | - Filippo Rapetto
- Divisione di Cardiochirurgia, IRCCS San Martino-IST, Genova, Italy
| | - Giuseppe Tarantini
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Massimo Napodano
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | | | - Francesco Saia
- Cardio-Thoraco-Vascular Department, University Hospital Policlinico S. Orsola - Malpighi, Bologna, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Claudio Moretti
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | | | | | | | - Roberto Di Bartolomeo
- Cardio-Thoraco-Vascular Department, University Hospital Policlinico S. Orsola - Malpighi, Bologna, Italy
| | - Gino Gerosa
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Mauro Rinaldi
- Department of Surgical Sciences, University of Turin, Turin, Italy
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Filograna L, Magarelli N, La Torre M, Pedone L, Leone A, J. Thali M, Bonomo L. Dual-Energy CT (DECT): A New Technique for Artifact Reduction from Metallic Orthopedic Implants. Curr Med Imaging 2016. [DOI: 10.2174/1573405612999160510145931] [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: 11/22/2022]
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Faletti R, Gatti M, Salizzoni S, Bergamasco L, Bonamini R, Garabello D, Marra WG, La Torre M, Morello M, Veglia S, Fonio P, Rinaldi M. Cardiovascular magnetic resonance as a reliable alternative to cardiovascular computed tomography and transesophageal echocardiography for aortic annulus valve sizing. Int J Cardiovasc Imaging 2016; 32:1255-63. [PMID: 27117264 DOI: 10.1007/s10554-016-0899-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/16/2016] [Indexed: 11/26/2022]
Abstract
To assess the accuracy and reproducibly of cardiovascular magnetic resonance (CMR) in the measurement of the aortic annulus and in process of valve sizing as compared to intra-operative sizing, cardiovascular computed tomography (CCT) and transesophageal echocardiography (TEE). Retrospective study on 42 patients who underwent aortic valve replacement from September 2010 to September 2015, with available records of pre surgery annulus assessment by CMR, CCT and TEE and of peri-operative assessment. In CCT and CMR, the annular plane was considered a virtual ring formed by the lowest hinge points of the valvular attachments to the aorta. In TEE the annulus was measured at the base of leaflet insertion in the mid-esophageal long-axis view using the X-plane technique. Two double-blinded operators performed the assessments for each imaging technique. Intra-operative evaluation was performed using Hegar dilators. Continuous variables were studied with within-subject ANOVA, Bland-Altman (BA) plots, Wilcoxon's and Friedman's tests; trends were explored with scatter plots. Categorical variables were studied with Fisher's exact test. The intra- and inter-operator reliability was satisfying. There were no significant differences between the annulus dimensions measured by CMR and either one of the three references. Valve sizing for CoreValve by CMR had the same good agreement with CCT and TEE, with a 78 % match rate; for SAPIEN XT the agreement was slightly better (82 %) for CCT than for TEE (66 %). MR performs well when compared to the surgical reference of intra-operative sizing and stands up to the level of the most used imaging references (CCT and TEE).
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Affiliation(s)
- Riccardo Faletti
- Department of Surgical Sciences, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy.
| | - Marco Gatti
- Department of Surgical Sciences, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Stefano Salizzoni
- Division of Cardiac Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Laura Bergamasco
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Rodolfo Bonamini
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Domenica Garabello
- Department of Radiodiagnostic, S.C. Radiodiagnostica Ospedaliera, Turin, Italy
| | - Walter Grosso Marra
- Division of Cardiology, Department of Medical Sciences,, University of Turin, Turin, Italy
| | - Michele La Torre
- Division of Cardiac Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Mara Morello
- Division of Cardiology, Department of Medical Sciences,, University of Turin, Turin, Italy
| | - Simona Veglia
- Department of Radiodiagnostic, S.C. Radiodiagnostica Ospedaliera, Turin, Italy
| | - Paolo Fonio
- Department of Surgical Sciences, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Mauro Rinaldi
- Division of Cardiac Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy
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Salizzoni S, Anselmino M, Fornengo C, Giordana F, La Torre M, Moretti C, D'Amico M, Omedé P, Marra S, Rinaldi M, Gaita F. One-year follow-up of conduction disturbances following transcatheter aortic valve implantation. J Cardiovasc Med (Hagerstown) 2016; 16:296-302. [PMID: 25719906 DOI: 10.2459/jcm.0000000000000179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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]
Abstract
AIMS To describe the postprocedural and 1-year follow-up incidence of heart conduction disturbances in patients with severe symptomatic aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). METHODS Ninety-five patients were enrolled from 2008 to 2011 (mean age 81.8 ± 7.2 years, 63.1% women). Clinical and ECG data were recorded at admission, discharge, and 3, 6 and 12 months following TAVI. RESULTS Fifty-seven Edwards SAPIEN (31 transapical, 26 transfemoral) and 38 transfemoral CoreValve implants were used. Two (2.1%) patients died during the procedure and 11 (11.6%) patients received a pacemaker prior to discharge (7 CoreValve, 3 transapical, 1 transfemoral SAPIEN; P = 0.18). Among the surviving patients not receiving a pacemaker, TAVI increased the PQ interval (176 ± 29 vs. 188 ± 36 ms; P = 0.001), QRS width (90 ± 15 vs. 108 ± 26 ms; P < 0.001), and first-grade atrioventricular block (17 vs. 29%; P < 0.001). Postprocedural complete left bundle branch block was reported most in transapical (from 10 to 36%; P = 0.01) and CoreValve (from 8 to 64%; P < 0.001) recipients compared to the transfemoral SAPIEN group. At the 12-month follow-up, 24 (25.3%) patients had died [two (2.1%) sudden deaths] and four (4.2%) required pacemaker implantation. Among the survivors not receiving a pacemaker at the 1-year follow-up, the PQ interval (178 ± 27 vs. 188 ± 36 ms; P = 0.39) remained unchanged in the ECG, whereas the QRS width (100 ± 22 vs. 108 ± 26 ms; P = 0.008) decreased compared to measurements taken at discharge. CONCLUSION Conduction disturbances following TAVI primarily develop during hospitalization and subsequently stabilize. However, the small percentage of patients suffering sudden death or pacemaker implantation requires attention.
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Affiliation(s)
- Stefano Salizzoni
- aUniversity of Torino - Department of Surgical Sciences, Division of Cardiac Surgery bUniversity of Torino - Department of Medical Sciences, Division of Cardiology c'Città della Salute e della Scienza' Hospital, Division of Cardiology, Torino, Italy
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Cannavo S, Ragonese M, Puglisi S, Romeo PD, Torre ML, Alibrandi A, Scaroni C, Occhi G, Ceccato F, Regazzo D, De Menis E, Sartorato P, Arnaldi G, Trementino L, Trimarchi F, Ferrau F. Acromegaly Is More Severe in Patients With AHR or AIP Gene Variants Living in Highly Polluted Areas. J Clin Endocrinol Metab 2016; 101:1872-9. [PMID: 26963951 DOI: 10.1210/jc.2015-4191] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT An increased prevalence of acromegaly was found some years ago in a highly polluted area in North-Eastern Sicily, where high concentration of nonmethane hydrocarbons, volatile organic compounds, and cadmium was found. Aryl hydrocarbon receptor (AHR) pathway has a key role in detoxification of these compounds and in tumorigenesis. OBJECTIVE We correlated the occurrence of AHR and/or AHR-interacting protein (AIP) gene variants with acromegaly severity according to pollution exposition. DESIGN, SETTING, AND PATIENTS This was an observational, perspective study conducted over 7 years in four Italian referral centers for pituitary diseases in which 210 patients with acromegaly were enrolled between 2008 and 2015. INTERVENTION Genetic screening of patients for AHR and AIP variants. MAIN OUTCOME MEASURES Clinical, biochemical, and radiological data of patients with and without AIP and/or AHR gene variants, living in polluted (high-risk for health, [HR]) or nonpolluted (NP) areas of five Italian regions were evaluated and compared. RESULTS Among the 23 patients from HR areas, nine showed AHR or AIP variants. Mean IGF-I levels and pituitary tumor diameter were significantly higher in these nine patients (HR/VAR+) than in the other 14 (HR/VAR−) and in the 187 from NP areas (44 NP/VAR+). Somatostatin analogs significantly decreased mean GH and IGF-I levels in patients from NP areas and in HR/VAR− (GH P < .05; IGF-I times the upper limit of normal P < .01) but not in HR/VAR+ group. CONCLUSIONS Genetic variants potentially inducing functional abnormalities of the aryl hydrocarbon receptor (AHR) pathway are associated with a more severe acromegaly, increased pituitary tumor size, and somatostatin analog resistance in patients living in HR areas.
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Affiliation(s)
- S Cannavo
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - M Ragonese
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - S Puglisi
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - P D Romeo
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - M L Torre
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - A Alibrandi
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - C Scaroni
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - G Occhi
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - F Ceccato
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - D Regazzo
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - E De Menis
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - P Sartorato
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - G Arnaldi
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - L Trementino
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - F Trimarchi
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
| | - F Ferrau
- Department of Clinical and Experimental Medicine-Endocrinology Unit (S.C., M.R., S.P., P.D.R., M.L.T., F.T., F.F.), and Department of Economics (A.A.), University of Messina, 98100 Messina, Italy; Endocrinology Unit, Department of Medicine (C.S., G.O., F.C., D.R.), DIMED, University of Padua, 35128 Padua, Italy; Department of Internal Medicine (E.D., P.S.), General Hospital, 31044 Montebelluna, Italy; and Department of Endocrinology and Metabolic Diseases (G.A., L.T.), Azienda Ospedaliera Universitaria Ospedali Riuniti di Ancona, 60126 Ancona, Italy
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Serra E Moura Garcia C, Sokolova A, Torre ML, Amaro C. Acute Hemorrhagic Edema of Infancy. Eur Ann Allergy Clin Immunol 2016; 48:22-26. [PMID: 26808448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Acute Hemorrhagic Edema of Infancy is a small vessel leucocytoclastic vasculitis affecting young infants. It is characterized by large, target-like, macular to purpuric plaques predominantly affecting the face, ear lobes and extremities. Non-pitting edema of the distal extremities and low-grade fever may also be present. Extra-cutaneous involvement is very rare. Although the lesions have a dramatic onset in a twenty-four to forty-eight hour period, usually the child has a non-toxic appearance. In most cases there are no changes in laboratory parameters. The cutaneous biopsy reveals an inflammatory perivascular infiltrate. It is a benign and auto-limited disease, with complete resolution within two to three weeks leaving no sequelae in the majority of cases. No recurrences are described. We report a case of a 42-day old girl admitted at our hospital with Acute Hemorrhagic Edema of Infancy.
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Affiliation(s)
- C Serra E Moura Garcia
- Department of Paediatrics, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal. E-Mail:
| | - A Sokolova
- Department of Paediatrics, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal
| | - M L Torre
- Department of Paediatrics, Hospital Prof. Doutor Fernando Fonseca EPE, Amadora, Portugal
| | - C Amaro
- Department of Dermatology, Hospital CurryCabral, Centro Hospitalar Lisboa Central, Lisbon, Portugal
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Perteghella S, Vigani B, Crivelli B, Spinaci M, Galeati G, Bucci D, Vigo D, Torre ML, Chlapanidas T. Sperm Encapsulation from 1985 to Date: Technology Evolution and New Challenges in Swine Reproduction. Reprod Domest Anim 2015; 50 Suppl 2:98-102. [DOI: 10.1111/rda.12538] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/20/2015] [Indexed: 11/29/2022]
Affiliation(s)
- S Perteghella
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - B Vigani
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - B Crivelli
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - M Spinaci
- Department of Veterinary Medical Sciences-DIMEVET; University of Bologna; Ozzano dell'Emilia Bologna Italy
| | - G Galeati
- Department of Veterinary Medical Sciences-DIMEVET; University of Bologna; Ozzano dell'Emilia Bologna Italy
| | - D Bucci
- Department of Veterinary Medical Sciences-DIMEVET; University of Bologna; Ozzano dell'Emilia Bologna Italy
| | - D Vigo
- Department of Veterinary Sciences and Public Health; University of Milan; Milan Italy
| | - ML Torre
- Department of Drug Sciences; University of Pavia; Pavia Italy
| | - T Chlapanidas
- Department of Drug Sciences; University of Pavia; Pavia Italy
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Baronetto A, Centofanti P, Attisani M, La Torre M, Ricci D, Rinaldi M. VAD infections: the lead, the graft and the pump. Ann Cardiothorac Surg 2014; 3:505-6. [PMID: 25452911 DOI: 10.3978/j.issn.2225-319x.2014.08.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 08/19/2014] [Indexed: 11/14/2022]
Affiliation(s)
- Andrea Baronetto
- Division of Cardiac Surgery, San Giovanni Battista Hospital "Molinette", University of Turin, Turin 10126, Italy
| | - Paolo Centofanti
- Division of Cardiac Surgery, San Giovanni Battista Hospital "Molinette", University of Turin, Turin 10126, Italy
| | - Matteo Attisani
- Division of Cardiac Surgery, San Giovanni Battista Hospital "Molinette", University of Turin, Turin 10126, Italy
| | - Michele La Torre
- Division of Cardiac Surgery, San Giovanni Battista Hospital "Molinette", University of Turin, Turin 10126, Italy
| | - Davide Ricci
- Division of Cardiac Surgery, San Giovanni Battista Hospital "Molinette", University of Turin, Turin 10126, Italy
| | - Mauro Rinaldi
- Division of Cardiac Surgery, San Giovanni Battista Hospital "Molinette", University of Turin, Turin 10126, Italy
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Giordana F, D'Ascenzo F, Nijhoff F, Moretti C, D'Amico M, Biondi Zoccai G, Sinning JM, Nickenig G, Van Mieghem NM, Chieffo A, Dumonteil N, Tchetche D, Barbash IM, Waksman R, D'Onofrio A, Lefevre T, Pilgrim T, Amabile N, Codner P, Kornowski R, Yong ZY, Baan J, Colombo A, Latib A, Salizzoni S, Omedè P, Conrotto F, La Torre M, Marra S, Rinaldi M, Gaita F. Meta-analysis of predictors of all-cause mortality after transcatheter aortic valve implantation. Am J Cardiol 2014; 114:1447-55. [PMID: 25217456 DOI: 10.1016/j.amjcard.2014.07.081] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/30/2014] [Accepted: 07/30/2014] [Indexed: 02/05/2023]
Abstract
The aim of this study was to identify predictors of 30-day and midterm mortality after transcatheter aortic valve implantation (TAVI) by means of a systemic review. TAVI was demonstrated to be safe and efficacious in patients with severe aortic stenosis. An accurate estimation of procedural risk of these patients represents an actual challenge. The PubMed and Cochrane Collaboration databases were systematically searched for studies reporting on the incidence and independent predictors of 30-day and midterm mortality. Adverse events were pooled with random effect, whereas independent predictors are reported as odds ratios (ORs) with 95% confidence intervals (CIs). A total of 25 studies with 8,874 patients were included (median age 82.5 ± 1.5 years, 54.6% women). At 30 days, 7.5% of patients (n = 663) died. At midterm follow-up (median 365 days, interquartile range 267 to 365 days), the cumulative mortality rate was 21.6% (n = 1,917). Acute kidney injury (AKI) stage ≥2 (OR 18.0, 95% CI 6.3 to 52), preprocedural hospitalization for heart failure (OR 9.4, 95% CI 2.6 to 35), periprocedural acute myocardial infarction (OR 8.5, 95% CI 2.6 to 33.5), and increased pro-brain natriuretic peptide (pro-BNP) levels (OR 5.4, 95% CI 1.7 to 16.5) were the most important independent predictors of 30-day mortality. Increased pro-BNP levels (OR 11, 95% CI 1.5 to 81), AKI stage 3 (OR 6.8, 95% CI 2.6 to 15.7), left ventricular ejection fraction <30% (OR 6.7, 95% CI 3.5 to 12.7), and periprocedural acute myocardial infarction (OR 6.5, 95% CI 2.3 to 18.1) represented the predictors of midterm mortality. In conclusion, in this large meta-analysis of patients undergoing TAVI, we found that high pro-BNP levels and postprocedural AKI were the strongest independent predictors of both 30-day and 1-year mortality. These findings may contribute to a better understanding of the risk assessment process of patients undergoing TAVI.
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Affiliation(s)
- Francesca Giordana
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy.
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Freek Nijhoff
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Claudio Moretti
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Maurizio D'Amico
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Giuseppe Biondi Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Jan Malte Sinning
- Medizinische Klinik und Poliklinik II, Innere Medizin, Universitätsklinikum, Bonn, Germany
| | - George Nickenig
- Medizinische Klinik und Poliklinik II, Innere Medizin, Universitätsklinikum, Bonn, Germany
| | - Nicolas M Van Mieghem
- Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Adelaide Chieffo
- Division of Metabolic and Cardiovascular Sciences, San Raffaele Scientific Institute, Milan, Italy
| | - Nicolas Dumonteil
- Pôle Cardiovasculaire et Métabolique, Hôpital Rangueil, Toulouse, France
| | - Didier Tchetche
- Department of General and Interventional Cardiology, Clinique Pasteur, Toulouse, France
| | - Israel M Barbash
- Interventional Cardiology, Division of Cardiology, Washington Hospital Center, Washington, DC
| | - Ron Waksman
- Interventional Cardiology, Division of Cardiology, Washington Hospital Center, Washington, DC
| | | | - Thierry Lefevre
- Institut Cardiovasculaire Paris Sud, Institut Hospitalier Jacques Cartier, Massy, France
| | - Thomas Pilgrim
- Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Bern, Switzerland
| | - Nicolas Amabile
- Department of Cardiology, Centre Marie Lannelongue, Le Plessis-Robinson, France
| | - Pablo Codner
- Division of Cardiology, Beilinson Hospital, Rabin Medical Center, Petach-Tikva, Israel; Tel-Aviv University, Sackler Faculty of Medicine, Tel-Aviv, Israel
| | - Ran Kornowski
- Division of Cardiology, Beilinson Hospital, Rabin Medical Center, Petach-Tikva, Israel; Tel-Aviv University, Sackler Faculty of Medicine, Tel-Aviv, Israel
| | - Ze Yie Yong
- Department of Cardiology and Cardio-Thoracic Surgery, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Baan
- Department of Cardiology and Cardio-Thoracic Surgery, Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands
| | - Antonio Colombo
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Azeem Latib
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Stefano Salizzoni
- Division of Cardio-Surgery, Cardiovascular and Thoracic Department, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Pierluigi Omedè
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Federico Conrotto
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Michele La Torre
- Division of Cardio-Surgery, Cardiovascular and Thoracic Department, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Sebastiano Marra
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Mauro Rinaldi
- Division of Cardio-Surgery, Cardiovascular and Thoracic Department, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Fiorenzo Gaita
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
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Annetta MG, Silvestri D, Grieco DL, La Torre M, Magarelli N, Caricato A, Antonelli M. A new and promising tool to evaluate mass and structural changes of skeletal muscle in trauma patients. Intensive Care Med 2014; 41:360-1. [PMID: 25341692 DOI: 10.1007/s00134-014-3523-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2014] [Indexed: 11/26/2022]
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Cannavo S, Ferrau F, Ragonese M, Romeo PD, Torre ML, Puglisi S, De Menis E, Arnaldi G, Salpietro C, Cotta OR, Albani A, Ruggeri RM, Trimarchi F. Increased frequency of the rs2066853 variant of aryl hydrocarbon receptor gene in patients with acromegaly. Clin Endocrinol (Oxf) 2014; 81:249-53. [PMID: 24521362 DOI: 10.1111/cen.12424] [Citation(s) in RCA: 15] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 12/03/2013] [Accepted: 02/03/2014] [Indexed: 12/13/2022]
Abstract
CONTEXT Aryl hydrocarbon receptor (AHR) pathway has a key role in cellular detoxification mechanisms and seems implicated in tumorigenesis. Moreover, polymorphisms and mutations of AHR gene have been associated with several human and animal tumours. Although AHR has been found differently expressed in pituitary adenomas, AHR gene mutation status has never been investigated in acromegalic patients. DESIGN In this study, we evaluated patients with apparently sporadic GH-secreting pituitary adenoma for AHR gene variants. PATIENTS AND METHODS Seventy patients with sporadic GH-secreting pituitary adenoma (M = 27, age 59.1 ± 1.6 years) and 157 sex- and age-matched controls were enrolled in the study. In all patients and controls, the exons 1, 2, 3, 5 and 10 of AHR gene were evaluated for nucleotide variants by sequencing analysis. RESULTS The rs2066853 polymorphism was identified in the exon 10 of 18/70 acromegalic patients and 9/157 healthy subjects (25.7 vs. 5.7%, χ(2) = 18.98 P < 0.0001), in homozygosis in one patient and in heterozygosis in the other 17 and in the 9 healthy subjects. Moreover, a heterozygous rs4986826 variant in exon 10 was identified in a patient with heterozygous rs2066853 polymorphism, and in the patient with homozygous rs2066853 variant. This second polymorphism was not detected in the control group. Patients with rs2066853 polymorphism showed increased IGF-1 ULN (P < 0.05) and prevalence of cavernous sinus invasion (P = 0.05), thyroid (P = 0.02), bladder (P = 0.0001) or lymphohematopoietic (P < 0.05) tumours. CONCLUSIONS AHR gene rs2066853 polymorphism is significantly more frequent in acromegalic patients than in healthy subjects and is associated with increased disease aggressivity. Moreover, the rs4986826 variant was detected in few patients with rs2066853 polymorphism, but its role is to be cleared.
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Affiliation(s)
- S Cannavo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Salizzoni S, Romagnoli R, Rispoli P, Strignano P, Suita R, David E, La Torre M, Rinaldi M. Solution to recurrent suprahepatic caval stenosis after liver transplantation: cardiac surgery after repeated dilatations and stenting. Liver Transpl 2014; 20:624-6. [PMID: 24677378 DOI: 10.1002/lt.23856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 01/27/2014] [Accepted: 02/08/2014] [Indexed: 01/12/2023]
Affiliation(s)
- Stefano Salizzoni
- Division of Cardiac Surgery, San Giovanni Battista Hospital, City Hospital of Health and Science of Turin, Department of Surgical Sciences, University of Turin, Turin, Italy
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Conrotto F, D'Ascenzo F, Giordana F, Salizzoni S, Tamburino C, Tarantini G, Presbitero P, Barbanti M, Gasparetto V, Mennuni M, Napodano M, Rossi ML, La Torre M, Ferraro G, Omedè P, Scacciatella P, Marra WG, Colaci C, Biondi-Zoccai G, Moretti C, D'Amico M, Rinaldi M, Gaita F, Marra S. Impact of diabetes mellitus on early and midterm outcomes after transcatheter aortic valve implantation (from a multicenter registry). Am J Cardiol 2014; 113:529-34. [PMID: 24315111 DOI: 10.1016/j.amjcard.2013.10.025] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 10/23/2013] [Accepted: 10/23/2013] [Indexed: 02/05/2023]
Abstract
Several clinical and procedural factors have been identified as predictors of early and midterm events after transcatheter aortic valve implantation (TAVI), but incidence and prognostic impact of diabetes mellitus (DM), especially insulin treated, on short- and midterm outcomes remain to be defined. All consecutive patients who underwent TAVI at our institutions were enrolled and stratified according to DM status. All-cause mortality at 30 days or in hospital and at follow-up was the primary end point, whereas periprocedural complications, rates of myocardial infarction, stroke, and reintervention at follow-up were the secondary ones. All end points were adjudicated according to the Valve Academic Research Consortium definitions. In all, 511 patients were enrolled: 361 without DM, 78 with orally treated DM, and 72 with insulin-treated DM. Orally treated DM patients were more frequently women, whereas insulin-treated DM patients were younger. Thirty-day Valve Academic Research Consortium mortality was not significantly higher in patients with orally treated DM and insulin-treated DM compared with patients without diabetes (6.4%, 9.7%, and 4.7%, p = 0.09). Bleedings, vascular complications, postprocedural acute kidney injury, and periprocedural strokes were not significantly different in the 3 groups. At midterm follow-up (median 400 days), patients with insulin-treated DM had a significantly higher mortality rate (33.3% vs 18.6%, p = 0.01) and higher myocardial infarction incidence (8.3% vs 1.4%, p = 0.002) if compared with patients without diabetes. Strokes and reinterventions at follow-up were similar in the 3 groups. After multivariable adjustment, insulin-treated DM was independently correlated with death (hazard ratio 2, 95% confidence interval 1.3 to 3.3) and myocardial infarction (hazard ratio 3.73, 95% confidence interval 1.1 to 13). In conclusion, DM does not significantly affect rates of complications in patients who underwent TAVI. Insulin-treated DM, but not orally treated DM, is independently associated with death and myocardial infarction at midterm follow-up and should be included into future TAVI-dedicated scores.
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Affiliation(s)
- Federico Conrotto
- Division of Cardiology 2, Città della Salute e della Scienza Hospital, Turin, Italy.
| | - Fabrizio D'Ascenzo
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Francesca Giordana
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Stefano Salizzoni
- Division of Cardiac Surgery, Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Giuseppe Tarantini
- Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | | | - Marco Barbanti
- Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Valeria Gasparetto
- Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Marco Mennuni
- Division of Cardiology, Istituto Humanitas, Milan, Italy
| | - Massimo Napodano
- Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Marco L Rossi
- Division of Cardiology, Istituto Humanitas, Milan, Italy
| | - Michele La Torre
- Division of Cardiac Surgery, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Gaetana Ferraro
- Division of Cardiology 2, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Pierluigi Omedè
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Paolo Scacciatella
- Division of Cardiology 2, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Walter Grosso Marra
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Chiara Colaci
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Claudio Moretti
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Maurizio D'Amico
- Division of Cardiology 2, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Mauro Rinaldi
- Division of Cardiac Surgery, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Fiorenzo Gaita
- Division of Cardiology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Sebastiano Marra
- Division of Cardiology 2, Città della Salute e della Scienza Hospital, Turin, Italy
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Salizzoni S, La Torre M, Barbero C, Marra WG, Moretti C, D’Amico M, Rinaldi M. Transjugular Tricuspid Valve-in-Valve Implantation. Heart Lung Circ 2013; 22:1036-9. [DOI: 10.1016/j.hlc.2013.04.113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 03/22/2013] [Accepted: 04/07/2013] [Indexed: 11/28/2022]
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Chlapanidas T, Tosca MC, Faragò S, Perteghella S, Galuzzi M, Lucconi G, Antonioli B, Ciancio F, Rapisarda V, Vigo D, Marazzi M, Faustini M, Torre ML. Formulation and characterization of silk fibroin films as a scaffold for adipose-derived stem cells in skin tissue engineering. Int J Immunopathol Pharmacol 2013; 26:43-9. [PMID: 24046948 DOI: 10.1177/03946320130260s106] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Skin substitutes are epidermal, dermal or complete bilayered constructs, composed by natural or synthetic scaffolds and by adherent cells such as fibroblasts, keratinocytes or mesenchymal stem cells. Silk fibroin is a promising polymer to realize scaffolds, since it is biocompatible, biodegradable, and exhibits excellent mechanical properties in terms of tensile strength. Moreover, fibroin can be added of others components in order to modify the biomaterial properties for the purpose. The aim of this work is to prepare silk fibroin films for adipose-derived stem cell (ADSCs) culture as a novel feeder layer for skin tissue engineering. Pectin has been added to promote the protein conformational transition and construct strength, while glycerol as plasticizer, providing biomaterial flexibility. Eighteen formulations were prepared by casting method using fibroin, pectin (range 1-10% w/w), and glycerol (range 0-20% w/w); films were characterized by Fourier transform infrared spectroscopy and differential scanning calorimetry assay, to select the optimal composition. A stable fibroin conformation was obtained using 6% w/w pectin, and the best mechanical properties were obtained using 12% w/w glycerol. Films were sterilized, and human ADSCs were seeded and cultured for 15 days. Cells adhere to the support assuming a fibroblastic-like shape and reaching confluence. The ultrastructural analysis evidences typical active-cell features and adhesion structures that promote cell anchorage to the film, thus developing a multilayered cell structure. This construct could be advantageously employed in cutaneous wound healing or where the use of ADSCs scaffold is indicated either in human or veterinary field.
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Affiliation(s)
- T Chlapanidas
- Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Pavia, Italy
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D’Ascenzo F, Gonella A, Moretti C, Omedè P, Salizzoni S, La Torre M, Giordana F, Barbanti M, Ussia GP, Brambilla N, Bedogni F, Gaita F, Tamburino C, Sheiban I. Gender differences in patients undergoing TAVI: a multicentre study. EUROINTERVENTION 2013; 9:367-372. [DOI: 10.4244/eijv9i3a59] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Giordana F, Capriolo M, Frea S, Marra WG, Giorgi M, Bergamasco L, Omedè PL, Sheiban I, D'Amico M, Bovolo V, Salizzoni S, La Torre M, Rinaldi M, Marra S, Gaita F, Morello M. Impact of TAVI on Mitral Regurgitation: A Prospective Echocardiographic Study. Echocardiography 2012. [DOI: 10.1111/echo.12050] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Francesca Giordana
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Michele Capriolo
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Simone Frea
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Walter Grosso Marra
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Mauro Giorgi
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | | | - Pier Luigi Omedè
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Imad Sheiban
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Maurizio D'Amico
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Virginia Bovolo
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Stefano Salizzoni
- Division of Cardiac-Surgery; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Michele La Torre
- Division of Cardiac-Surgery; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Mauro Rinaldi
- Division of Cardiac-Surgery; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Sebastiano Marra
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Fiorenzo Gaita
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
| | - Mara Morello
- Medical Sciences Department; San Giovanni Battista “Molinette” Hospital; University of Torino; Italy
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Faustini M, Vigo D, Spinaci M, Galeati G, Torre ML. Enhancing Insemination Performance in Pigs Through Controlled Release of Encapsulated Spermatozoa. Reprod Domest Anim 2012; 47 Suppl 4:353-8. [DOI: 10.1111/j.1439-0531.2012.02098.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Attisani M, Centofanti P, La Torre M, Boffini M, Ricci D, Ribezzo M, Baronetto A, Rinaldi M. Advanced heart failure in critical patients (INTERMACS 1 and 2 levels): ventricular assist devices or emergency transplantation? Interact Cardiovasc Thorac Surg 2012; 15:678-84. [PMID: 22815322 DOI: 10.1093/icvts/ivs256] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE For patients in advanced heart failure, emergency transplantation or ventricular assist devices (VADs) are possible strategies. The aim of this single-centre, retrospective study was to evaluate early and long-term results for these two strategies. METHODS From 2005 to 2011, we analysed 49 INTERMACS level 1 and 2 patients, who were divided into the following two groups: group A comprised 26 patients on the waiting list for heart transplantation with urgent conditions; and group B comprised 23 patients who underwent VAD implantation as a bridge to candidacy. RESULTS In group A, 25 patients underwent transplantation. In group B, 19 patients were supported with left VAD and four with biventricular VAD. Of these 23 patients, 13 underwent transplantation (mean time 279 ± 196 days). The 30 day mortality was 42.3 and 4.3% in group A and B, respectively. Survival at 6 and 12 months was significantly better in group B than in group A (87 vs 53%, P = 0.018 at 6 months; and 77 vs 48%, P = 0.045 at 12 months). CONCLUSION Improved outcomes may justify the use of mechanical assistance devices as a bridge to candidacy or bridge to transplantation in INTERMACS 1 and 2 patients in order to avoid high-risk transplants. Evaluation of long-term multicentre outcomes is needed to assess future strategies.
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Affiliation(s)
- Matteo Attisani
- Division of Cardiac Surgery, San Giovanni Battista Hospital 'Molinette', University of Turin, Turin, Italy.
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Giordana F, Salizzoni S, Mancuso S, La Torre M, Attisani M, Sheiban I, Moretti C, Conrotto F, D'amico M, Rinaldi M. Age affects early mortality in TAVI. Cardiovascular Revascularization Medicine 2012. [DOI: 10.1016/j.carrev.2012.01.034] [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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Giordana F, Salizzoni S, Marra WG, Mancuso S, Moretti C, La Torre M, D'amico M, Giorgi M, Sheiban I, Gaita F, Rinaldi M. Postoperative prosthesis insufficiency affects mortality in patients undergoing TAVI. Cardiovascular Revascularization Medicine 2012. [DOI: 10.1016/j.carrev.2012.01.064] [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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Centofanti P, La Torre M, Attisani M, Sansone F, Rinaldi M. Rapid Pacing for the Off-Pump Insertion of the Jarvik Left Ventricular Assist Device. Ann Thorac Surg 2011; 92:1536-8. [DOI: 10.1016/j.athoracsur.2011.03.139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 01/28/2011] [Accepted: 03/25/2011] [Indexed: 10/17/2022]
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Sansone F, Boffini M, Centofanti P, La Torre M, Rinaldi M. A Simple Method for Cardioplegia Administration and Suture Control Using Foley Catheter During Ascending Aorta Replacement and Aortic Root Surgery. Heart Lung Circ 2011; 20:127-9. [DOI: 10.1016/j.hlc.2010.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Revised: 09/18/2010] [Accepted: 09/26/2010] [Indexed: 10/18/2022]
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Cannavò S, Marini F, Curtò L, Torre ML, de Gregorio C, Salamone I, Alibrandi A, Trimarchi F. High prevalence of coronary calcifications and increased risk for coronary heart disease in adults with growth hormone deficiency. J Endocrinol Invest 2011; 34:32-7. [PMID: 20511726 DOI: 10.1007/bf03346692] [Citation(s) in RCA: 13] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Assessment of coronary calcium deposits (CCD) by coronary computed tomography (CT) was recently introduced for evaluation of risk to develop events related to coronary heart disease (CHD). We investigated occurrence of CCD in 19 hypopituitary patients (patients), 34 healthy (H) subjects (H controls) and 36 patients with a similar rate of diabetes mellitus and hypertension (morbid, M), but without pituitary diseases (M controls). Patients were replaced with L-thyroxine, cortone acetate, sex hormones and/or desmopressin, but never with GH. Unenhanced coronary CT was performed by 16-row multislice scanner. Framingham score (FS) was calculated and CCD were measured by Agatston score (AS) in all subjects. AS>10 indicates increased CHD risk. CCD and AS >10 were detected in 50% and 33% of patients, respectively. Prevalence of CCD and mean AS were higher in patients than in H and M controls. In patients, AS was negatively dependent on IGF-I levels (p<0.01) and IGF-I SD (p<0.05), and AS >10 was associated with occurrence of hypertension (p<0.02) and hyperinsulinism (p<0.05). Men and women showed the same prevalence of AS >10 (25 vs 31%). FS and AS correlated significantly (rs=0.33, p<0.001), but CCD were detected also in 3/11 patients with low FS. In conclusion, 58% of patients were at CHD risk on the basis of increased FS and/or AS, above all if they were hypertensive and/or showed hyperinsulinism. CCD were detected also in patients with low FS. CHD risk is higher in women. Risk of CCD is increased in patients with low IGF-I levels.
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Affiliation(s)
- S Cannavò
- Section of Endocrinology, Department of Medicine and Pharmacology, University of Messina, 98125 Messina, Italy
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Attisani M, Centofanti P, La Torre M, Campanella A, Sansone F, Rinaldi M. Safety and effectiveness of low dosing of double antiplatelet therapy during long-term left ventricular support with the INCOR system. J Artif Organs 2010; 13:202-6. [DOI: 10.1007/s10047-010-0527-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Accepted: 11/02/2010] [Indexed: 01/21/2023]
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Cannavò S, Ferraù F, Ragonese M, Curtò L, Torre ML, Magistri M, Marchese A, Alibrandi A, Trimarchi F. Increased prevalence of acromegaly in a highly polluted area. Eur J Endocrinol 2010; 163:509-13. [PMID: 20621957 DOI: 10.1530/eje-10-0465] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Despite the contribution of national registries and population-based reports, data concerning the epidemiology of acromegaly is scanty. In addition, the role of the environmental context has not been investigated. DESIGN Epidemiology of acromegaly was studied in the province of Messina (Sicily, Italy), focusing on the influence of environmental factors. METHODS Four zones, characterized by different degrees of exposition to environmental toxins due to industrial pollution, were identified in the province: area A (76,338 inhabitants), area B (287,328 inhabitants), area C (243,381 inhabitants), and area D (47,554 inhabitants) at low, middle-low, middle, and high industrial density respectively. We identified all acromegalics who were born and resided in the province of Messina, among patients either referred to our endocrine unit or referred elsewhere but recorded in the archives of the provincial healthcare agency. RESULTS In the province of Messina, we found 64 patients (2 in area A, 24 in area B, 28 in area C, and 10 in area D). Macroadenomas were 60%, the male/female ratio was 1, and mean age at diagnosis (±s.e.m.) was 45.4±1.6 years. Overall, prevalence was 97 c.p.m. in the province (26 c.p.m. in area A, 84 c.p.m. in area B, 115 c.p.m. in area C, and 210 c.p.m. in area D). Risk ratio (RR), calculated in every area assuming area A as a reference, showed an increased risk of developing acromegaly in people residing in area D (RR=8.03; P<0.0014). CONCLUSION This study confirms the prevalence of acromegaly reported recently. The increased risk of developing this disease in area D suggests that the pathogenetic role of environmental context needs to be better evaluated.
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Affiliation(s)
- S Cannavò
- Section of Endocrinology, Department of Medicine and Pharmacology, University of Messina, Messina, Italy
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Faustini M, Bucco M, Galeati G, Spinaci M, Villani S, Chlapanidas T, Ghidoni I, Vigo D, Torre ML. Boar Sperm Encapsulation ReducesIn VitroPolyspermy. Reprod Domest Anim 2010; 45:359-62. [DOI: 10.1111/j.1439-0531.2008.01213.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Curtò L, Granata F, Torre ML, Trimarchi F, Cannavò S. Unusual magnetic resonance imaging finding in a male with lymphocytic hypophysitis mimicking a pituitary tumor. J Endocrinol Invest 2010; 33:128-9. [PMID: 19498319 DOI: 10.1007/bf03346567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vigo D, Faustini M, Villani S, Orsini F, Bucco M, Chlapanidas T, Conte U, Ellis K, Torre ML. Semen controlled-release capsules allow a single artificial insemination in sows. Theriogenology 2009; 72:439-44. [PMID: 19505716 DOI: 10.1016/j.theriogenology.2009.03.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 02/18/2009] [Accepted: 03/29/2009] [Indexed: 11/28/2022]
Abstract
Controlled-release capsules containing boar spermatozoa were developed to extend the preservation time of spermatozoa and maximize the efficiency of a single artificial insemination. A large trial (4245 sows) was performed with these capsules using double/triple conventional artificial insemination as a control. The effect of treatment on pregnancy diagnosis, delivery, and born piglets was investigated, with allowance being made for considering season, spermatozoa amount, and the weaning-to-estrus interval as confounding variables. The same pregnancy rate and prolificacy were obtained by two insemination techniques, and a higher parturition frequency was reached with capsules. The reproductive performance in pigs has therefore been optimized by a single instrumental insemination with controlled-release capsules.
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Affiliation(s)
- D Vigo
- Dipartimento di Scienze e Tecnologie Veterinarie per la Sicurezza Alimentare, University of Milan, 20133 Milan, Italy
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Patanè F, Centofanti P, Zingarelli E, Sansone F, La Torre M. Potential role of the Impella Recover left ventricular assist device in the management of postinfarct ventricular septal defect. J Thorac Cardiovasc Surg 2009; 137:1288-9. [DOI: 10.1016/j.jtcvs.2008.02.061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Revised: 02/11/2008] [Accepted: 02/23/2008] [Indexed: 10/21/2022]
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Ruggeri RM, Santarpia L, Curtò L, Torre ML, Galatioto M, Galatioto S, Trimarchi F, Cannavò S. Non-functioning pituitary adenomas infrequently harbor G-protein gene mutations. J Endocrinol Invest 2008; 31:946-9. [PMID: 19169048 DOI: 10.1007/bf03345630] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Mutations of the genes encoding the alpha subunit of the stimulatory G protein (Gs) and of the inhibiting Gi2 protein (GNAS1 and GNAI2 genes, respectively) have been described in various endocrine neoplasias, including pituitary tumors. AIM To search for mutations of GNAS1 and GNAI2 in a continuous series of non-functioning pituitary adenoma (NFPA) patients neurosurgically treated. SUBJECTS AND METHODS The surgical samples of 22 patients who have been defined and characterized on a clinical, biochemical, histological, and immunohistochemical point of view have been processed for investigating the presence of the above mutations by PCR amplification of the hot spots exons 8 and 9 of GNAS1, and exons 5 and 6 of GNAI2, followed by direct sequencing. Moreover, the promoter region of GNAI2, in order to assess the prevalence of single nucleotide polymorphisms (SNP), was investigated in the same series. RESULTS A CGT>TGT mutation at codon 201 of GNAS1 gene in a single case of NFPA was found, but no mutation of GNAI2A was demonstrated. CONCLUSIONS This finding suggests and confirms that G-protein mutations are rare and not crucial in NFPA development. Additionally, we found a silent SNP at codon 318 in the promoter of the Gi2alpha gene in one out of the 22 NFPA.
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Affiliation(s)
- R M Ruggeri
- Department of Medicine and Pharmacology, Section of Endocrinology, University of Messina, 98125 Messina, Italy.
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Centofanti P, Flocco R, Ceresa F, Attisani M, La Torre M, Weltert L, Calafiore AM. Reply. Ann Thorac Surg 2007. [DOI: 10.1016/j.athoracsur.2007.04.089] [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: 11/27/2022]
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Centofanti P, Flocco R, Ceresa F, Attisani M, La Torre M, Weltert L, Calafiore AM. Reply. Ann Thorac Surg 2007. [DOI: 10.1016/j.athoracsur.2007.02.083] [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: 12/01/2022]
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