bluuebunny/crossref_metadata_2025_split huggingface dataset:
154 PROBIOTICS: OBSERVATION IN PRACTICAL MEDICINE
Authors: Acquistapace Flavio , Camponovo Claudio , Odello Tania , Negrini Alice , Graziano Elisa 
Published: December 2022

Abstract

Background
There are several, even recent, basic research studies that have demonstrated the microbiota's cause for the predisposition and development of degenerative disorders and risk factors: cardiovascular diseases, obesity, metabolic syndrome and diabetes. Studies, knowledge and communication on probiotics have gone and are increasingly growing, so much so that almost a "trend" of the probiotic has developed. The importance of defining the "probiotic", developing knowledge and clinical research, or evaluating the results in real clinical practice, is essential for the appropriate use for the benefit of the person. The doctor has and must have a central and primary role.

Purpose
The study, which we conducted in clinical practice, is of an observational type, and has as its primary outcome that of evaluating the impact of nutriceutic integration with probiotics on risk factors of inflammatory and metabolic markers and as a secondary outcome the functional capacity and perception of psychophysical health.

Methods
Out of 70 patients followed, 50 patients were selected and evaluated for homogeneity and adherence characteristics. Eligibility characteristics below: risk profile, familiarity for cardiovascular diseases, dysendocrine disorders, overweight and obesity, hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, fatigue syndrome, neurovegetative dystonia. The evaluation of probiotic therapy was carried out in two stages on the basis of the following parameters: psychophysical perception of the state of health, using the SF-36 Questionnaire, functional capacity by means of the physical ability test (Six Minute Walking Test 6MWT or Walking Test), blood tests: PCR, Vitamins, lipid profile. The nutraceutical scheme consists of taking 2cps after breakfast and 2 cps after Enterelle's dinner, during the first week. Bifiselle, second week, Ramnoselle third week Serobrain 1 cps after breakfast fourth week. Serobioma, one tablet per day, for 3 months: maintenance phase.

Results and Conclusions
The observational study in real practice indicated an efficacy of the probiotic nutraceutical treatment on patients with regard to the reduction of the measurable risk profile, improvement of the perception of health including objective level of functional capacity, stabilization of the levels of vitamins (vit B and D).
300 LITERATURE CASE SERIES REVIEW ON LANDIOLOL IN ACUTE DECOMPENSATED HEART FAILURE SECONDARY TO TACHYARRHYTHMIAS
Authors: Cereda Alberto , Laricchia Alessandra , Marini Claudia , Franchina Gabriele , Conconi Barbara , Lucreziotti Stefano 
Published: December 2022

Abstract

Introduction
Landiolol is a recently innovated ultra-short-acting beta-blocker. Landiolol is the only beta-blocker with a specific dose recommendation for patients with cardiac dysfunction and acute atrial fibrillation (Class I recommendation according to the ESC guidelines). Landiolol has a shorter elimination half-life than any other beta-blocker, and it can be administered safely to patients with various tachyarrhythmias. The short duration of action and titratability of landiolol makes it ideal for use in critically ill patients.

Purpose of the Study
Review the case reports in the literature on the administration of landiolol in critically ill patients with acute decompensated heart failure (ADHF) secondary to tachyarrhythmias.

Methods
11 case reports of ADHF secondary to tachyarrhythmias were identified. Personal, clinical and humoral data were collected. The heart rate and systolic pressure values in the time before and after the administration of Landiolol were plotted in a summary graph.

Results
The mean age of the 11 patients was 55 years old with high proBNP values at admission. The etiological diagnosis of heart failure was heterogeneous but tachyarrhythmia was the trigger event in all patients. Patients were critically ill with a mean EF of 26 ± 16% and an initial shock index of 1.4 ±0.5. Landiolol administered together with other antiarrhythmic drugs (amiodarone in 4/11 patients), epinephrine/norepinephrine (9/11) and levosimendan (4/11) favoured heart rate lowering and an increase in systolic blood pressure.At discharge, 4/11 had improved EF, in 10/11 sinus rhythm was restored, and all patients recovered hemodynamic stability without adverse events related to Landiolol (Figure 1).

Conclusion
In this case series review, Landiolol was a useful strategy in patients with ADHF refractory to conventional therapy by facilitating rate/rhythm control, limiting the toxicity of inotropic drugs and improving the hemodynamic profile.
Figure 1
1032 FEASIBILITY AND RELIABILITY OF COMPREHENSIVE THREE DIMENSIONAL TRANSESOPHAGEAL ECHOCARDIOGRAPHY SCREENING PROCESS FOR TRANSCATHETER MITRAL VALVE REPLACEMENT
Authors: Boccellino Antonio , Piroli Francesco , Ingallina Giacomo , Rolando Marco , Melillo Francesco , Francesco Ancona , Stella Stefano , Biondi Federico , Baldetti Luca , Palmisano Anna , Esposito Antonio , Denti Paolo , Montorfano Matteo , Maisano Francesco , Castiglioni Alessandro , Agricola Eustachio 
Published: December 2022

Abstract
The procedural planning of transcatheter mitral valve replacement (TMVR) requires a specific imaging assessment to establish patient eligibility. Computed tomography (CT) is considered the reference method. In this setting, data regarding the role of transesophageal echocardiography (TEE) are lacking.

Aims
To evaluate the feasibility and reliability of a comprehensive 3D-TEE screening in TMVR candidates.

Methods
we performed a retrospective observational study including 72 consecutive patients who underwent a pre-procedural CT and 3D-TEE for TMVR evaluation. The measurements of mitral annulus (MA), length of anterior mitral leaflet (AML), native left ventricular outflow tract (LVOT) and predicted neo-LVOT acquired with CT and 3DTEE were compared using a novel semi-automated software for post processing analysis (3mensio Structural Heart 10.1 - 3mSH, Pie Medical Imaging, Bilthoven, Netherlands). The final suitability decision was given by the valve manufacturer based on CT measurements and clinical conditions.

Results
Among 72 patients screened, all patients had adequate image quality for 3D-TEE analysis. 3D-TEE and CT measurements for AML length (r=0.97), MA area (r=0.90), perimeter (r=0.68), anteroposterior (r=0.88) and posteromedial-anterolateral (r=0.74) diameters were found highly correlated, as well as for native LVOT (r=0.86) and predicted neo-LVOT areas (r=0.96) (all P -values &lt;0.0001). An almost perfect agreement among CT and 3d TEE was found in assessing the eligibility for TMVR implantation (Cohen Kappa 0.83, p&lt;0.001).

Conclusions
3D-TEE appraisements showed good correlations with CT measurements and high accuracy to predict TMVR screening success.
Central Illustration. Mitral annulus segmentation and neo-LVOT area measurement performed by means of the 3mensio software (Pie Medical Imaging, Bilthoven, Netherlands) in a step-by-step fashion by TEE and CT imaging. After the virtual simulation of a valve implantation, the minimal systolic neo-LVOT area is manually measured by planimetry on a plane orthogonal to the centerline.
288 LAY LADY LAY, A TRICKY CASE OF PLATYPNEA ORTHODEOXIA SYNDROME
Authors: Coraducci Francesca , Barbarossa Alessandro , Manfredi Roberto , Coretti Francesca , Torselletti Lorenzo , Belleggia Sara , Paolini Federico , Alfieri Michele , Brugiatelli Leonardo , Bastianoni Gianmarco , Principi Samuele , Ciliberti Giuseppe , Stronati Giulia , Dello Russo Antonio , Guerra Federico 
Published: December 2022

Abstract
Platypnea orthodeoxia syndrome (POS) is characterized by dispnoea and a fall in oxygen saturation levels when in the upright position that resolves lying down in the supine position. It is secondary to a right to left shunt (R-L shunt), typically trough a patent foramen ovale (PFO).
Normally, in the presence of a PFO, R-L shunt does not occur unless there is a clinical condition that raises right side pressures like venous thromboembolism, hydrothorax, pneumothorax or chronic pulmunary hypertension. Although its physiopathological mechanisms are not entirely understood, in the POS, R-L shunt mostly occurs due to anatomical alteration of the interatrial septum in the upright position. Venous flow therefore can pass from the inferior vena cava through the PFO or an atrial septal defect (ASD) to the left side of the heart.
We present a case of a 77 y.o. woman with no relevant past medical hystory, that was admitted to hospital care because of a mild pulmonary embolism and deep vein trombosis of the right popliteal vein. She was promptly treated for PE with direct oral anticoagulation achieving the resolution of the embolism. Despite the CT scan showed the complete resolution of the embolism her dysponoea did not improve. Her blood gas analysis showed normocapnic hypoxiemic respiratory insufficiency with a suspicious lowering of oxygen saturation levels when in the upright position which however improved in the supine position. She also had a transient episode of dysarthria and hypostenia to the right upper limb, the negative head CT scan was suggestive of a transient ischaemic attack. A pulmonary scintigraphy showed arterious renal perfusion as in a right to left shunt. She then underwent a transoesophageal echocardiography which showed an hypermobile interatrial septum with evidence of a patent foramen ovale with left to right shunt. The exame was in fact executed in the supine position. Given these findings, we concluded for a diagnosis of POS. Because of this records, the severity of the shunt and the suggestive clinical hystory of ortodeoxya she underwent PFO closure positioning an Amplatzer PFO Occluder 25 mm. The procedure was carried out without complications and led to complete resolution of the symptoms and the signs of platipnoea-ortodeoxya.
458 CARDIOVASCULAR MAGNETIC RESONANCE IMAGING IN SUSPECTED CARDIAC MASSES: HISTOLOGICAL CORRELATION AND CLINICAL OUTCOMES
Authors: Dellino Carlo Maria , Gaspari Monica De , Garlini Paolo , De Lazzari Manuel , Cipriani Alberto , Cecchetto Antonella , Baritussio Anna , Cecere Anna Grazia , Ruocco Alessandro , Rizzo Stefania , De Conti Giorgio , Motta Raffaella , Basso Cristina , Iliceto Sabino , Perazzolo Marra Martina 
Published: December 2022

Abstract

Background
Cardiac masses represent a major diagnostic challenge given the difficulty in assessing their nature through imaging examinations. Cardiac Magnetic Resonance (CMR) is a noninvasive key diagnostic tool that can provide important anatomical, functional, and tissue characteristic information.

Objectives of the study
analyze the clinical and CMR features of patients with benign and malignant tumors and thrombus; asses the accuracy of CMR in comparison with the histologic examination; evaluate the prognostic rule of clinical and CMR features in predicting the primary endpoint of all cause mortality.

Methods
92 Patients undergoing CMR for suspected cardiac masses between June 2004 and January 2022 were retrospectively evaluated. Patients with no mass 8 (9%) or pseudomass 11 (12%) were excluded. Clinical, CMR and histological data were collected.

Results
73 patients with masses were finally enrolled, 27 (37%) with a diagnosis at CMR of benign tumor, 22 (30%) with malignant tumor, and 24 (33%) with thrombus. Among clinical variables the history of malignancy and smoking were seen in patients with malignant tumors (p&gt;0,02). Among CMR features high size, infiltration, pericardial repeats, pericardial effusion, signal inhomogeneity, First Pass Perfusion and Late Gadolinium Enhancement were associated with malignant masses (p&lt;0.05), while reduced pre-contrast visualization, altered kinetics, low ejection fraction and long-TI were observed in thrombi (p&lt;0.05). CMR was accurate in 91.2% (31/34) of patients in comparison with the histological examination. Accuracy for benign tumors was 91.3% (AUC=0.913), for malignant tumors 94% (AUC=0.940) and for thrombi 83% (AUC=0.833). Patients with thrombus at CMR had similar mortality as those with benign tumor while patients with malignant lesions had higher mortality (HR: 4.98 [95% CI: 1.11-22.2]). Regardless of diagnosis at CMR, age, tumor history, mass size, signal inhomogeneity, presence of FPP, pericardial effusion, and pericardial repeats were found to predict long-term mortality (p&lt;0.05).

Conclusions
although CMR has high diagnostic accuracy, histologic examination remains the diagnostic gold standard in determining the type of cardiac mass. In addition to playing a key role in the diagnostic process, CMR is useful in predicting the outcome of patients with cardiac masses.
704 STRESS TEST STRATEGY WITH CMR AND SPECT-MPI REDUCES CARDIAC EVENTS IN CANDIDATES TO NON-CARDIAC SURGERIES
Authors: Fazzari Fabio , Cannata Francesco , Figliozzi Stefano , Didedda Emanuele , Catapano Federica , Lisi Costanza , Brilli Federica , Chiarito Mauro , Storniolo Salvatore , Chiti Arturo , Condorelli Gianluigi , Monti Lorenzo , Francone Marco 
Published: December 2022

Abstract

Introduction
. Cardiac complications related to non-cardiac surgery have a variable incidence, from less than 1% to more than 5% with a great variability depending on type of intervention, patient's risk factors and results from tests performed during the pre-operative evaluation. The aim of our single centre retrospective study was to evaluate the prognostic role of stress cardiac magnetic resonance (sCMR) and single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) in relation to 30 days post-surgery cardiac events.

Method
Clinical data of patients from January 2015 to December 2021 were retrospectively collected from review of electronical medical records. Only intermediate and high risk surgeries were included. All patients underwent to cardiologic, electrocardiographic and echocardiographic evaluation before surgery. Stress test was performed according to cardiologist judgment. Primary endpoint was a composite endpoint of myocardial infarction, unstable angina, cardiac death, cardiogenic shock, pulmonary oedema and life threatening cardiac arrythmias. Secondary endpoint were the research of ischemia predictors and the rate of revascularization.

Results
One-thousand-five-hundred-ninety patients were included, 669 stress tests were performed (287 sCMR, 382 SPECT-MPI). Rate of 30-days cardiac events was lower in the stress test group vs non-stress test group (1,2% vs 3,4%; p 0,006). Imaging stress test strategy showed a significant reduction of composite endpoint at multivariate analysis (OR: 0.334, IC: 0.155–0.766, p 0.009). Predictors of ischemia were hypertension, coronary artery disease and diastolic dysfunction. SCMR was non inferior to SPECT with regard the risk of cardiac events, while showed a greater accuracy to predict coronary revascularization (AUC for sCMR: 0.94).

Conclusions
Stress test strategy reduces cardiac events in high risk patients candidate to moderate- to high- risk surgeries. Stress CMR is non-inferior to SPECT with regards to the risk of cardiac events, but has a greater accuracy to predict the need for revascularization.
790 LEFT VENTRICULAR OUTFLOW TRACT VELOCITY TIME INTEGRAL OUTPERFORMS LEFT VENTRICULAR EJECTION FRACTION IN HEART FAILURE PATIENTS WITH SIGNIFICANT MITRAL REGURGITATION
Authors: Gentile Francesco , Buoncristiani Francesco , Chubuchny Vlad , Sciarrone Paolo , Panichella Giorgia , Gasparini Simone , Bazan Lorenzo , Fabiani Iacopo , Taddei Claudia , Poggianti Elisa , Petersen Christina , Pasanisi Emilio , Passino Claudio , Emdin Michele , Giannoni Alberto 
Published: December 2022

Abstract

Background
Reduced left ventricular ejection fraction (LVEF) has been used as a key criterion for the management of mitral regurgitation (MR) in patients with heart failure (HF), including the decision about mitral valve repair. However, LVEF, not taking into account mitral regurgitant volume, may be an imprecise predictor of outcome in HF patients with MR. Conversely, the estimation of the forward volume through the LV outflow tract (LVOT) may be a better metric in this setting. In this regard, LVOT velocity time integral (LVOT-VTI), not relying on geometrical assumptions, has been shown to be more reproducible than the calculated stroke volume (i.e., LVOT-VTI * LVOT cross sectional area), at least in the acute setting.

Objective
To assess the prognostic significance of LVOT-VTI in a contemporary cohort of patients with chronic HF and significant MR.

Methods
Consecutive patients with chronic HF with reduced (≤40%) or mildly reduced (41-49%) LVEF and moderate-to-severe or severe MR, according to the latest European Society of Cardiology criteria, were selected and followed-up for the endpoint of cardiovascular death.

Results
203 patients were enrolled in the study (74±11 years, 66% men, 47% ischemic etiology, HFrEF 86%, LVEF 31±9%, mean LVOT-VTI 21±6 cm). Most patients showed a NYHA class II (40%) or III (31%) and received beta-blockers (95%), ACE-inhibitors/ARBs or ARNI (77%), and mineralocorticoid receptor antagonists (82%). Seventy-seven patients (38%) had permanent atrial fibrillation and 46 (23%) a cardiac resynchronization therapy device. Over a median follow-up of 18 (7-33) months, 30 patients died, 24 of whom for a cardiovascular cause, and 10 underwent mitral valve repair/replacement. When stratified according to the optimal prognostic cut-off of LVOT-VTI, patients with a LVOT-VTI &lt;16 cm (n=36) showed the greater risk of cardiovascular death (Log Rank 18.2, p&lt;0.001, Figure). Similarly, patients with a LVEF &lt;33% (n=122) showed a higher risk of cardiovascular death (Log Rank 5.5, p=0.019). Nevertheless, at Cox regression analysis, a unit decrease in LVOT-VTI (hazard ratio, HR 0.87 [95%CI 0.79-0.95], p=0.002) but not in LVEF (p=0.729) was associated with a higher risk of cardiovascular death (Figure).

Conclusion
Left ventricular forward volume, noninvasively estimated through LVOT-VTI, but not LVEF, predicts the risk of cardiac death in patients with chronic HF and significant MR.
335 CORONARY CT SCREENING: A PRIMARY ROLE IN CORONARY EVENTS PREVENTION
Authors: Mura Lucia La , Izzo Carmine 
Published: December 2022

Abstract

Background
Coronary CT (CCT) is one of the most used noninvasive imaging for the detection of coronary artery disease (CAD) in the US, especially in patients with intermediate CAD risk.
European Society of Cardiology also recommends risk stratifications using coronary CT angiography in patients with suspected CAD (level IB).

Purpose
the purpose of the study was to evaluate in a population that underwent CCT screening, how many had significant coronary lesions and which cardiovascular (CV) risk factors were most involved.

Methods
228 patients (37% female, 63,34±9.9 years) with no previous coronary events and 64,5% with no coronary symptoms (angor, dyspnea), were enrolled. All patients underwent a cardiological evaluation for CV risk factors (age, sex, hypertension, early familiarity for CAD, dyslipidemia, smoke, obesity, diabetes, chronic kidney failure, vascular atherosclerosis) and a CCT (Ca scoring and CT angiography), performed by a 128-slices system and analyzed by a single operator with over 3 years of experience. CCT was considered positive if CAD-RADS was ≥ 4A.

Results
60 patients (26,3%) had a positive CCT and were hospitalized for coronary angiography. The CCT positivity correlated significantly with the sex (p&lt;0.001), familiarity (p&lt;0.001), hypertension (p= 0.006) and Ca Score (p&lt;0.001), but did not significantly correlate with the other risk factors (dyslipidemia, smoke, age, obesity, diabetes, chronic kidney failure, vascular atherosclerosis) or symptoms (Table.1).

Conclusions
family history and sex, together with hypertension, seem to be the factors that most determine the presence of ischemic heart disease, more than the other common risk factors. The possibility of performing CCT in all patients with early family history could be considered to effectively prevent the onset of coronary events.
Table.1
669 ECHOCARDIOGRAPHIC PREDICTORS FOR MORTALITY IN LIVER TRANSPLANT
Authors: Landi Irene , Alharbi Suliman , Alfehaid Abdullah , Eltayed Abdalla , Aldosari Sarah Radaan , Pirisi Mario , Troisi Roberto , Vriz Olga 
Published: December 2022

Abstract

Background and aim
According to the evidence, cirrhotic cardiomyopathy affects about 50% of patients with cirrhosis.). The aim of our study was to evaluate pre- and post-surgery transthoracic echocardiography (TTE) parameters in a cohort of patients undergoing liver transplant (LT) and their relationship with LT complications and mortality.

Methods
We recruited 102 (61 males, 59.8%; median age 59 [54-65] years) patients who underwent comprehensive TTE before and after LT and compared TTE parameters measured before and after LT.

Results
At the end of the follow-up, 76 patients (74.5%) survived, 16 (15.7%) died and 10 (9.8%) were lost at follow-up. Both, left and right side heart chambers significantly decreased after LT as did left ventricular function (EF from 62,9% to 58,8%, p&lt;0,001; global longitudinal strain from -21,5 to -18,13, p&lt;0,001) and right ventricular function (TAPSE from 24mm to 21mm, p&lt;0,001; FAC from 51,54% to 49,14%, p=0,003; right ventricular global strain from pre-LT -23,66 vs post-LT -19,94, p&lt;0,001). Though pulmonary arterial pressure (PAPs) did not change significantly, RV-pulmonary arterial coupling was significantly lower after LT either as TAPSE/PASP (0.9 vs 0.8, p=0.02). Interestingly, post-LT PASP was significantly higher in the group that did not survive. Furthermore higher difference in PASP between pre and post-LT TTE, and TAPSE (Diff PASP HR 1,044, p- value 0,01, C.I 1,01-1,08; TAPSE Diff HR 1,088, p- value 0,03, C.I 1,01-1,17) were determinant of increased risk for death combined with LV EF.

Conclusions
Our data suggest that elevated PASP and lower TAPSE have been associated with increased risk of death after LT.