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Smit JM, Rocchiccioli S, Signore G, Michelucci E, Di Giorgi N, van Rosendael AR, El Mahdiui M, Neglia D, Knuuti J, Saraste A, Buechel RR, Teresinska A, Pizzi MN, Roque A, Poddighe R, Mertens BJ, Caselli C, Parodi O, Pelosi G, Scholte AJ. Plasma Lipidomics and Coronary Plaque Changes: A Substudy of the SMARTool Clinical Trial. Eur Heart J Cardiovasc Imaging 2024:jeae058. [PMID: 38445505 DOI: 10.1093/ehjci/jeae058] [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] [Received: 07/10/2023] [Revised: 01/09/2024] [Accepted: 01/25/2024] [Indexed: 03/07/2024] Open
Abstract
AIMS To date, no studies have investigated the association between lipid species and coronary plaque changes over time, quantitatively assessed by serial imaging. We aimed to prospectively determine the association between lipid species quantified by plasma lipidomic analysis, with coronary plaque changes according to composition assessed by quantitative serial analysis of coronary computed tomography angiography (CTA). METHODS AND RESULTS Patients with suspected coronary artery disease (CAD) undergoing baseline coronary CTA were prospectively enrolled by 7 EU Centers in the SMARTool study and submitted to clinical, molecular and coronary CTA re-evaluation at follow-up (interscan period 6.39 ± 1.17 years). From the 202 patients that were analysed in the SMARTool main clinical study, lipidomic analysis was performed in 154 patients before the baseline coronary CTA, and this group was included in the present study. Quantitative CTA analysis was performed by a separate core laboratory blinded from clinical data. In univariable analysis, no lipid species were significantly associated with annual total and calcified plaque changes. After adjusting for clinical variables at baseline and statin use, 3 lipid species were significantly associated with non-calcified plaque progression. In detail, cholesteryl ester (CE)(20:3), sphingomyelin (SM)(40:3) and SM(41:1) were found positively related to non-calcified plaque progression (Bonferroni adjusted P-value = 0.005, 0.016 and 0.004, respectively). CONCLUSION The current study showed an independent relationship between specific lipid species determined by plasma lipidomic analysis, and non-calcified coronary plaque progression assessed by serial, quantitative coronary CTA analysis.
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Affiliation(s)
- Jeff M Smit
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Silvia Rocchiccioli
- Institute of Clinical Physiology CNR, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | - Giovanni Signore
- Department of Biology, Biochemistry Unit, University of Pisa, 56126, Pisa, Italy
| | - Elena Michelucci
- Institute of Clinical Physiology CNR, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | - Nicoletta Di Giorgi
- Institute of Clinical Physiology CNR, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | | | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Danilo Neglia
- Fondazione Toscana Gabriele Monasterio, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | - Juhani Knuuti
- Heart Center and PET Centre, Turku University Hospital and University of Turku, 20520, Turku, Finland
| | - Antti Saraste
- Heart Center and PET Centre, Turku University Hospital and University of Turku, 20520, Turku, Finland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital and University of Zurich, Switzerland
| | - Anna Teresinska
- Department of Nuclear Medicine, National Institute of Cardiology, Warsaw, Poland
| | - Maria N Pizzi
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Albert Roque
- Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Bart J Mertens
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Chiara Caselli
- Institute of Clinical Physiology CNR, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | - Oberdan Parodi
- Cardiovascular Department, Fondazione Toscana G. Monasterio, Via G. Moruzzi 1, Pisa, Italy
| | - Gualtiero Pelosi
- Institute of Clinical Physiology CNR, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | - Arthur J Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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2
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Hofman P, Calabrese F, Kern I, Adam J, Alarcão A, Alborelli I, Anton NT, Arndt A, Avdalyan A, Barberis M, Bégueret H, Bisig B, Blons H, Boström P, Brcic L, Bubanovic G, Buisson A, Caliò A, Cannone M, Carvalho L, Caumont C, Cayre A, Chalabreysse L, Chenard MP, Conde E, Copin MC, Côté JF, D'Haene N, Dai HY, de Leval L, Delongova P, Denčić-Fekete M, Fabre A, Ferenc F, Forest F, de Fraipont F, Garcia-Martos M, Gauchotte G, Geraghty R, Guerin E, Guerrero D, Hernandez S, Hurník P, Jean-Jacques B, Kashofer K, Kazdal D, Lantuejoul S, Leonce C, Lupo A, Malapelle U, Matej R, Merlin JL, Mertz KD, Morel A, Mutka A, Normanno N, Ovidiu P, Panizo A, Papotti MG, Parobkova E, Pasello G, Pauwels P, Pelosi G, Penault-Llorca F, Picot T, Piton N, Pittaro A, Planchard G, Poté N, Radonic T, Rapa I, Rappa A, Roma C, Rot M, Sabourin JC, Salmon I, Prince SS, Scarpa A, Schuuring E, Serre I, Siozopoulou V, Sizaret D, Smojver-Ježek S, Solassol J, Steinestel K, Stojšić J, Syrykh C, Timofeev S, Troncone G, Uguen A, Valmary-Degano S, Vigier A, Volante M, Wahl SGF, Stenzinger A, Ilié M. Real-world EGFR testing practices for non-small-cell lung cancer by thoracic pathology laboratories across Europe. ESMO Open 2023; 8:101628. [PMID: 37713929 PMCID: PMC10594022 DOI: 10.1016/j.esmoop.2023.101628] [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: 04/13/2023] [Revised: 06/14/2023] [Accepted: 08/02/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Testing for epidermal growth factor receptor (EGFR) mutations is an essential recommendation in guidelines for metastatic non-squamous non-small-cell lung cancer, and is considered mandatory in European countries. However, in practice, challenges are often faced when carrying out routine biomarker testing, including access to testing, inadequate tissue samples and long turnaround times (TATs). MATERIALS AND METHODS To evaluate the real-world EGFR testing practices of European pathology laboratories, an online survey was set up and validated by the Pulmonary Pathology Working Group of the European Society of Pathology and distributed to 64 expert testing laboratories. The retrospective survey focussed on laboratory organisation and daily EGFR testing practice of pathologists and molecular biologists between 2018 and 2021. RESULTS TATs varied greatly both between and within countries. These discrepancies may be partly due to reflex testing practices, as 20.8% of laboratories carried out EGFR testing only at the request of the clinician. Many laboratories across Europe still favour single-test sequencing as a primary method of EGFR mutation identification; 32.7% indicated that they only used targeted techniques and 45.1% used single-gene testing followed by next-generation sequencing (NGS), depending on the case. Reported testing rates were consistent over time with no significant decrease in the number of EGFR tests carried out in 2020, despite the increased pressure faced by testing facilities during the COVID-19 pandemic. ISO 15189 accreditation was reported by 42.0% of molecular biology laboratories for single-test sequencing, and by 42.3% for NGS. 92.5% of laboratories indicated they regularly participate in an external quality assessment scheme. CONCLUSIONS These results highlight the strong heterogeneity of EGFR testing that still occurs within thoracic pathology and molecular biology laboratories across Europe. Even among expert testing facilities there is variability in testing capabilities, TAT, reflex testing practice and laboratory accreditation, stressing the need to harmonise reimbursement technologies and decision-making algorithms in Europe.
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Affiliation(s)
- P Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France.
| | - F Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - I Kern
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J Adam
- Department of Pathology, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Alarcão
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - I Alborelli
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - N T Anton
- Department of Genetics, University Hospital Bichat-Claude Bernard, Paris University, Paris, France
| | - A Arndt
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - A Avdalyan
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - M Barberis
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - H Bégueret
- Department of Pathology, University Hospital of Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - B Bisig
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - H Blons
- Pharmacogenomics and Molecular Oncology Unit, Biochemistry Department, Assistance Publique-Hopitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - P Boström
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - L Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - G Bubanovic
- Laboratory for Molecular Pathology, Department of Pathology, University of Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb, Croatia
| | - A Buisson
- Department of Biopathology, Centre Léon Bérard, Lyon, France
| | - A Caliò
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - M Cannone
- Inter-Hospital Pathology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), MultiMedica, Milan, Italy
| | - L Carvalho
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - C Caumont
- Department of Tumor Biology, University Hospital of Bordeaux, Hospital Haut-Lévêque, Pessac, France
| | - A Cayre
- Department of Biopathology, Jean Perrin Centre, Clermont-Ferrand, France
| | - L Chalabreysse
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - M P Chenard
- Department of Pathology, University Hospital of Strasbourg, 67098 Strasbourg, France
| | - E Conde
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - M C Copin
- Department of Pathology, Université d'Angers, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - J F Côté
- Department of Pathology, Institut Mutualiste Montsouris, Paris, France
| | - N D'Haene
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium
| | - H Y Dai
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - L de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - P Delongova
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | | | - A Fabre
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - F Ferenc
- Department of Pathology, University of Oradea, Oradea, Romania
| | - F Forest
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - F de Fraipont
- Medical Unit of Molecular Genetic (Hereditary Diseases and Oncology), Grenoble University Hospital, Grenoble, France
| | - M Garcia-Martos
- Department of Pathology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - G Gauchotte
- Department of Biopathology, CHRU-ICL, CHRU Nancy, Vandoeuvre-lès-Nancy, France
| | - R Geraghty
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - E Guerin
- Department of Molecular Cancer Genetics, Laboratory of Biochemistry and Molecular Biology, University Hospital of Strasbourg, Strasbourg, France
| | - D Guerrero
- Biomedical Research Centre, Navarra Health Service, Pamplona, Navarra, Spain
| | - S Hernandez
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - P Hurník
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | - B Jean-Jacques
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - K Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - D Kazdal
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - S Lantuejoul
- Department of Biopathology, Centre Leon Berard Unicancer and Pathology Research Platform, Cancer Research Center of Lyon (CRCL), Lyon, France
| | - C Leonce
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - A Lupo
- Department of Pathology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - U Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - R Matej
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - J L Merlin
- Department of Biopathology, Institut de Cancérologie de Lorraine, University of Lorraine, Vandoeuvre-Les-Nancy, France
| | - K D Mertz
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - A Morel
- Department of Innate Immunity and Immunotherapy, Institut de Cancérologie de l'Ouest - Centre Paul Papin, Angers, France
| | - A Mutka
- HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki, Finland
| | - N Normanno
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - P Ovidiu
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Panizo
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - M G Papotti
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - E Parobkova
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - G Pasello
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - P Pauwels
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - G Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - F Penault-Llorca
- Department of Pathology, Clermont Auvergne University, "Molecular Imaging and Theranostic Strategies", Center Jean Perrin, Montalembert, Clermont-Ferrand, France
| | - T Picot
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - N Piton
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - A Pittaro
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - G Planchard
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - N Poté
- Department of Pathology, Hospital Bichat Bichat, Assistance Publique Hôpitaux de Paris; Université Paris Cité, Paris, France
| | - T Radonic
- Department of Pathology, Amsterdam University Medical Center, VUMC, University of Amsterdam, Amsterdam, Netherlands
| | - I Rapa
- Pathology Unit, San Luigi Hospital, Orbassano Turin, Italy
| | - A Rappa
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - C Roma
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - M Rot
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J C Sabourin
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - I Salmon
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium; CurePath, Jumet, Belgium
| | - S Savic Prince
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - A Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - E Schuuring
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - I Serre
- Department of Pathology, Gui de Chauliac Hospital, Montpellier University Medical Center, University of Montpellier, 80 Avenue Augustin Fliche, Montpellier, France
| | - V Siozopoulou
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - D Sizaret
- Department of Pathology, CHRU Tours - Hôpital Trousseau, Chambray-lès-Tours, France
| | - S Smojver-Ježek
- Division for Pulmonary Cytology, Department of Pathology and Cytology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - J Solassol
- Solid Tumour Laboratory, Pathology and Oncobiology Department, CHU Montpellier, University of Montpellier, Montpellier, France
| | - K Steinestel
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - J Stojšić
- Department of Thoracic Pathology, Section of Pathology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - C Syrykh
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - S Timofeev
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - G Troncone
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Uguen
- Department of Pathological Anatomy and Cytology, CHRU de Brest, Brest, France; LBAI, UMR1227, INSERM, University of Brest, CHU de Brest, Brest, France
| | - S Valmary-Degano
- Department of Pathology, Institute for Advanced Biosciences, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - A Vigier
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - M Volante
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - S G F Wahl
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - A Stenzinger
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - M Ilié
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
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Sbrana S, Cecchettini A, Bastiani L, Mazzone A, Vozzi F, Caselli C, Neglia D, Clemente A, Scholte AJHA, Parodi O, Pelosi G, Rocchiccioli S. Association of Circulating Neutrophils with Relative Volume of Lipid-Rich Necrotic Core of Coronary Plaques in Stable Patients: A Substudy of SMARTool European Project. Life (Basel) 2023; 13:life13020428. [PMID: 36836785 PMCID: PMC9958623 DOI: 10.3390/life13020428] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND AIMS Coronary atherosclerosis is a chronic non-resolving inflammatory process wherein the interaction of innate immune cells and platelets plays a major role. Circulating neutrophils, in particular, adhere to the activated endothelium and migrate into the vascular wall, promoting monocyte recruitment and influencing plaque phenotype and stability at all stages of its evolution. We aimed to evaluate, by flow cytometry, if blood neutrophil number and phenotype-including their phenotypic relationships with platelets, monocytes and lymphocytes-have an association with lipid-rich necrotic core volume (LRNCV), a generic index of coronary plaque vulnerability, in a group of stable patients with chronic coronary syndrome (CCS). METHODS In 55 patients, (68.53 ± 1.07 years of age, mean ± SEM; 71% male), the total LRNCV in each subject was assessed by a quantitative analysis of all coronary plaques detected by computed tomography coronary angiography (CTCA) and was normalized to the total plaque volume. The expression of CD14, CD16, CD18, CD11b, HLA-DR, CD163, CCR2, CCR5, CX3CR1, CXCR4 and CD41a cell surface markers was quantified by flow cytometry. Adhesion molecules, cytokines and chemokines, as well as MMP9 plasma levels, were measured by ELISA. RESULTS On a per-patient basis, LRNCV values were positively associated, by a multiple regression analysis, with the neutrophil count (n°/µL) (p = 0.02), neutrophil/lymphocyte ratio (p = 0.007), neutrophil/platelet ratio (p = 0.01), neutrophil RFI CD11b expression (p = 0.02) and neutrophil-platelet adhesion index (p = 0.01). Significantly positive multiple regression associations of LRNCV values with phenotypic ratios between neutrophil RFI CD11b expression and several lymphocyte and monocyte surface markers were also observed. In the bivariate correlation analysis, a significantly positive association was found between RFI values of neutrophil-CD41a+ complexes and neutrophil RFI CD11b expression (p < 0.0001). CONCLUSIONS These preliminary findings suggest that a sustained increase in circulating neutrophils, together with the up-regulation of the integrin/activation membrane neutrophil marker CD11b may contribute, through the progressive intra-plaque accumulation of necrotic/apoptotic cells exceeding the efferocytosis/anti-inflammatory capacity of infiltrating macrophages and lymphocytes, to the relative enlargement of the lipid-rich necrotic core volume of coronary plaques in stable CAD patients, thus increasing their individual risk of acute complication.
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Affiliation(s)
- Silverio Sbrana
- CNR Institute of Clinical Physiology, 54100 Massa, Italy
- Correspondence: (S.S.); (S.R.)
| | - Antonella Cecchettini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- CNR Institute of Clinical Physiology, 56124 Pisa, Italy
| | - Luca Bastiani
- CNR Institute of Clinical Physiology, 54100 Massa, Italy
| | | | | | | | - Danilo Neglia
- Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | | | | | | | | | - Silvia Rocchiccioli
- CNR Institute of Clinical Physiology, 56124 Pisa, Italy
- Correspondence: (S.S.); (S.R.)
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Caselli C, Ragusa R, Di Giorgi N, Lorenzoni V, Buechel RR, Teresinska A, Pizzi MN, Roque A, Poddighe R, Knuuti J, Parodi O, Pelosi G, Scholte A, Rocchiccioli S, Neglia D. Association of serum MMP9 with adverse features of plaque progression in patients with chronic coronary syndrome (CCS). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1109] [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: 11/14/2022] Open
Abstract
Abstract
Background
Previous studies have demonstrated that MMP-9 may be a predictor of atherosclerotic plaque instability and future adverse cardiovascular events, but longitudinal data on the association between MMP9 and coronary disease progression are lacking.
Purpose
This study is aimed at investigating whether MMP9 is associated with atherosclerotic plaque progression.
Methods
MMP9 serum levels were measured in stable patients with chronic coronary syndrome (CCS) undergoing coronary computed tomography angiography at baseline and after a period of 6.5±1.1 years of follow up to assess progression of Total, Fibrous, Fibro-fatty, Necrotic Core, and Dense Calcium plaque volume (PV). The relationship of serum MMP9 with plaque progression was assessed using linear regression analysis, adjusting for clinical variables including, age, sex, risk factors, medical therapy, LDL-C, TG/HDL-C ratio, hs-CRP, and the presence of obstructive CAD (>50% coronary stenosis in at least one major coronary vessels).
Results
A total of 157 patients (58±8 years of age; 66% males) were included in the analysis, with median MMP9 values of 135±186 mg/dL (mean ± SD). Annual changes of Total, Fibrous-Fatty and Necrotic Core PV were significantly different across MMP9 tertiles (Figure 1). Multivariable linear regression analysis demonstrated a positive association between serum levels of MMP9 and annual change of Total and Necrotic Core PV (Figure 1).
Conclusion
Among patients with CCS, MMP9 serum levels were an independent predictor of progression of coronary plaque burden and, in particular, of adverse plaque features, such as Necrotic Core PV. This association was robust and independent from baseline traditional cardiovascular risk factors and medications, supporting for MMP9 a role as a novel marker of residual coronary risk.
Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Horizon 2020 - Project “Simulation Modeling of coronary ARTery disease: a tool for clinical decision support–SMARTool”
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Affiliation(s)
- C Caselli
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - R Ragusa
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - N Di Giorgi
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - V Lorenzoni
- Sant'Anna School of Advanced Studies , Pisa , Italy
| | - R R Buechel
- University Hospital Zurich , Zurich , Switzerland
| | | | - M N Pizzi
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - A Roque
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - R Poddighe
- USL Toscana Northwest , Viareggio , Italy
| | - J Knuuti
- University of Turku , Turku , Finland
| | - O Parodi
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
| | - G Pelosi
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - A Scholte
- Leiden University Medical Center , Leiden , The Netherlands
| | | | - D Neglia
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
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5
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Caselli C, Di Giorgi N, Ragusa R, Lorenzoni V, Smit J, El Mahdiui M, Buechel RR, Teresinska A, Pizzi MN, Roque A, Poddighe R, Knuuti J, Schütte M, Parodi O, Pelosi G, Scholte A, Rocchiccioli S, Neglia D. Association of MMP9 with adverse features of plaque progression and residual inflammatory risk in patients with chronic coronary syndrome (CCS). Vascul Pharmacol 2022; 146:107098. [PMID: 36100166 DOI: 10.1016/j.vph.2022.107098] [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: 06/22/2022] [Revised: 08/18/2022] [Accepted: 08/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS MMP-9 is a predictor of atherosclerotic plaque instability and adverse cardiovascular events, but longitudinal data on the association between MMP9 and coronary disease progression are lacking. This study is aimed at investigating whether MMP9 is associated with atherosclerotic plaque progression and the related molecular basis in stable patients with chronic coronary syndrome (CCS). METHODS MMP9 serum levels were measured in 157 CCS patients (58 ± 8 years of age; 66% male) undergoing coronary computed tomography angiography at baseline and after a follow up period of 6.5 ± 1.1 years to assess progression of Total, Fibrous, Fibro-fatty, Necrotic Core, and Dense Calcium plaque volumes (PV). Gene expression analysis was evaluated in whole blood using a transcriptomic approach by RNA-seq. RESULTS At multivariate analysis, serum MMP9 was associated with annual change of Total and Necrotic Core PV (Coefficient 3.205, SE 1.321, P = 0.017; 1.449, SE 0.690, P = 0.038, respectively), while MMP9 gene expression with Necrotic Core PV (Coefficient 70.559, SE 32.629, P = 0.034), independently from traditional cardiovascular risk factors, medications, and presence of obstructive CAD. After transcriptomic analysis, MMP9 expression was linked to expression of genes involved in the innate immunity. CONCLUSIONS Among CCS patients, MMP9 is an independent predictive marker of progression of adverse coronary plaques, possibly reflecting the activity of inflammatory pathways conditioning adverse plaque phenotypes. Thus, blood MMP9 might be used for the identification of patients with residual risk even with optimal management of classical cardiovascular risk factors who may derive the greatest benefit from targeted anti-inflammatory drugs.
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Affiliation(s)
- Chiara Caselli
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | | | - Rosetta Ragusa
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | - Valentina Lorenzoni
- Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, Pisa, Italy.
| | - Jeff Smit
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | - Mohammed El Mahdiui
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital and University of Zurich, Switzerland.
| | | | - Maria N Pizzi
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Albert Roque
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Juhani Knuuti
- PET Center, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, Turku, Finland.
| | - Moritz Schütte
- Alacris Theranostics GmbH, Max-Planck-Straße 3, 12489 Berlin, Germany.
| | - Oberdan Parodi
- Fondazione Toscana G. Monasterio, Via G. Moruzzi 1, Pisa, Italy
| | - Gualtiero Pelosi
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | - Arthur Scholte
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | | | - Danilo Neglia
- Fondazione Toscana G. Monasterio, Via G. Moruzzi 1, Pisa, Italy.
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6
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thunnissen E, Borczuk A, Beasly M, Tsao M, Kerr K, Dacic S, Minami Y, Nicholson A, Lissenberg-Witte B, Roden A, Papotti M, Poleri C, Travis B, Jain D, Pelosi G, Chung J, Botling J, Bubendorf L, Mino-Kenudson M, Motoi N, Lantuejoul S, Cooper W, Hwang D, Moreira A, Noguchi M. MA12.07 Defining Morphologic Features of Invasion in Pulmonarynon-Mucinousadenocarcinoma with Lepidic Growth. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.146] [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: 11/26/2022]
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7
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Cabiati M, Giacomarra M, Fontanini M, Cecchettini A, Pelosi G, Vozzi F, Del Ry S. Bone morphogenetic protein-4 system expression in human coronary artery endothelial and smooth muscle cells under dynamic flow: effect of medicated bioresorbable vascular scaffolds at low and normal shear stress. Heart Vessels 2022; 37:2137-2149. [PMID: 35857064 DOI: 10.1007/s00380-022-02140-w] [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: 02/01/2022] [Accepted: 07/06/2022] [Indexed: 11/04/2022]
Abstract
Endothelial and smooth muscle cell dysfunction is an early event at the onset of atherosclerosis, a heterogeneous and multifactorial pathology of the vascular wall. Bone morphogenetic protein (BMP)-4, a mechanosensitive autocrine cytokine, and BMPR-1a, BMPR-1b, BMPR-2 specific receptors play a key role in atherosclerotic plaque formation and vascular calcification and BMP4 is regarded as a biomarker of endothelial cell activation. The study aimed to examine the BMP4 system expression by Real-Time PCR in Human Coronary Artery Endothelial (HCAECs) and Smooth Muscle Cells (HCASMCs) under different flow rates determining low or physiological shear stress in the presence/absence of medicated Bioresorbable Vascular Scaffold (BVS). The HCAEC and HCASMC were subjected to 1-10-20 dyne/cm2 shear stress in a laminar flow bioreactor system, with/without BVS+ Everolimus (600 nM). In HCAECs without BVS the BMP4 expression was similar at 1, 20 dyne/cm2 decreasing at 10 dyne/cm2, while adding BVS+ Everolimus, it decreased both at 1, 10 compared to 20 dyne/cm2. In HCASMCs without BVS + Everolimus, the BMP4 system mRNA expression was significantly reduced at 1, 10 dyne/cm2 compared to 20 dyne/cm2, while in the presence of BVS+ Everolimus, higher BMP4 mRNA levels were observed at 10 compared to 1, 20 dyne/cm2. In HCAECs and HCASMCs BMPRs were expressed in all experimental conditions except for BMPR-1a at 1 dyne/cm2 in HCAEC. Significant correlations were found between BMP4 and BMPRs. The more negligible on BMP4 expression due to low shear stress in HCAEC compared to HCASMC and its reduction in the presence of BVS+ Everolimus at low shear stress highlighted the protection of BMP4-mediated against endothelial dysfunction and neoatherogenesis.
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Affiliation(s)
- Manuela Cabiati
- Laboratory of Biochemistry and Molecular Biology, Institute of Clinical Physiology CNR, Via Giuseppe Moruzzi 1, 56124, Pisa, Italy.
| | - Manuel Giacomarra
- Laboratory of Biochemistry and Molecular Biology, Institute of Clinical Physiology CNR, Via Giuseppe Moruzzi 1, 56124, Pisa, Italy
| | - Martina Fontanini
- Laboratory of Biochemistry and Molecular Biology, Institute of Clinical Physiology CNR, Via Giuseppe Moruzzi 1, 56124, Pisa, Italy
| | - Antonella Cecchettini
- Laboratory of Proteomics, Institute of Clinical Physiology, IFC-CNR, Pisa, Italy.,Department of Experimental and Clinical Medicine, University of Pisa, Pisa, Italy
| | - Gualtiero Pelosi
- Laboratory of Biomimetic Materials and Tissue Engineering, Institute of Clinical Physiology CNR, Pisa, Italy
| | - Federico Vozzi
- Laboratory of Biomimetic Materials and Tissue Engineering, Institute of Clinical Physiology CNR, Pisa, Italy
| | - Silvia Del Ry
- Laboratory of Biochemistry and Molecular Biology, Institute of Clinical Physiology CNR, Via Giuseppe Moruzzi 1, 56124, Pisa, Italy
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8
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Kigka VI, Georga E, Tsakanikas V, Kyriakidis S, Tsompou P, Siogkas P, Michalis LK, Naka KK, Neglia D, Rocchiccioli S, Pelosi G, Fotiadis DI, Sakellarios A. Machine Learning Coronary Artery Disease Prediction Based on Imaging and Non-Imaging Data. Diagnostics (Basel) 2022; 12:diagnostics12061466. [PMID: 35741275 PMCID: PMC9221964 DOI: 10.3390/diagnostics12061466] [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: 04/15/2022] [Revised: 06/06/2022] [Accepted: 06/11/2022] [Indexed: 11/16/2022] Open
Abstract
The prediction of obstructive atherosclerotic disease has significant clinical meaning for the decision making. In this study, a machine learning predictive model based on gradient boosting classifier is presented, aiming to identify the patients of high CAD risk and those of low CAD risk. The machine learning methodology includes five steps: the preprocessing of the input data, the class imbalance handling applying the Easy Ensemble algorithm, the recursive feature elimination technique implementation, the implementation of gradient boosting classifier, and finally the model evaluation, while the fine tuning of the presented model was implemented through a randomized search optimization of the model’s hyper-parameters over an internal 3-fold cross-validation. In total, 187 participants with suspicion of CAD previously underwent CTCA during EVINCI and ARTreat clinical studies and were prospectively included to undergo follow-up CTCA. The predictive model was trained using imaging data (geometrical and blood flow based) and non-imaging data. The overall predictive accuracy of the model was 0.81, using both imaging and non-imaging data. The innovative aspect of the proposed study is the combination of imaging-based data with the typical CAD risk factors to provide an integrated CAD risk-predictive model.
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Affiliation(s)
- Vassiliki I. Kigka
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110 Ioannina, Greece; (V.I.K.); (E.G.); (V.T.); (S.K.); (P.T.); (P.S.); (D.I.F.)
- Institute of Molecular Biology and Biotechnology, Department of Biomedical Research—FORTH, University Campus of Ioannina, GR 45110 Ioannina, Greece
| | - Eleni Georga
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110 Ioannina, Greece; (V.I.K.); (E.G.); (V.T.); (S.K.); (P.T.); (P.S.); (D.I.F.)
- Institute of Molecular Biology and Biotechnology, Department of Biomedical Research—FORTH, University Campus of Ioannina, GR 45110 Ioannina, Greece
| | - Vassilis Tsakanikas
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110 Ioannina, Greece; (V.I.K.); (E.G.); (V.T.); (S.K.); (P.T.); (P.S.); (D.I.F.)
- Institute of Molecular Biology and Biotechnology, Department of Biomedical Research—FORTH, University Campus of Ioannina, GR 45110 Ioannina, Greece
| | - Savvas Kyriakidis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110 Ioannina, Greece; (V.I.K.); (E.G.); (V.T.); (S.K.); (P.T.); (P.S.); (D.I.F.)
- Institute of Molecular Biology and Biotechnology, Department of Biomedical Research—FORTH, University Campus of Ioannina, GR 45110 Ioannina, Greece
| | - Panagiota Tsompou
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110 Ioannina, Greece; (V.I.K.); (E.G.); (V.T.); (S.K.); (P.T.); (P.S.); (D.I.F.)
| | - Panagiotis Siogkas
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110 Ioannina, Greece; (V.I.K.); (E.G.); (V.T.); (S.K.); (P.T.); (P.S.); (D.I.F.)
- Institute of Molecular Biology and Biotechnology, Department of Biomedical Research—FORTH, University Campus of Ioannina, GR 45110 Ioannina, Greece
| | - Lampros K. Michalis
- Department of Cardiology, Medical School, University of Ioannina, GR 45110 Ioannina, Greece; (L.K.M.); (K.K.N.)
| | - Katerina K. Naka
- Department of Cardiology, Medical School, University of Ioannina, GR 45110 Ioannina, Greece; (L.K.M.); (K.K.N.)
| | - Danilo Neglia
- Fondazione Toscana Gabriele Monasterio, IT 56126 Pisa, Italy;
| | - Silvia Rocchiccioli
- Institute of Clinical Physiology, National Research Council, IT 56124 Pisa, Italy; (S.R.); (G.P.)
| | - Gualtiero Pelosi
- Institute of Clinical Physiology, National Research Council, IT 56124 Pisa, Italy; (S.R.); (G.P.)
| | - Dimitrios I. Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110 Ioannina, Greece; (V.I.K.); (E.G.); (V.T.); (S.K.); (P.T.); (P.S.); (D.I.F.)
- Institute of Molecular Biology and Biotechnology, Department of Biomedical Research—FORTH, University Campus of Ioannina, GR 45110 Ioannina, Greece
| | - Antonis Sakellarios
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110 Ioannina, Greece; (V.I.K.); (E.G.); (V.T.); (S.K.); (P.T.); (P.S.); (D.I.F.)
- Institute of Molecular Biology and Biotechnology, Department of Biomedical Research—FORTH, University Campus of Ioannina, GR 45110 Ioannina, Greece
- Correspondence: ; Tel.: +30-26510-07848
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9
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Rocchiccioli S, Di Giorgi N, Michelucci E, Signore G, Scholte AJHA, Knuuti J, Buechel RR, Teresinska A, Pizzi MN, Roque A, Poddighe R, Parodi O, Pelosi G, Neglia D, Caselli C. A common plasma lipidomics signature of cardiometabolic and coronary risk in statin users. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.091] [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: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Commission in the H2020 program: Project SMARTool, “Simulation
Modeling of coronary ARTery disease: a tool for clinical decision support—SMARTool”
Background and aims
The coexistence of elevated plasma triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C) may contribute to the residual cardiometabolic risk of coronary artery disease (CAD) independently of total cholesterol and low-density lipoprotein cholesterol (LDL-C) absolute plasma levels [1]. Aim of this study is to assess whether a high TG/HDL-C ratio is characterized by a specific lipidomics signature in statin users and its relationship with the coronary risk score defined by coronary computed tomography angiography (CTA).
Methods
TG/HDL-C ratio was calculated in 132 patients (68.8±7.7 years, 85 males) with suspected or known CAD referred to coronary CTA and receiving statins treatment in the last 6.3 ± 1.4 years before enrolment. Patients were grouped according to TG/HDL-C ratio quartiles: IQ (≤1.694), IIQ (1.695-2.399), IIIQ (2.400-3.281), and IVQ (>3.282). Coronary CTA exams were analysed according to the modified 17-segment American Heart Association classification [2] and interpretable segments were visually assessed for degree of stenosis and plaque composition. A comprehensive coronary risk score (CTA score) [3], previously validated as predictor of adverse outcome, was calculated in each patient. Except for subjects with normal arteries (CTA score = 0), all patients were classified into 3 groups of CTA score severity: low (score < 5), intermediate (score 5-20) and high (score > 20) risk [4]. Patient-specific plasma targeted lipidomics was performed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). This approach allowed to quantify 69 circulating lipids encompassing six lipid classes (triacylglycerol [TG], phosphatidylcholine [PC], phosphatidylethanolamine [PE], ceramide [Cer], sphingomyelin [SM], cholesterol ester [CE]). Differential analysis was performed using TG/HDL-C and CTA score annotation.
Results
18 altered lipid species in the group with higher TG/HDL-C ratio were also altered in the group with higher CTA risk score. This common set of lipids is composed of CE(16:0), CE(18:0), PC(38:2), 8 SM [SM(34:2), SM(38:2), SM(41:2), SM(41:1), SM(42:4), SM(42:3), SM(42:1), SM(43:3)], TG(52:1) and 6 PE [PE(34:0), PE(34:1), PE(34:2), PE(36:1), PE(36:2), PE(36:3)], and represents the lipidomics signature associating elevated plasma TG/HDL-C ratio with high CTA risk score in statin users.
Conclusion
In patients with stable CAD under statin treatment, a specific pattern of altered lipids, characterized by reduced plasma levels of cholesterol esters and sphingomyelins and increased levels of triacylglicerols and phosphatidylethanolamines, is associated with high TG/HDL-C ratio and high CTA score. This specific lipidomic signature identifies patients with higher residual cardiometabolic and coronary risk, not tackled by current lipid lowering therapy, unveiling possible new molecular targets of treatment.
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Affiliation(s)
| | - N Di Giorgi
- Institute of Clinical Physiology of CNR , Pisa , Italy
| | - E Michelucci
- Institute of Clinical Physiology of CNR , Pisa , Italy
| | - G Signore
- University of Pisa, Department of Biology, Biochemistry Unit , Pisa , Italy
| | - AJHA Scholte
- Leiden University Medical Center, Department of Cardiology , Leiden , Netherlands (The)
| | - J Knuuti
- Turku PET Centre , Turku , Finland
| | - RR Buechel
- University Hospital Zurich, Department of Nuclear Medicine, Cardiac Imaging , Zurich , Switzerland
| | - A Teresinska
- National Institute of Cardiology , Warsaw , Poland
| | - MN Pizzi
- University Hospital Vall d'Hebron, Department of Cardiology , Barcelona , Spain
| | - A Roque
- University Hospital Vall d'Hebron, Department of Radiology , Barcelona , Spain
| | - R Poddighe
- USL Toscana Northwest, Cardiologia , Viareggio , Italy
| | - O Parodi
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
| | - G Pelosi
- Institute of Clinical Physiology of CNR , Pisa , Italy
| | - D Neglia
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
| | - C Caselli
- Institute of Clinical Physiology of CNR , Pisa , Italy
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10
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Carcelli M, Montalbano S, Rogolino D, Gandin V, Miglioli F, Pelosi G, Buschini A. Antiproliferative activity of nickel(II), palladium(II) and zinc(II) thiosemicarbazone complexes. Inorganica Chim Acta 2022. [DOI: 10.1016/j.ica.2021.120779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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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11
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Sakellarios AI, Siogkas P, Kigka V, Tsompou P, Pleouras D, Kyriakidis S, Karanasiou G, Pelosi G, Nikopoulos S, Naka KK, Rocchiccioli S, Michalis LK, Fotiadis DI. Error Propagation in the Simulation of Atherosclerotic Plaque Growth and the Prediction of Atherosclerotic Disease Progression. Diagnostics (Basel) 2021; 11:diagnostics11122306. [PMID: 34943545 PMCID: PMC8699876 DOI: 10.3390/diagnostics11122306] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022] Open
Abstract
Assessments of coronary artery disease can be achieved using non-invasive computed tomography coronary angiography (CTCA). CTCA can be further used for the 3D reconstruction of the coronary arteries and the development of computational models. However, image acquisition and arterial reconstruction introduce an error which can be propagated, affecting the computational results and the accuracy of diagnostic and prognostic models. In this work, we investigate the effect of an imaging error, propagated to a diagnostic index calculated using computational modelling of blood flow and then to prognostic models based on plaque growth modelling or binary logistic predictive modelling. The analysis was performed utilizing data from 20 patients collected at two time points with interscan period of six years. The collected data includes clinical and risk factors, biological and biohumoral data, and CTCA imaging. The results demonstrated that the error propagated and may have significantly affected some of the final outcomes. The calculated propagated error seemed to be minor for shear stress, but was major for some variables of the plaque growth model. In parallel, in the current analysis SmartFFR was not considerably affected, with the limitation of only one case located into the gray zone.
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Affiliation(s)
- Antonis I. Sakellarios
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology—FORTH, University Campus of Ioannina, 45110 Ioannina, Greece; (P.S.); (V.K.); (P.T.); (S.K.); (G.K.); (D.I.F.)
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, 45110 Ioannina, Greece;
- Correspondence: ; Tel.: +30-265-100-7837
| | - Panagiotis Siogkas
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology—FORTH, University Campus of Ioannina, 45110 Ioannina, Greece; (P.S.); (V.K.); (P.T.); (S.K.); (G.K.); (D.I.F.)
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, 45110 Ioannina, Greece;
| | - Vassiliki Kigka
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology—FORTH, University Campus of Ioannina, 45110 Ioannina, Greece; (P.S.); (V.K.); (P.T.); (S.K.); (G.K.); (D.I.F.)
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, 45110 Ioannina, Greece;
| | - Panagiota Tsompou
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology—FORTH, University Campus of Ioannina, 45110 Ioannina, Greece; (P.S.); (V.K.); (P.T.); (S.K.); (G.K.); (D.I.F.)
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, 45110 Ioannina, Greece;
| | - Dimitrios Pleouras
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, 45110 Ioannina, Greece;
| | - Savvas Kyriakidis
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology—FORTH, University Campus of Ioannina, 45110 Ioannina, Greece; (P.S.); (V.K.); (P.T.); (S.K.); (G.K.); (D.I.F.)
| | - Georgia Karanasiou
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology—FORTH, University Campus of Ioannina, 45110 Ioannina, Greece; (P.S.); (V.K.); (P.T.); (S.K.); (G.K.); (D.I.F.)
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, 45110 Ioannina, Greece;
| | - Gualtiero Pelosi
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (G.P.); (S.R.)
| | - Sotirios Nikopoulos
- Department of Cardiology, Medical School, University of Ioannina, 45110 Ioannina, Greece; (S.N.); (K.K.N.); (L.K.M.)
| | - Katerina K. Naka
- Department of Cardiology, Medical School, University of Ioannina, 45110 Ioannina, Greece; (S.N.); (K.K.N.); (L.K.M.)
| | - Silvia Rocchiccioli
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (G.P.); (S.R.)
| | - Lampros K. Michalis
- Department of Cardiology, Medical School, University of Ioannina, 45110 Ioannina, Greece; (S.N.); (K.K.N.); (L.K.M.)
| | - Dimitrios I. Fotiadis
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology—FORTH, University Campus of Ioannina, 45110 Ioannina, Greece; (P.S.); (V.K.); (P.T.); (S.K.); (G.K.); (D.I.F.)
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, 45110 Ioannina, Greece;
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12
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Sakellarios AI, Tsompou P, Kigka V, Karanasiou G, Tsarapatsani K, Kyriakidis S, Karanasiou G, Siogkas P, Nikopoulos S, Rocchiccioli S, Pelosi G, Michalis LK, Fotiadis DI. A proof-of-concept study for the prediction of the de-novo atherosclerotic plaque development using finite elements . Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:4354-4357. [PMID: 34892184 DOI: 10.1109/embc46164.2021.9629792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The type of the atherosclerotic plaque has significant clinical meaning since plaque vulnerability depends on its type. In this work, we present a computational approach which predicts the development of new plaques in coronary arteries. More specifically, we employ a multi-level model which simulates the blood fluid dynamics, the lipoprotein transport and their accumulation in the arterial wall and the triggering of inflammation using convection-diffusion-reaction equations and in the final level, we estimate the plaque volume which causes the arterial wall thickening. The novelty of this work relies on the conceptual approach that using the information from 94 patients with computed tomography coronary angiography (CTCA) imaging at two time points we identify the correlation of the computational results with the real plaque components detected in CTCA. In the next step, we use these correlations to generate two types of de-novo plaques: calcified and non-calcified. Evaluation of the model's performance is achieved using eleven patients, who present de-novo plaques at the follow-up imaging. The results demonstrate that the computationally generated plaques are associated significantly with the real plaques indicating that the proposed approach could be used for the prediction of specific plaque type formation.
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13
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Siogkas PK, Lakkas L, Sakellarios AI, Rigas G, Kyriakidis S, Stefanou KA, Anagnostopoulos CD, Clemente A, Rocchiccioli S, Pelosi G, Parodi O, Papafaklis MI, Naka KK, Michalis LK, Neglia D, Fotiadis DI. SmartFFR, a New Functional Index of Coronary Stenosis: Comparison With Invasive FFR Data. Front Cardiovasc Med 2021; 8:714471. [PMID: 34490377 PMCID: PMC8418116 DOI: 10.3389/fcvm.2021.714471] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/25/2021] [Accepted: 07/27/2021] [Indexed: 12/22/2022] Open
Abstract
Aims: In this study, we evaluate the efficacy of SmartFFR, a new functional index of coronary stenosis severity compared with gold standard invasive measurement of fractional flow reserve (FFR). We also assess the influence of the type of simulation employed on smartFFR (i.e. Fluid Structure Interaction vs. rigid wall assumption). Methods and Results: In a dataset of 167 patients undergoing either computed tomography coronary angiography (CTCA) and invasive coronary angiography or only invasive coronary angiography (ICA), as well as invasive FFR measurement, SmartFFR was computed after the 3D reconstruction of the vessels of interest and the subsequent blood flow simulations. 202 vessels were analyzed with a mean total computational time of seven minutes. SmartFFR was used to process all models reconstructed by either method. The mean FFR value of the examined dataset was 0.846 ± 0.089 with 95% CI for the mean of 0.833-0.858, whereas the mean SmartFFR value was 0.853 ± 0.095 with 95% CI for the mean of 0.84-0.866. SmartFFR was significantly correlated with invasive FFR values (RCCTA = 0.86, p CCTA < 0.0001, RICA = 0.84, p ICA < 0.0001, R overall = 0.833, p overall < 0.0001), showing good agreement as depicted by the Bland-Altman method of analysis. The optimal SmartFFR threshold to diagnose ischemia was ≤0.83 for the overall dataset, ≤0.83 for the CTCA-derived dataset and ≤0.81 for the ICA-derived dataset, as defined by a ROC analysis (AUCoverall = 0.956, p < 0.001, AUCICA = 0.975, p < 0.001, AUCCCTA = 0.952, p < 0.001). Conclusion: SmartFFR is a fast and accurate on-site index of hemodynamic significance of coronary stenosis both at single coronary segment and at two or more branches level simultaneously, which can be applied to all CTCA or ICA sequences of acceptable quality.
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Affiliation(s)
- Panagiotis K Siogkas
- Biomedical Research Institute, Foundation for Research and Technology Hellas, Ioannina, Greece.,Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Lampros Lakkas
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Antonis I Sakellarios
- Biomedical Research Institute, Foundation for Research and Technology Hellas, Ioannina, Greece
| | - George Rigas
- Biomedical Research Institute, Foundation for Research and Technology Hellas, Ioannina, Greece
| | - Savvas Kyriakidis
- Biomedical Research Institute, Foundation for Research and Technology Hellas, Ioannina, Greece
| | - Kostas A Stefanou
- Biomedical Research Institute, Foundation for Research and Technology Hellas, Ioannina, Greece
| | - Constantinos D Anagnostopoulos
- PET-CT Department & Preclinical Imaging Unit, Center for Experimental Surgery, Clinical & Translational Research, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Alberto Clemente
- Fondazione Toscana G. Monasterio and Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - Silvia Rocchiccioli
- Fondazione Toscana G. Monasterio and Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - Gualtiero Pelosi
- Fondazione Toscana G. Monasterio and Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - Oberdan Parodi
- Fondazione Toscana G. Monasterio and Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy.,Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Michail I Papafaklis
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Katerina K Naka
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Lampros K Michalis
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Danilo Neglia
- Fondazione Toscana G. Monasterio and Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - Dimitrios I Fotiadis
- Biomedical Research Institute, Foundation for Research and Technology Hellas, Ioannina, Greece.,Materials Science and Engineering, University of Ioannina, Ioannina, Greece
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14
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Kusmic C, Vizzoca A, Taranta M, Tedeschi L, Gherardini L, Pelosi G, Giannetti A, Tombelli S, Grimaldi S, Baldini F, Domenici C, Trivella MG, Cinti C. Silencing Survivin: a Key Therapeutic Strategy for Cardiac Hypertrophy. J Cardiovasc Transl Res 2021; 15:391-407. [PMID: 34409583 DOI: 10.1007/s12265-021-10165-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/05/2021] [Indexed: 11/29/2022]
Abstract
Cardiac hypertrophy, in its aspects of localized thickening of the interventricular septum and concentric increase of the left ventricle, constitutes a risk factor of heart failure. Myocardial hypertrophy, in the presence of different degree of myocardial fibrosis, is paralleled by significant molecular, cellular, and histological changes inducing alteration of cardiac extracellular matrix composition as well as sarcomeres and cytoskeleton remodeling. Previous studies indicate osteopontin (OPN) and more recently survivin (SURV) overexpression as the hallmarks of heart failure although SURV function in the heart is not completely clarified. In this study, we investigated the involvement of SURV in intracellular signaling of hypertrophic cardiomyocytes and the impact of its transcriptional silencing, laying the foundation for novel target gene therapy in cardiac hypertrophy. Oligonucleotide-based molecules, like theranostic optical nanosensors (molecular beacons) and siRNAs, targeting SURV and OPN mRNAs, were developed. Their diagnostic and therapeutic potential was evaluated in vitro in hypertrophic FGF23-induced human cardiomyocytes and in vivo in transverse aortic constriction hypertrophic mouse model. Engineered erythrocyte was used as shuttle to selectively target and transfer siRNA molecules into unhealthy cardiac cells in vivo. The results highlight how the SURV knockdown could negatively influence the expression of genes involved in myocardial fibrosis in vitro and restores structural, functional, and morphometric features in vivo. Together, these data suggested that SURV is a key factor in inducing cardiomyocytes hypertrophy, and its shutdown is crucial in slowing disease progression as well as reversing cardiac hypertrophy. In the perspective, targeted delivery of siRNAs through engineered erythrocytes can represent a promising therapeutic strategy to treat cardiac hypertrophy. Theranostic SURV molecular beacon (MB-SURV), transfected into FGF23-induced hypertrophic human cardiomyocytes, significantly dampened SURV overexpression. SURV down-regulation determines the tuning down of MMP9, TIMP1 and TIMP4 extracellular matrix remodeling factors while induces the overexpression of the cardioprotective MCAD factor, which counterbalance the absence of pro-survival and anti-apoptotic SURV activity to protect cardiomyocytes from death. In transverse aortic constriction (TAC) mouse model, the SURV silencing restores the LV mass levels to values not different from the sham group and counteracts the progressive decline of EF, maintaining its values always higher with respect to TAC group. These data demonstrate the central role of SURV in the cardiac reverse remodeling and its therapeutic potential to reverse cardiac hypertrophy.
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Affiliation(s)
- Claudia Kusmic
- Institute of Clinical Physiology (IFC), National Research Council of Italy (CNR), via Moruzzi 1, 56124, Pisa, Italy
| | - Alessio Vizzoca
- Institute of Organic Synthesis and Photoreactivity (ISOF), National Research Council of Italy (CNR), Via Gobetti 101, 40129, Bologna, Italy
| | - Monia Taranta
- Institute of Clinical Physiology (IFC), National Research Council of Italy (CNR), via Moruzzi 1, 56124, Pisa, Italy
| | - Lorena Tedeschi
- Institute of Clinical Physiology (IFC), National Research Council of Italy (CNR), via Moruzzi 1, 56124, Pisa, Italy
| | - Lisa Gherardini
- Institute of Clinical Physiology (IFC), National Research Council of Italy (CNR), via Moruzzi 1, 56124, Pisa, Italy
| | - Gualtiero Pelosi
- Institute of Clinical Physiology (IFC), National Research Council of Italy (CNR), via Moruzzi 1, 56124, Pisa, Italy
| | - Ambra Giannetti
- Institute of Applied Physics, Nello Carrara"(IFAC), National Research Council of Italy (CNR), Florence, Italy
| | - Sara Tombelli
- Institute of Applied Physics, Nello Carrara"(IFAC), National Research Council of Italy (CNR), Florence, Italy
| | - Settimio Grimaldi
- Institute of Translational Pharmacology (IFT), National Research Council of Italy (CNR), Rome, Italy
| | - Francesco Baldini
- Institute of Applied Physics, Nello Carrara"(IFAC), National Research Council of Italy (CNR), Florence, Italy
| | - Claudio Domenici
- Institute of Clinical Physiology (IFC), National Research Council of Italy (CNR), via Moruzzi 1, 56124, Pisa, Italy
| | - Maria Giovanna Trivella
- Institute of Clinical Physiology (IFC), National Research Council of Italy (CNR), via Moruzzi 1, 56124, Pisa, Italy.
| | - Caterina Cinti
- Institute of Clinical Physiology (IFC), National Research Council of Italy (CNR), via Moruzzi 1, 56124, Pisa, Italy.
- Institute of Organic Synthesis and Photoreactivity (ISOF), National Research Council of Italy (CNR), Via Gobetti 101, 40129, Bologna, Italy.
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15
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Djukic T, Saveljic I, Pelosi G, Parodi O, Filipovic N. A study on the accuracy and efficiency of the improved numerical model for stent implantation using clinical data. Comput Methods Programs Biomed 2021; 207:106196. [PMID: 34091419 DOI: 10.1016/j.cmpb.2021.106196] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/17/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Stent implantation procedure should be carefully planned and adapted to the particular patient in order to minimize possible complications. Numerical simulations can provide useful quantitative data about the state of the artery after the implantation, as well as information about the benefits of the intervention from the hemodynamical point of view. METHODS In this paper, a numerical model for stent implantation is presented. This numerical model simulates the stent expansion, the interaction of the stent with arterial wall and the deformation of the arterial wall under the influence of the stent. FE method was used to perform CFD simulations and the effects of stenting were analyzed by comparing the hemodynamic parameters before and after stent implantation. RESULTS Clinical data for overall 34 patients was used for the simulations, and for 9 of them data from follow up examinations was used to validate the results of simulations of stent implantation. CONCLUSIONS The good agreement of results (less than 4.1% of SD error for all the 9 validation cases) demonstrated the accuracy of the presented numerical model. The developed approach can be a valuable tool for the improvement of pre-operative planning and patient-specific treatment optimization.
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Affiliation(s)
- Tijana Djukic
- Bioengineering Research and Development Center, BioIRC, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia; Institute for Information Technologies, University of Kragujevac, Jovana Cvijica bb, 34000 Kragujevac, Serbia.
| | - Igor Saveljic
- Bioengineering Research and Development Center, BioIRC, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia; Institute for Information Technologies, University of Kragujevac, Jovana Cvijica bb, 34000 Kragujevac, Serbia.
| | - Gualtiero Pelosi
- Institute of Clinical Physiology, National Research Council, Via Giuseppe Moruzzi, 1, 56124 Pisa, Italy.
| | - Oberdan Parodi
- Institute of Clinical Physiology, National Research Council, Via Giuseppe Moruzzi, 1, 56124 Pisa, Italy.
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16
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Caselli C, De Caterina R, Smit JEFF, El Mahdiui M, Ragusa R, Clemente A, Sampietro T, Clerico A, Liga R, Pelosi G, Rocchiccioli S, Parodi O, Scholte A, Knuuti J, Neglia D. Elevated triglycerides and low HDL cholesterol predict coronary heart disease risk in patients with stable angina. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.002] [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: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): The EVINCI study was supported by a grant from the European Union FP7-CP-FP506 2007 project (GA 222915). The SMARTool study was supported by a grant from the European Union H2020-PHC-30-2015 (GA 689068). This study was also partially supported by a grant from AMGEN (Protocol N. 20167781, 2017).
Background. High triglycerides (TG) and low high-density lipoprotein cholesterol (HDL-C) characterize an atherosclerotic cardiovascular disease (CAD) risk condition defined as atherogenic dyslipidemia.
Aim. To assess whether atherogenic dyslipidemia defined by TG/HDL-C ratio predicts CAD related outcomes in patients with stable angina, independently of other risk factors and treatments.
Methods. We studied 355 patients (60 ± 9 y, 211m) with stable angina from the EVINCI Outcome study. Patients were characterized for clinical, bio-humoral and imaging profiles, managed clinically, and followed for 4.5 ± 0.9 years. A computed tomography angiography (CTA) coronary risk score was obtained at baseline in all patients, and at follow-up in 154 of them. The primary composite outcome was all-cause mortality and non-fatal myocardial infarction. CTA scan was repeated at follow-up in 154 patients to assess CAD progression.
Results. The median value of TG/HDL-C ratio was 2.095 (2.079IQR). At baseline, the proportion of males, smoking, diabetes and metabolic syndrome, as well as circulating bio-markers of abnormal glucose metabolism and myocardial damage progressively increased across quartiles of TG/HDL-C ratio. The CTA score was significantly higher in the IV quartile of the TG/HDL-C ratio and both were the only independent predictors of the primary (CTA Score: HR 1.06, 95%CI 1.03-1.09, p = 0.001; TG/HDL-C IV quartile: HR 2.85, 95%CI 1.30-6.26, p < 0.01). In the 154 patients re-evaluated at follow-up, TG/HDL-C ratio associated cardio-metabolic disorder, systemic inflammation and CTA risk score progressed over time despite increased use of lipid-lowering drugs, anti-diabetics and other cardioactive medications and reduction in LDL-C levels.
Conclusions. In patients with stable angina, the TG/HDL-C ratio expresses a cardio-metabolic atherogenic disorder which is progressive over time and is associated with CAD related outcomes independently of LDL-C levels and treatments.
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Affiliation(s)
- C Caselli
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - R De Caterina
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - JEFF Smit
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - M El Mahdiui
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - R Ragusa
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - A Clemente
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - T Sampietro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - A Clerico
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - R Liga
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - G Pelosi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | | | - O Parodi
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - A Scholte
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - J Knuuti
- University of Turku, Turku, Finland
| | - D Neglia
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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17
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Bodini A, Michelucci E, Di Giorgi N, Caselli C, Signore G, Neglia D, Smit JM, Scholte AJHA, Mincarone P, Leo CG, Pelosi G, Rocchiccioli S. Predictive Added Value of Selected Plasma Lipids to a Re-estimated Minimal Risk Tool. Front Cardiovasc Med 2021; 8:682785. [PMID: 34336947 PMCID: PMC8322727 DOI: 10.3389/fcvm.2021.682785] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/10/2021] [Indexed: 01/13/2023] Open
Abstract
Background: Lipidomics is emerging for biomarker discovery in cardiovascular disease, and circulating lipids are increasingly incorporated in risk models to predict cardiovascular events. Moreover, specific classes of lipids, such as sphingomyelins, ceramides, and triglycerides, have been related to coronary artery disease (CAD) severity and plaque characteristics. To avoid unnecessary testing, it is important to identify individuals at low CAD risk. The only pretest model available so far to rule out the presence of coronary atherosclerosis in patients with chest pain, but normal coronary arteries, is the minimal risk tool (MRT). Aim: Using state-of-the-art statistical methods, we aim to verify the additive predictive value of a set of lipids, derived from targeted plasma lipidomics of suspected CAD patients, to a re-estimated version of the MRT for ruling out the presence of coronary atherosclerosis assessed by coronary CT angiography (CCTA). Methods: Two hundred and fifty-six subjects with suspected stable CAD recruited from five European countries within H2020-SMARTool, undergoing CCTA and blood sampling for clinical biochemistry and lipidomics, were selected. The MRT was validated by regression methods and then re-estimated (reMRT). The reMRT was used as a baseline model in a likelihood ratio test approach to assess the added predictive value of each lipid from 13 among ceramides, triglycerides, and sphingomyelins. Except for one lipid, the analysis was carried out on more than 240 subjects for each lipid. A sensitivity analysis was carried out by considering two alternative models developed on the cohort as baseline models. Results: In 205 subjects, coronary atherosclerosis ranged from minimal lesions to overt obstructive CAD, while in 51 subjects (19.9%) the coronary arteries were intact. Four triglycerides and seven sphingomyelins were significantly (p < 0.05) and differentially expressed in the two groups and, at a lesser extent, one ceramide (p = 0.067). The probability of being at minimal risk was significantly better estimated by adding either Cer(d18:1/16:0) (p = 0.01), SM(40:2) (p = 0.04), or SM(41:1) at a lesser extent (p = 0.052) to reMRT than by applying the reMRT alone. The sensitivity analysis confirmed the relevance of these lipids. Furthermore, the addition of SM(34:1), SM(38:2), SM(41:2), and SM(42:4) improved the predictive performance of at least one of the other baseline models. None of the selected triglycerides was found to provide an added value. Conclusions: Plasma lipidomics can be a promising source of diagnostic and prognostic biomarkers in cardiovascular disease, exploitable not only to assess the risk of adverse events but also to identify subjects without coronary atherosclerosis, thus reducing unnecessary further testing in normal subjects.
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Affiliation(s)
- Antonella Bodini
- Institute for Applied Mathematics and Information Technologies "E. Magenes," National Research Council, Milan, Italy
| | - Elena Michelucci
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | | | - Chiara Caselli
- Institute of Clinical Physiology, National Research Council, Pisa, Italy.,Cardiovascular Department, Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Giovanni Signore
- NEST, Scuola Normale Superiore, Pisa, Italy.,Fondazione Pisana per la Scienza, San Giuliano Terme, Italy
| | - Danilo Neglia
- Cardiovascular Department, Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Jeff M Smit
- Department of Cardiology, Leiden University Medical Centre, Leiden, Netherlands
| | | | - Pierpaolo Mincarone
- Institute for Research on Population and Social Policies, National Research Council, Brindisi, Italy
| | - Carlo G Leo
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
| | - Gualtiero Pelosi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
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18
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Mincarone P, Bodini A, Tumolo MR, Vozzi F, Rocchiccioli S, Pelosi G, Caselli C, Sabina S, Leo CG. Discrimination capability of pretest probability of stable coronary artery disease: a systematic review and meta-analysis suggesting how to improve validation procedures. BMJ Open 2021; 11:e047677. [PMID: 34244268 PMCID: PMC8268916 DOI: 10.1136/bmjopen-2020-047677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Externally validated pretest probability models for risk stratification of subjects with chest pain and suspected stable coronary artery disease (CAD), determined through invasive coronary angiography or coronary CT angiography, are analysed to characterise the best validation procedures in terms of discriminatory ability, predictive variables and method completeness. DESIGN Systematic review and meta-analysis. DATA SOURCES Global Health (Ovid), Healthstar (Ovid) and MEDLINE (Ovid) searched on 22 April 2020. ELIGIBILITY CRITERIA We included studies validating pretest models for the first-line assessment of patients with chest pain and suspected stable CAD. Reasons for exclusion: acute coronary syndrome, unstable chest pain, a history of myocardial infarction or previous revascularisation; models referring to diagnostic procedures different from the usual practices of the first-line assessment; univariable models; lack of quantitative discrimination capability. METHODS Eligibility screening and review were performed independently by all the authors. Disagreements were resolved by consensus among all the authors. The quality assessment of studies conforms to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). A random effects meta-analysis of area under the receiver operating characteristic curve (AUC) values for each validated model was performed. RESULTS 27 studies were included for a total of 15 models. Besides age, sex and symptom typicality, other risk factors are smoking, hypertension, diabetes mellitus and dyslipidaemia. Only one model considers genetic profile. AUC values range from 0.51 to 0.81. Significant heterogeneity (p<0.003) was found in all but two cases (p>0.12). Values of I2 >90% for most analyses and not significant meta-regression results undermined relevant interpretations. A detailed discussion of individual results was then carried out. CONCLUSIONS We recommend a clearer statement of endpoints, their consistent measurement both in the derivation and validation phases, more comprehensive validation analyses and the enhancement of threshold validations to assess the effects of pretest models on clinical management. PROSPERO REGISTRATION NUMBER CRD42019139388.
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Affiliation(s)
- Pierpaolo Mincarone
- Institute for Research on Population and Social Policies, National Research Council, Brindisi, Italy
| | - Antonella Bodini
- Institute for Applied Mathematics and Information Technologies "Enrico Magenes", National Research Council, Milan, Italy
| | - Maria Rosaria Tumolo
- Institute for Research on Population and Social Policies, National Research Council, Brindisi, Italy
| | - Federico Vozzi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | | | - Gualtiero Pelosi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Chiara Caselli
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Saverio Sabina
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
| | - Carlo Giacomo Leo
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
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19
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Vozzi F, Cecchettini A, Cabiati M, Mg F, Aretini P, Del Ry S, Rocchiccioli S, Pelosi G. Modulated molecular markers of restenosis and thrombosis by in-vitrovascular cells exposed to bioresorbable scaffolds. Biomed Mater 2021; 16. [PMID: 34020430 DOI: 10.1088/1748-605x/ac0401] [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: 01/28/2021] [Accepted: 05/21/2021] [Indexed: 01/06/2023]
Abstract
Drug-eluting bioresorbable vascular scaffolds (BVSs) have emerged as a potential breakthrough for the treatment of coronary artery stenosis, providing mechanical support and drug delivery followed by complete resorption. Restenosis and thrombosis remain the primary limitations in clinical use. The study aimed to identify potential markers of restenosis and thrombosis analyzing the vascular wall cell transcriptomic profile modulation triggered by BVS at different values of shear stress (SS). Human coronary artery endothelial cells and smooth muscle cells were cultured under SS (1 and 20 dyne cm-2) for 6 h without and with application of BVS and everolimus 600 nM. Cell RNA-Seq and bioinformatics analysis identified modulated genes by direct comparison of SS conditions and Gene Ontology (GO). The results of different experimental conditions and GO analysis highlighted the modulation of specific genes as semaphorin 3E, mesenchyme homeobox 2, bone morphogenetic protein 4, (heme oxygenase 1) and selectin E, with different roles in pathological evolution of disease. Transcriptomic analysis of dynamic vascular cell cultures identifies candidate genes related to pro-restenotic and pro-thrombotic mechanisms in anin-vitrosetting of BVS, which are not adequately contrasted by everolimus addition.
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Affiliation(s)
- F Vozzi
- Institute of Clinical Physiology IFC-CNR, Via Giuseppe Moruzzi 1, Pisa, Italy
| | - A Cecchettini
- Institute of Clinical Physiology IFC-CNR, Via Giuseppe Moruzzi 1, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Via Volta 4, Pisa, Italy
| | - M Cabiati
- Institute of Clinical Physiology IFC-CNR, Via Giuseppe Moruzzi 1, Pisa, Italy
| | - Fornaro Mg
- Institute of Clinical Physiology IFC-CNR, Via Giuseppe Moruzzi 1, Pisa, Italy
| | - P Aretini
- Fondazione Pisana per la Scienza ONLUS, Via Ferruccio Giovannini, 13, San Giuliano Terme, Italy
| | - S Del Ry
- Institute of Clinical Physiology IFC-CNR, Via Giuseppe Moruzzi 1, Pisa, Italy
| | - S Rocchiccioli
- Institute of Clinical Physiology IFC-CNR, Via Giuseppe Moruzzi 1, Pisa, Italy
| | - G Pelosi
- Institute of Clinical Physiology IFC-CNR, Via Giuseppe Moruzzi 1, Pisa, Italy
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20
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El Mahdiui M, Smit JM, van Rosendael AR, Neglia D, Knuuti J, Saraste A, Buechel RR, Teresinska A, Pizzi MN, Roque A, Magnacca M, Mertens BJ, Caselli C, Rocchiccioli S, Parodi O, Pelosi G, Scholte AJ. Sex differences in coronary plaque changes assessed by serial computed tomography angiography. Int J Cardiovasc Imaging 2021; 37:2311-2321. [PMID: 33694122 PMCID: PMC8286938 DOI: 10.1007/s10554-021-02204-4] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/22/2021] [Indexed: 01/03/2023]
Abstract
Long-term data on sex-differences in coronary plaque changes over time is lacking in a low-to-intermediate risk population of stable coronary artery disease (CAD). The aim of this study was to evaluate the role of sex on long-term plaque progression and evolution of plaque composition. Furthermore, the influence of menopause on plaque progression and composition was also evaluated. Patients that underwent a coronary computed tomography angiography (CTA) were prospectively included to undergo a follow-up coronary CTA. Total and compositional plaque volumes were normalized using the vessel volume to calculate a percentage atheroma volume (PAV). To investigate the influence of menopause on plaque progression, patients were divided into two groups, under and over 55 years of age. In total, 211 patients were included in this analysis, 146 (69%) men. The mean interscan period between baseline and follow-up coronary CTA was 6.2 ± 1.4 years. Women were older, had higher HDL levels and presented more often with atypical chest pain. Men had 434 plaque sites and women 156. On a per-lesion analysis, women had less fibro-fatty PAV compared to men (β -1.3 ± 0.4%; p < 0.001), with no other significant differences. When stratifying patients by 55 years age threshold, fibro-fatty PAV remained higher in men in both age groups (p < 0.05) whilst women younger than 55 years demonstrated more regression of fibrous (β -0.8 ± 0.3% per year; p = 0.002) and non-calcified PAV (β -0.7 ± 0.3% per year; p = 0.027). In a low-to-intermediate risk population of stable CAD patients, no significant sex differences in total PAV increase over time were observed. Fibro-fatty PAV was lower in women at any age and women under 55 years demonstrated significantly greater reduction in fibrous and non-calcified PAV over time compared to age-matched men. (ClinicalTrials.gov number, NCT04448691.)
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Affiliation(s)
- Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Jeff M Smit
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Alexander R van Rosendael
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Danilo Neglia
- Fondazione Toscana Gabriele Monasterio, Viale Giuseppe Moruzzi 1 56124, Pisa, Italy
| | - Juhani Knuuti
- Heart Center and PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Antti Saraste
- Heart Center and PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital and University of Zurich, Zurich, Switzerland
| | | | - Maria N Pizzi
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Barcelona, Spain
| | - Albert Roque
- Department of Radiology, Hospital Universitari Vall D'Hebron, Barcelona, Spain
| | | | - Bart J Mertens
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Chiara Caselli
- Institute of Clinical Physiology CNR, Viale Giuseppe Moruzzi 1 56124, Pisa, Italy
| | - Silvia Rocchiccioli
- Institute of Clinical Physiology CNR, Viale Giuseppe Moruzzi 1 56124, Pisa, Italy
| | - Oberdan Parodi
- Institute of Clinical Physiology CNR, Viale Giuseppe Moruzzi 1 56124, Pisa, Italy.,Institute of Information Science and Technologies CNR, Pisa, Italy
| | - Gualtiero Pelosi
- Institute of Clinical Physiology CNR, Viale Giuseppe Moruzzi 1 56124, Pisa, Italy
| | - Arthur J Scholte
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
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21
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Carlicchi E, Caminati A, Fughelli P, Pelosi G, Harari S, Zompatori M. High-resolution CT in smoking-related interstitial lung diseases. Int J Tuberc Lung Dis 2021; 25:106-112. [PMID: 33656421 DOI: 10.5588/ijtld.20.0622] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In addition to chronic obstructive pulmonary disease (COPD) and bronchogenic carcinoma, smoking can also cause interstitial lung diseases (ILDs) such as respiratory bronchiolitis (RB), RB with ILD (RB-ILD), desquamative interstitial pneumonia (DIP), Langerhans cell granulomatosis (LCG) and idiopathic pulmonary fibrosis-usual interstitial pneumonia (IPF-UIP). However, smoking seems to have a protective effect against hypersensitivity pneumonitis (HP), sarcoidosis and organising pneumonia (OP). High-resolution computed tomography (HRCT) has a pivotal role in the differential diagnosis. RB is extremely frequent in smokers, and is considered a marker for smoking exposure. It has no clinical relevance in itself since most patients with RB are asymptomatic. It is frequent to observe the association of RB with other smoking-related diseases, such as LCG or pulmonary neoplasms. In RB-ILD, HRCT features are more conspicuous and diffuse than in RB, but there is no definite cut-off between the two entities and any distinction can only be made by integrating imaging and clinical data. RB, RB-ILD and DIP may represent different degrees of the same pathological process, consisting in a bronchiolar and alveolar inflammatory reaction to smoking. Smoking is also a well-known risk factor for pulmonary fibrosis. Multidisciplinary discussion and follow-up can generally solve even the most difficult cases.
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Affiliation(s)
- E Carlicchi
- Postgraduated School in Radiodiagnostic, Università degli Studi di Milano, Milan
| | - A Caminati
- Unità Operativa di Pneumologia e Terapia Semi-Intensiva Respiratoria, Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare. Ospedale San Giuseppe, MultiMedica Istituto di Ricovero e Cura a Carattere scientifico (IRCCS), Milan
| | - P Fughelli
- Alma Mater Studiorum, Università di Bologna, Bologna
| | - G Pelosi
- Servizio Interaziendale di Anatomia Patologica, Polo Scientifico e Tecnologico, IRCCS MultiMedica, Milan, Dipartimento di Oncologia ed Onco-ematologia, Università degli Studi di Milano, Milan
| | - S Harari
- Unità Operativa di Pneumologia e Terapia Semi-Intensiva Respiratoria, Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare. Ospedale San Giuseppe, MultiMedica Istituto di Ricovero e Cura a Carattere scientifico (IRCCS), Milan, Department of Medical Sciences, San Giuseppe Hospital MultiMedica IRCCS and Community Health, Università degli Studi di Milano, Milan
| | - M Zompatori
- Diagnostica per Immagini, Ospedale San Giuseppe, IRCCS Multimedica, Milan, Italy
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22
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Pleouras D, Sakellarios A, Rigas G, Karanasiou GS, Tsompou P, Karanasiou G, Kigka V, Kyriakidis S, Pezoulas V, Gois G, Tachos N, Ramos A, Pelosi G, Rocchiccioli S, Michalis L, Fotiadis DI. A Novel Approach to Generate a Virtual Population of Human Coronary Arteries for In Silico Clinical Trials of Stent Design. IEEE Open J Eng Med Biol 2021; 2:201-209. [PMID: 35402969 PMCID: PMC8901009 DOI: 10.1109/ojemb.2021.3082328] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/06/2021] [Accepted: 05/17/2021] [Indexed: 11/15/2022] Open
Abstract
Goal: To develop a cardiovascular virtual population using statistical modeling and computational biomechanics. Methods: A clinical data augmentation algorithm is implemented to efficiently generate virtual clinical data using a real clinical dataset. An atherosclerotic plaque growth model is employed to 3D reconstructed coronary arterial segments to generate virtual coronary arterial geometries (geometrical data). Last, the combination of the virtual clinical and geometrical data is achieved using a methodology that allows for the generation of a realistic virtual population which can be used in in silico clinical trials. Results: The results show good agreement between real and virtual clinical data presenting a mean gof 0.1 ± 0.08. 400 virtual coronary arteries were generated, while the final virtual population includes 10,000 patients. Conclusions: The virtual arterial geometries are efficiently matched to the generated clinical data, both increasing and complementing the variability of the virtual population.
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Affiliation(s)
| | - Antonis Sakellarios
- Department of Biomedical ResearchFORTH-IMBB GR 45110 Ioannina Greece
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and EngineeringUniversity of Ioannina GR 45110 Greece
| | - George Rigas
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and EngineeringUniversity of Ioannina GR 45110 Greece
| | | | - Panagiota Tsompou
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and EngineeringUniversity of Ioannina GR 45110 Greece
| | - Gianna Karanasiou
- Department of Biomedical ResearchFORTH-IMBB GR 45110 Ioannina Greece
| | - Vassiliki Kigka
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and EngineeringUniversity of Ioannina GR 45110 Greece
| | - Savvas Kyriakidis
- Department of Biomedical ResearchFORTH-IMBB GR 45110 Ioannina Greece
| | - Vasileios Pezoulas
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and EngineeringUniversity of Ioannina GR 45110 Greece
| | - George Gois
- Department of Biomedical ResearchFORTH-IMBB GR 45110 Ioannina Greece
| | - Nikolaos Tachos
- Department of Biomedical ResearchFORTH-IMBB GR 45110 Ioannina Greece
| | - Aidonis Ramos
- Department of Cardiology, Medical SchoolUniversity of Ioannina Ioannina GR 45110 Greece
| | - Gualtiero Pelosi
- Institute of Clinical PhysiologyNational Research Council 56124 Pisa Italy
| | | | - Lampros Michalis
- Department of Cardiology, Medical SchoolUniversity of Ioannina Ioannina GR 45110 Greece
| | - Dimitrios I Fotiadis
- Department of Biomedical ResearchFORTH-IMBB GR 45110 Ioannina Greece
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and EngineeringUniversity of Ioannina GR 45110 Greece
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23
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Panetta D, Gabelloni M, Faggioni L, Pelosi G, Aringhieri G, Caramella D, Salvadori PA. Cardiac Computed Tomography Perfusion: Contrast Agents, Challenges and Emerging Methodologies from Preclinical Research to the Clinics. Acad Radiol 2021; 28:e1-e13. [PMID: 32220550 DOI: 10.1016/j.acra.2019.12.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/20/2019] [Accepted: 12/24/2019] [Indexed: 12/19/2022]
Abstract
Computed Tomography (CT) has long been regarded as a purely anatomical imaging modality. Recent advances on CT technology and Contrast Agents (CA) in both clinical and preclinical cardiac imaging offer opportunities for the use of CT in functional imaging. Combined with modern ECG-gating techniques, functional CT has now become a reality allowing a comprehensive evaluation of myocardial global and regional function, perfusion and coronary angiography. This article aims at reviewing the current status of cardiac CT perfusion and micro-CT perfusion with established and experimental scanners and contrast agents, from clinical practice to the experimental domain of investigations based on animal models of heart diseases.
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24
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Pinelli S, Alinovi R, Corradi M, Poli D, Cavallo D, Pelosi G, Ampollini L, Goldoni M, Mozzoni P. A comparison between the effects of over-expression of miRNA-16 and miRNA-34a on cell cycle progression of mesothelioma cell lines and on their cisplatin sensitivity. Cancer Treat Res Commun 2020; 26:100276. [PMID: 33338854 DOI: 10.1016/j.ctarc.2020.100276] [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: 10/12/2020] [Revised: 11/26/2020] [Accepted: 12/09/2020] [Indexed: 11/17/2022]
Abstract
The prognosis of patients affected by malignant pleural mesothelioma (MPM) is presently poor and no therapeutic strategies have improved their survival yet. Introduction of miRNA mimics to restore their reduced or absent functionality in cancer cells is considered an important opportunity and a combination of miR's might be even more effective. In the present study, miR-16 and miR-34a were transfected, singularly and in combination, in MPM cell lines H2052 and H28, and their effects on cell proliferation and sensitivity to cisplatin are reported. Interestingly, the overexpression of both miRs, alone or combined, slows down the cell cycle progression, modulates the p53 and HMGB1 expression and increases the sensitivity of cells to cisplatin, producing a marked impairment of cell proliferation and strengthening the apoptotic effect of the drug. However, the co-overexpression of the two miRs results more effective only in the regulation of the cell cycle, but does not enhance the sensitivity of MPM cells to cisplatin. Consequently, although the potential of miR-16 and miR-34a is confirmed, we must conclude that their combination does not improve the response of MPM to chemotherapy.
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Affiliation(s)
- S Pinelli
- Department of Medicine and Surgery, University of Parma, via A. Gramsci 14, 43126 Parma, Italy.
| | - R Alinovi
- Department of Medicine and Surgery, University of Parma, via A. Gramsci 14, 43126 Parma, Italy.
| | - M Corradi
- Department of Medicine and Surgery, University of Parma, via A. Gramsci 14, 43126 Parma, Italy; University Hospital of Parma, Parma, Italy.
| | - D Poli
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene Via Fontana Candida1, 00078 Monte Porzio Catone, Rome, Italy.
| | - D Cavallo
- INAIL Research, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene Via Fontana Candida1, 00078 Monte Porzio Catone, Rome, Italy.
| | - G Pelosi
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 17/A, 43124 Parma, Italy.
| | - L Ampollini
- Department of Medicine and Surgery, University of Parma, via A. Gramsci 14, 43126 Parma, Italy; University Hospital of Parma, Parma, Italy.
| | - M Goldoni
- Department of Medicine and Surgery, University of Parma, via A. Gramsci 14, 43126 Parma, Italy.
| | - P Mozzoni
- Department of Medicine and Surgery, University of Parma, via A. Gramsci 14, 43126 Parma, Italy.
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25
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Hofman P, Ilié M, Chamorey E, Brest P, Schiappa R, Nakache V, Antoine M, Barberis M, Begueret H, Bibeau F, Bonnetaud C, Boström P, Brousset P, Bubendorf L, Carvalho L, Cathomas G, Cazes A, Chalabreysse L, Chenard MP, Copin MC, Côté JF, Damotte D, de Leval L, Delongova P, Thomas de Montpreville V, de Muret A, Dema A, Dietmaier W, Evert M, Fabre A, Forest F, Foulet A, Garcia S, Garcia-Martos M, Gibault L, Gorkiewicz G, Jonigk D, Gosney J, Hofman A, Kern I, Kerr K, Kossai M, Kriegsmann M, Lassalle S, Long-Mira E, Lupo A, Mamilos A, Matěj R, Meilleroux J, Ortiz-Villalón C, Panico L, Panizo A, Papotti M, Pauwels P, Pelosi G, Penault-Llorca F, Pop O, Poté N, Cajal SRY, Sabourin JC, Salmon I, Sajin M, Savic-Prince S, Schildhaus HU, Schirmacher P, Serre I, Shaw E, Sizaret D, Stenzinger A, Stojsic J, Thunnissen E, Timens W, Troncone G, Werlein C, Wolff H, Berthet JP, Benzaquen J, Marquette CH, Hofman V, Calabrese F. Clinical and molecular practice of European thoracic pathology laboratories during the COVID-19 pandemic. The past and the near future. ESMO Open 2020; 6:100024. [PMID: 33399086 PMCID: PMC7780004 DOI: 10.1016/j.esmoop.2020.100024] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 12/18/2022] Open
Abstract
Background This study evaluated the consequences in Europe of the COVID-19 outbreak on pathology laboratories orientated toward the diagnosis of thoracic diseases. Materials and methods A survey was sent to 71 pathology laboratories from 21 European countries. The questionnaire requested information concerning the organization of biosafety, the clinical and molecular pathology, the biobanking, the workload, the associated research into COVID-19, and the organization of education and training during the COVID-19 crisis, from 15 March to 31 May 2020, compared with the same period in 2019. Results Questionnaires were returned from 53/71 (75%) laboratories from 18 European countries. The biosafety procedures were heterogeneous. The workload in clinical and molecular pathology decreased dramatically by 31% (range, 3%-55%) and 26% (range, 7%-62%), respectively. According to the professional category, between 28% and 41% of the staff members were not present in the laboratories but did teleworking. A total of 70% of the laboratories developed virtual meetings for the training of residents and junior pathologists. During the period of study, none of the staff members with confirmed COVID-19 became infected as a result of handling samples. Conclusions The COVID-19 pandemic has had a strong impact on most of the European pathology laboratories included in this study. Urgent implementation of several changes to the organization of most of these laboratories, notably to better harmonize biosafety procedures, was noted at the onset of the pandemic and maintained in the event of a new wave of infection occurring in Europe. Biosafety measures used in the first wave of the COVID-19 crisis were heterogeneous in 53 European pathology laboratories. A dramatic decrease of the workload in pathology laboratories was noted. No case of healthcare workers contaminated with SARS-CoV-2 associated with samples handling was identified.
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Affiliation(s)
- P Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France.
| | - M Ilié
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - E Chamorey
- Epidemiology and Biostatistics Unit, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - P Brest
- Team 4, IRCAN, INSERM, CNRS, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - R Schiappa
- Epidemiology and Biostatistics Unit, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - V Nakache
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - M Antoine
- Department of Pathology, Hôpital Tenon, AP-HP, Paris, France
| | - M Barberis
- Unit of Histopathology and Molecular Diagnostics, Division of Pathology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - H Begueret
- Department of Pathology, University Hospital of Bordeaux, Bordeaux, France
| | - F Bibeau
- Department of Pathology, CHU de Caen, Université de Caen Normandie, Caen, France
| | - C Bonnetaud
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - P Boström
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - P Brousset
- Department of Pathology, IUC-T-Oncopole, Inserm U1037 CRCT, Université de Toulouse, Toulouse, France
| | - L Bubendorf
- Institute of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - L Carvalho
- Institute of Anatomical and Molecular Pathology and University Hospital, University of Coimbra, Coimbra, Portugal
| | - G Cathomas
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - A Cazes
- Department of Pathology, Bichat Hospital, AP-HP, Inserm UMR 1152, Université de Paris, Paris, France
| | - L Chalabreysse
- Department of Pathology, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - M-P Chenard
- Department of Pathology, University Hospital of Strasbourg, Strasbourg, France
| | - M-C Copin
- Institut de Pathologie, CHU Lille, Université de Lille, Lille, France
| | - J-F Côté
- Department of Pathology, Institut Mutualiste Montsouris, Paris, France
| | - D Damotte
- Department of Pathology, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Inserm U1138, Université de Paris, Paris, France
| | - L de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - P Delongova
- Institute of Pathology, University Hospital Ostrava, Ostrava, Czech Republic
| | | | - A de Muret
- Department of Pathology, University Hospital of Tours, Tours, France
| | - A Dema
- Department of Pathology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - W Dietmaier
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - M Evert
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - A Fabre
- Department of Histopathology, St Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - F Forest
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - A Foulet
- Department of Pathology, Centre Hospitalier, Le Mans, France
| | - S Garcia
- Department of Pathology, Hôpital Nord, AP-HM, Aix Marseille University, Marseille, France
| | - M Garcia-Martos
- Pulmonary Pathology Department, Gregorio Marañon University Hospital, Madrid, Spain
| | - L Gibault
- Department of Pathology, Hôpital Européen Georges Pompidou, AP-HP, Université de Paris, Paris, France
| | - G Gorkiewicz
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - D Jonigk
- Institute of Pathology, German Center for Lung Research, Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hannover Medical School, Hannover, Germany
| | - J Gosney
- Liverpool University Hospitals, Royal Liverpool University Hospital, Liverpool, UK
| | - A Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - I Kern
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - K Kerr
- Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - M Kossai
- Department of Pathology and Molecular Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - M Kriegsmann
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, and German Center for Lung Research (DZL), Germany
| | - S Lassalle
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - E Long-Mira
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - A Lupo
- Department of Pathology, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Inserm U1138, Université de Paris, Paris, France
| | - A Mamilos
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - R Matěj
- Department of Pathology and Molecular Medicine, Third Faculty of Medicine, Charles University, Thomayer Hospital and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - J Meilleroux
- Department of Pathology, IUC-T-Oncopole, Inserm U1037 CRCT, Université de Toulouse, Toulouse, France
| | - C Ortiz-Villalón
- Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - L Panico
- Unit of Pathology, Azienda Ospedaliera dei Colli, Monaldi-Cotugno-CTO, Naples, Italy
| | - A Panizo
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M Papotti
- Department of Oncology, University of Torino, Torino, Italy
| | - P Pauwels
- Centre for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium
| | - G Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, and IRCCS MultiMedica, Milan, Italy
| | - F Penault-Llorca
- Department of Pathology and Molecular Pathology, Centre Jean Perrin, Clermont-Ferrand, France
| | - O Pop
- Department of Pathology, University of Oradea, Oradea, Romania
| | - N Poté
- Department of Pathology, Bichat Hospital, AP-HP, Inserm UMR 1152, Université de Paris, Paris, France
| | - S R Y Cajal
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - J-C Sabourin
- Department of Pathology, Inserm 1245, Rouen University Hospital Normandy University, Rouen, France
| | - I Salmon
- Department of Pathology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - M Sajin
- Department of Pathology, Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - S Savic-Prince
- Institute of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - H-U Schildhaus
- Institute of Pathology, University Hospital Essen, Essen, Germany
| | - P Schirmacher
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, and German Center for Lung Research (DZL), Germany
| | - I Serre
- Department of Biopathology, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France
| | - E Shaw
- Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - D Sizaret
- Department of Pathology, University Hospital of Tours, Tours, France
| | - A Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, and German Center for Lung Research (DZL), Germany
| | - J Stojsic
- Department of Thoracic Pathology, Service of Pathology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - E Thunnissen
- Department of Pathology, Amsterdam University Medical Centres, Location VUmc, Amsterdam, The Netherlands
| | - W Timens
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - G Troncone
- Department of Public Health, University of Naples Frederico II, Naples, Italy
| | - C Werlein
- Institute of Pathology, German Center for Lung Research, Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hannover Medical School, Hannover, Germany
| | - H Wolff
- Laboratory of Pathology, Finnish Institute of Occupational Health, Helsinki, Finland
| | - J-P Berthet
- Department of Thoracic Surgery, FHU OnoAge, Louis Pasteur Hospital, University Côte d'Azur, Nice, France
| | - J Benzaquen
- Department of Pneumology, FHU OncoAge, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - C-H Marquette
- Department of Pneumology, FHU OncoAge, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - V Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
| | - F Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Pathological Anatomy Section, University of Padova Medical School, Padova, Italy
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26
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Vozzi F, Cecchettini A, Cabiati M, Fornaro M, Del Ry S, Pelosi G. Effect of shear stress on vascular cell transcriptomics in an vitro setting of drug-eluting bioresorbable vascular scaffolds (BVS). Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.055] [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: 10/22/2022]
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27
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Kafouris P, Kalykakis G, Antonopoulos A, Siogkas P, Liga R, Thomas P, Giannopoulos A, Scolte A, Kaufmann P, Pelosi G, Parodi O, Knuuti J, Fotiadis D, Neglia D, Anagnostopoulos C. Coronary CT angiography derived features for predicting an abnormal pet myocardial perfusion imaging: a machine learning approach. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3455] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Computed Tomography Coronary Angiography (CTCA) is an effective non-invasive imaging modality for anatomo-functional assessment of coronary artery disease (CAD). Machine learning (ML) algorithms allow extraction and process of useful information from multidimensional spaces for evaluation of coronary lesions.
Purpose
To investigate the ability of ML to integrate computational fluid dynamics (CFD) derived parameters with quantitative plaque burden, plaque morphology and anatomical characteristics for predicting impaired myocardial flow reserve by PET myocardial perfusion imaging (MPI).
Methods
49 patients (29 male, mean age 65.3±6.3 years) with intermediate pre-test likelihood of CAD who underwent CTCA and PET-MPI were included. PET was considered positive when >1 contiguous segment demonstrated Myocardial flow reserve (MFR) ≤2.5 mL/g/min for 15O-water or ≤2.0 for 13N-ammonia respectively. CDF derived parameters such as a previously validated CT-FFR surrogate, virtual functional assessment index (vFAI), segmental endothelial shear stress (ESS), as well as anatomical and plaque characteristics were assessed. k-nearest neighbor (k-NN), support vector machines (SVM) and feedforward neural networks (FF-NN) were implemented. ML was internally validated using 5-fold cross validation, repeated 100 times. Using sequential forward selection (SFS), the 5 highest rank features based on appearances in each classification scheme were selected and following exhaustive search (ES) the best features combinations were identified. Each classifier's performance was evaluated using an area-under-receiver operating characteristic curve (AUC) analysis.
Results
85 coronary segments were analyzed and 28 features derived from CTCA were extracted. The features ranking for every classifier are depicted in Figure 1. k-NN using a combination only of ESS in the proximal (ESSprox) and distal segment achieved an AUC=0.78 (Sens=0.71, Spec=0.77, p<0.05) for predicting a positive PET result. Combining ESSprox with burden fibrofatty tissue and non-calcified plaque burden, SVM achieved an AUC=0.75 (Sens=0.74, Spec=0.67, p<0.05) whilst for FF-NN, the corresponding AUC was 0.79 (Sens=0.76, Spec=0.7, p<0.05) using ESSprox, vFAI and % Fibrofatty volume. Among the best features combinations, ESSprox was the most consistent one achieving an AUC=0.75 (Sens=0.66, Spec=0.73, p<0.05) for k-NN, AUC=0.73 (Sens=0.58, Spec=0.59, p<0.05), for SVM and an AUC=0.73 (Sens=0.63, Spec=0.62, p<0.05) for FF-NN respectively.
Conclusion
ML analysis is feasible for predicting abnormal MFR by PET using a combination of CFD derived parameters, anatomical and morphological features. ESSprox was present in every combination of best features. As a single characteristic was a moderate predictor of impaired MFR, whilst in combination with plaque characteristics and CFD derived features resulted in improved sensitivity and specificity.
Figure 1
Funding Acknowledgement
Type of funding source: Public grant(s) – EU funding. Main funding source(s): This research is co-financed by Greece and the European Union (European Social Fund-ESF) through the Operational Programme “Human, Resources Development, Education and Lifelong Learning 2014-2020” in the context of the project “Assessment of coronary atherosclerosis: a new complete, anatomo-functional, morphological and biomechanical approach” and from p-Med GR 5002802
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Affiliation(s)
- P Kafouris
- University of Athens, Department of informatics and telecommunications, Athens, Greece
| | - G Kalykakis
- Academy of Athens Biomedical Research Foundation, Athens, Greece
| | | | - P Siogkas
- Biomedical Research Institute - FORTH, Ioannina, Greece
| | - R Liga
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - P Thomas
- University of Athens, Department of informatics and telecommunications, Athens, Greece
| | | | - A Scolte
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - P Kaufmann
- University Hospital Zurich, Zurich, Switzerland
| | - G Pelosi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - O Parodi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - J Knuuti
- Turku PET Centre, Turku, Finland
| | - D Fotiadis
- University of Ioannina, Ioannina, Greece
| | - D Neglia
- Institute of Clinical Physiology (IFC), Pisa, Italy
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28
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Caselli C, Rocchiccioli S, Smit J, Ragusa R, Rosendael R, Buechel R, Teresinska A, Pizzi M, Magnacca M, Campolo J, Knuuti J, Parodi O, Pelosi G, Scholte A, Neglia D. Elevated TG/HDL-C ratio is an independent predictor of outcome and it is associated with CAD progression in patients with stable coronary artery disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1503] [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
Background
Elevated TG/HDL-C ratio is associated with CVD outcomes in high-risk populations presenting for coronary angiography, but studies were limited in gender-specific populations or in pts with ACS.
Purpose
Aim of this study was to evaluate the prognostic role of TG/HDL-C levels and their association with CAD progression in pts with suspected stable CAD.
Methods
TG/HDL-C ratio was calculated in 545 pts (60±9yrs,330males) with symptoms of stable CAD enrolled in the EVINCI study. 490 pts underwent coronary CTA to assess the presence of CAD (>50%stenosis) and entered a clinical follow up (4.5±0.9yrs). The CVD outcome measure included all cause mortality, non fatal MI, hospitalization for unstable angina or HF. After 6±1yrs, during the SMARTool study, a second CTA was obtained in 171 EVINCI pts and a CTA risk score (based on plaque extent, severity, composition, and location) was calculated at enrolment and at follow up to assess CAD progression (ΔCTA score).
Results
Pts were divided according to TG/HDL-C quartiles: IQ (<1.32), IIQ (1.32–2.03), IIIQ (2.04–3.33), and IVQ (>3.33). As reported in Table, the frequency of male, diabetes, metabolic syndrome and obesity increased among quartiles. Glucidic biomarkers progressively increased from quartile I to IV, while LDL-C decreased. The prevalence of obstructive CAD at CTA did not differ among groups. The CVD endpoint occurred in 7% of pts. At multivariable analyses, high TG/HDL-C ratio (IVQ) was associated with the outcome endpoint independently from presence of obstructive CAD and treatment (HR 3.477, 95% CI 1.181–10.239, P=0.0237). CTA score was significantly higher in pts in IVQ compared to IQ at both SMARTool enrolment and follow up (Figure1). A significantly higher ΔCTA score was observed in pts in III-IVQ compared with those in I-IIQ (Figure2).
Conclusion
Elevated TG/HDL-C ratio is an independent predictor of outcome and it is associated with CAD progression in patients with stable CAD.
Funding Acknowledgement
Type of funding source: Public grant(s) – EU funding. Main funding source(s): “EValuation of INtegrated Cardiac Imaging” - EVINCI [GA number: 222915]; “Simulation Modeling of coronary ARTery disease: a tool for clinical decision support - SMARTool” [GA number: 689068]
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Affiliation(s)
- C Caselli
- Insitute of Clinical Physiology, Pisa, Italy
| | | | - J.M Smit
- Leiden University Medical Center, Department of Cardiology, Leiden, Netherlands (The)
| | - R Ragusa
- Insitute of Clinical Physiology, Pisa, Italy
| | - R Rosendael
- Leiden University Medical Center, Department of Cardiology, Leiden, Netherlands (The)
| | - R Buechel
- University of Zurich, Zurich, Switzerland
| | | | - M.N Pizzi
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - M Magnacca
- Versilia Hospital, Lido Di Camaiore, Italy
| | - J Campolo
- Institute of Clinical Physiology, Milan, Italy
| | - J Knuuti
- University of Turku, Turku, Finland
| | - O Parodi
- Insitute of Clinical Physiology, Pisa, Italy
| | - G Pelosi
- Institute of Clinical Physiology (IFC), Massa, Italy
| | - A.J Scholte
- Leiden University Medical Center, Department of Cardiology, Leiden, Netherlands (The)
| | - D Neglia
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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29
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Anagnostopoulos C, Kalykakis G, Antonopoulos A, Siogkas P, Manniittyy T, Kafouris P, Liga R, Giannopoulos A, Scolte A, Kaufmann P, Pelosi G, Parodi O, Knuuti J, Fotiadis D, Neglia D. Relationship between endothelial shear stress, plaque burden and stenosis severity and their comparative performance in predicting impaired coronary vasodilation by pet myocardial perfusion imaging. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0184] [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
Background
Advances in CTCA imaging enable assessment of coronary plaque burden, a predictor of myocardial perfusion abnormalities and more recently, with the use of computational fluid dynamics (CFD) of endothelial shear stress (ESS), an established contributor to atherosclerotic plaque development and progression.
Purpose
To investigate the relationship of local endothelial shear stress (ESS) and plaque burden (PB) between them and with stenosis severity as well as their comparative performance in predicting impaired coronary vasodilating capability assessed by PET myocardial perfusion imaging (MPI).
Methods
49 patients (29 males, mean age 65.3±6.3 years, intermediate pre-test likelihood of coronary artery disease, CAD), who underwent PET-MPI with 15O-water or 13N-ammonia and CTCA were included. PET was considered abnormal when >1 contiguous segment showed both stress Myocardial Blood Flow ≤2.3 mL/g/min and Myocardial Flow Reserve ≤2.5 for 15O-water or <1.79 mL/g/min and ≤2.0 for 13N-ammonia respectively. On CTCA, stenosis (sten) severity was classified as: <30%, 31–50%, 51–70% and 71–90%. CFD were applied to every vessel, assuming a mean pressure of 100 mmHg as the inlet boundary condition and a coronary velocity profile of 1 ml/sec as the outlet. ESS was calculated for the full length of a stenosis (total), as well as in the proximal (prox), minimum lumen area (MLA) and distal (dist) stenotic segments. Atherosclerotic PB was defined as lesion plaque volume/lesion vessel volume ×100.
Results
85 coronary vessels were evaluated. There was a positive correlation between ESS and PB (r(total)=0.544, r(prox)=0.528, r(MLA)=0.529, r(dist)=0.474, p<0.001 for all). All ESS indices and PB increased progressively with stenosis severity compared to segments with a <30% stenosis (p≤0.004 for all comparisons). ESS indices and PB were also higher in lesions demonstrating impaired vasodilating capacity compared to those without (p≤0.02 for all comparisons, figure 1). All ESS indices performed equally with PB and sten >50% in predicting an abnormal PET MPI, (AUC: from 0.682 to 0.780, p-diff >0.5 for all comparisons). The pairwise combination of sten >50% with the ESS segments, except the distal one, increased the predictive ability of the model over stenosis alone (AUC (sten >50% + ESS(total)) = 0.80, AUC (sten >50% + ESS(prox)) = 0.797, AUC (sten >50% + ESS(MLA)) = 0.822, p-diff ≤0.01 for all comparisons, AUC (sten >50% + ESS(dist)) = 0.768, p-diff=0.07).
Conclusion
There is a low to moderate positive association between lesion plaque burden and ESS indices. Like PB, ESS increases progressively with stenosis severity and is higher in lesions paired with abnormal PET results. ESS is a moderate predictor of impaired vasodilating capability, performing equally with PB and stenosis severity. The addition of ESS to stenosis severity can improve prediction of an abnormal PET result.
Figure 1
Funding Acknowledgement
Type of funding source: Public grant(s) – EU funding. Main funding source(s): This study is co-financed by Greece and the European Union (European Social Fund-ESF) through the Operational Programme “Human Resources Development, Education and Lifelong Learning 2014-2020” in the context of the project “Assessment of coronary atherosclerosis: a new complete, anatomo-functional, morphological and biomechanical approach” and from p-Med GR 5002802
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Affiliation(s)
| | - G Kalykakis
- Academy of Athens Biomedical Research Foundation, Athens, Greece
| | | | - P Siogkas
- Biomedical Research Institute - FORTH, Ioannina, Greece
| | | | - P Kafouris
- University of Athens, Department of informatics and telecommunications, Athens, Greece
| | - R Liga
- Institute of Clinical Physiology, Pisa, Italy
| | | | - A Scolte
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - P Kaufmann
- University Hospital Zurich, Zurich, Switzerland
| | - G Pelosi
- Institute of Clinical Physiology, Pisa, Italy
| | - O Parodi
- Institute of Clinical Physiology, Pisa, Italy
| | - J Knuuti
- Institute of Clinical Physiology, Pisa, Italy
| | - D Fotiadis
- University of Ioannina, Ioannina, Greece
| | - D Neglia
- Institute of Clinical Physiology, Pisa, Italy
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30
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El Mahdiui M, Smit J, Van Rosendael A, Neglia D, Knuuti J, Buechel R, Teresinska A, Pizzi M, Poddighe R, Mertens B, Caselli C, Rocchiccioli S, Parodi O, Pelosi G, Scholte A. Sex differences in the natural history of plaque progression by serial coronary computed tomography angiography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0187] [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
Background
Sex related differences exist for coronary artery disease (CAD). Women tend to be older when presenting with CAD and have lower rates of obstructive disease. Invasive intravascular ultrasound studies have shown differences in plaque composition between males and females. However, these studies were performed in a high risk population needing invasive imaging. Coronary computed tomography angiography (CTA) allows for a fast and non-invasive quantification of CAD in low risk patients. Sex differences and quantitative analysis of plaque progression and changes in plaque composition have not been studied intensively.
Purpose
To evaluate the role of sex on long term plaque progression and on the change of plaque composition in a population with low-intermediate risk.
Methods
Patients that received a coronary CTA were prospectively included in the SMARTool study to receive a follow-up coronary CTA. In total, 275 patients from 5 European countries were recruited in 7 centers. Baseline and follow-up coronary CTA were quantitative analyzed on a per-lesion basis using dedicated software package. Patients without coronary plaques at follow-up or with uninterpretable coronary CTA results were excluded. Total plaque volume and compositional volumes, calcified or non-calcified (defined as fibrous, fibro-fatty or necrotic core), were normalized using the vessel volume to calculate a percentage atheroma volume (PAV). Lesions between males and females were compared using linear mixed models. We further classified patients into age groups <55 and ≥55 years to evaluate the influence of menopause on plaque progression.
Results
In total, 211 patients were included in this analysis, 146 (69%) were male and 65 (31%) were female. Mean interscan period was 6.2±1.4 years. Females were older (64±7 vs 61±8 years; p<0.001), had higher HDL levels (56±15 vs 49±15 mg/dL; p=0.003) and presented more often with atypical chest pain (62 vs 38%; p=0.017). Males had 434 plaque sites and females 156. On a per-lesion analysis females had less fibro-fatty PAV compared to males (β −1.3±0.4%; p<0.001), no other differences were seen (p>0.05). When stratifying the patients in above and below 55 years old, females still had less fibro-fatty PAV compared to males in both age groups (p<0.05). However, females in the age group <55 years showed more regression of fibrous PAV compared to males (β −0.8±0.3% per year; p=0.002) and non-calcified plaque PAV (β −0.7±0.3% per year; p=0.027) (Figure).
Conclusions
Males have larger fibro-fatty PAV compared to females, however the rate of change did not differ. Younger women showed more regression of fibrous PAV and non-calcified PAV compared to males. No differences in the rate of plaque progression or plaque composition changes were seen between males and females in the older age group.
Figure plaque progression and sex diff
Funding Acknowledgement
Type of funding source: Public grant(s) – EU funding. Main funding source(s): EU H2020 research and innovation program
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Affiliation(s)
- M El Mahdiui
- Leiden University Medical Center, Cardiology, Leiden, Netherlands (The)
| | - J.M Smit
- Leiden University Medical Center, Cardiology, Leiden, Netherlands (The)
| | - A.R Van Rosendael
- Leiden University Medical Center, Cardiology, Leiden, Netherlands (The)
| | - D Neglia
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - J Knuuti
- Turku PET Centre, Turku, Finland
| | | | | | - M.N Pizzi
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - R Poddighe
- Versilia Hospital, Lido Di Camaiore, Italy
| | - B.J Mertens
- Leiden University Medical Center, Cardiology, Leiden, Netherlands (The)
| | - C Caselli
- National Council of Research, Pisa, Italy
| | | | - O Parodi
- National Council of Research, Pisa, Italy
| | - G Pelosi
- National Council of Research, Pisa, Italy
| | - A.J.H.A Scholte
- Leiden University Medical Center, Cardiology, Leiden, Netherlands (The)
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31
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Pleouras DS, Sakellarios AI, Tsompou P, Kigka V, Kyriakidis S, Rocchiccioli S, Neglia D, Knuuti J, Pelosi G, Michalis LK, Fotiadis DI. Simulation of atherosclerotic plaque growth using computational biomechanics and patient-specific data. Sci Rep 2020; 10:17409. [PMID: 33060746 PMCID: PMC7562914 DOI: 10.1038/s41598-020-74583-y] [Citation(s) in RCA: 16] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 09/24/2020] [Indexed: 11/08/2022] Open
Abstract
Atherosclerosis is the one of the major causes of mortality worldwide, urging the need for prevention strategies. In this work, a novel computational model is developed, which is used for simulation of plaque growth to 94 realistic 3D reconstructed coronary arteries. This model considers several factors of the atherosclerotic process even mechanical factors such as the effect of endothelial shear stress, responsible for the initiation of atherosclerosis, and biological factors such as the accumulation of low and high density lipoproteins (LDL and HDL), monocytes, macrophages, cytokines, nitric oxide and formation of foams cells or proliferation of contractile and synthetic smooth muscle cells (SMCs). The model is validated using the serial imaging of CTCA comparing the simulated geometries with the real follow-up arteries. Additionally, we examine the predictive capability of the model to identify regions prone of disease progression. The results presented good correlation between the simulated lumen area (P < 0.0001), plaque area (P < 0.0001) and plaque burden (P < 0.0001) with the realistic ones. Finally, disease progression is achieved with 80% accuracy with many of the computational results being independent predictors.
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Affiliation(s)
- Dimitrios S Pleouras
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology - FORTH, University Campus of Ioannina, 45110, Ioannina, Greece
| | - Antonis I Sakellarios
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology - FORTH, University Campus of Ioannina, 45110, Ioannina, Greece
| | - Panagiota Tsompou
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology - FORTH, University Campus of Ioannina, 45110, Ioannina, Greece
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, PO BOX 1186, 45110, Ioannina, Greece
| | - Vassiliki Kigka
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology - FORTH, University Campus of Ioannina, 45110, Ioannina, Greece
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, PO BOX 1186, 45110, Ioannina, Greece
| | - Savvas Kyriakidis
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology - FORTH, University Campus of Ioannina, 45110, Ioannina, Greece
| | - Silvia Rocchiccioli
- Institute of Clinical Physiology, National Research Council, 56124, Pisa, Italy
| | - Danilo Neglia
- Fondazione Toscana G. Monasterio, 56124, Pisa, Italy
| | - Juhani Knuuti
- Turku PET Centre, University of Turku, and Turku University Hospital, Turku, Finland
| | - Gualtiero Pelosi
- Institute of Clinical Physiology, National Research Council, 56124, Pisa, Italy
| | - Lampros K Michalis
- Department of Cardiology, Medical School, University of Ioannina, 45110, Ioannina, Greece
| | - Dimitrios I Fotiadis
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology - FORTH, University Campus of Ioannina, 45110, Ioannina, Greece.
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, PO BOX 1186, 45110, Ioannina, Greece.
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32
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Kigka VI, Sakellarios AI, Georga EI, Siogkas P, Tsompou P, Kyriakidis S, Rocchiccioli S, Pelosi G, Naka K, Michalis LK, Fotiadis DI. Site specific prediction of PCI stenting based on imaging and biomechanics data using gradient boosting tree ensembles. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:2812-2815. [PMID: 33018591 DOI: 10.1109/embc44109.2020.9175612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cardiovascular diseases are nowadays considered as the main cause of morbidity and mortality worldwide. Coronary Artery Disease (CAD), the most typical form of cardiovascular disease is diagnosed by a variety of imaging modalities, both invasive and non-invasive, which involve either risk implications or high cost. Therefore, several attempts have been undertaken to early diagnose and predict either the high CAD risk patients or the cardiovascular events, implementing machine learning techniques. The purpose of this study is to present a classification scheme for the prediction of Percutaneous Coronary Intervention (PCI) stenting placement, using image-based data. The proposed classification model is a gradient boosting classifier, incorporated into a class imbalance handling technique, the Easy ensemble scheme and aims to classify coronary segments into high CAD risk and low CAD risk, based on their PCI placement. Through this study, we investigate the importance of image based features, concluding that the combination of the coronary degree of stenosis and the fractional flow reserve achieves accuracy 78%.
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33
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Sakellarios A, Correia J, Kyriakidis S, Georga E, Tachos N, Siogkas P, Sans F, Stofella P, Massimiliano V, Clemente A, Rocchiccioli S, Pelosi G, Filipovic N, Fotiadis DI. A cloud-based platform for the non-invasive management of coronary artery disease. ENTERP INF SYST-UK 2020. [DOI: 10.1080/17517575.2020.1746975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Antonis Sakellarios
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology – FORTH, University Campus of Ioannina, Ioannina, Greece
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | | | - Savvas Kyriakidis
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology – FORTH, University Campus of Ioannina, Ioannina, Greece
| | - Elena Georga
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology – FORTH, University Campus of Ioannina, Ioannina, Greece
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Nikolaos Tachos
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology – FORTH, University Campus of Ioannina, Ioannina, Greece
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | - Panagiotis Siogkas
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology – FORTH, University Campus of Ioannina, Ioannina, Greece
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
| | | | | | | | - Alberto Clemente
- Department of Radiology, Fondazione Toscana Gabriele Monasterio, Pisa and Massa, Italy
| | | | - Gualtiero Pelosi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Nenad Filipovic
- Faculty of Engineering, University of Kragujevac, Kragujevac, Serbia
| | - Dimitrios I. Fotiadis
- Department of Biomedical Research, Institute of Molecular Biology and Biotechnology – FORTH, University Campus of Ioannina, Ioannina, Greece
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
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34
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Smit JM, van Rosendael AR, El Mahdiui M, Neglia D, Knuuti J, Saraste A, Buechel RR, Teresinska A, Pizzi MN, Roque A, Poddighe R, Mertens BJ, Caselli C, Rocchiccioli S, Parodi O, Pelosi G, Scholte AJ. Impact of Clinical Characteristics and Statins on Coronary Plaque Progression by Serial Computed Tomography Angiography. Circ Cardiovasc Imaging 2020; 13:e009750. [DOI: 10.1161/circimaging.119.009750] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 12/12/2022]
Abstract
Background
Progression of coronary artery disease using serial coronary computed tomography angiography (CTA) is of clinical interest. Our primary aim was to prospectively assess the impact of clinical characteristics and statin use on quantitatively assessed coronary plaque progression in a low-risk study population during long-term follow-up.
Methods
Patients who previously underwent coronary CTA for suspected coronary artery disease were prospectively included to undergo follow-up coronary CTA. The primary end point was coronary artery disease progression, defined as the absolute annual increase in total, calcified, and noncalcified plaque volume by quantitative CTA analysis.
Results
In total, 202 patients underwent serial coronary CTA with a mean interscan period of 6.2±1.4 years. On a per-plaque basis, increasing age (β=0.070;
P
=0.058) and hypertension (β=1.380;
P
=0.075) were nonsignificantly associated with annual total plaque progression. Male sex (β=1.676;
P
=0.009), diabetes mellitus (β=1.725;
P
=0.012), and statin use (β=1.498;
P
=0.046) showed an independent association with annual progression of calcified plaque. While hypertension (β=2.259;
P
=0.015) was an independent determinant of noncalcified plaque progression, statin use (β=−2.178;
P
=0.050) was borderline significantly associated with a reduced progression of noncalcified plaque.
Conclusions
Statin use was associated with an increased progression of calcified coronary plaque and a reduced progression of noncalcified coronary plaque, potentially reflecting calcification of the noncalcified plaque component. Whereas hypertension was the only modifiable risk factor predictive of noncalcified plaque progression, diabetes mellitus mainly led to an increase in calcified plaque. These findings could yield the need for intensified preventive treatment of patients with diabetes mellitus and hypertension to slow and stabilize coronary artery disease progression and improve clinical outcome.
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Affiliation(s)
- Jeff M. Smit
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.M.S., A.R.v.R., M.E.M., A.J.S.)
| | - Alexander R. van Rosendael
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.M.S., A.R.v.R., M.E.M., A.J.S.)
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.M.S., A.R.v.R., M.E.M., A.J.S.)
| | - Danilo Neglia
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy (D.N.)
| | - Juhani Knuuti
- Heart Center and PET Centre, Turku University Hospital, University of Turku, Finland (J.K., A.S.)
| | - Antti Saraste
- Heart Center and PET Centre, Turku University Hospital, University of Turku, Finland (J.K., A.S.)
| | - Ronny R. Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital and University of Zurich, Switzerland (R.R.B.)
| | - Anna Teresinska
- Instytut Kardiologii im. Prymasa Tysiąclecia Stefana Kardynała Wyszyńskiego, ul. Alpejska, Warszawa, Poland (A.T.)
| | | | - Albert Roque
- Department of Radiology, Hospital Universitari Vall d’Hebron, Barcelona, Spain (A.R.)
| | | | - Bart J. Mertens
- Department of Medical Statistics, Leiden University Medical Center, The Netherlands (B.J.M.)
| | - Chiara Caselli
- Institute of Clinical Physiology CNR, Pisa, Italy (C.C., S.R., G.P.)
| | | | - Oberdan Parodi
- Institute of Clinical Physiology CNR, Pisa, Italy (C.C., S.R., G.P.)
- Institute of Information Science and Technologies CNR, Pisa, Italy (O.P.)
| | - Gualtiero Pelosi
- Institute of Clinical Physiology CNR, Pisa, Italy (C.C., S.R., G.P.)
| | - Arthur J. Scholte
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.M.S., A.R.v.R., M.E.M., A.J.S.)
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Siogkas PK, Sakellarios AI, Kyriakidis SK, Anagnostopoulos CD, Pelosi G, Rocchiccioli S, Michalis LK, Fotiadis DI. The effect of error propagation in the 3D reconstruction of coronary segments using CTCA images on crucial hemodynamic parameters. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:5006-5009. [PMID: 31946984 DOI: 10.1109/embc.2019.8857829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The development of 3D reconstruction methods of the coronary vasculature has gained substantial ground during the past years. The accurate 3D reconstruction is of utmost importance because the propagation of errors caused by either equipment calibration errors, human errors or other error sources can seriously affect the computation of critical hemodynamic parameters such as Endothelial Shear Stress, intracoronary pressures etc. In this work, we present a study on how the 3D reconstruction error can affect the subsequent blood flow simulations in 3D coronary arterial models. Eight arterial segments were reconstructed, creating the control models and were then modified in order to create an underestimated and an overestimated model of the same segment using a 5% error. Cross-sectional ESS values, as well as, smartFFR values were calculated to examine the effect of the reconstruction error. As it was expected, the underestimated models presented with higher ESS values and lower smartFFR values, whereas the overestimated models presented with lower ESS values and higher smartFFR values, respectively.
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36
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Anagnostopoulos C, Kalykakis G, Pitsargiotis T, Siogkas P, Liga R, Maaniittyy T, Kafouris P, Giannopoulos A, Scolte A, Kaufmann P, Pelosi G, Parodi O, Knuuti J, Fotiadis D, Neglia D. P2702Assessment of endothelial shear stress and functional significance of coronary lesions by computed tomography coronary angiography (CTCA) and computational fluid dynamics: a comparison with PET. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1019] [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
The feasibility of assessing endothelial shear stress (ESS) in coronary lesions by non-invasive imaging and its potential role in different clinical settings has been recently explored. However, the relationship of ESS with functional indices derived by computed tomography coronary angiography (CTCA) and its value in predicting perfusion changes by quantitative positron emission tomography (PET) downstream stenotic vessels has not been assessed.
Purpose
To investigate the feasibility of calculating local ESS, its relationship with stenosis severity as well as with virtual functional assessment index (vFAI), and the comparative performance of the two parameters for predicting impaired coronary vasodilating capability in terms both of stress myocardial blood flow (MBF) and myocardial flow reserve (MFR) in patients submitted to CTCA.
Methods
Thirty-two patients (23 male-9 female, mean age 65.6±7.2 years) with intermediate pre-test likelihood of coronary artery disease (CAD), who were enrolled in the EVINCI and SMARTool projects, and had undergone CTCA with vFAI and PET myocardial perfusion imaging with 15 O-water or 13 N-ammonia were included in the study. PET was considered positive when >1 contiguous segments showed both stress MBF ≤2.3 mL/g/min and MFR ≤2.5 for 15 O-water or ≤1.79 mL/g/min and ≤2.0, for 13 N-ammonia respectively. A vFAI threshold of 0.85 was used as predictor of impaired vasodilating capability. ESS computation was based on a mean aortic pressure of 100 mmHg for the inlet and a mean blood flow at rest of 0.00105 kg/s for the outlet. ESS was calculated (Pa) in the full length of the stenosis and the mean value was obtained.
Results
Hybrid imaging analysis was performed in CTCA and PET datasets. 51 coronary segments were assessed. There were 27 lesions with stenosis 31–50% and 24 lesions with stenosis 51–70%. ESS was higher in the latter (20.4, IQ: 11.4–32.1 vs. 10.4, IQ: 5.5–15.7, p=0.04). Similarly, ESS was higher in stenoses with impaired vasodilating capacity compared to those without, although this difference did not reach statistical significance (22.8, IQ: 13.2–35.1 vs. 10.6, IQ: 5.7–22.1, p=0.10). The ROC curve analysis for prediction of both abnormal stress MBF and MFR followed the same pattern (AUC=0.668, 95% confidence interval (CI): 0.490–0.810, p=0.11).On the other hand, there was a moderate negative correlation (r=−0.41, p=0.004) between ESS and vFAI and the former was lower in stenoses with vFAI >0.85 compared to those below this threshold (7.35, IQ: 3.2–13.9 vs. 19.1, IQ: 14.1–32.8, p=0.012). vFAI was a good predictor of coronary flow capacity (AUC=0.737, CI: 0.58–0.85, p=0.02).
Conclusion
Calculation of ESS is feasible in CTCA datasets. ESS was related with stenosis severity and there was a trend to be higher in lesions with impaired coronary vasodilating capability. ESS is modestly related with vFAI and may also be an additional predictor of impaired regional myocardial flow obtained by PET imaging.
Acknowledgement/Funding
This study has received funding from the EU H2020 research and innovation programme under grant agreement No 689068 and from p-Med GR 5002802
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Affiliation(s)
| | - G Kalykakis
- Academy of Athens Biomedical Research Foundation, Athens, Greece
| | - T Pitsargiotis
- Academy of Athens Biomedical Research Foundation, Athens, Greece
| | - P Siogkas
- Biomedical Research Institute - FORTH, Ioannina, Greece
| | - R Liga
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | | | - P Kafouris
- National & Kapodistrian University of Athens, Department of informatics and telecommunications, Athens, Greece
| | | | - A Scolte
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - P Kaufmann
- University Hospital Zurich, Zurich, Switzerland
| | - G Pelosi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - O Parodi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - J Knuuti
- Turku PET Centre, Turku, Finland
| | - D Fotiadis
- University of Ioannina, Ioannina, Greece
| | - D Neglia
- Institute of Clinical Physiology (IFC), Pisa, Italy
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Caselli C, Rocchiccioli S, Rosendael A, Buechel R, Teresinska A, Pizzi MN, Smith JM, Poddighe R, Campolo J, Vozzi F, Knuuti J, Pelosi G, Parodi O, Scholte A, Neglia D. P6167Low leptin plasma levels are associated with progression of coronary atherosclerosis in patients with stable coronary artery disease from the SMARTool Study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0773] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Leptin is an adipokine involved in energy homeostasis and has been related with established vascular risk factors. However, studies on the association of leptin plasma levels with coronary artery disease (CAD) have yielded conflicting results.
Purpose
Aim of the present study was to evaluate the association between leptin plasma levels and presence, severity and progression of coronary atherosclerosis in patients with suspected stable CAD.
Methods
In a cohort of 257 patients with symptoms of stable CAD enrolled in the SMARTool study, coronary computed tomography angiography (CTA), plasma leptin levels and clinical and bio-humoral CAD risk profile (including glucose, lipid and inflammation variables) were obtained at enrolment and after 6±1yrs of follow-up. Sixty-four patients were revascularized and the remaining 193 represent the population for the present study. CTA findings were categorised as no-minimal CAD (<30% stenosis), non-obstructive CAD (30%-50% stenosis) and obstructive CAD (≥50% stenosis in at least one major coronary vessel). A CTA risk score (based on plaque extent, severity, composition, and location) was calculated at baseline and at follow-up to assess coronary atherosclerotic burden and its progression (Δ CTA score≥5).
Results
CTA findings showed obstructive CAD in 11% of patients at baseline and in 15% at follow-up (p<0.0001). CTA risk score, was 8.03±7.80 at baseline and increased to 10.33±8.17 at follow-up (p<0.0001) with CAD progression in 20% of patients. Leptin plasma levels were inversely related with CTA findings both at baseline and follow-up (Figure). In a Cox model, baseline plasma leptin was an independent predictor of CAD progression, after adjustment for clinical risk factors, biomarkers, and treatment (HR 0.572, 95% CI 0.393–0.834, P=0.0037).
Figure 1
Conclusion
Plasma leptin is inversely associated with coronary atherosclerotic burden and disease progression in patients with stable CAD. This association is independent of known factors affecting leptin levels. These results could prompt further investigations on the pathophysiological mechanisms of this association.
Acknowledgement/Funding
EU H2020 research and innovation program under grant agreement No 689068
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Affiliation(s)
- C Caselli
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | | | - A Rosendael
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - R Buechel
- University of Zurich, Zurich, Switzerland
| | | | - M N Pizzi
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J M Smith
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - R Poddighe
- Versilia Hospital, Lido Di Camaiore, Italy
| | - J Campolo
- CNR Institute of Clinical Physiology, Milan, Italy
| | - F Vozzi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - J Knuuti
- University of Turku, Turku, Finland
| | - G Pelosi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - O Parodi
- Institute of Clinical Physiology (IFC), Pisa, Italy
| | - A Scholte
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - D Neglia
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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38
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Kigka VI, Sakellarios A, Kyriakidis S, Rigas G, Athanasiou L, Siogkas P, Tsompou P, Loggitsi D, Benz DC, Buechel R, Lemos PA, Pelosi G, Michalis LK, Fotiadis DI. A three-dimensional quantification of calcified and non-calcified plaques in coronary arteries based on computed tomography coronary angiography images: Comparison with expert's annotations and virtual histology intravascular ultrasound. Comput Biol Med 2019; 113:103409. [PMID: 31480007 DOI: 10.1016/j.compbiomed.2019.103409] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/23/2019] [Accepted: 08/23/2019] [Indexed: 12/31/2022]
Abstract
The detection, quantification and characterization of coronary atherosclerotic plaques has a major effect on the diagnosis and treatment of coronary artery disease (CAD). Different studies have reported and evaluated the noninvasive ability of Computed Tomography Coronary Angiography (CTCA) to identify coronary plaque features. The identification of calcified plaques (CP) and non-calcified plaques (NCP) using CTCA has been extensively studied in cardiovascular research. However, NCP detection remains a challenging problem in CTCA imaging, due to the similar intensity values of NCP compared to the perivascular tissue, which surrounds the vasculature. In this work, we present a novel methodology for the identification of the plaque burden of the coronary artery and the volumetric quantification of CP and NCP utilizing CTCA images and we compare the findings with virtual histology intravascular ultrasound (VH-IVUS) and manual expert's annotations. Bland-Altman analyses were employed to assess the agreement between the presented methodology and VH-IVUS. The assessment of the plaque volume, the lesion length and the plaque area in 18 coronary lesions indicated excellent correlation with VH-IVUS. More specifically, for the CP lesions the correlation of plaque volume, lesion length and plaque area was 0.93, 0.84 and 0.85, respectively, whereas the correlation of plaque volume, lesion length and plaque area for the NCP lesions was 0.92, 0.95 and 0.81, respectively. In addition to this, the segmentation of the lumen, CP and NCP in 1350 CTCA slices indicated that the mean value of DICE coefficient is 0.72, 0.7 and 0.62, whereas the mean HD value is 1.95, 1.74 and 1.95, for the lumen, CP and NCP, respectively.
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Affiliation(s)
- Vassiliki I Kigka
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110, Ioannina, Greece; Institute of Molecular Biology and Biotechnology, Dept. of Biomedical Research Institute - FORTH, University Campus of Ioannina, GR 45110, Ioannina, Greece
| | - Antonis Sakellarios
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110, Ioannina, Greece; Institute of Molecular Biology and Biotechnology, Dept. of Biomedical Research Institute - FORTH, University Campus of Ioannina, GR 45110, Ioannina, Greece
| | - Savvas Kyriakidis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110, Ioannina, Greece; Institute of Molecular Biology and Biotechnology, Dept. of Biomedical Research Institute - FORTH, University Campus of Ioannina, GR 45110, Ioannina, Greece
| | - George Rigas
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110, Ioannina, Greece; Institute of Molecular Biology and Biotechnology, Dept. of Biomedical Research Institute - FORTH, University Campus of Ioannina, GR 45110, Ioannina, Greece
| | - Lambros Athanasiou
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, United States
| | - Panagiotis Siogkas
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110, Ioannina, Greece; Institute of Molecular Biology and Biotechnology, Dept. of Biomedical Research Institute - FORTH, University Campus of Ioannina, GR 45110, Ioannina, Greece
| | - Panagiota Tsompou
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110, Ioannina, Greece
| | | | - Dominik C Benz
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Ronny Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Pedro A Lemos
- Dept. of Interventional Cardiology, Heart Institute, University of São Paulo Medical School, São Paulo-SP, 05403-000, Brazil; Dept. of Interventional Cardiology, Hospital Israelita Albert Einstein, Sao Paulo-SP, 05652-000, Brazil
| | - Gualtiero Pelosi
- Institute of Clinical Physiology, National Research Council, Pisa, IT 56124, Italy
| | - Lampros K Michalis
- Dept. of Interventional Cardiology, Medical School, University of Ioannina, GR 45110, Ioannina, Greece
| | - Dimitrios I Fotiadis
- Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110, Ioannina, Greece; Institute of Molecular Biology and Biotechnology, Dept. of Biomedical Research Institute - FORTH, University Campus of Ioannina, GR 45110, Ioannina, Greece.
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39
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Alcala N, Leblay N, Gabriel AAG, Mangiante L, Hervas D, Giffon T, Sertier AS, Ferrari A, Derks J, Ghantous A, Delhomme TM, Chabrier A, Cuenin C, Abedi-Ardekani B, Boland A, Olaso R, Meyer V, Altmuller J, Le Calvez-Kelm F, Durand G, Voegele C, Boyault S, Moonen L, Lemaitre N, Lorimier P, Toffart AC, Soltermann A, Clement JH, Saenger J, Field JK, Brevet M, Blanc-Fournier C, Galateau-Salle F, Le Stang N, Russell PA, Wright G, Sozzi G, Pastorino U, Lacomme S, Vignaud JM, Hofman V, Hofman P, Brustugun OT, Lund-Iversen M, Thomas de Montpreville V, Muscarella LA, Graziano P, Popper H, Stojsic J, Deleuze JF, Herceg Z, Viari A, Nuernberg P, Pelosi G, Dingemans AMC, Milione M, Roz L, Brcic L, Volante M, Papotti MG, Caux C, Sandoval J, Hernandez-Vargas H, Brambilla E, Speel EJM, Girard N, Lantuejoul S, McKay JD, Foll M, Fernandez-Cuesta L. Integrative and comparative genomic analyses identify clinically relevant pulmonary carcinoid groups and unveil the supra-carcinoids. Nat Commun 2019; 10:3407. [PMID: 31431620 PMCID: PMC6702229 DOI: 10.1038/s41467-019-11276-9] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 07/02/2019] [Indexed: 02/06/2023] Open
Abstract
The worldwide incidence of pulmonary carcinoids is increasing, but little is known about their molecular characteristics. Through machine learning and multi-omics factor analysis, we compare and contrast the genomic profiles of 116 pulmonary carcinoids (including 35 atypical), 75 large-cell neuroendocrine carcinomas (LCNEC), and 66 small-cell lung cancers. Here we report that the integrative analyses on 257 lung neuroendocrine neoplasms stratify atypical carcinoids into two prognostic groups with a 10-year overall survival of 88% and 27%, respectively. We identify therapeutically relevant molecular groups of pulmonary carcinoids, suggesting DLL3 and the immune system as candidate therapeutic targets; we confirm the value of OTP expression levels for the prognosis and diagnosis of these diseases, and we unveil the group of supra-carcinoids. This group comprises samples with carcinoid-like morphology yet the molecular and clinical features of the deadly LCNEC, further supporting the previously proposed molecular link between the low- and high-grade lung neuroendocrine neoplasms.
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Affiliation(s)
- N Alcala
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - N Leblay
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - A A G Gabriel
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - L Mangiante
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - D Hervas
- Health Research Institute La Fe, Avenida Fernando Abril Martorell, Torre 106 A 7planta, 46026, Valencia, Spain
| | - T Giffon
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - A S Sertier
- Synergie Lyon Cancer, Centre Léon Bérard, 28 Rue Laennec, 69008, Lyon, France
| | - A Ferrari
- Synergie Lyon Cancer, Centre Léon Bérard, 28 Rue Laennec, 69008, Lyon, France
| | - J Derks
- Maastricht University Medical Centre (MUMC), GROW School for Oncology and Developmental Biology, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
| | - A Ghantous
- International Agency for Research on Cancer (IARC/WHO), Section of Mechanisms of Carcinogenesis, 150 Cours Albert Thomas, 69008, Lyon, France
| | - T M Delhomme
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - A Chabrier
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - C Cuenin
- International Agency for Research on Cancer (IARC/WHO), Section of Mechanisms of Carcinogenesis, 150 Cours Albert Thomas, 69008, Lyon, France
| | - B Abedi-Ardekani
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - A Boland
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, 2 rue Gaston Crémieux, CP 5706, 91057, Evry Cedex, France
| | - R Olaso
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, 2 rue Gaston Crémieux, CP 5706, 91057, Evry Cedex, France
| | - V Meyer
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, 2 rue Gaston Crémieux, CP 5706, 91057, Evry Cedex, France
| | - J Altmuller
- Cologne Centre for Genomics (CCG) and Centre for Molecular Medicine Cologne (CMMC), University of Cologne, Weyertal 115, 50931, Cologne, Germany
| | - F Le Calvez-Kelm
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - G Durand
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - C Voegele
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - S Boyault
- Translational Research and Innovation Department, Cancer Genomic Platform, 28 Rue Laennec, 69008, Lyon, France
| | - L Moonen
- Maastricht University Medical Centre (MUMC), GROW School for Oncology and Developmental Biology, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
| | - N Lemaitre
- Institute for Advanced Biosciences, Site Santé, Allée des Alpes, 38700, La Tronche, Grenoble, France
| | - P Lorimier
- Institute for Advanced Biosciences, Site Santé, Allée des Alpes, 38700, La Tronche, Grenoble, France
| | - A C Toffart
- Pulmonology-Physiology Unit, Grenoble Alpes University Hospital, 38700, La Tronche, France
| | - A Soltermann
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Schmelzbergstrasse 12, 8091, Zurich, Switzerland
| | - J H Clement
- Department Hematology and Medical Oncology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - J Saenger
- Bad Berka Institute of Pathology, Robert-Koch-Allee 9, 99438, Bad Berka, Germany
| | - J K Field
- Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, 6 West Derby Street, L7 8TX, Liverpool, UK
| | - M Brevet
- Pathology Institute, Hospices Civils de Lyon, University Claude Bernard Lyon 1, 59 Boulevard Pinel, 69677, BRON Cedex, France
| | - C Blanc-Fournier
- CLCC François Baclesse, 3 avenue du Général Harris, 14076, Caen Cedex 5, France
| | - F Galateau-Salle
- Department of Pathology, Centre Léon Bérard, 28, rue Laennec, 69373, Lyon Cedex 8, France
| | - N Le Stang
- Department of Pathology, Centre Léon Bérard, 28, rue Laennec, 69373, Lyon Cedex 8, France
| | - P A Russell
- St. Vincent's Hospital and University of Melbourne, Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia
| | - G Wright
- St. Vincent's Hospital and University of Melbourne, Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia
| | - G Sozzi
- Pathology Division Fondazione, IRCCS Istituto Nazionale dei Tumori, Via G. Venezian 1, 20133, Milan, Italy
| | - U Pastorino
- Pathology Division Fondazione, IRCCS Istituto Nazionale dei Tumori, Via G. Venezian 1, 20133, Milan, Italy
| | - S Lacomme
- Nancy Regional University Hospital, CHRU, CRB BB-0033-00035, INSERM U1256, 29 Avenue du Maréchal de Lattre de Tassigny, 54035, Nancy Cedex, France
| | - J M Vignaud
- Nancy Regional University Hospital, CHRU, CRB BB-0033-00035, INSERM U1256, 29 Avenue du Maréchal de Lattre de Tassigny, 54035, Nancy Cedex, France
| | - V Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Nice Hospital, Biobank BB-0033-00025, IRCAN Inserm U1081 CNRS 7284, University Côte d'Azur, 30 avenue de la voie Romaine, CS, 51069-06001, Nice Cedex 1, France
| | - P Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Nice Hospital, Biobank BB-0033-00025, IRCAN Inserm U1081 CNRS 7284, University Côte d'Azur, 30 avenue de la voie Romaine, CS, 51069-06001, Nice Cedex 1, France
| | - O T Brustugun
- Drammen Hospital, Vestre Viken Health Trust, Vestre Viken HF, Postboks 800, 3004, Drammen, Norway
- Institute of Cancer Research, Oslo University Hospital, Ullernchausseen 70, 0379, Oslo, Norway
| | - M Lund-Iversen
- Institute of Cancer Research, Oslo University Hospital, Ullernchausseen 70, 0379, Oslo, Norway
| | | | - L A Muscarella
- Fondazione IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini 1, 71013, San Giovanni Rotondo FG, Italy
| | - P Graziano
- Fondazione IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini 1, 71013, San Giovanni Rotondo FG, Italy
| | - H Popper
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010, Graz, Austria
| | - J Stojsic
- Department of Thoracopulmonary Pathology, Service of Pathology, Clinical Center of Serbia, Pasterova 2, Belgrade, 11000, Serbia
| | - J F Deleuze
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, 2 rue Gaston Crémieux, CP 5706, 91057, Evry Cedex, France
| | - Z Herceg
- International Agency for Research on Cancer (IARC/WHO), Section of Mechanisms of Carcinogenesis, 150 Cours Albert Thomas, 69008, Lyon, France
| | - A Viari
- Synergie Lyon Cancer, Centre Léon Bérard, 28 Rue Laennec, 69008, Lyon, France
| | - P Nuernberg
- Cologne Centre for Genomics (CCG) and Centre for Molecular Medicine Cologne (CMMC), University of Cologne, Weyertal 115, 50931, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Joseph-Stelzmann-Straße 26, 50931, Cologne, Germany
| | - G Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, and Inter-Hospital Pathology Division, IRCCS Multimedica, Via Gaudenzio Fantoli, 16/15, 20138, Milan, Italy
| | - A M C Dingemans
- Maastricht University Medical Centre (MUMC), GROW School for Oncology and Developmental Biology, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
| | - M Milione
- Pathology Division Fondazione, IRCCS Istituto Nazionale dei Tumori, Via G. Venezian 1, 20133, Milan, Italy
| | - L Roz
- Pathology Division Fondazione, IRCCS Istituto Nazionale dei Tumori, Via G. Venezian 1, 20133, Milan, Italy
| | - L Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010, Graz, Austria
| | - M Volante
- Department of Oncology, University of Turin, Pathology Division, Via Santena 7, 10126, Torino, Italy
| | - M G Papotti
- Department of Oncology, University of Turin, Pathology Division, Via Santena 7, 10126, Torino, Italy
| | - C Caux
- Department of Immunity, Virus, and Inflammation, Cancer Research Centre of Lyon (CRCL), 28 Rue Laennec, 69008, Lyon, France
| | - J Sandoval
- Health Research Institute La Fe, Avenida Fernando Abril Martorell, Torre 106 A 7planta, 46026, Valencia, Spain
| | - H Hernandez-Vargas
- Cancer Research Centre of Lyon (CRCL), Inserm U 1052, CNRS UMR 5286, Centre Léon Bérard, Université de Lyon, 28 Rue Laennec, 69008, Lyon, France
| | - E Brambilla
- Institute for Advanced Biosciences, Site Santé, Allée des Alpes, 38700, La Tronche, Grenoble, France
| | - E J M Speel
- Maastricht University Medical Centre (MUMC), GROW School for Oncology and Developmental Biology, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
| | - N Girard
- Institut Curie, 26 Rue d'Ulm, 75005, Paris, France
- European Reference Network (ERN-EURACAN), 28 rue Laennec, 69008, Lyon, France
| | - S Lantuejoul
- Synergie Lyon Cancer, Centre Léon Bérard, 28 Rue Laennec, 69008, Lyon, France
- Translational Research and Innovation Department, Cancer Genomic Platform, 28 Rue Laennec, 69008, Lyon, France
- Department of Pathology, Centre Léon Bérard, 28, rue Laennec, 69373, Lyon Cedex 8, France
| | - J D McKay
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - M Foll
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France
| | - L Fernandez-Cuesta
- International Agency for Research on Cancer (IARC/WHO), Section of Genetics, 150 Cours Albert Thomas, 69008, Lyon, France.
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Anagnostopoulos CD, Siogkas PK, Liga R, Benetos G, Maaniitty T, Sakellarios AI, Koutagiar I, Karakitsios I, Papafaklis MI, Berti V, Sciagrà R, Scholte AJHA, Michalis LK, Gaemperli O, Kaufmann PA, Pelosi G, Parodi O, Knuuti J, Fotiadis DI, Neglia D. Characterization of functionally significant coronary artery disease by a coronary computed tomography angiography-based index: a comparison with positron emission tomography. Eur Heart J Cardiovasc Imaging 2019; 20:897-905. [PMID: 30629151 DOI: 10.1093/ehjci/jey199] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 08/29/2023] Open
Abstract
Abstract
Aims
To test the hypothesis that virtual functional assessment index (vFAI) is related with regional flow parameters derived by quantitative positron emission tomography (PET) and can be used to assess abnormal vasodilating capability in coronary vessels with stenotic lesions at coronary computed tomography angiography (CCTA).
Methods and results
vFAI, stress myocardial blood flow (MBF), and myocardial flow reserve (MFR) were assessed in 78 patients (mean age 62.2 ± 7.7 years) with intermediate pre-test likelihood of coronary artery disease (CAD). Coronary stenoses ≥50% were considered angiographically significant. PET was considered positive for significant CAD, when more than one contiguous segments showed stress MBF ≤2.3 mL/g/min for 15O-water or <1.79 mL/g/min for 13N-ammonia. MFR thresholds were ≤2.5 and ≤2.0, respectively. vFAI was lower in vessels with abnormal stress MBF (0.76 ± 0.10 vs. 0.89 ± 0.07, P < 0.001) or MFR (0.80 ± 0.10 vs. 0.89 ± 0.07, P < 0.001). vFAI had an accuracy of 78.6% and 75% in unmasking abnormal stress MBF and MFR in 15O-water and 82.7% and 71.2% in 13N-ammonia studies, respectively. Addition of vFAI to anatomical CCTA data increased the ability for predicting abnormal stress MBF and MFR in 15O-water studies [AUCccta + vfai = 0.866, 95% confidence interval (CI) 0.783–0.949; P = 0.013 and AUCccta + vfai = 0.737, 95% CI 0.648–0.825; P = 0.007, respectively]. An incremental value was also demonstrated for prediction of stress MBF (AUCccta + vfai = 0.887, 95% CI 0.799–0.974; P = 0.001) in 13N-ammonia studies. A similar trend was recorded for MFR (AUCccta + vfai = 0.780, 95% CI 0.632–0.929; P = 0.13).
Conclusion
vFAI identifies accurately the presence of impaired vasodilating capability. In combination with anatomical data, vFAI enhances the diagnostic performance of CCTA.
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Affiliation(s)
| | - Panagiotis K Siogkas
- University of Ioannina, Materials Science and Engineering, Ioannina, Greece
- Biomedical Research Institute, FORTH, Ioannina, Greece
| | - Riccardo Liga
- Institute of Clinical Physiology, National Research Council, Pisa, IT, Italy
| | - Georgios Benetos
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University Medical School, Athens, Greece
| | | | | | - Iosif Koutagiar
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University Medical School, Athens, Greece
| | - Ioannis Karakitsios
- Biomedical Research Foundation of Academy of Athens, 4 Soranou Ephesiou, Athens, Greece
| | | | - Valentina Berti
- Department of Biomedical, Experimental and Clinical Sciences, Mario Serio, Nuclear Medicine Unit, University of Florence, Largo Brambilla 3, Florence, FI, Italy
| | - Roberto Sciagrà
- Department of Biomedical, Experimental and Clinical Sciences, Mario Serio, Nuclear Medicine Unit, University of Florence, Largo Brambilla 3, Florence, FI, Italy
| | | | | | | | | | - Gualtiero Pelosi
- Institute of Clinical Physiology, National Research Council, Pisa, IT, Italy
| | - Oberdan Parodi
- Institute of Clinical Physiology, National Research Council, Pisa, IT, Italy
| | | | - Dimitrios I Fotiadis
- University of Ioannina, Materials Science and Engineering, Ioannina, Greece
- Biomedical Research Institute, FORTH, Ioannina, Greece
| | - Danilo Neglia
- Institute of Clinical Physiology, National Research Council, Pisa, IT, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, IT, Italy
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Djukic T, Saveljic I, Pelosi G, Parodi O, Filipovic N. Numerical simulation of stent deployment within patient-specific artery and its validation against clinical data. Comput Methods Programs Biomed 2019; 175:121-127. [PMID: 31104701 DOI: 10.1016/j.cmpb.2019.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/02/2019] [Accepted: 04/07/2019] [Indexed: 05/05/2023]
Abstract
BACKGROUND AND OBJECTIVE One of the most widely adopted endovascular treatment procedures is the stent implantation. The effectiveness of the treatment depends on the appropriate stent expansion. However, it is difficult to accurately predict the outcome of such an endovascular intervention. Numerical simulations represent a useful tool to study the complex behavior of the stent during deployment. This study presents a numerical model capable of simulating this process. METHODS The numerical model consists of three parts: modeling of stent expansion, modeling the interaction of the stent with the arterial wall and the deformation of the arterial wall. The model is able to predict the shapes of both stent and arterial wall during the entire deployment process. Simulations are performed using patient-specific clinical data that ensures more realistic results. RESULTS The numerical simulations of stent deployment are performed using the extracted geometry of the coronary arteries of two patients. The obtained results are validated against clinical data from the follow up examination and both quantitative and qualitative analysis of the results is presented. The areas of several slices of the arterial wall are calculated for all the three states (before, after and follow up) and the standard error of the area when comparing simulation and follow up examination is 5.27% for patient #1 and 4.5% for patient #2. CONCLUSIONS The final goal of numerical simulations in stent deployment should be to provide a clinical tool that is capable of reliably predicting the treatment outcome. This study showed through the good agreement of results of the numerical simulations and clinical data that the presented numerical model represents a step towards this final goal. These simulations can also provide valuable information about distribution of forces and stress in the arterial wall that can improve pre-operative planning and treatment optimization.
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Affiliation(s)
- Tijana Djukic
- Bioengineering Research and Development Center, BioIRC, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia.
| | - Igor Saveljic
- Bioengineering Research and Development Center, BioIRC, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia; Faculty of Engineering, University of Kragujevac, Sestre Janjic 6, 34000 Kragujevac, Serbia.
| | - Gualtiero Pelosi
- Institute of Clinical Physiology, National Research Council, Via Giuseppe Moruzzi, 1, 56124 Pisa, Italy.
| | - Oberdan Parodi
- Institute of Clinical Physiology, National Research Council, Via Giuseppe Moruzzi, 1, 56124 Pisa, Italy.
| | - Nenad Filipovic
- Bioengineering Research and Development Center, BioIRC, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia; Faculty of Engineering, University of Kragujevac, Sestre Janjic 6, 34000 Kragujevac, Serbia
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42
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Pitsargiotis T, Neglia D, Siogkas PK, Benetos G, Liga R, Sakellarios AI, Maaniitty T, Scholte A, Gaemperli O, Kaufmann PA, Pelosi G, Parodi O, Reyes E, Fotiadis DI, Anagnostopoulos CD. 359Characterization of functionally significant coronary artery disease by a computed tomography coronary angiography (CTCA) based index: a comparison with SPECT. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez146.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Pitsargiotis
- Academy of Athens Biomedical Research Foundation, Athens, Greece
| | - D Neglia
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | - P K Siogkas
- Biomedical Research Institute - FORTH, Ioannina, Greece
| | - G Benetos
- University Hospital Zurich, Zurich, Switzerland
| | - R Liga
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | | | | | - A Scholte
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - O Gaemperli
- University Hospital Zurich, Zurich, Switzerland
| | | | - G Pelosi
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | - O Parodi
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | - E Reyes
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - D I Fotiadis
- University of Ioannina, Materials Science and Engineering, Ioannina, Greece
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Siogkas PK, Papafaklis MI, Lakkas L, Exarchos TP, Karmpaliotis D, Ali ZA, Pelosi G, Parodi O, Katsouras CS, Fotiadis DI, Michalis LK. Virtual Functional Assessment of Coronary Stenoses Using Intravascular Ultrasound Imaging: A Proof-of-Concept Pilot Study. Heart Lung Circ 2019; 28:e33-e36. [PMID: 29895487 DOI: 10.1016/j.hlc.2018.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 12/19/2017] [Accepted: 02/11/2018] [Indexed: 11/27/2022]
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Georga EI, Tachos NS, Sakellarios AI, Kigka VI, Exarchos TP, Pelosi G, Parodi O, Michalis LK, Fotiadis DI. Artificial Intelligence and Data Mining Methods for Cardiovascular Risk Prediction. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/978-981-10-5092-3_14] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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45
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Kigka VI, Georga EI, Sakellarios AI, Tachos NS, Andrikos I, Tsompou P, Rocchiccioli S, Pelosi G, Parodi O, Michalis LK, Fotiadis DI. A Machine Learning Approach for the Prediction of the Progression of Cardiovascular Disease based on Clinical and Non-Invasive Imaging Data. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2018:6108-6111. [PMID: 30441728 DOI: 10.1109/embc.2018.8513620] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nowadays, cardiovascular diseases are very common and are considered as the main cause of morbidity and mortality worldwide. Coronary Artery Disease (CAD), the most typical cardiovascular disease is diagnosed by a variety of medical imaging modalities, which involve costs and complications. Therefore, several attempts have been undertaken to early diagnose and predict CAD status and progression through machine learning approaches. The purpose of this study is to present a machine learning technique for the prediction of CAD, using image-based data and clinical data. We investigate the effect of vascular anatomical features of the three coronary arteries on the graduation of CAD. A classification model is built to predict the future status of CAD, including cases of "no CAD" patients, "non-obstructive CAD" patients and "obstructive CAD" patients. The best accuracy was achieved by the implementation of a tree-based classifier, J48 classifier, after a ranking feature selection methodology. The majority of the selected features are the vessel geometry derived features, among the traditional risk factors. The combination of geometrical risk factors with the conventional ones constitutes a novel scheme for the CAD prediction.
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46
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Smit JM, Van Rosendael AR, Barbon F, Neglia D, Knuuti J, Buechel R, Teresinska A, Pizzi MN, Poddighe R, Caselli C, Rocchiccioli S, Parodi O, Pelosi G, Scholte AJ. 3009Quantitative CTA analysis of coronary plaque progression in SMARTool clinical study: the association between baseline clinical parameters and plaque progression. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J M Smit
- Leiden University Medical Center, Cardiology, Leiden, Netherlands
| | | | | | - D Neglia
- Gabriele Monasterio Foundation, Pisa, Italy
| | - J Knuuti
- Turku University Hospital, Turku, Finland
| | - R Buechel
- University of Zurich, Zurich, Switzerland
| | | | - M N Pizzi
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - R Poddighe
- ASL12 U.O.C. Cardiologia, Viareggio, Italy
| | - C Caselli
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | | | - O Parodi
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | - G Pelosi
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | - A J Scholte
- Leiden University Medical Center, Cardiology, Leiden, Netherlands
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Abstract
Many Studies Have Confirmed Our Original Observation That Dialysate T Set At About 35° C Affords A Better Hemodynamic Protection Than The Standard Dialysate T Of 37-38° C. In This Review We Present Some New Data On The Hemodynamic Mechanism Of The Protective Effect Of Cold Dialysis On Blood Pressure. The Study Was Based On Serial Assessment Of The Percent Changes Occurring During Dialysis Treatment In Estimated Stroke Volume (Aortic Blood Flow Determined By Doppler Echocardiography), Blood Volume (Hemoglobinometry), Arterial Pressure (Dynamap), And Heart Rate (Ecg), From Which Cardiac Output (Co) Indexes And Total Peripheral Vascular Resistances (Tpvr) Were Derived. Of The 14 Pts Studied, 7 Showed A Drop In Mean Arterial Pressure (Map) Of 25° Or Greater During Standard Dialysis (Unstable Patients). Compared With The 7 Patients Having More Stable Intradialysis Map, Unstable Pts Showed Greater Reduction In Co Which Was Disproportionately Greater Than The Reduction In Blood Volume, And A Paradoxical Decrease In Tpvr, The Difference Being Highly Significant (P ≤ 0.01 For Both Changes). When Crossed-Over To Cold Dialysis, Along With A Significantly Lower Reduction In Map (P ≤ 0.01) The Unstable Pts Showed A Lower Decrease In Co Which Paralleled The Reduction In Blood Volume, And An Increase In Tpvr. These Changes Were Highly Significant (P ≤ 0.01). Data Suggest That Dialysis Hypotension Is Characterized By An Impaired Venous Return, Probably Due To The Peripheral Blood Pooling (Increased Ratio Between The ‘Unstressed’ And ‘Stressed’ Blood Volume) Associated With The Decrease In Tpvr. Exposure Of Extracorporeal Blood To Cold Dialysate Favours The Venous Return To The Heart By Increasing Tpvr And The ‘Stressed’ Blood Volume.
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Affiliation(s)
- Q. Maggiore
- Dialysis And Nephrology Unit, Cnr Clinical Physiology Institute, Ospedale S.M. Annunziata, Firenze - Italy
| | - P. Dattolo
- Dialysis And Nephrology Unit, Cnr Clinical Physiology Institute, Ospedale S.M. Annunziata, Firenze - Italy
| | - M. Piacenti
- Dialysis And Nephrology Unit, Cnr Clinical Physiology Institute, Ospedale S.M. Annunziata, Firenze - Italy
| | - M.A. Morales
- Dialysis And Nephrology Unit, Cnr Clinical Physiology Institute, Ospedale S.M. Annunziata, Firenze - Italy
| | - G. Pelosi
- Dialysis And Nephrology Unit, Cnr Clinical Physiology Institute, Ospedale S.M. Annunziata, Firenze - Italy
| | - F. Pizzarelli
- Dialysis And Nephrology Unit, Cnr Clinical Physiology Institute, Ospedale S.M. Annunziata, Firenze - Italy
| | - T. Cerrai
- Dialysis And Nephrology Unit, Cnr Clinical Physiology Institute, Ospedale S.M. Annunziata, Firenze - Italy
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48
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Ucciferri N, Rocchiccioli S, Comelli L, Marconi M, Ferrari M, Pelosi G, Cecchettini A. Extracellular matrix characterization in plaques from carotid endarterectomy by a proteomics approach. Talanta 2017; 174:341-346. [DOI: 10.1016/j.talanta.2017.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 05/19/2017] [Accepted: 06/02/2017] [Indexed: 11/30/2022]
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49
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Siogkas P, Neglia D, Sakellarios A, Liga R, Pelosi G, Papafaklis M, Niittymaki T, Scholte A, Gaemperli O, Kaufmann P, Parodi O, Michalis L, Fotiadis D, Knuuti J, Anagnostopoulos C. 2178Characterization of functionally significant coronary artery disease by a novel coronary computed tomography angiography based index: a comparison with quantitative PET perfusion. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.2178] [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: 11/14/2022] Open
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50
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Trivella MG, Piersigilli A, Bernini F, Pelosi G, Burchielli S, Puzzuoli S, Kusmic C, L'Abbate A. Percutaneous cardiac support during myocardial infarction drastically reduces mortality: perspectives from a swine model. Int J Artif Organs 2017; 40:338-344. [PMID: 28604999 PMCID: PMC6159849 DOI: 10.5301/ijao.5000604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Accepted: 04/27/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND/AIMS Acute myocardial infarction (AMI) with cardiogenic shock (CS) remains the leading cause of in-hospital death in acute coronary syndromes. In the AMI-CS pig model we tested the efficacy of temporary percutaneous cardiorespiratory assist device (PCRA) in rescuing the failing heart and reducing early mortality. METHODS In open-chest pigs we induced AMI by proximal left anterior descending coronary artery (LAD) ligation. Eight animals without PCRA (C group) were compared with 12 animals otherwise treated with PCRA (T group), starting approximately at 60 minutes post-occlusion and lasting 120-180 minutes. In 3 animals of the T group, regional myocardial oxygen content was also imaged by two-dimensional near infrared spectroscopy (2D-NIRS) with and without PCRA, before and after LAD reperfusion. RESULTS All animals without PCRA died despite unrelenting resuscitation maneuvers (120 minutes average survival time). Conversely, animals treated with PCRA showed a reduction in life-threatening arrhythmia and maintenance of aortic pressure, allowing interruption of PCRA in all cases early in the experiments, with sound hemodynamics at the end of the observation period. During LAD occlusion, NIRS showed severe de-oxygenation of the LAD territory that improved with PCRA. After PCRA suspension and LAD reperfusion, the residual de-oxygenated area proved to be smaller than the initial risk area. CONCLUSIONS In AMI, PCRA initiated during advanced CS drastically reduced early mortality from 100% to 0% in a 4-5 hour observation period. PCRA promoted oxygenation of the ischemic area during LAD occlusion. Results support the use of PCRA as first line of treatment in AMI-CS, improving myocardial rescue and short-term survival.
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Affiliation(s)
| | - Alessandra Piersigilli
- Weill Cornell Medicine, New York City, NY - USA
- />Prof. Alessandra Piersigilli and Dr. Stefano Puzzuoli participated in the study during their PhD at the Scuola Superiore Sant'Anna, Pisa - Italy
| | - Fabio Bernini
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa - Italy
| | | | | | - Stefano Puzzuoli
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa - Italy
- />Prof. Alessandra Piersigilli and Dr. Stefano Puzzuoli participated in the study during their PhD at the Scuola Superiore Sant'Anna, Pisa - Italy
| | | | - Antonio L'Abbate
- CNR Institute of Clinical Physiology, Pisa - Italy
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa - Italy
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