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Iacono A, Wijesinha M, Rajagopal K, Murdock N, Hughes T, McGee S, Timofte I, Kim J, Rinaldi J, Terrin M. Stabilization of Lung Function and Survival Improvement By Aerosolized Liposomal Cyclosporine A (L-CsA) for Bronchiolitis Obliterans Syndrome. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Iacono A, Pompa A, De Marchis F, Bellucci M, Grassi F, Grohmann U, Pallotta M. Relationship between functions and intracellular localization of the immune checkpoint target indoleamine 2,3-dioxygenase 1. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy047.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pallotta M, Iacono A, Albini E, Orabona C, Belladonna M, Bianchi R, Coletti A, Greco F, Macchiarulo A, Grohmann U. Towards the identification of the mechanism of action of antitumor 1-methyl-D-tryptophan. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy047.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bonifazi F, Conte R, Baiardi P, Bonifazi D, Felisi M, Giordano P, Giannuzzi V, Iacono A, Padula R, Pepe A, Caterina Putti M, Ruggieri L, Carlo Del Vecchio G, Filosa A, Maggio A, Ceci A. Pattern of complications and burden of disease in patients affected by beta thalassemia major. Curr Med Res Opin 2017; 33:1525-1533. [PMID: 28471307 DOI: 10.1080/03007995.2017.1326890] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Despite the correct application of blood transfusions and chelation treatments, beta thalassemia patients have many complications. Systematic population analyses on types and frequency of these complications are very few. The aim of this study is to characterize the complications, their risk factors and their clinical and economic impact. METHODS Complications at baseline and events occurring during one observational year were analyzed in 272 patients aged >12 years. Risk factors were analyzed through chi-squared and unpaired t tests. Logistic regression was applied to perform the risk factors multivariate analysis. RESULTS A total of 554 complications (1-6 per patient) affected 82.3% of patients. Cardiac complications were less represented than expected. Musculoskeletal diseases were the most represented complications followed by hepatic, sexual and endocrine diseases. Splenectomized patients, born before 1970 and aged >40 years, starting iron chelation therapy when aged >4 years or after receiving more than 20 blood transfusions, presented a significantly higher number of complications. A total of 885 adverse events requiring 34125 additional medical services occurred in 1 year. Of these, 34.9% were related to treatments and 65.1% to other causes. Event numbers, additional medical interventions and cost increased progressively in patients affected by one or more complication compared to patients with no complications. CONCLUSIONS The pattern of complications changes according to birth cohort and differentiates older from younger patients. The burden of the disease and its costs increase after the onset of the first complication, therefore prevention of complications is fundamental in these patients.
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Kim J, Barr E, Terrin M, Timofte I, Sanchez P, Kon Z, Pierson R, Wijesinha M, Pham S, Iacono A. Change in Body Mass Index at Listing from Primary Transplant to Re-Transplantation Predicts Re-Transplant Survival. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Timofte I, Terrin M, Wijesinha M, Sanchez P, Pierson R, Barr E, Kim J, Kon Z, Pham S, Iacono A. Pulmonary Hypertension in COPD: A Survival Analysis of Patients Listed for Lung Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Agbor-Enoh S, Fideli U, Doveikis J, Zhu J, Tunc I, Shah P, Russell S, Feller E, Shah K, Rodrigo M, Shah P, Pham S, Iacono A, Nathan S, Orens J, GRAfT Investigators N, Valantine H. Genomic Research Alliance for Transplantation (GRAfT): A Model for Long Term Transplant Studies in Thoracic Organ Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Conte R, Ruggieri L, Gambino A, Bartoloni F, Baiardi P, Bonifazi D, Bonifazi F, Felisi M, Giannuzzi V, Padula R, Pepe A, Putti MC, Del Vecchio GC, Maggio A, Filosa A, Iacono A, Mangiarini L, Ceci A. The Italian multiregional thalassemia registry: Centers characteristics, services, and patients' population. ACTA ACUST UNITED AC 2016; 21:415-24. [PMID: 26863102 DOI: 10.1080/10245332.2015.1101971] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The prognosis of beta-Thalassemia major and other congenital hemoglobinopathies has profoundly changed over the last decades. Moreover, only few countries in Europe provide dedicated services and the description of the measures for patients monitoring and treatment is overall very scarce. The HTA-Thal project is aimed to identify the services available in Italy and to collect epidemiological and clinical data on the thalassemic population (HTA-Thal Registry). METHODS A map of the existing centers was created and two electronic questionnaires were completed with information on the services and patients. RESULTS On 182 centers identified, 60 completed the two questionnaires. Centers resulted to be extremely heterogeneous in terms of size, age of patients in care, and services availability. The transition of pediatric patients to adult centers was not guaranteed. Thousand eight hundred and seventy-three beta-Thalassemia major patients (of which 259 pediatrics), regularly transfused, were registered. Deferasirox is the most used chelator as monotherapy (616 patients) and its use prevails in younger patients. A higher number of patients (847 patients) use Deferoxamine, either alone (448 patients) or in combination with DFP (399 patients), while 782 patients use Deferiprone alone (383 patients) or in combination (399 patients). 31.6 and 66.6% of centers were not equipped for specialized visits or local MRI, respectively. Centers with 30-80 patients show the high percentage of patients appropriately monitored when compared to smaller or bigger centers. CONCLUSIONS This analysis confirms the importance of patients' registries for the collection of large datasets and the need for dedicated 'specialized centers' equipped to provide the best standard treatment to patients.
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Collins J, Iacono A, Drachenberg C, Burke A. Histologic Findings in Allograft Lung Biopsies: Correlation With Serologic Alloimmunity. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Xu L, Drachenberg C, Iacono A, Burke A. Histological Characterization of Pulmonary Transplant Patients with Donor Specific Antibodies and Those without. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Xu L, Drachenberg C, Iacono A, Burke A. Pathologic Findings in Explanted Pulmonary Allografts. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Saglimbene V, D'Alonzo D, Ruospo M, Vecchio M, Natale P, Gargano L, Nicolucci A, Pellegrini F, Craig JC, Triolo G, Procaccini DA, Santoro A, Di Giulio S, La Rosa S, Murgo A, Di Toro Mammarella R, Sambati M, D'Ambrosio N, Greco V, Giannoccaro G, Flammini A, Boccia E, Montalto G, Pagano S, Amarù S, Fici M, Lumaga GB, Mancini E, Veronesi M, Patregnani L, Querques M, Schiavone P, Chimienti S, Palumbo R, Di Franco D, Della Volpe M, Gori E, Salomone M, Iacono A, Moscoloni M, Treglia A, Casu D, Piras AM, Di Silva A, Mandreoli M, Lopez A, Quarello F, Catizone L, Russo G, Forcellini S, Maccarone M, Catucci G, Di Paolo B, Stingone A, D'Angelo B, Guastoni C, Pasquali S, Minoretti C, Bellasi A, Boscutti G, Martone M, David S, Schito F, Urban L, Di Iorio B, Caruso F, Mazzoni A, Musacchio R, Andreoli D, Cossu M, Li Cavoli G, Cornacchiari M, Granata A, Clementi A, Giordano R, Guastoni C, Barzaghi W, Valentini M, Hegbrant J, Tognoni G, Strippoli GFM. [Effects of dose of erythropoiesis stimulating agents on cardiovascular outcomes, quality of life and costs of haemodialysis. the clinical evaluation of the DOSe of erythropoietins (C.E. DOSE) Trial]. GIORNALE ITALIANO DI NEFROLOGIA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI NEFROLOGIA 2013; 30:gin/00072.21. [PMID: 23832463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Anaemia is a risk factor for death, adverse cardiovascular outcomes and poor quality of life in patients with chronic kidney disease (CKD). Erythropoietin Stimulating Agents (ESA) are the most used treatment option. In observational studies, higher haemoglobin (Hb) levels (around 11-13 g/dL) are associated with improved survival and quality of life compared to Hb levels around 9-10 g/dL. Randomized studies found that targeting higher Hb levels with ESA causes an increased risk of death, mainly due to adverse cardiovascular outcomes. It is possible that this is mediated by ESA dose rather than haemoglobin concentration, although this hypothesis has never been formally tested. METHODS We present the protocol of the Clinical Evaluation of the Dose of Erythropoietins (C.E. DOSE) trial, which will assess the benefits and harms of a high versus a low ESA dose therapeutic strategy for the management of anaemia of end stage kidney disease (ESKD). This is a randomized, prospective open label blinded end-point (PROBE) design trial due to enroll 900 haemodialysis patients. Patients will be randomized 1:1 to 4000 UI/week i. v. versus 18000 UI/week i. v. of epoetin alfa, beta or any other epoetin in equivalent doses. The primary outcome of the trial is a composite of cardiovascular events. In addition, quality of life and costs of these two strategies will be assessed. The study has been approved and funded by the Italian Agency of Drugs (Agenzia Italiana del Farmaco (AIFA)) within the 2006 funding plan for independent research on drugs (registered at www.clinicaltrials.gov (NCT00827021)).
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Orditura M, Sarubbi B, Devita F, Ducceschi V, Santangelo L, Cariello A, Iacono A, Catalano G. Prolonged corrected QT dispersion. Oncol Rep 2012; 4:1047-50. [PMID: 21590193 DOI: 10.3892/or.4.5.1047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The anthracyclines are antibiotics effective in the treatment of many malignancies. However, their usefulness is limited by the development of potentially acute or chronic cardiotoxicity. No definitive guidelines exist for monitoring cardiac function during and after anthracyclines although methods have been suggested. Electrocardiograms and echocardiograms are routinely utilized for noninvasive assessment of myocardial function. The aim of the study was to assess the effects of doxorubicin on ventricular repolarization time indexes, as they have been shown to be effective in the identification of electrical myocardial instability and hence in the identification of the risk for either arrhythmia or heart failure. Electrocardiographic parameters were compared in 27 cancer patients before and after chemotherapy including doxorubicin. The data of the present study show that after only a short period of treatment with doxorubicin there is a significant increase in ventricular recovery time indexes (QTc dispersion and 'Adjusted' QTc dispersion). The relation between the electrophysiological response to doxorubicin and the potential cardiotoxic effect of this drug remains to be established through prospective studies.
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Johnson B, Zamora M, Budev M, Kotloff R, Iacono A, Dilly S, Verret W, Golden J. 172 Cyclosporine Inhalation Solution Does Not Improve Bronchiolitis Obliterans Syndrome-Free Survival Following Lung Transplant: Results from the CYCLIST Trial. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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La Rana G, Russo R, D’Agostino G, Sasso O, Mattace Raso G, Iacono A, Meli R, Piomelli D, Calignano A. Corrigendum to “AM404, an anandamide transport inhibitor, reduces plasma extravasation in a model of neuropathic pain in rat: Role for cannabinoid receptors” [Neuropharmacology 54 (2008) 521–529]. Neuropharmacology 2011. [DOI: 10.1016/j.neuropharm.2011.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Raso GM, Esposito E, Vitiello S, Iacono A, Santoro A, D'Agostino G, Sasso O, Russo R, Piazza PV, Calignano A, Meli R. Palmitoylethanolamide stimulation induces allopregnanolone synthesis in C6 Cells and primary astrocytes: involvement of peroxisome-proliferator activated receptor-α. J Neuroendocrinol 2011; 23:591-600. [PMID: 21554431 DOI: 10.1111/j.1365-2826.2011.02152.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Palmitoylethanolamide (PEA) regulates many pathophysiological processes in the central nervous system, including pain perception, convulsions and neurotoxicity, and increasing evidence points to its neuroprotective action. In the present study, we report that PEA, acting as a ligand of peroxisome-proliferator activated receptor (PPAR)-α, might regulate neurosteroidogenesis in astrocytes, which, similar to other glial cells and neurones, have the enzymatic machinery for neurosteroid de novo synthesis. Accordingly, we used the C6 glioma cell line and primary murine astrocytes. In the mitochondrial fraction from cells stimulated with PEA, we demonstrated an increase in steroidogenic acute regulatory protein (StAR) and cytochrome P450 enzyme (P450scc) expression, both comprising proteins considered to be involved in crucial steps of neurosteroid formation. The effects of PEA were completely blunted by GW6471, a selective PPAR-α antagonist, or by PPAR-α silencing by RNA interference. Accordingly, allopregnanolone (ALLO) levels were increased in supernatant of PEA-treated astrocytes, as revealed by gas chromatography-mass spectrometry, and this effect was inhibited by GW6471. Moreover, PEA showed a protective effect, reducing malondialdehyde formation in cells treated with l-buthionine-(S,R)-sulfoximine, a glutathione depletor and, interestingly, the effect of PEA was partially inhibited by finasteride, a 5α-reductase inhibitor. A similar profile of activity was demonstrated by ALLO and the lack of an additive effect with PEA suggests that the reduction of oxidative stress by PEA is mediated through ALLO synthesis. The present study provides evidence indicating the involvement of the saturated acylethanolamide PEA in ALLO synthesis through PPAR-α in astrocytes and explores the antioxidative activity of this molecule, confirming its homeostatic and protective role both under physiological and pathological conditions.
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Ferrante M, Mattace Raso G, Esposito E, Bianco G, Iacono A, Clausi M, Amero P, Santoro A, Simeoli R, Autore G, Meli R. Effects of non-dioxin-like polychlorinated biphenyl congeners (PCB 101, PCB 153 and PCB 180) alone or mixed on J774A.1 macrophage cell line: modification of apoptotic pathway. Toxicol Lett 2011; 202:61-8. [DOI: 10.1016/j.toxlet.2011.01.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 01/21/2011] [Accepted: 01/25/2011] [Indexed: 11/28/2022]
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Gravina AG, Iacono A, Alagia I, D'Armiento FP, Sansone S, Romano M. Gastric xanthomatosis associated with gastric intestinal metaplasia in a dyspeptic patient. Dig Liver Dis 2009; 41:765. [PMID: 18829401 DOI: 10.1016/j.dld.2008.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2008] [Accepted: 08/12/2008] [Indexed: 12/11/2022]
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Iacono A, Bianco G, Mattace Raso G, Esposito E, d'Emmanuele di Villa Bianca R, Sorrentino R, Cuzzocrea S, Calignano A, Autore G, Meli R. Maternal adaptation in pregnant hypertensive rats: improvement of vascular and inflammatory variables and oxidative damage in the kidney. Am J Hypertens 2009; 22:777-83. [PMID: 19373215 DOI: 10.1038/ajh.2009.68] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Mechanisms of normalization of blood pressure in spontaneously hypertensive rats (SHR) during pregnancy were investigated. We hypothesized that at the end of pregnancy (20th day), the modified renal renin-angiotensin system (RAS) plays a pivotal role in this effect associated with reduced inflammation and oxidative damage. METHODS We measured blood pressure and heart rate (HR) using a noninvasive tail-cuff method in conscious SHR and Wistar Kyoto rats (WKY). Nonpregnant (-NP) or pregnant (-P) SHR and WKY were used to compare the changes of angiotensin II (ANG II) type 1 (AT1) and type 2 (AT2) receptor expression in the kidney. Renal modification of proinflammatory enzyme expression, cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS) and their transcription factor nuclear factor-kappaB (NF-kappaB) were also evaluated. Renal malonyldialdehyde (MDA) content and protein nitrotyrosylation, as indicators of oxidative stress, were assessed. Moreover monocyte chemotactic protein-1 (MCP-1) mRNA was determined. RESULTS Our findings indicate that the significant reduction of blood pressure induced by pregnancy in the SHR strain could be related to reduced AT1 and increased AT2 expression. We also saw a significant decline in renal NF-kappaB, COX-2, iNOS, and macrophage infiltration, as well as the fall in oxidative stress indicators. CONCLUSIONS The increased proinflammatory and oxidative variables, seen in SHR, are strongly ameliorated by pregnancy. In pregnant SHR animals, the adaptive and compensative changes of RAS and inflammation in the kidney seem to contribute to the reduction of blood pressure near term.
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Irace L, Iarussi D, Guadagno I, De Rimini ML, Lucca P, Spadaro P, Romano A, Mansi L, Iacono A. Left ventricular function and exercise tolerance in patients with type II diabetes mellitus. Clin Cardiol 2009; 21:567-71. [PMID: 9702383 PMCID: PMC6656135 DOI: 10.1002/clc.4960210807] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Left ventricular (LV) preload changes may alter exercise tolerance (ET), probably lessening activation of the Maestrini-Starling mechanism. Reduced LV filling (pre-load) during the diastolic phase, usually impaired in diabetic patients, could affect ventricular function. HYPOTHESIS To evaluate the relationship between some echocardiographic LV function indices and ET, 24 patients (age 43-75 years, mean 54 +/- 13 years, Group A) with type II diabetes mellitus (DM), not suffering from other pathologies, and for whom the ergometric stress test (EST) resulted in an early interruption because of muscular fatigue and/or dyspnea, and 14 patients (age 38-70 years, mean 53 +/- 12 years, Group B) with type II DM and maximal ergometric stress test, used as control group, were studied. METHODS The EST was performed by increasing the load by 25 W every 2 min; its duration was used as an ET index and correlated with clinical parameters of LV function obtained with M-mode, two-dimensional, and Doppler echocardiography. RESULTS No patients in either Group A or Group B showed a high systolic blood pressure value at rest and/or an LV hypertrophy and/or an alteration of systolic functional indices. In neither group was there significant correlation between ET and duration of DM, basal heart rate, basal and max systolic blood pressure, and EF values. Linear regression analysis showed a significant correlation between Doppler parameters of the diastolic function and ET index in Group A, while there was no significant correlation in Group B. CONCLUSION From these data we can deduce that in absence of left systolic ventricular dysfunction the impairment of LV relaxation in DM can influence exercise tolerance, probably by limiting activation of the contractile reserve.
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Iarussi D, Galderisi M, Ratti G, Tedesco MA, Indolfi P, Casale F, Di Tullio MT, de Divitiis O, Iacono A. Left ventricular systolic and diastolic function after anthracycline chemotherapy in childhood. Clin Cardiol 2009; 24:663-9. [PMID: 11594412 PMCID: PMC6655021 DOI: 10.1002/clc.4960241006] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND In childhood, late cardiotoxicity is characterized by inappropriately thin wall and consequent increased end-systolic wall stress, but the associations of impaired left ventricular geometry and function occurring under these circumstances need further investigation. HYPOTHESIS The purpose of this study was to assess anthracycline late effects on the relationships occurring between increased end-systolic stress (ESS) and changes in both M-mode systolic measurements (i.e., endocardial and midwall fractional shortening) and Doppler diastolic indices in the pediatric age. METHODS The population consisted of 101 children treated with anthracyclines for at least 12 months and 91 healthy children. Using M-mode echocardiography, end-systolic wall stress was calculated as index of afterload, and endocardial and midwall fractional shortening as systolic indices. Doppler transmitral measurements were made as diastolic indices. RESULTS Patients treated with anthracyclines showed significantly lower relative wall thickness and left ventricular mass index, greater end-systolic wall stress, reduced endocardial and midwall fractional shortening and peak E/A ratio, prolonged deceleration, and isovolumic relaxation times. Direct relationships were found between end-systolic wall stress and both endocardial and midwall shortening. The use of midwall shortening in the relation showed a greater, but not significant increase (from 3 to 6%) in the proportion of patients with depressed systolic function than did endocardial shortening. In the anthracycline group, end-systolic wall stress was also inversely related to relative wall thickness and directly to isovolumic relaxation time. CONCLUSIONS In childhood, reduced myocardial thickness and increased afterload explain much of systolic and diastolic dysfunction of late anthracycline toxicity. Midwall fractional shortening does not seem to add useful information for identifying subsets of children more prone to the development of heart failure.
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Tedesco MA, Di Salvo G, Ratti G, Natale F, Iarussi D, Iacono A. Left atrial size in 164 hypertensive patients: an echocardiographic and ambulatory blood pressure study. Clin Cardiol 2009; 24:603-7. [PMID: 11558842 PMCID: PMC6655175 DOI: 10.1002/clc.4960240907] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Left atrial enlargement (LAE) is associated with an increased risk of death and cardiovascular (CV) hospitalization. Whether or not LAE reflects early structural change from hypertension is unclear. HYPOTHESIS The aim of this study was to evaluate the relationship between LA size, 24-h blood pressure measurements, age, body mass index (BMI), and left ventricular mass index (LVMI) in hypertensive patients. METHODS We studied 164 outpatients (age range 30-76 years, 73 men and 91 women) with mild to moderate hypertension. Physical examination, electrocardiogram, noninvasive blood pressure monitoring (ABPM), Doppler echocardiogram were performed. Left ventricular mass index and LA dimensions were calculated. The sample was divided by age (< 60 and > or = 60 years). RESULTS Left ventricular hypertrophy (LVH) was present in 45% of patients aged < 60 years and in 70% of patients aged > or = 60 years (p = 0.002). Left atrial enlargement (> 4 cm) was present in 35% of elderly and in 24% of young patients (p = 0.31), and in 36% of patients with and 21% of patients without LVH (p = 0.0057). There was no significant difference in the younger patients with and without LVH. The incidence of obesity was low (31%) in the whole sample. The percentage of overweight in the elderly patients with LVH and higher LA size was equally low. Multivariate analysis showed age (p = 0.044) and LVMI (p = 0.002) as the only significant predictors of LA enlargement. CONCLUSION Since LAE is associated with a high risk of death and CV hospitalization, we emphasize the importance of development and use of drugs that inhibit LVH.
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Ducceschi V, Sarubbi B, D'Andrea A, Liccardo B, Lucca P, Mayer MS, Scialdone A, Santangelo L, Iacono A. Electrophysiologic significance of leftward QRS axis deviation in bifascicular and trifascicular blocks. Clin Cardiol 2009; 21:579-83. [PMID: 9702385 PMCID: PMC6655374 DOI: 10.1002/clc.4960210809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Intraventricular conduction disturbances determine complete impairment of impulse propagation along the right or left bundle branch or the two left fascicles. HYPOTHESIS This study was undertaken to investigate the electrophysiologic significance of QRS axis (QRSA) orientation in bifascicular and trifascicular blocks. METHODS A group of 76 subjects, 43 with right bundle-branch block (RBBB) and left anterior hemiblock (LAH) (Group A), and 33 with left bundle-branch block (LBBB) (Group B), was submitted to electrophysiologic evaluation. RESULTS In Group A, QRSA was inversely related only to intraventricular conduction, while in Group B, QRSA inversely related to infrahisal conduction times. A value of < -60 degrees was considered the cut-off point for determining subjects with a considerable leftward QRSA deviation. Of the 27 Group A patients with a QRSA < -60 degrees, 38.5% developed an infrahisal second-degree atrioventricular (AV) block during incremental atrial stimulation (IAS) in comparison with 11.1% of those with QRSA > -60 degrees. Of the 9 Group B patients with a QRSA < -60 degrees, 44.4% exhibited severe impairment of infrahisal conduction at baseline and 66.6% developed an infrahisal second-degree AV block during IAS, whereas among the remaining 24 with a QRSA > -60 degrees, in only 8.3% were both infrahisal (HV1 and HV2) intervals dangerously prolonged, and 23.8% encountered an infrahisal second-degree AV block during IAS. In Group A, atrioventricular conduction time > 200 ms exhibited a better predictive accuracy than QRSA < -60 degrees for the development of an infrahisal second-degree AV block during IAS, whereas the latter appeared the best noninvasive predictor in Group B with a slightly lesser predictive accuracy than HV > 80 ms. CONCLUSION The degree of leftward QRSA deviation seems to reflect the entity of intraventricular conduction delay in patients with RBBB + LAH, while it appears to be directly related to infrahisal conduction prolongation in those with LBBB.
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van Loenhout K, Groves S, Moainie S, Galazka M, Sherman B, O'Keefe S, Wade C, Britt E, Lesser S, Todd N, van Hal P, Griffith B, Iacono A. 430: Alemtuzumab Induction Therapy in Lung Transplantation: Early Outcomes. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ferrante M, Raso GM, Bilancione M, Esposito E, Iacono A, Meli R. Differential modification of inflammatory enzymes in J774A.1 macrophages by ochratoxin A alone or in combination with lipopolysaccharide. Toxicol Lett 2008; 181:40-6. [DOI: 10.1016/j.toxlet.2008.06.866] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2008] [Revised: 06/24/2008] [Accepted: 06/26/2008] [Indexed: 11/24/2022]
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