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Tumminello G, Cereda A, Laricchia A, Carlà M, Conconi B, Barbieri L, Lucreziotti S, Carugo S. P185 META–ANALYSIS OF PLACEBO–CONTROLLED TRIALS OF LEVOSIMENDAN IN ACUTE MYOCARDIAL INFARCTION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Despite the potential beneficial effects in the acute phase of myocardial infarction, the use of Levosimendan in recent guidelines is currently limited to patients with heart failure and a severe reduction in cardiac output not responding to standard therapy. In spite of everything, the haemodynamic effects of the drug that reduces afterload, the beneficial pleiotropic effects on myocardial stunning and the improvement of microcirculatory indices make Levosimendan still an interesting therapeutic prospect in AMI.
Purpose of the Study
The study aimed to analyse the available data of the use of Levosimendan in the acute setting of myocardial infarction Materials and Methods This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) and was conducted and presented according to best practice recommendations, including the Preferred Reporting Items for Systematic Reviews and Meta–Analyses (PRISMA) reporting guidelines. Seven selected studies were included in the meta–analysis. Meta–Analysis Levosimendan treatment was associated with a reduction in one year mortality and adverse event rates, without inconsistency. A trend of the increase of cardiac index and reduction of wedge pressure was evident, with an inconsistent effect on blood pressure and heart rate. No evidence of small study effects was found upon the inspection of funnel plots or regression tests. Finally, possibly given the limited number of included studies, metaregression analysis did not identify any major effect modifier.
Discussion
A clearly significant mortality reduction in the acute phase and long–term mortality induced by Levosimendan in AMI is evident. In the acute ischemic field, the haemodynamic properties of Levosimendan may explain part of the benefits. Levosimendan, over an inotropic effect, has a positive effect on ventriculo–arterial coupling, peripheral vasodilation consequently increasing tissue perfusion, anti–stunning effects and anti–inflammatory effects.
Conclusions
Our data support the idea that Levosimendan may already have a role in the treatment of acute ischemic heart disease. Further studies, specifically designed to investigate the early role in the treatment of ischemic heart failure are needed.
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Affiliation(s)
- G Tumminello
- FONDAZIONE IRCCS CÀ GRANDA OSPEDALE MAGGIORE POLICLINICO, MILANO; ASST SANTI PAOLO E CARLO, MILANO
| | - A Cereda
- FONDAZIONE IRCCS CÀ GRANDA OSPEDALE MAGGIORE POLICLINICO, MILANO; ASST SANTI PAOLO E CARLO, MILANO
| | - A Laricchia
- FONDAZIONE IRCCS CÀ GRANDA OSPEDALE MAGGIORE POLICLINICO, MILANO; ASST SANTI PAOLO E CARLO, MILANO
| | - M Carlà
- FONDAZIONE IRCCS CÀ GRANDA OSPEDALE MAGGIORE POLICLINICO, MILANO; ASST SANTI PAOLO E CARLO, MILANO
| | - B Conconi
- FONDAZIONE IRCCS CÀ GRANDA OSPEDALE MAGGIORE POLICLINICO, MILANO; ASST SANTI PAOLO E CARLO, MILANO
| | - L Barbieri
- FONDAZIONE IRCCS CÀ GRANDA OSPEDALE MAGGIORE POLICLINICO, MILANO; ASST SANTI PAOLO E CARLO, MILANO
| | - S Lucreziotti
- FONDAZIONE IRCCS CÀ GRANDA OSPEDALE MAGGIORE POLICLINICO, MILANO; ASST SANTI PAOLO E CARLO, MILANO
| | - S Carugo
- FONDAZIONE IRCCS CÀ GRANDA OSPEDALE MAGGIORE POLICLINICO, MILANO; ASST SANTI PAOLO E CARLO, MILANO
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Bernelli C, Pellegrini D, Pescetelli I, Garbo R, Sirbu V, Fiocca L, Canova P, Colombo F, Cereda A, Boccuzzi G, Rodriguez Pereira G, Bezerra H, Saia F, Capodanno D, Guagliumi G. Incidence, mechanisms and clinical impact of largely uncovered struts in current generation drug-eluting-stents: insight from the TRANSFORM-OCT Study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Thin-strut drug-eluting stents (DES) and optimal implantation technique reduce the rate of stent failure significantly. Nevertheless, uncovered struts (US) have been observed as a key factor for stent thrombosis regardless of stent generation and time of follow-up. Associated factors and temporal evolution are currently unknown.
Purpose
To evaluate the prevalence, mechanisms and long-term clinical impact of largely-US after state-of-the-art DES implantation in complex coronary clinical/lesion cohorts
Methods
The study was a pre-specified analysis of TRASFORM-OCT, a randomized controlled trial comparing bioabsorbable or durable polymer DES by serial optical coherence tomography (OCT), obtained at baseline, immediately after procedure, at 3 and 18 months follow-up. Methods and results were published previously. For the current analysis enrolled patients (n=90) were divided in 2 groups according to the amount of US identified by OCT at 3 months: a largely US (LUS ≥30%) group and the control group (<30% US), to evaluate factors associated to LUS, and the clinical impact at follow-up.
Results
Out of 90 patients, 31 (34.4%) were assigned to the LUS group, and 59 (65.6%) to the control group. At baseline, LUS patients had larger vessels (reference area 5.51±1.1 vs. 4.27±1.5 mm2, p=0.001), a higher rate of plaque rupture (41.9 vs. 18.6%, p=0.02), thin-cap fibroatheroma (58.1% vs. 51.7% p=0.03) and thrombus (58.1% vs. 35.6%, p=0.001) as detected by OCT. 98% patients continued dual antiplatelet therapy up to 12 months, and 24% of them up to 18 months.
At stent implant, performed with high pressure dilation (21.18±3.8 vs 20.54±3.6 atm in LUS vs control group, p 0.48), the rate of apposed and embedded struts was high in both groups, although higher in controls (93.92±5.30% vs 96.46±3.68%, p 0.03 and 16.8±11.5% vs 21.7±15.8%, p=0.12, respectively for controls and LUS). At 3 months, US rate was 48.4±12% in the LUS group, and 13.3±7% in the control group (p<0.001). Global malapposition rate was 7.95±7.5% and 1.69±1.6% (p<0.001), respectively. 84.52±12.41% of the US in the LUS group and 86.49±19.98% in controls group were apposed to the wall (p 0.07). At 18 months, the rate of US dropped significantly to 8.4±10% in LUS group and 1.8±3% in control group (p<0.001), with malapposition rate being 1.4±3.3 and 0.16±0.43% (p 0.006). Of the US, 81.6±25.15 and 91.11±21.76% were apposed to the wall, respectively. At 5 years clinical follow-up, no differences were observed at the composite endpoint of major adverse cardiovascular events (detailed data will be presented).
Conclusions
In a setting of optimal PCI with modern DES and high-pressure inflation, LUS occur in 30% of patients at early follow-up, more frequently in large vessels with lipid-rich, complex plaques. The vast majority of US is apposed to the wall and near-complete coverage is observed at long-term follow-up, with no clinical impact compared to subjects with a low rate of US.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Bernelli
- Ospedale Santa Corona, Pietra Ligure, Italy
| | | | | | - R Garbo
- San Giovanni Bosco Hospital of Turino, Turin, Italy
| | - V Sirbu
- Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - L Fiocca
- Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - P Canova
- Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - F Colombo
- San Giovanni Bosco Hospital of Turino, Turin, Italy
| | - A Cereda
- ASST della Valtellina e dell'Alto Lario, Sondrio, Italy
| | - G Boccuzzi
- San Giovanni Bosco Hospital of Turino, Turin, Italy
| | | | - H Bezerra
- University Hospitals Case Medical Center, Cleveland, United States of America
| | - F Saia
- Universitary Hospital Sant'orsola Malpighi, Bologna, Italy
| | - D Capodanno
- AOU Policlinico - Vittorio Emanuele, Catania, Italy
| | - G Guagliumi
- Papa Giovanni XXIII Hospital, Bergamo, Italy
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Cereda A, Toselli M, Laricchia A, Mangieri A, Ruggiero R, Gallo F, Sticchi A, Khokhar A, Giannini F, Colombo A. Stress-induced cardiomyopathy related to SARS-CoV-2. Heart Mind 2020. [DOI: 10.4103/hm.hm_10_20] [Citation(s) in RCA: 2] [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] [Indexed: 11/04/2022] Open
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Fontana L, Bedeschi MF, Maitz S, Cereda A, Faré C, Motta S, Seresini A, D'Ursi P, Orro A, Pecile V, Calvello M, Selicorni A, Lalatta F, Milani D, Sirchia SM, Miozzo M, Tabano S. Characterization of multi-locus imprinting disturbances and underlying genetic defects in patients with chromosome 11p15.5 related imprinting disorders. Epigenetics 2018; 13:897-909. [PMID: 30221575 PMCID: PMC6284780 DOI: 10.1080/15592294.2018.1514230] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The identification of multilocus imprinting disturbances (MLID) appears fundamental to uncover molecular pathways underlying imprinting disorders (IDs) and to complete clinical diagnosis of patients. However, MLID genetic associated mechanisms remain largely unknown. To characterize MLID in Beckwith-Wiedemann (BWS) and Silver-Russell (SRS) syndromes, we profiled by MassARRAY the methylation of 12 imprinted differentially methylated regions (iDMRs) in 21 BWS and 7 SRS patients with chromosome 11p15.5 epimutations. MLID was identified in 50% of BWS and 29% of SRS patients as a maternal hypomethylation syndrome. By next-generation sequencing, we searched for putative MLID-causative mutations in genes involved in methylation establishment/maintenance and found two novel missense mutations possibly causative of MLID: one in NLRP2, affecting ADP binding and protein activity, and one in ZFP42, likely leading to loss of DNA binding specificity. Both variants were paternally inherited. In silico protein modelling allowed to define the functional effect of these mutations. We found that MLID is very frequent in BWS/SRS. In addition, since MLID-BWS patients in our cohort show a peculiar pattern of BWS-associated clinical signs, MLID test could be important for a comprehensive clinical assessment. Finally, we highlighted the possible involvement of ZFP42 variants in MLID development and confirmed NLRP2 as causative locus in BWS-MLID.
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Affiliation(s)
- L Fontana
- a Laboratory of Molecular Pathology, Department of Pathophysiology and Transplantation , Università degli Studi di Milano , Milano , Italy
| | - M F Bedeschi
- b Clinical Genetics Unit , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - S Maitz
- c Clinical Pediatric, Genetics Unit , MBBM Foundation, San Gerardo Monza , Monza , Italy
| | - A Cereda
- d Medical Genetics Unit , Papa Giovanni XXIII Hospital , Bergamo , Italy
| | - C Faré
- e Division of Pathology , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - S Motta
- e Division of Pathology , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - A Seresini
- f Medical Genetics Laboratory , Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico , Milano , Italy.,g Fondazione Grigioni per il Morbo di Parkinson , Milano , Italy
| | - P D'Ursi
- h Department of Biomedical Sciences National Research Council , Institute for Biomedical Technologies , Segrate , Italy
| | - A Orro
- h Department of Biomedical Sciences National Research Council , Institute for Biomedical Technologies , Segrate , Italy
| | - V Pecile
- i Medical Genetics Division , Institute for maternal and child health IRCCS Burlo Garofolo , Trieste , Italy
| | - M Calvello
- e Division of Pathology , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy.,j Division of Cancer Prevention and Genetics, IEO , European Institute of Oncology IRCCS , Milano , Italy
| | - A Selicorni
- k UOC Pediatria , ASST Lariana , Como , Italy
| | - F Lalatta
- b Clinical Genetics Unit , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - D Milani
- l Pediatric Highly Intensive Care Unit , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - S M Sirchia
- m Medical Genetics, Department of Health Sciences , Università degli Studi di Milano , Milano , Italy
| | - M Miozzo
- a Laboratory of Molecular Pathology, Department of Pathophysiology and Transplantation , Università degli Studi di Milano , Milano , Italy.,e Division of Pathology , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano , Italy
| | - S Tabano
- a Laboratory of Molecular Pathology, Department of Pathophysiology and Transplantation , Università degli Studi di Milano , Milano , Italy
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Arzanauskaite M, Bereda J, Cecchetto A, Casadei F, Lorenzo N, Gizzi G, Huitema MP, Baksi AJ, Mohiaddin RH, Grodecki Ł, Chiampan A, Bonapace S, Albrigi L, Adamo E, Lanzoni L, Barbieri E, Quattrocchi S, Moreo A, Ammirati E, Musca F, Artioli D, De Chiara B, Vigano' E, Cereda A, Giannattasio C, Rodriguez AM, Bartolome S, Darriba MJ, Berzal B, Perez E, Galan L, Gonzalez R, Lavorgna A, Fabiani D, Restauri L, Villani C, Di Eusanio M, Napoletano C, Grutters JC, Van Es HW, Bakker AL, Post MC. Clinical Cases: HIT session - Top of the hub: best clinical cases852A rare cause of severe chest pain and sustained ventricular tachycardia during a football game853Thrombosed iliac venous aneurysm as a extremely rare source of pulmonary thromboembolism8543D transesophageal echo: guide to anticoagulation therapy after surgical closure of the left atrial appendage855A unusual case of giant coronary aneurysm: role of multimodality imaging in the diagnosis and follow-up858Myocardial cleft in a patient with acute coronary syndrome assessed by multimodal imaging859A rare case of subacute left atrial dissection860A case of pulmonary sarcoidosis with severe precapillary pulmonary hypertension and extrinsic compression of the pulmonary artery. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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6
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Bidviene J, Zhukovskiy N, Peritore A, Rodrigues I, Tundidor Sanz ME, Guerreiro RA, Marini C, Cereda A, Dorobantu DM, Cavalli G, Cavaliere A, Genovese D, Romeo G, Aruta P, Cucchini U, Iliceto S, Badano LP, Muraru D, Okhotin A, Privorotskaya V, De Chiara B, Musca F, Spano' F, Santambrogio G, Casadei F, Forti E, Mutignani M, Giannattasio C, Moreo A, Galrinho A, Branco L, Bravio I, Machado D, Monteiro A, Daniel P, Ferreira L, Carvalho R, Ferreira R, Tierra Rodriguez AM, Dios Diez P, Mayorga Bajo A, Fernandez Gomez MJ, Dominguez Calvo JI, Rogriguez Palomo D, Hernandez Rodriguez J, Congo K, Carvalho J, Pais J, Bras D, Picarra B, Caeiro A, Fragata J, Aguiar J, Stella S, Rosa I, Pavon AG, Ancona F, Margonato A, Colombo A, Latib A, Montorfano M, Agricola E, Casadei F, Moreo A, Ghiorghiu IA, Popescu BA, Coman IM, Ginghina CD, Enache R. Clinical Cases: See that case at least once1174An unrecognized mechanism of functional tricuspid regurgitation revealed by transthoracic three-dimensional echocardiography1175Left ventricular pseudoaneurysm after radiofrequency ablation of premature ventricular contractions1176Succesfull management of buckling of echocardiographic transesophageal probe1177An extremely rare tumor of cardiovascular system1178Pneumopericardium: a rare complication of esophageal cancer1179Left atrial dissection after myocardial infarction1180Late appearance of a ventricular septal defect after transcatheter aortic valve replacement: a rare complication1181Doppler flow velocities pattern in a trombophiliac patient with an lvad thrombosis1182An unusual cause of aortic diastolic reflux in a failed single ventricle palliation. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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7
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Jung IH, Kurnicka K, Enache R, Nagy AI, Martins E, Cereda A, Vitiello G, Magda SL, Styczynski G, Lo Iudice F, De Barros Viegas H, Shahab F, Trunina I, Mata Caballero R, De Barros Viegas H, Marques A, Shimoni S, Generati G, Generati G, Bendix Salkvist Jorgensen T, Chen TE, Andrianova A, Fernandez-Golfin C, Corneli MC, Ali M, Seo HS, Kim MJ, Lichodziejewska B, Goliszek S, Dzikowska-Diduch O, Zdonczyk O, Kozlowska M, Kostrubiec M, Ciurzynski M, Palczewski P, Pruszczyk P, Popa E, Coman IM, Badea R, Platon P, Calin A, Beladan CC, Rosca M, Ginghina C, Popescu BA, Jurcut R, Venkateshvaran AI, Sola SC, Govind SC, Dash PK, Lund L, Manouras AI, Merkely B, Magne J, Aboyans V, Boulogne C, Lavergne D, Jaccard A, Mohty D, Casadei F, Spano F, Santambrogio G, Musca F, Belli O, De Chiara B, Bokor D, Giannattasio C, Corradi E, Colombo CA, Moreo A, Vicario ML, Castellani S, Cammelli D, Gallini C, Needleman L, Cruz BK, Maggi E, Marchionni N, Bratu VD, Mincu RI, Mihai CM, Gherghe AM, Florescu M, Cinteza M, Vinereanu D, Sobieraj P, Bielicki P, Krenke R, Szmigielski CA, Petitto M, Ferrone M, Esposito R, Vaccaro A, Buonauro A, Trimarco B, Galderisi M, Mendes L, Dores H, Melo I, Madeira V, Patinha J, Encarnacao C, Ferreia Santos J, Habib F, Soesanto AM, Sedyawan J, Abdurrazak G, Sharykin A, Popova NE, Karelina EV, Telezhnikova ND, Hernandez Jimenez V, Saavedra J, Molina L, Alberca MT, Gorriz J, L Pais J, Pavon I, Navea C, Alonso JJ, Mendes L, Sonia S, Madeira V, Encarnacao C, Patinha J, Melo I, Ferreia Santos J, Cruz I, Joao I, Gomes AC, Caldeira D, Lopes L, Fazendas P, Pereira H, Edri O, Edri O, Schneider N, Schneider N, Abaye N, Abaye N, Goerge J, Goerge J, Gandelman G, Gandelman G, Bandera F, Alfonzetti E, Guazzi M, Bandera F, Villani S, Ferraro O, Alfonzetti E, Guazzi M, Ramberg E, Bhardwaj P, Nepper ML, Binko TS, Olausson M, Fink-Jensen T, Andersen AM, Roland J, Gleerup Fornitz G, Ong K, Suri RM, Enrique-Sarano M, Michelena HI, Burkhart HM, Gillespie SM, Cha S, Mankad SV, Saidova MA, Bolotova MN, Salido Tahoces L, Izurieta C, Villareal G, Esteban A, Urena Vacas A, Ayala A, Jimenez Nacher JJ, Hinojar Baydes R, Gonzalez Gomez A, Garcia A, Mestre JL, Hernandez Antolin R, Zamorano Gomez JJ, Perea G, Covelli Y, Henquin R, Ronderos R, Hepinstall MJ, Cassidy CS, Pellikka PA, Pislaru SV, Kane G. P569Diastolic dyssynchrony is associated with exercise intolerance in hypertensive patients with left ventricular hypertrophyP570Echocardiographic pattern of acute pulmonary embolism, analysis of consecutive 511 patientsP571Clinical significance of ventricular interdependence and left ventricular function in patients with pulmonary hypertension receiving specific vasodilator therapyP572Haemodynamic characteristics and ventricular mechanics in post-capillary and combined pre- and post-capillary pulmonary hypertensionP573Relationship between hematological response and echocardiographic features in patients with light chains systemic amyloidosisP574Myocardial changes in patients with anorexia nervosaP575Giant cell arteritis presenting as fever of unknown origin: role of clinical history, early positron emission tomography and ultrasound screeningP576Subclinical systolic dysfunction in systemic sclerosis is not influenced by standard rheumatologic therapy - a 4D echocardiographic studyP577Cardiac index correlates with the degree of hepatic steathosis in obese patients with obstructive sleep apneaP578Myocardial mechanics in top-level endurance athletes: a three-dimensional speckle tracking studyP579The athlete heart: what happens to myocardial deformation in physiological adaptation to sportsP580Association between left ventricle intrinsic function and urine protein-creatinine ratio in preeclampsia before and after deliveryP581Dilatation of the aorta in children with bicuspid aortic valveP582Cardiovascular functional abnormalities in patients with osteogenesis imperfectaP583Dobutamine stress test fast protocol: diagnostic accuracy and securityP584Prognostic value of non-positive exercise echocardiography in the patients submitted to percutaneous coronary interventionP585The use of myocardial strain imaging in the detection of coronary artery disease during stress echocardiographyP586Preserved O2 extraction exercise response in heart failure patients with chronotropic insufficiency: evidence for a central cardiac rather than peripheral oxygen uptake limitationP587Major determinant of O2 artero-venous difference at peak exercise in heart failure and healthy subjectsP588Stress echocardiography with contrast perfusion analysis for a more sensitive test for ischemic heart diseaseP589Assessment of mitral annular physiology in myxomatous mitral disease with 3D transesophageal echocardiography: comparison between early severe mitral regurgitation and decompensated groupP590Three-dimensional transesophageal echocardiographic assessment of the mitral valve geometry in patients with mild, moderate and severe chronic ischemic mitral regurgitationP591Left atrial appendage closure. Multimodality imaging in device size selectionP592Contributions of three-dimensional transesophageal echocardiography in the evaluation of aortic atherosclerotic plaquesP593Agitated blood-saline is superior to agitated air-saline for echocardiographic shunt studies. Eur Heart J Cardiovasc Imaging 2016; 17:ii102-ii109. [DOI: 10.1093/ehjci/jew248.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Parenti I, Gervasini C, Pozojevic J, Wendt KS, Watrin E, Azzollini J, Braunholz D, Buiting K, Cereda A, Engels H, Garavelli L, Glazar R, Graffmann B, Larizza L, Lüdecke HJ, Mariani M, Masciadri M, Pié J, Ramos FJ, Russo S, Selicorni A, Stefanova M, Strom TM, Werner R, Wierzba J, Zampino G, Gillessen-Kaesbach G, Wieczorek D, Kaiser FJ. Expanding the clinical spectrum of the 'HDAC8-phenotype' - implications for molecular diagnostics, counseling and risk prediction. Clin Genet 2016; 89:564-73. [PMID: 26671848 DOI: 10.1111/cge.12717] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 11/30/2015] [Accepted: 12/12/2015] [Indexed: 01/25/2023]
Abstract
Cornelia de Lange syndrome (CdLS) is a clinically heterogeneous disorder characterized by typical facial dysmorphism, cognitive impairment and multiple congenital anomalies. Approximately 75% of patients carry a variant in one of the five cohesin-related genes NIPBL, SMC1A, SMC3, RAD21 and HDAC8. Herein we report on the clinical and molecular characterization of 11 patients carrying 10 distinct variants in HDAC8. Given the high number of variants identified so far, we advise sequencing of HDAC8 as an indispensable part of the routine molecular diagnostic for patients with CdLS or CdLS-overlapping features. The phenotype of our patients is very broad, whereas males tend to be more severely affected than females, who instead often present with less canonical CdLS features. The extensive clinical variability observed in the heterozygous females might be at least partially associated with a completely skewed X-inactivation, observed in seven out of eight female patients. Our cohort also includes two affected siblings whose unaffected mother was found to be mosaic for the causative mutation inherited to both affected children. This further supports the urgent need for an integration of highly sensitive sequencing technology to allow an appropriate molecular diagnostic, genetic counseling and risk prediction.
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Affiliation(s)
- I Parenti
- Sektion für Funktionelle Genetik am Institut für Humangenetik Lübeck, Universität zu Lübeck, Lübeck, Germany.,Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - C Gervasini
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - J Pozojevic
- Sektion für Funktionelle Genetik am Institut für Humangenetik Lübeck, Universität zu Lübeck, Lübeck, Germany
| | - K S Wendt
- Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | - E Watrin
- Faculté de Médecine, Institut de Génétique et Développement de Rennes, UMR6290-CNRS, Rennes, France
| | - J Azzollini
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - D Braunholz
- Sektion für Funktionelle Genetik am Institut für Humangenetik Lübeck, Universität zu Lübeck, Lübeck, Germany
| | - K Buiting
- Institut für Humangenetik, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - A Cereda
- U.O.S. Genetica Clinica Pediatrica, Clinica Pediatrica Fondazione MBBM, A.O. S.Gerardo, Monza, Italy
| | - H Engels
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - L Garavelli
- Clinical Genetics Unit, Department of Obstetrics and Pediatrics, IRCCS S. Maria Nuova Hospital, Reggio Emilia, Italy
| | - R Glazar
- The Center for Medical Genetics GENESIS Poznan, Poland
| | - B Graffmann
- Department of Pediatrics, University Hospital Linköping, Linköping, Sweden
| | - L Larizza
- Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - H J Lüdecke
- Institut für Humangenetik, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - M Mariani
- U.O.S. Genetica Clinica Pediatrica, Clinica Pediatrica Fondazione MBBM, A.O. S.Gerardo, Monza, Italy
| | - M Masciadri
- Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - J Pié
- Unit of Clinical Genetics and Functional Genomics, Departments of Pharmacology-Physiology and Pediatrics, Medical School, University of Zaragoza, CIBERER-GCV and ISS-Aragon, Zaragoza, Spain
| | - F J Ramos
- Unit of Clinical Genetics and Functional Genomics, Departments of Pharmacology-Physiology and Pediatrics, Medical School, University of Zaragoza, CIBERER-GCV and ISS-Aragon, Zaragoza, Spain.,Unidad de Genetica Clınica, Servicio de Pediatrıa, Hospital Clınico Universitario "Lozano Blesa", CIBERER-GCV and ISS-Aragon, Zaragoza, Spain
| | - S Russo
- Laboratory of Medical Cytogenetics and Molecular Genetics, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - A Selicorni
- U.O.S. Genetica Clinica Pediatrica, Clinica Pediatrica Fondazione MBBM, A.O. S.Gerardo, Monza, Italy
| | - M Stefanova
- Department of Clinical Genetics, University Hospital Linköping, Linköping, Sweden
| | - T M Strom
- Institute of Human Genetics, Technische Universität München, Munich, Germany.,Institute of Human Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - R Werner
- Division of Experimental Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, University of Lübeck, Lübeck, Germany
| | - J Wierzba
- Department and Clinic of Pediatrics, Hematooncology, Oncology and Endocrinology, Medical University of Gdańsk, Gdańsk, Poland.,Department of General Nursing, Medical University of Gdańsk, Gdańsk, Poland
| | - G Zampino
- Birth Defects Unit, Department of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - D Wieczorek
- Institut für Humangenetik, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - F J Kaiser
- Sektion für Funktionelle Genetik am Institut für Humangenetik Lübeck, Universität zu Lübeck, Lübeck, Germany
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Parenti I, Gervasini C, Pozojevic J, Graul-Neumann L, Azzollini J, Braunholz D, Watrin E, Wendt K, Cereda A, Cittaro D, Gillessen-Kaesbach G, Lazarevic D, Mariani M, Russo S, Werner R, Krawitz P, Larizza L, Selicorni A, Kaiser F. Broadening of cohesinopathies: exome sequencing identifies mutations in ANKRD11
in two patients with Cornelia de Lange-overlapping phenotype. Clin Genet 2015; 89:74-81. [DOI: 10.1111/cge.12564] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 02/06/2023]
Affiliation(s)
- I. Parenti
- Medical Genetics, Department of Health Sciences; Università degli Studi di Milano; Milan Italy
- Sektion für Funktionelle Genetik am Institut für Humangenetik Lübeck; Universität zu Lübeck; Lübeck Germany
| | - C. Gervasini
- Medical Genetics, Department of Health Sciences; Università degli Studi di Milano; Milan Italy
| | - J. Pozojevic
- Sektion für Funktionelle Genetik am Institut für Humangenetik Lübeck; Universität zu Lübeck; Lübeck Germany
| | - L. Graul-Neumann
- Ambulantes Gesundheitszentrum der Charité Campus Virchow, Humangenetik; Universitätsmedizin Berlin; Berlin Germany
| | - J. Azzollini
- Medical Genetics, Department of Health Sciences; Università degli Studi di Milano; Milan Italy
| | - D. Braunholz
- Sektion für Funktionelle Genetik am Institut für Humangenetik Lübeck; Universität zu Lübeck; Lübeck Germany
| | - E. Watrin
- Institut de Génétique et Développement de Rennes, Faculté de Médecine; UMR6290-CNRS; Rennes France
| | - K.S. Wendt
- Department of Cell Biology; Erasmus MC; Rotterdam Netherlands
| | - A. Cereda
- A.O. S.Gerardo; U.O.S. Genetica Clinica Pediatrica, Clinica Pediatrica Fondazione MBBM; Monza Italy
| | - D. Cittaro
- Centre for Translational Genomics and Bioinformatics; San Raffaele Scientific Institute; Milan Italy
| | | | - D. Lazarevic
- Centre for Translational Genomics and Bioinformatics; San Raffaele Scientific Institute; Milan Italy
| | - M. Mariani
- A.O. S.Gerardo; U.O.S. Genetica Clinica Pediatrica, Clinica Pediatrica Fondazione MBBM; Monza Italy
| | - S. Russo
- Laboratory of Medical Cytogenetics and Molecular Genetics; IRCCS Istituto Auxologico Italiano; Milan Italy
| | - R. Werner
- Department of Paediatrics and Adolescent Medicine, Division of Experimental Paediatric Endocrinology and Diabetes; University of Lübeck; Lübeck Germany
| | - P. Krawitz
- Ambulantes Gesundheitszentrum der Charité Campus Virchow, Humangenetik; Universitätsmedizin Berlin; Berlin Germany
- Max Planck Institute for Molecular Genetics; Berlin Germany
| | - L. Larizza
- Medical Genetics, Department of Health Sciences; Università degli Studi di Milano; Milan Italy
- Laboratory of Medical Cytogenetics and Molecular Genetics; IRCCS Istituto Auxologico Italiano; Milan Italy
| | - A. Selicorni
- A.O. S.Gerardo; U.O.S. Genetica Clinica Pediatrica, Clinica Pediatrica Fondazione MBBM; Monza Italy
| | - F.J. Kaiser
- Sektion für Funktionelle Genetik am Institut für Humangenetik Lübeck; Universität zu Lübeck; Lübeck Germany
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Cesana F, Colombo C, Valsecchi C, Stucchi M, Vallerio P, Cereda A, Meani P, Ricotta R, Siena S, Giannattasio C. P4.20 SHORT-TERM EFFECT OF ANTI-VEGF DRUGS ON HEART AND VESSELS. Artery Res 2013. [DOI: 10.1016/j.artres.2013.10.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Alloni M, Vincenzi A, Cesana F, De Carlini C, Villa P, Cereda A, Viganò E, Canova P, Paciocco G, Facchetti R, Cirò A, Giannattasio C, Mancia G. P5.24 PULMONARY ARTERIAL HYPERTENSION AND ARTERIAL STIFFNESS. Artery Res 2011. [DOI: 10.1016/j.artres.2011.10.079] [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: 11/16/2022] Open
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Tagliabue L, Bestetti A, Dileo C, Posterli R, Cereda A, Tarolo GL. [Incidence and functional role of antithyroid antibodies in hyperthyroidism]. Radiol Med 1998; 95:188-92. [PMID: 9638164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION We report our personal experience in patients with biochemical hyperthyroidism and no nodules, studying the correlations between antithyroid autoantibodies titers, thyroid function and clinical symptoms. MATERIAL AND METHODS We examined 93 patients (13 men and 80 women, mean age: 44.6 years, range: 25-68 years) referred for suspected hyperthyroidism. Thyroid 99mTc scintigraphy was performed and the 20 minutes' uptake index (UI) calculated: all these patients had a scintigraphic pattern of normal or enlarged thyroid with homogeneous radiotracer uptake. The presence and titer of antiperoxidase (TPO) and anti-TSH receptor antibodies (TRAB), FT3, FT4, TSH were assayed. Based on the results, the patients were divided into 4 subgroups: A (high TRAB/high TPO, no. 17), B (low TRAB/high TPO, no. 15), C (high TRAB/low TPO, no. 35), D (low TRAB/low TPO, no. 26). The incidence of hyperthyroidism symptoms was 94% in Group A, 40% in Group B, 89% in Group C, 50% in group D. RESULTS UI significantly correlated with FT3 (p < .001), FT4 (p < .01) and TRAB (p < .01) titers. FT3 and UI average values were significantly higher in Group A and Group C patients (high TRAB) than in Group B and Group D patients (low TRAB) (p < .01); these parameters were significantly higher also in Group A than in Group B patients (p < .05 for FT3 and p < .03 for UI, respectively). Mean intergroup TSH values did not differ (p = ns) and anti-TPO antibodies did not correlate with FT3, FT4 and TSH titers. CONCLUSIONS UI behaved as a good marker of hyperthyroidism in all patients and TRAB correlated well with organ function and the clinical picture; however, about 18% of patients exhibited no antibody production. No correlation was found between TPO and thyroid function. The lack of antithyroid antibodies seems to indicate a better clinical course for hyperthyroidism. The patients without TRAB and/or with high anti-TPO titers may follow different clinical courses and need a regular follow-up.
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Affiliation(s)
- L Tagliabue
- Servizio e Cattedra di Medicina Nucleare, Università degli Studi, Ospedale S. Paolo, Milano
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Picca M, Azzollini F, Cereda A, Pelosi G. Comparison of the antianginal efficacy of four calcium antagonists and propranolol in stable angina pectoris. Eur J Clin Pharmacol 1989; 37:325-31. [PMID: 2513206 DOI: 10.1007/bf00558494] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The antianginal effects of propranolol 160 mg/day, diltiazem 240 mg/day, nicardipine 80 mg/day, nifedipine 40 to 80 mg/day and verapamil 320 mg/day were compared in 12 patients with chronic stable angina pectoris using a symptom-limited exercise test. Compared to placebo propranolol and calcium antagonists similarly reduced (p less than 0.001) the frequency of antianginal attacks and nitroglycerin consumption, and increased exercise tolerance and time to greater than or equal to 1 mm S-T segment depression. After propranolol the pressure-rate product at submaximal and maximal exercise was significantly decreased. The calcium antagonists produced a significant reduction in the submaximal pressure-rate product, but no significant change in the peak pressure-rate product. Maximum ST depression was significantly lower after propranolol and was unchanged after the calcium antagonists. None of the drugs caused significant adverse effects. The results indicate that in patients with stable effort angina pectoris, diltiazem, nicardipine, nifedipine and verapamil were as effective as propranolol in improving exercise tolerance and time to ischaemia, and they did not alter the peak pressure-rate product. Different antianginal mechanisms may be operative for the various calcium antagonists.
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Affiliation(s)
- M Picca
- Istituto Ospedaliero Provinciale, Divisione di Medicina Generale e Servizio di Cardiologia Milan, Italy
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Pelosi G, Bracchi G, Orazio S, Cereda A. [Serum levels of beta-methyldigoxin and contractile efficiency of the myocardium evaluated with systolic polygraphy and determination of cardiac output]. Minerva Med 1981; 72:225-31. [PMID: 7010220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
0.3 mg/day betamethyldigoxin was given per os in three daily administrations to 8 healthy subjects, and 8 compensated and 8 decompensated heart patients. Prior to the treatment, and 6 hr after the last administration, blood digoxin values were determined radio-immunologically, together with cardiac output, systolic stroke volume, cardiac index (dilution of indocyanine green), and systolic time intervals, by simultaneous recording of the ECG, carotid pulse, and the phonocardiogram. No significant change in output, stroke volume and cardiac index was noted in the healthy subjects, whereas these parameters were distinctly improved in the decompensated patients. Changes in the systolic intervals after treatment were significant in all cases though there was no significant correlation with the blood digoxin levels reached. In particular, the healthy and compensated subjects displayed a reduction in the corrected electromechanical systole (delta Q-S2), the corrected pre-ejection period (delta PEP), the corrected left ventricular ejection time (delta LVET), and their ratio (PEP/LVET), whereas in the decompensated patients the picture differed to the extent that the LVET increased owing to an augment-systolic stroke volume, the other parameters being reduced. In the healthy subjects, the polygraphic data were normal prior to the treatment, while in the compensated patients delta PEP and the PEP/LVET ratio were enhanced, and the delta LVET was less than in the normal subjects. It is felt that recording of the systolic intervals may be regarded as a sound method, owing to its simplicity and its ability to demonstrate latent cardiac failure before haemodynamic changes appear. Simultaneous determination of serum digoxin and the polygraphic data, therefore, opens the way to the commencement of appropriate, safe and timely management of as yet non-decompensated heart patients.
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