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Piepoli MF, Corrà U, Veglia F, Bonomi A, Salvioni E, Cattadori G, Metra M, Lombardi C, Sinagra G, Limongelli G, Raimondo R, Re F, Magrì D, Belardinelli R, Parati G, Minà C, Scardovi AB, Guazzi M, Cicoira M, Scrutinio D, Di Lenarda A, Bussotti M, Frigerio M, Correale M, Villani GQ, Paolillo S, Passino C, Agostoni P. Exercise tolerance can explain the obesity paradox in patients with systolic heart failure: data from the MECKI Score Research Group. Eur J Heart Fail 2016; 18:545-53. [DOI: 10.1002/ejhf.534] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 01/08/2016] [Accepted: 01/09/2016] [Indexed: 11/12/2022] Open
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Ammirati E, Contri R, Coppini R, Cecchi F, Frigerio M, Olivotto I. Pharmacological treatment of hypertrophic cardiomyopathy: current practice and novel perspectives. Eur J Heart Fail 2016; 18:1106-18. [DOI: 10.1002/ejhf.541] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 02/07/2016] [Accepted: 03/10/2016] [Indexed: 12/20/2022] Open
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128
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Scrutinio D, Passantino A, Guida P, Ammirati E, Oliva F, Lagioia R, Sarzi Braga S, Agostoni P, Frigerio M. Incremental utility of prognostic variables at discharge for risk prediction in hospitalized patients with acutely decompensated chronic heart failure. Heart Lung 2016; 45:212-9. [PMID: 27066878 DOI: 10.1016/j.hrtlng.2016.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/08/2016] [Accepted: 03/08/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the incremental prognostic utility of discharge serum creatinine (SCr), systolic blood pressure (SBP), and NT-proBNP and sodium concentrations in hospitalized patients with acutely decompensated chronic heart failure. BACKGROUND Whether key prognostic variables at discharge provide incremental prognostic information beyond that provided by a model based on admission variables (referent) remains incompletely defined. METHODS The primary outcome was a composite of death, urgent heart transplantation, or ventricular assist device implantation at 1 year. The gain in predictive performance was assessed using C index, Bayesian Information Criterion, and Net Reclassification Improvement. RESULTS The best fit was obtained when discharge NT-proBNP was added to the referent model. No interaction between admission and discharge NT-proBNP was found. Discharge SCr, SBP, and sodium did not improve goodness-of-fit. CONCLUSIONS Admission and discharge NT-proBNP provide complementary and independent prognostic information; as such, they should be taken into account concurrently.
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Frigerio M. [Will big data satisfy the unmet needs of clinical research?]. GIORNALE ITALIANO DI CARDIOLOGIA (2006) 2016; 17:186-8. [PMID: 27029876 DOI: 10.1714/2190.23658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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130
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Gelosa S, Parisoli F, Lattuada P, Frigerio M, Berlusconi C, Ostinelli A. Impact of the MLC delivery errors on patient dose for IMRT treatments: A comparison between planned DVH and reconstructed DVH based on MLC log file (DynaLog). Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.092] [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: 10/22/2022] Open
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131
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Duchini M, Frigerio M, Berlusconi C, Gelosa S, Lattuada P, Prest M, Vallazza E, Guallini F, Ostinelli A. The neutron contamination in radiotherapy treatments with photon and electron beams: Dy activation measurements. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.01.073] [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: 10/22/2022] Open
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132
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Colombo G, Tobaldini E, Del Medico M, Angaroni L, Bulgheroni M, Frigerio M, Montano N. Cardiovascular autonomic control in patients with left ventricular assistance continous flow devices. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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133
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Paolillo S, Agostoni P, Masarone D, Corrà U, Passino C, Scrutinio D, Correale M, Cattadori G, Metra M, Girola D, Piepoli MF, Salvioni E, Giovannardi M, Iorio A, Emdin M, Raimondo R, Re F, Cicoira M, Belardinelli R, Guazzi M, Clemenza F, Parati G, Scardovi AB, Di Lenarda A, La Gioia R, Frigerio M, Lombardi C, Gargiulo P, Sinagra G, Pacileo G, Perrone-Filardi P, Limongelli G. Prognostic role of atrial fibrillation in patients affected by chronic heart failure. Data from the MECKI score research group. Eur J Intern Med 2015; 26:515-20. [PMID: 26026698 DOI: 10.1016/j.ejim.2015.04.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 04/22/2015] [Accepted: 04/27/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) is common in heart failure (HF). It is unclear whether AF has an independent prognostic role in HF. The aim of the present study was to assess the prognostic role of AF in HF patients with reduced ejection fraction (EF). METHODS HF patients were followed in 17 centers for 3.15years (1.51-5.24). Study endpoints were the composite of cardiovascular (CV) death and heart transplant (HTX) and all-cause death. Data analysis was performed considering the entire population and a 1 to 1 match between sinus rhythm (SR) and AF patients. Match process was done for age±5, gender, left ventricle EF±5, peakVO2±3 (ml/min/kg) and recruiting center. RESULTS A total of 3447 patients (SR=2882, AF=565) were included in the study. Considering the entire population, CV death and HTX occurred in 114 (20%) AF vs. 471 (16%) SR (p=0.026) and all-cause death in 130 (23%) AF vs. 554 (19.2%) SR patients (p=0.039). At univariable Cox analysis, AF was significantly related to prognosis. Applying a multivariable model based on all variables significant at univariable analysis (EF, peakVO2, ventilation/carbon dioxide relationship slope, sodium, kidney function, hemoglobin, beta-blockers and digoxin) AF was no longer associated with adverse outcomes. Matching procedure resulted in 338 couples. CV death and HTX occurred in 63 (18.6%) AF vs. 74 (21.9%) SR (p=0.293) and all-cause death in 71 (21%) AF vs. 80 (23.6%) SR (p=0.406), with no survival differences between groups. CONCLUSION In systolic HF AF is a marker of disease severity but not an independent prognostic indicator.
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Piselli P, Busnach G, Citterio F, Frigerio M, Arbustini E, Burra P, Pinna AD, Bresadola V, Ettorre GM, Baccarani U, Buda A, Lauro A, Zanus G, Cimaglia C, Spagnoletti G, Lenardon A, Agozzino M, Gambato M, Zanfi C, Miglioresi L, Di Gioia P, Mei L, Ippolito G, Serraino D. Risk of Kaposi sarcoma after solid-organ transplantation: multicenter study in 4,767 recipients in Italy, 1970-2006. Transplant Proc 2015; 41:1227-30. [PMID: 19460525 DOI: 10.1016/j.transproceed.2009.03.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Given the high prevalence of infection with human herpesvirus type 8, Italy is an area of utmost interest for studying Kaposi sarcoma (KS). We investigated the risk of KS in transplant recipients compared with the general population. A longitudinal study was performed from 1970 to 2006 in 4767 kidney, heart, liver, and lung transplant recipients from 7 Italian transplantation centers. The sample included 72.3% male patients with an overall patient median age of 48 years. Patient-years (PYs) at risk for KS were computed from 30 days posttransplantation to the date of KS, death, last follow-up, or study closure (December 31, 2007). Standardized incidence ratios (SIRs) and 95% confidence intervals were computed to quantify the risk of KS in transplant recipients compared with the general Italian population. Incidence rate ratios were computed to identify risk factors using adjusted Poisson regression. Based on 33,621 PYs, KS was diagnosed in 73 patients (62 men): 31 in kidney recipients, 27 in heart recipients, 8 in liver recipients, and 7 in lung recipients. The overall incidence was 217 cases per 10(5) PYs, with a significantly increased SIR of 125. SIR was particularly high in women (n = 34) and lung recipients (n = 428) but decreased significantly with time posttransplantation. The primary predictors of increased risk of KS were male sex, older age, and lung transplantation. A 5-fold reduction was observed after 18 months posttransplantation. After adjustment, patients born in southern Italy compared with northern Italy demonstrated a significant 2.2-fold increased risk. Our findings confirm that in the early posttransplantation period, Italian patients who have undergone solid-organ transplantation, particularly those from southern Italy and those who are lung recipients, are at greater risk of KS compared with the general population. These findings underscore the need for appropriate models for monitoring transplant recipients for KS, especially those at greater risk and, in particular, in the early postoperative period.
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Ammirati E, Roghi A, Oliva F, Turazza FM, Frigerio M, Pedrotti P. [Ventricular aneurysm as a complication of giant cell myocarditis]. GIORNALE ITALIANO DI CARDIOLOGIA (2006) 2015; 16:389-90. [PMID: 26156701 DOI: 10.1714/1934.21040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Ventricular aneurysm as late complication has been described in cardiac sarcoidosis and occasionally in giant cell myocarditis. The images from the present case of ventricular aneurysm formation as a late complication of giant cell myocarditis underline a potential cause of sudden arrhythmic death in patients who survive this life-threatening condition in the absence of recurrent inflammation and with preserved left ventricular ejection fraction. Follow-up with cardiac magnetic resonance can detect small aneurysms, and an implantable cardioverter-defibrillator may be considered when this complication occurs.
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Pedrotti P, Bonacina E, Vittori C, Frigerio M, Roghi A. Pathologic correlates of late gadolinium enhancement cardiovascular magnetic resonance in a heart transplant patient. Cardiovasc Pathol 2015; 24:247-9. [DOI: 10.1016/j.carpath.2015.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 02/01/2015] [Accepted: 02/04/2015] [Indexed: 11/26/2022] Open
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137
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Ammirati E, Stucchi M, Brambatti M, Spanò F, Bonacina E, Recalcati F, Cerea G, Vanzulli A, Frigerio M, Oliva F. Eosinophilic myocarditis: a paraneoplastic event. Lancet 2015; 385:2546. [PMID: 26122067 DOI: 10.1016/s0140-6736(15)60903-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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138
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Frigerio M. [The heart of Nicholas Green - why transplant matters]. GIORNALE ITALIANO DI CARDIOLOGIA (2006) 2015; 16:323-4. [PMID: 25994472 DOI: 10.1714/1870.20444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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139
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Frigerio M, Bonfanti P, Ostinelli A. EP-1555: A pre-treatment verification method for intensitymodulated photon beams using VERO machine EPID. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41547-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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140
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De Simone V, Cipriani M, Verde A, Garascia A, Turazza F, Macera F, Pacher V, Ammirati E, Milazzo F, Paino R, Russo C, Colombo T, Taglieri C, Martinelli L, Frigerio M. Right Ventricular Failure After Left Ventricular Assist Device Implantation: The Importance of Preoperative Hemodynamic Profile. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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141
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Ammirati E, Lilliu M, Cipriani M, Garascia A, Brambatti M, Turazza F, Nonnini S, Paino R, Russo C, Oliva F, Frigerio M. Mid-Term Outcome of Acute Fulminant Myocarditis Presenting With Cardiogenic Shock: A Single Centre Experience. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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142
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Gavazzi A, De Maria R, Manzoli L, Bocconcelli P, Di Leonardo A, Frigerio M, Gasparini S, Humar F, Perna G, Pozzi R, Svanoni F, Ugolini M, Deales A. Palliative needs for heart failure or chronic obstructive pulmonary disease: Results of a multicenter observational registry. Int J Cardiol 2015; 184:552-558. [DOI: 10.1016/j.ijcard.2015.03.056] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 01/26/2015] [Accepted: 03/03/2015] [Indexed: 01/07/2023]
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143
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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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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144
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Scrutinio D, Ammirati E, Passantino A, Guida P, D'Angelo L, Oliva F, Ciccone MM, Iacoviello M, Dentamaro I, Santoro D, Lagioia R, Sarzi Braga S, Guzzetti D, Frigerio M. Predicting short-term mortality in advanced decompensated heart failure - role of the updated acute decompensated heart failure/N-terminal pro-B-type natriuretic Peptide risk score. Circ J 2015; 79:1076-83. [PMID: 25753469 DOI: 10.1253/circj.cj-14-1219] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The first few months after admission are the most vulnerable period in patients with acute decompensated heart failure (ADHF). METHODS AND RESULTS We assessed the association of the updated ADHF/N-terminal pro-B-type natriuretic peptide (NT-proBNP) risk score with 90-day and in-hospital mortality in 701 patients admitted with advanced ADHF, defined as severe symptoms of worsening HF, severely depressed left ventricular ejection fraction, and the need for i.v. diuretic and/or inotropic drugs. A total of 15.7% of the patients died within 90 days of admission and 5.2% underwent ventricular assist device (VAD) implantation or urgent heart transplantation (UHT). The C-statistic of the ADHF/NT-proBNP risk score for 90-day mortality was 0.810 (95% CI: 0.769-0.852). Predicted and observed mortality rates were in close agreement. When the composite outcome of death/VAD/UHT at 90 days was considered, the C-statistic decreased to 0.741. During hospitalization, 7.6% of the patients died. The C-statistic for in-hospital mortality was 0.815 (95% CI: 0.761-0.868) and Hosmer-Lemeshow χ(2)=3.71 (P=0.716). The updated ADHF/NT-proBNP risk score outperformed the Acute Decompensated Heart Failure National Registry, the Organized Program to Initiate Lifesaving Treatment in Patients Hospitalized for Heart Failure, and the American Heart Association Get with the Guidelines Program predictive models. CONCLUSIONS Updated ADHF/NT-proBNP risk score is a valuable tool for predicting short-term mortality in severe ADHF, outperforming existing inpatient predictive models.
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Scrutinio D, Agostoni P, Gesualdo L, Corrà U, Mezzani A, Piepoli M, Di Lenarda A, Iorio A, Passino C, Magrì D, Masarone D, Battaia E, Girola D, Re F, Cattadori G, Parati G, Sinagra G, Villani GQ, Limongelli G, Pacileo G, Guazzi M, Metra M, Frigerio M, Cicoira M, Minà C, Malfatto G, Caravita S, Bussotti M, Salvioni E, Veglia F, Correale M, Scardovi AB, Emdin M, Giannuzzi P, Gargiulo P, Giovannardi M, Perrone-Filardi P, Raimondo R, Ricci R, Paolillo S, Farina S, Belardinelli R, Passantino A, La Gioia R. Renal Function and Peak Exercise Oxygen Consumption in Chronic Heart Failure With Reduced Left Ventricular Ejection Fraction. Circ J 2015; 79:583-91. [DOI: 10.1253/circj.cj-14-0806] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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146
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Frigerio M, De Maria R. [Prognostication in heart failure]. GIORNALE ITALIANO DI CARDIOLOGIA (2006) 2015; 16:31-33. [PMID: 25689749 DOI: 10.1714/1776.19246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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147
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Caruso R, Caselli C, Cozzi L, Campolo J, Viglione F, Parolini M, Nonini S, Trunfio S, D'Amico A, Pelosi G, Giannessi D, Marraccini P, Frigerio M, Parodi O. Myocardial interleukin-6 in the setting of left ventricular mechanical assistance: relation with outcome and C-reactive protein. Clin Chem Lab Med 2014; 53:1359-66. [PMID: 25411996 DOI: 10.1515/cclm-2014-0633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 10/13/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND In left ventricular assist device (LVAD) recipients, plasma levels of interleukin (IL)-6 are associated with Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profiles, reflecting post-operative risk. However, it is not clear how the cardiac level of IL-6, detectable on the tissue samples at the time of implantation, can contribute to predict the post-operative outcome. METHODS In 40 LVAD recipients, blood and myocardial samples from LV-apex were collected at the time of implantation to assess plasma and cardiac IL-6 levels. Serum C-reactive protein (CRP) levels were considered as inflammatory variable routinely used in LVAD-based therapy. RESULTS Cardiac IL-6 levels did not correlate with either plasma IL-6 levels (R=0.296, p=0.063) and tissue IL-6 mRNA expression (R=-0.013, p=0.954). Contrary to what happened for the plasma IL-6 and CRP, no differences were observed in cardiac IL-6 levels with respect to INTERMACS profiles (p=0.090). Furthermore, cardiac IL-6 concentrations, unlike IL-6 and CRP circulating levels, were not correlated with the length of intensive care unit stay and hospitalization. CONCLUSIONS Cardiac IL-6 levels do not contribute to improve risk profile of LVAD recipients in relation to clinical inpatient post-implantation. Instead, plasma IL-6 and serum CRP concentrations are more effective in predicting the severity of the clinical course in the early phase of LVAD therapy.
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Ammirati E, Cipriani M, De Chiara B, D'Angelo L, Belli O, Moreo A, Oliva F, Martinelli L, Frigerio M. Left ventricular or Bi-ventricular assist device? How dobutamine stress echocardiography can untie the dilemma of right ventricular dysfunction. Int J Cardiol 2014; 177:e6-8. [PMID: 25125006 DOI: 10.1016/j.ijcard.2014.07.194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 07/27/2014] [Indexed: 10/24/2022]
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149
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Biselli M, Conti F, Gramenzi A, Frigerio M, Cucchetti A, Fatti G, D'Angelo M, Dall'Agata M, Giannini EG, Farinati F, Ciccarese F, Andreone P, Bernardi M, Trevisani F. A new approach to the use of α-fetoprotein as surveillance test for hepatocellular carcinoma in patients with cirrhosis. Br J Cancer 2014; 112:69-76. [PMID: 25314061 PMCID: PMC4453600 DOI: 10.1038/bjc.2014.536] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 07/25/2014] [Accepted: 09/15/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Surveillance for hepatocellular carcinoma (HCC) is recommended in patients with cirrhosis. As α-fetoprotein (AFP) is considered a poor surveillance test, we tested the performance of its changes over time. METHODS Eighty patients were diagnosed with HCC (cases) during semiannual surveillance with ultrasonography and AFP measurement were recruited and matched for age, gender, etiology and Child-Pugh class with 160 contemporary cancer-free controls undergoing the same surveillance training group (TG). As a validation group (VG) we considered 36 subsequent patients diagnosed with HCC, matched 1 : 3 with contemporary cancer-free controls. α-Fetoprotein values at the time of HCC diagnosis (T0) and its changes over the 12 (Δ12) and 6 months (Δ6) before cancer detection were considered. RESULTS In both TG and VG, >80% of HCCs were found at an early stage. In TG, AFP significantly increased over time only in cases. T0 AFP and a positive Δ6 were independently associated with HCC diagnosis (odds ratio: 1.031 and 2.402, respectively). The area under the curve of T0 AFP was 0.76 and its best cutoff (BC) was 10 ng ml(-1) (sensitivity 66.3%, specificity 80.6%). The combination of AFP >10 ng ml(-1) or a positive Δ6 composite α-fetoprotein index (CAI) increased the sensitivity to 80% with a negative predictive value (NPV) of 86.2%. Negative predictive value rose to 99%, considering a cancer prevalence of 3%. In the VG, the AFP-BC was again 10 ng ml(-1) (sensitivity 66.7%, specificity 88.9%), and CAI sensitivity was 80.6% with a NPV value of 90.5%. CONCLUSIONS CAI achieves adequate sensitivity and NPV as a surveillance test for the early detection of HCC in cirrhosis.
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Magrì D, Agostoni P, Corrà U, Passino C, Scrutinio D, Perrone-Filardi P, Correale M, Cattadori G, Metra M, Girola D, Piepoli MF, Iorio A, Emdin M, Raimondo R, Re F, Cicoira M, Belardinelli R, Guazzi M, Limongelli G, Clemenza F, Parati G, Frigerio M, Casenghi M, Scardovi AB, Ferraironi A, Di Lenarda A, Bussotti M, Apostolo A, Paolillo S, La Gioia R, Gargiulo P, Palermo P, Minà C, Farina S, Battaia E, Maruotti A, Pacileo G, Contini M, Oliva F, Ricci R, Sinagra G. Deceptive meaning of oxygen uptake measured at the anaerobic threshold in patients with systolic heart failure and atrial fibrillation. Eur J Prev Cardiol 2014; 22:1046-55. [DOI: 10.1177/2047487314551546] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 08/26/2014] [Indexed: 01/23/2023]
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