Altavilla Vicentina, Italy
Altavilla Vicentina, Italy

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Origa R.,Clinica Pediatrica 2 | Danjou F.,Clinica Pediatrica 2 | Cossa S.,Radiology Service | Matta G.,Radiology Service | And 7 more authors.
British Journal of Haematology | Year: 2013

This study aimed to verify the impact of heart magnetic resonance imaging on chelation choices and patient compliance in a single-institution cohort as well as its predictive value for heart failure and arrhythmias. Abnormal cardiac T2* values determined changes in treatment in most subjects. Heart T2* was confirmed to be highly predictive over 1 year for heart failure and arrhythmias. The choice of chelation regimens known to remove heart iron efficiently was not sufficient by itself to influence the risk. Compliance with treatment had a more remarkable role. © 2013 John Wiley & Sons Ltd.


Mascitelli L.,Medical Service | Pezzetta F.,Cardiology Service | Sullivan J.L.,University of Central Florida
Medical Hypotheses | Year: 2010

A consensus view has emerged favoring an anticancer effect of long-term aspirin use. Aspirin-induced loss of stored iron from chronic gastrointestinal bleeding is proposed as a mechanism underlying this beneficial effect. In iron depletion, less iron may be available for carcinogenesis through free-radical mediated mechanisms and for promotion of tumor growth. Low-dose aspirin increases gastrointestinal losses of transfused radiolabeled autologous red cells. Observational studies report lower serum ferritin values with regular aspirin use. A protective effect of induced iron reduction against cancer mortality has been confirmed in a recent trial (FeAST) with subjects randomized to iron reduction or observation. Serum ferritin reductions in the FeAST trial were within conventionally normal reference ranges and were quantitatively similar to ferritin reductions in observational studies in regular aspirin users. Delayed anticancer effects of aspirin are compatible with the proposed mechanism, as continual microbleeding has a gradual cumulative effect on stored iron. © 2009 Elsevier Ltd. All rights reserved.


Faruolo M.,Cardiology Service | Fiorentino A.,IRCCS CROB | Gallucci G.,Cardiology Service | Lapadula L.,IRCCS CROB | Fusco V.,IRCCS CROB
Clinical and Translational Oncology | Year: 2013

Objectives: To investigate the effect of external beam radiotherapy (EBRT) for head and neck cancer (HNC) the intimal-medial thickness (IMT) and the lumen of the carotid artery. Methods: Patients with HNC and an indication for EBRT were enrolled. A carotid artery color Doppler examination was performed before and 6 and 12 months after EBRT. Results: From 2008 to 2011, 50 patients were enrolled. The mean carotid IMT was 0.9 vs. 1.02 mm before and 6 months after EBRT, respectively (p = 0.0001). The common carotid artery lumen was narrowed without statistical significance, 6 months after EBRT (p = 0.3). 1 year from EBRT, the IMT increase and the lumen reduction were statistically significant (p = 0.001, p = 0.01, respectively). Neurological events (stroke or TIA) were not observed. Conclusions: Our data showed a significant IMT increase 6 months from EBRT without a corresponding narrowing of the common carotid lumen while a significant increase 12 months after EBRT. © 2013 Federación de Sociedades Españolas de Oncología (FESEO).


Pfister S.,Eastern Colorado Health Care System | Wagar P.,Cardiology Service | Casserly I.P.,Aurora University
AANA Journal | Year: 2010

Stress-related cardiomyopathy (SRC), initially referred to as Tako-Tsubo cardiomyopathy and later as apical ballooning syndrome, has been largely observed in postmenopausal women. It is frequently precipitated by a stressful event. This is a case report of a 31-year-old woman who experienced SRC immediately after a bilateral mastectomy.


Mascitelli L.,Comando Brigata Alpina Julia | Goldstein M.R.,Fountain | Pezzetta F.,Cardiology Service
Journal of Cardiovascular Medicine | Year: 2011

We suggest that lower body iron stores, and not the loss of ovarian function, explain the differences between men and women, and between fertile and menopausal women in the development of coronary heart disease. © 2010 Italian Federation of Cardiology.


Pastore S.,University of Trieste | de Cunto A.,University of Trieste | Benettoni A.,Cardiology Service | Berton E.,Cardiology Service | And 2 more authors.
Rheumatology | Year: 2011

Objectives: The annual incidence of ARF ranges from 5 to 51/100 000 population worldwide in the 5- to 15-year age group. In the past, there was a decline in the incidence of ARF; however, focal outbreaks have been reported. This study evaluated the incidence of ARF in 2007-08 in a region of a developed country compared with the previous decade. Methods: A retrospective review of all admission records for ARF in Trieste between January 2007 and December 2008 was undertaken. The diagnosis of ARF was established by the Jones criteria according to the 1992 revision. Results: Between January 2007 and December 2008: 13 cases of ARF were recorded, 11 females and 2 males. The estimated incidence was 23 and 27/100 000 population new cases each year, respectively, in the 5- to 15-year age group. Migratory polyarthritis occurred in 6/13, chorea in 7/13 and clinical carditis in 5/13 cases. Five out of 13 patients had only echocardiographic abnormalities, with no clinical cardiac manifestations. Another two patients did not fulfil diagnostic criteria for ARF, presenting with only three minor criteria, but they revealed silent carditis at echocardiography evaluation. During the follow-up, in one case the carditis receded and in the other it significantly improved. Conclusions: Our experience underlines that ARF has not yet disappeared in industrialized countries. We observed a high incidence of chorea, always associated with mild carditis. Echocardiographic assessment should be routinely performed in all patients with suspected ARF in order to identify those subclinical cases of valvulitis that would otherwise pass undiagnosed without receiving proper prophylaxis. © The Author 2010. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.


Faggiano P.,University of Brescia | Frattini S.,University of Brescia | Zilioli V.,University of Brescia | Rossi A.,Ospedale Borgo Trento | And 5 more authors.
International Journal of Cardiology | Year: 2012

Objectives: Aortic valve replacement (AVR) is recommended in patients with symptomatic aortic stenosis (AS). However a large number of elderly patients remain untreated because of a high operative risk. The aim of this study was to assess the risk profile of a group of AS patients, evaluating the prevalence of comorbidities and associated cardiac diseases and their impact on therapeutic decisions. Methods: Two-hundred forty consecutive AS patients underwent complete clinical evaluation, in order to define the stenosis severity, the prevalence of several associated cardiac conditions and comorbidities. Furthermore, the treatment choices based on this approach were recorded. Results: Mean age was 78.6 ± 8.93 years, 75.5% was ≥ 75 years old, 60% females; 226 patients (94.2%) had symptoms and 54.2% was in NYHA classes III-IV. Valve area < 1 cm2 was detected in 81.6% of patients. Both comorbidities and associated cardiac diseases were common; particularly, renal dysfunction was detected by estimated glomerular filtration rate in 52.7%, chronic obstructive lung disease in 25.4%, cerebrovascular/peripheral artery disease in 30.8% and 11.6%, respectively, diabetes in 30%, malignancies (current or previous) in 26.6% of patients. Among associated cardiac diseases, coronary artery disease was detected in 43.7%, LV systolic dysfunction in 28.7%, pulmonary hypertension in 67%, at least moderate mitral regurgitation in 32.5% and porcelain aorta in 7.5% of patients. Fourteen asymptomatic patients (pts) (5.9%) remained in follow-up, 77 (32%) underwent surgical AVR, 64 (26.7%) underwent transcatheter valve implantation, 28 (11.6%) underwent balloon valvuloplasty and 57 (23.8%), despite symptoms, remained on medical therapy alone. Conclusions: Comorbidities and coexisting cardiac diseases are very common in AS and may strongly influence the decision-making process. © 2011 Elsevier Ireland Ltd.


Mascitelli L.,Comando Brigata Alpina Julia | Pezzetta F.,Cardiology Service | Goldstein M.R.,Fountain
Archives of Medical Research | Year: 2010

Ezetimibe is a lipid-lowering agent that inhibits intestinal absorption of dietary cholesterol. It substantially lowers low-density lipoprotein cholesterol levels when used alone or in combination with statins. Although there is a growing push for the continued use of ezetimibe for the prevention of cardiovascular disease, ezetimibe studies available so far are inconsistent, without allowing use of the drug with confidence. © 2010 IMSS.


Ballo P.,S Maria Annunziata Hospital | Nistri S.,Cardiology Service | Cameli M.,University of Siena | Papesso B.,Cardiology Service | And 4 more authors.
Journal of Cardiac Failure | Year: 2014

Background The relationships of left ventricular (LV) longitudinal and circumferential systolic dysfunction with diastolic performance in hypertensive patients have never been compared. Methods and Results In 532 asymptomatic hypertensive patients, circumferential function was assessed with the use of midwall fractional shortening (mFS) and stress-corrected mFS (SCmFS), whereas longitudinal function was assessed with the use of left atrioventricular plane displacement (AVPD) and systolic mitral annulus velocity (s′). Early diastolic annular velocity (e′) and the E/e′ ratio were measured. Global longitudinal and circumferential strain were determined in a subset of 210 patients. e′ was linearly related to all systolic indexes (AVPD: R = 0.40; s′: R = 0.39; mFS: R = 0.16; SCmFS: R = 0.17; all P <.0001), but the correlations were stronger with longitudinal indexes than with circumferential ones (P <.0001). E/e′ was nonlinearly related to AVPD (R = -0.49; P <.0001) and s′ (R = -0.34; P <.0001) and showed no relationship with mFS and SCmFS. Longitudinal indexes were superior to circumferential ones in predicting e′ <8 cm/s, E/e′ <8, and E/e′ ≥13. The effect of LV geometry on LV diastolic function was evident among patients with preserved systolic longitudinal function, but was blunted among patients with impaired longitudinal function. In multivariable analyses, only longitudinal indexes remained associated with e′ and E/e′. Analyses using strains provided similar results. Conclusions In asymptomatic hypertensive subjects, LV diastolic performance is independently associated with longitudinal systolic dysfunction, but not with circumferential systolic dysfunction. Subtle longitudinal systolic impairment plays a role in mediating the effect of LV geometry on diastolic performance. These findings may support the need of critically revising the concept of isolated diastolic dysfunction in these patients. © 2014 Elsevier Inc. All rights reserved.


PubMed | University of Ferrara, University of Verona, University of Cagliari, University of Naples Federico II and 5 more.
Type: Journal Article | Journal: Heart failure reviews | Year: 2016

Assessment of left ventricular (LV) systolic function is the cornerstone of the echocardiographic examination. There are many echocardiographic parameters that can be used for clinical and research purposes, each one with its pros and cons. The LV ejection fraction is the most used one due to its feasibility and predictability, but it also has many limits, related to both the imaging technique used for calculation and to the definition itself. LV longitudinal function is expression of subendocardial fibers contraction. Because the subendocardium is often involved early in many pathological processes, its analysis has been a fertile field for the development of sensitive parameters. Longitudinal function can be evaluated in many ways, such as M-mode echocardiography, tissue Doppler imaging, and speckle tracking echocardiography. This latter is a relatively new tool to assess LV function through measurement of myocardial strain, with a high temporal and spatial resolution and a better inter- and intra-observer reproducibility compared to Doppler strain. It is angle independent, not affected by translation cardiac movements, and can assess simultaneously the entire myocardium along all the three-dimensional geometrical (longitudinal, circumferential, and radial) axes. Speckle tracking echocardiography also allows the analysis of LV torsion. The aim of this paper was to review the main echocardiographic parameters of LV systolic function and to describe its pros and cons.

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