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Aversa T, De Sanctis L, Faienza MF, Gambineri A, Balducci A, D'Aprile R, Di Somma C, Giavoli C, Grossi A, Meriggiola MC, Profka E, Salerno M, Stagi S, Scarano E, Zatelli MC, Wasniewska M. Transition from pediatric to adult care in patients with Turner syndrome in Italy: a consensus statement by the TRAMITI project. J Endocrinol Invest 2024:10.1007/s40618-024-02315-4. [PMID: 38376731 DOI: 10.1007/s40618-024-02315-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/11/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE Transition from pediatric to adult care is associated with significant challenges in patients with Turner syndrome (TS). The objective of the TRansition Age Management In Turner syndrome in Italy (TRAMITI) project was to improve the care provided to patients with TS by harnessing the knowledge and expertise of various Italian centers through a Delphi-like consensus process. METHODS A panel of 15 physicians and 1 psychologist discussed 4 key domains: transition and referral, sexual and bone health and oncological risks, social and psychological aspects and systemic and metabolic disorders. RESULTS A total of 41 consensus statements were drafted. The transition from pediatric to adult care is a critical period for patients with TS, necessitating tailored approaches and early disclosure of the diagnosis to promote self-reliance and healthcare autonomy. Fertility preservation and bone health strategies are recommended to mitigate long-term complications, and psychiatric evaluations are recommended to address the increased prevalence of anxiety and depression. The consensus also addresses the heightened risk of metabolic, cardiovascular and autoimmune disorders in patients with TS; regular screenings and interventions are advised to manage these conditions effectively. In addition, cardiac abnormalities, including aortic dissections, require regular monitoring and early surgical intervention if certain criteria are met. CONCLUSIONS The TRAMITI consensus statement provides valuable insights and evidence-based recommendations to guide healthcare practitioners in delivering comprehensive and patient-centered care for patients with TS. By addressing the complex medical and psychosocial aspects of the condition, this consensus aims to enhance TS management and improve the overall well-being and long-term outcomes of these individuals.
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Affiliation(s)
- T Aversa
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
- Pediatric Unit, University Hospital "G. Martino", Via Consolare Valeria N. 1, 98124, Messina, Italy
| | - L De Sanctis
- Pediatric Endocrinology, Regina Margherita Children Hospital, Turin, Italy
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - M F Faienza
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", 70124, Bari, Italy
| | - A Gambineri
- Division of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy
| | - A Balducci
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio - Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero - Universitaria Di Bologna, Bologna, Italy
| | - R D'Aprile
- Department of Women's and Children's Health, University of Padua, Padua, Italy
- A.Fa.D.O.C. Association OdV, Vicenza, Italy
| | - C Di Somma
- Unit of Endocrinology, AOU Federico II, Naples, Italy
| | - C Giavoli
- Endocrinology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Grossi
- Endocrine Pathology of Chronic and Post-Tumor Diseases Unit, "Bambino Gesù" Pediatric Hospital, Rome, Italy
| | - M C Meriggiola
- Division of Gynecology and Physiopathology of Reproduction, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy
| | - E Profka
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Salerno
- Pediatric Section, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - S Stagi
- Health Sciences Department, University of Florence, Florence, Italy
- Meyer Children's Hospital IRCCS, Florence, Italy
| | - E Scarano
- Pediatric Unit, IRCCS Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy
| | - M C Zatelli
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - M Wasniewska
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.
- Pediatric Unit, University Hospital "G. Martino", Via Consolare Valeria N. 1, 98124, Messina, Italy.
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Franceschi P, Balducci A, Nardi E, Niro F, Attinà D, Russo V, Donti A, Angeli E, Gargiulo GD, Lovato L. Predictive value of Cardiac Magnetic Resonance: new and old parameters in the natural history of repaired Tetralogy of Fallot. BMC Cardiovasc Disord 2024; 24:15. [PMID: 38172687 PMCID: PMC10765701 DOI: 10.1186/s12872-023-03671-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Patients with repaired Tetralogy of Fallot (rTOF) often develop pulmonary regurgitation (PR) and right ventricle (RV) dysfunction, experiencing increased mortality and morbidity rates in adulthood. Pulmonary valve replacement (PVR) timing to address PR is controversial. Cardiac Magnetic Resonance (CMR) is the gold standard for morpho-functional evaluation of complex cardiopathies. This study aims to identify CMR parameters predictive of adverse outcomes to help defining the best therapeutic management of rTOF patients. METHODS 130 rTOF patients who underwent CMR (2006-2019) were enrolled in this retrospective single-center study. CMR, clinical, ECG and exercise data were analyzed. Univariate and multivariate analyses identified clinical and CMR parameters predictive of adverse outcomes both individually (e.g., death, arrhythmias, heart failure (HF), pharmacological therapy, QRS ≥ 160ms) and as composite outcome. RESULTS Univariate analysis confirmed RV volumes and RV ejection fraction corrected for PR as adverse outcome predictors and identified interesting correlations: pulmonary artery bifurcation geometry and abnormal interventricular septum (IVS) motion with arrhythmias (p < .001; p = .037), HF (p = .049; p = .005), composite outcome (p = .039; p = .009); right atrium (RA) dimensions with the composite outcome and the outcomes individually (p < .001). The best predictive models by multivariate analysis included sex (male), RV and RA dilation for QRS ≥ 160ms, time form repair to CMR, age at TOF repair and IVS fibrosis for pharmacological therapy. CONCLUSIONS Besides RV volumes, new adverse prognostic factors could guide rTOF therapeutic management: pulmonary arteries morphology, abnormal IVS motion, RV dysfunction, RA dilation. Perspective multicentric evaluation is needed to specify their effective role.
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Affiliation(s)
- Paola Franceschi
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via G. Massarenti, 9, Bologna, 40138, Italy.
| | - A Balducci
- Pediatric Cardiology, Pediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero- Universitaria di Bologna, Via G. Massarenti, 9, Bologna, 40138, Italy
| | - E Nardi
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliero- Universitaria di Bologna, Via G. Massarenti, 9, Bologna, 40138, Italy
- Department of Surgical and Medical Sciences, University of Bologna, Bologna, Italy
| | - F Niro
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via G. Massarenti, 9, Bologna, 40138, Italy
| | - D Attinà
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via G. Massarenti, 9, Bologna, 40138, Italy
| | - V Russo
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via G. Massarenti, 9, Bologna, 40138, Italy
| | - A Donti
- Pediatric Cardiology, Pediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero- Universitaria di Bologna, Via G. Massarenti, 9, Bologna, 40138, Italy
| | - E Angeli
- Pediatric Cardiology, Pediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero- Universitaria di Bologna, Via G. Massarenti, 9, Bologna, 40138, Italy
| | - G D Gargiulo
- Pediatric Cardiology, Pediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero- Universitaria di Bologna, Via G. Massarenti, 9, Bologna, 40138, Italy
- Department of Surgical and Medical Sciences, University of Bologna, Bologna, Italy
| | - L Lovato
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via G. Massarenti, 9, Bologna, 40138, Italy
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Bartolacelli Y, Palleri D, Balducci A, Ragni L, Hasan T, Bonetti S, Egidy Assenza G, Mariucci ME, Fabi M, Angeli E, Gargiulo GD, Donti A. Echocardiographic score to predict neonatal surgery for aortic coarctation in newborns with prenatal suspicion and patent ductus arteriosus. J Matern Fetal Neonatal Med 2023; 36:2201654. [PMID: 37073133 DOI: 10.1080/14767058.2023.2201654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
INTRODUCTION The evaluation of upcoming Aortic Coarctation (CoA) in new-borns with prenatal suspicion entails a close echocardiographic monitor until Arterial Duct (AD) closure, in a department with pediatric cardiological and surgical expertise. The significant number of false-positive prenatal diagnoses causes parental stress and healthcare costs. AIM The aim of this study was to elaborate an echocardiographic prediction model to be employed at birth when PDA is still present, in patients suspected of CoA during fetal life in order to foretell CoA requiring neonatal surgical intervention. METHODS This retrospective monocentric study included consecutive full-term and late preterm neonates with prenatal suspicion of CoA born from 01 January 2007 to 31 December 2020. Patients were divided into two groups according to the need for aortic surgery (CoA - NoCoA). All patients underwent a comprehensive transthoracic echocardiographic exam in presence of PDA. Multivariable logistic regression was used to create a coarctation probability model (CoMOD) including isthmal (D4), transverse arch (D3) diameters, the distance between a left common carotid artery (LCA) and left subclavian artery (LSA), presence/absence of ventricular septal defect (VSD) and bicuspid aortic valve (BAV). RESULTS We enrolled 87 neonates (49 male, 56%). 44 patients developed CoA in need of surgical repair. Our index CoMOD showed an AUC = 0.9382, high sensitivity (91%) and specificity (86%) in the prediction of CoA in neonates with prenatal suspicion. We classified neonates with CoMOD > 0 to be at high risk for surgical correction of CoA, with good PPV (86.9%) and NPV (90.9%). CONCLUSIONS CoMOD > 0 is highly suggestive of the need for CoA corrective surgery in newborns with prenatal suspicion.
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Affiliation(s)
- Ylenia Bartolacelli
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Daniela Palleri
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Anna Balducci
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Luca Ragni
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Tammam Hasan
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Simone Bonetti
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Gabriele Egidy Assenza
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Maria Elisabetta Mariucci
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Marianna Fabi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Emanuela Angeli
- Pediatric Cardiac Surgery and Adult Congenital Unit, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Gaetano Domenico Gargiulo
- Pediatric Cardiac Surgery and Adult Congenital Unit, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Andrea Donti
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
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Montaguti E, Gesuete V, Perolo A, Balducci A, Fiorentini M, Donti A, Pilu G. A case of massive fetal cardiac rhabdomyoma: ultrasound features and management. J Matern Fetal Neonatal Med 2023; 36:2197099. [PMID: 37031967 DOI: 10.1080/14767058.2023.2197099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
We report the case of a massive fetal cardiac rhabdomyoma recently occurred at our clinic. A woman at 23 weeks of gestational age was referred to our center for a fetal cardiac echogenic mass of 26 mm detected at the second-trimester screening ultrasound. During pregnancy, though, the mass progressively increased its dimensions until reaching 48 mm in diameter at 37 weeks of gestation. Fetal echoencephalography and brain magnetic resonance did not show any further fetal anomalies, but molecular genetic testing at amniocentesis revealed a heterozygotic missense variant of gene TSC2 associated with Tuberous Sclerosis. The mass was therefore most likely preferable to a single large rhabdomyoma of gradually increasing dimensions. The baby was delivered at term with a cesarean section. Because of the rhabdomyoma remarkable size and newborn ECG electrical alterations, postnatal therapies with Flecainide and Everolimus were started. Everolimus treatment led to a significant and progressive reduction in the cardiac mass volume. This case, therefore, shows the efficacy of what seems to be a promising treatment in pediatric patients with large rhabdomyomas.Learning points:Rhabdomyomas may present with different features: most often they appear as multiple masses along the interventricular sept, but they may also appear as a single large thoracic mass.When a rhabdomyoma is suspected, genetic counseling is recommended.Both before and after birth, a multidisciplinary approach is useful to choose the appropriate therapy for the newborn.mTOR inhibitors therapies look like promising therapeutic approaches to stimulate the involution of rhabdomyomas.
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Affiliation(s)
- Elisa Montaguti
- Obstetric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna Italy
| | - Valentina Gesuete
- Pediatric Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna Italy
| | - Antonella Perolo
- Obstetric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna Italy
| | - Anna Balducci
- Pediatric Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna Italy
| | - Marta Fiorentini
- Obstetric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna Italy
| | - Andrea Donti
- Pediatric Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna Italy
| | - Gianluigi Pilu
- Obstetric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna Italy
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Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D’Angelo M, Da Ros S, D’Andrea F, D’Andrea A, D’Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Del Giudice C, Dell’Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Bella G, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi RM, Inserra CA, Iori E, Izzo A, La Rosa G, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Picano E, Carerj S. Stress Echocardiography in Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging. J Cardiovasc Echogr 2023; 33:125-132. [PMID: 38161775 PMCID: PMC10756319 DOI: 10.4103/jcecho.jcecho_48_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 01/03/2024] Open
Abstract
Background The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand the volumes of activity, modalities and stressors used during stress echocardiography (SE) in Italy. Methods We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved through an electronic survey based on a structured questionnaire, uploaded on the SIECVI website. Results Data were obtained from 228 echocardiographic laboratories, and SE examinations were performed in 179 centers (80.6%): 87 centers (47.5%) were in the northern regions of Italy, 33 centers (18.4%) were in the central regions, and 61 (34.1%) in the southern regions. We annotated a total of 4057 SE. We divided the SE centers into three groups, according to the numbers of SE performed: <10 SE (low-volume activity, 40 centers), between 10 and 39 SE (moderate volume activity, 102 centers) and ≥40 SE (high volume activity, 37 centers). Dipyridamole was used in 139 centers (77.6%); exercise in 120 centers (67.0%); dobutamine in 153 centers (85.4%); pacing in 37 centers (21.1%); and adenosine in 7 centers (4.0%). We found a significant difference between the stressors used and volume of activity of the centers, with a progressive increase in the prevalence of number of stressors from low to high volume activity (P = 0.033). The traditional evaluation of regional wall motion of the left ventricle was performed in all centers, with combined assessment of coronary flow velocity reserve (CFVR) in 90 centers (50.3%): there was a significant difference in the centers with different volume of SE activity: the incidence of analysis of CFVR was significantly higher in high volume centers compared to low - moderate - volume (32.5%, 41.0% and 73.0%, respectively, P < 0.001). The lung ultrasound (LUS) was assessed in 67 centers (37.4%). Furthermore for LUS, we found a significant difference in the centers with different volume of SE activity: significantly higher in high volume centers compared to low - moderate - volume (25.0%, 35.3% and 56.8%, respectively, P < 0.001). Conclusions This nationwide survey demonstrated that SE was significantly widespread and practiced throughout Italy. In addition to the traditional indication to coronary artery disease based on regional wall motion analysis, other indications are emerging with an increase in the use of LUS and CFVR, especially in high-volume centers.
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Affiliation(s)
- Quirino Ciampi
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Mauro Pepi
- Cardiology Division, Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Francesco Antonini-Canterin
- Department of Rehabilitative Cardiology, Rehabilitative Hospital High Speciality, Motta di Livenza, TV, Italy
| | - Andrea Barbieri
- Department of Biomedical, Metabolic and Neural Sciences, Cardiology Division, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Agata Barchitta
- Semi Intensive Care Department, Padova University Hospital, Padova, Italy
| | | | - Sofia Miceli
- Geriatric Division, University Hospital Renato Dulbecco, Catanzaro, Italy
| | - Vito Maurizio Parato
- Cardiology Division, Madonna del Soccorso Hospital, San Benedetto del Tronto, AP, Italy
| | - Antonio Tota
- Cardiology Division, Polyclinic Hospital, Bari, Italy
| | - Giuseppe Trocino
- Non Invasive Cardiac Imaging Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Massimiliana Abbate
- Cardiology Vanvitelli Division, AORN dei Colli, Monaldi Hospital, Napoli, Italy
| | - Maria Accadia
- Cardiology Division, Del Mare Hospital, Ponticelli, NA, Italy
| | - Rossella Alemanni
- Cardiac Surgery Division, Casa Sollievo Della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | | | | | - Maurizio Anselmi
- Cardiology Division, Fracastoro Hospital, San Bonifacio, VR, Italy
| | - Iolanda Aquila
- Cardiology Division, University Hospital Mater Domini, Catanzaro, Italy
| | - Simona Aramu
- Cardiology Division, San Martino Hospital, Oristano, Italy
| | - Enrico Avogadri
- Department of Rehabilitative Cardiology, SS Trinità Hospital, Fossano, CN, Italy
| | | | - Luigi Badano
- Department of Medicine and Surgery, University MIlano-Bicocca, Integrated Cardiovascular Diagnosi Unit, Istituto Auxologico Italiano, IRCCS, Italy
| | - Anna Balducci
- Pediatric Cardiology Division, Polyclinico S. Orsola-Malpighi IRCCS Hospital, Bologna, Italy
| | | | | | | | - Valentina Barletta
- Cardiology 2 Division, Cardiac Vascular Thoracic Department, Pisa University Hospital, Pisa, Italy
| | - Daniele Barone
- Cardiology Division, S. Andrea Hospital, La Spezia, Pisa, Italy
| | - Francesco Becherini
- Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | | | | | | | | | | | - Massimo Bolognesi
- Center for Internal Medicine and Sports Cardiology, Local Health Unit of Romagna, Cesena, FC, Italy
| | - Stefano Bongiovi
- Cardiology Division, Immacolata Concezione Civil Hospital, Piove di Sacco, PD, Italy
| | - Renato Maria Bragato
- Echocardiography and Emergency Cardiovascular Care Division, Humanitas Clinical and Research Centre, Rozzano, Italy
| | - Gabriele Braggion
- Cardiology Division, Santa Maria Regina Degli Angeli Hospital, Adria, RO, Italy
| | | | - Francesca Bursi
- Department of Health Sciences, Cardiology Division, University of Milan, San Paolo Hospital, ASST Santi Paolo e Carlo, Milano, Italy
| | | | - Matteo Cameli
- Cardiology Division, Polyclinic Le Scotte Hospital, Siena, Italy
| | - Antonella Canu
- Cardiology Division, Santissima Annunziata Hospital, Siena, Italy
| | - Mariano Capitelli
- Internal Medicine Division, Pavullo Hospital, Pavullo nel Frignano, MO, Italy
| | | | - Rosa Carbonara
- Cardiology Division, Maugeri Institute IRCCS, Bari, Italy
| | - Maria Carbone
- Emergency Medicine Division, St. Anna and St. Sebastiano Hospital, Caserta, Italy
| | - Marco Carbonella
- Cardiology Division, SS Maria Addolorata Hospital, Eboli, SA, Italy
| | - Nazario Carrabba
- Cardiology Division, Careggi University Hospital, Firenze, Italy
| | - Grazia Casavecchia
- Cardiology Division, University Hospital Ospedali Riuniti, Foggia, Italy
| | - Margherita Casula
- Cardiology Division, Nostra Signora di Bonaria Hospital, San Gavino Monreale, SU, Italy
| | - Elena Chesi
- Neonatology Division, S. Maria Nuova Hospital, Reggio Emilia, Italy
| | - Sebastiano Cicco
- Department of Precision and Regenerative Medicine and Ionian Area, Unit of Internal Medicine “G. Baccelli” and Unit of Hypertension “A.M. Pirrelli”, University of Bari Aldo Moro Medical School, AUOC Policlinico di Bari, Bari, Italy
| | - Rodolfo Citro
- Echocardiography Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | | | - Paolo Colonna
- Cardiology Division, Polyclinic Hospital, Bari, Italy
| | - Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Pietro Cortesi
- Cardioncology Division, IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori”, Meldola, FC, Italy
| | | | | | - Fabiana Cozza
- Cardiology Division, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Umberto Cucchini
- Cardiology Division, San Bassiano Hospital, Bassano Del Grappa, VI, Italy
| | - Myriam D’Angelo
- Cardiology Division, Bonino Pulejo IRCCS Hospital, Messina, Italy
| | - Santina Da Ros
- Division of Cardiology, Riuniti Padova Sud Hospital, Monselice, PD, Italy
| | | | | | - Francesca D’Auria
- Vascular - Endovascular Surgery Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Giovanni De Caridi
- Vascular Surgery Division, University Hospital Polyclinic G. Martino, University of Messina, Messina, Italy
| | - Stefania De Feo
- Cardiology Division, P Pederzoli Hospital, Peschiera del Garda, VR, Italy
| | | | - Simona De Vecchi
- Cardiology Division, Major University Hospital of Charity, Novara, Italy
| | | | - Luca Dell’Angela
- Cardiology Division, Gorizia-Monfalcone Hospital, Gorizia, Italy
| | | | - Ilaria Dentamaro
- Cardiology Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | - Paola Destefanis
- Cardiology Division, San Luigi Gonzaga University Hospital, Orbassano, Italy
| | - Gianluca Di Bella
- Cardiology Division, University Hospital Polyclinic G. Martino, University of Messina, Messina, Italy
| | | | | | | | - Angelo Di Gioia
- Cardiology Division, St. Giuliano Hospital, Giugliano in Campania, NA, Italy
| | | | | | - Concetta Di Nora
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Giovanni Di Salvo
- Pediatric Cardiology and Congenital Heart Disease Division, Padova University Hospital, Padova, Italy
| | - Claudio Dodi
- Cardiology Division, San Antonino Clinic, Piacenza, Italy
| | - Sarah Dogliani
- Cardiology Division, SS. Annunziata Civil Hospital, Savigliano, Italy
| | - Federica Donati
- Pascia Center, Polyclinic, University Hospital Modena Polyclinic, Modena, Italy
| | - Melissa Dottori
- Cardiology Division, Marche University Hospital, Ancona, Italy
| | - Giuseppe Epifani
- Internal Medicine Division, Camberlingo Hospital, Francavilla Fontana, BR, Italy
| | - Iacopo Fabiani
- Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Francesca Ferrara
- Internal Medicine Division, University Hospital Modena Polyclinic, Modena, Italy
| | - Luigi Ferrara
- Cardiology Division, Villa Dei Fiori Clinic, Acerra, Italy
| | | | - Gemma Filice
- Cardiology Division, Annunziata Hospital, Cosenza, Italy
| | - Maria Fiorino
- Cardiology Division, ARNAS Civico Hospital, Cremona, Italy
| | - Davide Forno
- Cardiology Division, Maria Vittoria Hospital, Torino, Italy
| | | | | | - Giuseppe Gigantino
- Cardiology Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Mauro Giorgi
- Cardiology Division, Molinette Hospital - Città della Salute e della Scienza, Torino, Italy
| | | | | | | | | | - Anna Holzl
- Internal Medicine Division, Quisisana Clinic, Italy
| | - Alessandra Iaiza
- Cardiac Surgery Division, San Camillo-Fornalinini Hospital, Roma, Italy
| | - Andrea Iannaccone
- Internal Medicine Division, Ordine Mauriziano Hospital, Torino, Italy
| | - Federica Ilardi
- Cardiology Division, Federico II University Hospital, Napoli, Italy
| | - Egidio Imbalzano
- Internal Medicine Division, University Hospital Polyclinic G. Martino, University of Messina, Messina, Italy
| | | | | | - Emilio Iori
- Cardiology Division, New Civil Hospital, Sassuolo, Italy
| | - Annibale Izzo
- Cardiology Division, St. Anna and St. Sebastiano Hospital, Caserta, Italy
| | | | | | | | - Laura Lanzoni
- Cardiology Division, Sacro Cuore Don Calabria IRCCS Hospital, Verona, Italy
| | | | - Elisa Leiballi
- Cardiology and Rehabilitative Division, Azienda Sanitaria Friuli Occidentale (ASFO), Health Care, Sacile (Pd), Italy
| | | | - Carmenita Lo Conte
- Cardiology Division, St. Ottone Frangipane Hospital, Ariano Irpino, AV, Italy
| | - Maria Lo Monaco
- Cardiology Division, Humanitas Gavazzeni Hospital, Bergamo, Italy
| | - Antonella Lombardo
- Cardiology Division, Fondazione Policlinico A. Gemelli-IRCCS, Università Cattolica, Roma, Italy
| | | | - Paola Lusardi
- Cardiology and Cardiac Surgery Division, Maria Pia Hospital, Torino, Italy
| | - Antonio Magnante
- Cardiology Division, Madonna delle Grazie Hospital, Matera, Italy
| | - Alessandro Malagoli
- Division of Cardiology, Nephro Cardiovascular Department, Baggiovara Hospital, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | | | - Fiore Manganelli
- Cardiology Division, St. Giuseppe Moscati Hospital, Avellino, Italy
| | - Francesca Mantovani
- Cardiology Division, Azienda USL- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Valeria Marchese
- Cardiology Division, St. Maria della Speranza Hospital, Battipaglia, SA, Italy
| | - Lina Marinacci
- Cardiology Division, Civil Hospital, Città di Castello, Italy
| | - Roberto Mattioli
- Cardiology Division, IRCCS Multimedica Hospital, Sesto San Giovanni, Italy
| | - Civelli Maurizio
- Cardiology Division, European Institute of Oncology, Milano, Italy
| | - Giuseppe Antonio Mazza
- Pediaric Cardiology Division, Regina Margherita Hospital - Città Della Salute e Della Scienza, Torino, Italy
| | - Stefano Mazza
- Cardiology Division, Maggiore St. Andrea Hospital, Vercelli, Italy
| | - Marco Melis
- Cardiology Division, Brotzu Hospital, Cagliari, Italy
| | - Giulia Meloni
- Center for Prevention, Diagnosis and Therapy of Arterial Hypertension and Cardiovascular Complications, St. Camillo Hospital, Sassari, Italy
| | - Elisa Merli
- Cardiology Division, Degli Infermi Hospital, Faenza, RA, Italy
| | - Alberto Milan
- Internal Medicine 4 Division, Molinette Hospital - Città della Salute e Della Scienza, Torino, Italy
| | | | - Antonella Monaco
- Cardiology Outpatient Clinic, Cardiology Outpatient Clinic, Civitanova Marche, MC, Italy
| | - Ines Monte
- Cardiology Division, University Hospital Polyclinic “G.Rodolico-S. Marco”, University of Catania, Catania, Italy
| | | | - Antonella Moreo
- De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Fabio Mori
- Non-invasive Cardiovascular Diagnostic Division, Careggi University Hospital, Firenze, Italy
| | - Sofia Morini
- Cardiology Division, Riuniti della Valdichiana Hospital, Montepulciano, SI, Italy
| | - Claudio Moro
- Cardiology Division, Pio XI Hospital, Desio, MB, Italy
| | | | - Francesco Negri
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Carmelo Nipote
- Cardiology Division, Civil Hospital, Sant’Agata di Militello, ME, Italy
| | - Fulvio Nisi
- Anesthesia and Intensive Care Division, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Silvio Nocco
- Cardiology Division, Sirai Hospital, Carbonia, CI, Italy
| | - Luigi Novello
- Geriatric Division, Valdagno Hospital, Arzignano, VI, Italy
| | - Luigi Nunziata
- Cardiology Division, St. Maria della Pietà Hospital, Nola, NA, Italy
| | | | - Antonello Parodi
- Cardiology Division, Padre Antero Micone Hospital, Genova, Italy
| | | | - Guido Pastorini
- Cardiology Division, Regina Montis Regalis Hospital, Mondovì, CN, Italy
| | - Rita Pavasini
- Cardiology Division, University Hospital of Ferrara, Italy
| | - Daisy Pavoni
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Chiara Pedone
- Cardiology Division, Maggiore Hospital, Bologna, Italy
| | | | | | | | - Valeria Pergola
- Cardiology Division, Padova University Hospital, Padova, Italy
| | | | | | - Chiara Pezzullo
- Cardiology Division, G.B. Grassi Hospital, Lido di Ostia, Italy
| | - Gerardo Piacentini
- Fetal and Neonatal Cardiology Unit - Fatebenefratelli Isola Tiberina Gemelli Isola Hospital, Roma, Italy
| | - Elisa Picardi
- Cardiology Division, Civic Hospital, Chivasso, Italy
| | - Giovanni Pinna
- Neonatology and Neonatal Intensive Care Division, San Camillo-Fornalinini Hospital, Roma, Italy
| | | | - Alfredo Pizzuti
- Cardiology Outpatient Clinic, Koelliker Hospital, Torino, Italy
| | - Matteo Maria Poggi
- Interdisciplinary Internal Medicine Division, Careggi University Hospital, Firenze, Italy
| | - Alfredo Posteraro
- Cardiology Division, St. Giovanni Evangelista Hospital, Tivoli, Italy
| | | | - Debora Rampazzo
- Cardiology Division, Madonna della Navicella Hospital, Chioggia, Italy
| | - Carlo Ratti
- Cardiology Division, St. Maria Bianca Hospital, Mirandola, Italy
| | | | - Fabrizio Ricci
- Cardiology Division, Ss. Annunziata Hospital, Chieti, Italy
| | - Caterina Ricci
- Cardiology Outpatient Clinic, Casa della Salute “Regina Margherita”, Castelfranco Emilia, MO, Italy
| | | | | | - Chiara Rovera
- Cardiology Division, Civic Hospital, Chivasso, Italy
| | | | | | - Nicola Sacchi
- Medical Division, St. Agostino Hospital, Castiglione del Lago, PG, Italy
| | | | - Francesca Sani
- Cardiology Division, St. Giovanni di Dio Hospital, Firenze, Italy
| | - Chiara Sartori
- Cardiology Division, Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Virginia Scarabeo
- Cardiology Division, Camposampiero Hospital, Camposampiero, PD, Italy
| | - Angela Sciacqua
- Geriatric Division, University Hospital Renato Dulbecco, Catanzaro, Italy
| | - Antonio Scillone
- Intensive Cardiac Rehabilitation Unit, Villa del Sole Clinic, Cosenza, Italy
| | | | - Alfredo Scorza
- Cardiology Division, Riuniti Anzio-Nettuno Hospital, Anzio, RM, Italy
| | | | | | - Walter Serra
- Cardiology Division, University Hospital, Parma, Italy
| | | | | | - Domenico Sirico
- Pediatric Cardiology and Congenital Heart Disease Division, Padova University Hospital, Padova, Italy
| | - Marco Solari
- Cardiology Division, St. Giuseppe Hospital, Empoli, FI, Italy
| | | | - Laura Stefani
- Sports Medicine Division, Careggi University Hospital, Firenze, Italy
| | - Antonio Strangio
- Cardiology Division, St. Giovanni di Dio Hospital, Crotone, Italy
| | - Francesca Chiara Surace
- Pediatric Cardiac Surgery and Cardiology Division, Marche University Hospital, Ancona, Italy
| | - Gloria Tamborini
- Cardiology Division, Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Nicola Tarquinio
- Internal Medicine Division, IRCCS INRCA Hospital, Osimo AN, Italy
| | | | | | - Bertrand Tchana
- Pediatric Cardiology Division, University Hospital, Parma, Italy
| | | | - Monica Tinto
- Cardiology Division, Mater Salutis Hospital, Legnago, VR, Italy
| | - Daniela Torzillo
- Internal Medicine Division, L. Sacco Hospital, University of Milan, Italy
| | - Antonio Totaro
- Department of Cardiovascular Sciences, Responsible Research Hospital, Campobasso, Italy
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | | | - Federica Troisi
- Cardiology Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | - Maurizio Tusa
- Cardiology Division, St. Donato Polyclinic, San Donato Milanese, Milan, Italy
| | | | - Vincenzo Varasano
- Internal and Emergency Medicine Division, Civil Hospital, Policoro MT, Italy
| | - Amedeo Venezia
- Geriatric Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | | | - Bruno Villari
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | | | - Jessica Zannoni
- Cardiology Division, St. Donato Polyclinic, San Donato Milanese, Milan, Italy
| | - Concetta Zito
- Cardiology Division, University Hospital Polyclinic G. Martino, University of Messina, Messina, Italy
| | | | - Eugenio Picano
- CNR, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy
| | - Scipione Carerj
- Cardiology Division, University Hospital Polyclinic G. Martino, University of Messina, Messina, Italy
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Ciuca C, Balducci A, Angeli E, Di Dio M, Assenza GE, Mariucci E, Ragni L, Lovato L, Niro F, Gesuete V, Careddu L, Bartolacelli Y, Bulgarelli A, Donti A, Gargiulo GD. Long Term Follow-Up of Patients with Systemic Right Ventricle and Biventricular Physiology: A Single Centre Experience. J Cardiovasc Dev Dis 2023; 10:jcdd10050219. [PMID: 37233186 DOI: 10.3390/jcdd10050219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND A progressively increasing prevalence of congenital heart disease (CHD) in adulthood has been noticed in recent decades; CHD cases with a systemic right ventricle have a poorer outcome. METHODS Seventy-three patients with SRV evaluated in an outpatient clinic between 2014 and 2020 were enrolled in this study. Thirty-four patients had a transposition of the great arteries treated with an atrial switch operation; 39 patients had a congenitally corrected transposition of the great arteries (ccTGA). RESULTS Mean age at the first evaluation was 29.6 ± 14.2 years; 48% of the patients were female. The NYHA class at the visit was III or IV in 14% of the cases. Thirteen patients had at least one previous pregnancy. In 25% of the cases, complications occurred during pregnancy. Survival free from adverse events was 98.6% at one year and 90% at 6-year follow-up without any difference between the two groups. Two patients died and one received heart transplantation during follow-up. The most common adverse event during follow-up was the presence of arrhythmia requiring hospitalization (27.1%), followed by heart failure (12.3%). The presence of LGE together with lower exercise capacity, higher NYHA class and more dilated and/or hypokinetic RV predicted a poorer outcome. Quality of life was similar to the QoL of the Italian population. CONCLUSIONS Long-term follow-up of patients with a systemic right ventricle is characterized by a high incidence of clinical events, prevalently arrhythmias and heart failure, which cause most of the unscheduled hospitalizations.
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Affiliation(s)
- Cristina Ciuca
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Anna Balducci
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Emanuela Angeli
- Pediatric Cardiac Surgery and Adult Congenital Heart Disease, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Mariateresa Di Dio
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Gabriele Egidy Assenza
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Elisabetta Mariucci
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Luca Ragni
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Luigi Lovato
- Radiology Unit, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Fabio Niro
- Radiology Unit, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Valentina Gesuete
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Lucio Careddu
- Pediatric Cardiac Surgery and Adult Congenital Heart Disease, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Ylenia Bartolacelli
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Ambra Bulgarelli
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Andrea Donti
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Gaetano Domenico Gargiulo
- Pediatric Cardiac Surgery and Adult Congenital Heart Disease, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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7
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Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D’Angelo M, Ros SD, D’Andrea F, D’Andrea A, D’Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Giudice CD, Dell’Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi R, Inserra CA, Iori E, Izzo A, Rosa GL, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Di Bella G, Carerj S. Organization and Activity of Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging. J Cardiovasc Echogr 2023; 33:1-9. [PMID: 37426716 PMCID: PMC10328129 DOI: 10.4103/jcecho.jcecho_16_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 07/11/2023] Open
Abstract
Background The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy. Methods We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website. Results Data were obtained from 228 echocardiographic laboratories: 112 centers (49%) in the northern, 43 centers (19%) in the central, and 73 (32%) in the southern regions. During the month of observation, we collected 101,050 transthoracic echocardiography (TTE) examinations performed in all centers. As concern other modalities there were performed 5497 transesophageal echocardiography (TEE) examinations in 161/228 centers (71%); 4057 stress echocardiography (SE) examinations in 179/228 centers (79%); and examinations with ultrasound contrast agents (UCAs) in 151/228 centers (66%). We did not find significant regional variations between the different modalities. The usage of picture archiving and communication system (PACS) was significantly higher in the northern (84%) versus central (49%) and southern (45%) centers (P < 0.001). Lung ultrasound (LUS) was performed in 154 centers (66%), without difference between cardiology and noncardiology centers. The evaluation of left ventricular (LV) ejection fraction was evaluated mainly using the qualitative method in 223 centers (94%), occasionally with the Simpson method in 193 centers (85%), and with selective use of the three-dimensional (3D) method in only 23 centers (10%). 3D TTE was present in 137 centers (70%), and 3D TEE in all centers where TEE was done (71%). The assessment of LV diastolic function was done routinely in 80% of the centers. Right ventricular function was evaluated using tricuspid annular plane systolic excursion in all centers, using tricuspid valve annular systolic velocity by tissue Doppler imaging in 53% of the centers, and using fractional area change in 33% of the centers. When we divided into cardiology (179, 78%) and noncardiology (49, 22%) centers, we found significant differences in the SE (93% vs. 26%, P < 0.001), TEE (85% vs. 18%), UCA (67% vs. 43%, P < 0001), and STE (87% vs. 20%, P < 0.001). The incidence of LUS evaluation was similar between the cardiology and noncardiology centers (69% vs. 61%, P = NS). Conclusions This nationwide survey demonstrated that digital infrastructures and advanced echocardiography modalities, such as 3D and STE, are widely available in Italy with a notable diffuse uptake of LUS in the core TTE examination, a suboptimal diffusion of PACS recording, and conservative use of UCA, 3D, and strain. There are significant differences between northern and central-southern regions and echocardiographic laboratories that pertain to the cardiac unit. This inhomogeneous distribution of technology represents one of the main issues that must be solved to standardize the practice of echocardiography.
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Affiliation(s)
- Quirino Ciampi
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Mauro Pepi
- Cardiology Division, Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | | | - Andrea Barbieri
- Department of Biomedical, Cardiology Division, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Agata Barchitta
- Semi Intensive Care Department, Semi-Intensive Care Unit, Padova University Hospital, Padova, Italy
| | | | - Sofia Miceli
- Geriatric Division, University Hospital Mater Domini, Catanzaro, Italy
| | - Vito Maurizio Parato
- Cardiology Division, Madonna del Soccorso Hospital, San Benedetto del Tronto, AP, Italy
| | - Antonio Tota
- Cardiology Division, Polyclinic Hospital, Bari, Italy
| | - Giuseppe Trocino
- Non Invasive Cardiac Imaging Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Massimiliana Abbate
- Cardiology Vanvitelli Division, AORN dei Colli, Monaldi Hospital, Napoli, Italy
| | - Maria Accadia
- Cardiology Division, Del Mare Hospital, Ponticelli, NA, Italy
| | - Rossella Alemanni
- Cardiac Surgery Division, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | | | | | - Maurizio Anselmi
- Cardiology Division, Fracastoro Hospital, San Bonifacio, VR, Italy
| | - Iolanda Aquila
- Cardiology Division, University Hospital Mater Domini, Catanzaro, Italy
| | - Simona Aramu
- Cardiology Division, San Martino Hospital, Oristano, Italy
| | - Enrico Avogadri
- Department of Cardiology, SS Trinità Hospital, Fossano, CN, Italy
| | | | - Luigi Badano
- Integrated Cardiovascular Diagnostic Division, Auxologico San Luca IRCCS Hospital, Milano, Italy
| | - Anna Balducci
- Pediatric Cardiology Division, Polyclinico S. Orsola-Malpighi IRCCS Hospital, Bologna, Italy
| | | | | | | | - Valentina Barletta
- Cardiology 2 Department, Cardiac Vascular Thoracic Department, Pisa University Hospital, Pisa, Italy
| | - Daniele Barone
- Cardiology Division, S. Andrea Hospital, La Spezia, Italy
| | - Francesco Becherini
- Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | | | | | | | | | | | - Massimo Bolognesi
- Center for Internal Medicine and Sports Cardiology, Local Health Unit of Romagna, Cesena, FC, Italy
| | - Stefano Bongiovi
- Cardiology Division, Immacolata Concezione Civil Hospital, Piove di Sacco, PD, Italy
| | - Renato Maria Bragato
- Echocardiography and Emergency Cardiovascular Care Division, Humanitas Clinical and Research Centre, Rozzano, MI, Italy
| | - Gabriele Braggion
- Cardiology Division, Santa Maria Regina degli Angeli Hospital, Adria, RO, Italy
| | | | - Francesca Bursi
- Department of Health Science, Cardiology Division, University of Milan, San Paolo Hospital, ASST Santi Paolo e Carlo, Milano, Italy
| | | | - Matteo Cameli
- Cardiology Division, Polyclinic Le Scotte Hospital, Siena, Italy
| | - Antonella Canu
- Cardiology Division, Santissima Annunziata Hospital, Sassari, Italy
| | - Mariano Capitelli
- Internal Medicine Division, Pavullo Hospital, Pavullo Nel Frignano, MO, Italy
| | | | - Rosa Carbonara
- Cardiology Division, Maugeri Institute IRCCS, Bari, Italy
| | - Maria Carbone
- Emergency Medicine Division, St Anna and St Sebastiano Hospital, Caserta, Italy
| | - Marco Carbonella
- Cardiology Division, SS Maria Addolorata Hospital, Eboli, SA, Italy
| | - Nazario Carrabba
- Cardiology Division, Careggi University Hospital, Firenze, Italy
| | - Grazia Casavecchia
- Cardiology Division, University Hospital Ospedali Riuniti, Foggia, Italy
| | - Margherita Casula
- Cardiology Division, Nostra Signora di Bonaria Hospital, San Gavino Monreale, SU, Italy
| | - Elena Chesi
- Neonatology Division, S. Maria Nuova Hospital, Reggio Emilia, Italy
| | - Sebastiano Cicco
- Department of Precision and Regenerative Medicine and Ionian Area, Unit of Internal Medicine “G. Baccelli” and Unit of Hypertension “A.M. Pirrelli”, University of Bari Aldo Moro Medical School, AUOC Policlinico di Bari, Bari, Italy
| | - Rodolfo Citro
- Echocardiography Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | | | - Paolo Colonna
- Cardiology Division, Polyclinic Hospital, Bari, Italy
| | - Maddalena Conte
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Pietro Cortesi
- Cardioncology Division, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, FC, Italy
| | | | | | - Fabiana Cozza
- Cardiology Division, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Umberto Cucchini
- Cardiology Division, San Bassiano Hospital, Bassano Del Grappa, VI, Italy
| | - Myriam D’Angelo
- Cardiology Division, Bonino Pulejo IRCCS Hospital, Messina, Italy
| | - Santina Da Ros
- Division of Cardiology, Riuniti Padova Sud Hospital, Monselice, PD, Italy
| | | | | | - Francesca D’Auria
- Vascular - Endovascular Surgery Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Giovanni De Caridi
- Vascular Surgery Division, University Hospital Polyclinic G.Martino, University of Messina, Messina, Italy
| | - Stefania De Feo
- Cardiology Division, P Pederzoli Hospital, Peschiera del Garda, VR, Italy
| | | | - Simona De Vecchi
- Cardiology Division, Major University Hospital of Charity, Novara, Italy
| | | | - Luca Dell’Angela
- Cardiology Division, Gorizia-Monfalcone Hospital, Gorizia, Italy
| | | | - Ilaria Dentamaro
- Cardiology Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | - Paola Destefanis
- Cardiology Division, San Luigi Gonzaga University Hospital, Orbassano, Italy
| | - Maria Di Fulvio
- Cardiology-ICCU Division, Ss. Annunziata Hospital, Chieti, Italy
| | | | | | - Angelo Di Gioia
- Cardiology Division, St Giuliano Hospital, Giugliano in Campania, NA, Italy
| | | | | | - Concetta Di Nora
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Giovanni Di Salvo
- Pediatric Cardiology and Congenital Heart Disease Division, Padova University Hospital, Padova, Italy
| | - Claudio Dodi
- Cardiology Division, San Antonino Clinic, Piacenza, Italy
| | - Sarah Dogliani
- Cardiology Division, SS. Annunziata Civil Hospital, Savigliano, CN, Italy
| | | | - Melissa Dottori
- Cardiology Division, Marche University Hospital, Ancona, Italy
| | - Giuseppe Epifani
- Internal Medicine Division, Camberlingo Hospital, Francavilla Fontana, BR, Italy
| | - Iacopo Fabiani
- Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Francesca Ferrara
- Internal Medicine Division, University Hospital Modena Polyclinic, Modena, Italy
| | - Luigi Ferrara
- Cardiology Division, Villa Dei Fiori Clinic, Acerra, NA, Italy
| | | | - Gemma Filice
- Cardiology Division, Annunziata Hospital, Cosenza, Italy
| | - Maria Fiorino
- Cardiology Division, ARNAS Civico Hospital, Palermo, Italy
| | - Davide Forno
- Cardiology Division, Maria Vittoria Hospital, Torino, Italy
| | | | | | - Giuseppe Gigantino
- Cardiology Division, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Mauro Giorgi
- Cardiology Division, Molinette Hospital - Città della Salute e della Scienza, Torino, Italy
| | | | | | | | | | - Anna Holzl
- Internal Medicine Division, Quisisana Clinic, Ferrara, Italy
| | - Alessandra Iaiza
- Cardiac Surgery Division, San Camillo-Fornalinini Hospital, Roma, Italy
| | - Andrea Iannaccone
- Internal Medicine Division, Ordine Mauriziano Hospital, Torino, Italy
| | - Federica Ilardi
- Cardiology Division, Federico II University Hospital, Napoli, Italy
| | - Egidio Imbalzano
- Internal Medicine Division, University Hospital Polyclinic G.Martino, University of Messina, Messina, Italy
| | | | | | - Emilio Iori
- Cardiology Division, New Civil Hospital, Sassuolo, MO, Italy
| | - Annibale Izzo
- Cardiology Division, St Anna and St Sebastiano Hospital, Caserta, Italy
| | | | | | | | - Laura Lanzoni
- Cardiology Division, Sacro Cuore Don Calabria IRCCS Hospital, Verona, Italy
| | | | - Elisa Leiballi
- Cardiological and Cardio Oncological Rehabilitation Department, Sacile (PN) CRO (PN) Hospital, Sacile (PN), Italy
| | | | - Carmenita Lo Conte
- Cardiology Division, St Ottone Frangipane Hospital, Ariano Irpino, AV, Italy
| | - Maria Lo Monaco
- Cardiology Division, Humanitas Gavazzeni Hospital, Bergamo, Italy
| | - Antonella Lombardo
- Cardiology Division, Fondazione Policlinico A. Gemelli-IRCCS, Università Cattolica, Roma, Italy
| | | | - Paola Lusardi
- Cardiology and Cardiac Surgery Division, Maria Pia Hospital, Torino, Italy
| | - Antonio Magnante
- Cardiology Division, Madonna delle Grazie Hospital, Matera, Italy
| | - Alessandro Malagoli
- Division of Cardiology, Nephro-Cardiovascular Department, Baggiovara Hospital, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | | | - Fiore Manganelli
- Cardiology Division, St Giuseppe Moscati Hospital, Avellino, Italy
| | - Francesca Mantovani
- Cardiology Division, Azienda USL- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Valeria Marchese
- Cardiology Division, St Maria della Speranza Hospital, Battipaglia, SA, Italy
| | - Lina Marinacci
- Cardiology Division, Civil Hospital, Città di Castello, PG, Italy
| | - Roberto Mattioli
- Cardiology Division, IRCCS Multimedica Hospital, Sesto San Giovanni, MI, Italy
| | - Civelli Maurizio
- Cardiology Division, European Institute of Oncology, Milano, Italy
| | - Giuseppe Antonio Mazza
- Pediaric Cardiology Division, Regina Margherita Hospital - Città della Salute e della Scienza, Torino, Italy
| | - Stefano Mazza
- Cardiology Division, Maggiore St Andrea Hospital, Vercelli, Italy
| | - Marco Melis
- Cardiology Division, Brotzu Hospital, Cagliari, Italy
| | - Giulia Meloni
- Center for Prevention, Diagnosis and Therapy of Arterial Hypertension and Cardiovascular Complications, St Camillo Hospital, Sassari, Italy
| | - Elisa Merli
- Cardiology Division, Degli Infermi Hospital, Faenza, RA, Italy
| | - Alberto Milan
- Internal Medicine 4 Department, Molinette Hospital - Città della Salute e della Scienza, Torino, Italy
| | | | - Antonella Monaco
- Cardiology Outpatient Clinic, Cardiology Outpatient Clinic, Civitanova Marche, MC, Italy
| | - Ines Monte
- Cardiology Division, University Hospital Polyclinic “G.Rodolico-S. Marco”, University of Catania, Catania, Italy
| | | | - Antonella Moreo
- De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Fabio Mori
- Non-invasive Cardiovascular Diagnostic Division, Careggi University Hospital, Firenze, Italy
| | - Sofia Morini
- Cardiology Division, Riuniti della Valdichiana Hospital, Montepulciano, SI, Italy
| | - Claudio Moro
- Cardiology Division, Pio XI Hospital, Desio, MB, Italy
| | | | - Francesco Negri
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Carmelo Nipote
- Cardiology Division, Civil Hospital, Sant’Agata di Militello, ME, Italy
| | - Fulvio Nisi
- Anesthesia and Intensive Care Division, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Silvio Nocco
- Cardiology Division, Sirai Hospital, Carbonia, CI, Italy
| | - Luigi Novello
- Geriatric Division, Valdagno Hospital, Arzignano, VI, Italy
| | - Luigi Nunziata
- Cardiology Division, St Maria della Pietà Hospital, Nola, NA, Italy
| | | | - Antonello Parodi
- Cardiology Division, Padre Antero Micone Hospital, Genova, Italy
| | | | - Guido Pastorini
- Cardiology Division, Regina Montis Regalis Hospital, Mondovì, CN, Italy
| | - Rita Pavasini
- Cardiology Division, St Anna University Hospital, Ferrara, Italy
| | - Daisy Pavoni
- Cardiology Division, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Chiara Pedone
- Cardiology Division, Maggiore Hospital, Bologna, Italy
| | | | | | | | - Valeria Pergola
- Cardiology Division, Padova University Hospital, Padova, Italy
| | | | | | - Chiara Pezzullo
- Cardiology Division, G.B. Grassi Hospital, Lido di Ostia, RM, Italy
| | - Gerardo Piacentini
- Fetal and Neonatal Cardiology Unit - Fatebenefratelli Isola Tiberina Gemelli Isola Hospital, Roma, Italy
| | - Elisa Picardi
- Cardiology Division, Civic Hospital, Chivasso, TO, Italy
| | - Giovanni Pinna
- Neonatology and Neonatal Intensive Care Division, San Camillo-Fornalinini Hospital, Roma, Italy
| | | | - Alfredo Pizzuti
- Cardiology Outpatient Clinic, Koelliker Hospital, Torino, Italy
| | - Matteo Maria Poggi
- Interdisciplinary Internal Medicine Division, Careggi University Hospital, Firenze, Italy
| | - Alfredo Posteraro
- Cardiology Division, St Giovanni Evangelista Hospital, Tivoli, RM, Italy
| | | | - Debora Rampazzo
- Cardiology Division, Madonna della Navicella Hospital, Chioggia, VE, Italy
| | - Carlo Ratti
- Cardiology Division, St Maria Bianca Hospital, Mirandola, MO, Italy
| | - Sara Rettegno
- Cardiology Division, Hospital, Moncalieri, TO, Italy
| | - Fabrizio Ricci
- Cardiology Division, Ss. Annunziata Hospital, Chieti, Italy
| | - Caterina Ricci
- Cardiology Outpatient Clinic, Casa della Salute “Regina Margherita”, Castelfranco Emilia, MO, Italy
| | | | | | - Chiara Rovera
- Cardiology Division, Civic Hospital, Chivasso, TO, Italy
| | | | | | - Nicola Sacchi
- Medical Division, St Agostino Hospital, Castiglione del Lago, PG, Italy
| | | | - Francesca Sani
- Cardiology Division, St Giovanni di Dio Hospital, Firenze, Italy
| | - Chiara Sartori
- Cardiology Division, Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Virginia Scarabeo
- Cardiology Division, Camposampiero Hospital, Camposampiero, PD, Italy
| | - Angela Sciacqua
- Geriatric Division, University Hospital Mater Domini, Catanzaro, Italy
| | - Antonio Scillone
- Intensive Cardiac Rehabilitation Unit, Villa del Sole Clinic, Cosenza, Italy
| | | | - Alfredo Scorza
- Cardiology Division, Riuniti Anzio-Nettuno Hospital, Anzio, RM, Italy
| | | | | | - Walter Serra
- Cardiology Division, University Hospital, Parma, Italy
| | | | | | - Domenico Sirico
- Pediatric Cardiology and Congenital Heart Disease Division, Padova University Hospital, Padova, Italy
| | - Marco Solari
- Cardiology Division, St Giuseppe Hospital, Empoli, FI, Italy
| | | | - Laura Stefani
- Sports Medicine Division, Careggi University Hospital, Firenze, Italy
| | - Antonio Strangio
- Cardiology Division, St Giovanni di Dio Hospital, Crotone, Italy
| | - Francesca Chiara Surace
- Pediatric Cardiac Surgery and Cardiology Division, Marche University Hospital, Ancona, Italy
| | - Gloria Tamborini
- Cardiology Division, Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Nicola Tarquinio
- Internal Medicine Division, IRCCS INRCA Hospital, Osimo AN, Italy
| | | | | | - Bertrand Tchana
- Pediatric Cardiology Division, University Hospital, Parma, Italy
| | | | - Monica Tinto
- Cardiology Division, Mater Salutis Hospital, Legnago, VR, Italy
| | - Daniela Torzillo
- Internal Medicine Division, L. Sacco Hospital, University of Milan, Italy
| | - Antonio Totaro
- Cardiology Division, Gemelli Molise Hospital, Campobasso, Italy
| | | | - Federica Troisi
- Cardiology Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | - Maurizio Tusa
- Cardiology Division, St Donato Polyclinic, San Donato Milanese MI, Italy
| | | | - Vincenzo Varasano
- Internal and Emergency Medicine Division, Civil Hospital, Policoro MT, Italy
| | - Amedeo Venezia
- Geriatric Division, Miulli Hospital, Acquaviva delle Fonti, BA, Italy
| | | | - Bruno Villari
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | | | - Jessica Zannoni
- Cardiology Division, St Donato Polyclinic, San Donato Milanese MI, Italy
| | - Concetta Zito
- Cardiology Division, University Hospital Polyclinic G.Martino, University of Messina, Messina, Italy
| | - Antonello Zugaro
- Department of Cardiology, Intensive Care Unit, St Salvatore Hospital, L’Aquila, Italy
| | - Gianluca Di Bella
- Cardiology Division, University Hospital Polyclinic G.Martino, University of Messina, Messina, Italy
| | - Scipione Carerj
- Cardiology Division, University Hospital Polyclinic G.Martino, University of Messina, Messina, Italy
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Pezza L, Balducci A, Bartolacelli Y, Bonetti S, Ciuca C, Gesuete V, Paoli G, Todero S, Donti A. 3D-echocardiography for evaluation of the right ventricle in patients with repaired Tetralogy of Fallot: a comparison study with cardiac magnetic resonance. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patients with repaired Tetralogy of Fallot (ToF) need periodic instrumental assessments, due to complications they can meet during lifetime. Right ventricle (RV) dilation and dysfunction are some examples that explain why those patients regularly undergo Cardiac Magnetic Resonance (CMR), currently the gold standard method to detect these complications.
Purpose
3D-echocardiography is an emerging tool to study RV, but there is little data supporting its use in congenital heart diseases. This study aimed at evaluating its accuracy in assessing RV dimensions and systolic function in ToF patients, in comparison to CMR.
Methods
34 patients were prospectively enrolled after CMR performance. They all underwent standard 2D-echocardiography and Multi-Beat-ECG-triggered 3D Full-Volume acquisition.
RV End Diastolic Volume (RV-EDV), End Systolic Volume and Ejection Fraction (RV-EF) were defined both in 3D-echocardiography and CMR.
Results
Post-hoc analysis of 3D images was performed through a vendor-independent software in 30 patients, resulting in a feasibility of 88%.
A Bland-Altman analysis was performed, showing that 3D-echocardiography underestimates the RV-EDV/BSA of −27.39 mL/m2 on average (CI 95%: −29.46; −25.31, SD: 5.68 mL/m2), compared to CMR, as expected. However, when compared to normality reference, 3D-echocardiography identified RV dilatation with a significant correlation to CMR (V=0.66, p<0.001). Moreover, ROC curves showed that 3D-echo-RV-EDV/BSA is the echocardiographic measure that best correlates to CMR in detecting RV dilatation (AUC 1, CI 95%: 1.00; 1.00), followed by RVOT diameter in PLAX (AUC 0.89, CI 95%: 0.69; 0.99).
Youden analysis suggested 77 mL/m2 (Se 95%, Sp 100%; J 0,95) as optimal limit to define RV dilatation in 3D-echocardiography.
Regarding the RV-EF, the Bland-Altman analysis showed that 3D-echocardiography overestimates the RV-EF by 1,97% on average (CI 95%: 0.01; 3.95, SD: 5.43), compared to CMR.
Secondly, accuracy of different echocardiographic parameters (both 2D and 3D) in detecting a RV systolic impairment was analyzed: ROC curves showed that RV-EF in 3D echocardiography is the measurement that best correlates to CMR in detecting RV dysfunction (AUC 0.92, CI 95%: 0.79–1.00), followed by Fractional Area Change (FAC) (AUC 0.78, CI 95%: 0.60; 0.96).
Tricuspid Annular Plane Systolic Excursion (TAPSE) and tricuspid valve annular motion velocities in systole (S'-TDI), instead, showed very poor correlation.
Conclusions
3D-echocardiography showed good agreement with CMR in defining RV dimensions and systolic function in ToF patients, even more than the bidimensional measurements cardiologists are used to. This could lead to a wider use of this tool in daily clinical practice, involving a reduction in the execution of the numerous CMR patients usually undergo. Moreover, it could be a valid instrument in patients with contraindication to CMR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- L Pezza
- Azienda Ospedaliero-Universitaria di Parma, Division of Cardiology , Parma , Italy
| | - A Balducci
- S. Orsola-Malpighi Hospital, Paediatric Cardiology and Adult Congenital Unit , Bologna , Italy
| | - Y Bartolacelli
- S. Orsola-Malpighi Hospital, Paediatric Cardiology and Adult Congenital Unit , Bologna , Italy
| | - S Bonetti
- S. Orsola-Malpighi Hospital, Paediatric Cardiology and Adult Congenital Unit , Bologna , Italy
| | - C Ciuca
- S. Orsola-Malpighi Hospital, Paediatric Cardiology and Adult Congenital Unit , Bologna , Italy
| | - V Gesuete
- S. Orsola-Malpighi Hospital, Paediatric Cardiology and Adult Congenital Unit , Bologna , Italy
| | - G Paoli
- Azienda Ospedaliero-Universitaria di Parma, Division of Cardiology , Parma , Italy
| | - S Todero
- S. Orsola-Malpighi Hospital, Paediatric Cardiology and Adult Congenital Unit , Bologna , Italy
| | - A Donti
- S. Orsola-Malpighi Hospital, Paediatric Cardiology and Adult Congenital Unit , Bologna , Italy
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Langham RG, Kalantar-Zadeh K, Bonner A, Balducci A, Hsiao LL, Kumaraswami LA, Laffin P, Liakopoulos V, Saadi G, Tantisattamo E, Ulasi I, Lui SF. Kidney health for all: bridging the gap in kidney health education and literacy. Braz J Med Biol Res 2022; 55:e12161. [PMID: 35584454 PMCID: PMC9113529 DOI: 10.1590/1414-431x2022e12161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/11/2022] [Indexed: 11/21/2022] Open
Abstract
The high burden of kidney disease, global disparities in kidney care, and the poor outcomes of kidney failure place a growing burden on affected individuals and their families, caregivers, and the community at large. Health literacy is the degree to which individuals and organizations have, or equitably enable individuals to have, the ability to find, understand, and use information and services to make informed health-related decisions and actions for themselves and others. Rather than viewing health literacy as a patient deficit, improving health literacy lies primarily with health care providers communicating and educating effectively in codesigned partnership with those with kidney disease. For kidney policy makers, health literacy is a prerequisite for organizations to transition to a culture that places the person at the center of health care. The growing capability of and access to technology provides new opportunities to enhance education and awareness of kidney disease for all stakeholders. Advances in telecommunication, including social media platforms, can be leveraged to enhance persons’ and providers’ education. The World Kidney Day declares 2022 as the year of “Kidney Health for All” to promote global teamwork in advancing strategies in bridging the gap in kidney health education and literacy. Kidney organizations should work toward shifting the patient-deficit health literacy narrative to that of being the responsibility of health care providers and health policy makers. By engaging in and supporting kidney health-centered policy making, community health planning, and health literacy approaches for all, the kidney communities strive to prevent kidney diseases and enable living well with kidney disease.
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Affiliation(s)
- R G Langham
- St. Vincent's Hospital, Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - K Kalantar-Zadeh
- Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, CA, USA
| | - A Bonner
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
| | | | - L L Hsiao
- Brigham and Women's Hospital, Renal Division, Department of Medicine, Boston, MA, USA
| | - L A Kumaraswami
- Tamilnad Kidney Research (TANKER) Foundation, The International Federation of Kidney Foundations - World Kidney Alliance (IFKF - WKA), Chennai, India
| | - P Laffin
- International Society of Nephrology, Brussels, Belgium
| | - V Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - E Tantisattamo
- Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, CA, USA
| | - I Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | - S F Lui
- International Federation of Kidney Foundations - World Kidney Alliance, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Bragantini G, Bartolacelli Y, Balducci A, Ciuca C, Gesuete V, Palleri D, Assenza GE, Mariucci E, Angeli E, Gargiulo GD, Donti A. Left ventricle function after arterial switch procedure for D-transposition of the great arteries: Long term evaluation by speckle-tracking analysis. International Journal of Cardiology Congenital Heart Disease 2022. [DOI: 10.1016/j.ijcchd.2022.100374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Brighenti M, Balducci A, Egidy Assenza G, Mariucci ME, Perolo A, Pilu G, Donti A. [Fetal aortic valvuloplasty in a patient with critical, congenital aortic valve stenosis and severe left ventricular dysfunction]. G Ital Cardiol (Rome) 2021; 22:23-26. [PMID: 35343487 DOI: 10.1714/3723.37136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We present a case of prenatal diagnosis of critical congenital aortic valve stenosis with progressive systolic left ventricular failure. An ultrasound-guided balloon aortic valvuloplasty was performed at 28 weeks of gestational age because of left ventricular dysfunction associated with signs of fetal heart failure. There were no significant post-procedural complications and the pregnancy was carried to term with elective cesarean section at 38 weeks of gestational age. At birth, an echocardiogram showed severe aortic valve stenosis with global hypokinesia of the left ventricle. Therefore a percutaneous balloon aortic valvuloplasty was repeated through transseptal approach with prompt improvement of the antegrade aortic flow and of the left ventricular systolic function. The baby is currently 2 months old and he is doing fine.
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Affiliation(s)
- Maurizio Brighenti
- U.O. Cardiologia Pediatrica e dell'Età Evolutiva, Centro per le Cardiopatie Congenite dell'Adulto, Dipartimento Cardio-Toraco-Vascolare, IRCCS Azienda Ospedaliero-Universitaria di Bologna
| | - Anna Balducci
- U.O. Cardiologia Pediatrica e dell'Età Evolutiva, Centro per le Cardiopatie Congenite dell'Adulto, Dipartimento Cardio-Toraco-Vascolare, IRCCS Azienda Ospedaliero-Universitaria di Bologna
| | - Gabriele Egidy Assenza
- U.O. Cardiologia Pediatrica e dell'Età Evolutiva, Centro per le Cardiopatie Congenite dell'Adulto, Dipartimento Cardio-Toraco-Vascolare, IRCCS Azienda Ospedaliero-Universitaria di Bologna
| | - Maria Elisabetta Mariucci
- U.O. Cardiologia Pediatrica e dell'Età Evolutiva, Centro per le Cardiopatie Congenite dell'Adulto, Dipartimento Cardio-Toraco-Vascolare, IRCCS Azienda Ospedaliero-Universitaria di Bologna
| | - Antonella Perolo
- U.O. Ostetricia e Medicina dell'Età Prenatale, Dipartimento di Scienze Mediche e Chirurgiche, IRCCS Azienda Ospedaliero-Universitaria di Bologna
| | - Gianluigi Pilu
- U.O. Ostetricia e Medicina dell'Età Prenatale, Dipartimento di Scienze Mediche e Chirurgiche, IRCCS Azienda Ospedaliero-Universitaria di Bologna
| | - Andrea Donti
- U.O. Cardiologia Pediatrica e dell'Età Evolutiva, Centro per le Cardiopatie Congenite dell'Adulto, Dipartimento Cardio-Toraco-Vascolare, IRCCS Azienda Ospedaliero-Universitaria di Bologna
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12
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Palleri D, Guidarini M, Mariucci E, Balducci A, Assenza GE, Esposito S, Donti A. Patent Foramen Ovale Related Cryptogenic Stroke during COVID-19 Disease in Three Patients: A Case Series. J Stroke Cerebrovasc Dis 2021; 30:106115. [PMID: 34562792 PMCID: PMC8437761 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/27/2021] [Accepted: 09/07/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
- Daniela Palleri
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Marta Guidarini
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Elisabetta Mariucci
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
| | - Anna Balducci
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Gabriele Egidy Assenza
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Italy
| | - Andrea Donti
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
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13
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Marzullo R, Balducci A, Cafiero G, Cifra B, Trocchio G, Varnier M, Colonna P. [Physical activity in patients with repaired and unrepaired congenital heart diseases. Task Force for exercise prescription in patients with congenital heart disease of the Italian Society of Pediatric Cardiology and Congenital Heart Disease]. G Ital Cardiol (Rome) 2021; 22:756-766. [PMID: 34463685 DOI: 10.1714/3660.36453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Regular physical activity is essential for physical health and mental wellbeing in children and teenagers. However, patients with congenital heart disease are often restricted from being physically active due to parental overprotection and lack of physical activity promotion or exercise prescription from their physicians. A comprehensive medical evaluation is crucial for the development of personalized exercise programs for these patients. The aim of this review is to provide physicians with a practical guide on how to promote physical activity and prescribe exercise for patients with congenital heart disease with or without surgical correction.
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Affiliation(s)
- Raffaella Marzullo
- Cardiochirurgia e Cardiologia Pediatrica e Congenita A.O.U. Ospedali Riuniti di Ancona, Ancona
| | - Anna Balducci
- Cardiologia Pediatrica e dell'Età Evolutiva, Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Bologna
| | - Giulia Cafiero
- U.O.S.D. Medicina dello Sport, Dipartimento di Cardiochirurgia e Cardiologia, IRCCS Bambino Gesù, Roma
| | - Barbara Cifra
- Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada
| | | | - Maurizio Varnier
- U.O.C. Medicina dello Sport e dell'Esercizio Fisico, Azienda Ospedaliera Università di Padova, Padova
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14
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Angeli E, Martens S, Careddu L, Petridis FD, Quarti AG, Ciuca C, Balducci A, Fabozzo A, Ragni L, Donti A, Gargiulo GD. Myocardial oxygen consumption during histidine-tryptophan-ketoglutarate cardioplegia in young human hearts. Interact Cardiovasc Thorac Surg 2021; 32:319-324. [PMID: 33398332 DOI: 10.1093/icvts/ivaa262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 08/12/2020] [Accepted: 09/22/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Energy demand and supply need to be balanced to preserve myocardial function during paediatric cardiac surgery. After a latent aerobic period, cardiac cells try to maintain energy production by anaerobic metabolism and by extracting oxygen from the given cardioplegic solution. Myocardial oxygen consumption (MVO2) changes gradually during the administration of cardioplegia. METHODS MVO2 was measured during cardioplegic perfusion in patients younger than 6 months of age (group N: neonates; group I: infants), with a body weight less than 10 kg. Histidine-tryptophan-ketoglutarate crystalloid solution was used for myocardial protection and was administered during a 5-min interval. To measure pO2 values during cardioplegic arrest, a sample of the cardioplegic fluid was taken from the inflow line before infusion. Three fluid samples were taken from the coronary venous effluent 1, 3 and 5 min after the onset of cardioplegia administration. MVO2 was calculated using the Fick principle. RESULTS The mean age of group N was 0.2 ± 0.09 versus 4.5 ± 1.1 months in group I. The mean weight was 3.1 ± 0.2 versus 5.7 ± 1.6 kg, respectively. MVO2 decreased similarly in both groups (min 1: 0.16 ± 0.07 vs 0.36 ± 0.1 ml/min; min 3: 0.08 ± 0.04 vs 0.17 ± 0.09 ml/min; min 5: 0.05 ± 0.04 vs 0.07 ± 0.05 ml/min). CONCLUSIONS We studied MVO2 alterations after aortic cross-clamping and during delivery of cardioplegia in neonates and infants undergoing cardiac surgery. Extended cardioplegic perfusion significantly reduces energy turnover in hearts because the balance procedures are both volume- and above all time-dependent. A reduction in MVO2 indicates the necessity of a prolonged cardioplegic perfusion time to achieve optimized myocardial protection.
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Affiliation(s)
- Emanuela Angeli
- Department of Pediatric and Adult Congenital Cardiac Surgery, S. Orsola University Hospital, University of Bologna, Bologna, Italy
| | - Sabrina Martens
- Department of Cardiac Surgery, University of Münster, Münster, Germany
| | - Lucio Careddu
- Department of Pediatric and Adult Congenital Cardiac Surgery, S. Orsola University Hospital, University of Bologna, Bologna, Italy
| | - Francesco D Petridis
- Department of Pediatric and Adult Congenital Cardiac Surgery, S. Orsola University Hospital, University of Bologna, Bologna, Italy
| | - Andrea G Quarti
- Department of Pediatric and Adult Congenital Cardiac Surgery, S. Orsola University Hospital, University of Bologna, Bologna, Italy
| | - Cristina Ciuca
- Department of Pediatric and Adult Congenital Cardiology, S. Orsola University Hospital, University of Bologna, Bologna, Italy
| | - Anna Balducci
- Department of Pediatric and Adult Congenital Cardiology, S. Orsola University Hospital, University of Bologna, Bologna, Italy
| | - Assunta Fabozzo
- Cardiac Surgery Unit, University Hospital of Padova, Padova, Italy
| | - Luca Ragni
- Department of Pediatric and Adult Congenital Cardiology, S. Orsola University Hospital, University of Bologna, Bologna, Italy
| | - Andrea Donti
- Department of Pediatric and Adult Congenital Cardiology, S. Orsola University Hospital, University of Bologna, Bologna, Italy
| | - Gaetano D Gargiulo
- Department of Pediatric and Adult Congenital Cardiac Surgery, S. Orsola University Hospital, University of Bologna, Bologna, Italy
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15
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Della Gatta AN, Contro E, Lenzi J, Balducci A, Gargiulo G, Bodnar T, Palleri D, Bonetti S, Hasan T, Donti A, Ragni L, Angeli E, Bartolacelli Y, Larcher L, Pilu G, Perolo A. Prenatal sonography of the foramen ovale predicts urgent balloon atrial septostomy in neonates with complete transposition of the great arteries. Am J Obstet Gynecol MFM 2021; 3:100379. [PMID: 33965655 DOI: 10.1016/j.ajogmf.2021.100379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Hypoxia caused by inadequate intracardiac mixing owing to a restrictive foramen ovale is a potentially life-threatening complication in neonates with dextro-transposition of the great arteries. An urgent balloon atrial septostomy is a procedure of choice in such cases, but dependent on the availability of a 24-hour interventional cardiology facility. The prenatal identification of predictors for an urgent balloon atrial septostomy at birth would help in optimizing the management of these neonates, minimizing the risk of hypoxic damage. OBJECTIVE This study aimed to predict with prenatal echocardiography the need of urgent balloon atrial septostomy in neonates with dextro-transposition of the great arteries. STUDY DESIGN This was a retrospective cohort study of patients with a prenatal diagnosis of transposition of the great arteries that were delivered in our center between 2010 and 2019, for whom fetal ultrasound echocardiograms obtained at less than 3 weeks before delivery were available. The following parameters were systematically obtained at fetal echocardiography: size and appearance of the foramen ovale, septum primum excursion (foramen ovale flap angle at the maximal excursion), diameters of the atria, and size of the ductus arteriosus. Balloon atrial septostomy was defined as urgent if performed within 12 hours from birth in neonates with restrictive foramen ovale. Neonatal follow-up was obtained through medical records analysis. RESULTS From November 2007 to April 2019, 160 fetuses with complete transposition of the great arteries were referred to our echocardiography laboratory and 60 of these were included in the analysis; 27 underwent urgent balloon atrial septostomy, 11 elective balloon atrial septostomy, and 22 no balloon atrial septostomy. The size of the foramen ovale was the best predictor of an urgent balloon atrial septostomy. A measurement of >6.5 mm had a sensitivity of 100% and a false positive rate of 45%. CONCLUSION Fetal echocardiography predicts the need of an urgent balloon atrial septostomy in fetuses with dextro-transposition of the great arteries although with a limited precision. In our experience, a measurement of the foramen ovale within 3 weeks of delivery had the greatest accuracy.
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Affiliation(s)
- Anna Nunzia Della Gatta
- Obstetric Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna (Drs Della Gatta, Contro, Larcher, Pilu, and Perolo).
| | - Elena Contro
- Obstetric Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna (Drs Della Gatta, Contro, Larcher, Pilu, and Perolo)
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy (Dr Lenzi)
| | - Anna Balducci
- Department of Pediatric Cardiology and Adult Congenital Cardiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna (Drs Balducci, Bodnar, Palleri, Bonetti, Hasan, Donti, Ragni, and Bartolacelli)
| | - Gaetano Gargiulo
- Department of Pediatric and Adult Congenital Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna (Drs Gargiulo and Angeli), University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Bologna, Italy
| | - Tetyana Bodnar
- Department of Pediatric Cardiology and Adult Congenital Cardiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna (Drs Balducci, Bodnar, Palleri, Bonetti, Hasan, Donti, Ragni, and Bartolacelli)
| | - Daniela Palleri
- Department of Pediatric Cardiology and Adult Congenital Cardiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna (Drs Balducci, Bodnar, Palleri, Bonetti, Hasan, Donti, Ragni, and Bartolacelli)
| | - Simone Bonetti
- Department of Pediatric Cardiology and Adult Congenital Cardiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna (Drs Balducci, Bodnar, Palleri, Bonetti, Hasan, Donti, Ragni, and Bartolacelli)
| | - Tammam Hasan
- Department of Pediatric Cardiology and Adult Congenital Cardiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna (Drs Balducci, Bodnar, Palleri, Bonetti, Hasan, Donti, Ragni, and Bartolacelli)
| | - Andrea Donti
- Department of Pediatric Cardiology and Adult Congenital Cardiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna (Drs Balducci, Bodnar, Palleri, Bonetti, Hasan, Donti, Ragni, and Bartolacelli)
| | - Luca Ragni
- Department of Pediatric Cardiology and Adult Congenital Cardiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna (Drs Balducci, Bodnar, Palleri, Bonetti, Hasan, Donti, Ragni, and Bartolacelli)
| | - Emanuela Angeli
- Department of Pediatric and Adult Congenital Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna (Drs Gargiulo and Angeli), University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Bologna, Italy
| | - Ylenia Bartolacelli
- Department of Pediatric Cardiology and Adult Congenital Cardiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna (Drs Balducci, Bodnar, Palleri, Bonetti, Hasan, Donti, Ragni, and Bartolacelli)
| | - Laura Larcher
- Obstetric Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna (Drs Della Gatta, Contro, Larcher, Pilu, and Perolo)
| | - Gianluigi Pilu
- Obstetric Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna (Drs Della Gatta, Contro, Larcher, Pilu, and Perolo)
| | - Antonella Perolo
- Obstetric Unit, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna (Drs Della Gatta, Contro, Larcher, Pilu, and Perolo)
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16
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Gerlach P, Balducci A. The influence of current density, rest time and electrolyte composition on the self-discharge of organic radical polymers. Electrochim Acta 2021. [DOI: 10.1016/j.electacta.2021.138070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Kalantar-Zadeh K, Li PKT, Tantisattamo E, Kumaraswami L, Liakopoulos V, Lui SF, Ulasi I, Andreoli S, Balducci A, Dupuis S, Harris T, Hradsky A, Knight R, Kumar S, Ng M, Poidevin A, Saadi G, Tong A. Living well with kidney disease by patient and care partner empowerment: kidney health for everyone everywhere. Hong Kong Med J 2021; 27:97-98. [PMID: 33879627 DOI: 10.12809/hkmj209122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- K Kalantar-Zadeh
- The International Federation of Kidney Foundation-World Kidney Alliance (IFKF-WKA), Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine, Orange, California, United States.,Members of the World Kidney Day Steering Committee
| | - P K T Li
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.,Members of the World Kidney Day Steering Committee
| | - E Tantisattamo
- Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, University of California Irvine School of Medicine, Orange, California, United States
| | - L Kumaraswami
- Tanker Foundation, Chennai, India.,Members of the World Kidney Day Steering Committee
| | - V Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Members of the World Kidney Day Steering Committee
| | - S F Lui
- Hong Kong Kidney Foundation and the International Federation of Kidney Foundations-World Kidney Alliance, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.,Members of the World Kidney Day Steering Committee
| | - I Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria.,Members of the World Kidney Day Steering Committee
| | - S Andreoli
- James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, United States.,Members of the World Kidney Day Steering Committee
| | - A Balducci
- Italian Kidney Foundation, Rome, Italy.,Members of the World Kidney Day Steering Committee
| | - S Dupuis
- World Kidney Day Office, Brussels, Belgium.,Members of the World Kidney Day Steering Committee
| | - T Harris
- Polycystic Kidney Disease Charity, London, United Kingdom
| | - A Hradsky
- World Kidney Day Office, Brussels, Belgium
| | - R Knight
- American Association of Kidney Patients, Tampa, Florida, United States
| | - S Kumar
- Tanker Foundation, Chennai, India
| | - M Ng
- Hong Kong Kidney Foundation, Hong Kong
| | - A Poidevin
- World Kidney Day Office, Brussels, Belgium
| | - G Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt.,Members of the World Kidney Day Steering Committee
| | - A Tong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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18
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Dodaro MG, Montaguti E, Balducci A, Perolo A, Angeli E, Lenzi J, Lombardo L, Donti A, Gargiulo G, Pilu G. Fetal speckle-tracking echocardiography: a comparison between two-dimensional and electronic spatio-temporal image correlation (e-STIC) technique. J Matern Fetal Neonatal Med 2021; 35:6090-6096. [PMID: 33823732 DOI: 10.1080/14767058.2021.1906855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Speckle tracking technology has been applied to assess ventricular deformation throughout the cardiac cycle. An electronic four dimensional probe that allows rapid acquisition of electronic spatio-temporal image correlation volumes (eSTIC) has been recently introduced. OBJECTIVES The aim of our study was to investigate whether e-STIC acquisition improves deformation analyses reproducibility. STUDY DESIGN We recruited fetuses between 20 and 40 weeks of gestation. We obtained a 2D video clip and an e-STIC volume of a four-chamber view. We focused on left ventricular global strain (LV-GS) and left ventricular ejection fraction (LV-FE). Intraobserver, interobserver and intermethod agreement were assessed by means of intraclass correlation coefficient (ICC) and illustrated by Bland-Altman plots. Systematic differences between measurements were assessed using a paired t-test. RESULTS The mean difference between LV-GS values obtained with e-STIC and 2D analysis was -0.10 (95% CI -2.28, 2.08). No systematic differences were found between the two techniques for LV-GS values (p-value = .927). The mean difference between LV-FE values obtained with e-STIC and 2D analysis was 7.55 (95% CI 4.16, 10.95; p-value <.001). The inter-rater reliability of LV-GS was moderate-to-substantial for both e-STIC and 2D. The inter-rater reliability of LV-FE obtained via e-STIC was superior to that obtained via 2D analysis. The intra-rater reliability of LV-GS obtained with e-STIC was superior to that obtained with 2D analysis (ICC 0.857; 95% IC 0.761-0.917). The intra-rater reliability of LV-FE obtained via e-STIC was superior to that obtained via 2D analysis (ICC 0.647; IC 0.51-0.783). CONCLUSIONS e-STIC seems to be a better technique than 2D analysis for intra-rater reliability of LV-GS. 4D acquisition might improve intrinsic limitations of speckle tracking echocardiography.
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Affiliation(s)
- Maria Gaia Dodaro
- Department of Medical and Surgical Sciences, Obstetric Unit, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
| | - Elisa Montaguti
- Department of Medical and Surgical Sciences, Obstetric Unit, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
| | - Anna Balducci
- Department of Cardiac, Thoracic and Vascular Sciences, Paediatric Cardiology and Adult Congenital Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Antonella Perolo
- Department of Medical and Surgical Sciences, Obstetric Unit, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
| | - Emanuela Angeli
- Department of Pediatric and Adult Congenital Heart Cardiac Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Lorenzo Lombardo
- Department of Cardiac, Thoracic and Vascular Sciences, Paediatric Cardiology and Adult Congenital Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Andrea Donti
- Department of Cardiac, Thoracic and Vascular Sciences, Paediatric Cardiology and Adult Congenital Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Gaetano Gargiulo
- Department of Pediatric and Adult Congenital Heart Cardiac Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Gianluigi Pilu
- Department of Medical and Surgical Sciences, Obstetric Unit, University of Bologna and IRCCS Azienda Ospedaliero-Universitaria S.Orsola-Malpighi, Bologna, Italy
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19
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Bothe A, Balducci A. The impact of the thermal stability of non-conventional electrolytes on the behavior of high voltage electrochemical capacitors operating at 60 °C. Electrochim Acta 2021. [DOI: 10.1016/j.electacta.2021.137919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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20
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Ciuca C, Fabi M, Di Luca D, Niro F, Ghizzi C, Donti A, Balducci A, Rocca A, Zarbo C, Gargiulo GD, Lanari M. Myocarditis and coronary aneurysms in a child with acute respiratory syndrome coronavirus 2. ESC Heart Fail 2020; 8:761-765. [PMID: 33332751 PMCID: PMC7835580 DOI: 10.1002/ehf2.13048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/04/2020] [Accepted: 09/17/2020] [Indexed: 12/25/2022] Open
Abstract
A 6‐year‐old African boy with multi‐viral infection including parvovirus B19 and severe acute respiratory syndrome coronavirus 2 was admitted for persistent fever associated with respiratory distress and myocarditis complicated by cardiogenic shock needing ventilatory and inotropic support. Coronary aneurysms were also documented in the acute phase. Blood tests were suggestive of macrophage activation syndrome. He was treated with intravenous immunoglobulins, aspirin, diuretics, dexamethasone, hydroxychloroquine, and prophylactic low molecular weight heparin. Normalization of cardiac performance and coronary diameters was noticed within the first days. Cardiac magnetic resonance imaging, performed 20 days after the hospitalization, evidenced mild myocardial interstitial oedema with no focal necrosis, suggesting a mechanism of cardiac stunning related to cytokines storm rather than direct viral injury of cardiomyocytes.
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Affiliation(s)
- Cristina Ciuca
- Pediatric Cardiology and Cardiac Surgery Unit, University of Bologna, S. Orsola Hospital, Bologna, Italy
| | - Marianna Fabi
- Department of Pediatrics, University of Bologna, S. Orsola Hospital, Bologna, Italy
| | - Daniela Di Luca
- Department of Anesthesiology, University of Bologna, S. Orsola Hospital, Bologna, Italy
| | - Fabio Niro
- Department of Radiology, University of Bologna, S. Orsola Hospital, Bologna, Italy
| | - Chiara Ghizzi
- Department of Pediatrics, Maggiore Hospital, Bologna, Italy
| | - Andrea Donti
- Pediatric Cardiology and Cardiac Surgery Unit, University of Bologna, S. Orsola Hospital, Bologna, Italy
| | - Anna Balducci
- Pediatric Cardiology and Cardiac Surgery Unit, University of Bologna, S. Orsola Hospital, Bologna, Italy
| | - Alessandro Rocca
- Department of Pediatrics, University of Bologna, S. Orsola Hospital, Bologna, Italy
| | - Chiara Zarbo
- Department of Pediatrics, University of Bologna, S. Orsola Hospital, Bologna, Italy
| | - Gaetano Domenico Gargiulo
- Pediatric Cardiology and Cardiac Surgery Unit, University of Bologna, S. Orsola Hospital, Bologna, Italy
| | - Marcello Lanari
- Department of Pediatrics, University of Bologna, S. Orsola Hospital, Bologna, Italy
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21
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Fabi M, Filice E, Andreozzi L, Conti F, Gabrielli L, Balducci A, Vergine G, Cicero, MD C, Iughetti L, Guerzoni ME, Corinaldesi E, Lazzarotto T, Pession A, Lanari M. Spectrum of Cardiovascular Diseases in Children During High Peak Coronavirus Disease 2019 Period Infection in Northern Italy: Is There a Link? J Pediatric Infect Dis Soc 2020; 10:714-721. [PMID: 33283237 PMCID: PMC7798942 DOI: 10.1093/jpids/piaa162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/13/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Children with coronavirus disease-2019 (COVID-19) have a milder clinical course than adults. We describe the spectrum of cardiovascular manifestations during a COVID-19 outbreak in Emilia-Romagna, Italy. METHODS A cross-sectional multicenter study was performed, including all patients diagnosed with Kawasaki disease (KD), myocarditis, and multisystem inflammatory syndrome in children (MIS-C) from February to April 2020. KD patients were compared with those diagnosed before the epidemic. RESULTS KD: 8 patients (6/8 boys, all negative for severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]): complete presentation in 5/8, 7/8 immunoglobulin (IVIG) responders, and 3/8 showed transient coronary lesions (CALs). Myocarditis: one 5-year-old girl negative for SARS-CoV-2 and positive for parvovirus B19. She responded to IVIG. MIS-C: 4 SARS-CoV-2-positive boys (3 patients with positive swab and serology and 1 patient with negative swab and positive serology): 3 presented myocardial dysfunction and pericardial effusion, and 1 developed multicoronary aneurysms and hyperinflammation; all responded to treatment. The fourth boy had mitral and aortic regurgitation that rapidly regressed after steroids. CONCLUSIONS KD, myocarditis, and MIS-C were distinguishable cardiovascular manifestations. KD did not show a more aggressive form compared with previous years: coronary involvement was frequent but always transient. MIS-C and myocarditis rapidly responded to treatment without cardiac sequelae despite high markers of myocardial injury at the onset, suggesting a myocardial depression due to systemic inflammation rather than focal necrosis. Evidence of actual or previous SARS-CoV-2 infection was documented only in patients with MIS-C.
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Affiliation(s)
- Marianna Fabi
- Department of Pediatrics, University of Bologna, S.Orsola Hospital, Bologna, Italy,The corresponding author is Dr. Marianna Fabi, Department of Pediatrics, University of Bologna, S.Orsola Hospital, Bologna, Italy. Via Massarenti 11. 40138 Bologna, Italy. Tel: +39 333 8351572. Fax +39 051 2143116.
| | - Emanuele Filice
- Department of Pediatrics, University of Bologna, S.Orsola Hospital, Bologna, Italy
| | - Laura Andreozzi
- Department of Pediatrics, University of Bologna, S.Orsola Hospital, Bologna, Italy
| | - Francesca Conti
- Department of Pediatrics, University of Bologna, S.Orsola Hospital, Bologna, Italy
| | - Liliana Gabrielli
- Operative Unit of Clinical Microbiology, Laboratory of Virology, St. Orsola Hospital, University of Bologna, Italy
| | - Anna Balducci
- Pediatric Cardiology and Congenital Heart Disease Unit, S. Orsola Hospital, University of Bologna, Italy
| | | | - Cristina Cicero, MD
- Department of Pediatrics, AUSL, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria Elena Guerzoni
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Tiziana Lazzarotto
- Operative Unit of Clinical Microbiology, Laboratory of Virology, St. Orsola Hospital, University of Bologna, Italy
| | - Andrea Pession
- Department of Pediatrics, University of Bologna, S.Orsola Hospital, Bologna, Italy
| | - Marcello Lanari
- Department of Pediatrics, University of Bologna, S.Orsola Hospital, Bologna, Italy
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Contro E, Cattani L, Balducci A, Prandstraller D, Perolo A, Larcher L, Reggiani MLB, Farina A, Donti A, Gargiulo GD, Pilu G. Prediction of neonatal coarctation of the aorta at fetal echocardiography: a scoring system. J Matern Fetal Neonatal Med 2020; 35:4299-4305. [PMID: 33203263 DOI: 10.1080/14767058.2020.1849109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Coarctation of the aorta (CoA) is common and can lead to neonatal emergency. Despite its burden, antenatal detection of this condition remains inaccurate. OBJECTIVE To evaluate the diagnostic performance of fetal echocardiography and to design a scoring system for risk stratification of CoA in suspected cases. DESIGN A retrospective cohort study. SETTING S. Orsola Hospital, Bologna, Italy. POPULATION About 140 fetuses referred for suspected CoA to our tertiary center in a 9-year period. METHODS The following parameters were systematically obtained at fetal echocardiography: ventricular disproportion, great vessels asymmetry, transverse aortic arch hypoplasia, flow turbulence, and Z-scores of the ascending aorta and of the aortic isthmus. Associated anomalies were recorded, if present. When CoA was not confirmed at birth, neonates were followed up for 12 months to identify also a tardive onset of this condition. MAIN OUTCOME MEASURES The primary outcome was the presence of COA after birth. RESULTS 108 fetuses were eligible for the purpose of the study. CoA was confirmed postnatally in 55 neonates (50.9%). Arch hypoplasia yielded the highest correlation with CoA. The affected neonates presented also significantly lower Z scores of the ascending aorta and of the aortic isthmus. Earlier gestational age at referral was positively correlated with neonatal CoA. An odds ratio-based multiparametric model was designed to build a scoring system (AUC 0.89). CONCLUSION In our cohort, no single ultrasound parameter was sufficiently accurate to predict postnatal CoA. The scoring system permitted a better identification of the affected fetuses.
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Affiliation(s)
- Elena Contro
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, S. Orsola University Hospital, Bologna, Italy
| | - Laura Cattani
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, S. Orsola University Hospital, Bologna, Italy.,Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - Anna Balducci
- Department of Pediatric Cardiology, S. Orsola University Hospital, Bologna, Italy
| | | | - Antonella Perolo
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, S. Orsola University Hospital, Bologna, Italy
| | - Laura Larcher
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, S. Orsola University Hospital, Bologna, Italy
| | | | - Antonio Farina
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, S. Orsola University Hospital, Bologna, Italy
| | - Andrea Donti
- Department of Pediatric Cardiology, S. Orsola University Hospital, Bologna, Italy
| | | | - Gianluigi Pilu
- Department of Obstetrics and Gynecology, Fetal Medicine Unit, S. Orsola University Hospital, Bologna, Italy
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Contro E, Larcher L, Balducci A, Prandstraller D, Perolo A, Lenzi J, Farina A, Donti A, Gargiulo G, Pilu G, Gatta AD. OC01.01: Foramen ovale morphology at fetal echocardiography may predict neonatal outcome in fetuses with complete transposition of the great arteries. Ultrasound Obstet Gynecol 2020; 56 Suppl 1:1-378. [PMID: 33063402 DOI: 10.1002/uog.22195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/09/2020] [Accepted: 08/18/2020] [Indexed: 06/11/2023]
Affiliation(s)
- E Contro
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - L Larcher
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - A Balducci
- Department of Cardiac Pediatric Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - D Prandstraller
- Department of Cardiac Pediatric Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - A Perolo
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - J Lenzi
- Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - A Farina
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - A Donti
- Department of Cardiac Pediatric Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - G Gargiulo
- Department of Cardiac Pediatric Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - G Pilu
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - A Della Gatta
- Department of Obstetrics and Perinatal Medicine, University degli Studi di Bologna, Bologna, Italy
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Montaguti E, Balducci A, Perolo A, Livi A, Contro E, Casadio P, Donti A, Angeli E, Gargiulo G, Pilu G. Prenatal diagnosis of congenital heart defects and voluntary termination of pregnancy. Am J Obstet Gynecol MFM 2020; 2:100207. [PMID: 33345922 DOI: 10.1016/j.ajogmf.2020.100207] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/28/2020] [Accepted: 08/04/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND The prenatal diagnosis of an isolated congenital heart defect is a matter of concern for parents. The decision of whether to terminate the pregnancy according to the different types of congenital heart defects has not been investigated yet. OBJECTIVE This study aimed to evaluate the frequency of voluntary termination of pregnancy after the prenatal diagnosis of a congenital heart defect in a tertiary care center. STUDY DESIGN This was a retrospective study of patients who were referred to our center from January 2013 to December 2019, underwent fetal echocardiography, and were counseled by a perinatologist and a pediatric cardiologist. The following data were collected: prenatal diagnosis, including genetic testing; gestational age at diagnosis; and outcome of pregnancy. The diagnoses were stratified retrospectively according to the type of congenital heart defect and its severity (low complexity, moderate complexity, and high complexity) by a perinatologist and a pediatric cardiologist. RESULTS Of 704 women who received a diagnosis of fetal congenital heart defect, 531 (75.4%) were seen before 23 weeks' gestation, which is the upper limit imposed for the termination of pregnancy by the Italian legislation. Congenital heart defects were apparently isolated in 437 of 531 cases (82.3%). Overall, 108 of 531 patients (20.3%) requested a termination of pregnancy. The rate of termination of pregnancy was found to vary according to the severity of congenital heart defects: low complexity, 0%; moderate complexity, 12.1%, and high complexity, 33.2% (P<.001). The presence or absence of associated anomalies or the ethnicity of the couples was not found to have an influence on women's decisions. CONCLUSION In our population, the decision to terminate a pregnancy after the diagnosis of a fetal congenital heart defect is influenced by the surgical complexity of the congenital heart defect itself. However, most patients, including those with the most severe forms of congenital heart defect, decided to continue the pregnancy.
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Affiliation(s)
- Elisa Montaguti
- Obstetric Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy.
| | - Anna Balducci
- Paediatric Cardiology and Adult Congenital Unit, Department of Cardiac, Thoracic and Vascular Sciences, Sant'Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy
| | - Antonella Perolo
- Obstetric Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy
| | - Alessandra Livi
- Obstetric Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy
| | - Elena Contro
- Obstetric Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy
| | - Paolo Casadio
- Obstetric Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy
| | - Andrea Donti
- Paediatric Cardiology and Adult Congenital Unit, Department of Cardiac, Thoracic and Vascular Sciences, Sant'Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy
| | - Emanuela Angeli
- Department of Pediatric and Adult Congenital Heart Cardiac Surgery, Sant'Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy
| | - Gaetano Gargiulo
- Department of Pediatric and Adult Congenital Heart Cardiac Surgery, Sant'Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy
| | - Gianluigi Pilu
- Obstetric Unit, Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Polyclinic, University of Bologna, Bologna, Italy
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Fabi M, Balducci A, Cazzato S, Aceti A, Gallucci M, Di Palmo E, Gargiulo G, Donti A, Lanari M. Resting respiratory lung volumes are "healthier" than exercise respiratory volumes in different types of palliated or corrected congenital heart disease. Pediatr Pulmonol 2020; 55:697-705. [PMID: 31951681 DOI: 10.1002/ppul.24640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 12/27/2019] [Indexed: 11/12/2022]
Abstract
AIMS Cardiac surgery has improved life expectancy of patients with congenital heart diseases (CHDs). Exercise capacity is an important determinant of survival in patients with CHDs. There is a lack of studies focusing on the role of resting respiratory performance in reducing exercise tolerance in these patients. OBJECTIVES To determine the prevalence and severity of respiratory functional impairment in different types of corrected/palliated CHDs, and its impact on an exercise test. MATERIALS AND METHODS Retrospective single-center study involving 168 corrected/palliated patients with CHD and 52 controls. Patients CHD were divided into subgroups according to the presence of native pulmonary blood flow or total cavopulmonary connection (TCPC). All subjects performed complete pulmonary function tests and gas diffusion; patients with CHD also performed cardiopulmonary exercise test (CPX). RESULTS Mean values of lung volumes were within the normal range in all CHD groups. Comparing to controls, patients with the reduced pulmonary flow and with TCPC had the highest reduction in lung volumes. CPX was reduced in all groups, most severely in TCPC, and it was correlated to decreased dynamic volumes in all CHD groups except in TCPC. Younger age at intervention and number of surgical operations negatively affected lung volumes. CONCLUSIONS Respiratory function is within the normal range in our patients with different CHDs at rest but altered in all CHDs during exercise when cardiorespiratory balance is likely to be inadequate. Comparing the different groups, patients with reduced pulmonary flow and TCPC are the most impaired.
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Affiliation(s)
- Marianna Fabi
- Department of Cardiac, Thoracic and Vascular Sciences, Paediatric Cardiology and Adult Congenital Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Anna Balducci
- Department of Cardiac, Thoracic and Vascular Sciences, Paediatric Cardiology and Adult Congenital Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Salvatore Cazzato
- Department of Mother and Child Health, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Umberto I G M Lancisi G Salesi, Ancona, Marche, Italy
| | - Arianna Aceti
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Marcella Gallucci
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Emanuela Di Palmo
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Gaetano Gargiulo
- Department of Pediatric and Adult Congenital Heart Cardiac Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Andrea Donti
- Department of Cardiac, Thoracic and Vascular Sciences, Paediatric Cardiology and Adult Congenital Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Marcello Lanari
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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Ciuca C, Angeli E, Careddu L, Di Dio M, Petridis F, Ragni L, Hasan T, Donti A, Gargiulo D, Balducci A. P1599 Longue term outcome after surgical repair of complete atrioventricular septal defect: 2D versus 3D echocardiographic evaluation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose
Assessment of longue term follow-up after surgical repair of Complete Atrioventricular Septal Defect (cAVSD). Evaluation of 3D versus standard 2D echocardiographic accuracy during the last follow-up.
Methods
43 patients were included in this study. Mean age at surgical repair was 7 months, 48.8% of patients were male; 67.4% had Down Syndrome. Mean time follow-up was 13 ± 6 years. During the last follow-up 2D and 3D echo evaluation were performed.
Results
All patients were alive and had a NYHA class I at the last follow-up. Survival free from new cardiac surgery at 13 years was 86%. During follow-up a progressive moderate to severe/severe mitral regurgitation (MR) was observed in 6 patients (16.3%) while 4 patients developed a progressive left ventricular outflow tract obstruction (LVOTO); overall 5 patients underwent new cardiac surgery (3 for MR and 2 for LVOTO). Echocardiographic evaluation showed: LV end diastolic volume 55.7 ± 13.0ml/m2, LV ejection fraction 64 ± 5%, left atrium volume 24.9 ± 13.9ml/m2, right ventricle systolic pression 21.0 ± 2.0 and a LVOT gradient 14.6 ± 16.4 mmHg. Mitral valve evaluation is evidenced in Table 1. Predictor factors of severe MR during follow-up were the cleft area and depth and the presence of anterior leaflet prolapse. Cohen’s kappa evidenced a good correlation between 2D and 3D VC evaluation with a higher sensibility of 3D evaluation to identify severe MR, data confirmed by the ROC curve analysis (Figure A and B).
Conclusions
Clinical outcome after cAVSD surgical repair is excellent with a low rate of reintervention. 3D echo evaluation is more sensitive to identify both predictors and severity of MR ì.
LAST Follow-up echocardiography 2D evaluation 3D evaluation Mitral Valve evaluation Vena contracta, mm 4.8 ± 2.5 5.3 ± 2.5 Regurgitant volume, ml 25 ± 20 ERO, cm2 0.17 ± 0.13 Mean gradient, mmHg 4 ± 2.4 Residual cleft, n(%) A1 A2 A3 30 (90.7) 4 (9.3) 33 (76.8) 6 (13.9) Cleft area,cm2 0.19 ± 0.21 Cleft depth, mm 5 .0 ± 2.9 Valve thickening, n(%) 14 (13.6) Leaflet Prolapse, n (%) Anterior Leaflet Prolapse, n (%) Posterior Leaflet Prolapse, n (%) 30 (69.7) 25 (58.1) 10 (23.2) Single papilary, n(%) 10 (23.2)
Abstract P1599 Figure.
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Affiliation(s)
- C Ciuca
- Pediatric Cardiology and Adults Congenital Heart Disease Unit, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - E Angeli
- Pediatric Cardiac Surgery, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - L Careddu
- Pediatric Cardiac Surgery, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - M Di Dio
- University Hospital Policlinic S. Orsola-Malpighi, Cardiology Istitute, Bologna, Italy
| | - F Petridis
- Pediatric Cardiac Surgery, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - L Ragni
- Pediatric Cardiology and Adults Congenital Heart Disease Unit, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - T Hasan
- Pediatric Cardiology and Adults Congenital Heart Disease Unit, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - A Donti
- Pediatric Cardiology and Adults Congenital Heart Disease Unit, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - D Gargiulo
- Pediatric Cardiac Surgery, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - A Balducci
- Pediatric Cardiology and Adults Congenital Heart Disease Unit, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
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Ciuca C, Balducci A, Lovato L, Niro F, Angeli E, Cesaretti S, Bonfiglioli R, Gargiulo G, Donti A. P642 Coronary arteriovenous fistulas. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Clinical case
A 53 years woman in good health and un uneventful clinical history except for a mild hypercholesteremia was evaluated for palpitations. At the clinical examination she had a systolic murmur 3/6 Levine, with no signs of heart failure.
The ECG showed normal sinus rhythm with a normal heart rate (62bpm), normal atrio-ventricular and intraventricular conduction and normal repolarisation, one supraventricular premature beat. The echocardiography showed normal biventricular dimension and function, no valvular heart diseases, no septal defects, regular aortic dimensions. A giant right coronary was evidenced (Figure, panel a) with an arteriovenous fistula originating from the right coronary artery and draining through the coronary sinus into the right atrium (Figure, panel b). The CT coronary angiogram evidenced an dilated right coronary artery communicating with the coronary sinus (arteriovenous fistula) draining into the right atrium. A smaller arteriovenous fistula was evidenced between the circumflex artery (slightly dilated) and the great cardiac vein. (Figure, panel c-e)
The Treadmill test didn’t evidence an induced ischemia; however the patient didn’t perform a maximal exercise (double product 20400mmHb*bpm). Moreover, during the first steps of recovery frequent supraventricular premature beats were registered with phases of bigeminies followed by a junctional rhythm phase. Thus, a Gated myocardial Perfusion SPECT was performed evidenced a mild stress induced ischemia of the inferolateral and apical left ventricle wall with normal rest perfusion and normal left ventricle volumes (125ml during exercise and 134ml at rest) with a normal ejection fraction ( > 65%). (Figure, panel f)An elective coronarography was planned. The patient is on therapy with beta-blockers and aspirin. The patient is asymptomatic for angina. Antibiotic prophylaxis was recommended for dental, gastrointestinal, or urologic procedures. Discussion: Coronary arteriovenous fistula (CAVF), first described in 1865 by Krausein (1), are a rare congenital heart disease representing less than 0.5% of all congenital heart diseases with an extremely rare prevalence 0.002% in the general population (2). Moreover, therapy of CAVF is still controversial with previous data showing a relatively high rate of myocardial infarction after surgical repair (3). The recent AHA/ACC guideline for the management of adults with Congenital heart disease recommend a review by a knowledgeable team that may include congenital or noncongenital cardiologists and surgeons to determine the role of medical therapy and/or percutaneous or surgical closure (4) Conclusion: CAVF is a very rare congenital heart defect and might be asymptomatic and evidenced by hazard in adults patients. Therapy strategy demands a multidisciplinary team evaluation and should be be individualized according to the clinic presentation, the presence or absence of myocardial ischemia or ventricular dysfunction.
Abstract P642 Figure.
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Affiliation(s)
- C Ciuca
- Pediatric Cardiology and Adults Congenital Heart Disease Unit, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - A Balducci
- Pediatric Cardiology and Adults Congenital Heart Disease Unit, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - L Lovato
- Radiology, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi, bologna, Italy
| | - F Niro
- Radiology, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi, bologna, Italy
| | - E Angeli
- Pediatric Cardiac Surgery, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - S Cesaretti
- University Hospital Policlinic S. Orsola-Malpighi, Cardiology Istitute, Bologna, Italy
| | - R Bonfiglioli
- University Hospital Policlinic S. Orsola-Malpighi, Nuclear Medicine, Bologna, Italy
| | - G Gargiulo
- Pediatric Cardiac Surgery, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
| | - A Donti
- Pediatric Cardiology and Adults Congenital Heart Disease Unit, Cardiothoracic-Vascular Department, University Hospital Policlinic S. Orsola-Malpighi , Bologna, Italy
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Fabi M, Calicchia M, Miniaci A, Balducci A, Tronconi E, Bonetti S, Frabboni I, Biagi C, Bronzetti G, Pession A, Donti A, Lanari M. Carditis in Acute Rheumatic Fever in a High-Income and Moderate-Risk Country. J Pediatr 2019; 215:187-191. [PMID: 31587860 DOI: 10.1016/j.jpeds.2019.07.072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To describe clinical presentation, electrocardiographic, and echocardiographic characteristics of carditis at the time of diagnosis of acute rheumatic fever (ARF) over a 13-year period. STUDY DESIGN A single-center retrospective chart analysis was conducted involving all consecutive patients diagnosed with ARF between 2003 and 2015. Patient age, sex, clinical characteristics, recent medical history for group A streptococcal pharyngotonsillitis and antibiotic treatment, and laboratory, echocardiographic, and electrocardiographic findings were recorded. RESULTS Of 98 patients (62 boys, mean age 8.81 ± 3.04 years), 59 (60.2%) reported a positive history of pharyngotonsillitis; 48 (49%) had received antibiotic (mean duration of treatment of 5.9 ± 3.1 days), and, among these, 28 (58.3%) had carditis. Carditis was the second most frequent finding, subclinical in 27% of patients. Mitral regurgitation was present in 49 of 56 patients (87.5%) and aortic regurgitation in 36/56 (64.3%) no stenosis was documented. CONCLUSIONS ARF is still present in high-income countries and can develop despite primary prophylaxis, especially when given for a short course. Our findings highlight the need for 10 days of antistreptococcal treatment to prevent ARF. Echocardiography is important because 27% of cases with carditis were subclinical.
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Affiliation(s)
- Marianna Fabi
- Department of Pediatrics, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
| | - Margherita Calicchia
- Department of Pediatrics, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Angela Miniaci
- Department of Pediatrics, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Anna Balducci
- Cardiology and Adult Congenital Unit, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Elena Tronconi
- Department of Pediatrics, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Simone Bonetti
- Cardiology and Adult Congenital Unit, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Ilaria Frabboni
- Department of Pediatrics, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Carlotta Biagi
- Department of Pediatrics, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Gabriele Bronzetti
- Cardiology and Adult Congenital Unit, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Andrea Pession
- Department of Pediatrics, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Andrea Donti
- Cardiology and Adult Congenital Unit, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Marcello Lanari
- Department of Pediatrics, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
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Ciuca C, Ragni L, Hasan T, Balducci A, Angeli E, Prandstraller D, Egidy-Assenza G, Donti A, Bonvicini M, Gargiulo GD. Dilated cardiomyopathy in a pediatric population: etiology and outcome predictors - a single-center experience. Future Cardiol 2019; 15:95-107. [PMID: 30848673 DOI: 10.2217/fca-2018-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIM The aim of the study was to assess predictors of outcome in patients hospitalized for dilated cardiomyopathy (DCM) and severe left ventricular dysfunction. Patients & methods: 83 pediatric patients hospitalized for heart failure due to DCM with coexistent left ventricular dysfunction were enrolled. RESULTS Overall, 5-year survival free from heart transplantation was 69.8%. Normalization of left ventricular function was achieved in 39.8% of patients during follow-up: younger age, less necessity of inotropic support and other than idiopathic DCM predicted left ventricular function, while familial history for cardiac disease or sudden death and inotropic support during hospitalization were associated with poorer outcome. CONCLUSION Almost 40% of patients with DCM experienced a complete normalization of cardiac function. Outcome was extremely variable according to the type of DCM.
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Affiliation(s)
- Cristina Ciuca
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Luca Ragni
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Tammam Hasan
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Anna Balducci
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Emanuela Angeli
- Pediatric & Grown-up Congenital Cardiac Surgery Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Daniela Prandstraller
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Gabriele Egidy-Assenza
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Andrea Donti
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Marco Bonvicini
- Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
| | - Gaetano D Gargiulo
- Pediatric & Grown-up Congenital Cardiac Surgery Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy
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Careddu L, Petridis FD, Angeli E, Balducci A, Buia F, Lovato L, Gargiulo GD. Endovascular repair in extra-anatomic bypass after hypoplastic aortic arch repair. J Cardiovasc Med (Hagerstown) 2019; 20:261-263. [PMID: 30664070 DOI: 10.2459/jcm.0000000000000762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | | | | | | | - Francesco Buia
- Cardiovascular Radiology Department, Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Luigi Lovato
- Cardiovascular Radiology Department, Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi University Hospital, Bologna, Italy
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Careddu L, Petridis FD, Angeli E, Balducci A, Mariucci E, Egidy Assenza G, Donti A, Gargiulo GD. Dacron Conduit for Extracardiac Total Cavopulmonary Anastomosis: A Word of Caution. Heart Lung Circ 2018; 28:1872-1880. [PMID: 30555011 DOI: 10.1016/j.hlc.2018.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 08/25/2018] [Accepted: 11/03/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND The extracardiac conduit technique is a valid option for completing total cavopulmonary anastomosis (TCPC) in patients with a single ventricle. The technique allows for beating heart surgery, optimal flow dynamics, and reduced postoperative atrial arrhythmia. Different types of conduit have been proposed. This study reported a single-centre experience with two different types of conduit. METHODS Consecutive patients referred for TCPC at the current institution between January 2001 and September 2013 were included. Retrospective extraction of pertinent variables was accomplished through electronic patient chart review. Patients were stratified based on the type of conduit used to perform the TCPC: polytetrafluoroethylene (PTFE) conduit (Group A) and polyethylene-terephthalate (Dacron) conduit (Group B). RESULTS The patient population included 105 patients: Group A had 80 patients, and Group B had 25 patients. The two groups were similar in major clinical and procedural variables, including conduit size and Nakata index. Eighteen patients (Group A: one [1.25%]; Group B: 17 [68%]) had conduit occlusion or severe stenosis requiring intervention after a mean 46.9±35months after the operation. The percentage of patients in Group A who were free of conduit obstruction at 3, 5, and 10 years was 100%, 100%, and 96%, respectively, whereas these figures were 68%, 52%, and 35% in Group B (log-rank <0.000). Conduit re-intervention was associated with an increased risk of overall mortality after primary intervention (p<0.004). Dacron tube was found to be an independent risk factor for mid-term stenosis or obstruction (hazard ratio, 62.9; 95% CI, 8.2-482.2; p=0.000). CONCLUSION Dacron conduit for TCPC surgery was associated with a higher risk of obstruction and need for early re-intervention compared with PTFE conduit. Surgical or percutaneous re-interventions for conduit obstruction increased the risk of late mortality.
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Affiliation(s)
- Lucio Careddu
- Pediatric and Adult Congenital Heart Cardiac Surgery and Cardiology Program Unit, S. Orsola-Malpighi Hospital, University of Bologna Medical School, Bologna, Italy.
| | - Francesco Dimitri Petridis
- Pediatric and Adult Congenital Heart Cardiac Surgery and Cardiology Program Unit, S. Orsola-Malpighi Hospital, University of Bologna Medical School, Bologna, Italy
| | - Emanuela Angeli
- Pediatric and Adult Congenital Heart Cardiac Surgery and Cardiology Program Unit, S. Orsola-Malpighi Hospital, University of Bologna Medical School, Bologna, Italy
| | - Anna Balducci
- Pediatric and Adult Congenital Heart Cardiac Surgery and Cardiology Program Unit, S. Orsola-Malpighi Hospital, University of Bologna Medical School, Bologna, Italy
| | - Elisabetta Mariucci
- Pediatric and Adult Congenital Heart Cardiac Surgery and Cardiology Program Unit, S. Orsola-Malpighi Hospital, University of Bologna Medical School, Bologna, Italy
| | - Gabriele Egidy Assenza
- Pediatric and Adult Congenital Heart Cardiac Surgery and Cardiology Program Unit, S. Orsola-Malpighi Hospital, University of Bologna Medical School, Bologna, Italy
| | - Andrea Donti
- Pediatric and Adult Congenital Heart Cardiac Surgery and Cardiology Program Unit, S. Orsola-Malpighi Hospital, University of Bologna Medical School, Bologna, Italy
| | - Gaetano Domenico Gargiulo
- Pediatric and Adult Congenital Heart Cardiac Surgery and Cardiology Program Unit, S. Orsola-Malpighi Hospital, University of Bologna Medical School, Bologna, Italy
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Petridis F, Angeli E, Careddu L, Romano G, Tonelli F, Balducci A, Donti A, Gargiulo G. RF12 CLINICAL OUTCOME AND HEALTH RELATED QUALITY OF LIFE AFTER CRYOPRESERVED HOMOGRAFT IMPLANTATION FOR RIGHT VENTRICULAR OUTFLOW RECONSTRUCTION. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550047.73625.9a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Angeli E, Careddu L, Petridis F, Tonelli F, Romano G, Balducci A, Assenza GE, Donti A, Gargiulo G. RF79 SURGERY OF GROWN UP CONGENITAL HEART DISEASE. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550020.65108.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Balducci A, Hasan T, Donti A, Egidy Assenza G, Lovato L, Fabi M, Gesuete V, Prandstraller D, Formigari R, Ragni L, Angeli E, Gargiulo GD, Picchio FM, Bonvicini M. Multimodality imaging, single center, cross-sectional study in adolescents or young adults with repaired tetralogy of Fallout. J Cardiovasc Med (Hagerstown) 2018; 19:643-649. [PMID: 30234684 DOI: 10.2459/jcm.0000000000000713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Proper integration of multiple imaging modalities in the routine follow-up of patients with repaired tetralogy of Fallout (TOF) is poorly supported by data. We report our single center comparative study between cardiac magnetic resonance (CMR) and echocardiography to assess equipoise in the clinical utility of these two imaging methods in an unselected consecutive cohort of TOF patients referred to our outpatient clinic. MATERIAL AND METHODS In this cross-sectional study, repaired TOF patients who underwent CMR and echocardiography within a 4-week period between 2010 and 2011 at our Center were included. Linear regression was used to analyze degree of inter modality correlation. A prediction model tested the association between functional data/probrain natriuretic peptide (Pro-BNP) with CMR. RESULTS Fifty patients were included in the study (mean age 31 ± 18 years). The best predictors of right ventricle (RV) ejection fraction at CMR were tricuspid anular plane systolic excursion (tricuspid valve anular plane systolic excursion, R 0.37, P < 0.0001) and RV peak S-wave velocity (R 0.40, P < 0.001). Pro-BNP levels did present weak correlation with New York Heart Association functional class (R 0.31, P < 0.002) and QRS duration (R 0.32, P < 0.002) and a moderate correlation with right atrium area at CMR (R 0.46, P < 0.0001). CONCLUSION We found limited correlation between the two imaging modalities in the evaluation of RV after intracardiac repair of TOF. Pro-BNP level presents moderate correlation with right atrium area measured with echocardiography. Serial CMR evaluations are needed in this patient population, but they may be interchanged by routine echocardiography in particular in patients with normal or stable echocardiographic parameters.
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Affiliation(s)
- Anna Balducci
- Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program
| | - Tammam Hasan
- Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program
| | - Andrea Donti
- Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program
| | - Gabriele Egidy Assenza
- Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program
| | | | - Marianna Fabi
- Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program
| | - Valentina Gesuete
- Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program
| | - Daniela Prandstraller
- Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program
| | - Roberto Formigari
- Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program
| | - Luca Ragni
- Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program
| | - Emanuela Angeli
- Department of Cardiovascular Medicine, Pediatric Cardiac and Adult Congenital Heart Surgery, 'Azienda Ospedaliera-Universitaria Sant'Orsola-Malpighi' Hospital, 'Alma Mater Studiorum' Medical School, Bologna, Italy
| | - Gaetano D Gargiulo
- Department of Cardiovascular Medicine, Pediatric Cardiac and Adult Congenital Heart Surgery, 'Azienda Ospedaliera-Universitaria Sant'Orsola-Malpighi' Hospital, 'Alma Mater Studiorum' Medical School, Bologna, Italy
| | - Fernando M Picchio
- Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program
| | - Marco Bonvicini
- Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program
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Stettner T, Huang P, Goktas M, Adelhelm P, Balducci A. Mixtures of glyme and aprotic-protic ionic liquids as electrolytes for energy storage devices. J Chem Phys 2018; 148:193825. [DOI: 10.1063/1.5013117] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T. Stettner
- Institute for Technical Chemistry and Environmental Chemistry, Friedrich-Schiller-University Jena, 07743 Jena, Germany
- Center for Energy and Environmental Chemistry Jena (CEEC Jena), Friedrich-Schiller-University Jena, 07743 Jena, Germany
| | - P. Huang
- Institute for Technical Chemistry and Environmental Chemistry, Friedrich-Schiller-University Jena, 07743 Jena, Germany
- Center for Energy and Environmental Chemistry Jena (CEEC Jena), Friedrich-Schiller-University Jena, 07743 Jena, Germany
| | - M. Goktas
- Institute for Technical Chemistry and Environmental Chemistry, Friedrich-Schiller-University Jena, 07743 Jena, Germany
- Center for Energy and Environmental Chemistry Jena (CEEC Jena), Friedrich-Schiller-University Jena, 07743 Jena, Germany
| | - P. Adelhelm
- Institute for Technical Chemistry and Environmental Chemistry, Friedrich-Schiller-University Jena, 07743 Jena, Germany
- Center for Energy and Environmental Chemistry Jena (CEEC Jena), Friedrich-Schiller-University Jena, 07743 Jena, Germany
| | - A. Balducci
- Institute for Technical Chemistry and Environmental Chemistry, Friedrich-Schiller-University Jena, 07743 Jena, Germany
- Center for Energy and Environmental Chemistry Jena (CEEC Jena), Friedrich-Schiller-University Jena, 07743 Jena, Germany
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Grigioni M, Daniele C, Del Gaudio C, Morbiducci U, Balducci A, D'Avenio G, Amodeo A, Barbaro V, Di Donato R. Numerical Simulation of a Realistic Total Cavo-pulmonary Connection: Effect of Unbalanced Pulmonary Resistances on Hydrodynamic Performance. Int J Artif Organs 2018; 26:1005-14. [PMID: 14708830 DOI: 10.1177/039139880302601107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Total cavo pulmonary connection (TCPC) is one of the surgical techniques adopted to compensate the failure of the right heart in pediatric patients. The main goal of this procedure is the realization of a configuration for the caval veins and for the pulmonary arteries that can guarantee as low as possible pressure losses and appropriate lung perfusion. Starting from this point of view, a realistic TCPC with extracardiac conduit (TECPC) is investigated by means of Computational Fluid Dynamics (CFD) to evaluate the pressure loss under different pressure conditions, simulating different vessel resistances, on the pulmonary arteries. A total flow of 3 L/min, with a distribution between the inferior vena cava (IVC) and the superior vena cava (SVC) equal to 6/4, was investigated; three different boundary conditions for the pressure were imposed, resulting in three simulations in steady-state conditions, to the right pulmonary artery (RPA) and to the left pulmonary artery (LPA), simulating a balanced (deltaP(LPA-RPA) = 0 mmHg) and two unbalanced pulmonary resistances to blood flow (a pressure difference deltaP(LPA-RPA) = +/- 2 mmHg, respectively). The geometry for the TECPC was realized according to MRI derived physiological values for the vessels and for the configuration adopted for the anastomosis (the extra-cardiac conduit was inclined 22 degrees towards the left pulmonary artery with respect to the IVC axis). The computed power losses agree with previous in vitro Particle Image Velocimetry investigations. The results show that a higher resistance on the LPA causes the greater pressure loss for the TECPC under study, while the minimum pressure loss can be achieved balancing the pulmonary resistances, subsequently obtaining a balanced flow repartition towards the lungs.
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Affiliation(s)
- M Grigioni
- Laboratory of Biomedical Engineering, Istituto Superiore di Sanità, Rome, Italy.
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Grigioni M, Daniele C, Morbiducci U, Del Gaudio C, D'Avenio G, Balducci A, Barbaro V. Proposal for a Quantitative Description of Blood Spiral Flow in Medical Devices. Int J Artif Organs 2018; 27:231-42. [PMID: 15112889 DOI: 10.1177/039139880402700310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The association between specific blood flow patterns and blood behaviour through medical devices suggests that a Lagrangian study may be a useful instrument for the evaluation of the thrombogenic and/or hemolytic potential of certain devices' geometries and biomaterials. In this study a description of blood particle trajectories in terms of their spiral contents is proposed; such a mathematical description for blood spiral flow, computed along several pathlines, is tested for a quantitative determination of the spiralled motion of blood flow into two three-dimensional numerical models, having different design characteristics, of venous cannula inserted in a vessel. As the influence of vortical flow conditions have been observed to have both beneficial and detrimental influence on blood behaviour in terms of blood-device interaction, of the degradation of its components, and of the efficiency of mass-exchange (in red cells oxygenation and plasma filtration, for example), the herein proposed method for the description of spiral laminar motion may be a helpful instrument to build up a tool to investigate, for example, the existence of correlations between level of spiral flow and geometry (as in the present investigated test case), rather than the effects of blood-surface contact. The results obtained in this test case investigation, confirm the effectiveness of the proposed function for a quantitative analysis of spiral flow in medical devices.
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Affiliation(s)
- M Grigioni
- Laboratory of Biomedical Engineering, Istituto Superiore di Sanità, Rome, Italy.
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Splendiani G, Morosetti M, Manni M, Jankovic L, Naticchia A, Sturniolo A, Tullio T, Balducci A, Coen G. Cardiac Calcium Evaluation in Hemodialysis Patients with Multisection Spiral Computed Tomography. Int J Artif Organs 2018; 27:759-65. [PMID: 15521215 DOI: 10.1177/039139880402700905] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim The aim of this study is cardiac calcium content evaluation in hemodialysis patients by a new technique, based on ultrafast multisection CT (MTC). Methods The study was carried out on 30 HD patients, 14F and 16 M, average age 57.7±13.9 years, average HD age 57.3±47.4 months. The intact PTH levels were 625.4±571 pg/mL. Serum calcium, phosphate and CaxP product were 9.75±0.84 mg/mL, 6.21±1.01 mg/dL and 60.2±10.7 mg2/dL2, respectively. Results The values obtained with the MTC technique were reported in terms of Agatson scores. Score values frankly in the pathologic range (>100) were found in 24 patients (80%). Correlation analysis has shown positive and significant correlation coefficients of the score with patients’ age (p=0.003), serum calcium (p=0.012), CaxP (p=0.015), iPTH (=0.049), and borderline, to HD age (p=0.06). Conclusion Risk factors for cardiac calcification are mainly age, degree of hyperparathyroidism, increased CaxP and serum calcium levels. A control of calcium phosphate parameters in hemodialysis patients seems to be mandatory to avoid increased severity of coronary artery disease.
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Affiliation(s)
- G Splendiani
- Department of Nephrology and Dialysis Service, University Hospital Tor Vergata Rome, Italy.
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Vogl T, Passerini S, Balducci A. The impact of mixtures of protic ionic liquids on the operative temperature range of use of battery systems. Electrochem commun 2017. [DOI: 10.1016/j.elecom.2017.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Gesuete V, Fabi M, Balducci A, Ragni L, Bonvicini M. [Pulmonary embolism in complex corrected congenital heart disease]. G Ital Cardiol (Rome) 2016; 17:241-2. [PMID: 27029884 DOI: 10.1714/2190.23674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Pulmonary embolism is an uncommon but potentially fatal disease in children, especially with congenital heart disease where pulmonary perfusion depends on caval flow. Anticoagulation is the mainstay of therapy for children with pulmonary embolism. However, thrombolytic therapy can also be considered. The outcome of pediatric pulmonary embolism is uncertain and needs further investigation. We suggest increased awareness and a high index of suspicion in the presence of suggestive clinical signs in high-risk patients in order to initiate prompt diagnostic imaging and treatment.
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Affiliation(s)
- Valentina Gesuete
- Cardiologia e Cardiochirurgia Pediatrica e dell'Età evolutiva, Policlinico S. Orsola-Malpighi, Bologna
| | - Marianna Fabi
- Cardiologia e Cardiochirurgia Pediatrica e dell'Età evolutiva, Policlinico S. Orsola-Malpighi, Bologna
| | - Anna Balducci
- Cardiologia e Cardiochirurgia Pediatrica e dell'Età evolutiva, Policlinico S. Orsola-Malpighi, Bologna
| | - Luca Ragni
- Cardiologia e Cardiochirurgia Pediatrica e dell'Età evolutiva, Policlinico S. Orsola-Malpighi, Bologna
| | - Marco Bonvicini
- Cardiologia e Cardiochirurgia Pediatrica e dell'Età evolutiva, Policlinico S. Orsola-Malpighi, Bologna
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Pohlmann S, Olyschläger T, Goodrich P, Vicente JA, Jacquemin J, Balducci A. Mixtures of Azepanium Based Ionic Liquids and Propylene Carbonate as High Voltage Electrolytes for Supercapacitors. Electrochim Acta 2015. [DOI: 10.1016/j.electacta.2014.11.189] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Menne S, Vogl T, Balducci A. The synthesis and electrochemical characterization of bis(fluorosulfonyl)imide-based protic ionic liquids. Chem Commun (Camb) 2015; 51:3656-9. [DOI: 10.1039/c4cc09665g] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The use of PYRH4FSI represents a significant step towards the realization of high performance IL-based systems, which are able to fill the performance gap existing between these innovative electrolytes and the conventional ones.
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Affiliation(s)
- S. Menne
- Westfälische Wilhelms-Universität Münster
- Institute of Physical Chemistry
- 48149 Münster
- Germany
| | - T. Vogl
- Westfälische Wilhelms-Universität Münster
- Institute of Physical Chemistry
- 48149 Münster
- Germany
| | - A. Balducci
- Westfälische Wilhelms-Universität Münster
- Institute of Physical Chemistry
- 48149 Münster
- Germany
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van der Bom T, Winter MM, Knaake JL, Cervi E, de Vries LSC, Balducci A, Meregalli PG, Pieper PG, van Dijk APJ, Bonvicini M, Mulder BJM, Bouma BJ. Long-term benefits of exercise training in patients with a systemic right ventricle. Int J Cardiol 2014; 179:105-11. [PMID: 25464425 DOI: 10.1016/j.ijcard.2014.10.042] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 10/14/2014] [Accepted: 10/18/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The aim of the present study is to determine the long-term effects of a ten-week exercise training program in adult patients with a systemic right ventricle. METHODS All patients who participated in a 2009 randomized controlled trial were approached. At approximately three years of follow-up from initial baseline, patients underwent cardiopulmonary exercise testing, filled out two quality of life questionnaires, and NT proBNP levels were measured. All examinations were performed according to the protocols of the 2009 trial. In addition, patients were asked about their current sports habits. RESULTS Of the 54 patients who were randomized in the 2009-trial 40 participated in the current re-evaluation (male 50%, ccTGA 35%, age 36 ± 10 years, intervention group n=22, control group n=18). After three years, no persistent effect of exercise training on V'O₂peak training remained (-2% of predicted, 95% CI -3% to 5%; p=.56). However, patients who already participated in regular sports or exercise at baseline (n=23/40 (58%)) showed higher V'O₂peak of 13% of predicted (95% CI 4% to 23%; p>.01) and a decrease of 62% in plasma NT-proBNP (95% CI -115% to -10%; p>.03) during follow-up, when compared to patients who did not. Moreover, sports were associated with a lower incidence of clinical events (p=.032). CONCLUSION Short-term beneficial effects of exercise training did not persist over a three-year follow-up period. However, sports participation at baseline was associated with better exercise capacity, lower neurohormone levels, and increased event-free survival.
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Affiliation(s)
- Teun van der Bom
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Michiel M Winter
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Jennifer L Knaake
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Elena Cervi
- Pediatric Cardiology and Adult Congenital Unit, University of Bologna, Bologna, Italy
| | - Leonie S C de Vries
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Anna Balducci
- Pediatric Cardiology and Adult Congenital Unit, University of Bologna, Bologna, Italy
| | - Paola G Meregalli
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Petronella G Pieper
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Arie P J van Dijk
- Department of Cardiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Marco Bonvicini
- Pediatric Cardiology and Adult Congenital Unit, University of Bologna, Bologna, Italy
| | - Barbara J M Mulder
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Berto J Bouma
- Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
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Di Lullo L, Gorini A, Rivera R, De Pascalis A, Bellasi A, Russo D, Barbera V, Ronco C, Balducci A, Santoboni A. [Cardiac magnetic resonance and uremic cardiomyopathy]. G Ital Nefrol 2014; 31:gin/00199.6. [PMID: 25504164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Cardiovascular disease (CV) represents the main risk factor for morbidity and mortality in chronic kidney disease (CKD) patients. Large epidemiological studies have shown direct association between severity of CKD and CV event rates. Although patients with end-stage renal disease (ESRD), including dialysis ones, are at greater CV risk, cardiovascular involvement is already evident at the early stages of CKD. End-stage CKD is characterized conventional atherosclerotic risk factor but they cannot account for CV risk as reflected in high rates of sudden cardiac death, heart failure and myocardial infarction. Non-atherosclerotic processes, including left ventricular hypertrophy and fibrosis, mostly account for the excess risk of CV. Employment of cardiac magnetic resonance (CMR) in CKD has brought an improved understanding of the adverse CV changes, known as uremic cardiomyopathy. It is due to ability of cardiac magnetic resonance to provide a comprehensive non - invasive examination of cardiac structure and function, arterial function, myocardial tissue characterization (T1 mapping and inversion recovery imaging), and myocardial metabolic function (spectroscopy).
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Vogl T, Menne S, Balducci A. Mixtures of protic ionic liquids and propylene carbonate as advanced electrolytes for lithium-ion batteries. Phys Chem Chem Phys 2014; 16:25014-23. [DOI: 10.1039/c4cp03830d] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Vitali F, Galletti S, Aceti A, Aquilano G, Fabi M, Balducci A, Faldella G. Pilot observational study on haemodynamic changes after surfactant administration in preterm newborns with respiratory distress syndrome. Ital J Pediatr 2014; 40:26. [PMID: 24594243 PMCID: PMC3984744 DOI: 10.1186/1824-7288-40-26] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Accepted: 02/26/2014] [Indexed: 11/20/2022] Open
Abstract
Background Surfactant treatment reduces respiratory morbidity and mortality in preterm infants. Data on its haemodynamic consequences are conflicting. The aim was to characterise the haemodynamic effects of surfactant treatment on cardiac function in preterm newborns with respiratory distress syndrome (RDS). Methods Preterm infants (gestational age <34 weeks, birth weight <2000 g) with RDS, who received surfactant within 72 hours of life, were recruited. Echocardiography was performed before surfactant, and 2 and 24 hours after. Left and right ventricular peak systolic, early diastolic and late diastolic myocardial velocities were measured using Tissue Doppler Imaging (TDI), while characteristics of the ductus arteriosus, pulmonary artery pressure, right ventricular (RVO) and left ventricular output were measured by standard echocardiography. Tricuspidal Annular Plane Systolic Excursion (TAPSE) was measured on the free wall of the tricuspid annulus. Results Fourteen patients were studied. Surfactant was associated with a decrease in pulmonary pressure and an increase in RVO. The improvement of right ventricular function was also confirmed by a significant increase in right peak systolic velocity and in TAPSE. Left ventricular velocities did not change significantly after surfactant. Conclusions Surfactant administration in preterm infants with RDS did not impair myocardial contractility and was followed by increased RVO, in agreement with other parameters of right ventricular function. TDI and TAPSE appeared to be reliable and feasible in this population. The addition of TDI and TAPSE to standard neonatal echocardiography may provide additional information about cardiac function.
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Affiliation(s)
| | - Silvia Galletti
- Neonatology and Neonatal Intensive Care Unit, S, Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
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Menne S, Kühnel RS, Balducci A. The influence of the electrochemical and thermal stability of mixtures of ionic liquid and organic carbonate on the performance of high power lithium-ion batteries. Electrochim Acta 2013. [DOI: 10.1016/j.electacta.2012.12.042] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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