bluuebunny/crossref_metadata_2025_split huggingface dataset:
577 PACING LEADS THROMBOSIS IN CHILDREN AND YOUNG ADULTS WITH IMPLANTABLE ELECTRONIC DEVICES: OCCURRENCE OF A RARE COMPLICATION.
Authors: Yammine Marie Laure , Gimigliano Fabrizio , Rinelli Gabriele , Campisi Marta , Battista Virginia , Tamburri Ilaria , Anselmo Saputo Fabio , Stefano Silvetti Massimo , Drago Fabrizio 
Published: December 2022

Abstract

Background
Pacemakers (PMKs) and implantable cardioverter-defibrillators (ICDs) are frequently utilized in patients with specific cardiac rhythm disorders. The downfalls of these devices are several but no data exist regarding leads thrombosis.

Aim of the study
the analysis of pacing lead thrombosis occurrence in paediatric PMK-ICD patients.

Methods
single Centre retrospective study of a series of paediatric/young adult patients showing pacing lead thrombosis. Data are reported as median (interquartile range).

Results
from 2015 to 2021 five patients (2 males), aged 16 (12-22) years, showed transthoracic echocardiographic evidence of lead vegetations during routine follow-up after 5 (1-16) years from lead's initial implantation. Age at device implantation was 9 (5-12) years. Two patients had dual-chamber ICD, 3 had PMKs (2 DDD, 1 VVI). No patient had any early wound complications after implantation. At the time of thrombosis detection, no patient reported any recent fever or symptoms of clinical illness. Devices and leads were normally functioning in all patients. Blood examination revealed absence of infectious or inflammatory signs, and all patients had negative hemocultures for aerobic, anaerobic bacteria and fungi. Therefore, lead thrombosis was diagnosed. Transesophageal echocardiogram (TEE) confirmed the echo finding. Thrombophilia testing revealed that 4 out of 5 patients had methylenetetrahydrofolate reductase (MTHFR) mutation, homozygous and heterozygous (2 each). Patients received oral anticoagulation therapy (OAT) and TEE showed complete recovery in 4 patients after 6-12 months; one adult patient is followed-up elsewhere.

Conclusions
pacing lead thrombosis is a rare complication in paediatric/young adult patients with PMK/ICD, well treated with OAT. MTHFR mutation is a risk factor for this complication.
155 CARDIO PSYCHE: OBSERVATION IN PRACTICAL MEDICINE
Authors: Acquistapace Flavio 
Published: December 2022

Abstract

Background
Our historical period is characterized by speeding evolution of technological processes that have allowed us to achieve excellent results in all fields. The association with the improvement of the quality of life, in its global aspect, is not a so obvious condition. Environmental factors affect more and more our perception of psychophysical health, up to, in the most serious cases, to undermine the same organic functionality, particularly at the cardiovascular level.

Purpose
Our observational study in clinical practice wants, as primary outcome, to evaluate the impact, on subjects showing characteristics of neurovegetative dystonia, of an integration with a homeopathic product (in association with the therapy) on the functional capacity and on the perception of psychophysical health and, as secondary outcome, the control and stabilization of functional parameters related to the cardiovascular system.

Method
50 patients were selected and evaluated for characteristics of homogeneity and adherence. Features of eligibility: anxiety, panic attacks, heart palms, fatigue syndrome, autonomic (nurovegetative) dystonia, insomnia. The evaluation of the therapy by integrating a homeopathic product, where provided, in support of therapies and raise awareness to the correct lifestyle was carried out in two stages based on the following parameters: psychophysical perception of the state of health, through Questionnaire SF-36, specialist cardiological visit. The therapeutic indication provided for the intake of 15 drops of medicine 3 times a day, plus 10 drops (every 10 minutes up to an hour) in case of episodes.

Results and Conclusions
The observational study in real practice indicated an efficacy of the treatment both individually and in support of the therapy, without presenting contraindications. Patients reported an improvement in psychophysical health, also confirmed by medical observation and the improvement of parameters (in particular HR, but also PA, as an adjuvant to stabilization).
1141 CARDIAC METASTASIS
Authors: Ricci Giulia , Vannelli Andrea , Onorato Federica , Morgagni Riccardo 
Published: December 2022

Abstract
Introduction: in medical literature, studies on cardiac metastases are few and discordant and their actual incidence is underestimated. Autoptic examination shows evidence of cardiac metastases in about 9% of all the patients affected by malignant tumor. Each malignant tumor can metastasize to the heart (incidence varying from 2.3% to 18.3%); nevertheless, formation of cardiac metastases is more frequently associated with primitive neoplasms such as pleural mesothelioma (48.4%), melanoma (27.8%), adenocarcinoma as well as lung and kidney carcinomas.
Clinical case: patient aged 66, former smoker, no further cardiovascular disease risk factors, no occurrences of heart disease in his past medical history. In 2008 surgical excision of melanoma skin cancer, negative sentinel lymph node. In 2014 cancer relapse, final cycle of chemotherapy treatment completed in July. In October 2014 evidence of liver and adrenal gland metastases. In November 2014 evidence of bone metastases. As the CT scan showed evidence of pleural and pericardial effusion, the patient was requested to undergo cardiac examination and an echocardiogram test in preparation for further chemotherapy treatment. During the medical examination the patient presented with symptoms of marked asthenia, dyspnea under moderate effort (NYHA II), palpitations. BP: 100/60 mmHg. ECG: low voltages, sinus tachycardia, incomplete RBBB, inverted T waves in V1 – V4, III. Home Therapy: Furosemide 25 mg, Cortisone 25 mg, Tramadolo Cloridrato 50 mg, Albumina. The findings of the echocardiogram test showed: enlarged and hyperkinetic left ventricle, abundant circumferential pericardial effusion measuring up to 2,3 cm. Evidence of hyperechogenic areas in the epicardium, myocardium and at the level of mitral valve flaps (figure 1 and 2). In December 2014 hospital admission due to worsening of clinical symptoms, onset of ascites, hyperpotassemia, anemization (Hb 8.6g/dL). During the 72 hours following hospitalisation: STEMI, acute kidney failure, respiratory failure, metabolic acidosis, death. The autoptic examination showed evidence of undifferentiated large cell neoplasm with formation of metastases in the myocardium, mitral valve apparatus and coronary tree.

Conclusions
echocardiography should always be included in the clinical examinations which patients affected by neoplasm are required to undergo. Serial evaluations allow to identify the occurrence of pericardial effusion and/or heart involvement even in the absence of clinical suspicion. Identifying such anomalies may have important therapeutic implications.
722 NATURAL ACTIVATORS OF AUTOPHAGY PROTECT THE HEART FROM DOX-INDUCED CARDIOMYOPATHY
Authors: Schirone Leonardo , Vecchio Daniele , Forte Maurizio , Sciarretta Sebastiano 
Published: December 2022

Abstract

Introduction
Heart failure is a frequent death cause for oncological patients who received treatment with doxorubicin (DOX). DOX administration inhibits autophagy in cardiomyocytes and causes myocardial damage. Natural activators of autophagy (NAA) such as trehalose, a natural disaccharide, and spermidine, a putrescine-derived polyamine initially isolated from semen, were previously found to be promising candidates to recover the autophagic flux and treat cardiovascular diseases in mice.

Hypothesis
The administration of natural activators of autophagy protects the heart from DOX-induced myocardial injury.

Methods
C57BL/6J WT mice were fed ad libitum with trehalose or spermidine in drinking water and received 3 weekly injections of DOX, reaching a final cumulative dose of 15 mg/kg. Echocardiographic, histological and biochemical analyses were performed 6 weeks after the first administration of DOX. Also, in vitro experimentation was performed on neonatal rat primary cardiomyocytes.

Results
Mice treated with DOX had reduced systolic function (FS: 44±1.05% vs. 34.1±2.33%, n=6-8), but trehalose administration preserved left ventricular fractional shortening (FS: 34.1 [Office1]±2.33% vs. 45.1±0.75%, n=6-8). Autophagy-deficient Beclin1+/- mice had reduced FS and were not protected by trehalose administration (35.4±2.48% vs. 45.1±0.75%, n=7-8). Mice treated with DOX developed fibrosis (0.1±0.08% vs. 8.6±3.5%, n=5), but this effect was reduced in trehalose-fed mice that received DOX (8.6±3.5% vs. 2±0.68%, n=4-5). DOX administration increased the levels of damaged-mitochondria disposal (2.6±0.74 vs. 9.4±1.7 mitophagic bodies per TEM field, n=13) and trehalose administration further boosted this effect (9.4±1.7 vs. 24.1±1.45, n=13).
The mRFP-eGFP-Lc3-dots assay was used for evaluating the autophagic flux in neonatal primary cardiomyocytes and a reduction of autophagy was observed in cells treated with DOX (51.9±4.57 vs. 29.9±3.52 red dots per cell, n=34-51), while trehalose recovered the autophagic flux (29.9±3.52 vs. 121.5±8.02 red dots per cell, n=33-34). Mitochondrial biogenesis reporter ‘MitoTimer’ mice that received DOX showed increased levels of biogenesis (0.8±0.38 vs. 3.3±0.9, n=5-6), while mice receiving DOX and trehalose did not (3.3±0.9 vs. 0.3±0.12, n=5-6). Similarly, spermidine preserved systolic function (FS: 29.4±2.03 vs. 39±3.22, n=5-6) and increased myocardial autophagy.

Conclusion
NAA-mediated mitophagy induction protects the heart from developing DOX-induced cardiomyopathy by disposing of damaged mitochondria.
[Office1]Le virgole diventano punti
821 DAPAGLIFOZIN ON LEFT VENTRICULAR DIASTOLIC FUNCTION IN PATIENTS WITH CHRONIC HEART FAILURE AND WITHOUT DIABETIC MELLITUS.
Authors: Lamaida Norman , Cerciello Antonio 
Published: December 2022

Abstract

Background
:Heart failure (HF) with reduced ejection fraction (HFrEF) remains a challenging problem due to its high mortality rate. Another novelty in HF therapy is dapagliflozin, a sodium–glucose transporter–2 inhibitor (SGLT2i) which decreased the rates of cardiac death and worsening of HF in the DAPA–HF trial, when added in other guideline recommended therapy.

Material and Methods
A prospective cohort study of 30 symptomatic HF patients with EF &lt; 35% (aged 65 610 years) (20 males and 10 females) was conducted. The patients of NYHA classification II–III, previously treated with ARNI, b– blocker, and mineralocorticoid receptor antagonists (MRA) were included. Dapagliflozin 10 mg was added as a novel therapy of HF patients. Clinical examination and complete echocardiographic evaluation were performed at baseline and 30 days after the addition of SGLT2i to their treatment. 2D echocardiography and Doppler measurements were used for the evaluation of left ventricular function, and more specifically, peak early (E–wave) and late (A–wave) transmitral filling velocities and their ratio E/A, deceleration time of E velocity (DTE). To classify diastolic dysfunction according to the ASE/EACVI guidelines published in 2016, transmitral E and A waves velocities, septal and lateral E’ tissue velocities, indexed left atrium volume and peak velocity of tricuspid regurgitation were collected.

Results
After 30 days of therapy with dapagliflozin, blood pressure was reduced significantly and the echocardiographic parameters of diastolic function were improved. More specifically, after 6.163.6 months of treatment E/A ratio decreased from 1.7 61.5 to 1.0160.70 (P &lt; 0.05), the E/Ea ratio decreased from 13.56 6.3 vs. 10.26 5.2 (P &lt; 0.05), tricuspid regurgitation peak velocity decreased from 3.060.4 to 2.46 0.5m/s (P ¼ 0.03) and left atrial volume decreased from 53 629.3 to 40.3611.5ml/m2 (P &lt; 0.05). Subsequently, both left–ventricular diastolic function and filling pressure improved significantly (P &lt; 0.05,).

Conclusions
Our data support the evidence that SGLT2i ameliorate echocardiographic indexes of diastolic function. The ratio of early diastolic transmitral flow velocity seems to correlate well with LV filling pressures, and may be use das a prognostic tool in patients with HFrEF. We have to emphasize that the diastolic function improvement may be considered an early marker.
852 DAPAGLIFOZIN IN PATIENTS WITH CARDIAC HEART FAILURE
Authors: Lamaida Norman , Cerciello Antonio 
Published: December 2022

Abstract
Dapaglifozin on diastolic function in patients with type 2 diabetic mellitus and chronic heart failure
Heart failure (HF) with reduced ejection fraction (HFrEF) remains a challenging problem due to its high mortality rate. Another novelty in HF therapy is dapagliflozin, a sodium-glucose transporter-2 inhibitor (SGLT2i) which decreased the rates of cardiac death and worsening of HF in the DAPA-HF trial, when added in other guideline recommended therapy.

Material and methods
A prospective cohort study of 30 symptomatic HF patients with EF &lt; 35% (aged 65 ±10 years) (20 males and 10 females) was conducted. Diabetic (2TDM) patients of NYHA status II–III, previously treated with ARNI, β-blocker, and mineralocorticoid receptor antagonists (MRA) were included. Dapagliflozin 10 mg was added as an adjunct therapy for 2TDM but also as a novel therapy of HF in diabetic patients. Clinical examination and complete echocardiographic evaluation were performed at baseline and 30 days after the addition of SGLT2i to their treatment. 2D echocardiography and Doppler measurements were used for the evaluation of left ventricular function, and more specifically, peak early (E-wave) and late (A-wave) transmitral filling velocities and their ratio E/A, deceleration time of E velocity (DTE). To classify diastolic dysfunction according to the ASE/EACVI guidelines published in 2016, transmitral E and A waves velocities, septal and lateral E’ tissue velocities, indexed left atrium volume and peak velocity of tricuspid regurgitation were collected.

Results
After 30 days of therapy with dapagliflozin, blood pressure was reduced significantly and the echocardiographic parameters of diastolic function were improved. More specifically, after 6.1±3.6 months of treatment E/A ratio decreased from 1.7 ±1.5 to 1.01±0.70 (P &lt;0.05), the E/Ea ratio decreased from 13.5± 6.3 vs. 10.2± 5.2 (P &lt;0.05), tricuspid regurgitation peak velocity decreased from 3.0±0.4 to 2.4± 0.5m/s (P =0.03) and left atrial volume decreased from 53 ±29.3 to 40.3±11.5ml/m2 (P &lt;0.05). Subsequently, both left-ventricular diastolic function and filling pressure improved significantly (P &lt;0.05,).

Discussion
Our data support the evidence that SGLT2i ameliorate both the conventional echocardiographic indexes of diastolic function and this effect is noted quite promptly. The ratio of early diastolic transmitral flow velocity seems to correlate well with LV filling pressures, and may be use das a prognostic tool in patients with HFrEF. We have to emphasize that the diastolic function improvement was observed 30 days after the initiation of dapagliflozin treatment, and thus it may be considered an early marker of improvement and adequacy of treatment apart from BNP.

Conclusions
in this study classical diastolic echocardiographic parameters were improved promptly after initiation of dapagliflozin therapy. The ratio of early diastolic transmitral flow velocity at the early filling phase of diastole (E/SRE) may be considered a reliable index of HF therapy responders.
682 UNEXPECTED TRIGLYCERIDES-LOWERING EFFECT OF A NOVEL NUTRACEUTICAL COMPOUND FOR IBS
Authors: Natale Francesco , Loffredo Francesco , Molinari Riccardo , Covino Simona , Alfieri Roberta , Altobelli Ippolita , Pezzullo Enrica , Cimmino Giovanni 
Published: December 2022

Abstract

Background
In the last few years the role of gut microbiome in human health has been reported. Growing evidence indicate that it is linked to intestinatal diseases, such as the irritable bowel syndrome (IBS), and atherosclerotic disorders. The effect on lipid metabolism seems to be one of the potential mechanisms by which gut microbiome might favour the atherosclerotic process. IBS is a functional bowel disorder defined by the presence of recurrent episodes of abdominal pain associated with altered bowel habits. The severity of psychological and gastrointestinal symptoms in IBS has been linked with a distinct intestinal microbiota signature. In this retrospective study the effect of a novel nutraceutical compound, namely Triobiotix, on gastrointestinal symptoms in IBS patients has been evaluated. Effects on lipid profile have bee also recorded.

Methods
Triobiotix is a nutraceutical consisting of: Maltodextrin; mineralized extract of Lithothamnion (Lithothamnion calcareum (Pallas) Areschoug, thallus dry extract); Bioecolians® gluco-oligosaccharides; Ferment mix (corn starch, Bifidobacterium animalis ssp. Lactis BLC1 (DSM 17741), Lactobacillus acidophilus LA3 (DSM 17742), Lactobacillus rhamnosus IMC 501 (DSM 16104), Lactobacillus paracasei Streptococc5 501 IMC102 SP4 (DSM 19385); short-chain fructo-oligosaccharides powder. The database of 40 Italian General Practitioners (GPs) were analyzed. At total of 587 patients with IBS and on Triobiotix were identified. Of these in only 535, a complete first and second control data was available. The primary endpoint of these analysis was to assess whether Triobiotix resulted in a reduction in pain and meteorism, thus resulting in a lesser intensity of the main gastrointestinal symptoms. Secondary endpoints were to look for significative changes in lab values of total cholesterol, triglycerides levels and glycaemia.

Results
Treatment with Triobiotix for four weeks resulted in a reduction in the frequency and intensity of bloating, abdominal pain, and tenesmus. Unexpectedly, at the T1 control, mean cholesterol values were significatively reduced compared to the T0 evaluation. Triglycerides levels were also significantly decreased (186.37±66.4 vs. 176.13±67.9; p &lt; 0.05).

Conclusions
Our analysis showed an unexpected effect of this combination of micronutrients on lipid profile beyond IBS symptoms. However, further studies are needed to confirm this evidence and to evaluate the particular compound responsible of this effect. A goal of LDL-C less of 115mg/dL is desirable for patients at low to moderate CVR, a significative portion of population is far from this target. The discovery of novel micronutrients combinations with cholesterol lowering effects could be of great importance for the management of patients with low-moderate dyslipidaemia.
562 ACQUIRED CORONARY FISTULA IN A PATIENT WITH CONGENITAL AORTIC STENOSIS TREATED WITH PERCUTANEOUS VALVULOPLASTY
Authors: Calvelli Pierangelo , Bianco Francesco , Mancuso Cinzia , Pasceri Eugenia , Canepa Annalisa , Mascaro Giuseppina , Indolfi Ciro , Aquila Iolanda 
Published: December 2022

Abstract

Introduction
coronary fistulas are abnormal communications between coronary arteries and an adjacent structure (vessel or cardiac chamber). They can be congenital or acquired and have traumatic, spontaneous or iatrogenic origin.

Aim
we report the case of a coronaro-cameral fistula in an asymptomatic 23-year-old male, with a congenital aortic stenosis treated with two percutaneous valvuloplasties in the first year of life, who was evaluated in our Division of Cardiology.

Methods
transthoracic echocardiography and angio-CT with 3D reconstructions were performed.

Results
echocardiography showed a dilated ventricle with ipertrabeculated aspect and a mildly reduced ejection fraction (47% Simpson), a moderate mitral regurgitation, a moderate/severe aortic insufficiency (PHT 242 ms) and a moderate aortic stenosis (valvular area 1.1 cm2; Gr max/mid 98/61 mmHg). In parasternal long axis view we appreciated a non-echogenic space between the aortic root and the right ventricle, communicating with left ventricular cavity. Angio-CT allowed us to appreciate a fistula connecting left ventricular outflow tract and right coronary artery, which was markedly dilated and tortuous. Surgical correction was deemed necessary for the patient, because of the severity of coronary dilatation and aortic and ventricular disfunction.

Conclusions
acquired fistulas are rare findings which can complicate surgical and non-surgical interventions. They are more often right-sided, but left fistulas have also been described. Integrated imaging is particularly useful for correct definition of anatomy and for surgical planning.
394 PROGNOSTIC POWER OF A NEW INDEX OF RIGHT VENTRICLE-PULMONARY ARTERY COUPLING BASED ON RIGHT VENTRICULAR VOLUMES IN PATIENTS WITH SECONDARY TRICUSPID REGURGITATION
Authors: Cascella Andrea , Gavazzoni Mara , Muraru Denisa , Heilbron Francesca , Caravita Sergio , Tomaselli Michele , Parati Gianfranco , Badano Luigi Paolo 
Published: December 2022

Abstract

Background
Echocardiographic surrogates of right ventricle (RV) to pulmonary artery (PA) coupling have been reported to be associated with outcomes in secondary tricuspid regurgitation (STR). However, pulmonary artery systolic pressure (PASP) is difficult to be estimated using echocardiography in patients with severe STR and 3D-derived indexes are loading dependent.

Objectives
To evaluate the predictive power of a new surrogate of RV-PA coupling obtained using RV volumes measured by three-dimensional echocardiography (3DE), accounting for regurgitant volume of STR.

Methods
Patients with moderate or severe STR were enrolled. The primary outcome was the composite endpoint of death from any cause and heart failure hospitalization.

Results
180 patients were included with a median follow up of 24 months (IQR: 2-48); 72 patients (40%) reached the primary endpoint. Among the tested RV-PA coupling indexes, the ratio between (RV stroke volume [SV]-regurgitant volume)/ RV End-systolic volume (ESV) (i.e. RV forward SV/ESV) showed the highest predictive power of the combined endpoint (AUC 0.85 [IC 95% 0.78-0.93]), with a threshold value of 0.40. It was followed by RV ejection fraction/PASP (AUC 0.75 [IC 95% 0.67-0.84]), and TAPSE/PASP (AUC 0.76 [IC 95% 0.68-0.85]). Severe TR (HR 2.04 [CI 95%: 1.10-3.78], p=0.02), TAPSE/PASP &lt;0.36 mm/mmHg (HR 2.39 [CI 95%: 1.26-4.54], p=0.01), and RV forward SV/ESV &lt;0.40 (HR 5.45 [CI 95% 2.47-12.00], p&lt;0.001) were independently associated with the combined endpoint.

Conclusions
RV forward SV/ESV is able to stratify the risk of death and HF hospitalization in patients with STR when added to TR severity, RV ejection fraction and TAPSE/PASP