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Spadafora L, Comandini GL, Giordano S, Polimeni A, Perone F, Sabouret P, Leonetti M, Cacciatore S, Cacia M, Betti M, Bernardi M, Zimatore FR, Russo F, Iervolino A, Aulino G, Moscardelli A. Blockchain technology in Cardiovascular Medicine: a glance to the future? Results from a social media survey and future perspectives. Minerva Cardiol Angiol 2024; 72:1-10. [PMID: 37971710 DOI: 10.23736/s2724-5683.23.06457-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
The leverage of digital facilities in medicine for disease diagnosis, monitoring, and medical history recording has become increasingly pivotal. However, the advancement of these technologies poses a significant challenge regarding data privacy, given the highly sensitive nature of medical information. In this context, the application of Blockchain technology, a digital system where information is stored in blocks and each block is linked to the one before, has the potential to enhance existing technologies through its exceptional security and transparency. This paradigm is of particular importance in cardiovascular medicine, where the prevalence of chronic conditions leads to the need for secure remote monitoring, secure data storage and secure medical history updating. Indeed, digital support for chronic cardiovascular pathologies is getting more and more crucial. This paper lays its rationale in three primary aims: 1) to scrutinize the existing literature for tangible applications of blockchain technology in the field of cardiology; 2) to report results from a survey aimed at gauging the reception of blockchain technology within the cardiovascular community, conducted on social media; 3) to conceptualize a web application tailored specifically to cardiovascular care based on blockchain technology. We believe that Blockchain technology may contribute to a breakthrough in healthcare digitalization, especially in the field of cardiology; in this context, we hope that the present work may be inspiring for physicians and healthcare stakeholders.
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Affiliation(s)
- Luigi Spadafora
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Rome, Italy -
| | - Gian L Comandini
- Department of Engineering, Guglielmo Marconi University, Rome, Italy
- Department of Economics and Law, University of Macerata, Macerata, Italy
| | - Salvatore Giordano
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Alberto Polimeni
- Division of Cardiology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Cosenza, Italy
| | - Francesco Perone
- Cardiac Rehabilitation Unit, Villa delle Magnolie Rehabilitation Clinic, Castel Morrone, Caserta, Italy
| | - Pierre Sabouret
- Heart Institute and Action Group, Pitié-Salpétrière, Sorbonne University, Paris, France
- National College of French Cardiologists, Paris, France
| | | | - Stefano Cacciatore
- Department of Geriatrics, Orthopedics and Rheumatology, Sacred Heart Catholic University, Rome, Italy
| | - Michele Cacia
- Cardiology Unit, A.O.U. Renato Dulbecco, Catanzaro, Italy
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Matteo Betti
- Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Marco Bernardi
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | | | | | - Adelaide Iervolino
- Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | - Giovanni Aulino
- Section of Legal Medicine, Department of Health Surveillance and Bioethics, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
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Cozzi O, Maurina M, Cacia M, Bernardini V, Gohar A, Cao D, Mangieri A, Condello F, Leone PP, Sticchi A, Rossi ML, Gasparini G, Stefanini GG, Condorelli G, Reimers B, Colombo A, Regazzoli D. Clinical and procedural outcomes of percutaneous coronary intervention for de novo lesions involving the ostial left circumflex coronary artery. Catheter Cardiovasc Interv 2023; 102:1048-1056. [PMID: 37933728 DOI: 10.1002/ccd.30903] [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: 08/10/2023] [Revised: 10/02/2023] [Accepted: 10/22/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Percutaneous treatment for ostial left circumflex artery (LCx) lesions is known to be associated with suboptimal results. AIMS The present study aims to assess the procedural and long-term clinical outcomes of percutaneous coronary intervention (PCI) for de novo ostial LCx lesions overall and according to the coronary revascularization strategy. METHODS Consecutive patients undergoing PCI with second generation drug eluting stents or drug coated balloons for de novo ostial LCx lesions in three high-volume Italian centers between 2012 and 2021 were retrospectively evaluated. The primary endpoint was target-vessel revascularization (TVR) at 2 years. Secondary endpoints included major adverse cardiovascular and cerebrovascular events (MACCE), target lesion revascularization, myocardial infarction, stroke, all-cause death, and repeat revascularization. RESULTS A total of 366 patients were included in the analysis with a median follow-up of 901 (IQR: 450-1728) days. 79.5% of the patients were male, 33.6% were diabetic, 49.7% had a previous PCI, and 23.1% a prior surgical revascularization. Very ostial LCx stenting was performed in 34.1%, crossover from left main to LCx in 17.3%, and a two-stent strategy in 48.6% of cases, respectively. In the overall population, the incidence of TVR at 2 years was 19.0% while MACCE rate was 25.7%. No major differences in clinical outcomes were found according to the stenting strategy. Use of intracoronary imaging was associated with fewer MACCE (HR: 0.47, 95% CI: 0.25-1.13, p = 0.01), while the diameter of the stent implanted in the ostial LCx was associated with less TVR (HR: 0.43, 95% CI: 0.25-0.75, p = 0.002). CONCLUSIONS Percutaneous revascularization of the ostial LCx is associated with a high rate of TVR, regardless of the stenting strategy. Intracoronary imaging and proper stent sizing may reduce the failure rates.
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Affiliation(s)
- Ottavia Cozzi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital IRCCS, Milan, Italy
| | - Matteo Maurina
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital IRCCS, Milan, Italy
| | - Michele Cacia
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | - Aisha Gohar
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Davide Cao
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Cardiology, Humanitas Gavazzeni, Bergamo, Italy
| | - Antonio Mangieri
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital IRCCS, Milan, Italy
| | - Francesco Condello
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital IRCCS, Milan, Italy
| | - Pier Pasquale Leone
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital IRCCS, Milan, Italy
| | - Alessandro Sticchi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital IRCCS, Milan, Italy
| | | | - Gabriele Gasparini
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital IRCCS, Milan, Italy
| | - Giulio G Stefanini
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital IRCCS, Milan, Italy
| | - Gianluigi Condorelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital IRCCS, Milan, Italy
| | - Bernhard Reimers
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital IRCCS, Milan, Italy
| | - Antonio Colombo
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - Damiano Regazzoli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Research Hospital IRCCS, Milan, Italy
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Cacia M, Cozzi O, Gohar A, Mangieri A, Sorropago G, Pacchioni A, Saccà S, Favero L, Regazzoli D, Reimers B. Different Degrees of Degeneration of Transcatheter Valves Implanted in the Aortic Position or Embolized Distally: A Case Report. Cardiovasc Revasc Med 2023; 53S:S144-S148. [PMID: 36402699 DOI: 10.1016/j.carrev.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Michele Cacia
- Clinical and Interventional Cardiology, Cardiac Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Ottavia Cozzi
- Clinical and Interventional Cardiology, Cardiac Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Aisha Gohar
- Clinical and Interventional Cardiology, Cardiac Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Antonio Mangieri
- Clinical and Interventional Cardiology, Cardiac Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | | | | | - Luca Favero
- Cardiology, ULSS2 Treviso Hospital, Treviso, Italy
| | - Damiano Regazzoli
- Clinical and Interventional Cardiology, Cardiac Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Bernhard Reimers
- Clinical and Interventional Cardiology, Cardiac Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
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Gasparini GL, Bollati M, Chiarito M, Cacia M, Roccasalva F, Ungureanu C, Colletti G, Muraglia S, Merella P, Ugo F, Pacchioni A, Colangelo S, Sanz Sanchez J, Leone PP, Latib A, Mazzarotto P. SUOH 03 Guidewire for the Management of Coronary Artery Dissection: Insights from a Multicenter Registry. J Interv Cardiol 2023; 2023:7958808. [PMID: 37560012 PMCID: PMC10409579 DOI: 10.1155/2023/7958808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/15/2023] [Accepted: 06/23/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND In the setting of coronary artery dissection, both spontaneous and iatrogenic, fixing the intimal tear, usually with stent implantation, can be extremely challenging if the distal wire position has been lost. Common complications are mainly related to the inadvertent subintimal tracking of the guidewire while attempting to gain the distal true lumen. AIMS To report the registry results of using the SUOH 0.3 guidewire for managing coronary artery dissection in a real-world multicenter setting. METHODS The study population in this retrospective, multicenter, international registry included 75 consecutive patients who underwent PCI and required an antegrade wiring of a dissected coronary artery. RESULTS Successful use of SUOH 0.3 was achieved in 69 (92%) patients. The use of a microcatheter was associated with a significantly higher rate of TIMI 3 flow at the end of the procedure (no microcatheter: n = 17, 81%; microcatheter: n = 52, 96.3%; p = 0.017). The first recanalization attempt was made with the SUOH 03 guidewire in 48 (64%) cases, and it was successful in 42 (87%). The overall PCI success rate was reported in 72 (96%) patients, with no significant differences among patients with different origins, mechanisms, and locations of dissection. CONCLUSIONS In this setting, the SUOH 0.3 guidewire provides high procedural success without additional complex techniques.
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Affiliation(s)
| | | | - Mauro Chiarito
- IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | | | | | | | | | | | | | | | | | | | - Jorge Sanz Sanchez
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
- Centro de Investicacion Biomedica en Red Efermedades Coardiovasculares (CIBERCV), Madrid, Spain
| | - Pier Pasquale Leone
- IRCCS Humanitas Research Hospital, Rozzano, Italy
- Montefiore Health System, Bronx, New York City, NY, USA
| | - Azeem Latib
- Montefiore Health System, Bronx, New York City, NY, USA
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Leone PP, Gohar A, Pagnesi M, Mangieri A, Stefanini G, Cacia M, Cozzi O, Barbanti M, Teles R, Adamo M, Taramasso M, De Marco F, Giannini F, Ohno Y, Saia F, Buono A, Ielasi A, Pighi M, Ribichini F, Maffeo D, Bedogni F, Kim WK, Maisano F, Tamburino C, Van Mieghem NM, Colombo A, Reimers B, Latib A, Regazzoli D. Clinical outcomes in women and men with small aortic annuli undergoing transcatheter aortic valve implantation: A multicenter, retrospective, propensity score-matched comparison. Int J Cardiol 2023; 379:16-23. [PMID: 36863420 DOI: 10.1016/j.ijcard.2023.02.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/05/2023] [Accepted: 02/26/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Sex-specific characteristics in patients with aortic stenosis and small annuli undergoing transcatheter aortic valve implantation (TAVI) might affect clinical outcomes and hemodynamics. METHODS TAVI-SMALL 2 international retrospective registry included 1378 patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area < 400 mm2) treated with transfemoral TAVI at 16 high-volume centers between 2011 and 2020. Women (n = 1233) were compared with men (n = 145). One-to-one propensity score (PS) matching resulted in 99 pairs. Primary endpoint was incidence of all-cause mortality. Incidence of pre-discharge severe prosthesis-patient mismatch (PPM) and its association with all-cause mortality were investigated. Binary logistic and Cox regression were performed to adjust the treatment effect for PS quintiles. RESULTS Incidence of all-cause mortality at a median follow-up of 377 days did not differ between sex in the overall (10.3 vs. 9.8%, p = 0.842) and PS-matched (8.5 vs. 10.9%, p = 0.586) populations. After PS matching, pre-discharge severe PPM was numerically higher in women vs. men (10.2 vs. 4.3%), even though no evidence of a difference was found (p = 0.275). Within the overall population, women with severe PPM suffered a higher incidence of all-cause mortality when compared to those with less than moderate PPM (log-rank p = 0.024) and less than severe PPM (p = 0.027). CONCLUSIONS No difference in all-cause mortality at medium-term follow-up was observed between women and men with aortic stenosis and small annuli undergoing TAVI. Incidence of pre-discharge severe PPM was numerically higher in women than men, and it was associated with increased all-cause mortality in women.
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Affiliation(s)
- Pier Pasquale Leone
- Division of Cardiology, Montefiore Medical Center, Bronx, NY, USA; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Aisha Gohar
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Matteo Pagnesi
- Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical specialties, Radiological sciences and Public Health, University of Brescia, Brescia, Italy
| | - Antonio Mangieri
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giulio Stefanini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Michele Cacia
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Ottavia Cozzi
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marco Barbanti
- U.O.C. Cardiologia, Centro Alte Specialità e Trapianti, A.O.U. Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Rui Teles
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Nova Medical School, CEDOC, Lisbon, Portugal
| | - Marianna Adamo
- Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical specialties, Radiological sciences and Public Health, University of Brescia, Brescia, Italy
| | - Maurizio Taramasso
- HerzZentrum Hirslanden Zurich, Switzerland and University of Zurich, Switzerland
| | - Federico De Marco
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Yohei Ohno
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
| | - Francesco Saia
- Cardiology Unit, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Buono
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Alfonso Ielasi
- Clinical and Interventional Unit, Sant'Ambrogio Cardio-Thoracic Center, Milan, Italy
| | - Michele Pighi
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Flavio Ribichini
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Diego Maffeo
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Francesco Bedogni
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Won-Keun Kim
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
| | - Francesco Maisano
- Cardio-Thoracic-Vascular Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Corrado Tamburino
- U.O.C. Cardiologia, Centro Alte Specialità e Trapianti, A.O.U. Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Nicolas M Van Mieghem
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Antonio Colombo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Bernhard Reimers
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Azeem Latib
- Division of Cardiology, Montefiore Medical Center, Bronx, NY, USA.
| | - Damiano Regazzoli
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
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Serratore S, Polimeni A, Mongiardo A, Spaccarotella C, Sorrentino S, Panuccio G, Cacia M, Lucchino A, Scebba J, Durante P, Trapuzzano A, Ciliberto F, De Rosa S, Indolfi C. 812 Prognostic impact of the COAPT inclusion and exclusion criteria in real-world patients with secondary mitral regurgitation undergoing MitraClip implantation. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab149.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aims
The COAPT randomized trial has shown a huge benefit in the survival of patients with s heart failure and functional mitral regurgitation treated with MitraClip. However, patients in COAPT were highly selected and the clinical course in real-world patients with and without fulfilment of the trial inclusion criteria is unclear.
Methods
The present study examined the clinical outcome in consecutive patients with symptomatic moderate-to-severe or severe MR of dominant functional aetiology undergoing MitraClip therapy by the presence of the inclusion criteria of the COAPT trial (left ventricular ejection fraction >20%, left ventricular end-systolic dimension <70 mm, non-commissural primary jet, estimated pulmonary artery systolic pressure <70 mmHg, mitral valve orifice area >4 cm2, no prior mitral valve leaflet surgery or any currently implanted prosthetic mitral valve or any prior transcatheter mitral valve procedure).
Results
The composite endpoint of all-cause mortality or heart failure hospitalization and the endpoint of heart failure hospitalization were analysed. Among 118 patients who underwent MitraClip implantation 61% fulfilled the inclusion criteria of COAPT. The composite endpoint was significantly less frequent (P = 0.05) in patients fulfilling the COAPT selection criteria than in those not fulfilling the criteria, with an estimated 1-year event rate of 25% vs. 49%. Heart failure hospitalization was significantly less frequent (P = 0.04) in patients fulfilling COAPT selection criteria than in those who did not, with an estimated 1-year event rate of 19% vs. 36.8%.
Conclusions
In this single centre study the outcome of patients with functional mitral regurgitation undergoing MitraClip therapy was significantly worse in patients not fulfilling COAPT inclusion criteria, indicating that these criteria might help identify futility.
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Affiliation(s)
- Serena Serratore
- Divisione Di Cardiologia, Università Magna Graecia Di Catanzaro, Italia
| | - Alberto Polimeni
- Divisione Di Cardiologia, Università Magna Graecia Di Catanzaro, Italia
| | | | | | - Sabato Sorrentino
- Divisione Di Cardiologia, Università Magna Graecia Di Catanzaro, Italia
| | - Giuseppe Panuccio
- Divisione Di Cardiologia, Università Magna Graecia Di Catanzaro, Italia
| | - Michele Cacia
- Divisione Di Cardiologia, Università Magna Graecia Di Catanzaro, Italia
| | | | - Jacopo Scebba
- Divisione Di Cardiologia, Università Magna Graecia Di Catanzaro, Italia
| | | | - Albino Trapuzzano
- Divisione Di Cardiologia, Università Magna Graecia Di Catanzaro, Italia
| | | | - Salvatore De Rosa
- Divisione Di Cardiologia, Università Magna Graecia Di Catanzaro, Italia
| | - Ciro Indolfi
- Divisione Di Cardiologia, Università Magna Graecia Di Catanzaro, Italia
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Sorrentino S, Cacia M, Leo I, Polimeni A, Sabatino J, Spaccarotella CAM, Mongiardo A, De Rosa S, Indolfi C. B-Type Natriuretic Peptide as Biomarker of COVID-19 Disease Severity-A Meta-Analysis. J Clin Med 2020; 9:jcm9092957. [PMID: 32932743 PMCID: PMC7564464 DOI: 10.3390/jcm9092957] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/20/2020] [Accepted: 09/08/2020] [Indexed: 12/25/2022] Open
Abstract
Up to 15% of coronavirus disease 2019 (COVID-19) patients experience severe clinical presentation, resulting in acute respiratory distress (ARDS) and finally death. N-terminal natriuretic peptide (NT-proBNP) is associated with a worse prognosis in patients with ARDS. However, whether or not this peptide can help discriminate high-risk COVID-19 patients remains unclear. Therefore, in this meta-analysis, we summarized the available evidence on NT-proBNP in patients admitted for COVID-19. Pooled mean, mean differences (MD) and standardized mean difference (SMD) were the summary metrics. Thirteen studies were finally selected for this analysis with a total of 2248 patients, of which 507 had a severe condition (n = 240) or died (n = 267). Pooled mean NT-proBNP levels on admission were 790.57 pg/mL (95% confidence intervals (CIs): 532.50 to 1048.64) in patients that experienced a severe clinical condition or died, and 160.56 pg/mL (95% CI: 118.15 to 202.96) in non-severe patients (SMD: 1.05; 95% (CI): 0.83 to 1.28; p < 0.001; I2 74%; and MD was 645.84 pg/mL (95% CI: 389.50–902.18). Results were consistent in studies categorizing patients as non-survivors versus survivors (SMD: 1.17; 95% CI 0.95 to 1.40; p < 0. 001; I2: 51%), and in those classifying populations in severe versus non-severe clinical condition (SMD: 0.94 95% CI 0.56 to 1.32; p < 0.001; I2: 81%; pinteraction = 0.30). In conclusion, our results suggest that assessing NT-proBNP may support physicians in discriminating high-risk COVID-19 patients.
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Affiliation(s)
- Sabato Sorrentino
- Division of Cardiology and Center of Cardiovascular Research, Department of Medical and Surgical Sciences, Università Magna Graecia di Catanzaro Viale Europa, 88100 Catanzaro, Italy; (S.S.); (M.C.); (I.L.); (A.P.); (J.S.); (C.A.M.S.); (A.M.); (S.D.R.)
| | - Michele Cacia
- Division of Cardiology and Center of Cardiovascular Research, Department of Medical and Surgical Sciences, Università Magna Graecia di Catanzaro Viale Europa, 88100 Catanzaro, Italy; (S.S.); (M.C.); (I.L.); (A.P.); (J.S.); (C.A.M.S.); (A.M.); (S.D.R.)
| | - Isabella Leo
- Division of Cardiology and Center of Cardiovascular Research, Department of Medical and Surgical Sciences, Università Magna Graecia di Catanzaro Viale Europa, 88100 Catanzaro, Italy; (S.S.); (M.C.); (I.L.); (A.P.); (J.S.); (C.A.M.S.); (A.M.); (S.D.R.)
| | - Alberto Polimeni
- Division of Cardiology and Center of Cardiovascular Research, Department of Medical and Surgical Sciences, Università Magna Graecia di Catanzaro Viale Europa, 88100 Catanzaro, Italy; (S.S.); (M.C.); (I.L.); (A.P.); (J.S.); (C.A.M.S.); (A.M.); (S.D.R.)
| | - Jolanda Sabatino
- Division of Cardiology and Center of Cardiovascular Research, Department of Medical and Surgical Sciences, Università Magna Graecia di Catanzaro Viale Europa, 88100 Catanzaro, Italy; (S.S.); (M.C.); (I.L.); (A.P.); (J.S.); (C.A.M.S.); (A.M.); (S.D.R.)
| | - Carmen Anna Maria Spaccarotella
- Division of Cardiology and Center of Cardiovascular Research, Department of Medical and Surgical Sciences, Università Magna Graecia di Catanzaro Viale Europa, 88100 Catanzaro, Italy; (S.S.); (M.C.); (I.L.); (A.P.); (J.S.); (C.A.M.S.); (A.M.); (S.D.R.)
| | - Annalisa Mongiardo
- Division of Cardiology and Center of Cardiovascular Research, Department of Medical and Surgical Sciences, Università Magna Graecia di Catanzaro Viale Europa, 88100 Catanzaro, Italy; (S.S.); (M.C.); (I.L.); (A.P.); (J.S.); (C.A.M.S.); (A.M.); (S.D.R.)
| | - Salvatore De Rosa
- Division of Cardiology and Center of Cardiovascular Research, Department of Medical and Surgical Sciences, Università Magna Graecia di Catanzaro Viale Europa, 88100 Catanzaro, Italy; (S.S.); (M.C.); (I.L.); (A.P.); (J.S.); (C.A.M.S.); (A.M.); (S.D.R.)
| | - Ciro Indolfi
- Division of Cardiology and Center of Cardiovascular Research, Department of Medical and Surgical Sciences, Università Magna Graecia di Catanzaro Viale Europa, 88100 Catanzaro, Italy; (S.S.); (M.C.); (I.L.); (A.P.); (J.S.); (C.A.M.S.); (A.M.); (S.D.R.)
- Mediterranea Cardio Center, 80122 Naples, Italy
- Correspondence: ; Tel.: +39-0961-3647067
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Gnasso A, Cacia M, Cutruzzolà A, Minieri M, Carallo C, Cortese C, Irace C. Influence of acute reduction of blood viscosity on endothelial function. Clin Hemorheol Microcirc 2019; 72:239-245. [PMID: 30909194 DOI: 10.3233/ch-180446] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The relationship between blood viscosity (BV) and endothelial function is rather complex. An increase in BV causes an increase in blood flow resistance, with negative hemodynamic effects; on the other hand, a moderate increase in BV causes an increase in wall stress shear (WSS), and consequent beneficial effects. As a matter of fact, the effect of changes in BV on endothelial function is not yet clear. OBJECTIVES Aim of the present study was to evaluate in-vivo the effects of the acute reduction in BV on endothelial function, in healthy male subjects. METHODS Fourteen healthy male blood donors were studied before and 48 hours after blood donation. Blood and plasma viscosity were measured at 37C° with a cone-plate viscometer. Endothelial function was evaluated through flow mediated vasodilation (FMD). RESULTS Blood viscosity was reduced after blood donation (BV225 (cP) 4.53±0.59 vs.4.18±0.31, p < 0.05). FMD 50 s after cuff deflation was unchanged: 6.23±3.84 vs. 6.62±4.81, p = NS. The vasodilation, however, lasted longer and the area under the curve of FMD was significantly increased: 8.74±8.77 vs.16.14±8.65, p < 0.005. CONCLUSIONS The present results demonstrate that the acute reduction of BV prolongs vasodilation, without affecting the amount of vasodilatation, possibly as adaptive reaction allowing more time for oxygen release.
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Gnasso A, Cacia M, Cortese C, Succurro E, Andreozzi F, Carallo C, Irace C. No effect on the short-term of a decrease in blood viscosity on insulin resistance. Clin Hemorheol Microcirc 2018; 68:45-50. [PMID: 29036798 DOI: 10.3233/ch-170288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Blood viscosity (BV) might influence glucose delivery to peripheral tissues and play an important role in insulin resistance and diabetes mellitus. However, the exact relationship between BV and insulin resistance is not yet clear. OBJECTIVES Aim of the present study is to evaluate the effects of the acute reduction in BV on insulin resistance, in healthy male subjects. METHODS Fifteen healthy male blood donors have been studied before and 48 hours after blood donation. Blood and plasma viscosity have been measured at 37°C with a cone-plate viscometer. Insulin resistance has been evaluated by euglycemic/hyperinsulinemic clamp in eight subjects, and by iHOMA2 Index in further seven subjects. RESULTS Blood viscosity was markedly reduced after blood donation (BV225 (cP) 4.53 ± 0.59 vs. 4.18 ± 0.31, p < 0.05). Insulin resistance was unchanged: MFFM clamp: 5.6 ± 4.5vs. 4.4 ± 2.2 and iHOMA2 Index 1.2 ± 0.6 vs. 1.2 ± 0.5, before vs. after respectively, p = NS. Blood pressure and lipids were unchanged after blood donation. CONCLUSIONS The present results demonstrate that acute reduction of BV in healthy male subjects does not change the insulin resistance, measured using both euglycemic/hyperinsulinemic clamp and iHOMA2 Index. Further intervention studies are needed to assess the effect that the reduction in BV can have in subjects with insulin resistance.
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Affiliation(s)
- Agostino Gnasso
- Department of Experimental and Clinical Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Michele Cacia
- Department of Experimental and Clinical Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Claudio Cortese
- Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Claudio Carallo
- Department of Experimental and Clinical Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Concetta Irace
- Department of Health Science, Magna Græcia University of Catanzaro, Catanzaro, Italy
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