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Marina di Pisa, Italy

Cantinotti M.,Fondazione Toscana G. Monasterio | Lopez L.,Childrens Hospital at Montefiore
Journal of the American Society of Echocardiography | Year: 2013

Interest in diastolic function in children has increased recently. However, the strengths and limitations of published pediatric nomograms for echocardiographic diastolic parameters have not been critically evaluated, especially in the neonatal population. A literature search was performed within the National Library of Medicine using the keywords normal/reference values, power Doppler/tissue Doppler velocities, and children/neonates. The search was further refined by adding the keywords diastolic function, myocardial, mitral/tricuspid inflow, pulmonary vein, and Tei index. Thirty-three published studies evaluating diastolic function in normal children were included in this review. In many studies, sample sizes were limited, particularly in terms of neonates. There was heterogeneity in the methodologies to perform and normalize measurements and to express normalized data (Z scores, percentiles, and mean values). Although most studies adjusted measurements for age, classification by specific age subgroups varied, and few addressed the relationships of measurements to body size and heart rate (especially with higher neonatal heart rates). Although reference values were reproducible in older children, they varied significantly in neonates and infants. Pediatric diastolic nomograms are limited by small sample sizes and inconsistent methodologies for the performance and normalization of measurements, with few data on neonates. Some studies do reveal reproducible patterns in diastolic function in older children. A comprehensive pediatric nomogram of diastolic function involving a large population of normal infants and older children and using standardized methodology is warranted and would have tremendous impact in the care of children with acquired and congenital heart disease. Copyright 2013 by the American Society of Echocardiography. Source


Frullini A.,Studio Medico Flebologico | Da Pozzo E.,University of Pisa | Felice F.,University of Pisa | Burchielli S.,Fondazione Toscana G. Monasterio | And 2 more authors.
Dermatologic Surgery | Year: 2014

The foam sclerotherapy technique has become one of the most commonly used treatments for superficial venous insufficiency. Despite excellent results, few visual/neurologic disturbances have been recently reported; their pathogenesis is still debated but a correlation with endothelin-1 (ET-1) release from the treated vein has been proposed. OBJECTIVE: The purpose of this work was to evaluate the ET-1 release after sclerotherapy and to investigate the effects of the anti-endothelin drug aminaphtone. METHODS AND MATERIALS: As in vitro sclerotherapy model, an endothelial cell culture, mimicking vascular endothelium, was pretreated with aminaphtone and exposed to detergents. Cell survival and ET-1 release were measured. In in vivo experiments, 45 rats, fed with different aminaphtone-rich diets, were subjected to sclerotherapy, and the systemic ET-1 was measured. RESULTS: Aminaphtone cell exposure caused a statistically significant reduction in ET-1 release, both before and after in vitro sclerotherapy. Rats fed with aminaphtone showed a trend toward reduced mortality and a significant decrease of ET-1 release after sclerotherapy. CONCLUSION: This is the first study in which an anti-endothelin agent was able to cause a significant reduction of ET-1 release during sclerotherapy. Although clinical studies are required, these findings might advocate the use of anti-endothelin agents in prophylaxis of neurologic or visual disturbances after sclerotherapy. © 2014 by the American Society for Dermatologic Surgery, Inc. Source


Del Turco S.,CNR Institute of Neuroscience | Basta G.,CNR Institute of Neuroscience | Lazzerini G.,CNR Institute of Neuroscience | Chancharme L.,Institute Of Recherches Internationales Servier | And 3 more authors.
Vascular Pharmacology | Year: 2014

Background: Thromboxane (TX) A2, prostaglandin endoperoxides and F2-isoprostanes exert their effects through a TX-prostanoid (TP) receptor, also expressed in endothelial cells. We investigated a role of the TP receptor in the endothelial expression of tissue factor (TF), a key trigger to thrombosis. Methods and results: Human umbilical vein endothelial cells (HUVEC) exposed to the TP receptor agonist U46619 featured a concentration-dependent increase in TF surface exposure and procoagulant activity. HUVEC pre-incubation with the TP receptor antagonist S18886, followed by stimulation with either U46619 or tumor necrosis factor-α (TNF-α), attenuated TF surface exposure and activity compared with stimulated control. Aspirin or indomethacin, while inhibiting cyclooxygenase (COX)-1 and -2 activities, did not mimic this effect. Probing of underlying mechanisms by selective pharmacological and gene silencing experiments showed that S18886 reduced U46619- or TNF-α-induced TF expression inhibiting ROS production, NAD(P)H oxidase and PKC activation. In addition, S18886 also inhibited ERK activation in the presence of both U46619 and TNF-α alone, while inhibition of JNK activation only occurred in the presence of U46619. Conclusion: The endothelial TP receptor contributes to TF surface exposure and activity induced not only by known TP receptor agonists, but also by TNF-α. Such findings expand the therapeutic potential of TP receptor inhibition. © 2014 Elsevier Inc. Source


The thyroid and the cardiovascular system are closely related, both in physiological and pathological conditions. The adverse consequences on the heart of overt thyroid disease are well-known and even subclinical forms of both hyperthyroidism and hypothyroidism are associated with increased cardiovascular mortality. In recent years, attention has shifted towards milder forms of thyroid disease, such as the so-called "low T3 syndrome", which is characterized by an isolated reduction in circulating levels of the biologically active form of thyroid hormone, triiodothyronine (T3). Furthermore, variations of T3 within the physiological range have been linked to coronary artery disease, one of the leading causes of morbidity and mortality worldwide. The present manuscript provides an overview of thyroid physiology and pathophysiology, with a particular focus on cardiovascular disease in patients with milder forms of thyroid dysfunction. © 2013 by AVES Yayi{dotless}nc i{dotless}li{dotless}k Ltd. Source


Gimelli A.,Fondazione Toscana G. Monasterio | Liga R.,University of Pisa | Pasanisi E.M.,Fondazione Toscana G. Monasterio | Giorgetti A.,Fondazione Toscana G. Monasterio | And 5 more authors.
European Heart Journal Cardiovascular Imaging | Year: 2014

Aims: To evaluate the relationships between measures of left ventricular (LV) filling dynamics at cadmium-zinc-telluride (CZT) imaging and indexes of LV diastolic function at transthoracic echocardiography. Methods and results: Two hundred and forty-seven patients underwent myocardial perfusion imaging at rest and after stress with a low-dose CZT protocol and a baseline transthoracic echocardiography study. All patients were submitted to invasive or computed coronary angiography. The peak filling rate (PFR) and the time to PFR (TPFR) were derived from gated CZT images as measures of LV filling dynamics. LV diastolic function was also evaluated at echocardiography and the presence of significantly increased LV filling pressures determined. Increased LV filling pressures at transthoracic echocardiography were evident in 103 (42%) patients. Interestingly, independently from the presence of coronary artery disease, therewasa strict correlation between the presence and severity of LV diastolic dysfunction at echocardiography and CZT-derived measures of filling dynamics, i.e. PFR (P = 0.001) and TPFR (P = 0.001). At receiving operating characteristic analysis, a composite index of reduced PFR (≤2.11 end-diastolic volumes -1) and increased TPFR (>234 ms) showed a sensitivity of 84% and a specificity of 67% in unmasking the presence of elevated LV filling pressures at echocardiography. Conclusions: CZT-derived measures of LV filling dynamics correlate with echocardiographic parameters of diastolic function and may identify the presence of increased LV filling pressures. © The Author 2014. Source

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