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Russo V, Rago A, Papa AA, Nigro G. Which is the true epidemiology of left ventricular dysfunction in patients with myotonic dystrophy type 1? J Chin Med Assoc 2017; 80:740-741. [PMID: 28958668 DOI: 10.1016/j.jcma.2017.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 07/06/2017] [Indexed: 10/18/2022] Open
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Russo V, AlTurki A, Rago A, Proietti R, Chaussé G, Monteleone AM, Scognamiglio P, Monteleone P, Nigro G. Temperament and character personality dimensions in nitrate-tilt-induced vasovagal syncope patients. Hellenic J Cardiol 2017; 58:411-416. [PMID: 28212873 DOI: 10.1016/j.hjc.2017.01.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 01/07/2017] [Accepted: 01/20/2017] [Indexed: 11/30/2022] Open
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Russo V, Rago A, Papa AA, Bianchi V, Tavoletta V, DE Vivo S, Cavallaro C, Nigro G, D'Onofrio A. Budget impact analysis of rivaroxaban vs. warfarin anticoagulation strategy for direct current cardioversion in non-valvular atrial fibrillation patients: the MonaldiVert Economic Study. Minerva Cardioangiol 2017; 66:1-5. [PMID: 28948752 DOI: 10.23736/s0026-4725.17.04500-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Rivaroxaban is the first novel oral anticoagulant to receive regulatory approval for non-valvular atrial fibrillation (NVAF) patients who require cardioversion. The MonaldiVert real life experience showed positive benefit-risk profile of short term rivaroxaban administration for transesophageal echocardiogram guided cardioversion in patients who had not achieved adequate pre-procedural vitamin K antagonist (VKA) anticoagulation. METHODS Aim of our study was to perform a budget impact analysis of MonaldiVert anticoagulation strategy for direct current cardioversion in NVAF patients and to compare the following costs borne by the Regional Healthcare System (RHS) with those for a hypothetical cohort of identical patients underwent from the beginning to early rivaroxaban treatment before direct current cardioversion. RESULTS The mean costs per each NVAF patient treated with VKA strategy and rivaroxaban rescue strategy were € 134.53 and € 189.83, respectively. Considering a hypothetical scenario in which all study population would be treated from the beginning with rivaroxaban (rivaroxaban early strategy), the mean cost per patient would have been € 81.11. The total cost borne by the RHS, including the cost of the cardioversion procedure, for the two therapeutic strategies carried out at Monaldi Hospital (VKA strategy and Rivaroxaban rescue strategy) was € 88,458.53. The total cost would be borne by the RHS for rivaroxaban early strategy, if applied to all study population, would have been € 69,989.15 with a saving of € 18,469.38 compared to the actually applied strategy. CONCLUSIONS Rivaroxaban rescue strategy for transesophageal echocardiography guided direct current cardioversion in NVAF patients, who had not achieved adequate pre-procedural VKA anticoagulation, is an effective and safe strategy, which allows to not delay the procedure, reducing times and wastage of cardioversion slots, without substantial costs increase.
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Russo V, Papa AA, Nigro G. The Controversial Epidemiology of Left Ventricular Dysfunction in Patients With Myotonic Dystrophy Type 1. JAMA Cardiol 2017; 2:1044. [PMID: 28492909 DOI: 10.1001/jamacardio.2017.0927] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
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Biffi M, Vado A, Nigro G, Narducci M, Ammendola E, Zingarini G, Calzolari V, Calo' L, Tomasi C, Ciaramitaro G, Boggian G, Zennaro M, Sassone B, Malacrida M, Zanon F. P6425Performance of sudden cardiac death risk score at the time of device replacement for patients with hypertrophic cardiomyopathy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Biffi M, Francia P, De Filippo P, Bongiorni M, D'Onofrio A, Nigro G, Adduci C, Frisoni J, Ferrari P, Viani S, Bianchi V, Campari M, Ammendola E. P6389S-ICD eligibility according to a novel automated screening tool and agreement with the standard manual ECG morphology tool: a preliminary multicenter experience. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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132
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Guerra F, Palmisano P, Ammendola E, Ziacchi M, Pisano E, Dell'era G, Aspromonte V, Zaccaria M, Capucci A, Nigro G, Boriani G, Milanese G, Occhetta E, Maglia G, Accogli M. P4255Physical activity measured by cardiac implanted devices predicts atrial fibrillation and patient outcomes. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Guerra F, Palmisano P, Dell'era G, Ziacchi M, Ammendola E, Pongetti G, Bonelli P, Patani F, Devecchi C, Accogli M, Occhetta E, Nigro G, Biffi M, Boriani G, Capucci A. P5479Cardiac resynchronization therapy reduces electrical storm incidence over a 3-year follow-up. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Guerra F, Palmisano P, Dell’Era G, Ziacchi M, Ammendola E, Pongetti G, Bonelli P, Patani F, Devecchi C, Accogli M, Occhetta E, Nigro G, Biffi M, Boriani G, Capucci A. Cardiac resynchronization therapy and electrical storm: results of the OBSERVational registry on long-term outcome of ICD patients (OBSERVO-ICD). Europace 2017; 20:979-985. [DOI: 10.1093/europace/eux166] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 04/24/2017] [Indexed: 11/14/2022] Open
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De Filippo P, D'onofrio A, Capucci A, Bongiorni MG, Nigro G, Vado A, Ferrari P, Bianchi V, Luzi M, Viani S, Rago A, Menardi E, Lucciola MT, Lovecchio M, Giammaria M. P1633Ease of use and acceptance of remote monitoring of subcutaneous implantable cardioverter defibrillators. Europace 2017. [DOI: 10.1093/ehjci/eux158.259] [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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Russo V, Papa AA, Rago A, Nigro G. Arrhythmic risk evaluation in myotonic dystrophy: the importance of selection criteria and methodological approach. Clin Auton Res 2017; 27:203-204. [PMID: 28451779 DOI: 10.1007/s10286-017-0421-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 04/18/2017] [Indexed: 11/24/2022]
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137
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Biffi M, Vado A, Nigro G, Narducci ML, Ammendola E, Zingarini G, Calzolari V, Calo' L, Tomasi C, Ciaramitaro G, Boggian G, Zennaro M, Sassone B, Malacrida M, Zanon F. P1476Performance of sudden cardiac death risk score at the time of device replacement for patients with hypertrophic cardiomyopathy. Europace 2017. [DOI: 10.1093/ehjci/eux158.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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138
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Francia P, Biffi M, De Filippo P, Bongiorni MG, D'onofrio A, Nigro G, Adducci C, Frisoni J, Ferrari P, Viani S, Bianchi V, Campari M, Ammendola E. P963S-ICD eligibility according to a novel automated screening tool and agreement with the standard manual ECG morphology tool: a preliminary multicenter experience. Europace 2017. [DOI: 10.1093/ehjci/eux151.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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139
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De Filippo P, D'onofrio A, Capucci A, Bongiorni MG, Giammaria M, Nigro G, Ferrari P, Bianchi V, Luzi M, Viani S, Lucciola MT, Rago A, Lovecchio M, Arupi M, Vado A. P961Changes in subcutaneous ECG detected by S-ICD over mid-term follow-up. Europace 2017. [DOI: 10.1093/ehjci/eux151.143] [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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Russo V, Nigro G, Politano L. Role of electrophysiological evaluation for the best device choice to prevent sudden cardiac death in patients with Myotonic Dystrophy Type 1 and Emery Dreifuss Muscular Dystrophy. Trends Cardiovasc Med 2017; 31:e1-e2. [PMID: 28237579 DOI: 10.1016/j.tcm.2017.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 02/01/2017] [Indexed: 11/28/2022]
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Durante-Mangoni E, Parrella A, Vitrone M, Rago A, Pafundi PC, Nigro G, Utili R, Russo V. Electrophysiological Adverse Effects of Direct Acting Antivirals in Patients With Chronic Hepatitis C. J Clin Pharmacol 2017; 57:924-930. [PMID: 28117887 DOI: 10.1002/jcph.872] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 12/12/2016] [Indexed: 11/05/2022]
Abstract
Recently, several cases of symptomatic, sometimes fatal bradycardia during the first days of direct-acting antiviral (DAA) (eg, sofosbuvir [SOF]) administration have been reported. We analyzed in detail electrocardiographic (ECG) changes during SOF- or non-SOF-based chronic hepatitis C (CHC) treatment, specifically focusing on bradyarrhythmias. All 39 consecutive patients treated at our center with any interferon-free regimen between June and December 2015 were included in this study (26 SOF-based therapy vs 13 no-SOF interferon-free regimens). ECG tracings were obtained from all patients the first day of treatment and after 7, 14, and 28 days. ECG parameters (P-wave, QRS, QT interval, JT interval, Tapex -Tend interval duration) were compared between the 2 groups at baseline and at the 3 different time points during antiviral therapy. There were no cases of symptomatic bradycardia/syncope. In the SOF group, QTc duration rose after 1 week (from 424.3 to 431.2 milliseconds; P = .013) and returned to baseline during therapy. QT dispersion dropped since week 1 (from 85.6 to 67.2 milliseconds) and remained significantly reduced until the end of the observation period (72.9 msec) (P = .003). JT dispersion reduced up to week 2 (P = .010) and returned to baseline at week 4; in the no-SOF group, QRS dispersion transiently reduced (from 41 to 34.5 milliseconds, day 7). No other significant changes were observed in the remaining parameters. In CHC patients treated with SOF and other DAAs, ECG parameter changes were mild and/or transient and did not translate into clinically significant electrophysiological effects in the absence of amiodarone coadministration.
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Russo V, Papa AA, Rago A, Nigro G. Atrial fibrillation in beta thalassemia major: how to perform effective screening and early detection. Hematology 2017; 22:368-369. [PMID: 28084158 DOI: 10.1080/10245332.2016.1277648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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143
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Muto C, Calvi V, Botto GL, Pecora D, Zuccaro LM, Costa A, Ciaramitaro G, Airò Farulla R, Nigro G, Tuccillo B, Racheli M, Lilli A, Reggiani A, Malacrida M, Valsecchi S, Maglia G. Right ventricular lead placement and ventricular dyssynchrony in a pacemaker population: An acute analysis from the evaluation of apical and non-apical position (right pace) study. Int J Cardiol 2016; 225:296-299. [DOI: 10.1016/j.ijcard.2016.09.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 09/27/2016] [Accepted: 09/29/2016] [Indexed: 10/20/2022]
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Palladino A, D'Ambrosio P, Papa AA, Petillo R, Orsini C, Scutifero M, Nigro G, Politano L. Management of cardiac involvement in muscular dystrophies: paediatric versus adult forms. ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2016; 35:128-134. [PMID: 28484313 PMCID: PMC5416740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Muscular dystrophies are a group of genetic disorders characterized by muscle degeneration and consequent substitution by fat and fibrous tissue. Cardiac involvement is an almost constant feature in a great part of these diseases, as both primary myocardial involvement and secondary involvement due to respiratory insufficiency, pulmonary hypertension or reduced mobility. Primary myocardial involvement usually begins more precociously compared to the secondary involvement. In fact the first signs of cardiomyopathy can be observed in the first decade of life in muscular dystrophies with childhood onset and later in adult form of muscular dystrophies as myotonic dystrophy type 1. At least an annual cardiac follow-up is recommended in these patients including clinical and instrumental examination (ECG, 24h Holter monitoring, ECHO), to detect cardiac involvement. A more frequent monitoring may be required according to the type of cardiomyopathy and the patient's needs. In this short review practical guide-lines are shown for physicians routinely involved in the management of these patients.
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Rago A, Russo V, Papa AA, Ciardiello C, Pannone B, Mayer MC, Cimmino G, Nigro G. The role of the atrial electromechanical delay in predicting atrial fibrillation in beta-thalassemia major patients. J Interv Card Electrophysiol 2016; 48:147-157. [PMID: 27878421 DOI: 10.1007/s10840-016-0201-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 10/11/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Paroxysmal atrial tachyarrhythmias frequently occur in beta-thalassemia major (β-TM) patients. The aim of the current study was to evaluate the atrial electromechanical delay (AEMD) in a large β-TM population with normal cardiac function and its relationship to atrial fibrillation (AF) onset. METHODS Eighty β-TM patients (44 men, 36 women), with a mean age of 36.2 ± 11.1 years, and 80 healthy subjects used as controls, matched for age and gender, were studied for the occurrence of AF during a 5-year follow-up, through 30-day external loop recorder (ELR) monitoring performed every 6 months. Intra-AEMD and inter-AEMD of both atria were measured through tissue Doppler echocardiography. P-wave dispersion (PD) was carefully measured using 12-lead electrocardiogram (ECG). RESULTS Compared to the healthy control group, the β-TM patients showed a statistically significant increase in inter-AEMD, intra-left AEMD, maximum P-wave duration, and PD. Dividing the β-TM group into two subgroups (patients with or without AF), the inter-AEMD, intra-left AEMD, maximum P-wave duration, and PD were significantly higher in the subgroup with AF compared to the subgroup without AF. There were significant good correlations of intra-left AEMD and inter-AEMD with PD. A cut-off value of 40.1 ms for intra-left AEMD had a sensitivity of 76.2% and a specificity of 97.5% in identifying β-TM patients with AF risk. A cut-off value of 44.8 ms for inter-AEMD had a sensitivity of 81.2% and a specificity of 98.7% in identifying this category of patients. CONCLUSIONS Our results showed that the echocardiographic atrial electromechanical delay indices (intra-left and inter-AEMD) and the PD were significantly increased in β-TM subjects with normal cardiac function. PD and AEMD represent non-invasive, inexpensive, useful, and simple parameters to assess the AF risk in β-TM patients.
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Russo V, Rago A, Di Meo F, Papa AA, Nigro G. Letter to the Editor - Arrhythmic risk evaluation in familial mediterranean fever: the role of electrocardiographic and echocardiographic parameters. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2016; 20:4623-4625. [PMID: 27906444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Russo V, Rago A, Proietti R, Di Meo F, Antonio Papa A, Calabrò P, D'Onofrio A, Nigro G, AlTurki A. Efficacy and safety of the target-specific oral anticoagulants for stroke prevention in atrial fibrillation: the real-life evidence. Ther Adv Drug Saf 2016; 8:67-75. [PMID: 28255434 DOI: 10.1177/2042098616673990] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of our article is to provide a concise review for clinicians entailing the main studies that evaluated the efficacy and safety of target-specific oral anticoagulants (TSOAs) for thromboembolic stroke prevention in the real-world setting. Atrial fibrillation (AF) is one of the most common supraventricular arrhythmias that requires anticoagulation therapy to prevent stroke and systemic embolism. TSOAs, dabigatran, apixaban and rivaroxaban have become available as an alternative to warfarin anticoagulation in nonvalvular atrial fibrillation (NVAF). Randomized clinical trials showed non-inferior or superior results in efficacy and safety of the TSOAs compared with warfarin for stroke prevention in NVAF patients. For this reason, the 2012 update to the European Society of Cardiology guidelines for the management of AF recommends TSOAs as broadly preferable to vitamin K antagonists (VKAs) in the vast majority of patients with NVAF [Camm et al. 2012]. Although the clinical trial results and the guideline's indications, there is a need for safety and efficacy data from unselected patients in everyday clinical practice. Recently, a large number of studies testing the efficacy and the safety of TSOAs in clinical practice have been published. The aim of our article is to provide a concise review for clinicians, outlining the main studies that evaluated the efficacy and safety of TSOAs for thromboembolic stroke prevention in the real-world setting.
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Russo V, Papa AA, Rago A, D'Ambrosio P, Cimmino G, Palladino A, Politano L, Nigro G. Increased heterogeneity of ventricular repolarization in myotonic dystrophy type 1 population. ACTA MYOLOGICA : MYOPATHIES AND CARDIOMYOPATHIES : OFFICIAL JOURNAL OF THE MEDITERRANEAN SOCIETY OF MYOLOGY 2016; 35:100-106. [PMID: 28344440 PMCID: PMC5343740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Sudden cardiac death in myotonic dystrophy type I (DM1) patients can be attributed to atrioventricular blocks as far as to the development of life-threatening arrhythmias which occur even in hearts with normal left ventricular systolic and diastolic function. Heterogeneity of ventricular repolarization is considered to provide an electrophysiological substrate for malignant arrhythmias. QTc dispersion (QTc-D), JTc dispersion (JTc-D) and transmural dispersion of repolarization (TDR) could reflect the physiological variability of regional and transmural ventricular repolarization. Aim of the present study was to investigate the heterogeneity of ventricular repolarization in patients with DM1 and preserved diastolic and systolic cardiac function. The study enrolled 50 DM1 patients (mean age 44 ± 5 years; M:F: 29:21) with preserved systolic and diastolic function of left ventricle among 247 DM1 patients followed at Cardiomyology and Medical Genetics of Second University of Naples, and 50 sexand age-matched healthy controls. The electrocardiographic parameters investigated were the following: Heart Rate, QRS duration, maximum and minimum QT and JT intervals, QTc- D, JTc-D and TDR. Compared to the controls, the DM1 group presented increased values of QTc-D (86.7 ± 40.1 vs 52.3 ± 11.9 ms; p = 0.03), JTc-D (78.6 ± 31.3 vs 61.3 ± 10.2 ms; p = 0.001) and TDR (101.6 ± 18.06 vs 90.1 ± 14.3 ms; p = 0.004) suggesting a significant increase in regional and transmural heterogeneity of the ventricular repolarization in these patients, despite a preserved systolic and diastolic cardiac function.
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Galli I, Nigro G. Relationship between Machiavellianism and External Control among Italian Undergraduates. Psychol Rep 2016. [DOI: 10.2466/pr0.1983.53.3f.1081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
148 Italian undergraduates (62 men and 86 women) responded to the Italian version of the Christie's Mach IV scale and to the Italian version of the Rotter's Internal-External (I-E) Control scale. The positive correlation between Machiavellianism and external locus of control of .40 was significant for men as well as for women. The results confirm previous findings that more external individuals tend to agree with Machiavellian positions than do internal persons. The implications of the findings were discussed.
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Russo V, Rago A, Papa AA, Nigro G. Electrocardiographic Presentation, Cardiac Arrhythmias, and Their Management in β-Thalassemia Major Patients. Ann Noninvasive Electrocardiol 2016; 21:335-42. [PMID: 27324981 DOI: 10.1111/anec.12389] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Beta-thalassemia major (β-TM) is a genetic hemoglobin disorder characterized by an absent synthesis of globin chains that are essential for hemoglobin formation, causing chronic hemolytic anemia. Clinical management of thalassemia major consists in regular long-life red blood cell transfusions and iron chelation therapy to remove iron introduced in excess with transfusions. Iron deposition in combination with inflammatory and immunogenic factors is involved in the pathophysiology of cardiac dysfunction in these patients. Heart failure and arrhythmias, caused by myocardial siderosis, are the most important life-limiting complications of iron overload in beta-thalassemia patients. Cardiac complications are responsible for 71% of global death in the beta-thalassemia major patients. The aim of this review was to describe the most frequent electrocardiographic abnormalities and arrhythmias observed in β-TM patients, analyzing their prognostic impact and current treatment strategies.
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