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Cosma J, Russo A, Schino S, Belli M, Mango R, Chiricolo G, Martuscelli E, Mariano EG. Acute myocardial infarction in a patient with MELAS syndrome: a possible link? Minerva Cardiol Angiol 2023; 71:374-380. [PMID: 35767235 DOI: 10.23736/s2724-5683.22.06021-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
The mitochondrial encephalomyopathy, lactic acidosis, and stroke (MELAS) syndrome is a mitochondrial disorder, commonly caused by m.3243A>G mutation in the MT-TL1 gene. It encodes for the mitochondrial leucine transfer RNA (tRNA Leu [UUR]), implicated in the translation of proteins involved in the assembly and function of mitochondrial complexes in the electron transport chain. The m.3243A>G mutation determines complex I (CI) deficiency, ultimately leading to NADH accumulation, higher rates of glycolysis in order to compensate for the reduced ATP production and increase in lactates, the end-product of glycolysis. Disruption of the oxidative phosphorylation function with an inability to produce sufficient energy results in multi-organ dysfunction, with high energy demanding cells, such as myocytes and neurons, being the most affected ones. Therefore, MELAS syndrome is characterized by a heterogeneous clinical spectrum. Here we report on a case of a 55-year-old man affected by MELA syndrome with no cardiovascular risk factors. He was admitted to our department because of a non ST-segment elevation myocardial infarction (NSTEMI). A coronary angioplasty of the posterior descending artery and of the left anterior descending artery was realized. Transthoracic echocardiography showed inferior and anterior left ventricular wall hypokinesis together with a moderate left ventricle hypertrophy. Cardiac involvement is reported in about a third of the patients and left ventricular hypertrophy (LVH) is the most common phenotype, with possible dilated cardiomyopathy in end-stage disease; brady- arrhythmias and tachy-arrhythmias are also frequently reported as well as Wolff- Parkinson-White (WPW) syndrome. Organ impairment and clinical manifestations depend on the heteroplasmy level of mutant DNA in cells that can differ among individuals, explaining why some patients present a more severe disease. A clear relationship between MELAS syndrome and atherosclerosis has never been established, however recently advocated. In vitro studies in MELAS patients have shown that higher mitochondrial ROS levels and increased expression of oxidative stress-related genes, as a consequence of complex I deficiency and disrupted electron transport, allow circulating LDL to be promptly oxidized into ox-LDL, contributing to endothelial dysfunction and atherosclerosis plaque formation. In light of the recent evidence suggesting a possible link between mitochondrial disorders and atherosclerosis, we speculate that MELAS syndrome may have played a role in the pathogenesis of coronary artery disease in our patient. Further investigations are needed to confirm a pathogenetic link.
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Affiliation(s)
- Joseph Cosma
- Department of Cardiology, Tor Vergata University of Rome, Rome, Italy -
- Department of Cardiology, Saint Martin Private Hospital Center, Caen, France -
| | - Alessandro Russo
- Department of Cardiology, Tor Vergata University of Rome, Rome, Italy
| | - Sofia Schino
- Department of Cardiology, Tor Vergata University of Rome, Rome, Italy
| | - Martina Belli
- Department of Cardiology, Tor Vergata University of Rome, Rome, Italy
| | - Ruggiero Mango
- Department of Cardiology, Tor Vergata University of Rome, Rome, Italy
| | - Gaetano Chiricolo
- Department of Cardiology, Tor Vergata University of Rome, Rome, Italy
| | | | - Enrica G Mariano
- Department of Cardiology, Tor Vergata University of Rome, Rome, Italy
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Matteucci A, Bonanni M, Massaro G, Chiricolo G, Stifano G, Forleo GB, Biondi-Zoccai G, Sangiorgi G. Treatment with gentamicin-impregnated collagen sponges in reducing infection of implantable cardiac devices: 10-year analysis with propensity score matching. Rev Port Cardiol 2023:S0870-2551(23)00220-2. [PMID: 37085085 DOI: 10.1016/j.repc.2023.01.023] [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: 09/20/2022] [Accepted: 01/01/2023] [Indexed: 04/23/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES The incidence of device infection has increased over time and is associated with increased mortality in patients with cardiac implantable electronic devices (CIEDs). Gentamicin-impregnated collagen sponges (GICSs) are useful in preventing surgical site infection (SSI) in cardiac surgery. Nevertheless, to date, there is no evidence concerning their use in CIED procedures. Our study aims to determine the effectiveness of treatment with GICSs in preventing CIED infection. METHODS A total of 2986 adult patients who received CIEDs between 2010 and 2020 were included. Before device implantation, all patients received routine periprocedural systemic antibiotic prophylaxis. The study endpoints were the CIED infection rate at one year and the effectiveness of the use of GICSs in reducing CIED infection. RESULTS Among 1524 pacemaker, 942 ICD and 520 CRT implantations, CIED infection occurred in 36 patients (1.2%). Early reintervention (OR 9 [95% CI 3.180-25.837], p<0.001), pocket hematoma (OR 11 [95% CI 4.195-28.961], p<0.001), diabetes (OR 2.9 [95% CI 1.465-5.799], p=0.002) and prolonged procedural time (OR 1.02 [95% CI 1.008-1.034], p=0.001) were independent risk factors for CIED infection. Treatment with GICSs reduced CIED infections significantly ([95% CI -0.031 to -0.001], p<0.001). CONCLUSIONS The use of GICSs may help in reducing infections associated with CIED implantation.
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Affiliation(s)
- Andrea Matteucci
- Division of Cardiology, University Hospital "Tor Vergata", Rome, Italy; Division of Cardiology, San Filippo Neri Hospital, Via Martinotti, 20, Rome, Italy.
| | - Michela Bonanni
- Division of Cardiology, University Hospital "Tor Vergata", Rome, Italy
| | - Gianluca Massaro
- Division of Cardiology, University Hospital "Tor Vergata", Rome, Italy
| | - Gaetano Chiricolo
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Giuseppe Stifano
- Division of Cardiology, University Hospital "Tor Vergata", Rome, Italy; Division of Cardiology, San Filippo Neri Hospital, Via Martinotti, 20, Rome, Italy; Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy; Arrhythmology, Luigi Sacco Hospital, Milan, Italy; Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy; Mediterranea Cardiocentro, Napoli, Italy
| | | | - Giuseppe Biondi-Zoccai
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy; Mediterranea Cardiocentro, Napoli, Italy
| | - Giuseppe Sangiorgi
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
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Schino S, Bezzeccheri A, Russo A, Bonanni M, Cosma J, Sangiorgi G, Chiricolo G, Martuscelli E, Santoro F, Mariano EG. Takotsubo Syndrome: The Secret Crosstalk between Heart and Brain. Rev Cardiovasc Med 2023. [DOI: 10.31083/j.rcm2401019] [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: 01/15/2023] Open
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Russo G, Maisano F, Massaro G, Terlizzese G, Mariano E, Bonanni M, Matteucci A, Bezzeccheri A, Benedetto D, Chiricolo G, Martuscelli E, Sangiorgi GM. Challenges and Open Issues in Transcatheter Mitral Valve Implantation: Smooth Seas Do Not Make Skillful Sailors. Front Cardiovasc Med 2022; 8:738756. [PMID: 35224022 PMCID: PMC8863742 DOI: 10.3389/fcvm.2021.738756] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 07/09/2021] [Accepted: 12/30/2021] [Indexed: 11/13/2022] Open
Abstract
According to the European and American guidelines, surgery represents the treatment of choice for mitral valve (MV) disease. However, a number of patients are deemed unsuitable for surgery due to a prohibitive/high operative risk. In such cases, transcatheter therapies aiming at MV repair have been proven to be a valuable alternative and have been recently introduced in the latest American guidelines on valvular heart disease. Indeed, percutaneous repair techniques, particularly transcatheter edge-to-edge, have gained a broad experience and demonstrated to be safe and effective. However, given the complexity and heterogeneity of MV anatomy and pathology, transcatheter MV implantation (TMVI) has grown as a possible alternative to percutaneous MV repair. Current data about TMVI are still limited and come from different settings: valve-in-native MV, valve-in-valve (ViV), valve-in-ring (ViR), and valve-in-mitral annular calcification. Preliminary data are promising although several open issues still need to be addressed. This paper provides a comprehensive review of the available devices in the different clinical settings, to discuss potentialities, limitations, and future directions for TMVI.
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Affiliation(s)
- Giulio Russo
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
- Dipartimento di Scienze Cardiovascolari, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Maisano
- Cardio-Thoracic-Vascular Department, San Raffaele Institute, Milan, Italy
| | - Gianluca Massaro
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - Giuseppe Terlizzese
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - Enrica Mariano
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - Michela Bonanni
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - Andrea Matteucci
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - Andrea Bezzeccheri
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - Daniela Benedetto
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - Gaetano Chiricolo
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - Eugenio Martuscelli
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
| | - Giuseppe Massimo Sangiorgi
- Department of Biomedicine and Prevention, Policlinico Tor Vergata, Rome, Italy
- *Correspondence: Giuseppe Massimo Sangiorgi
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Massaro G, Stifano G, Ambrogi V, Anemona L, Mariano EG, Chiricolo G, Martuscelli E, Sangiorgi GM. A thymic hyperplasia-related reversible complete atrioventricular block: When compression is more important than compressor. J Electrocardiol 2021; 69:68-70. [PMID: 34600403 DOI: 10.1016/j.jelectrocard.2021.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/06/2021] [Revised: 08/26/2021] [Accepted: 09/16/2021] [Indexed: 11/30/2022]
Abstract
A 19-year-old patient presented for syncope with third-degree AV block (TDAVB) at ECG. A chest-CT showed a thymic mass that could be responsible for TDAVB due to extrinsic vagal nerve compression. Thymectomy led to complete AV block resolution. An extrinsic vagal compression mechanism should be considered among causes of complete atrioventricular block.
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Affiliation(s)
- Gianluca Massaro
- Division of Cardiology, "Tor Vergata" University Hospital, 00133 Rome, Italy.
| | - Giuseppe Stifano
- Division of Cardiology, "Tor Vergata" University Hospital, 00133 Rome, Italy
| | - Vincenzo Ambrogi
- Unit of Thoracic Surgery, "Tor Vergata" University of Rome, 00133 Rome, Italy
| | - Lucia Anemona
- Anatomic Pathology, Department of Experimental Medicine, "Tor Vergata" University of Rome, 00133 Rome, Italy
| | | | - Gaetano Chiricolo
- Division of Cardiology, "Tor Vergata" University Hospital, 00133 Rome, Italy; Department of Biomedicine and Prevention, "Tor Vergata" University of Rome, 00133 Rome, Italy
| | - Eugenio Martuscelli
- Division of Cardiology, "Tor Vergata" University Hospital, 00133 Rome, Italy; Department of Biomedicine and Prevention, "Tor Vergata" University of Rome, 00133 Rome, Italy
| | - Giuseppe Massimo Sangiorgi
- Division of Cardiology, "Tor Vergata" University Hospital, 00133 Rome, Italy; Department of Biomedicine and Prevention, "Tor Vergata" University of Rome, 00133 Rome, Italy
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Massaro G, Lecis D, Martuscelli E, Chiricolo G, Sangiorgi GM. Clinical Features and Management of COVID-19–Associated Hypercoagulability. Card Electrophysiol Clin 2021; 14:41-52. [PMID: 35221084 PMCID: PMC8556574 DOI: 10.1016/j.ccep.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Sangiorgi GM, Cereda A, Porchetta N, Benedetto D, Matteucci A, Bonanni M, Chiricolo G, De Lorenzo A. Endovascular Bariatric Surgery as Novel Minimally Invasive Technique for Weight Management in the Morbidly Obese: Review of the Literature. Nutrients 2021; 13:nu13082541. [PMID: 34444701 PMCID: PMC8401754 DOI: 10.3390/nu13082541] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/28/2021] [Accepted: 07/21/2021] [Indexed: 12/13/2022] Open
Abstract
Nowadays, obesity represents one of the most unresolved global pandemics, posing a critical health issue in developed countries. According to the World Health Organization, its prevalence has tripled since 1975, reaching a prevalence of 13% of the world population in 2016. Indeed, as obesity increases worldwide, novel strategies to fight this condition are of the utmost importance to reduce obese-related morbidity and overall mortality related to its complications. Early experimental and initial clinical data have suggested that endovascular bariatric surgery (EBS) may be a promising technique to reduce weight and hormonal imbalance in the obese population. Compared to open bariatric surgery and minimally invasive surgery (MIS), EBS is much less invasive, well tolerated, with a shorter recovery time, and is probably cost-saving. However, there are still several technical aspects to investigate before EBS can be routinely offered to all obese patients. Further prospective studies and eventually a randomized trial comparing open bariatric surgery vs. EBS are needed, powered for clinically relevant outcomes, and with adequate follow-up. Yet, EBS may already appear as an appealing alternative treatment for weight management and cardiovascular prevention in morbidly obese patients at high surgical risk.
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Affiliation(s)
- Giuseppe Massimo Sangiorgi
- Department of Biomedicine and Prevention, Institute of Cardiology, Cardiac Cath Lab, University of Rome Tor Vergata, 00133 Rome, Italy; (N.P.); (D.B.); (A.M.); (M.B.); (G.C.); (A.D.L.)
- Correspondence:
| | - Alberto Cereda
- Department of Cardiology, Cardiac Cath Lab, San Gaudenzio Clinic, 28100 Novara, Italy;
| | - Nicola Porchetta
- Department of Biomedicine and Prevention, Institute of Cardiology, Cardiac Cath Lab, University of Rome Tor Vergata, 00133 Rome, Italy; (N.P.); (D.B.); (A.M.); (M.B.); (G.C.); (A.D.L.)
| | - Daniela Benedetto
- Department of Biomedicine and Prevention, Institute of Cardiology, Cardiac Cath Lab, University of Rome Tor Vergata, 00133 Rome, Italy; (N.P.); (D.B.); (A.M.); (M.B.); (G.C.); (A.D.L.)
| | - Andrea Matteucci
- Department of Biomedicine and Prevention, Institute of Cardiology, Cardiac Cath Lab, University of Rome Tor Vergata, 00133 Rome, Italy; (N.P.); (D.B.); (A.M.); (M.B.); (G.C.); (A.D.L.)
| | - Michela Bonanni
- Department of Biomedicine and Prevention, Institute of Cardiology, Cardiac Cath Lab, University of Rome Tor Vergata, 00133 Rome, Italy; (N.P.); (D.B.); (A.M.); (M.B.); (G.C.); (A.D.L.)
| | - Gaetano Chiricolo
- Department of Biomedicine and Prevention, Institute of Cardiology, Cardiac Cath Lab, University of Rome Tor Vergata, 00133 Rome, Italy; (N.P.); (D.B.); (A.M.); (M.B.); (G.C.); (A.D.L.)
| | - Antonino De Lorenzo
- Department of Biomedicine and Prevention, Institute of Cardiology, Cardiac Cath Lab, University of Rome Tor Vergata, 00133 Rome, Italy; (N.P.); (D.B.); (A.M.); (M.B.); (G.C.); (A.D.L.)
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Caracciolo M, Correale P, Mangano C, Foti G, Falcone C, Macheda S, Cuzzola M, Conte M, Falzea AC, Iuliano E, Morabito A, Caraglia M, Polimeni N, Ferrarelli A, Labate D, Tescione M, Di Renzo L, Chiricolo G, Romano L, De Lorenzo A. Efficacy and Effect of Inhaled Adenosine Treatment in Hospitalized COVID-19 Patients. Front Immunol 2021; 12:613070. [PMID: 33815368 PMCID: PMC8012541 DOI: 10.3389/fimmu.2021.613070] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 10/01/2020] [Accepted: 02/24/2021] [Indexed: 01/08/2023] Open
Abstract
Lack of specific antiviral treatment for COVID-19 has resulted in long hospitalizations and high mortality rate. By harnessing the regulatory effects of adenosine on inflammatory mediators, we have instituted a new therapeutic treatment with inhaled adenosine in COVID-19 patients, with the aim of reducing inflammation, the onset of cytokine storm, and therefore to improve prognosis. The use of inhaled adenosine in COVID19 patients has allowed reduction of length of stay, on average 6 days. This result is strengthened by the decrease in SARS-CoV-2 positive days. In treated patients compared to control, a clear improvement in PaO2/FiO2 was observed together with a reduction in inflammation parameters, such as the decrease of CRP level. Furthermore, the efficacy of inhaled exogenous adenosine led to an improvement of the prognosis indices, NLR and PLR. The treatment seems to be safe and modulates the immune system, allowing an effective response against the viral infection progression, reducing length of stay and inflammation parameters.
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Affiliation(s)
- Massimo Caracciolo
- Unit of Post-Surgery Intensive Therapy (USDO), Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Pierpaolo Correale
- Medical Oncology Unit, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Carmelo Mangano
- Unit of Infectious Disease, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Giuseppe Foti
- Unit of Infectious Disease, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Carmela Falcone
- Unit of Radiology, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Sebastiano Macheda
- Unit of Intensive Care Medicine and Anaesthesia, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Maria Cuzzola
- Microbiology Unit, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Marco Conte
- Microbiology Unit, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | | | - Eleonora Iuliano
- Medical Oncology Unit, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | | | - Michele Caraglia
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy.,Biogem Scarl, Institute of Genetic Research, Laboratory of Precision and Molecular Oncology, Ariano Irpino, Italy
| | - Nicola Polimeni
- Unit of Intensive Care Medicine and Anaesthesia, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Anna Ferrarelli
- Unit of Radiology, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Demetrio Labate
- Unit of Intensive Care Medicine and Anaesthesia, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Marco Tescione
- Unit of Intensive Care Medicine and Anaesthesia, Grand Metropolitan Hospital, Reggio Calabria, Italy
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Gaetano Chiricolo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Lorenzo Romano
- PhD School of Applied Medical, Surgical Sciences, University of Rome Tor Vergata, Rome, Italy
| | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Di Renzo L, Cinelli G, Romano L, Zomparelli S, Lou De Santis G, Nocerino P, Bigioni G, Arsini L, Cenname G, Pujia A, Chiricolo G, De Lorenzo A. Potential Effects of a Modified Mediterranean Diet on Body Composition in Lipoedema. Nutrients 2021; 13:nu13020358. [PMID: 33504026 PMCID: PMC7911402 DOI: 10.3390/nu13020358] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/13/2022] Open
Abstract
Lipoedema is a subcutaneous adipose tissue disease characterized by the increase in the amount and structure of fat mass (FM) in specific areas, causing pain and discomfort. 95% of patients fail to lose weight in the lipoedema areas. The study was conducted to evaluate body composition and general health status modification in a group of lipoedema patients (LIPPY) and a control group (CTRL) after four weeks of a modified Mediterranean diet therapy (mMeD). A total of 29 subjects were included in the data analysis, divided in two groups: 14 LIPPY and 15 CTRL. After the mMeD, both groups significantly decreased their weight and body mass index; the CTRL also showed a reduction of all the circumferences and all FM’s compartments. LIPPY showed a decrease of FM in upper and lower limbs. No significant differences in Δ% between the groups were observed for the lean mass (LM). In LIPPY, an increase in the patients’ ability to perform various daily physical activities related to the loss of arms’ and legs’ fat was observed. According to the European Quality of Life scale, the possibility for LIPPY subjects to perform simple daily activities with less fatigue, pain and anxiety is highlighted. Further long-term studies are recommended to confirm the mMeD as a good strategy for Lipoedema treatment.
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Affiliation(s)
- Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (P.N.); (A.D.L.)
- Correspondence: ; Tel.: +39-349-805-2962
| | - Giulia Cinelli
- School of Specialization in Food Science, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (L.R.); (S.Z.); (G.L.D.S.)
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Lorenzo Romano
- School of Specialization in Food Science, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (L.R.); (S.Z.); (G.L.D.S.)
| | - Samanta Zomparelli
- School of Specialization in Food Science, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (L.R.); (S.Z.); (G.L.D.S.)
| | - Gemma Lou De Santis
- School of Specialization in Food Science, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (L.R.); (S.Z.); (G.L.D.S.)
| | - Petronilla Nocerino
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (P.N.); (A.D.L.)
| | - Giulia Bigioni
- Department of Physics, University of Rome Sapienza, 00185 Rome, Italy; (G.B.); (L.A.)
| | - Lorenzo Arsini
- Department of Physics, University of Rome Sapienza, 00185 Rome, Italy; (G.B.); (L.A.)
| | - Giuseppe Cenname
- General Command of the Carabinieri, Health Department, 00197 Rome, Italy;
| | - Alberto Pujia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.P.); (G.C.)
| | - Gaetano Chiricolo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.P.); (G.C.)
| | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (P.N.); (A.D.L.)
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Di Renzo L, Cinelli G, Dri M, Gualtieri P, Attinà A, Leggeri C, Cenname G, Esposito E, Pujia A, Chiricolo G, Salimei C, De Lorenzo A. Mediterranean Personalized Diet Combined with Physical Activity Therapy for the Prevention of Cardiovascular Diseases in Italian Women. Nutrients 2020; 12:E3456. [PMID: 33187188 PMCID: PMC7697155 DOI: 10.3390/nu12113456] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular diseases (CVDs) and inflammatory risk indexes are used to calculate the exposure to morbidity. Most of them are suggested by the American College of Cardiology/American Heart Association to predict the risk of CVDs diagnosis in primary prevention, instead of treating the ongoing pathology. Prevention starts from habit changes with the prescription of diet and physical activity (PA). The aim of the study is to investigate the effectiveness of a personalized Mediterranean Diet (MD) and a PA intervention, on the risk indexes Atherogenic Index of Plasma (AIP), Lipid Accumulation Product (LAP) and Fatty Liver Index (FLI) in a population of women at risk of CVDs with different pathological conditions. After treatment, patients achieved the best results in body composition (BC) and laboratory tests. The BC analysis showed a significant reduction of total body Fat Mass (FM). CVDs risk indexes significantly decreased, except for Neutrophil/Lymphocyte (NLR) and Platelet/Lymphocyte Ratios (PLR). The reduction of the CVDs indexes associated with lipid profile was linked to both weight and FM decrease. AIP and LAP were significantly reduced when losing fat mass and body weight, respectively. A personalized MD therapy plus a PA program led to body weight loss, BC remodelling and risk indexes reduction.
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Affiliation(s)
- Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (P.G.); (A.D.L.)
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.P.); (G.C.)
| | - Giulia Cinelli
- School of Specialization in Food Sciences, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (A.A.); (C.L.)
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Maria Dri
- Department of Surgical Sciences, School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (P.G.); (A.D.L.)
| | - Alda Attinà
- School of Specialization in Food Sciences, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (A.A.); (C.L.)
| | - Claudia Leggeri
- School of Specialization in Food Sciences, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (A.A.); (C.L.)
| | - Giuseppe Cenname
- Comando Generale Arma Carabinieri, Direzione di Sanità, 00197 Rome, Italy;
| | - Ernesto Esposito
- Department of Human Policies (General Directorate) of Basilicata Region, 85100 Potenza, Italy;
| | - Alberto Pujia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.P.); (G.C.)
| | - Gaetano Chiricolo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (A.P.); (G.C.)
| | - Chiara Salimei
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (P.G.); (A.D.L.)
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11
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Iorio R, Cereda A, Vecchia A, Romagnoli E, Cioffi P, Chiricolo G, Sangiorgi G. Provisional stenting or not provisional stenting: seven critical points for bifurcations treatment with a glimpse on left main bifurcation stenting. Minerva Cardiol Angiol 2020; 69:322-330. [PMID: 32996303 DOI: 10.23736/s2724-5683.20.05294-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Stenting of coronary bifurcation lesions represents a challenge for the interventional cardiologist. A bifurcation lesion could be treated with several techniques. Therefore, it is of paramount importance to decide the strategical approach at the beginning of the procedure evaluating the patient's bifurcation anatomy, the angle between main and side branch, plaque burden at the level of the carina, and size of the side branch. Although it is clear that all bifurcation's treatment techniques have each one their advantages and disadvantages, provisional stenting remains the gold-standard technique, because it leaves the possibility to switch to other technical solutions with optimal angiographic and long-term clinical results. In this review, different tips and tricks for left main and bifurcation stenting are debated.
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Affiliation(s)
- Riccardo Iorio
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy
| | - Alberto Cereda
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy
| | - Augustin Vecchia
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy
| | - Enrico Romagnoli
- Department of Cardiology, Cardiac Cath Lab, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Paolo Cioffi
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy.,Department of Cardiology, Cardiac Cath Lab, Città di Alessandria Institute, Alessandria, Italy
| | - Gaetano Chiricolo
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Giuseppe Sangiorgi
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy - .,Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
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12
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Iorio R, Cereda A, Vecchia A, Romagnoli E, Cioffi P, Chiricolo G, Sangiorgi G. Provisional stenting or not provisional stenting: seven critical points for bifurcations treatment with a glimpse on left main bifurcation stenting. Minerva Cardiol Angiol 2020. [PMID: 32996303 DOI: 10.23736/s0026-4725.20.05294-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Stenting of coronary bifurcation lesions represents a challenge for the interventional cardiologist. A bifurcation lesion could be treated with several techniques. Therefore, it is of paramount importance to decide the strategical approach at the beginning of the procedure evaluating the patient's bifurcation anatomy, the angle between main and side branch, plaque burden at the level of the carina, and size of the side branch. Although it is clear that all bifurcation's treatment techniques have each one their advantages and disadvantages, provisional stenting remains the gold-standard technique, because it leaves the possibility to switch to other technical solutions with optimal angiographic and long-term clinical results. In this review, different tips and tricks for left main and bifurcation stenting are debated.
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Affiliation(s)
- Riccardo Iorio
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy
| | - Alberto Cereda
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy
| | - Augustin Vecchia
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy
| | - Enrico Romagnoli
- Department of Cardiology, Cardiac Cath Lab, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Paolo Cioffi
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy.,Department of Cardiology, Cardiac Cath Lab, Città di Alessandria Institute, Alessandria, Italy
| | - Gaetano Chiricolo
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Giuseppe Sangiorgi
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy - .,Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
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13
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Sangiorgi G, Pizzuto A, Diehm N, Greco F, Fusco F, Chiricolo G, Vismara A, Altieri VM, Cereda A, Bongo S. Endovascular therapy for erectile dysfunction: current knowledge and future perspectives. Minerva Cardiol Angiol 2020; 69:579-595. [PMID: 32492987 DOI: 10.23736/s2724-5683.20.05136-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Erectile dysfunction (ED) is defined as the inability to attain or maintain penile erection sufficient for successful sexual intercourse. ED carries a notable influence on quality of life, with significant implications for family and social relationships. Because atherosclerosis of penile arteries represents one of the most frequent causes of ED, patients presenting with it should always be investigated for potential coexistent coronary or peripheral disease. Up to 75% of patients with ED have a stenosis of the iliac-pudendal-penile arteries, supplying perfusion of the male genital organ. Recently the potential treatment of this pathological condition by percutaneous approaches has emerged with good angiographic results and with a significant improvement in symptoms and quality of life. This review will focus on the normal anatomy and physiology of erection, the pathophysiology of ED, the relation between ED and cardiovascular diseases and, lastly, on new treatment modalities aimed at restoration of normal erectile function.
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Affiliation(s)
- Giuseppe Sangiorgi
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy -
| | - Alessandra Pizzuto
- Division of Cardiology, Department of Systemic Medicine, Tor Vergata University, Rome, Italy
| | - Nicolas Diehm
- Vascular Institute Central Switzerland, Aarau, Switzerland
| | | | - Ferdinando Fusco
- Department of Urology, Luigi Vanvitelli University, Caserta, Italy
| | - Gaetano Chiricolo
- Division of Cardiology, Department of Systemic Medicine, Tor Vergata University, Rome, Italy
| | - Alberto Vismara
- Department of Urology, Humanitas Gavazzeni Hospital, Bergamo, Italy
| | | | - Alberto Cereda
- Division of Cardiology, San Gaudenzio Clinic, Novara, Italy
| | - Sante Bongo
- Division of Cardiology, San Gaudenzio Clinic, Novara, Italy
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14
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Sangiorgi G, Pizzuto A, Diehm N, Greco F, Fusco F, Chiricolo G, Vismara A, Altieri V, Cereda A, Bongo S. Endovascular therapy for erectile dysfunction: a state of the art review. Minerva Cardioangiol 2020. [PMID: 32492987 DOI: 10.23736/s0026-4725.20.05136-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Erectile dysfunction (ED) is defined as the inability to attain or maintain penile erection sufficient for successful sexual intercourse. ED carries a notable influence on quality of life, with significant implications for family and social relationships. Because atherosclerosis of penile arteries represents one of the most frequent causes of ED, patients presenting with it should always be investigated for potential coexistent coronary or peripheral disease. Up to 75% of patients with ED have a stenosis of the iliac-pudendal-penile arteries, supplying perfusion of the male genital organ. Recently the potential treatment of this pathological condition by percutaneous approaches has emerged with good angiographic results and with a significant improvement in symptoms and quality of life. This review will focus on the normal anatomy and physiology of erection, the pathophysiology of ED, the relation between ED and cardiovascular diseases and, lastly, on new treatment modalities aimed at restoration of normal erectile function.
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Affiliation(s)
- Giuseppe Sangiorgi
- Division of Cardiology, Department of Systemic Medicine, University of Tor Vergata, Rome, Italy -
| | - Alessandra Pizzuto
- Division of Cardiology, Department of Systemic Medicine, University of Tor Vergata, Rome, Italy
| | - Nicholas Diehm
- Vascular Institute Central Switzerland, Aarau, Switzerland
| | | | - Ferdinando Fusco
- Department of Urology, University "Luigi Vanvitelli", Caserta, Italy
| | - Gaetano Chiricolo
- Division of Cardiology, Department of Systemic Medicine, University of Tor Vergata, Rome, Italy
| | | | | | - Alberto Cereda
- Division of Cardiology, Clinica San Gaudenzio, Novara, Italy
| | - Sante Bongo
- Division of Cardiology, Clinica San Gaudenzio, Novara, Italy
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15
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Sangiorgi G, Chiricolo G, Nocella C, Carnevale R. Erectile and diastolic dysfunction: two sides of the same coin or same sides of two different coins? Minerva Cardioangiol 2020; 68:291-294. [PMID: 32326682 DOI: 10.23736/s0026-4725.20.05283-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Gaetano Chiricolo
- Department of Systemic Medicine, Tor Vergata University, Rome, Italy
| | - Cristina Nocella
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - Roberto Carnevale
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.,Mediterranea Cardiocentro, Naples, Italy
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16
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Singh H, Chiricolo G, Lin M, Mendoza C, Melniker L, Balk A. 83 B-Mode Ultrasound Signs in Ovarian Torsion and Normal Doppler Blood Flow: Masses, Cysts, and Follicular Ring Sign: A Potential Diagnostic Algorithm. Ann Emerg Med 2016. [DOI: 10.1016/j.annemergmed.2016.08.094] [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: 10/20/2022]
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17
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Behan L, Balk A, Dulani T, Vaccari N, Chiricolo G. 61 Can an “Ultrasound First” Policy Reduce Incidence of Computed Tomography Scan Use and Radiation Exposure in Pediatric Patients Presenting to the Emergency Department for Evaluation of Abdominal Pain? Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.093] [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: 11/29/2022]
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18
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Dulani T, Bajaj T, Ayala S, Giorgetti R, Balk A, Chiricolo G. 349 Assessing the Need for Dedicated Inferior Vena Cava Ultrasound Education in Emergency Medicine Residents. Ann Emerg Med 2014. [DOI: 10.1016/j.annemergmed.2014.07.377] [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: 10/24/2022]
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19
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Felicetta M, Chiricolo G. 354 Factors Associated With Decreased Utilization of CT after a Positive Point of Care Ultrasound in the Diagnosis of Acute Appendicitis. Ann Emerg Med 2014. [DOI: 10.1016/j.annemergmed.2014.07.382] [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: 10/24/2022]
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20
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Rizza S, Clementi F, Porzio O, Cardellini M, Savo A, Serino M, Chiricolo G, Romeo F, Lauro R, Federici M. Adiponectin isoforms are not associated with the severity of coronary atherosclerosis but with undiagnosed diabetes in patients affected by stable CAD. Nutr Metab Cardiovasc Dis 2009; 19:54-60. [PMID: 18472407 DOI: 10.1016/j.numecd.2007.12.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2007] [Revised: 11/26/2007] [Accepted: 12/02/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS Total adiponectin is emerging as an independent risk factor for cardiovascular diseases, but the role of adiponectin isoforms in coronary artery disease (CAD) is still unknown. We investigated the role of adiponectin isoforms with respect to the severity of coronary disease and to the presence of undiagnosed diabetes in patients with CAD. METHODS AND RESULTS We recruited 205 CAD patients, all living in the central area of Italy, with a history of a previous myocardial infarction but apparently not affected by type 2 diabetes (DM2). We compared the CAD patients to a control population (n=100) matched for age, sex, BMI and cardiovascular risk factors, but without overt diabetes and cardiovascular disease. In all patients we measured Total Adiponectin (Tot-Ad) and its isoforms, metabolic, pro- and anti-inflammatory markers and we performed an oral glucose tolerance test (OGTT). CAD patients underwent a coronary angiography and/or coronary multi-slice computed tomography. Based on the severity of CAD they were divided into mono-vessel versus multi-vessel patients. Tot-Ad levels and its isoforms were comparable in patients with mono-vessel versus multi-vessel CAD. After the OGTT, in CAD patients, the results showed that 19% of patients were affected by unknown DM2, 36.1% by unknown impaired glucose tolerance (IGT), and only 43.9% were truly normoglycemic (NGT). Low levels of high molecular weight-adiponectin (HMW-Ad) were significantly associated with undiagnosed IGT or DM2 status (p<0.01). CONCLUSIONS In our cohort of CAD patients, Tot-Ad and its isoforms do not correlate with severity of CAD, but with undiagnosed defects of glucose metabolism.
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Affiliation(s)
- Stefano Rizza
- Center for Atherosclerosis, University of Rome Tor Vergata, Rome, Italy
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21
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Modayil V, Dubon M, Patel J, Shah T, Cassara M, Nelson M, Chiricolo G, Goertz J, Sama A, Raio C. 272: Can Emergency Medical Services Personnel Identify Pneumothorax on Focused Ultrasound Examinations? Ann Emerg Med 2007. [DOI: 10.1016/j.annemergmed.2007.06.258] [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: 11/28/2022]
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22
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Postorino C, Gallagher MM, Santini L, Magliano G, Chiricolo G, Bindo M, Postorino A, Romeo F. Coronary spasm: a case of transient ST elevation and syncopal ventricular tachycardia without angina. Europace 2007; 9:568-70. [PMID: 17517803 DOI: 10.1093/europace/eum087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 11/14/2022] Open
Abstract
We report the case of a 60-year-old male with recurrent pre-syncope, referred with a provisional diagnosis of carotid sinus syndrome on the basis of a 4 s asystolic pause following carotid sinus massage. On repeat Holter monitoring there was ST-segment elevation followed by episodes of polymorphic ventricular tachycardia during a mild episode of pre-syncope. Coronary angiography showed mild right coronary artery irregularity without significant stenosis. An automatic cardioverter defibrillator was implanted and high dose combined vasodilator therapy was commenced. At follow-up 18 months after implantation, the device has recorded no episode of tachycardia and the patient reports no recurrence of symptoms.
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Affiliation(s)
- Claudia Postorino
- Dipartimento di Cardiologia, Policlinico Tor Vergata, Viale Oxford 81, Rome 00133, Italy
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23
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Romeo F, Leo R, Clementi F, Razzini C, Borzi M, Martuscelli E, Pizzuto F, Chiricolo G, Mehta JL. Multislice computed tomography in an asymptomatic high-risk population. Am J Cardiol 2007; 99:325-8. [PMID: 17261391 DOI: 10.1016/j.amjcard.2006.08.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2006] [Revised: 08/23/2006] [Accepted: 08/23/2006] [Indexed: 10/23/2022]
Abstract
Approximately 50% of all acute coronary syndromes occur in previously asymptomatic patients. This study evaluated the value of multislice computed tomography for early detection of significant coronary artery disease (CAD) in high-risk asymptomatic subjects. One hundred sixty-eight asymptomatic subjects with >or=1 major risk factor (hypertension, diabetes, hypercholesterolemia, family history, or smoking) and an inconclusive or unfeasible noninvasive stress test result (stress electrocardiography, echocardiography, or nuclear scintigraphy) were evaluated in an outpatient setting. After clinical examination and laboratory risk analysis, all patients underwent multislice computed tomographic (MSCT) coronary angiography within 1 week. In all subjects, conventional coronary angiography was also carried out. Multislice computed tomography displayed single-vessel CAD in 16% of patients, 2-vessel CAD in 7%, and 3-vessel CAD in 4%. Selective coronary angiography confirmed the results of multislice computed tomography in 99% of all patients. Sensitivity and specificity of MSCT coronary angiography were 100% and 98%, respectively, with a positive predictive value of 95% and a negative predictive value of 100%. In conclusion, MSCT coronary angiography is an excellent noninvasive technique for early identification of significant CAD in high-risk asymptomatic patients with inconclusive or unfeasible noninvasive stress test results.
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Affiliation(s)
- Francesco Romeo
- Department of Cardiology, University of Rome Tor Vergata, Rome, Italy
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24
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Leo R, Di Lorenzo G, Tesauro M, Razzini C, Forleo GB, Chiricolo G, Cola C, Zanasi M, Troisi A, Siracusano A, Lauro R, Romeo F. Association between enhanced soluble CD40 ligand and proinflammatory and prothrombotic states in major depressive disorder: pilot observations on the effects of selective serotonin reuptake inhibitor therapy. J Clin Psychiatry 2006; 67:1760-6. [PMID: 17196057 DOI: 10.4088/jcp.v67n1114] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is associated with low-grade inflammation, and it is considered a risk factor for coronary artery disease (CAD). CD40 ligand (CD40L) plays an important role in inflammation, platelet activation, and clotting system activation. We investigated soluble CD40L (sCD40L) expression in MDD and assessed whether it may represent a molecular mechanism that links inflammation and a prothrombotic state and whether this condition may be modified by selective serotonin reuptake inhibitor (SSRI) therapy. METHOD Levels of sCD40L, interleukin-1beta (IL-1beta), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), soluble P-selectin (sP-selectin), activated factor VII (FVIIa), and prothrombin fragment 1+2 (F1+2) were measured in 46 drug-naïve, first-episode MDD patients without conventional CAD risk factors and in 46 matched healthy controls. Participants were screened between March 2002 and November 2005. Twenty of the 46 MDD patients were then randomly assigned to either sertraline 100 mg/day (N = 10) or citalopram 20 mg/day (N = 10); the aforementioned variables were measured at baseline and after 6 weeks of treatment. RESULTS Compared with control subjects, MDD patients had higher baseline levels of sCD40L, IL-1beta, IL-6, TNF-alpha, sP-selectin, FVIIa, and F1+2. In the clinical group, sCD40L levels, HAM-D total scores, and proinflammatory markers were strongly intercorrelated. In contrast, there were no significant correlations in the control group. Mood improvement achieved with SSRI therapy was associated with significant reduction in sCD40L, proinflammatory markers, and prothrombotic markers expression. (All p values < .0001.) CONCLUSIONS This pilot study shows that CD40/ CD40L pathway up-regulation in MDD patients relates increased levels of sCD40L to a prothrombotic state and, preliminarily, indicates that SSRI therapy may significantly reduce sCD40L and CD40L levels associated with proinflammatory and prothrombotic states.
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Affiliation(s)
- Roberto Leo
- Department of Internal Medicine, University of Rome Tor Vergata, School of Medicine, Rome, Italy.
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25
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D’Amore J, Chiricolo G, Lee D, Zhou Q, Kiriaki S, Lewis V, Litroff A, Lukin M, Ward M, Sama A. 374. Ann Emerg Med 2006. [DOI: 10.1016/j.annemergmed.2006.07.840] [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: 10/24/2022]
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26
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Martuscelli E, Romagnoli A, Sardella G, Tomassini M, D'Eliseo A, Chiricolo G, Razzini C, Sperandio M, Simonetti G, Mehta JL, Romeo F. Thrombolysis in ST-segment elevation myocardial infarction: potential role of thin-slice computed tomography in the assessment of reperfusion and plaque characterization. Clin Cardiol 2006; 29:322. [PMID: 16881542 PMCID: PMC6654004 DOI: 10.1002/clc.4960290710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- E Martuscelli
- Department of Cardiology, Tor Vergata University, Italy
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27
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Pizzuto F, Voci P, Puddu PE, Chiricolo G, Borzi M, Romeo F. Functional assessment of the collateral-dependent circulation in chronic total coronary occlusion using transthoracic Doppler ultrasound and venous adenosine infusion. Am J Cardiol 2006; 98:197-203. [PMID: 16828592 DOI: 10.1016/j.amjcard.2006.01.075] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2005] [Revised: 01/19/2006] [Accepted: 01/19/2006] [Indexed: 11/27/2022]
Abstract
The measurement of collateral flow reserve (CFR; the hyperemic/baseline collateral flow velocity ratio) in patients with chronic total coronary occlusion requires invasive and expensive techniques. Noninvasive transthoracic coronary Doppler echocardiography may be an alternative option. Fifty-one patients with chronic total coronary occlusion were evaluated by transthoracic coronary Doppler echocardiography and venous adenosine infusion to measure CFR in occluded coronary arteries (the left anterior descending artery in 44 patients and the artery supplying the posterior descending artery in 7 patients). CFR data were plotted against 3 angiographic parameters: (1) grade of the epicardial filling of the occluded artery (1=absent, 2=partial, 3=complete), (2) stenosis of the donor artery, and (3) the extent of coronary artery disease (vessels with >or=70% stenosis). Collateral flow was maintained at stress in 34 patients (CFR>or=1, range 1.0 to 2.2) but was withdrawn in 17 patients (CFR<1, range 0.25 to 0.90). CFR increased with the degree of angiographic collateral flow (grade 1: 0.73+/-0.29; grade 2: 1.16+/-0.31; grade 3: 1.34+/-0.49; F=5.31, p=0.008). A multivariate model of CFR prediction showed a direct relation with angiographic collateral grade and the number of diseased vessels and an inverse relation with stenosis of the donor artery. In conclusion, CFR measurement is feasible by transthoracic coronary Doppler echocardiography. One third of the patients with chronic total coronary occlusion had collateral flow withdrawal at stress, which occurs when collateral circulation is poor and when the donor artery is stenotic. CFR correlates with angiographic collateral grade and with the extent of coronary artery disease.
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28
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Clementi F, Grelli S, Mango R, Federici M, Franchi L, Amato A, Forleo GB, Chiricolo G, Marchei M, De Luca L, Gallagher M, Favalli C, Lauro R, Novelli G, Romeo F. 1122-175 Ox-low-density lipoprotein are potent antigens for dendritic cell in plaque instability: Role of lipoxygenase-1. J Am Coll Cardiol 2004. [DOI: 10.1016/s0735-1097(04)92114-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Voci P, Pizzuto F, Mariano E, Emilio Puddu P, Andrea Chiavari P, Chiricolo G, Forleo G, Monti F, Romeo F. Transthoracic coronary doppler detects severe left anterior descending coronary artery stenosis. J Am Coll Cardiol 2003. [DOI: 10.1016/s0735-1097(03)81272-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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30
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Mango R, Clementi F, Contino G, Forleo GB, Borgiani P, Botta A, Nardone A, Chiricolo G, Marchei M, Romeo A, Guarino S, Cola C, D'Apice MR, Federici M, Fahdi I, Lauro R, Romeo F, Novelli G, Mehta JL. LOX-1 polymorphism as a susceptibility genetic marker for atherosclerosis. J Am Coll Cardiol 2003. [DOI: 10.1016/s0735-1097(03)82205-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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