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Grandinetti M, Locorotondo G, Leccisotti L, Guarneri A, Bruno P, Marcolini A, Farina P, Gaudino MF, Lanza GA, Crea F, Giordano A, Massetti M. Quantitative analysis of myocardial blood flow in surgically revascularized and not revascularized myocardial segments. A pilot PET study. Eur J Nucl Med Mol Imaging 2024; 51:1632-1638. [PMID: 38105304 DOI: 10.1007/s00259-023-06563-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE To prospectively compare changes in myocardial blood flow (MBF) and myocardial flow reserve (MFR) in multivessel coronary artery disease (MVCAD) patients undergoing incomplete revascularization (IR) versus complete revascularization (CR) by coronary artery bypass grafting (CABG). METHODS Seven male patients (age 68 ± 9 years) with MVCAD underwent myocardial perfusion PET/CT with [13N]ammonia before and at least 4 months after CABG. Segmental resting and stress MBF as well as MFR were measured. Resting and during stress left ventricle ejection fraction (LVEF) were also calculated. RESULTS Three patients (43%) underwent CR and four (57%) IR. Among 119 myocardial segments, 101 (85%) were revascularized, and 18 (15%) were not. After CABG, stress MBF (mL/min/gr) and MFR are significantly increased in all myocardial segments, with a greater increase in the revascularized segments (p = 0.013). In both groups, LVEF significantly decreased during stress at baseline PET (p = 0.04), but not after CABG. CONCLUSION Stress MBF and MFR significantly improve after CABG in both revascularized and not directly revascularized myocardial segments. IR strategy may be considered in patients with high surgical risk for CR.
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Affiliation(s)
- M Grandinetti
- Cardiac Surgery Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Locorotondo
- Non Invasive Cardiac Diagnostics Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - L Leccisotti
- Section of Nuclear Medicine, Department of Radiological and Haematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, Radiation Oncology and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
| | - A Guarneri
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, Radiation Oncology and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - P Bruno
- Cardiac Surgery Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Marcolini
- Cardiac Surgery Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - P Farina
- Cardiac Surgery Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M F Gaudino
- Department of Cardio-Thoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - G A Lanza
- Non Invasive Cardiac Diagnostics Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Unit of Cardiology, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F Crea
- Unit of Cardiology, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Giordano
- Section of Nuclear Medicine, Department of Radiological and Haematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, Radiation Oncology and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - M Massetti
- Cardiac Surgery Unit, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
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Ravenna E, Locorotondo G, Manfredonia L, Diana G, Filice M, Graziani F, Leone AM, Aurigemma C, Romagnoli E, Burzotta F, Trani C, Massetti M, Lombardo A, Lanza GA. Global longitudinal strain for prediction of mortality in ST-segment elevation myocardial infarction and aortic stenosis patients: two sides of the same coin. Eur Rev Med Pharmacol Sci 2023; 27:10736-10748. [PMID: 37975399 DOI: 10.26355/eurrev_202311_34354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Global longitudinal strain (GLS) predicts major adverse events in ST-segment elevation myocardial infarction (STEMI) and aortic stenosis (AS). Different cut-off values and different end-points have been proposed for prognostic stratification. We aimed to verify whether a single GLS cut-off value can be used to identify increased risk of all-cause death in STEMI and AS. PATIENTS AND METHODS One-hundred- seventeen successfully treated first STEMI (age 63.8±12.5 yrs, 70% men) and 64 AS (age 80.3±6.9 yrs, 44% men) patients, undergoing echocardiography before discharge and before AS treatment, respectively, were retrospectively analyzed. GLS was analyzed, together with pulmonary artery systolic pressure (PASP), Killip class and Genereux stage. End-point was all-cause death at 6-month follow-up. RESULTS All-cause death occurred in 4 (3.4%) STEMI and 5 (7.8%) AS patients (p=ns). AS patients who died had GLS similar to died STEMI patients (9.7±2.1 vs. 11.3±1.7, p=ns). GLS cut-off ≤12% predicted death with 89% sensitivity and 70% specificity (AUC 0.84, p=0.001): STEMI and AS patients with GLS ≤12% had worse survival than STEMI and AS patients with GLS >12% (log-rank p=0.001). At multivariate Cox regression analysis, lower GLS values independently predicted death (HR 0.667, 95% CI 0.451-0.986, p=0.042), and the prediction model was improved when GLS was added to old age, significant comorbidities, PASP and Killip/Genereux stage (χ2 6.691 vs. 1.364, p=0.010). CONCLUSIONS Died patients with STEMI and AS show similar values of GLS. A unique cut-off value of GLS can reliably be used to stratify the risk of all-cause death at 6-month follow-up in both two clinical settings.
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Affiliation(s)
- E Ravenna
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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3
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Rando MM, Biscetti F, Masciocchi C, Savino M, Nicolazzi MA, Nardella E, Cecchini AL, Rossini E, Massetti M, Gasbarrini A, Flex A. Impact of COVID-19 pandemic on patients affected by peripheral arterial disease: an Italian single-center study. Eur Rev Med Pharmacol Sci 2023; 27:10144-10155. [PMID: 37916384 DOI: 10.26355/eurrev_202310_34194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) has evolved into a global pandemic, affecting a wide range of medical and surgical specialties. During COVID-19, we assisted in the reallocation of medical resources and services, as well as social distancing measures, and many patients with chronic diseases and comorbidities may have experienced difficulties in obtaining the correct medical care. The aim of the study was to investigate the impact of the COVID-19 pandemic on major adverse cardiovascular events (MACE) and major adverse limb events (MALE) in patients with peripheral arterial disease (PAD) and chronic limb-threatening ischemia (CLTI), compared to previous years. PATIENTS AND METHODS We evaluated 1,335 hospital admissions of 877 patients with PAD admitted to Policlinico A. Gemelli Hospital between January 2017 and February 2020 and 368 hospital admissions of 272 patients with PAD admitted to the Policlinico A. Gemelli Hospital between March 2020 and March 2021. Data on demographic characteristics, comorbidities, symptoms, physical and radiological findings, laboratory tests, and routine visits before or after discharge were collected from electronic medical records. RESULTS Emergency room (ER) admissions among PAD patients during COVID-19 were higher than before the pandemic [190 (51.63%) vs. 579 (43.37%), p = 0.01]. A MACE was found in 78 (5.84%) pre-pandemic hospitalizations and 126 (34.24%) pandemic hospitalizations (p < 0.01). A MALE was identified in 942 (70.56%) pre-pandemic hospitalizations and 331 (89.95%) pandemic hospitalizations (p < 0.01). Amputation rates during the pandemic were higher than before the pandemic [80 (21.74%) vs. 191 (14.31%), p < 0.01]. The number of in-hospital deaths did not differ between the pandemic and pre-pandemic periods [11 (2.99%) vs. 51 (3.82%), p = 0.55]. CONCLUSIONS In patients with PAD and CLTI, the number of MACE, MALE, and amputations was higher during the COVID-19 period compared to the three years before the pandemic.
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Affiliation(s)
- M M Rando
- Cardiovascular Internal Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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Rando MM, Biscetti F, Masciocchi C, Capocchiano ND, Nicolazzi MA, Nardella E, Cecchini AL, Pecorini G, Colosimo C, Sanguinetti M, Massetti M, Gasbarrini A, Flex A. Identification of early predictors of clinical outcomes of COVID-19 outbreak in an Italian single center using a machine-learning approach. Eur Rev Med Pharmacol Sci 2023; 27:9454-9469. [PMID: 37843358 DOI: 10.26355/eurrev_202310_33974] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
OBJECTIVE SARS-CoV-2 disease (COVID-19) has become a pandemic disease, determining a public health emergency. The use of artificial intelligence in identifying easily available biomarkers capable of predicting the risk for severe disease may be helpful in guiding clinical decisions. The aim of the study was to investigate the ability of interleukin (IL)-6, troponin I, and D-dimer to identify patients with COVID-19 at risk for intensive care unit (ICU)-admission and death by using a machine-learning predictive model. PATIENTS AND METHODS Data on demographic characteristics, underlying comorbidities, symptoms, physical and radiological findings, and laboratory tests have been retrospectively collected from electronic medical records of patients admitted to Policlinico A. Gemelli Foundation from March 1, 2020, to September 15, 2020, by using artificial intelligence techniques. RESULTS From an initial cohort of 425 patients, 146 met the inclusion criteria and were enrolled in the study. The in-hospital mortality rate was 15%, and the ICU admission rate was 41%. Patients who died had higher troponin I (p-value<0.01) and IL-6 values (p-value=0.04), compared to those who survived. Patients admitted to ICU had higher levels of troponin I (p-value<0.01) and IL-6 (p-value<0.01), compared to those not admitted to ICU. Threshold values to predict in-hospital mortality and ICU admission have been identified. IL-6 levels higher than 15.133 ng/L have been associated with a 22.91% risk of in-hospital mortality, and IL-6 levels higher than 25.65 ng/L have been associated with a 56.16% risk of ICU admission. Troponin I levels higher than 12 ng/L have been associated with a 26.76% risk of in-hospital mortality and troponin I levels higher than 12 ng/L have been associated with a 52.11% risk of ICU admission. CONCLUSIONS Levels of IL-6 and troponin I are associated with poor COVID-19 outcomes. Cut-off values capable of predicting in-hospital mortality and ICU admission have been identified. Building a predictive model using a machine-learning approach may be helpful in supporting clinical decisions in a more precise and personalized way.
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Affiliation(s)
- M M Rando
- Cardiovascular Internal Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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Mongelli A, Panunzi S, Nesta M, Gottardi Zamperla M, Atlante S, Barbi V, Mongiardini V, Ferraro F, De Martino S, Cis L, Re A, Maltese S, Bachetti T, La Rovere MT, Martelli F, Pesce M, Nanni S, Massetti M, Pontecorvi A, Farsetti A, Gaetano C. Distinguishable DNA methylation defines a cardiac-specific epigenetic clock. Clin Epigenetics 2023; 15:53. [PMID: 36991505 PMCID: PMC10053964 DOI: 10.1186/s13148-023-01467-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/18/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The present study investigates whether epigenetic differences emerge in the heart of patients undergoing cardiac surgery for an aortic valvular replacement (AVR) or coronary artery bypass graft (CABG). An algorithm is also established to determine how the pathophysiological condition might influence the human biological cardiac age. RESULTS Blood samples and cardiac auricles were collected from patients who underwent cardiac procedures: 94 AVR and 289 CABG. The CpGs from three independent blood-derived biological clocks were selected to design a new blood- and the first cardiac-specific clocks. Specifically, 31 CpGs from six age-related genes, ELOVL2, EDARADD, ITGA2B, ASPA, PDE4C, and FHL2, were used to construct the tissue-tailored clocks. The best-fitting variables were combined to define new cardiac- and blood-tailored clocks validated through neural network analysis and elastic regression. In addition, telomere length (TL) was measured by qPCR. These new methods revealed a similarity between chronological and biological age in the blood and heart; the average TL was significantly higher in the heart than in the blood. In addition, the cardiac clock discriminated well between AVR and CABG and was sensitive to cardiovascular risk factors such as obesity and smoking. Moreover, the cardiac-specific clock identified an AVR patient's subgroup whose accelerated bioage correlated with the altered ventricular parameters, including left ventricular diastolic and systolic volume. CONCLUSION This study reports on applying a method to evaluate the cardiac biological age revealing epigenetic features that separate subgroups of AVR and CABG.
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Affiliation(s)
- A Mongelli
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy
- Center for Translational and Experimental Cardiology (CTEC), University of Zurich, 8952, Schlieren, Switzerland
| | - S Panunzi
- National Research Council (CNR)-IASI, 00185, Rome, Italy
| | - M Nesta
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - M Gottardi Zamperla
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy
| | - S Atlante
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy
| | - V Barbi
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy
| | - V Mongiardini
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy
- Molecular Medicine, Istituto Italiano di Tecnologia, Genoa, Italy
| | - F Ferraro
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - S De Martino
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - L Cis
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - A Re
- National Research Council (CNR)-IASI, 00185, Rome, Italy
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - S Maltese
- National Research Council (CNR)-IRIB, 90146, Palermo, Italy
| | - T Bachetti
- Direzione Scientifica Centrale ICS Maugeri IRCCS, Pavia, Italy
| | - M T La Rovere
- Dipartimento di Cardiologia ICS Maugeri and Direzione Scientifica ICS Maugeri Montescano IRCCS, Pavia, Italy
| | - F Martelli
- Molecular Cardiology Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - M Pesce
- Unità di Ingegneria Tissutale Cardiovascolare, Centro Cardiologico Monzino IRCCS, 20138, Milan, Italy
| | - S Nanni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - M Massetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - A Pontecorvi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - A Farsetti
- National Research Council (CNR)-IASI, 00185, Rome, Italy.
| | - C Gaetano
- Laboratorio di Epigenetica, Istituti Clinici Scientifici (ICS) Maugeri IRCCS, 27100, Pavia, Italy.
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Bonanni A, Pedicino D, D'aiello A, Vinci R, Severino A, Russo G, Cribari F, Conte C, Filomia S, Bruno P, Burzotta F, Trani C, Massetti M, Crea F, Liuzzo G. Transcatheter versus surgical aortic valve replacement in patients with aortic stenosis: characterization of molecular pathways before and after treatment. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
Recently, the transcatheter aortic valve replacement (TAVR) has reformed the management of Aortic Stenosis (AS), providing a valid therapeutic alternative to surgical aortic valve replacement (SAVR). Although optimizing the timing of surgery is a crucial aspiration, the introduction of innovative pharmacological therapies able to modify disease evolution might help clinicians to treat patients in a non-invasive way. Several evidences pointed out the role of inflammation, oxidative stress, and pathological remodelling in AS natural history.
Purpose
The aim of this study is to assess biological pathways modifications after aortic valve replacement, comparing the transcatheter and the surgical approach.
Methods
We enrolled a total of 35 consecutive patients with severe symptomatic aortic stenosis undergoing aortic valve replacement with transcatheter (n = 19) or surgical (n = 16) approach. Biological samples were collected and stored before (T0) and 72 hours after the procedure (T1). We firstly performed gene expression arrays for a total of 132 genes, on two groups of pooled cDNA from peripheral blood mononuclear cells of TAVR (n = 10) and SAVR (n = 10) patients. Then, taking into account the most relevant result of the arrays, we selected 15 genes for validation.
Results
Our preliminary data showed several differences in the gene expression levels of the two groups under examination for a large number of molecules, mostly associated with the oxidative balance. More in detail, after procedure, TAVR patients showed higher levels of glutathione peroxidase 1 (GPX1, TAVR p = 0.029; SAVR p = 0.031) and glutathione reductase (GSR, p = 0.029), while SAVR patients showed higher expression of GPX1, catalase (CAT, p = 0.019) and NADPH oxidase 2 (NOX2, p = 0.008), thus confirming an intense post-operative oxidative stress particularly for patients undergoing surgery. Moreover, Caspase 3 (CASP3, p = 0.013), involved in apoptotic pathway and myocyte enhancer factor 2C (MEF2C, p = 0.036), implicated in overload induced hypertrophy genes showed a significantly reduction in their expression after TAVR.
Conclusions
In our study, we describe different gene expression signatures in patients with an AS diagnosis and their recalibration after AV replacement with two kinds of procedure, TAVR and SAVR. Our data describe for the first time an altered oxidative balance in patient undergoing aortic valve replacement, that is particularly evident for patients undergoing SAVR. A clearer understanding of biological processes taking place in the first hours post AV replacement lays the ground to a more efficient management of post-operative status and, in the incessant research for a tailored therapy, the results of our study add a little piece of information to assist clinicians in selecting the optimal procedure for each patient.
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Affiliation(s)
- A Bonanni
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - D Pedicino
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - A D'aiello
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - R Vinci
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - A Severino
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - G Russo
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - F Cribari
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - C Conte
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - S Filomia
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - P Bruno
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - F Burzotta
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - C Trani
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - M Massetti
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - F Crea
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
| | - G Liuzzo
- Catholic University of the Sacred Heart - Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome , Italy
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7
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Panaioli E, Birritella L, Graziani F, Lillo R, Grandinetti M, Di Molfetta A, Przybyleka B, Lombardo A, Lanza G, Secinaro A, Perri G, Amodeo A, Massetti M, Crea F, Delogu AB. Right ventricle-pulmonary artery coupling in repaired tetralogy of fallot with pulmonary regurgitation: clinical implications. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The right ventricle-pulmonary artery (RV-PA) coupling is a strong prognostic marker in
several clinical settings, but only few studies focused on its role in repaired Tetralogy of
Fallot (rToF) with pulmonary regurgitation (PR). Aim of this study was to assess
whether differences exist in RV-PA coupling, estimated as by echocardiography,
between patients with rToF and PR with (i-PVR) or without (ni-PVR) indication for
pulmonary valve replacement (PVR).
3
Materials and Methods
The study population included 40 rToF patients allocated to two groups: 20 i-PVR and
20 ni-PVR; 40 healthy controls were also included. All subjects underwent
echocardiogram, while Cardiac magnetic resonance (CMR) was available in 27/40
rToF patients. RV-PA coupling was assessed by echocardiographic TAPSE/PASP and
RV stroke volume/RV end systolic volume (RVSV/RVESV) by CMR.
Results
TAPSE was similar in i-PVR vs ni-PVR (19.0 ± 3.4 vs 18.8 ± 2.7 mm, p = 0.85) while RV-PA coupling
was significantly worse in i-PVR vs ni-PVR (TAPSE/PASP 0.8 ± 0.3 vs 1.1 ± 0.5
mm/mmHg, p = 0.009) as well as in i-PVR vs controls (p = 0.02) while there was no
difference between ni-PVR and controls (p = 0.29). CMR data confirmed the echo
results, with a significant difference in RV-PA coupling between i-PVR and ni-PVR
(RVSV/RVESV 0.9 ± 0.2 vs 1.2 ± 0.3 mL/min/mL, p = 0.01).
Conclusions
This study shows the presence of worse RV-PA uncoupling, despite normal RV systolic
function, in rToF patients with indication to PVR. RV-PA coupling could be a sensitive
marker of a progressive maladaptive RV response to long-standing volume overload in
rToF prior to the onset of clinical symptoms and RV systolic dysfunction. Abstract Figure. example of an i-PVR patient
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Affiliation(s)
- E Panaioli
- Catholic University of the Sacred Heart, Rome, Italy
| | - L Birritella
- Catholic University of the Sacred Heart, Rome, Italy
| | - F Graziani
- Catholic University of the Sacred Heart, Rome, Italy
| | - R Lillo
- Catholic University of the Sacred Heart, Rome, Italy
| | - M Grandinetti
- Catholic University of the Sacred Heart, Rome, Italy
| | - A Di Molfetta
- Catholic University of the Sacred Heart, Rome, Italy
| | - B Przybyleka
- Catholic University of the Sacred Heart, Rome, Italy
| | - A Lombardo
- Catholic University of the Sacred Heart, Rome, Italy
| | - G Lanza
- Catholic University of the Sacred Heart, Rome, Italy
| | - A Secinaro
- Bambino Gesu Children"s Hospital, Rome, Italy
| | - G Perri
- Bambino Gesu Children"s Hospital, Rome, Italy
| | - A Amodeo
- Bambino Gesu Children"s Hospital, Rome, Italy
| | - M Massetti
- Catholic University of the Sacred Heart, Rome, Italy
| | - F Crea
- Catholic University of the Sacred Heart, Rome, Italy
| | - AB Delogu
- Catholic University of the Sacred Heart, Rome, Italy
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8
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Pedicino D, Angelini A, Russo G, D"aiello A, Rocco E, Ciampi P, Ponzo M, Graziani F, Locorotondo G, Sanna T, Rebuzzi AG, Lombardo A, Massetti M, Liuzzo G, Crea F. Non invasive ventilation and right ventricle function in cardiogenic pulmonary edema: an echocardiographic perspective to select the "right" ventilatory support. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
High-flow nasal cannulae oxygen therapy (HFNCOT) represents a better tolerated alternative to non-invasive pressure support ventilation (NIPSV) for acute cardiogenic pulmonary edema (ACPE) treatment. However, there are still few data on the effect of HFNCOT on cardiac function and hemodynamic.
Purpose
To assess and compare the effects of NIPSV and HFNCOT in ACPE setting on right ventricular (RV) systolic function and on indices of cardiac filling and output, as measured by echocardiography.
Methods
This is a cross-over controlled study, enrolling 15 consecutive patients admitted to our Cardiovascular Intensive Care Unit for ACPE and hypoxaemic, normo/hypocapnic acute respiratory failure, with P/F ratio < 200. Each patient received NIPSV, followed by HFNCOT. Full echocardiographic assessment and blood gas analysis (BGA) were performed 40 minutes from onset of each ventilation modality, respectively before NIPSV to HFNCOT switch and before HFNCOT interruption. In particular, RV function parameters, together with RV and atrial strain, were prospectively collected.
Results
In spite of not significant changes in BGA, RV function was significantly improved under HFNCOT, as compared to NIPSV, as assessed by the following parameters: tricuspid annular plane excursion (TAPSE) (P = 0.001), RV S’ wave (P = 0.007), RV fractional area change (RVFAC) (P = 0.006). Strain analysis confirmed the significant improvement in RV function, with free wall global longitudinal strain (GLS) and free wall and septum GLS significantly higher under HFNCOT, as compared to NIPSV (-21% vs -18% P < 0.001, and -15% vs -19% P = 0.008, respectively,), and a significant increase in right atrial positive longitudinal strain (P < 0.001).
Conclusions
NIPSV significantly affect RV function making more complex the management of patients presenting with ACPE. In this setting, HFNCOT represents a valuable alternative, providing similar respiratory outcomes while preserving good right ventricle performance.
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Affiliation(s)
- D Pedicino
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - A Angelini
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
| | - G Russo
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
| | - A D"aiello
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
| | - E Rocco
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
| | - P Ciampi
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
| | - M Ponzo
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
| | - F Graziani
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - G Locorotondo
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - T Sanna
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
| | - AG Rebuzzi
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
| | - A Lombardo
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
| | - M Massetti
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
| | - G Liuzzo
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
| | - F Crea
- Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy
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9
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Graziani F, Panaioli E, Lillo R, Delogu AB, Perri G, Grandinetti M, Burzotta F, Cialdella P, Lanzillo C, Massetti M, Crea F. P722 Unrepaired complex severe aortic coarctation determining restrictive cardiomyopathy with pulmonary hypertension in adulthood. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
A 54-year-old female presented to our Emergency Department with acute pulmonary edema. On physical examination she was tachypneic with arterial oxygen saturation of 91% and a grade 3/6 systolic murmur in the apex and left second intercostal space that was irradiated to the intrascapular area. Bilateral femoral and pedal pulses were quite faint on palpation. The blood pressure was 260/120 mmHg. Results of routine blood chemistry were normal with the exception of increased NT-proBNP (2746 pg/mL). Twelve-lead electrocardiogram revealed left ventricular hypertrophy with repolarization abnormalities and left atrial enlargement. The two dimensional (2D) echocardiography showed significant left ventricular hypertrophy (RWT 0.6; LVmass index 150 g/m2), no wall-motion abnormalities and normal left ventricular ejection fraction (EF 60%) but with reduced longitudinal components at TDI evaluation (6 cm/s). Severe ventricular diastolic dysfunction was detected with E/A 2,11 and E/e" 26 with a significant left atrial dilatation (LAVi 73 ml/m2) and severe pulmonary arterial hypertension ( PASP of 85 mmHg) . We were unable to visualize the aortic arch but reduced/absent pulsatile wall motion of abdominal aorta was identified. The patient reported to be affected by unrepaired aortic coarctation diagnosed at the age of 32 during pregnancy. She refused the surgical treatment twice and the she did not undergo any specific follow up but she had several admissions in emergency department for uncontrolled arterial hypertension. Our further evaluation with CT angiography showed a severe narrowing of the post isthmic aortic lumen with significant development collateral vessels (Figure 1). The patient was discharged after resolution of pulmonary edema and titration of hypertension treatment with a planning of hybrid approach to treat the aortic coarctation. The case shows a restrictive cardiomyopathy with post-capillary pulmonary hypertension due to severe unrepaired aortic coarctation.
Abstract P722 Figure. CT angiography,echo, right heart cath
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Affiliation(s)
- F Graziani
- Polyclinic Agostino Gemelli, Rome, Italy
| | - E Panaioli
- Polyclinic Agostino Gemelli, Rome, Italy
| | - R Lillo
- Polyclinic Agostino Gemelli, Rome, Italy
| | - A B Delogu
- Polyclinic Agostino Gemelli, Rome, Italy
| | - G Perri
- Polyclinic Agostino Gemelli, Rome, Italy
| | | | - F Burzotta
- Polyclinic Agostino Gemelli, Rome, Italy
| | | | | | - M Massetti
- Polyclinic Agostino Gemelli, Rome, Italy
| | - F Crea
- Polyclinic Agostino Gemelli, Rome, Italy
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10
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Rousseau S, Massetti M, Barre S, Leleu H, Gaillot-de Saintignon J. Evaluation of additional benefits of HPV vaccination to cervical cancer screening in France. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The National Cancer Institute (INCa) undertook the evaluation of the expected impact of HPV vaccination in the context of the recent marketing of nonavalent vaccine (Gardasil®9) and the implementation of organized screening (OS) of cervical cancer (CC) in France.
Methods
The study is based on a microsimulation model that replicates the natural history of CC. A cohort of 14-year-old women is generated and followed until death. Others HPV-infection related diseases (condyloma, anal cancer, penile cancer and oropharynx cancer) are not modelled. Different strategies were compared with the current vaccination coverage rate (VCR) of 21.4% (2017): impact of increased VCR alone and increased VCR combined with correction of inequalities (CI). Results are presented according to two hypotheses for the duration of protection offered by the vaccine (limited to 20 years and lifelong) and according to two hypotheses for price of the vaccine (French price and average European prices).
Results
The incremental cost-effectiveness ratio (ICER) was less than 15 000 euros per QALY (quality-adjusted life year) in all the assessed strategies. For each 14-year-old women cohort, 85% VCR with CI would prevent at least: 2 546 conations, 2 347 precancerous lesions CIN 2 / 3 diagnosed, 377 CCs, 139 deaths per CC (20 years vaccine protection). Scenarios based on increasing VCR with CI are the most cost-effective.
Conclusions
The study quantifies the increased risk of CC-related outcomes associated with current sub-optimal VCR and the possible investment to implement actions in order to improve the efficiency of the current strategies and tackle health inequalities (communication campaign, actions toward underserved women).
Key messages
Improving HPV vaccination uptake is a cost-effective measure, even considering only the cervical cancer prevention. Including health inequalities participation in modeling is crucial as underserved women are both less vaccinated and screened.
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Affiliation(s)
- S Rousseau
- Institut National du Cancer, Boulogne-Billancourt, France
| | | | - S Barre
- Institut National du Cancer, Boulogne-Billancourt, France
| | - H Leleu
- Public Health Expertise, Paris, France
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11
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Cammertoni F, Bruno P, Mazza A, Pavone N, Farina P, Perri G, Iafrancesco M, Nesta M, Chiariello G, Colizzi C, D’Errico D, Massetti M. RF30 INTEGRATED PERCUTANEOUS AND MINIMALLY INVASIVE APPROACH FOR HEART VALVE SURGERY. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549971.67787.79] [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: 11/05/2022]
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12
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Di Molfetta A, Iacobelli R, Rocchi M, Bellisari FC, Gagliardi M, Carotti A, Massetti M, Amodeo A, Guccione P. RF21 EVOLUTION OF VENTRICULAR ENERGETICS IN THE DIFFERENT STAGES OF PALLIATION OF HYPOPLASTIC LEFT HEART SYNDROME. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550045.27883.bc] [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: 11/05/2022]
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13
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Di Molfetta A, Iacobelli R, Filippelli S, Perri G, Massetti M, Amodeo A. RF63 PROSPECTIVE EVALUATION OF VENTRICULAR LOADING TREND IN PEDIATRIC PATIENTS WITH PULSATILE FLOW LVAD. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550027.72732.d7] [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: 11/05/2022]
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14
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Di Molfetta A, Zielinski K, Ferrari G, Iacobelli R, Perri G, Filippelli S, Darowski M, Massetti M, Amodeo A. OC07 CAN WE USE THE NEW INFANT JARVIK 2015 IN PATIENTS LESS THAN 8KG? A SIMULATION STUDY. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549893.33240.74] [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: 11/05/2022]
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15
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Perri G, Filippelli S, Di Molfetta A, Testa G, Iodice F, Adorisio R, Iacobelli R, Massetti M, Amodeo A. OC54 OUTCOME OF A CONTINOUS FLOW PUMP (JARVIK 2000) AS BRIDGE TO TRANSPLANTATION OR DESTINATION THERAPY IN PEDIATRIC PATIENTS. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549871.57072.9e] [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: 11/05/2022]
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16
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Chiariello G, Pasquini A, Bruno P, Colizzi C, Ruggio A, Nesta M, Mazza A, Iafrancesco M, Cammertoni F, Pavone N, Perri G, Massetti M. EP26 PRELIMINARY RESULTS OF LAST GENERATION SURGICAL BIOPROSTHESES IN SMALL AORTIC ANNULI. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549998.76303.f1] [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: 11/05/2022]
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17
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Tessari C, D’Onofrio A, Diena M, Solinas M, Alamanni F, Massetti M, Livi U, Di Eusanio M, Mignosa C, Russo C, Rinaldi M, Di Bartolomeo R, Luzi G, Antona C, De Paulis R, Salvador L, Maselli D, Portoghese M, Alfieri O, De Filippo C, Bortolotti U, Musumeci F, Gerosa G. OC21 EARLY OUTCOMES OF MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT WITH RAPID DEPLOYMENT BIOPROSTHESES. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549887.95122.c8] [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: 11/05/2022]
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18
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Di Molfetta A, Rotella S, Gagliardi M, Carotti A, Massetti M, Amodeo A, Guccione P. RF61 PREDICTING THE PRESSURE OF THE TOTAL CAVO-PULMONARY CONNECTION. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550053.96427.31] [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: 11/05/2022]
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19
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Perri G, Filippelli S, Di Molfetta A, Iacobelli R, Di Pasquale L, Ferrari G, Adachi I, Vera RZ, Massetti M, Amode A. RF40 LEFT VENTRICULAR UNLOADING DURING ECMO. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550046.66001.4e] [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: 11/05/2022]
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20
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D’Onofrio A, Tessari C, Filippini C, Diena M, Solinas M, Alamanni F, Massetti M, Livi U, Di Eusanio M, Mignosa C, Russo C, Rinaldi M, Di Bartolomeo R, Luzi G, Antona C, De Paulis R, Salvador L, Maselli D, Portoghese M, Alfieri O, De Filippo C, Bortolotti U, Musumeci F, Gerosa G. OC09 CLINICAL AND HEMODYNAMIC OUTCOMES AFTER AORTIC VALVE REPLACEMENT WITH RAPID-DEPLOYMENT BIOPROSTHESES. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549901.50273.24] [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: 11/05/2022]
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21
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Gallien S, Massetti M, Flandre P, Leleu H, Descamps D, Lazaro E. Comparison of 48-week efficacies of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide and nucleoside/nucleotide reverse transcriptase inhibitor-sparing regimens: a systematic review and network meta-analysis. HIV Med 2018; 19:559-571. [PMID: 30004176 DOI: 10.1111/hiv.12643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To compare nucleoside/nucleotide reverse transcriptase inhibitor (NRTI)-sparing regimens with tenofovir alafenamide (TAF)-based combinations in HIV-1-infected adults, we performed a network meta-analysis (NMA) to provide estimates of relative efficacy for these two regimens. METHODS A systematic literature review (SLR) was performed to identify phase 3/4 randomized controlled clinical trials evaluating the efficacy of commonly used combination antiretroviral therapy (cART) including an NRTI backbone or that of commonly used NRTI-sparing regimens. A Bayesian random-effect model was used to compare virological suppression rates at 48 weeks for NRTI-sparing regimens and elvitegravir/cobicistat/emtricitabine/TAF (E/C/F/TAF). RESULTS Twenty-three studies in treatment-naïve patients identified by the SLR were included in the NMA, including four studies assessing NRTI-sparing regimens. In treatment-naïve patients, the probability of achieving virological suppression at 48 weeks was between 40% and 60% higher with E/C/F/TAF than with NRTI-sparing strategies. The credible interval vs. darunavir/ritonavir (DVR/r) + raltegravir (RAL) and LPV/r monotherapy did not include 1. In the subgroup of naïve patients with viral load < 100 000 HIV-1 RNA copies/mL, a credible difference was found between NRTI-sparing treatments and E/C/F/TAF. Studies in treatment-experienced patients were too heterogeneous to allow for an NMA. CONCLUSIONS The NMA results suggest that E/C/F/TAF represents a more effective option than NRTI-sparing regimens in terms of 48-week efficacy in treatment-naïve patients. Furthermore, TAF pharmacological properties, as well as tolerability results in clinical studies, suggest a safety profile similar to that of NRTI-sparing regimens. Thus, the E/C/F/TAF combination might represent a more appropriate option than NRTI-sparing regimens for initiation of antiretroviral therapy in treatment-naïve HIV-infected patients.
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Affiliation(s)
- S Gallien
- Henri Mondor University Hospital, Créteil, France
- University of Paris-Est Créteil Val de Marne Medical School, Créteil, France
| | | | - P Flandre
- INSERM Sorbonne University, UPMC University Paris 06, UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - H Leleu
- Public Health Expertise, Paris, France
| | - D Descamps
- Bichat Claude Bernard University Hospital, Paris, France
- University Paris Diderot Medical School, Paris, France
| | - E Lazaro
- Bordeaux University Hospital, Bordeaux, France
- University of Bordeaux, Bordeaux, France
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22
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Babatasi G, Bara L, Galateau F, Agostini D, Massetti M, Gerard J, Rossi A, Bloch M, Samama M, Khayat A. An animal model for the evaluation of graft thrombosis in the acute phase on carbon-lined PTFE prosthesis. Int J Artif Organs 2018. [DOI: 10.1177/039139889401701205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Fortyfive carbon-lined (CL) and 45 standard (ST) 4 mm internal diameter polytetra-fluoroethylene (PTFE) grafts were implanted as aortic interposition in 90 rabbits. A pilot study of 20 animals: 10 CL and 10 ST grafts were used to develop microsurgical techniques, then 60 grafts were placed in 60 New Zealand rabbits with lower morbidity. The two hours graft patency (Doppler and angiographic studies) showed better patency rate in CL group (93% versus 80%). In 10 animals, platelet accumulation was investigated in vivo using gammacamera imaging after injection of autologous platelets labeled with Indium111. In vitro, radioactivity counting of the explanted midgraft sections at 2 hours revealed 6 times greater activity in ST grafts (6.60 ± 1.98 x 103platelets/mm2 versus 0.82 ± 0.25 x 103 platelets/mm2; p<0.05). Light microscopy found platelet and fibrin deposition (PFD) in nearly all ST grafts whereas PFD were found in only 13% of the CL grafts corresponding to those thrombosed (chi2: 61.117, p<0.001). Carbon-lining decreases platelet accumulation on PTFE grafts in the acute phase of a new experimental model.
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Affiliation(s)
- G. Babatasi
- Cardiovascular Surgery Department, University Hospital, Caen
| | - L Bara
- Laboratory of Experimental Thrombosis, Paris VI University PM Curie, Paris - France
| | - F. Galateau
- Cardiovascular Surgery Department, University Hospital, Caen
| | - D. Agostini
- Cardiovascular Surgery Department, University Hospital, Caen
| | - M. Massetti
- Cardiovascular Surgery Department, University Hospital, Caen
| | - J.L. Gerard
- Cardiovascular Surgery Department, University Hospital, Caen
| | - A. Rossi
- Cardiovascular Surgery Department, University Hospital, Caen
| | - M.F. Bloch
- Laboratory of Experimental Thrombosis, Paris VI University PM Curie, Paris - France
| | - M.M. Samama
- Laboratory of Experimental Thrombosis, Paris VI University PM Curie, Paris - France
| | - A. Khayat
- Cardiovascular Surgery Department, University Hospital, Caen
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23
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Tinelli G, Minelli F, De Nigris F, Vincenzoni C, Filipponi M, Bruno P, Massetti M, Flex A, Iezzi R. The potential role of quantitative digital subtraction angiography in evaluating type B chronic aortic dissection during TEVAR: preliminary results. Eur Rev Med Pharmacol Sci 2018; 22:516-522. [PMID: 29424912 DOI: 10.26355/eurrev_201801_14204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To evaluate the role of quantitative digital subtraction angiography (Q-DSA) with parametric color coding (PCC) in assessing patients with type B chronic thoracic aortic dissection (TBCAD) during thoracic endovascular aortic repair (TEVAR) procedures. PATIENTS AND METHODS A total of 11 patients electively treated in our Department for a TBCAD were retrospectively enrolled. All cases were treated with TEVAR for false lumen aneurysm of the thoracic descending aorta. For digital subtraction angiography (DSA) series post-processing, a newly implemented PCC algorithm was used to turn consecutive two-dimensional images into a single color-coded picture (syngo iFLOW, Siemens AG, Forchheim, Germany). In consensus reading, two clinicians experienced in vascular imaging evaluated the DSA series in blinded assessment and compared them to the color-coded images. PCC was assessed for its accuracy in identifying the true and false lumen as well as whether it could provide improved visualization in pre-deployment stent grafting and the final evaluation of treatment. RESULTS PCC facilitated the visualization of the aortic dissection angioarchitecture in terms of contemporary true and false lumen vision in 81.8% of the cases. In 72.7% of the procedures, Q-DSA was estimated to improve aorta information assessment in terms of false lumen viewing, and it was possible to identify the proximal entry tear position in 45.4% of the cases. After stent graft deployment, in 72.7% of the cases (all 8 patients in which the aortic arch false lumen was visible in pre-treatment), Q-DSA confirmed the absence of early false lumen reperfusion. CONCLUSIONS Our results indicate that Q-DSA could be useful in the intraprocedural evaluation of patients with aortic dissection during TEVAR procedures without additional x-ray costs and contrast exposure.
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Affiliation(s)
- G Tinelli
- Department of Cardiovascular Sciences, Vascular Unit, Gemelli Foundation, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy.
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24
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D'Amario D, La Neve F, Siracusano A, Perri G, Piacentini R, Massetti M, Adorisio R, Leone A, Grassi C, Crea F. P2549Characterization of the intracellular calcium signaling and the electrophysiological properties of cardiac progenitor cells isolated from duchenne muscular dystrophy patients undergoing LVAD implanta. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2549] [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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25
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D'Amario D, Leone A, Cannata F, Graziani F, Cobianchi Bellisari F, Massetti M, Galiuto L, Rebuzzi A, Crea F. P2535Granulocyte colony-stimulating factor in patients with a large anterior wall acute myocardial infarction to prevent left ventricular remodeling (the RIGENERA trial): 10 years follow-up – Final results. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2535] [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: 11/15/2022] Open
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26
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D'Amario D, Burzotta F, Leone A, Niccoli G, Ruggio A, Porto I, Trani C, Bruno P, Massetti M, Crea F. P1469Feasibility and safety of right and left heart catheterization via an antecubital fossa vein and the radial artery in patients with heart failure. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1469] [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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27
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Narducci ML, Pelargonio G, Pinnacchio G, Perna F, Bencardino G, Rio T, Cavaliere F, Massetti M, Crea F. P366Robotic ablation of atrial fibrillation: impact of lesion efficacy and biomarkers on recurrences. Europace 2017. [DOI: 10.1093/ehjci/eux141.092] [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: 11/13/2022] Open
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28
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Perri G, Filippelli S, Testa G, Iodice F, Adorisio R, Iacobelli R, Di Molfetta A, Massetti M, Amodeo A. Outcome of a Continous Flow Pump (Jarvik 2000) as Bridge to Transplantation or Destination Therapy in Pediatric Patients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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29
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Beretta D, Massetti M, Lanzani G, Caironi M. Thermoelectric characterization of flexible micro-thermoelectric generators. Rev Sci Instrum 2017; 88:015103. [PMID: 28147642 DOI: 10.1063/1.4973417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A new experimental setup for the characterization of flexible micro-thermoelectric generators is reported. The system can measure the power generated and the thermoelectric conversion efficiency of devices under mechanical stresses and deformations, in atmospheric environment and under vacuum, in the temperature interval 293 K-423 K, as a function of the load resistance and of the mechanical pressure, with an uncertainty on the temperature difference of ±0.02 K. The system has been tested on commercial rigid devices and on a custom-made, flexible, proof-of-concept, organic-inorganic hybrid generator made of eight thermocouples. Repeatability on the power generated and conversion efficiency within 5% and 3%, respectively, was demonstrated, and accuracy of the measurement was granted by minimization of all the potential sources of heat flux losses.
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Affiliation(s)
- D Beretta
- Center for Nano Science and Technology @PoliMi, Istituto Italiano di Tecnologia, via Pascoli 70/3, 20133 Milano (MI), Italy
| | - M Massetti
- Center for Nano Science and Technology @PoliMi, Istituto Italiano di Tecnologia, via Pascoli 70/3, 20133 Milano (MI), Italy
| | - G Lanzani
- Center for Nano Science and Technology @PoliMi, Istituto Italiano di Tecnologia, via Pascoli 70/3, 20133 Milano (MI), Italy
| | - M Caironi
- Center for Nano Science and Technology @PoliMi, Istituto Italiano di Tecnologia, via Pascoli 70/3, 20133 Milano (MI), Italy
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Falzarano M, D'Amario D, Osman H, Siracusano A, Scotton C, Maroni C, Massetti M, Amodeo A, Mercuri E, Manchi M, Crea F, Ferlini A. Isolation and characterization of human urinary stem cells from healthy donors and DMD patients as in vitro cell model for functional studies and drug testing. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.262] [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: 10/21/2022]
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Feltrin G, Frigerio M, Martinelli L, De Bonis M, Rinaldi M, Pilato M, Musumeci F, Faggian G, Livi U, Maccherini M, Iacovoni A, Barbone A, Di Giammarco G, Maiello C, Marinelli G, Alamanni F, Ambrosio G, Grimaldi A, Leonardi G, Pagani F, Massetti M, Rizzato L, Gerosa G, Nanni Costa A. Preliminary Results From ITAMACS, the Italian Multi Center Registry for Mechanically Assisted Circulatory Support. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.018] [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: 11/28/2022] Open
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Leone A, Gaudino M, Lupascu A, Mazza A, Flore R, Toesca A, Tondi P, Massetti M. 073-I * MORPHOLOGIC AND FUNCTIONAL CONSEQUENCES OF TRANSRADIAL CORONARY ANGIOGRAPHY ON THE RADIAL ARTERY: IMPLICATIONS FOR USE AS A BYPASS CONDUIT. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.73] [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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Massetti M, Bruno P. Mechanical circulatory support for acute heart failure in 2013: an update on available devices, indications and results. Minerva Anestesiol 2014; 80:373-381. [PMID: 24107834] [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: 06/02/2023]
Abstract
Severe acute heart failure often requires some form of mechanical support to circulation. The use of intraaortic balloon counterpulsation in postinfarction cardiogenic shock - perhaps the most common scenario of this kind - has been recently questioned in the IABP SHOCK trial. In the most severe forms, extracorporeal membrane oxygenation is becoming the mainstay of treatment to support circulation or in order to gain time for a further evaluation. Moreover, advances in technology and a reducing number of donors are leading to more extended indications to the implantation of ventricular assist devices. Herein, we offer a focused review on recent articles dealing with mechanical support to circulation in acute heart failure, which we found relevant in terms of their possible impact on therapeutic strategies and indication.
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Affiliation(s)
- M Massetti
- Sacro Cuore Catholic University, Rome, Italy -
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Bertrand P, Grieten L, Smeets C, Verbrugge F, Mullens W, Vrolix M, Rivero-Ayerza M, Verhaert D, Vandervoort P, Tong L, Ramalli A, Tortoli P, D'hoge J, Bajraktari G, Lindqvist P, Henein M, Obremska M, Boratynska M, Kurcz J, Zysko D, Baran T, Klinger M, Darahim K, Mueller H, Carballo D, Popova N, Vallee JP, Floria M, Chistol R, Tinica G, Grecu M, Rodriguez Serrano M, Osa-Saez A, Rueda-Soriano J, Buendia-Fuentes F, Domingo-Valero D, Igual-Munoz B, Alonso-Fernandez P, Quesada-Carmona A, Miro-Palau V, Palencia-Perez M, Bech-Hanssen O, Polte C, Lagerstrand K, Janulewicz M, Gao S, Erdogan E, Akkaya M, Bacaksiz A, Tasal A, Sonmez O, Turfan M, Kul S, Vatankulu M, Uyarel H, Goktekin O, Mincu R, Magda L, Mihaila S, Florescu M, Mihalcea D, Enescu O, Chiru A, Popescu B, Tiu C, Vinereanu D, Broch K, Kunszt G, Massey R, De Marchi S, Aakhus S, Gullestad L, Urheim S, Yuan L, Feng J, Jin X, Bombardini T, Casartelli M, Simon D, Gaspari M, Procaccio F, Hasselberg N, Haugaa K, Brunet A, Kongsgaard E, Donal E, Edvardsen T, Sahin T, Yurdakul S, Cengiz B, Bozkurt A, Aytekin S, Cesana F, Spano' F, Santambrogio G, Alloni M, Vallerio P, Salvetti M, Carerj S, Gaibazzi N, Rigo F, Moreo A, Wdowiak-Okrojek K, Michalski B, Kasprzak J, Shim A, Lipiec P, Generati G, Pellegrino M, Bandera F, Donghi V, Alfonzetti E, Guazzi M, Marcun R, Stankovic I, Farkas J, Vlahovic-Stipac A, Putnikovic B, Kadivec S, Kosnik M, Neskovic A, Lainscak M, Iliuta L, Szymanski P, Lipczynska M, Klisiewicz A, Sobieszczanska-Malek M, Zielinski T, Hoffman P, Gjerdalen GF, Hisdal J, Solberg E, Andersen T, Radunovic Z, Steine K, Svanadze A, Poteshkina N, Krylova N, Mogutova P, Shim A, Kasprzak J, Szymczyk E, Wdowiak-Okrojek K, Michalski B, Stefanczyk L, Lipiec P, Benedek T, Matei C, Jako B, Suciu Z, Benedek I, Yaroshchuk NA, Kochmasheva VV, Dityatev VP, Kerbikov OB, Przewlocka-Kosmala M, Orda A, Karolko B, Mysiak A, Kosmala W, Rechcinski T, Wierzbowska-Drabik K, Lipiec P, Chmiela M, Kasprzak J, Aziz A, Hooper J, Rayasamudra S, Uppal H, Asghar O, Potluri R, Zaroui A, Mourali M, Rezine Z, Mbarki S, Jemaa M, Aloui H, Mechmeche R, Farhati A, Gripari P, Maffessanti F, Tamborini G, Muratori M, Fusini L, Vignati C, Bartorelli A, Alamanni F, Agostoni P, Pepi M, Ruiz Ortiz M, Mesa D, Delgado M, Seoane T, Carrasco F, Martin M, Mazuelos F, Suarez De Lezo Herreros De Tejada J, Romero M, Suarez De Lezo J, Brili S, Stamatopoulos I, Misailidou M, Chrisochoou C, Christoforatou E, Stefanadis C, Ruiz Ortiz M, Mesa D, Delgado M, Martin M, Seoane T, Carrasco F, Ojeda S, Segura J, Pan M, Suarez De Lezo J, Cammalleri V, Ussia G, Muscoli S, Marchei M, Sergi D, Mazzotta E, Romeo F, Igual Munoz B, Bel Minguez A, Perez Guillen M, Maceira Gonzalez A, Monmeneu Menadas J, Hernandez Acuna C, Estornell Erill J, Lopez Lereu P, Francisco Jose Valera Martinez F, Montero Argudo A, Sunbul M, Akhundova A, Sari I, Erdogan O, Mutlu B, Cacicedo A, Velasco Del Castillo S, Anton Ladislao A, Aguirre Larracoechea U, Rodriguez Sanchez I, Subinas Elorriaga A, Oria Gonzalez G, Onaindia Gandarias J, Laraudogoitia Zaldumbide E, Lekuona Goya I, Ding W, Zhao Y, Lindqvist P, Nilson J, Winter R, Holmgren A, Ruck A, Henein M, Attenhofer Jost CH, Soyka R, Oxenius A, Kretschmar O, Valsangiacomo Buechel E, Greutmann M, Weber R, Keramida K, Kouris N, Kostopoulos V, Karidas V, Damaskos D, Makavos G, Paraskevopoulos K, Olympios C, Eskesen K, Olsen N, Fritz-Hansen T, Sogaard P, Cameli M, Lisi M, Righini F, Curci V, Massoni A, Natali B, Maccherini M, Chiavarelli M, Massetti M, Mondillo S, Mabrouk Salem Omar A, Ahmed Abdel-Rahman M, Khorshid H, Rifaie O, Santoro C, Santoro A, Ippolito R, De Palma D, De Stefano F, Muscariiello R, Galderisi M, Squeri A, Censi S, Baldelli M, Grattoni C, Cremonesi A, Bosi S, Saura Espin D, Gonzalez Canovas C, Gonzalez Carrillo J, Oliva Sandoval M, Caballero Jimenez L, Espinosa Garcia M, Garcia Navarro M, Valdes Chavarri M, De La Morena Valenzuela G, Ryu S, Shin D, Son J, Choi J, Goh C, Choi J, Park J, Hong G, Sklyanna O, Yuan L, Yuan L, Planinc I, Bagadur G, Ljubas J, Baricevic Z, Skoric B, Velagic V, Bijnens B, Milicic D, Cikes M, Gospodinova M, Chamova T, Guergueltcheva V, Ivanova R, Tournev I, Denchev S, Ancona R, Comenale Pinto S, Caso P, Arenga F, Coppola M, Calabro R, Neametalla H, Boitard S, Hamdi H, Planat-Benard V, Casteilla L, Li Z, Hagege A, Mericskay M, Menasche P, Agbulut O, Merlo M, Stolfo D, Anzini M, Negri F, Pinamonti B, Barbati G, Di Lenarda A, Sinagra G, Stolfo D, Merlo M, Pinamonti B, Gigli M, Poli S, Porto A, Di Nora C, Barbati G, Di Lenarda A, Sinagra G, Coppola C, Piscopo G, Cipresso C, Rea D, Maurea C, Esposito E, Arra C, Maurea N, Nemes A, Kalapos A, Domsik P, Forster T, Voilliot D, Huttin O, Vaugrenard T, Schwartz J, Sellal JM, Aliot E, Juilliere Y, Selton-Suty C, Sanchez Millan PJ, Cabeza Lainez P, Castillo Ortiz J, Chueca Gonzalez E, Gheorghe L, Fernandez Garcia P, Herruzo Rojas M, Del Pozo Contreras R, Fernandez Garcia M, Vazquez Garcia R, Rosca M, Popescu B, Botezatu D, Calin A, Beladan C, Gurzun M, Enache R, Ginghina C, Farouk H, Al-Maimoony T, Alhadad A, El Serafi M, Abdel Ghany M, Poorzand H, Mirfeizi S, Javanbakht A, Tellatin S, Famoso G, Dassie F, Martini C, Osto E, Maffei P, Iliceto S, Tona F, Radunovic Z, Steine K, Jedrzejewska I, Braksator W, Krol W, Swiatowiec A, Sawicki J, Kostarska-Srokosz E, Dluzniewski M, Maceira Gonzalez AM, Cosin-Sales J, Diago J, Aguilar J, Ruvira J, Monmeneu J, Igual B, Lopez-Lereu M, Estornell J, Olszanecka A, Dragan A, Kawecka-Jaszcz K, Czarnecka D, Scholz F, Gaudron P, Hu K, Liu D, Florescu C, Herrmann S, Bijnens B, Ertl G, Stoerk S, Weidemann F, Krestjyaninov M, Razin V, Gimaev R, Bogdanovic Z, Burazor I, Deljanin Ilic M, Peluso D, Muraru D, Cucchini U, Mihaila S, Casablanca S, Pigatto E, Cozzi F, Punzi L, Badano L, Iliceto S, Zhdanova E, Rameev V, Safarova A, Moisseyev S, Kobalava Z, Magnino C, Omede' P, Avenatti E, Presutti D, Losano I, Moretti C, Bucca C, Gaita F, Veglio F, Milan A, Bellsham-Revell H, Bell A, Miller O, Simpson J, Hwang Y, Kim G, Jung M, Woo G, Driessen M, Leiner T, Schoof P, Breur J, Sieswerda G, Meijboom F, Bellsham-Revell H, Hayes N, Anderson D, Austin B, Razavi R, Greil G, Simpson J, Bell A, Zhao X, Xu X, Qin Y, Szmigielski CA, Styczynski G, Sobczynska M, Placha G, Kuch-Wocial A, Ikonomidis I, Voumbourakis A, Triantafyllidi H, Pavlidis G, Varoudi M, Papadakis I, Trivilou P, Paraskevaidis I, Anastasiou-Nana M, Lekakis I, Kong W, Yip J, Ling L, Milan A, Tosello F, Leone D, Bruno G, Losano I, Avenatti E, Sabia L, Veglio F, Zaborska B, Baran J, Pilichowska-Paszkiet E, Sikora-Frac M, Michalowska I, Kulakowski P, Budaj A, Mega S, Bono M, De Francesco V, Castiglione I, Ranocchi F, Casacalenda A, Goffredo C, Patti G, Di Sciascio G, Musumeci F, Kennedy M, Waterhouse D, Sheahan R, Foley D, Mcadam B, Ancona R, Comenale Pinto S, Caso P, Arenga F, Coppola M, Calabro R, Remme EW, Smedsrud MK, Hasselberg NE, Smiseth OA, Edvardsen T, Halmai L, Nemes A, Kardos A, Neubauer S, Degiovanni A, Baduena L, Dell'era G, Occhetta E, Marino P, Hotchi J, Yamada H, Nishio S, Bando M, Hayashi S, Hirata Y, Amano R, Soeki T, Wakatsuki T, Sata M, Lamia B, Molano L, Viacroze C, Cuvelier A, Muir J, Lipczynska M, Piotr Szymanski P, Anna Klisiewicz A, Lukasz Mazurkiewicz L, Piotr Hoffman P, Van 'T Sant J, Wijers S, Ter Horst I, Leenders G, Cramer M, Doevendans P, Meine M, Hatam N, Goetzenich A, Aljalloud A, Mischke K, Hoffmann R, Autschbach R, Sikora-Frac M, Zaborska B, Maciejewski P, Bednarz B, Budaj A, Evangelista A, Torromeo C, Pandian N, Nardinocchi P, Varano V, Schiariti M, Teresi L, Puddu P, Storve S, Dalen H, Snare S, Haugen B, Torp H, Fehri W, Mahfoudhi H, Mezni F, Annabi M, Taamallah K, Dahmani R, Haggui A, Hajlaoui N, Lahidheb D, Haouala H, Colombo A, Carminati M, Maffessanti F, Gripari P, Pepi M, Lang R, Caiani E, Walker J, Abadi S, Agmon Y, Carasso S, Aronson D, Mutlak D, Lessick J, Saxena A, Ramakrishnan S, Juneja R, Ljubas J, Reskovic Luksic V, Matasic R, Pezo Nikolic B, Lovric D, Separovic Hanzevacki J, Quattrone A, Zito C, Alongi G, Vizzari G, Bitto A, De Caridi G, Greco M, Tripodi R, Pizzino G, Carerj S, Ibrahimi P, Jashari F, Johansson E, Gronlund C, Bajraktari G, Wester P, Henein M, Kosmala W, Marwick T, Souza JRM, Zacharias LGT, Geloneze B, Pareja JC, Chaim A, Nadruz WJ, Coelho OR, Apostolovic S, Stanojevic D, Jankovic-Tomasevic R, Salinger-Martinovic S, Djordjevic-Radojkovic D, Pavlovic M, Tahirovic E, Musial-Bright L, Lainscak M, Duengen H, Filipiak D, Kasprzak J, Lipiec P. Poster session Wednesday 11 December all day display: 11/12/2013, 09:30-16:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet202] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cuttone F, Ivascau C, Grollier G, Massetti M. Distal embolization of Edwards SAPIEN prosthesis during transcatheter aortic valve implantation. G Chir 2013; 34:275-277. [PMID: 24629815 PMCID: PMC3926483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Transcatheter aortic valve implantation (TAVI) is considered an alternative therapy in high risk patients with severe aortic stenosis. Despite this, such a minimally invasive procedure is not free from complications. CASE REPORT An 86-year-old woman underwent a 26-mm SAPIEN TAVI for aortic valve stenosis. Procedure was complicated by valve embolization into the ascending aorta likely due to a sub-optimal positioning of prosthesis during its deployment. Patient was treated by surgical removal of stent-valve and conventional valve replacement. Patient was discharged from hospital 7 days after surgery. At six months follow-up she was asymptomatic and the valve had a good competence with a mean transaortic gradient of 8 mmHg. CONCLUSIONS After TAVI prosthesis embolization, conversion to conventional surgical treatment is imperative and can be associated with excellent outcome.
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D'Amario D, Leone AM, Iaconelli A, Luciani M, Gaudino M, Manchi M, Ottaviani L, Siracusano A, Massetti M, Crea F. Cardiac stem cell replicative capacity predicts ventricular remodeling in patients undergoing coronary artery bypass grafting. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1311] [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: 11/13/2022] Open
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D'Amario D, Leone AM, Smaldone C, Narducci ML, Iaconelli A, Pelargonio G, Siracusano A, Manchi M, Massetti M, Crea F. Cardiac stem cells with high regenerative potential can be isolated and characterized from 3D-electroanatomic guided endomyocardial biopsies: a feasibility study in a preclinical animal model. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1470] [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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Cikes M, Tong L, Jasaityte R, Hamilton J, Sutherland G, D'hooge J, Yurdakul S, Oner F, Avci BK, Sahin S, Direskeneli H, Aytekin S, Fang F, Chan A, Zhang Q, Sanderson J, Kwong J, Yu C, Zaidi A, Raju H, Ghani S, Gati S, Cox A, Sheikh N, Sharma R, Sharma S, Kutty S, Kottam A, Padiyath A, Gao S, Drvol L, Lof J, Li L, Rangamani S, Danford D, Kuehne T, Rosner A, Avenarius D, Malm S, Iqbal A, Baltabaeva A, Schirmer H, Bijnens B, Myrmel T, Magalhaes A, Silva Marques J, Martins S, Carrilho Ferreira P, Jorge C, Silva D, Placido R, Goncalves S, Almeida A, Nunes Diogo A, Poulidakis E, Aggeli C, Sideris S, Dilaveris P, Gatzoulis K, Felekos I, Koutagiar I, Sfendouraki E, Roussakis G, Stefanadis C, Zhang Q, Sun J, Gao R, Feng Y, Liu X, Sheng W, Liu F, Yu C, Hallioglu O, Citirik D, Buyukakilli B, Ozeren M, Gurgul S, Tasdelen B, Rodriguez Lopez A, Rodriguez Lopez A, Garcia Cuenllas L, Garcia Cuenllas L, Medrano C, Medrano C, Granja S, Granja S, Marin C, Marin C, Maroto E, Maroto E, Alvarez T, Alvarez T, Ballesteros F, Ballesteros F, Camino M, Camino M, Centeno M, Centeno M, Alraies M, Aljaroudi W, Halley C, Rodriguez L, Grimm R, Thomas J, Jaber W, Knight D, Coghlan J, Muthurangu V, Grasso A, Toumpanakis C, Caplin M, Taylor A, Davar J, Mohlkert LA, Halvorsen C, Hallberg J, Sjoberg G, Norman M, Cameli M, Losito M, Lisi M, Natali B, Massoni A, Maccherini M, Chiavarelli M, Massetti M, Mondillo S, Sljivic A, Stojcevski B, Celic V, Pencic B, Majstorovic A, Cosic Z, Backovic S, Ilic-Djordjevic I, Muraru D, Gripari P, Esposito R, Tamborini G, Galderisi M, Ermacora D, Maffessanti F, Santoro C, Pepi M, Badano L, Bombardini T, Cini D, Picano E, Shahgaldi K, Gunyeli E, Sahlen A, Manouras A, Winter R, Banovic M, Vukcevic V, Ostojic M, Markovic Z, Mladenovic A, Trifunovic D, Stojkovic S, Bacic D, Dedovic D, Seferovic P, Huttin O, Coulibaly S, Mercy M, Schwartz J, Zinzius P, Sellal J, Popovic B, Marie P, Juilliere Y, Selton-Suty C, Gurzun MM, Ionescu A, Bahlay B, Jones G, Rimbas R, Enescu O, Mihaila S, Ciobanu A, Vinereanu D, Vlasseros I, Koumoulidis A, Tousoulis D, Veioglanis S, Avgeropoulou A, Katsi V, Stefanadis C, Kallikazaros I, Kiviniemi T, Ylitalo A, Airaksinen K, Lehtinen T, Saraste A, Pietila M, Karjalainen P, Trifunovic D, Ostojic M, Stankovic S, Vujisic-Tesic B, Petrovic M, Banovic M, Boricic M, Draganic G, Petrovic M, Stepanovic J, Kuznetsov V, Yaroslavskaya E, Pushkarev G, Krinochkin D, Zyrianov I, Dekleva M, Stevanovic A, Kleut M, Suzic Lazic J, Markovic Nikolic N, Akhunova S, Saifullina G, Sadykov A, Loudon M, D'arcy J, Arnold L, Reynolds R, Mabbet C, Prendergast B, Dahl J, Videbaek L, Poulsen M, Rudbaek T, Pellikka P, Rasmussen L, Moller J, Lowery C, Frenneaux M, Dawson D, Dwivedi G, Singh S, Rudd A, Mahadevan D, Srinivasan J, Jiminez D, Sahinarslan A, Vecchio F, Maccarthy P, Wendler O, Monaghan M, Harimura Y, Seo Y, Ishizu T, Noguchi Y, Aonuma K, Urdaniz MM, Palomares JFR, Rius JB, Surribas IB, Tura GT, Garcia-Moreno LG, Alujas TG, Masip AE, Mas PT, Dorado DG, Meimoun P, Germain A, Clerc J, Elmkies F, Zemir H, Luycx-Bore A, Nasr GM, Erraki A, Dulgheru R, Magne J, Capoulade R, Elhonsali Z, Pierard LA, Pibarot P, Lancellotti P, Wrideier S, Butz T, Schilling I, Gkiouras G, Sasko B, Van Bracht M, Prull M, Trappe HJ, Castillo Bernal F, Mesa Rubio M, Ruiz Ortiz M, Delgado Ortega M, Morenate Navio M, Baeza Garzon M, Del Pino ML, Toledano Delgado F, Mazuelos F, Suarez de Lezo Herreros de Tejada J, Prinz C, Schumann M, Burghardt A, Seggewiss H, Oldenburg O, Horstkotte D, Faber L, Bistola V, Banner N, Hedger M, Simon A, Rahman Haley S, Baltabaeva A, Adamyan K, Tumasyan LR, Chilingaryan A, Makavos G, Kouris N, Kostopoulos V, Stamatelatou M, Damaskos D, Kartsagoulis E, Olympios C, Sade L, Eroglu S, Bircan A, Pirat B, Sezgin A, Aydinalp A, Muderrisoglu H, Sargento L, Satendra M, Sousa C, Longo S, Lousada N, Dos Reis RP, Kuznetsov V, Krinochkin D, Gapon L, Vershinina A, Shurkevich N, Bessonova M, Yaroslavskaya E, Kolunin G, Sargento L, Satendra M, Sousa C, Lousada N, Dos Reis RP, Azevedo O, Lourenco M, Machado I, Guardado J, Medeiros R, Pereira A, Quelhas I, Lourenco A, Duman D, Sargin F, Kilicaslan B, Inan A, Ozgunes N, Goktas P, Ikonomidis I, Tzortzis S, Paraskevaidis I, Andreadou I, Katseli C, Katsimbri P, Papadakis I, Pavlidis G, Anastasiou-Nana M, Lekakis J, Charalampopoulos A, Howard L, Davies R, Gin-Sing W, Tzoulaki I, Grapsa I, Gibbs J, Dobson RA, Cuthbertson DJ, Burgess M, Lichodziejewska B, Kurnicka K, Goliszek S, Kostrubiec M, Dzikowska-Diduch O, Ciurzynski M, Krupa M, Grudzka K, Palczewski P, Pruszczyk P, Mansencal N, Marcadet D, Montalvan B, Dubourg O, Matveeva N, Nartsissova G, Chernjavskiy A, Eicher JC, Berthier S, Lorcerie B, Philip JL, Wolf JE, Wiesen P, Ledoux D, Massion P, Piret S, Canivet JL, Cusma-Piccione M, Zito C, Imbalzano E, Saitta A, Donato D, Madaffari A, Luzza G, Pipitone V, Tripodi R, Carerj S, Bombardini T, Gherardi S, Arpesella G, Maccherini M, Serra W, Del Bene R, Sicari R, Picano E, Al-Mallah M, Ananthasubramaniam K, Alam M, Chattahi J, Zweig B, Boedeker S, Song T, Khoo J, Davies J, Ang KL, Galinanes M, Chin D, Papamichael ND, Karassavidou D, Mpougialkli M, Antoniou S, Giannitsi S, Chachalos S, Gouva C, Naka K, Katopodis K, Michalis L, Tsang W, Cui V, Ionasec R, Takeuchi M, Houle H, Weinert L, Roberson D, Lang R, Altman M, Aussoleil A, Bergerot C, Sibellas F, Bonnefoy-Cudraz E, Derumeaux GA, Thibault H, Mohamed A, Omran A, Hussein M, Shahgaldi K, Gunyeli E, Sahlen A, Manouras A, Winter R, Squeri A, Binno S, Ferdenzi E, Reverberi C, Baldelli M, Barbieri A, Iaccarino D, Naldi M, Bosi S, Kalinowski M, Szulik M, Streb W, Stabryla J, Nowak J, Rybus-Kalinowska B, Kukulski T, Kalarus Z, Ouss A, Riezebos R, Nestaas E, Skranes J, Stoylen A, Brunvand L, Fugelseth D, Magalhaes A, Silva Marques J, Martins S, Carrilho Ferreira P, Placido R, Jorge C, Silva D, Goncalves S, Almeida A, Nunes Diogo A, Nagy A, Kovats T, Apor A, Nagy A, Vago H, Toth A, Toth M, Merkely B, Ranjbar S, Karvandi M, Hassantash S, Da Silva SG, Marin C, Rodriguez A, Marcos C, Rodriguez-Ogando A, Maroto E, Medrano C, Del Valle DI, Lopez-Fernandez T, Gemma D, Gomez-Rubin M, De Torres F, Feliu J, Canales M, Buno A, Ramirez E, Lopez-Sendon J, Magalhaes A, Silva Marques J, Martins S, Placido R, Silva D, Jorge C, Calisto C, Goncalves S, Almeida A, Nunes Diogo A, Jorge C, Cortez-Dias N, Goncalves S, Ribeiro S, Santos L, Silva D, Barreiros C, Bernardes A, Carpinteiro L, Sousa J, Kim SH, Choi W, Chidambaram S, Arunkumar R, Venkatesan S, Gnanavelu G, Dhandapani V, Ravi M, Karthikeyan G, Meenakshi K, Muthukumar D, Swaminathan N, Vitarelli A, Barilla F, Capotosto L, Truscelli G, Dettori O, Caranci F, D-Angeli I, De Maio M, De Cicco V, Bruno P, Doesch C, Sueselbeck T, Haghi D, Streitner F, Borggrefe M, Papavassiliu T, Laser K, Schaefer F, Fischer M, Habash S, Degener F, Moysich A, Haas N, Kececioglu D, Burchert W, Koerperich H, Dwivedi G, Al-Shehri H, Dekemp R, Ali I, Alghamdi A, Klein R, Scullion A, Beanlands R, Ruddy T, Chow B, Lipiec P, Szymczyk E, Michalski B, Wozniakowski B, Rotkiewicz A, Stefanczyk L, Szymczyk K, Kasprzak J, Angelov A, Yotov Y, Mircheva L, Kisheva A, Kunchev O, Ikonomidis I, Tsantes A, Triantafyllidi H, Tzortzis S, Dima K, Trivilou P, Papadopoulos C, Travlou A, Anastasiou-Nana M, Lekakis J, Bader R, Agoston-Coldea L, Lupu S, Mocan T, Loegstrup B, Hofsten D, Christophersen T, Moller J, Bjerre M, Flyvbjerg A, Botker H, Egstrup K, Park Y, Choi J, Yun K, Lee S, Han D, Kim J, Kim J, Kim J, Chun K. Poster Session Wednesday 5 December all day Display * Determinants of left ventricular performance. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Malev E, Zemtsovsky E, Zhelninova T, Dubrovskaya O, Perevoznikova M, Rudakov M, Luneva E, Khaletskaya L, Shlyakhto E, Magne J, Mahjoub H, Pibarot P, Elhonsali Z, Dulgheru R, Lancellotti P, Pierard L, Magne J, Mahjoub H, Elhonsali Z, Bologne J, Dulgheru R, Pierard L, Pibarot P, Lancellotti P, Cameli M, Lisi M, Righini F, Massoni A, Natali B, Tacchini D, Maccherini M, Chiavarelli M, Massetti M, Mondillo S, Le Tourneau T, Deswartes G, Richardson M, Foucher C, Polge A, Fayad G, Vincentelli A, Lamblin N, Trochu J, Bauters C. Oral Abstract Session * New insights into primary mitral regurgitation: Valvular heart disease associated with systemic conditions and others. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fischer M, Avram R, Cârjaliu I, Massetti M, Gérard J, Hanouz J, Fellahi J. Non-invasive continuous arterial pressure and cardiac index monitoring with Nexfin after cardiac surgery. Br J Anaesth 2012; 109:514-21. [DOI: 10.1093/bja/aes215] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Lemoine S, Zhu L, Buléon C, Massetti M, Gérard JL, Galera P, Hanouz JL. Mechanisms involved in the desflurane-induced post-conditioning of isolated human right atria from patients with type 2 diabetes. Br J Anaesth 2011; 107:510-8. [PMID: 21862498 DOI: 10.1093/bja/aer201] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Desflurane triggers post-conditioning in the diabetic human myocardium. We determined whether protein kinase C (PKC), mitochondrial adenosine triphosphate-sensitive potassium (mitoK(ATP)) channels, Akt, and glycogen synthase kinase-3β (GSK-3β) were involved in the in vitro desflurane-induced post-conditioning of human myocardium from patients with type 2 diabetes. METHODS The isometric force of contraction (FoC) of human right atrial trabeculae obtained from patients with type 2 diabetes was recorded during 30 min of hypoxia followed by 60 min of reoxygenation. Desflurane (6%) was administered during the first 5 min of reoxygenation either alone or in the presence of calphostin C (PKC inhibitor) or 5-hydroxydecanoate (5-HD) (mitoK(ATP) channel antagonist). Phorbol 12-myristate 13-acetate (PKC activator) and diazoxide (a mitoK(ATP) channel opener) were superfused during early reoxygenation. The FoC at the end of the 60 min reoxygenation period was compared among treatment groups (FoC(60); mean and sd). The phosphorylation of Akt and GSK-3β was studied using western blotting. RESULTS Desflurane enhanced the recovery of force [FoC(60): 79 (3)% of baseline] after 60 min of reoxygenation when compared with the control group (P>0.0001). Calphostin C and 5-HD abolished the beneficial effect of desflurane-induced post-conditioning (both P<0.0001). Phorbol 12-myristate 13-acetate and diazoxide enhanced the FoC(60) when compared with the control group (both P<0.0001). Desflurane increased the level of phosphorylation of Akt and GSK-3β (P<0.0001). CONCLUSIONS Desflurane-induced post-conditioning in human myocardium from patients with type 2 diabetes was mediated by the activation of PKC, the opening of the mitoK(ATP) channels, and the phosphorylation of Akt and GSK-3β.
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Affiliation(s)
- S Lemoine
- Laboratory of Experimental Anaesthesiology and Cellular Physiology EA3212, Institut Fédératif de Recherche ICORE146, Université de Caen Basse Normandie, Caen, France.
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Lemoine S, Zhu L, Massetti M, Gérard JL, Hanouz JL. Continuous administration of remifentanil and sufentanil induces cardioprotection in human myocardium, in vitro. Acta Anaesthesiol Scand 2011; 55:758-64. [PMID: 21615344 DOI: 10.1111/j.1399-6576.2011.02456.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Remifentanil and sufentanil are widely used opioids during general anaesthesia for cardiac and non-cardiac surgery. This study was conducted to evaluate the hypothesis that the continuous administration of remifentanil and sufentanil, at clinically relevant concentrations, could provide protection of human myocardium, in vitro, against hypoxia-reoxygenation injury. METHOD Isometrically contracting isolated human right atrial trabeculae were exposed to 30 min of hypoxia and 60 min of reoxygenation. In separate groups, remifentanil at 10(-11), 10(-10), 10(-9), or sufentanil at 10(-11), 10(-10), 10(-9) M were administered 10 min before hypoxia until the end of the experiment. The force of contraction (FoC) of trabeculae was recorded continuously. Developed force was compared (mean ± standard deviation) between the groups using a variance analysis and post hoc tests. RESULTS At the end of the 60-min reoxygenation, remifentanil 10(-11) M (FoC: 82 ± 7% of baseline), 10(-10) M (FoC: 78 ± 5% of baseline), 10(-9) M (FoC: 80 ± 4% of baseline) and sufentanil 10(-11) M (FoC: 78 ± 8% of baseline), 10(-10) M (FoC: 83 ± 6% of baseline), 10(-9) M (FoC: 83 ± 8% of baseline) enhanced the recovery of FoC as compared with the control group (53 ± 9% of baseline, P<0.0001). CONCLUSIONS Remifentanil and sufentanil, at clinically relevant concentrations, confer cardioprotection of human myocardium against hypoxia reoxygenation, in vitro.
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Affiliation(s)
- S Lemoine
- Laboratory of Experimental Anaesthesiology and Cellular Physiology, Institut Fédératif de Recherche ICORE146 Université de Caen Basse Normandie, France.
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Bellavita R, Massetti M, Arcidiacono F, Radicchia V, Matrone F, Montesi G, Abraha I, Aristei C. 1034 poster POSTOPERATIVE HIGH DOSE CONFORMAL RADIOTHERAPY IN PATIENTS WITH HIGH RISK PROSTATE CANCER. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71156-2] [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: 10/18/2022]
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Lemoine S, Durand C, Zhu L, Ivasceau C, Lepage O, Babatasi G, Massetti M, Gérard JL, Hanouz JL. Desflurane-induced postconditioning of diabetic human right atrial myocardium in vitro. Diabetes Metab 2009; 36:21-8. [PMID: 19945895 DOI: 10.1016/j.diabet.2009.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Revised: 06/01/2009] [Accepted: 06/03/2009] [Indexed: 11/25/2022]
Abstract
AIM We tested the hypothesis that brief exposure to desflurane at the time of reoxygenation might be able to protect against hypoxia-reoxygenation injury in human myocardium from diabetic (insulin-dependent, ID; and non-insulin-dependent, NID) patients and non-diabetic (ND) subjects. METHODS The force of contraction (34 degrees C, stimulation frequency 1Hz) in the right atrial trabeculae was recorded during 30min of hypoxia followed by 60min of reoxygenation. Desflurane (at 3, 6 and 9%) was administered during the first 5min of reoxygenation. The force of contraction at the end of the 60-min reoxygenation period (FoC(60)) was compared in the study groups (means+/-SD). RESULTS In the ND group, desflurane at 3, 6 and 9% (FoC(60): respectively 78+/-10%, 84+/-4% and 85+/-12% of baseline) enhanced the recovery of FoC(60) compared with the ND-controls (53+/-7% of baseline; P<0.05). In the ID group, desflurane at 3% (61+/-4%) did not modify the recovery of FoC(60) compared with the ID-controls (54+/-6%), whereas desflurane at 6 and 9% (75+/-11% and 81+/-8%, respectively) enhanced the recovery of FoC(60)vs the controls (P<0.05). In the NID group, desflurane at 3% (57+/-5%) also failed to modify the recovery of FoC(60) compared with the NID-controls (52+/-10%), while desflurane at 6 and 9% (80+/-10% and 79+/-7%, respectively) enhanced the recovery of FoC(60)vs the controls (P<0.05). CONCLUSION Desflurane in vitro was able to postcondition diabetic (both ID and NID) human myocardium at 6 and 9%, but not at 3%.
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Affiliation(s)
- S Lemoine
- Laboratoire d'anesthésiologie expérimentale et de physiologie cellulaire EA 3212, service d'anesthésie réanimation, institut fédératif de recherche ICORE 146, université de Caen, Basse Normandie, avenue Côte-de-Nacre, Caen cedex, France.
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Zhu L, Lemoine S, Babatasi G, Lepage O, Massetti M, Gérard JL, Hanouz JL. Sevoflurane- and desflurane-induced human myocardial post-conditioning through Phosphatidylinositol-3-kinase/Akt signalling. Acta Anaesthesiol Scand 2009; 53:949-56. [PMID: 19496766 DOI: 10.1111/j.1399-6576.2009.02009.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The role of phosphatidylinositol-3-kinase (PI3K) in sevoflurane- and desflurane-induced myocardial post-conditioning remains unknown. METHODS We recorded isometric contraction of isolated human right atrial trabeculae (oxygenated Tyrode's at 34 degrees C, stimulation frequency 1 Hz). In all groups, a 30-min hypoxic period was followed by a 60-min reoxygenation period. At the onset of reoxygenation, muscles were exposed to 5 min of sevoflurane 1%, 2%, and 3%, and desflurane 3%, 6%, and 9%. In separate groups, sevoflurane 2% and desflurane 6% were administered in the presence of 100 nM wortmannin, a PI3K inhibitor. Recovery of force after the 60-min reoxygenation period was compared between groups (mean +/- SD). RESULT As compared with the Control group (49 +/- 7% of baseline) PostC by sevoflurane 1%, 2%, and 3% (78 +/- 4%, 79 +/- 5%, and 85 +/- 4% of baseline, respectively) and desflurane 3%, 6%, and 9% (74 +/- 5%, 84 +/- 4%, and 86 +/- 11% of baseline, respectively) enhanced the recovery of force. This effect was abolished in the presence of wortmannin (56 +/- 5% of baseline for sevoflurane 2%+wortmannin; 56 +/- 3% of baseline for desflurane 6%+wortmannin). Wortmannin alone had no effect on the recovery of force (57 +/- 7% of baseline). CONCLUSION In vitro, sevoflurane and desflurane post-conditioned human myocardium against hypoxia through activation of phosphatidylinositol-3-kinase.
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Affiliation(s)
- L Zhu
- Laboratoire d'Anesthesiologie et de Physiologie Cellulaire, Centre Hospitalier Régional, Caen, France
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Massetti M, Neri E, Banfi C, Buklas D, Gerard JL, Vigano M, Chitwood RW. Video recording of cardiac surgical procedures: what the surgeon needs to know. J Cardiovasc Surg (Torino) 2008; 49:691-694. [PMID: 18670389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In the past, rudimentary devices were used to record surgical operations. Currently, the introduction of technologic advances such as high-definition television and the miniaturization of high-resolution digital video cameras provides an opportunity for making significantly enhanced surgical records. These enhancements, coupled with the recent advances in telemedicine and surgical simulation, will improve cardiac surgery training and skill acquisition, decrease operative times and costs, minimize morbidity, and improve overall patient care. The present paper provides a discussion of the media technology offered to surgeons for recording a surgical procedure on video. Hardware technology, including different types of cameras and analogical or digital post processing methods, are reviewed with a surgical ''eye''. This ''how to'' paper provides practical suggestions to surgeons in order to enhance surgical video recording.
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Affiliation(s)
- M Massetti
- Division of Cardiac Surgery, University Hospital Caen, France.
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Ouchikhe A, Lehoux P, Gringore A, Renouf P, Deredec R, Tasle M, Massetti M, Khayat A, Saloux E, Grollier G, Samama G, Gérard JL. Le phéochromocytome comme cause inhabituelle de choc cardiogénique. ACTA ACUST UNITED AC 2006; 25:46-9. [PMID: 16386403 DOI: 10.1016/j.annfar.2005.08.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2004] [Accepted: 08/29/2005] [Indexed: 11/19/2022]
Abstract
The authors reported a case involving a young patient with a cardiogenic shock associated to an acute pulmonary oedema. According to the seriousness of the shock, an external ventricular assist device (VAD) was initially inserted and replaced thereafter because of the cardiovascular instability, by an external pneumatic biventricular assist device. A cardiogenic shock induced by an acute adrenergic myocarditis due to a phaeochromocytoma was diagnosed. The patient was weaned from the VAD on day 84 and was scheduled for elective surgery of the phaeochromocytoma on day 93. The authors discussed the time of the surgery according to the anticoagulation therapy necessary to the VAD and the necessary caution taken if a cardiogenic shock appeared around surgery.
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Affiliation(s)
- A Ouchikhe
- Département d'anesthésie-réanimation et de médecine d'urgence, CHU Côte-de-Nacre, 14033 Caen, France.
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Massetti M, Babatasi G, Bruno P, Le Page O, Neri E, Nataf P, Gerard JL, Khayat A. Less invasive radial artery harvest. Heart Surg Forum 2003; 5 Suppl 4:S392-7. [PMID: 12759211] [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] [Accepted: 06/27/2001] [Indexed: 03/02/2023]
Abstract
BACKGROUND Recent studies have sparked a renewed interest in the use of autogenous radial arteries in coronary operations. Some concerns have been found about sequelae of conventional harvesting. A less invasive technique for radial artery harvesting has been proposed by others using endoscopic devices. This technique is time consuming, needs expensive instrumentation and an important learning curve. METHODS A new less invasive approach for radial harvesting has been developed with a light assisted retractor under direct vision. A small skin incision, median in the forearm, is followed by dissection of the proper plane of the artery. A subcutaneous tunnel is created around the vessel and all the branches are ligated or clipped. The dissection of the pedicle under the skin is completed with the aid of a modified light assisted retractor, originally designed for the saphenous vein harvesting. The incision is closed after heparin reversal with a small redon as drainage. RESULTS A preliminary serie of 15 patients have been operated with this technique. In all patients the radial artery was patent and functional at the postoperative angiography. Morbidity included only a light hematoma at the beginning of our experience. CONCLUSION This less invasive technique for the radial artery harvesting appears to be an excellent surgical compromise between the open technique and the endoscopic procedure; it is easy to perform, the learning curve is acceptable and it offers an excellent aesthetic result.
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Affiliation(s)
- M Massetti
- Thoracic and Cardiovascular Surgery Department, University Hospital, Caen, France.
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Babatasi G, Massetti M, Bruno PG, Hamon M, Le Page O, Morello R, Khayat A. Pre-operative balloon counterpulsation and off-pump coronary surgery for high-risk patients. Cardiovasc Surg 2003; 11:145-8. [PMID: 12664050 DOI: 10.1016/s0967-2109(03)00009-7] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED Coronary artery bypass surgery (CABG) can be performed less invasively without cardiopulmonary bypass (CPB). Multivessel off-pump CABG (OPCAB) is challenging in patients with critical left main stenosis (> 70%) and/or severe ventricular dysfunction (ejection fraction < 0.35) Our objective was the evaluation of efficiency of intra aortic balloon pump (IABP) preoperatively in this high-risk group in order to perform OPCABG safely. MATERIAL AND METHOD In a consecutive 10-month period (out of 88 OPCABG patients) 23 high-risk patients were treated and were compared with 15 on-pump patients (out of 69) with the same criteria. RESULTS Preoperative implantation of IABP was significantly higher in the OPCABG group (70% vs 46%, p < 0.05). No conversion to CPB was required in the OPCABG group. Post-operative angiography was systematically performed and demonstrated 97.5% patency of anastomosis. No device-related complications occurred. No difference was found concerning age, risk factors, emergency surgery, ejection fraction, mean number of grafts per patient (2.64 versus 2.75) and average operating time. In contrast, OPCABG demonstrated a trend toward reduced morbidity in terms of atrial fibrillation, reexploration for bleeding and prolonged ventilator requirement > 12 h. Mortality was less in the OPCABG group (p < 0.05). CONCLUSION More randomized controlled trials are needed to evaluate the true efficacy of elective IABP in OPCABG high-risk patients. Until such studies are evaluated, and therefore because older and sicker patients now constitute a greater percentage of candidates for OPCABG, the timing of application of the IABP is warranted. These results may further justify preoperative use of the IABP in a large proportion of this group of patients.
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Affiliation(s)
- G Babatasi
- Cardiovascular and Thoracic Surgery, University Hospital, Avenue Côte de Nacre, CHU Caen 14033 Caen, France.
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Neri E, Toscano T, Massetti M, Frati G, Buklas D, Tucci E, Capannini G, Mondillo S, Picchi A, Guerrini F, Sassi C. Surgical treatment of abdominal aortic aneurysms associated with aortic valve incompetence: strategies and outcomes. Cardiovasc Surg 2002; 10:452-9. [PMID: 12379402 DOI: 10.1016/s0967-2109(02)00029-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The exact incidence of associated aortic valve incompetence (AVI) and abdominal aortic aneurysm (AAA) in the general population is not known. In recent years, we have observed this association with increasing frequency. This observation is probably due to the extensive preoperative screening of the cardiac and vascular status of patients who are candidates for surgical procedures. The choice of the optimal surgical strategy is needed to achieve low operative morbidity and mortality. The present study reviews our experience with a subset of patients suffering the association of AVI and large AAA. Surgical strategy, clinical management and outcome are presented. METHODS Between January 1982 and May 2000, 76 patients with the association of AAA and AVI have been evaluated in our institution. Forty-four patients have been treated for both AAA and aortic valve (AV) regurgitation. These patients have been divided into three groups on the basis of the surgical strategy adopted. Group 1: combined procedure (16 patients); group 2: AAA repair prior to AV surgery (nine patients); group 3: AV surgery prior to aneurysm repair (19 patients). RESULTS Hospital mortality was 4.5% (two patients); overall mortality was 6.8% (three patients). CONCLUSIONS In patients with AAA and AVI, an accurate and complete preoperative evaluation is essential. Surgical strategy should be individualized on the basis of the cardiac preoperative status.
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Affiliation(s)
- E Neri
- Istituto di Chirurgia Toracica, Cardiovascolare Universita' agli Studi di Siena, Viale M Bracci Policlinico le Scotte, Italy.
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