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Annone U, Omede' P, D'Ascenzo F, Montefusco A, Milan A, Moretti C, Grosso Marra W, Veglio F, Gaita F. P4355Echocardiographic estimation of right ventricle wall tension: hemodynamic comparison and long term follow up. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0762] [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
Introduction
Prognosis in pulmonary hypertension (PH) is strictly linked to right ventricle (RV) failure, which results from uncoupling between RV and the superimposed pressure load; in first phases, coupling between these two actors still be preserved, at the price of augmented right ventricle wall tension (RVWT).
Purpose
We sought to describe how to estimate RVWT with echocardiography, how it correlates with RV hemodynamics and if it may predict prognosis.
Methods
A total of 190 patients without overt RV failure, with suspected pulmonary hypertension (PH) to a previous echocardiography, underwent to right heart catheterization (RHC) and nearly-simultaneous echocardiography. We estimated RVWT according to Laplace law (RV length × tricuspid regurgitation peak gradient [TRPG]), in order to predict initial RV stress, and was correlated with RV hemodynamic profile; its potential prognostic impact was tested along with canonical RV function parameters.
Results
In patients enrolled in our study, RVWT correlated significantly with invasive estimation of right ventricle end diastolic pressure (R 0.343, p<0.001); a significant relationship between RVWT and several hemodynamic variables was observed (mean pulmonary artery pressure, pulmonary artery compliance, transpulmonary gradient, pulmonary vascular resistance, RV telediastolic pressure, right atrial pressure, RV stroke work index; all p<0.001). At a mean follow up of five years and three months, only RVWT predicted all-cause mortality (p 0.036), while TAPSE, TAPSE/TRPG, RV fractional area change and RV S' wave did not.
Correlation: RWVT and RV hemodynamic Hemodynamic variable R R2 p value Mean pulmonary artery pressure 0.742 0.550 <0.001 RV differential pressure 0.794 0.630 <0.001 Pulmonary artery pulsatory pressure 0.740 0.547 <0.001 Mean right atrium pressure 0.326 0.106 <0.001 Cardiac index/right atrial pressure 0.209 0.044 0.012 RV stroke work index 0.588 0.346 <0.001 Pulmonary artery compliance 0.449 0.202 <0.001 Pulmonary vascular resistance 0.531 0.282 <0.001
Prognosis: different RV variables
Discussion
We identified a novel bedside echocardiographic predictor of altered RV hemodynamic, which results precociously altered in patients without overt RV failure, and able to predict all cause mortality at a long term follow up. Further studies are needed to confirm its role in PH patients.
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Affiliation(s)
- U Annone
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Division of Cardiology and Cardiovascular Diseases, Turin, Italy
| | - P Omede'
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Division of Cardiology and Cardiovascular Diseases, Turin, Italy
| | - F D'Ascenzo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Division of Cardiology and Cardiovascular Diseases, Turin, Italy
| | - A Montefusco
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Division of Cardiology and Cardiovascular Diseases, Turin, Italy
| | - A Milan
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Division of Internal Medicine, Turin, Italy
| | - C Moretti
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Division of Cardiology and Cardiovascular Diseases, Turin, Italy
| | - W Grosso Marra
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Division of Cardiology and Cardiovascular Diseases, Turin, Italy
| | - F Veglio
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Division of Internal Medicine, Turin, Italy
| | - F Gaita
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Division of Internal Medicine, Turin, Italy
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Angelini F, De Filippo O, D'Ascenzo F, Cerrato E, Omede' P, Escaned J, Sheiban I, Cortese B, Trabattoni D, Helft G, Mattesini A, Lusher TF, Biole' C, Giustetto C, Rinaldi M. P2690Safety and effectiveness of thin-strut DES for bifurcated coronary lesions not involving left main: a RAIN (veRy thin stents for patients with left mAIn or bifurcatioN in real life) sub-analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1008] [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
Thinner stent struts of new DES (drug eluting stent) are associated with shorter time of reendothelialization, a reduction of shear stress and inflammation of coronary walls. Despite this great innovations their clinical safety and efficacy in challenging scenarios as non left main bifurcation coronary lesions has not been tested.
Methods
RAIN is a multicenter registry enrolling patients treated on bifurcated coronary lesions and left main with thin-strut DES. Baseline characteristics and procedural data were recorded. Target lesion revascularization (TLR) was the primary endpoint, whereas major adverse clinical events (MACE; composite of all-cause death, myocardial infarction (MI), target vessel revascularization (TVR), TLR and stent thrombosis (ST)) along with its single components were the secondary endpoints. A multivariate analysis to identify predictors of TLR and sub-analysis according to stenting strategy (provisional vs 2-stent technique), use of final kissing balloon (FKB) and IVUS/OCT optimization were performed.
Results
Data from 1803 patients (59% ACS, 61% stable CAD) treated on bifurcations were retrospectively evaluated. Follow up was available for 1685 (94%) patients for a median of 12 months (IQR 7–18). TLR occurred globally in 2.5% of cases (2.2% in provisional stenting, 3.5% in 2-stent technique). The rate of MACE was 9.4%, whereas all-cause death and MI, occurred in 4.1% and 3.2% of cases respectively. TVR and definite ST incidence were 3.7% and 1.1%. At multivariate analysis, chronic kidney disease (CKD) negatively influenced the main endpoint (HR 1.95, 95% CI 1.06–3.6, p=0.03), whereas post-dilatation (HR 0.56, 95% CI 0.3–0.93, p=0.04) and provisional stenting resulted being protective factors. FKB reduced TLR occurrence at FU only in 2-stent technique (p=0.03), whereas intracoronary imaging (performed in 29% of patients) were uninfluential.
Conclusion
Very thin-strut DES represents a highly effective solution in bifurcation lesions. The risk of TLR is reduced by post-dilatation and provisional stenting. FKB is recommended in 2-stent technique, whereas further studies are required to address the impact of intracoronary imaging in this setting.
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Affiliation(s)
- F Angelini
- Città della Salute e della Scienza Hospital, Division of Cardiology, Turin, Italy
| | - O De Filippo
- Città della Salute e della Scienza Hospital, Division of Cardiology, Turin, Italy
| | - F D'Ascenzo
- Città della Salute e della Scienza Hospital, Division of Cardiology, Turin, Italy
| | - E Cerrato
- Degli Infermi Hospital, Division of Cardiology, Rivoli, Italy
| | - P Omede'
- Città della Salute e della Scienza Hospital, Division of Cardiology, Turin, Italy
| | - J Escaned
- Hospital Clinic San Carlos, Madrid, Spain
| | - I Sheiban
- Dr. Pederzoli Clinic, Cardiology, Peschiera del Garda, Italy
| | - B Cortese
- Fatebenefratelli Hospital, Division of Cardiology, Milan, Italy
| | - D Trabattoni
- Cardiology Center Monzino IRCCS, Division of Cardiology, Milan, Italy
| | - G Helft
- Hospital Pitie-Salpetriere, Division of Cardiology, Paris, France
| | - A Mattesini
- Careggi University Hospital (AOUC), Division of Cardiology, Florence, Italy
| | - T F Lusher
- Royal Brompton and Harefield NHS Foundation Trust, Division of Cardiology, Middlesex, United Kingdom
| | - C Biole'
- Città della Salute e della Scienza Hospital, Division of Cardiology, Turin, Italy
| | - C Giustetto
- Città della Salute e della Scienza Hospital, Division of Cardiology, Turin, Italy
| | - M Rinaldi
- Città della Salute e della Scienza Hospital, Cardiac Surgery, Turin, Italy
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Peyracchia M, Verardi M, Montrucchio C, Perl L, Grossomarra W, Calcagno A, Omede' P, Montefusco A, Bonora S, Moretti C, D'Amico M, D'Ascenzo F. P2692In-hospital and long-term outcomes of HIV-positive patients undergoing PCI according to kind of stent: A meta-analysis. Short title: Outcomes of HIV positive patients undergoing PCI: A meta-analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2692] [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)
- M Peyracchia
- Hospital 'Città della Salute e della Scienza di Torino', Division of Cardiology, Departement of Internal Medicine, Turin, Italy
| | - M Verardi
- Hospital 'Città della Salute e della Scienza di Torino', Division of Cardiology, Departement of Internal Medicine, Turin, Italy
| | - C Montrucchio
- University of Turin, Division of Infectious Disease, Turin, Italy
| | - L Perl
- Tel Aviv University, Rubin Medical Center, Cardiology Department, Tel Aviv, Israel
| | - W Grossomarra
- Hospital 'Città della Salute e della Scienza di Torino', Division of Cardiology, Departement of Internal Medicine, Turin, Italy
| | - A Calcagno
- University of Turin, Division of Infectious Disease, Turin, Italy
| | - P Omede'
- Hospital 'Città della Salute e della Scienza di Torino', Division of Cardiology, Departement of Internal Medicine, Turin, Italy
| | - A Montefusco
- Hospital 'Città della Salute e della Scienza di Torino', Division of Cardiology, Departement of Internal Medicine, Turin, Italy
| | - S Bonora
- Hospital 'Città della Salute e della Scienza di Torino', Division of Cardiology, Departement of Internal Medicine, Turin, Italy
| | - C Moretti
- Hospital 'Città della Salute e della Scienza di Torino', Division of Cardiology, Departement of Internal Medicine, Turin, Italy
| | - M D'Amico
- Hospital 'Città della Salute e della Scienza di Torino', Division of Cardiology, Departement of Internal Medicine, Turin, Italy
| | - F D'Ascenzo
- Hospital 'Città della Salute e della Scienza di Torino', Division of Cardiology, Departement of Internal Medicine, Turin, Italy
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Scacciatella P, Jorfida M, Omede P, Budano C, Castagno D, Zema D, Gagliardi M, Biava L, Meynet I, Gaita F. P4889Insertable cardiac monitor in older patients candidates to percutaneous PFO closure. Preliminary results of a perspective registry study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p4889] [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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Moretti C, De Simone V, D'Ascenzo F, Sciuto F, Omede P, Di Cuia M, Colaci C, Biondi Zoccai G, Sheiban I, Gaita F. Long term outcomes in patients who underwent percutaneous coronary intervention on left main coronary artery according to clinical and angiographic scores. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4799] [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: 11/12/2022] Open
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Lionetti M, Musto P, Di Martino MT, Fabris S, Agnelli L, Todoerti K, Tuana G, Mosca L, Gallo Cantafio ME, Grieco V, Bianchino G, D'Auria F, Statuto T, Mazzoccoli C, De Luca L, Petrucci MT, Offidani M, Di Raimondo F, Falcone A, Caravita T, Omede' P, Morabito F, Tassone P, Boccadoro M, Palumbo A, Neri A. Biological and clinical relevance of miRNA expression signatures in primary plasma cell leukemia. Clin Cancer Res 2013; 19:3130-42. [PMID: 23613318 DOI: 10.1158/1078-0432.ccr-12-2043] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Primary plasma cell leukemia (pPCL) is a rare and very aggressive form of plasma cell dyscrasia. To date, no information on microRNA (miRNA) expression in pPCL has been reported. This study aimed at investigating the involvement of miRNAs in pPCL and their possible relationship with higher tumor aggressiveness. EXPERIMENTAL DESIGN Global miRNA expression profiles were analyzed in highly purified malignant plasma cells from 18 pPCL untreated patients included in a prospective clinical trial. MiRNA expression patterns were evaluated in comparison with a representative series of multiple myeloma patients, in relation to the most recurrent chromosomal abnormalities (as assessed by fluorescence in situ hybridization and single-nucleotide polymorphism-array analysis), and in association with clinical outcome. MiRNA expression was also integrated with gene expression profiles in pPCL and multiple myeloma samples. RESULTS We identified a series of deregulated miRNAs in pPCL (42 upregulated and 41 downregulated) in comparison with multiple myeloma. Some of them, on the basis of their reported functions and putative target genes computed by integrative analysis, might have a role in the pathobiology of pPCL. As regards chromosomal aberrations, the expression of some miRNAs mapped to hotspot altered regions was associated with DNA copy number of the corresponding loci. Finally, 4 miRNA (miR-497, miR-106b, miR-181a*, and miR-181b) were identified as having expression levels that correlated with treatment response, and 4 (miR-92a, miR-330-3p, miR-22, and miR-146a) with clinical outcome. CONCLUSIONS Overall, our study provides insights into the possible contribution of miRNAs in the pathogenesis of pPCL and suggests targets for future therapeutic investigations.
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Affiliation(s)
- Marta Lionetti
- Department of Clinical Sciences and Community Health, University of Milan, Hematology 1 CTMO, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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Todoerti K, Agnelli L, Fabris S, Lionetti M, Tuana G, Mosca L, Lombardi L, Grieco V, Bianchino G, D'Auria F, Statuto T, Mazzoccoli C, De Luca L, Petrucci MT, Morabito F, Offidani M, Di Raimondo F, Falcone A, Omede' P, Tassone P, Boccadoro M, Palumbo A, Neri A, Musto P. Transcriptional Characterization of a Prospective Series of Primary Plasma Cell Leukemia Revealed Signatures Associated with Tumor Progression and Poorer Outcome. Clin Cancer Res 2013; 19:3247-58. [DOI: 10.1158/1078-0432.ccr-12-3461] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Musto P, Pagano L, Petrucci MT, Morabito F, Caravita T, Di Raimondo F, Baldini L, Tosi P, Bringhen S, Offidani M, Omede' P, Neri A, D'Auria F, Bochicchio GB, Cavo M, Boccadoro M, Palumbo A. Primary plasma cell leukemia in the era of new drugs: has something changed? Crit Rev Oncol Hematol 2011; 82:141-9. [PMID: 21719304 DOI: 10.1016/j.critrevonc.2011.04.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2011] [Revised: 03/20/2011] [Accepted: 04/14/2011] [Indexed: 12/16/2022] Open
Abstract
Primary plasma cell leukemia (PPCL) is a rare and aggressive variant of multiple myeloma. This disease is associated with a very poor prognosis, and unfortunately it has not significantly improved during the last three decades. Autologous stem cell transplantation is generally recommended in eligible patients, but survival in transplanted PPCL patients is significantly lower than that of multiple myeloma. Recent preliminary data indicate that new drugs, in particular lenalidomide and bortezomib, could significantly improve the clinical outcome of PPCL, increasing response rate and duration, as well as survival. In this review we report an updated literature analysis about the current therapeutic scenario of PPCL, with a particular focus on the use of novel agents.
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Affiliation(s)
- Pellegrino Musto
- Department of Onco-Hematology, IRCCS, Referral Cancer Center of Basilicata, Rionero in Vulture (Pz), Italy. ,
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Rawstron AC, Orfao A, Beksac M, Bezdickova L, Brooimans RA, Bumbea H, Dalva K, Fuhler G, Gratama J, Hose D, Kovarova L, Lioznov M, Mateo G, Morilla R, Mylin AK, Omede P, Pellat-Deceunynck C, Andres MP, Petrucci M, Ruggeri M, Rymkiewicz G, Schmitz A, Schreder M, Seynaeve C, Spacek M, de Tute RM, Van Valckenborgh E, Weston-Bell N, Owen RG, San Miguel JF, Sonneveld P, Johnsen HE. Report of the European Myeloma Network on multiparametric flow cytometry in multiple myeloma and related disorders. Haematologica 2008; 93:431-438. [DOI: 10.3324/haematol.11080] [Citation(s) in RCA: 349] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Abstract
The present work deals with the mechanisms of signal transduction mediated via CD38 in normal and neoplastic human B lymphocytes. The results indicate that CD38 is a receptor and that CD38-mediated signals are tightly regulated at 3 distinct levels. The first concerns the structural organization of CD38, which is clearly divided into monomeric and dimeric forms. The second level of regulation is based on the dynamic localization of CD38 molecules in lipid microdomains within the plasma membrane. Lateral associations with other proteins, namely with the CD19/CD81 complex, determine the third level of control. Raft localization and association with the CD19 complex are prerequisites for CD38-mediated signals in tonsillar B cells and in continuous lines. Lastly, the results indicate that lipid microdomain disruption and silencing of CD19 directly impacts on CD38's ability to mediate Ca(2+) fluxes, while leaving its surface expression unchanged. CD38 is also an enzyme capable of producing several calcium-mobilizing metabolites including cyclic adenosine diphosphate ribose (cADPR). Our inability to identify a correlation between the production of cADPR and the receptorial functions support the hypothesis that CD38 is a pleiotropic molecule whose behavior as a receptor is independent from its enzymatic activity.
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Affiliation(s)
- Silvia Deaglio
- Department of Genetics, Biology and Biochemistry, University of Torino Medical School, Torino, Italy.
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Senatore G, Donnici G, Taglieri C, Giordano B, Cicciarello C, Amellone C, Omede P, Di Leo A, D'Aulerio M, Traverso M, Fazzari M. P-183 Catheter ablation of atrial flutter with localisa navigation system. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b110-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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