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Lazzeroni D, Marchini C, Centorbi CS, Moderato L, Brambilla L, Bini M, Guazzi E, Magnani G, Aschieri D, Piepoli M, Nicolini F, Coruzzi P. Clinical parameters and cardiovascular risk factors related to heart failure with preserved ejection fraction: a comparative analysis between HFA-PEFF and H2FPEF Scores. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.795] [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
Heart failure with preserved ejection fraction (HFpEF) diagnosis remains challenging, since several mechanisms (diastolic and systolic reserve abnormalities, chronotropic incompetence, ventricular or vascular stiffening, atrial dysfunction, pulmonary hypertension, impaired vasodilation, endothelial dysfunction, energetic abnormalities and autonomic dysfunction) play different roles in HFpEF development. European Society of Cardiology HF guidelines recently suggested a stepwise non-invasive diagnostic approach consisting of three steps: the first is clinical, the second includes echocardiographic and laboratory data (natriuretic peptides), named HFA-PEEF score, and finally, in case of inconclusive findings, diastolic stress echocardiography is recommended. On the other hand, in United States, another multiparametric score, named H2FPEF, has been proposed for HFpEF diagnosis, and including, in addition to echocardiographic parameters, also clinical data; thereby more applicable in the outpatient clinical arena.
Purpose
Whether there is a clinical overlap between the two scores (HFA-PEEF and H2FPEF) as well as whether the addition of clinical data to the HFA-PEEF could improve its ability to identify different HFpEF phenotypes is still an open issue and these were the aims of our study.
Methods
HFA-PEEF and H2FPEF scores were systematically applied on 1,156 consecutive subjects with preserved ejection fraction who undergone cardiovascular evaluation at the Cardiovascular Prevention Center of Fondazione Don Gnocchi & University of Parma. All subjects underwent cardiovascular risk assessment followed by echocardiography and cardiopulmonary exercise testing; due to the outpatient (non-acute) setting of the evaluation, natriuretic peptides assay was not performed. Clinical data and cardiovascular risk factors data were compared between different groups of HFpEF risk.
Results
According to H2FPEF score, low risk (<40%) of HFpEF was found in 659 (57%), moderate in 300 (26%) and high (>75%) in 197 (17%); according to HFA-PEEF score, 675 (58%) had 0 or 1 point, 253 (22%) had 2 points and 230 (20%) had 3 or 4 points (moderate-to-high risk). Patients with higher HFA-PEEF score were older (p<0.001), had higher prevalence of HTN (p<0.001), diabetes (p<0.001), obesity (p<0.001), sedentary lifestyle (p<0.001), AF (p<0.001) and CCS (p<0.001) (figure 1). More specifically, AF was associated to a 6.3-fold higher risk (p<0.001) of high (3–4) HFA-PEEF Score, age >75 years to a 4.6-fold higher risk, HTN to a 3.6-fold higher risk (p<0.001), CCS to a 3.3-fold higher risk (p<0.001), obesity to a 2.2-fold higher risk (p<0.001), diabetes to a 1.9-fold higher risk (p<0.001) and sedentary to a 1.7-fold higher risk (p=0.001).
Conclusions
Although HFA-PEEF score does not include clinical data, patients with older age, atrial fibrillation, hypertension, hypertensive heart, diabetes, sedentary lifestyle and chronic coronary syndrome show a higher ESC risk of HFpEF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Lazzeroni
- IRCCS Don Carlo Gnocchi Foundation , Florence , Italy
| | - C Marchini
- Fondazione Don Gnocchi, Cardiovascolar Prevention and Rehabilitation Unit , parma , Italy
| | - C S Centorbi
- Fondazione Don Gnocchi, Cardiovascolar Prevention and Rehabilitation Unit , parma , Italy
| | - L Moderato
- Guglielmo da Saliceto Hospital , Piacenza , Italy
| | - L Brambilla
- Don Gnocchi Foundation - IRCCS Centro S. Maria Nascente , Milan , Italy
| | - M Bini
- Fondazione Don Gnocchi, Cardiovascolar Prevention and Rehabilitation Unit , parma , Italy
| | - E Guazzi
- Fondazione Don Gnocchi, Cardiovascolar Prevention and Rehabilitation Unit , parma , Italy
| | - G Magnani
- University of Parma, Cardiology Unit , Parma , Italy
| | - D Aschieri
- Guglielmo da Saliceto Hospital , Piacenza , Italy
| | - M Piepoli
- Sant'Anna School of Advanced Studies , Pisa , Italy
| | - F Nicolini
- University of Parma, Cardiac surgery Unit , Parma , Italy
| | - P Coruzzi
- Fondazione Don Gnocchi, Cardiovascolar Prevention and Rehabilitation Unit , parma , Italy
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Lazzeroni D, Marchini C, Centorbi CS, Moderato L, Brambilla L, Bini M, Guazzi E, Magnani G, Aschieri D, Piepoli M, Nicolini F, Coruzzi P. Cardiopulmonary response to exercise and heart failure with preserved ejection fraction risk: a comparative analysis of HFA-PEFF and H2FPEF scores. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Exercise intolerance evaluation in Heart failure with preserved ejection fraction (HFpEF) remains challenging, since several mechanisms (diastolic and systolic reserve abnormalities, low chronotropic reserve (CR), ventricular or vascular stiffening, atrial dysfunction, pulmonary hypertension, endothelial dysfunction, energetic abnormalities and autonomic dysfunction) play different roles. European Society of Cardiology HF guidelines recently suggested a stepwise non-invasive HFpEF diagnostic approach consisting of three steps: clinical, echocardiographic and laboratory data (natriuretic peptides), named HFA-PEEF Score, and finally, in case of inconclusive findings, diastolic stress echocardiography data. Cardiopulmonary exercise testing (CPET) may represent a promising further non-invasive diagnostic tool in HFpEF evaluation since allow to assess the presence of reduced functional capacity as well as to differentiate between cardiovascular, ventilatory or peripheral causes.
Purpose
Whether increased risk of HFpEF is associated with different and specific cardiopulmonary responses to exercise is still an open issue and this was the aim of our study.
Methods
1.156 consecutive subjects with preserved ejection fraction undergoing cardiovascular evaluation at the Cardiovascular Prevention Center of Fondazione Don Gnocchi & University of Parma were enrolled. All subjects underwent cardiovascular evaluation and echocardiography, HFA-PEEF and H2FPEF Score assessment and cardiopulmonary exercise testing. Different cardiopulmonary response to exercise were compared between different groups of HFpEF risk.
Results
According to HFA-PEEF Score, 675 (58%) had 0 or 1 point, 253 (22%) had 2 points and 230 (20%) had 3 or 4 points (moderate-to-high risk). Patients with both higher HFA-PEEF and H2FPEF Score showed lower functional capacity, expressed as low peak V02 (p<0.001) associated with lower oxygen pulse (V02/HR) (p<0.001), cardiac output (CO) at peak (p<0.001), CR (p<0.001), ventilatory efficiency (expressed as VE/VC02 slope) (p<0.001) and oxygen uptake extraction (OUES) (p<0.001). Moreover, higher H2FPEF Score patients showed lower stroke volume (SV) at peak (p<0.001), while high HFA-PEEF score was not associated to SV at peak (Table 1 and Figure 1). More specifically, the presence of reduced cardiovascular efficiency (V02/Watt Slope <7) was associated to a 2.2-fold higher risk of HFpEF (p=0.003), impaired ventilator efficiency (VE/VCO2 Slope >35) to a 2.4-fold higher risk (p<0.001), reduced CR (<70%) 4.3-fold higher risk (p<0.001).
Conclusions
Different degrees HFpEF risk, estimated using both HFA-PEEF and H2FPEF score, are associated with different cardiopulmonary responses to exercise. High HFpEF risk patients show low functional capacity, cardiovascular and ventilator efficiency due to lower cardiac output at peak, despite preserved ejection fraction, associated to lower chronotropic response to exercise.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Lazzeroni
- IRCCS Don Carlo Gnocchi Foundation , Florence , Italy
| | - C Marchini
- Fondazione Don Gnocchi, Cardiovascolar Prevention and Rehabilitation Unit , parma , Italy
| | - C S Centorbi
- Fondazione Don Gnocchi, Cardiovascolar Prevention and Rehabilitation Unit , parma , Italy
| | - L Moderato
- Guglielmo da Saliceto Hospital , Piacenza , Italy
| | - L Brambilla
- Don Gnocchi Foundation - IRCCS Centro S. Maria Nascente , Milan , Italy
| | - M Bini
- Fondazione Don Gnocchi, Cardiovascolar Prevention and Rehabilitation Unit , parma , Italy
| | - E Guazzi
- Fondazione Don Gnocchi, Cardiovascolar Prevention and Rehabilitation Unit , parma , Italy
| | - G Magnani
- University of Parma, Cardiology Unit , Parma , Italy
| | - D Aschieri
- Guglielmo da Saliceto Hospital , Piacenza , Italy
| | - M Piepoli
- Sant'Anna School of Advanced Studies , Pisa , Italy
| | - F Nicolini
- University of Parma, Cardiac surgery Unit , Parma , Italy
| | - P Coruzzi
- Fondazione Don Gnocchi, Cardiovascolar Prevention and Rehabilitation Unit , parma , Italy
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Denegri A, Magnani G, Kraler S, Wenzl F, Raeber L, Gencer B, Mach F, Nanchen D, Matter CM, Luescher TF. Prevalence and outcomes of peripheral artery disease in a real-world cohort of patients with acute coronary syndrome: insights from the prospective SPUM registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1321] [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: 11/15/2022] Open
Abstract
Abstract
Background
Despite substantial improvement in secondary preventive therapy, the burden of recurrent cardiovascular (CV) events remains high. Peripheral artery disease (PAD), is a potential marker of increased residual ischemic risk in acute coronary syndrome (ACS) patients suggesting greater net clinical benefit from intensified individualized therapy.
Purpose
We aimed to assess the prevalence and cardiovascular (CV) outcomes of peripheral arterial disease (PAD) in 4'787 patients with acute coronary syndromes (ACS) in the Swiss prospective multicenter SPUM study.
Methods
PAD was defined according to international guidelines. The composite primary endpoint was major adverse cardiac and cerebrovascular events (MACCE), i.e., stroke, myocardial infarction (MI) and death at 1 year. Adjusted Cox proportional hazards regression models were used to estimate the risk associated with PAD and outcomes.
Results
Out of 4'787 ACS patients, 285 patients (6.0%) had PAD. These patients were older (70.1±10.6 vs 63.3±12.4, p<0.001), presented all traditional CV risk factors (all p<0.001) and were more likely to have a complex history of CV disease, such as previous MI (24.3% vs 11.4%, p<0.001), prior percutaneous (32.3% vs 13.8%, p<0.001) or surgical (12.6% vs 3.5%, p<0.001) coronary revascularization. PAD-patients presented also higher levels of inflammatory biomarkers, such as hs-CRP, and GRACE 2.0 score (all p<0.001). At 1 year, patients with PAD had a higher rate of MACCE compared to those presenting without PAD. Rates of the individual components of the primary endpoint and CV-death were all significantly higher in patients with PAD (all p<0.001), except for a numerical increase in MI (5.3% vs 3.3%, p=0.060). This enhanced risk persisted after adjustment for differences in baseline characteristics, with a 53% (Adj. HR 1.53, CI95% 1.14–2.08, p=0.005) increase in MACCE. In spite of high-intensity anti-thrombotic therapy, PAD patients presented the same rate (Adj. HR 1.03, CI95% 0.68–1.54, p=0.901) of major bleeding events at 1 year.
Conclusions
Among a real-world cohort of ACS patients, the coexistence of PAD, a very-high CV risk phenotype, is associated with significantly increased rates of MACCE, but no difference in major bleeding events. These observations might help clinicians to further stratify this very-high risk population and to identify patients who may derive the greatest benefit from more intense secondary prevention therapies.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | | | - S Kraler
- Center for Molecular Cardiology, University of Zurich , Zurich , Switzerland
| | - F Wenzl
- Center for Molecular Cardiology, University of Zurich , Zurich , Switzerland
| | - L Raeber
- Bern University Hospital, Cardiology , Bern , Switzerland
| | - B Gencer
- University Hospital of Geneva, Cardiology , Geneva , Switzerland
| | - F Mach
- University Hospital of Geneva, Cardiology , Geneva , Switzerland
| | - D Nanchen
- Centre for Primary Care and Public Health (Unisante) , Lausanne , Switzerland
| | - C M Matter
- University Hospital Zurich, Cardiology , Zurich , Switzerland
| | - T F Luescher
- Royal Brompton and Harefield Hospital , London , United Kingdom
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Giacalone R, Ferretti M, Gurgoglione F, Noni M, Pelà G, Vezzani A, Cattabiani M, Benatti G, Tadonio I, Magnani G, Nicolini F, Niccoli G, Ardissino D, Vignali L, Solinas E. P56 SPONTANEOUS CORONARY ARTERY DISSECTIONS: ANALYSIS OF NON TRADITIONAL RISK FACTORS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
The etiology of spontaneous coronary dissection (SCAD) is not well defined and Non traditional risk factors (NT–RF) have assumed increasing interest, but few data are available. NT–RF include three categories: Sex–related (SR–NT–FR), Sex–predominant (SP–NT–RF) and Gender–related (GR–NT–RF). (Table 1)
Aim of the Study
The objective of our analysis was to evaluate the incidence of NT–RF in Parma SCAD registry population.
Material and methods
We reviewed 62 patients with SCAD enrolled between January 2013 through November 2021
Results
Traditional risk factors were less common: hypertension was the most prevalent (39 pts, 62.9%). When considering NT–RF, 51 patients (82%) had at least one of all, with at least one SR–RF (66%) or GR–RF (64,5%). Patients with NT–RF were younger at time of SCAD (mean age 53 vs 66; p = 0.027) and they were predominantly females (48 vs 7 pts, p = 0.004) (Table 2). No differences were found among NT–RF SCAD and nNT–RF SCAD patients by fibromuscular dysplasia, peripheral arterial disease and chronic kidney disease. Patients with SCAD more often presented with non ST–segment elevation myocardial infarction (43 pts, 72.6%) vs ST–segment elevation (17 pts, 27.4%). No differences in clinical presentation and angiographic characteristics were found among NT–RF and nNT–RF patients group. MACE occurred in 17.7% of patients of the overall study population, at a median follow–up of 23 (interquartile range: 11;57) months. When comparing the incidence of cardiovascular events in the 2 study groups there was a trend toward a higher prevalence of MACE in NT–RF group without statistical significance (NT–RF SCAD 19.6% – nNT–RF SCAD 9.1%; p = 0.4). (Table 3)
Conclusion
SCAD is an emerging cause of myocardial infarction in young and middle–aged women without the traditional cardiovascular risk profile. Although overall survival seems good, SCAD is a potentially malignant disease which can present with ventricular arrhythmias and sudden cardiac death. Risk estimation is difficult in women, due to the scarce validity of prediction models, therefore a great effort must be made by the clinical community for the widespread diffusion and use of models incorporating NT–RF. Acknowledgement of peculiar features of this disease could help clinicians and researchers to establish targeted interventions for cardiovascular primary prevention, early diagnosis and secondary prevention in women, including rehabilitation and stress management programmes.
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Affiliation(s)
- R Giacalone
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - M Ferretti
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - F Gurgoglione
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - M Noni
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - G Pelà
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - A Vezzani
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - M Cattabiani
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - G Benatti
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - I Tadonio
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - G Magnani
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - F Nicolini
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - G Niccoli
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - D Ardissino
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - L Vignali
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
| | - E Solinas
- DIVISIONE DI CARDIOLOGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; DIPARTIMENTO DI MEDICINA E CHIRURGIA, UNIVERSITÀ DI PARMA, PARMA; UNITA‘ DI TERAPIA INTENSIVA CARDIOCHIRURGICA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA; UNIVERSITA‘ DI PARMA, DIVISIONE DI CARDIOCHIRURGIA, AZIENDA OSPEDALIERO–UNIVERSITARIA DI PARMA, PARMA
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Sidoli C, Zambon A, Tassistro E, Rossi E, Mossello E, Inzitari M, Cherubini A, Marengoni A, Morandi A, Bellelli G, Tarasconi A, Sella M, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Porcella L, Nardiello I, Chimenti E, Zeni M, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, Pietrogrande L, Mosca M, Corazzin I, Rossi P, Nunziata V, D’Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell’Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Borghi C, Bianchetti A, Crucitti A, DiFrancesco V, Fontana G, Geriatria A, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cassadonte F, Vatrano M, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Seneci F, Fimognari F, Bambar V, Saitta A, Corica F, Braga M, Servi, Ettorre E, Camellini Bellelli CG, Annoni G, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Formilan M, Patrizia G, Santuar L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl’Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Alessandro M, Calogero P, Corvalli G, Di F, Pezzoni D, Platto C, D’Ambrosio V, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Bonetto M, Grasso M, Troisi E, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Faraci B, Bertoletti E, Vannucci M, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D’Amico F, Grippa A, Mazzone A, Cottino M, Vezzadini G, Avanzi S, Brambilla C, Orini S, Sgrilli F, Mello A, Lombardi Muti LE, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D’Amico F, D’Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Cortegiani A, Pistidda L, D’Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study. Aging Clin Exp Res 2022; 34:1827-1835. [PMID: 35396698 DOI: 10.1007/s40520-022-02099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. AIM We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the "Delirium Day project". METHODS We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the "Delirium Day project" (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. RESULTS Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17-1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08-2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62-2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10-1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02-1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68-3.36, p value < 0.0001). CONCLUSION This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.
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Zucchelli A, Manzoni F, Morandi A, Di Santo S, Rossi E, Valsecchi MG, Inzitari M, Cherubini A, Bo M, Mossello E, Marengoni A, Bellelli G, Tarasconi A, Sella M, Auriemma S, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Margola A, Porcella L, Nardiello I, Chimenti E, Zeni M, Giani A, Famularo S, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Ballestrero A, Minaglia C, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, De F, Pietrogrande L, De B, Mosca M, Corazzin I, Rossi P, Nunziata V, D‘Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell‘Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Bianchetti A, Crucitti A, Di Francesco V, Fontana G, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cannistrà U, Cassadonte F, Vatrano M, Cassandonte F, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Fimognari F, Bambara V, Saitta A, Corica F, Braga M, Ettorre E, Camellini C, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Patrizia G, Santuari L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl‘Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Calogero P, Corvalli G, Pezzoni D, Gentile S, Morandi A, Platto C, D‘Ambrosio V, Faraci B, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Confente S, Bonetto M, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Bertoletti E, Vannucci M, Tesi F, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D‘Amico F, Grippa A, Mazzone A, Riva E, Dell‘Acqua D, Cottino M, Vezzadini G, Avanzi S, Orini S, Sgrilli F, Mello A, Lombardi L, Muti E, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, De F, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D‘Amico F, D‘Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Scapigliati A, Cortegiani A, Vitale F, Pistidda L, D‘Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017. Aging Clin Exp Res 2022; 34:349-357. [PMID: 34417734 PMCID: PMC8847195 DOI: 10.1007/s40520-021-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/31/2021] [Indexed: 01/22/2023]
Abstract
Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric
syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01950-8.
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Denegri A, Magnani G, Rossi VA, Raeber L, Windecker S, Gencer B, Mach F, Rodondi N, Heg D, Nanchen D, Matter CM, Luescher TF. P6440The perils of polyvascular disease with concomitant type 2 diabetes in a real-world cohort of patients with acute coronary syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Despite substantial improvement in type 2 diabetes (DM2) care, the burden of recurrent cardiovascular (CV) events remains high. Polyvascular disease (PVD), has recently emerged as a potential marker of heightened residual ischemic risk in DM2 patients, that are likely to derive a greater absolute risk reduction from more intense, individualized therapy.
Purpose
We sought to assess the relationship between DM2, PVD and CV outcomes among 2,168 all-comers patients admitted to four Swiss University Hospital for acute coronary syndrome (ACS) and enrolled in the prospective multicenter SPUM registry (NCT 01000701).
Methods
PVD was defined as concomitant peripheral artery disease, stroke or transient ischemic attack, or both. The composite primary endpoint was major adverse cardiac and cerebrovascular events (MACCE: Stroke, myocardial infarction, CV death). Adjusted Cox proportional hazards regression models were implemented to determine the risk associated with PVD disease in DM2 and outcomes, and intention-to-treat analysis was performed.
Results
Out of 2,168 ACS patients, 396 patients (18.3%) had DM2; of these 62 (15%) had PVD. Despite compared with the general ACS population, those with PVD + DM2 were more likely to have a complex history of CV disease, such as previous MI (27.4% vs 14.7%, p=0.021), prior percutaneous (37.1% vs 17%, p<0.001) or surgical (24.2% vs 5.1%, p<0.001) coronary revascularization, one third was not on statin therapy. At 1 year, patients with PVD + DM2 had a higher rate of MACCE compared to those presenting with PVD or DM2 alone. Rates of the single components of the primary endpoint and all-cause of death were all significantly higher in patients with PVD + DM2 vs. PVD or DM2 alone (Fig. 1A, all p<0.001). This enhanced risk persisted after adjustment for significant baseline differences, with a 34% (Adj. HR 1.34, 95% CI 1.15–1.49, p=0.02) increase in MACCE and a 44% increment of all cause of death (Adj. HR 1.44, 95% CI 1.06–1.54, p=0.02, Fig. 1B).
Outcomes by PVD and DM2 status.
Conclusions
Among a real-world cohort of ACS-patients, the coexistence of PVD and DM2 highlights the highest CV risk phenotype, being associated with significant increased rates of MACCE and all-cause of death. These observations might help clinicians to furtherly stratify the very high risk population and to identify patients who may derive the greatest benefit from more intense secondary prevention therapies.
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Affiliation(s)
| | - G Magnani
- University Hospital of Parma, Cardiology, Parma, Italy
| | - V A Rossi
- University Hospital Zurich, Cardiology, Zurich, Switzerland
| | - L Raeber
- Bern University Hospital, Cardiology, Bern, Switzerland
| | - S Windecker
- Bern University Hospital, Cardiology, Bern, Switzerland
| | - B Gencer
- Geneva University Hospitals, Cardiology, Geneva, Switzerland
| | - F Mach
- Geneva University Hospitals, Cardiology, Geneva, Switzerland
| | - N Rodondi
- Bern University Hospital, Department of Family Medicine, Bern, Switzerland
| | - D Heg
- Bern University Hospital, Institute of Social and Preventive Medicine, Bern, Switzerland
| | - D Nanchen
- University of Lausanne, Center for Primary Care and Public Health, Lausanne, Switzerland
| | - C M Matter
- University Hospital Zurich, Cardiology, Zurich, Switzerland
| | - T F Luescher
- Royal Brompton Hospital, Cardiology, London, United Kingdom
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Modica S, Rossetti B, Lombardi F, Lagi F, Maffeo M, D'Autilia R, Pecorari M, Vicenti I, Bruzzone B, Magnani G, Paolucci S, Francisci D, Penco G, Sacchini D, Zazzi M, De Luca A, Di Biagio A. Prevalence and determinants of resistance mutations in HIV-1-infected patients exposed to integrase inhibitors in a large Italian cohort. HIV Med 2018; 20:137-146. [PMID: 30461149 DOI: 10.1111/hiv.12692] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aim of the study was to analyse the prevalence of integrase resistance mutations in integrase strand transfer inhibitor (INSTI)-experienced HIV-1-infected patients and its predictors. METHODS We selected HIV-1 integrase sequences from the Antiviral Response Cohort Analysis (ARCA) database, derived from INSTI-experienced patients between 2008 and 2017. Differences in the prevalence of resistance to raltegravir (RAL), elvitegravir (EVG) and dolutegravir (DTG) were assessed by χ2 test and predictors of resistance were analysed by logistic regression. RESULTS We included 462 genotypes from INSTI-exposed individuals: 356 'INSTI-failing' patients and 106 'previously INSTI-exposed' patients (obtained a median of 42 weeks after INSTI discontinuation [interquartile range (IQR) 17-110 weeks]). Overall, at least low-level resistance (LLR) to any INSTI (Stanford 8.5 algorithm) was detected in 198 (42.9%) cases. The most frequent INSTI resistance mutation was N155H, followed by Q148H/K/R, G140A/C/S, E138A/K/T and Y143C/H/R. Y143R and E138A were more prevalent in viral subtype B versus non-B [5.2 versus 1.5%, respectively (P = 0.04), and 3.1 versus 0%, respectively (P = 0.02)]. Overall, the Q148H/K/R plus G140A/C/S and/or E138A/K/T pattern, defining an intermediate level of resistance to DTG, was detected in 70 (15%) cases. Independent predictors of at least LLR to any INSTI were current use versus past use of INSTIs, a lower genotypic sensitivity score (GSS) for contemporary antiretroviral drugs used, and having an integrase sequence obtained in calendar year 2016 as compared to 2008-2009. CONCLUSIONS The results support integrase resistance testing in INSTI-experienced patients. Emergence of INSTI resistance is facilitated by the reduced genetic barrier of the regimen as a consequence of resistance to companion drugs. However, INSTI resistance may become undetectable by standard population sequencing upon INSTI discontinuation.
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Affiliation(s)
- S Modica
- Infectious Diseases Unit, Siena University Hospital, Siena, Italy.,Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - B Rossetti
- Infectious Diseases Unit, Siena University Hospital, Siena, Italy
| | - F Lombardi
- Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy
| | - F Lagi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - M Maffeo
- Infectious Diseases Unit, Siena University Hospital, Siena, Italy.,Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - R D'Autilia
- Department of Mathematics, University of Roma Tre, Rome, Italy
| | - M Pecorari
- Unit of Microbiology and Virology, Modena University Hospital, Modena, Italy
| | - I Vicenti
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - B Bruzzone
- Hygiene Unit, Policlinico San Martino Hospital, Genoa, Italy
| | - G Magnani
- Department of Infectious Diseases, S. Maria Nuova IRCCS Hospital, Reggio Emilia, Italy
| | - S Paolucci
- Molecular Virology Unit, Microbiology and Virology Department, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - D Francisci
- Infectious Diseases Clinic, Perugia University Hospital, Perugia, Italy
| | - G Penco
- Department of Infectious Diseases, Galliera Hospital, Genoa, Italy
| | - D Sacchini
- Clinic of Infectious Diseases, 'Guglielmo da Saliceto' Hospital, Piacenza, Italy
| | - M Zazzi
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - A De Luca
- Infectious Diseases Unit, Siena University Hospital, Siena, Italy.,Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - A Di Biagio
- Infectious Diseases Clinic, Policlinico San Martino Hospital, Genoa, Italy
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Amato N, Nossa A, Magnani G, Martins-Silva A, Martinelli V, Comi G, Leocani L. 102. Enhanced cognitive control in healthy aging revealed by increased prefrontal bioelectrical activity to the Stroop task. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.110] [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: 10/22/2022]
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Huang S, Ferrari L, Coppi E, Vitali F, Magnani G, Comi G, Leocani L. Retinal ganglion cell layer correlates with cognitive involvement in Alzheimer’s disease and mild cognitive impairment. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.116] [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: 10/22/2022]
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Coppi E, Ferrari L, Nuara A, Chieffo R, Houdayer E, Bernasconi M, Falautano M, Ambrosi A, Zangen A, Comi G, Magnani G, Leocani L. ID 295 – Deep repetitive transcranial magnetic stimulation with the H-coil in Alzheimer’s disease: A placebo-controlled, double-blind study. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.413] [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: 10/22/2022]
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12
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Ferrari L, Coppi E, Vitali F, Magnani G, Comi G, Leocani L. ID 299 – Retinal involvement in fronto-temporal dementia: Role of optical coherence tomography and clinical implications. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.187] [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: 10/22/2022]
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13
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Masetti M, Malossi M, Potena L, Prestinenzi P, Manfredini V, Barberini F, Borgese L, Sabatino M, Magnani G, Grigioni F, Rapezzi C. Everolimus (EVE) vs. Mycophenolate (MMF) De Novo After Heart Transplantation (HTx): Does It Matter for Long Term Outcomes? J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.356] [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: 11/25/2022] Open
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14
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Borgese L, Potena L, Manfredini V, Bontadini A, Iannelli S, Fruet F, Capelli S, Chiavaroli M, Barra B, Prestinenzi P, Magnani G, Grigioni F, Rapezzi C. Three Years Outcome of Virtual Crossmatch Strategy in Heart Transplant Recipients. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.349] [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: 10/23/2022] Open
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15
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Ferrari L, Vitali F, Di Maggio G, Santangelo R, Houdayer E, Coppi E, Magnani G, Comi G, Leocani L. 31. Retinal nerve fiber layer thinning as a mirror of neurodegeneration in Alzheimer’s disease. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.050] [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: 11/24/2022]
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16
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Potena L, Bianchi G, Chiereghin A, Perciaccante B, Borgese L, Petrisli E, Prestinenzi P, Magnani G, Lazzarotto T, Rapezzi C, Grigioni F. Reconstitution of CMV-Specific Immunity After Heart Transplantation May Guide Customization of Immunosuppressive and Antiviral Strategies: A Prospective Randomized Study. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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17
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Coppi E, Ferrari L, Santangelo R, Caso F, Pinto P, Passerini G, Comi G, Magnani G. Further evidence about the crucial role of CSF biomarkers in diagnosis of posterior cortical atrophy. Neurol Sci 2014; 35:785-7. [DOI: 10.1007/s10072-014-1644-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 01/17/2014] [Indexed: 11/29/2022]
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18
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Joshi P, Turola E, Ruiz A, Bergami A, Libera DD, Benussi L, Giussani P, Magnani G, Comi G, Legname G, Ghidoni R, Furlan R, Matteoli M, Verderio C. Microglia convert aggregated amyloid-β into neurotoxic forms through the shedding of microvesicles. Cell Death Differ 2013; 21:582-93. [PMID: 24336048 DOI: 10.1038/cdd.2013.180] [Citation(s) in RCA: 185] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 10/15/2013] [Accepted: 10/30/2013] [Indexed: 01/09/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by extracellular amyloid-β (Aβ) deposition, which activates microglia, induces neuroinflammation and drives neurodegeneration. Recent evidence indicates that soluble pre-fibrillar Aβ species, rather than insoluble fibrils, are the most toxic forms of Aβ. Preventing soluble Aβ formation represents, therefore, a major goal in AD. We investigated whether microvesicles (MVs) released extracellularly by reactive microglia may contribute to AD degeneration. We found that production of myeloid MVs, likely of microglial origin, is strikingly high in AD patients and in subjects with mild cognitive impairment and that AD MVs are toxic for cultured neurons. The mechanism responsible for MV neurotoxicity was defined in vitro using MVs produced by primary microglia. We demonstrated that neurotoxicity of MVs results from (i) the capability of MV lipids to promote formation of soluble Aβ species from extracellular insoluble aggregates and (ii) from the presence of neurotoxic Aβ forms trafficked to MVs after Aβ internalization into microglia. MV neurotoxicity was neutralized by the Aβ-interacting protein PrP and anti-Aβ antibodies, which prevented binding to neurons of neurotoxic soluble Aβ species. This study identifies microglia-derived MVs as a novel mechanism by which microglia participate in AD degeneration, and suggest new therapeutic strategies for the treatment of the disease.
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Affiliation(s)
- P Joshi
- 1] Department of Biotechnology and Translational Medicine, University of Milano, via Vanvitelli 32, Milano 20129, Italy [2] Department of Medicine, CNR Institute of Neuroscience, via Vanvitelli 32, Milano 20129, Italy
| | - E Turola
- 1] Department of Biotechnology and Translational Medicine, University of Milano, via Vanvitelli 32, Milano 20129, Italy [2] Department of Medicine, CNR Institute of Neuroscience, via Vanvitelli 32, Milano 20129, Italy
| | - A Ruiz
- Department of Biotechnology and Translational Medicine, University of Milano, via Vanvitelli 32, Milano 20129, Italy
| | - A Bergami
- INSPE, Division of Neuroscience, San Raffaele Scientific Institute, via Olgettina 60, Milano 20132, Italy
| | - D D Libera
- INSPE, Division of Neuroscience, San Raffaele Scientific Institute, via Olgettina 60, Milano 20132, Italy
| | - L Benussi
- Proteomics Unit, IRCCS Istituto centro San Giovanni di Dio Fatebenefratelli, via Pilastroni, Brescia 4 25125, Italy
| | - P Giussani
- Department of Biotechnology and Translational Medicine, University of Milano, via Vanvitelli 32, Milano 20129, Italy
| | - G Magnani
- INSPE, Division of Neuroscience, San Raffaele Scientific Institute, via Olgettina 60, Milano 20132, Italy
| | - G Comi
- INSPE, Division of Neuroscience, San Raffaele Scientific Institute, via Olgettina 60, Milano 20132, Italy
| | - G Legname
- SISSA, Department of Neuroscience, Via Bonomea 265, Trieste I-34136, Italy
| | - R Ghidoni
- Proteomics Unit, IRCCS Istituto centro San Giovanni di Dio Fatebenefratelli, via Pilastroni, Brescia 4 25125, Italy
| | - R Furlan
- INSPE, Division of Neuroscience, San Raffaele Scientific Institute, via Olgettina 60, Milano 20132, Italy
| | - M Matteoli
- 1] Department of Biotechnology and Translational Medicine, University of Milano, via Vanvitelli 32, Milano 20129, Italy [2] IRCCS Humanitas,via Manzoni 56, Rozzano 20089, Italy
| | - C Verderio
- 1] Department of Medicine, CNR Institute of Neuroscience, via Vanvitelli 32, Milano 20129, Italy [2] IRCCS Humanitas,via Manzoni 56, Rozzano 20089, Italy
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19
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Filippi M, Agosta F, Galantucci S, Sala S, Valsasina P, Meani A, Canu E, Caso F, Cappa S, Magnani G, Franceschi M, Falini A, Comi G. Network analysis of intrinsic functional connectivity in the semantic variant of primary progressive aphasia. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Vagnarelli F, Potena L, Norscini G, Manfredini V, Amabile A, Grigioni F, Magnani G, Marzocchi A, Melandri G, Branzi A. Clinical course and long-term outcome of patients with severe heart failure receiving intra-aortic balloon pump as a bridge to heart transplantation. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2183] [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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21
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Agosta F, Sala S, Valsasina P, Meani A, Canu E, Magnani G, Cappa SF, Scola E, Quatto P, Horsfield MA, Falini A, Comi G, Filippi M. Brain network connectivity assessed using graph theory in frontotemporal dementia. Neurology 2013; 81:134-43. [DOI: 10.1212/wnl.0b013e31829a33f8] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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22
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Pedroni M, Di Gregorio C, Cortesi L, Reggiani Bonetti L, Magnani G, Simone ML, Medici V, Priore Oliva C, Marino M, Ponz de Leon M. Double heterozygosity for BRCA1 and hMLH1 gene mutations in a 46-year-old woman with five primary tumors. Tech Coloproctol 2013; 18:285-9. [DOI: 10.1007/s10151-013-1030-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 05/07/2013] [Indexed: 01/13/2023]
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23
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Masetti M, Potena L, Nardozza M, Prestinenzi P, Taglieri N, Saia F, Pece V, Magnani G, Fallani F, Coccolo F, Russo A, Rapezzi C, Grigioni F, Branzi A. Differential effect of everolimus on progression of early and late cardiac allograft vasculopathy in current clinical practice. Am J Transplant 2013; 13:1217-26. [PMID: 23621161 DOI: 10.1111/ajt.12208] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 01/21/2013] [Accepted: 01/27/2013] [Indexed: 01/25/2023]
Abstract
Randomized trials showed that mTOR inhibitors prevent early development of cardiac allograft vasculopathy (CAV). However, the action of these drugs on CAV late after transplant is controversial, and their effectiveness for CAV prevention in clinical practice is poorly explored. In this observational study we included 143 consecutive heart transplant recipients who underwent serial intravascular ultrasound (IVUS), receiving either everolimus or mycophenolate as adjunctive therapy to cyclosporine. Ninety-one recipients comprised the early cohort, receiving IVUS at weeks 3-6 and year 1 after transplant, and 52 the late cohort, receiving IVUS at years 1 and 5 after transplant. Everolimus independently reduced the odds for early CAV (0.14 [0.01-0.77]; p = 0.02) but it did not appear to influence late CAV progression. High-dose statins were found to be associated with reduced CAV progression both early and late after transplant (p ≤ 0.05). Metabolic abnormalities, such as high triglycerides, were associated with late, but not with early CAV progression. By highlighting a differential effect of everolimus and metabolic abnormalities on early and late changes of graft coronary morphology, this observational study supports the hypothesis that everolimus may be effective for CAV prevention but not for CAV treatment, and that risk factors intervene in a time-dependent sequence during CAV development.
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Affiliation(s)
- M Masetti
- Cardiovascular Department of the University of Bologna, Bologna, Italy.
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24
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Masetti M, Potena L, Nardozza M, Prestinenzi P, Taglieri N, Saia F, Pece V, Magnani G, Fallani F, Coccolo F, Russo A, Rapezzi C, Grigioni F, Branzi A. Differential Effect of Everolimus on Progression of Early and Late Cardiac Allograft Vasculopathy in Current Clinical Practice. Am J Transplant 2013. [DOI: 10.1002/ajt.12208] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- M. Masetti
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - L. Potena
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - M. Nardozza
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - P. Prestinenzi
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - N. Taglieri
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - F. Saia
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - V. Pece
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - G. Magnani
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - F. Fallani
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - F. Coccolo
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - A. Russo
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - C. Rapezzi
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - F. Grigioni
- Cardiovascular Department of the University of Bologna; Bologna; Italy
| | - A. Branzi
- Cardiovascular Department of the University of Bologna; Bologna; Italy
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Masetti M, Potena L, Pece V, Prestinenzi P, Bianchi I, Lonetti C, Taglieri N, Russo A, Magnani G, Grigioni F, Branzi A. Late Changes in Maximal Intimal Thickness after Heart Transplant: Prognostic Implications and Risk Factors. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.886] [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: 11/25/2022] Open
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26
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Borgese L, Fanizza M, Potena L, Leone O, Bontadini A, Iannelli S, Fruet F, Prestinenzi P, Manfredini V, Magnani G, Grigioni F, Branzi A. Clinical and Prognostic Correlates of pAMR Grading in Patients with Suspect Antibody Mediated Rejection. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.1023] [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: 11/15/2022] Open
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27
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Caso F, Onofrio F, Falautano M, Todeschini P, Migliaccio R, Comi G, Perani D, Magnani G. From primary progressive aphasia to corticobasal syndrome: two clinical and rCBF functional reports. Neurocase 2013; 19:201-7. [PMID: 22512772 DOI: 10.1080/13554794.2012.667117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We describe two cases, both presenting with a 2-year history of isolated language disorders, one compatible with logopenic variant and the other with non-fluent variant of primary progressive aphasia (PPA). Afterwards, each developed a corticobasal syndrome (CBS) with alien limb phenomenon and a multi-domain cognitive impairment. Regional cerebral perfusion (rCBF) study using 99mTc-ECD single photon emission computed tomography (SPECT) revealed hypoperfusion patterns consistent with these aphasia types and with the presence of limb apraxia. We report two cases of PPA variants associated with CBS and we suggest that SPECT rCBF correlates can be useful in making a differential diagnosis within the PPA spectrum.
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Affiliation(s)
- F Caso
- Department of Neurology, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy.
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28
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Lonetti C, Manfredini V, Potena L, Pece V, Masetti M, Martin-Suarez S, Pilato E, Loforte A, Magnani G, Grigioni F, Arpesella G, Branzi A. Role of Donor-Recipient Match in Determining the Risk for Primary Graft Failure after Heart Transplantation. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.662] [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] [Indexed: 10/27/2022] Open
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29
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Bozzali M, Spanò B, Parker GJM, Giulietti G, Castelli M, Basile B, Rossi S, Serra L, Magnani G, Nocentini U, Caltagirone C, Centonze D, Cercignani M. Anatomical brain connectivity can assess cognitive dysfunction in multiple sclerosis. Mult Scler 2013; 19:1161-8. [PMID: 23325589 DOI: 10.1177/1352458512474088] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Brain disconnection plays a major role in determining cognitive disabilities in multiple sclerosis (MS). We recently developed a novel diffusion-weighted magnetic resonance imaging (DW-MRI) tractography approach, namely anatomical connectivitity mapping (ACM), that quantifies structural brain connectivity. OBJECTIVE Use of ACM to assess structural connectivity modifications in MS brains and ascertain their relationship with the patients' Paced-Auditory-Serial-Addition-Test (PASAT) scores. METHODS Relapsing-remitting MS (RRMS) patients (n = 25) and controls (n = 25) underwent MRI at 3T, including conventional images, T1-weighted volumes and DW-MRI. Volumetric scans were coregistered to fractional anisotropy (FA) images, to obtain parenchymal FA maps for both white and grey matter. We initiated probabilistic tractography from all parenchymal voxels, obtaining ACM maps by counting the number of streamlines passing through each voxel, then normalizing by the total number of streamlines initiated. The ACM maps were transformed into standard space, for statistical use. RESULTS RRMS patients had reduced grey matter volume and FA, consistent with previous literature. Also, we showed reduced ACM in the thalamus and in the head of the caudate nucleus, bilaterally. In our RRMS patients, ACM was associated with PASAT scores in the corpus callosum, right hippocampus and cerebellum. CONCLUSIONS ACM opens a new perspective, clarifying the contribution of anatomical brain disconnection to clinical disabilities in MS.
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Affiliation(s)
- M Bozzali
- Santa Lucia Foundation, Rome, Italy.
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30
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Agosta F, Scola E, Canu E, Marcone A, Magnani G, Sarro L, Copetti M, Caso F, Cerami C, Comi G, Cappa SF, Falini A, Filippi M. White Matter Damage in Frontotemporal Lobar Degeneration Spectrum. Cereb Cortex 2012; 22:2705-14. [DOI: 10.1093/cercor/bhr288] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Agosta F, Scola E, Canu E, Magnani G, Marcone A, Valsasina P, Caso F, Copetti M, Comi G, Cappa S, Falini A, Filippi M. Functional Network Connectivity in the Behavioral Variant of Frontotemporal Dementia (P04.216). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.216] [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: 11/15/2022] Open
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32
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Sarro L, Agosta F, Scola E, Canu E, Marcone A, Magnani G, Franceschi M, Comi G, Cappa S, Falini A, Filippi M. Functional Connectivity during Resting State Functional MR Imaging in the Semantic Variant of Primary Progressive Aphasia (P04.217). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.217] [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: 11/15/2022] Open
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33
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Canu E, Agosta F, Scola E, Magnani G, Marcone A, Noris A, Falautano M, Cappa S, Falini A, Comi G, Filippi M. Patterns of Microstructural White Matter Damage in Early and Late Age of Onset Alzheimer's Disease Patients (P05.044). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.044] [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: 11/15/2022] Open
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34
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Dalla Libera D, Bergami A, Agosta F, Magnani G, Martinelli V, Martino G, Comi G, Filippi M, Verderio C, Furlan R. Microglial Microvesicles as Potential Biomarkers for Dementia (S14.003). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s14.003] [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: 11/15/2022] Open
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35
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Masetti M, Potena L, Nardozza M, Prestinenzi P, Pece V, Taglieri N, Saia F, Magnani G, Coccolo F, Fallani F, Grigioni F, Branzi A. 491 Differential Effect of Everolimus and Metabolic Risk Factors on Early vs. Late Progression of Allograft Vasculopathy: Dissecting Two Faces of the Same Disease. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.502] [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: 10/28/2022] Open
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36
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Petrisli E, Potena L, Bianchi I, Chiereghin A, Masetti M, Prestinenzi P, Barberini F, Angeli F, Magnani G, Lazzarotto T, Grigioni F, Branzi A. 402 Reconstitution of CMV-Specific Immunity after Heart Transplantation Is Modulated by mTOR Inhibition, but Not by Antiviral Strategy. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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37
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Pan A, Gagliotti C, Arlotti M, Bassi P, Bertozzi L, Borsari M, Cancellieri C, Carletti R, Giordani S, Libanore M, Magnani G, Marchegiano P, Mazzini E, Mezzadri S, Minghetti M, Nola S, Puggioli C, Ragni P, Ratti G, Sisti M, Vandelli C, Viale P, Vitali P, Moro ML. Antimicrobial stewardship programs in Emilia-Romagna, Italy. BMC Proc 2011. [PMCID: PMC3239559 DOI: 10.1186/1753-6561-5-s6-p143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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38
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Wang M, Yan G, Yue W, Siu C, Tse H, Perperidis A, Cusack D, White A, Macgillivray T, Mcdicken W, Anderson T, Ryabov V, Shurupov V, Suslova T, Markov V, Elmstedt N, Ferm Widlund K, Lind B, Brodin LA, Westgren M, Mantovani F, Barbieri A, Bursi F, Valenti C, Quaglia M, Modena M, Peluso D, Muraru D, Dal Bianco L, Beraldo M, Solda' E, Tuveri M, Cucchini U, Al Mamary A, Badano L, Iliceto S, Goncalves A, Almeria C, Marcos-Alberca P, Feltes G, Hernandez-Antolin R, Rodriguez H, Maroto L, Silva Cardoso J, Macaya C, Zamorano J, Squarciotta S, Innocenti F, Guzzo A, Bianchi S, Lazzeretti D, De Villa E, Vicidomini S, Del Taglia B, Donnini C, Pini R, Mennie C, Salmasi AM, Kutyifa V, Nagy V, Edes E, Apor A, Merkely B, Nyrnes S, Lovstakken L, Torp H, Haugen B, Said K, Shehata A, Ashour Z, El-Tobgy S, Cameli M, Bigio E, Lisi M, Righini F, Franchi F, Scolletta S, Mondillo S, Gayat E, Weinert L, Yodwut C, Mor-Avi V, Lang R, Hrynchyshyn N, Kachenoura N, Diebold B, Khedim R, Senesi M, Redheuil A, Mousseaux E, Perdrix L, Yurdakul S, Erdemir V, Tayyareci Y, Memic K, Yildirimturk O, Aytekin V, Gurel M, Aytekin S, Gargani L, Fernandez Cimadevilla C, La Falce S, Landi P, Picano E, Sicari R, Smedsrud MK, Gravning J, Eek C, Morkrid L, Skulstad H, Aaberge L, Bendz B, Kjekshus J, Edvardsen T, Bajraktari G, Hyseni V, Morina B, Batalli A, Tafarshiku R, Olloni R, Henein M, Mjolstad O, Snare S, Folkvord L, Helland F, Torp H, Haraldseth O, Grimsmo A, Haugen B, Berry M, Zaghden O, Nahum J, Macron L, Lairez O, Damy T, Bensaid A, Dubois Rande J, Gueret P, Lim P, Nciri N, Issaoui Z, Tlili C, Wanes I, Foudhil H, Dachraoui F, Grapsa J, Dawson D, Nihoyannopoulos P, Gianturco L, Turiel M, Atzeni F, Sarzi-Puttini P, Stella D, Donato L, Tomasoni L, Jung P, Mueller M, Huber T, Sevilmis G, Kroetz F, Sohn H, Panoulas V, Bratsas A, Dawson D, Nihoyannopoulos P, Raso R, Tartarisco G, Gargani L, La Falce S, Pioggia G, Picano E, Gargiulo P, Petretta M, Cuocolo A, Prastaro M, D'amore C, Vassallo E, Savarese G, Marciano C, Paolillo S, Perrone Filardi P, Aggeli C, Felekos I, Roussakis G, Poulidakis E, Pietri P, Toutouzas K, Stefanadis C, Kaladaridis A, Skaltsiotis I, Kottis G, Bramos D, Takos D, Matthaios I, Agrios I, Papadopoulou E, Moulopoulos S, Toumanidis S, Carrilho-Ferreira P, Cortez-Dias N, Jorge C, Silva D, Silva Marques J, Placido R, Santos L, Ribeiro S, Fiuza M, Pinto F, Stoickov V, Ilic S, Deljanin Ilic M, Kim W, Woo J, Bae J, Kim K, Descalzo M, Rodriguez J, Moral S, Otaegui I, Mahia P, Garcia Del Blanco L, Gonzalez Alujas T, Figueras J, Evangelista A, Garcia-Dorado D, Takeuchi M, Kaku K, Otani K, Iwataki M, Kuwaki H, Haruki N, Yoshitani H, Otsuji Y, Kukucka M, Pasic M, Unbehaun A, Dreysse S, Mladenow A, Kuppe H, Hetzer R, Rajamannan N, Yurdakul S, Tayyareci Y, Tanrikulu A, Yildirimturk O, Aytekin V, Aytekin S, Kristiansson L, Gustafsson S, Lindmark K, Henein MY, Evdoridis C, Stougiannos P, Thomopoulos M, Fosteris M, Spanos P, Sionis G, Giatsios D, Paschalis A, Sakellaris C, Trikas A, Yong ZY, Boerlage-Van Dijk K, Koch K, Vis M, Bouma B, Piek J, Baan J, Abid L, Frikha Z, Makni K, Maazoun N, Abid D, Hentati M, Kammoun S, Barbier P, Staron A, Cefalu' C, Berna G, Gripari P, Andreini D, Pontone G, Pepi M, Ring L, Rana B, Ho S, Wells F, Yurdakul S, Tayyareci Y, Yildirimturk O, Dogan A, Aytekin V, Aytekin S, Karaca O, Guler G, Guler E, Gunes H, Alizade E, Agus H, Gol G, Esen O, Esen A, Turkmen M, Agricola E, Ingallina G, Ancona M, Maggio S, Slavich M, Tufaro V, Oppizzi M, Margonato A, Orsborne C, Irwin B, Pearce K, Ray S, Garcia Alonso C, Vallejo N, Labata C, Lopez Ayerbe J, Teis A, Ferrer E, Nunez Aragon R, Gual F, Pedro Botet M, Bayes Genis A, Santos CM, Carvalho M, Andrade M, Dores H, Madeira S, Cardoso G, Ventosa A, Aguiar C, Ribeiras R, Mendes M, Petrovic M, Petrovic M, Milasinovic G, Vujisic-Tesic B, Nedeljkovic I, Zamaklar-Trifunovic D, Petrovic I, Draganic G, Banovic M, Boricic M, Villarraga H, Molini-Griggs Bs C, Silen-Rivera Bs P, Payne Mph Ms B, Koshino Md Phd Y, Hsiao Md J, Monivas Palomero V, Mingo Santos S, Mitroi C, Garcia Lunar I, Garcia Pavia P, Castro Urda V, Toquero J, Gonzalez Mirelis J, Cavero Gibanel M, Fernandez Lozano I, Oko-Sarnowska Z, Wachowiak-Baszynska H, Katarzynska-Szymanska A, Trojnarska O, Grajek S, Bellavia D, Pellikka P, Dispenzieri A, Oh JK, Polizzi V, Pitrolo F, Musumeci F, Miller F, Ancona R, Comenale Pinto S, Caso P, Severino S, Cavallaro C, Vecchione F, D'onofrio A, Calabro' R, Maceira Gonzalez AM, Ripoll C, Cosin-Sales J, Igual B, Salazar J, Belloch V, Cosin-Aguilar J, Pinamonti B, Iorio A, Bobbo M, Merlo M, Barbati G, Massa L, Faganello G, Di Lenarda A, Sinagra GF, Ishizu T, Seo Y, Enomoto M, Kameda Y, Ishibashi N, Inoue M, Aonuma K, Saleh A, Matsumori A, Negm H, Fouad H, Onsy A, Hamodraka E, Paraskevaidis I, Kallistratos M, Lezos V, Zamfir T, Manetos C, Mavropoulos D, Poulimenos L, Kremastinos D, Manolis A, Citro R, Rigo F, Ciampi Q, Patella M, Provenza G, Zito C, Tagliamonte E, Rotondi F, Silvestri F, Bossone E, Monivas Palomero V, Mingo Santos S, Beltran Correas P, Gutierrez Landaluce C, Mitroi C, Garcia Lunar I, Gonzalez Mirelis J, Cavero Gibanel M, Gomez Bueno M, Segovia Cubero J, Beladan C, Matei F, Popescu B, Calin A, Rosca M, Boanta A, Enache R, Savu O, Usurelu C, Ginghina C, Ciobanu AO, Dulgheru R, Magda S, Dragoi R, Florescu M, Vinereanu D, Silva Marques J, Robalo Martins S, Jorge C, Calisto C, Goncalves S, Ribeiro S, Barrigoto I, Carvalho De Sousa J, Almeida A, Nunes Diogo A, Sargento L, Satendra M, Sousa C, Lousada N, Palma Reis R, Schiano Lomoriello V, Esposito R, Santoro A, Raia R, Schiattarella P, Dores E, Galderisi M, Mansencal N, Caille V, Dupland A, Perrot S, Bouferrache K, Vieillard-Baron A, Jouffroy R, Moceri P, Liodakis E, Gatzoulis M, Li W, Dimopoulos K, Sadron M, Seguela PE, Arnaudis B, Dulac Y, Cognet T, Acar P, Shiina Y, Gatzoulis M, Uemura H, Li W, Kupczynska K, Kasprzak J, Michalski B, Lipiec P, Carvalho V, Almeida AMG, David C, Marques J, Silva D, Cortez-Dias N, Ferreira P, Amaro M, Costa P, Diogo A, Tritakis V, Ikonomidis I, Paraskevaidis I, Lekakis J, Tzortzis S, Kadoglou N, Papadakis I, Trivilou P, Koukoulis C, Anastasiou-Nana M, Bombardini T, Picano E, Gherardi S, Arpesella G, Maccherini M, Serra W, Magnani G, Del Bene R, Pasanisi E, Sicari R, Startari U, Panchetti L, Rossi A, Piacenti M, Morales M, Mansencal N, El Hajjaji I, El Mahmoud R, Digne F, Dubourg O, Gargani L, Agoston G, Moreo A, Pratali L, Moggi Pignone A, Pavellini A, Doveri M, Musca F, Varga A, Picano E, Pratali L, Faita F, Rimoldi S, Sartori C, Alleman Y, Salinas Salmon C, Villena M, Scherrer U, Picano E, Sicari R, Baptista R, Serra S, Castro G, Martins R, Salvador M, Monteiro P, Silva J, Szudi L, Temesvary A, Fekete B, Kassai I, Szekely L, Abdel Moneim SS, Martinez M, Mankad S, Bernier M, Dhoble A, Pellikka P, Chandrasekaran K, Oh J, Mulvagh S, Hong GR, Kim JY, Lee SC, Choi SH, Sohn IS, Seo HS, Choi JH, Cho KI, Yoon SJ, Lim SJ, Lipiec P, Wejner-Mik P, Kusmierek J, Plachcinska A, Szuminski R, Kasprzak J, Stoebe S, Tarr A, Trache T, Hagendorff A, Mor-Avi V, Yodwut C, Jenkins C, Kuhl H, Nesser H, Marwick T, Franke A, Niel J, Sugeng L, Lang R, Gustafsson S, Henein M, Soderberg S, Lindmark K, Lindqvist P, Necas J, Kovalova S, Saha SK, Kiotsekoglou A, Toole R, Govind S, Gopal A, Amzulescu MS, Florian A, Bogaert J, Janssens S, Voigt J, Parisi V, Losi M, Parrella L, Contaldi C, Chiacchio E, Caputi A, Scatteia A, Buonauro A, Betocchi S, Rimbas R, Dulgheru R, Mihaila S, Vinereanu D, Caputo M, Navarri R, Innelli P, Urselli R, Capati E, Ballo P, Furiozzi F, Favilli R, Mondillo S, Lindquist R, Miller A, Reece C, O'leary P, Cetta F, Eidem BW, Cikes M, Gasparovic H, Bijnens B, Velagic V, Kopjar T, Biocina B, Milicic D, Ta-Shma A, Nir A, Perles Z, Gavri S, Golender J, Rein A, Pinnacchio G, Barone L, Battipaglia I, Cosenza A, Marinaccio L, Coviello I, Scalone G, Sestito A, Lanza G, Crea F, Cakal S, Eroglu E, Ozkan B, Kulahcioglu S, Bulut M, Koyuncu A, Acar G, Alici G, Dundar C, Esen A, Labombarda F, Zangl E, Pellissier A, Bougle D, Maragnes P, Milliez P, Saloux E, Aggeli C, Lagoudakou S, Felekos I, Gialafos E, Poulidakis E, Tsokanis A, Roussakis G, Stefanadis C, Nagy A, Kovats T, Apor A, Vago H, Toth A, Sax B, Kovacs A, Merkely B, Elnoamany MF, Badran H, Abdelfattah I, Khalil T, Salama M, Butz T, Taubenberger C, Thangarajah F, Meissner A, Van Bracht M, Prull M, Yeni H, Plehn G, Trappe H, Rydman R, Bone D, Alam M, Caidahl K, Larsen F, Staron A, Gasior Z, Tabor Z, Sengupta P, Liu D, Niemann M, Hu K, Herrmann S, Stoerk S, Morbach C, Knop S, Voelker W, Ertl G, Weidemann F, Cawley P, Hamilton-Craig C, Mitsumori L, Maki J, Otto C, Astrom Aneq M, Nylander E, Ebbers T, Engvall J, Arvanitis P, Flachskampf F, Duvernoy O, De Torres Alba F, Valbuena Lopez S, Guzman Martinez G, Gomez De Diego J, Rey Blas J, Armada Romero E, Lopez De Sa E, Moreno Yanguela M, Lopez Sendon J, Aggeli C, Felekos I, Poulidakis E, Trikalinos N, Siasos G, Aggeli A, Roussakis G, Stefanadis C, Tomaszewski A, Kutarski A, Tomaszewski M, Ikonomidis I, Lekakis J, Tritakis V, Tzortzis S, Kadoglou N, Papadakis I, Trivilou P, Anastasiou-Nana M, Koukoulis C, Paraskevaidis I, Vriz O, Driussi C, Bettio M, Pavan D, Bossone E, Antonini Canterin F, Doltra Magarolas A, Fernandez-Armenta J, Silva E, Solanes N, Rigol M, Barcelo A, Mont L, Berruezo A, Brugada J, Sitges M, Ciciarello FL, Mandolesi S, Fedele F, Agati L, Marceca A, Rhee S, Shin S, Kim S, Yun K, Yoo N, Kim N, Oh S, Jeong J, Alabdulkarim N. Poster Session 4: Friday 9 December 2011, 14:00-18:00 * Location: Poster Area. European Journal of Echocardiography 2011. [DOI: 10.1093/ejechocard/jer216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Coppi E, Magnani G, Ferrari L, Spagnolo F, Chieffo R, Straffi L, Bianco M, Dalla Libera D, Velikova S, Nuara A, Di Maggio G, Comi G, Leocani L. P20.7 Safety and efficacy of deep repetitive transcranial magnetic stimulation (rTMS) with H-coil in Alzheimer disease. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60529-4] [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: 10/17/2022]
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Prestinenzi P, Potena L, Bianchi I, Masetti M, Romani P, Magnani G, Fallani F, Coccolo F, Russo A, Grigioni F, Branzi A. 206 Improvement of Renal Function after Cyclosporine Reduction Is Influenced by Baseline Proteinuria in Patients Converted to Everolimus: Long Term Follow-Up of the Shirakiss Randomized Study. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.213] [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: 11/28/2022] Open
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Masetti M, Potena L, Pantaleo M, Magnani G, Fallani F, Coccolo F, Nannini M, Prestinenzi P, Grigioni F, Branzi A. 120 Outcome of Heart Transplant Recipients with Cancer: Focusing on the Role of Surgery, Staging and Immunosuppressive Therapy. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.127] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Spinelli M, Maccauro G, Graci C, Cittadini A, Magnani G, Sangiorgi S, Del Bravo V, Manicone P, Raffaelli L, Muratori F, Sgambato A. Zirconia Toughened Alumina (ZTA) Powders: Ultrastructural and Histological Analysis. Int J Immunopathol Pharmacol 2011; 24:153-6. [DOI: 10.1177/03946320110241s229] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Ceramic materials, as Alumina and Zirconia, has made an improvement in the choice of new biomaterials for the load bearing application in dental and orthopaedic implants. These materials has shown mechanical resistance to high stress related to weight bearing and low debris in time. For this reason they are indicated on young patients implant, with high demanding activities and long life expectance. In literature however the risk of chronic inflammation due to chronic wear debris release and the possibility of carcinogenesis, is still to be definitively investigated. Another point to investigate is the acute reaction of the tissue in case of acute release of powders of these materials. The aim of this study was to investigate the possible local and systemic acute effects of ceramic precursors in form of powders of different size when released into articular joint. Powders of ZTA were implanted in the knee joint of twenty-four New Zealand white adult rabbits, that were sacrificed at 1,3,6, and 12 months. Radiographic, histological and immunoistochemestry analysis were conducted on periprosthetic tissue and peripheral organs, to verifying local host response and systemic toxic effects.
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Affiliation(s)
| | | | - C. Graci
- Department of Orthopedics, Italy
| | | | | | | | | | - Pf Manicone
- Clinical Dentistry Catholic University of Rome, Italy
| | - L. Raffaelli
- Clinical Dentistry Catholic University of Rome, Italy
| | - F. Muratori
- Department of Orthopedics Arcispedale Reggio Emilia
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Bignami F, Pilotti E, Bertoncelli L, Ronzi P, Gulli M, Marmiroli N, Magnani G, Pinti M, Mussini C, Lopalco L, Ruotolo R, Galli M, Cossarizza A, Casoli C. Changes in CD4+ cells’ miRNA expression following exposure to HIV-1. J Int AIDS Soc 2010. [PMCID: PMC2999381 DOI: 10.1186/1758-2652-13-s3-o11] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Maccauro G, Cittadini A, Magnani G, Sangiorgi S, Muratori F, Manicone P, Iommetti PR, Marotta D, Chierichini A, Raffaelli L, Sgambato A. In Vivo Characterization of Zirconia Toughened Alumina Material: A Comparative Animal Study. Int J Immunopathol Pharmacol 2010; 23:841-6. [DOI: 10.1177/039463201002300319] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The development of a new chromia-doped Zirconia Toughened Alumina (ZTA) material was previously reported as displaying mechanical properties suitable for implants with load bearing applications, such as orthopaedic and dental implants. This type of biomaterial is expected to be in contact with living tissues for a long period of time and its long-term toxicity must be carefully evaluated. In this study the suitability of this ZTA material as a candidate biomaterial for orthopaedic implants and dental devices was further investigated in vivo in comparison to alumina and zirconia, which are currently used in orthopaedic and dental surgery. Cylinders of the materials were implanted in vivo in white rabbits, and local and systemic tissue reactions were analyzed at different time intervals after surgery. Radiologic examinations displayed the absence of radiolucence around cylinders and no signs of implant loosening up to twelve months. No tumours developed in the animals either locally (at the site of implantation), or systemically in the peripheral organs. The results obtained suggest that this new ZTA material does not display any long term pathogenic effect in vivo. These findings extend our previous observations on the biocompatibility and the absence of any long-term carcinogenic effect in vitro of this material which displays interesting properties for biomedical applications. In conclusion, we report the in vivo characterization of a new chromia-doped ZTA material and confirm its suitability as a candidate biomaterial for orthopaedic implants and dental devices since it does not give any local nor systemic toxicity even after a long period of time after implantation.
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Affiliation(s)
| | - A. Cittadini
- Institute of General Pathology, Catholic University, Rome
| | | | | | | | - P.F. Manicone
- Institute of Clinical Dentistry, Catholic University
| | | | | | - A. Chierichini
- Institute of Anesthesiology, Catholic University, Rome, Italy
| | - L. Raffaelli
- Institute of Clinical Dentistry, Catholic University
| | - A. Sgambato
- Institute of General Pathology, Catholic University, Rome
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Bacchi G, Potena L, Mosconi G, Quarta C, Buscaroli A, Magnani G, Feliciangeli G, Grigioni F, Branzi A, Stefoni S. COMBINED HEART-KIDNEY TRANSPLANTATION USING A SINGLE DONOR: REPORT ON SEVEN CASES. Transplantation 2010. [DOI: 10.1097/00007890-201007272-01444] [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: 11/25/2022]
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Caso F, Fiorino A, Falautano M, Leocani L, Martinelli V, Minicucci F, Falini A, Comi G, Magnani G. Treatment of Wernicke’s encephalopathy with high dose of thiamine in a patient with pyloric sub-stenosis: description of a case. Neurol Sci 2010; 31:859-61. [DOI: 10.1007/s10072-010-0253-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 03/08/2010] [Indexed: 11/28/2022]
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Grigioni F, Specchia S, Maietta P, Potena L, Bacchi-Reggiani ML, Ghetti G, Boriani G, Foschi E, Corazza I, Ionico T, Magnani G, Zannoli R, Tentoni C, Branzi A. Changes in exercise capacity induced by heart transplantation: prognostic and therapeutic implications. Scand J Med Sci Sports 2010; 21:519-25. [PMID: 20459480 DOI: 10.1111/j.1600-0838.2009.01065.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Survival and exercise performance are key targets of heart transplantation (HT). We designed this study to help in identifying (1) patients with chronic heart failure (CHF) at risk of poor exercise capacity after HT and (2) HT recipients presenting risk factors modifiable with exercise showing a potential impact on outcome. We enrolled 49 HT recipients (age 52 ± 12 years, 84% males) who underwent a cardiopulmonary exercise test before (9 ± 6 months) and after (20 ± 14 months) HT. In the CHF phase, lower peak oxygen consumption (VO(2) ) (odds ratio 0.69, P=0.017) independently predicted peak VO(2) improvement after HT. In the post-HT phase, body mass index (BMI) [adjusted hazard ratio (HR) 1.16, P=0.034] and VE (ventilation)/VCO(2) (carbon dioxide production) slope (adjusted HR 1.07, P=0.031) independently predicted mortality. In conclusion, CHF patients with only a moderate impairment of peak VO(2) are at a risk of failing to achieve a significant improvement of exercise performance after HT. In the post-HT phase, a BMI≥28 and/or a VE/VCO(2) slope ≥47 represent risk factors for death, which are potentially modifiable with exercise. Prospective randomized studies are needed to analyze the effects of training on functional capacity and outcome in the different subsets of HT recipients.
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Affiliation(s)
- F Grigioni
- Department of Cardiovascular Diseases, School of Medicine, University of Bologna, Bologna, Italy.
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Potena L, d'Agostino C, Abate D, Magnani G, Baccolini F, Ionico T, Grigioni F, Gambino A, Sgarabotto D, Toscano G. 474: Interaction of CMV Prophylaxis and Pre-Emptive Strategies with Immunosuppressive Therapy: Potential Antiviral Effect of Everolimus. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.490] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Fabbri F, Ionico T, Potena L, Prestinenzi P, Magnani G, Masetti M, Leone O, Fallani F, Coccolo F, Grigioni F. 179: Interplay between Graft-Function and Intravascular Deposition of C4d in Heart Transplant Recipients. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.189] [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: 10/19/2022] Open
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Modugno GC, Brandolini C, Magnani G, Ferri GG, Sabattini E, Pirodda A. Langerhans cell histiocytosis: bilateral temporal bone involvement in an adult with diabetes insipidus. B-ENT 2010; 6:67-72. [PMID: 20420085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVE To present a clinical case of an adult affected by Langerhans cell histiocytosis with bilateral, non-simultaneous, involvement of the temporal bone, associated with diabetes insipidus and to review the literature. METHODOLOGY A rare case of bilateral temporal bone involvement of Langerhans cell histiocytosis in a 42-year-old woman affected by diabetes insipidus is reported. We present patient's clinical history supported by radiologic, histopathologic and audiologic findings. RESULTS The patient was submitted to a series of otologic surgical procedures due to the progression of the disease. Ossicular chain was always preserved, so that conservative surgery (canal wall-up technique) was performed, permitting the achievement of good hearing results, bilaterally. CONCLUSIONS Temporal bone involvement of Langerhans cell histiocytosis may lead to a progressive chronic disease. However, the ossicular chain can remain uninvolved, making a conservative surgical treatment possible. Careful follow-up is essential for detecting new lesions and serial CT scans are mandatory.
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Affiliation(s)
- G C Modugno
- Department of Specialistic Surgical and Anaesthesiological Sciences, ENT Section, Policlinico S.Orsola-Malpighi, University of Bologna, Italy
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