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Muscoli S, Lecis D, Prandi FR, Ylli D, Chiocchi M, Cammalleri V, Lauro D, Andreadi A. Risk of sudden cardiac death in a case of spontaneous coronary artery dissection presenting with thyroid storm. Eur Rev Med Pharmacol Sci 2022; 26:3712-3717. [PMID: 35647853 DOI: 10.26355/eurrev_202205_28867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Spontaneous coronary artery dissection (SCAD) is a spontaneous separation of the coronary artery wall whose etiology appears to be poorly understood. SCAD is a rare cause of acute coronary syndromes, and it is a life-threatening condition. CASE REPORT We report the case of a young woman who developed SCAD during a thyroid storm (TS). RESULTS To the best of our knowledge, this is the first reported case of SCAD during a TS, and it suggests a possible association between high levels of circulating thyroid hormones and SCAD susceptibility. CONCLUSIONS Early identification of SCAD predisposing factors is important to identify high-risk patients. In patients presenting to the emergency department because of chest pain with a history of dysthyroidism, early determination of thyroid hormones and troponin could prevent certain forms of sudden cardiac death.
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Affiliation(s)
- S Muscoli
- Division of Cardiology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Di Donna C, Cavallo AU, Pugliese L, Ricci F, De Stasio V, Presicce M, Spiritigliozzi L, Di Tosto F, Di Luozzo M, Muscoli S, Benelli L, D'Errico F, Pasqualetto M, Sbordone FP, Grimaldi F, Meschini V, Verzicco R, Romeo F, Floris R, Chiocchi M. Anatomic features in SCAD assessed by CCT: A propensity score matching case control study. Ann Cardiol Angeiol (Paris) 2021; 70:161-167. [PMID: 33958189 DOI: 10.1016/j.ancard.2021.01.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/28/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Spontaneous coronary artery dissection (SCAD) may occur in middle age population without any cardiovascular risk factor. We retrospectively evaluated anatomic features of 11 patients with SCAD using a coronary arteries computed tomography (CCT), compared to age and sex balanced patients who underwent CCT. MATERIAL AND METHODS CCT was performed in 11 patients (7 females and 4 males) as follow-up in patients with SCAD (left anterior descending - LAD or circumflex artery - Cx) and compared, using the propensity score matching analysis, with 11 healthy patients. Several anatomic features were evaluated: Left main (LM) length, angle between descending coronary artery (LAD) and its first branch, angle between LAD and LM, distance from the annulus to RCA (a-RCA distance) and LM (a-LM distance) ostia and their ratio; ratio between LM length and length a-LM and tortuosity score of the vessel with SCAD. A fluid dynamic analysis has been performed to evaluate the effects on shear stress of vessels wall. RESULTS LM length was significantly shorter in patients with SCAD versus healthy subjects (P=0.01) as well as LM length/a-LM (P=0.03) and the angle between LAD and the first adjacent branch was sharper (P<0.01). Tortuosity score showed a statistically significant difference between groups (P<0.001). Fluid dynamic analysis demonstrates that, in SCAD group, an angle<90 degree is present at the first bifurcation and it can be a cause of increased strain on vessel wall in patients with high tortuosity of coronary artery. CONCLUSION Tortuosity and angle between the LAD and the adjacent arterial branch combined may determine increased shear stress on the vessel wall that increases the risk of SCAD.
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Affiliation(s)
- C Di Donna
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - A U Cavallo
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - L Pugliese
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - F Ricci
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - V De Stasio
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - M Presicce
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - L Spiritigliozzi
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - F Di Tosto
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - M Di Luozzo
- Division of Cardiology, University Hospital Policlinico "Tor Vergata", Rome, Italy.
| | - S Muscoli
- Division of Cardiology, University Hospital Policlinico "Tor Vergata", Rome, Italy.
| | - L Benelli
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - F D'Errico
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - M Pasqualetto
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - F P Sbordone
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - F Grimaldi
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - V Meschini
- Postdoctoral researcher at university of Roma Tor Vergata, Rome, Italy.
| | - R Verzicco
- Department of Industrial Engineering, Università di Roma "Tor Vergata", Rome, Italy.
| | - F Romeo
- Division of Cardiology, University Hospital Policlinico "Tor Vergata", Rome, Italy.
| | - R Floris
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
| | - M Chiocchi
- Division of Radiology, University Hospital Policlinico "Tor Vergata", Viale Oxford, 81, 00133 Rome, Italy.
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Rizza S, Coppeta L, Grelli S, Ferrazza G, Chiocchi M, Vanni G, Bonomo OC, Bellia A, Andreoni M, Magrini A, Federici M. High body mass index and night shift work are associated with COVID-19 in health care workers. J Endocrinol Invest 2021; 44:1097-1101. [PMID: 32852704 PMCID: PMC7450678 DOI: 10.1007/s40618-020-01397-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/15/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the magnitude of COVID-19 spread and the associated risk factors among health care workers (HCWs), we conducted an in-hospital survey in a central Italian COVID Hospital. METHODS Participants underwent nasopharyngeal swab and/or serum collection for SARS-CoV-2 IgG examination. We divided participants according to working status, into rotating-night shift workers (r-NSW) and day-workers. RESULTS We found 30 cases of COVID-19 infection in a total of 1180 HCWs (2.5%). Most COVID-19-positive hospital employees were r-NSWs with significantly higher BMI than that of individuals who tested negative. After adjustment for covariates, night work and BMI > 30 were associated with a markedly greater risk of COVID-19 diagnosis (OR 3.049 [95%CI 1.260-7.380] and OR 7.15 [95%CI 2.91-17.51], respectively). CONCLUSIONS Our results describe a low prevalence of COVID-19 infection among HCWs at a central Italian COVID Hospital. COVID-19 infection risk appears to be associated with obesity and night shift work, thus supporting the need for careful health surveillance among frontline HCWs exposed to COVID-19.
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Affiliation(s)
- S Rizza
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
| | - L Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - S Grelli
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - G Ferrazza
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - M Chiocchi
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - G Vanni
- Department of Surgical Science, University of Rome Tor Vergata, Rome, Italy
| | - O C Bonomo
- Department of Surgical Science, University of Rome Tor Vergata, Rome, Italy
| | - A Bellia
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - M Andreoni
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - A Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - M Federici
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
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Acconcia MC, Caretta Q, Monzo L, Tanzilli G, Sili Scavalli A, Sergi D, Di Luozzo M, Marchei M, Chiocchi M, Romeo F, Gaudio C. Effectiveness of the new generation transcatheter aortic valve in the real life studies. Review and meta-analysis. Eur Rev Med Pharmacol Sci 2020; 23:8018-8027. [PMID: 31599427 DOI: 10.26355/eurrev_201909_19018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of the meta-analysis was to assess post-procedural outcome of the new generation of transcatheter aortic valve implantation (TAVI) devices, focusing on the transfemoral and balloon-expandable SAPIEN 3 (Edwards Lifesciences Inc., Irvine, CA, USA), the self-expanding CoreValveTM Evolut series R and PRO (R/PRO)TM (Medtronic Inc., Minneapolis, MN, USA) and ACURATE neoTM transcatheter aortic valve (Symetis SA, a Boston Scientific company, Ecublens, Switzerland). MATERIALS AND METHODS All observational studies were retrieved through PubMed computerized database from January 2014 until June 30th, 2019. The risk difference (RD) with the 95% confidence interval (CI) was used to assess the effectiveness of the intervention under comparison. The primary end point was 30-day mortality. Safety end points included: (i) stroke, (ii) moderate/severe paravalvular leak, and (iii) the need for new permanent pacemaker implantation. RESULTS Meta-analysis demonstrated no significant differences as regards to either 30-day mortality or stroke for all the groups of prostheses under comparison. ACURATE neo was associated with significantly less new permanent pacemaker implantation compared to SAPIEN 3 (RD: -0.06; 95% CI -0.08 to -0.03; p<0.0001; I2=0%) or to EVOLUT R/PRO (RD: -0.06; 95% CI -0.09 to -0.02; p=0.0009; I2=0%). A significant reduction of new permanent pacemaker need was observed in the group of patients implanted with SAPIEN 3 compared to EVOLUT R/PRO (RD: -0.07; 95% CI -0.09 to -0.04; p<0.00001; I2=7%). The occurrence of moderate/severe leak was significantly increased in the group of patients implanted with ACURATE neo vs. SAPIEN 3 (RD: 0.04; 95% CI 0.02 to 0.05; p<0.00001; I2=0%). No significant differences were found between ACURATE neo vs. EVOLUT R/PRO (RD: -0.01; 95% CI -0.04 to 0.02; p=0.69; I2=0%) and between SAPIEN 3 vs. EVOLUT R/PRO (RD: -0.01; 95% CI -0.04 to 0.01; p=0.28; I2=73%). CONCLUSIONS The results of the meta-analysis show that: (1) ACURATE neo was associated with significantly less new permanent pacemaker implantation than SAPIEN 3 and EVOLUT R/PRO; (2) SAPIEN 3 had significantly lower occurrence of moderate/severe valvular leak than ACURATE neo.
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Affiliation(s)
- M C Acconcia
- Department of Cardiovascular Disease, "Sapienza" University of Rome, Rome, Italy.
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Sergi D, Acconcia MC, Muscoli S, Perrone MA, Cammalleri V, Di Luozzo M, Marchei M, Giannoni MF, Barillà F, Gaudio C, Chiocchi M, Romeo F, Caretta Q. Meta-analysis of the impact on early and late mortality of TAVI compared to surgical aortic valve replacement in high and low-intermediate surgical risk patients. Eur Rev Med Pharmacol Sci 2019; 23:5402-5412. [PMID: 31298393 DOI: 10.26355/eurrev_201906_18209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE We studied the impact of transcatheter aortic valve implantation (TAVI) compared to the surgical aortic valve replacement (SAVR) on 30-day and one-year mortality from randomized controlled trials (RCTs) in patients with severe aortic stenosis at high or low-intermediate surgical risk. MATERIALS AND METHODS All RCTs were retrieved through PubMed computerized database and the site https://www.clinicaltrials.gov from January 2010 until March 31st, 2019. The absolute risk reduction (RD) with the 95% confidence interval (CI) was used to assess the effectiveness of the intervention under comparison. We evaluated overall mortality rates at 30-day and one-year follow-up in the comparison between TAVI vs. SAVR. We also evaluated the role played by the site access for TAVI performed through the femoral or subclavian artery (TV-TAVI) vs. SAVR, or transapically (TA-TAVI) vs. SAVR. RESULTS In the "as-treated population" the overall 30-day mortality was significantly lower in TAVI (p=0.03) with respect to SAVR. However, the analysis for TAVI subgroups showed that 30-day mortality was (1) significantly lower in TV-TAVI vs. SAVR (p=0.006), (2) increased, not significantly, in TA-TAVI vs. SAVR (p=0.62). No significant differences were found between TAVI vs. SAVR at one-year follow-up. CONCLUSIONS The results of our meta-analysis suggest that TV-TAVI is a powerful tool in the treatment of severe aortic stenosis at high or low-intermediate surgical risk, with a significant lower mortality with respect to SAVR. On the contrary, SAVR seems to provide better results than TA-TAVI.
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Affiliation(s)
- D Sergi
- Department of Cardiovascular Disease, University of Rome "Tor Vergata", Rome, Italy.
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Bertoldo F, Pisano C, Nardi P, Donzelli C, Laganà G, Salehi B, Sangiuolo F, Bollero P, De Maio F, Mancino R, Chiocchi M, De Stefano A, Cozza P, Ruvolo G, Novelli G. EP34 ROLE OF SPECIALIZED CENTRE AND TEAMWORK IN THE DIAGNOSIS OF MARFAN SYNDROME AND PREVENTION OF ACUTE AORTIC DISSECTION. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549994.53432.00] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Angelini F, Corrente S, Romiti M, Moschese V, Polito A, Chiocchi M, Monteferrario E, Masala S, Chini L. Lack of Systemic Side Effects of Long-Term Inhaled Fluticasone Propionate Use in a Cohort of Asthmatic Children. EUR J INFLAMM 2013. [DOI: 10.1177/1721727x1301100132] [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: 11/16/2022] Open
Abstract
Inhaled corticosteroids (ICS) are established as first-line therapy for persistent asthma in children. Fluticasone propionate (FP) has been used because it has equivalent efficacy when used at half-dose of older-generation ICS and has a comparable safety profile. However, concerns persist about the potential risk of adverse effects of long-term FP therapy on childhood growth, bone, adrenal function and immune system. To evaluate the potential adverse effects of FP, we analyzed growth, glucidic metabolism, hypothalamic-pituitary-adrenal axis, bone metabolism, bone mass density and immune system in a cohort of 19 children (average 102±18 months), with asthma who were in treatment with FP (average duration: 14 months, range: 11–17 months). Of these, 11 children homogenous for control of asthma symptoms, and compliance to therapy, were selected for a prospective study during which they were treated with FP250 mg/day for further 6 months (total period of treatment average duration: 22 months, range: 18–23 months). In all children, no alterations of growth, glucidic metabolism, hypothalamic-pituitary-adrenal axis, bone metabolism, bone mass density, immune system nor severe exacerbation of the disease were observed. Our study, showing that FP was able to control the symptoms of asthma and confirming the lack of systemic side effects at the recommended doses, supports its long-term use in children with asthma.
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Affiliation(s)
- F. Angelini
- Division of Pediatrics, University of Rome “Tor Vergata”, Rome, Italy
- Immunology, Allergy and Rheumatology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - S. Corrente
- Division of Pediatrics, University of Rome “Tor Vergata”, Rome, Italy
- Pediatric Allergology and Immunology Division, Policlinico Tor Vergata, University of Rome “Tor Vergata”, Rome, Italy
| | - M.L. Romiti
- Division of Pediatrics, University of Rome “Tor Vergata”, Rome, Italy
| | - V. Moschese
- Division of Pediatrics, University of Rome “Tor Vergata”, Rome, Italy
- Pediatric Allergology and Immunology Division, Policlinico Tor Vergata, University of Rome “Tor Vergata”, Rome, Italy
| | - A. Polito
- Pediatric Allergology and Immunology Division, Policlinico Tor Vergata, University of Rome “Tor Vergata”, Rome, Italy
| | - M. Chiocchi
- Department of Radiology, Policlinico Tor Vergata, University of Rome “Tor Vergata”, Rome, Italy
| | - E. Monteferrario
- Pediatric Allergology and Immunology Division, Policlinico Tor Vergata, University of Rome “Tor Vergata”, Rome, Italy
| | - S. Masala
- Department of Radiology, Policlinico Tor Vergata, University of Rome “Tor Vergata”, Rome, Italy
| | - L. Chini
- Division of Pediatrics, University of Rome “Tor Vergata”, Rome, Italy
- Pediatric Allergology and Immunology Division, Policlinico Tor Vergata, University of Rome “Tor Vergata”, Rome, Italy
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Gandini R, Angelopoulos G, Konda D, Messina M, Chiocchi M, Perretta T, Simonetti G. Transcatheter Embolization of a Large Symptomatic Pelvic Arteriovenous Malformation with Glubran 2 Acrylic Glue. Cardiovasc Intervent Radiol 2007; 31:1030-3. [PMID: 17968618 DOI: 10.1007/s00270-007-9224-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2007] [Revised: 09/21/2007] [Accepted: 10/08/2007] [Indexed: 11/24/2022]
Affiliation(s)
- R Gandini
- Interventional Radiology Department, University Hospital of Rome Tor Vergata, Rome, Italy
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