Objectives: T3 is cardioprotective, however, no clinically translatable protocol is available for myocardial infarction (MI). Hypothesis: Low-dose oral T3 will be safe and efficacious for MI. Metho...
Research Interests:
Research Interests: Medicine, Low Dose, Acute Myocardial Infarction, Public health systems and services research, Indexation, and 10 moreObservational Study, Unstable Angina, The American, Stress echocardiography, Myocardial Ischemia, Test Methods, Cardiovascular medicine and haematology, Cox proportional hazards model, Coronary Angioplasty, and hazard ratio
Research Interests: Endocrinology, Medicine, Heart Failure, Humans, Internal Medicine, and 15 morePlacebo, Thyroid gland, Aldosterone, Chronic Disease, Female, Male, Heart, Dilated cardiomyopathy, Clinical Sciences, Aged, Middle Aged, Chronic Heart Failure, Hormone Replacement Therapy, Triiodothyronine, and Paediatrics and reproductive medicine
Research Interests: Cardiology, Medicine, Adipose tissue, Humans, Internal Medicine, and 15 moreFemale, Male, Dilated cardiomyopathy, Aged, Middle Aged, Single Photon Emission Computed Tomography, Cardiomyopathy, Sudden Cardiac Death, Cardiomyopathies, X ray Computed Tomography, Magnetic resonance image, Myocardial Ischemia, Cardiovascular medicine and haematology, ventricle, and Metaplasia
Research Interests: Medicine, Electrocardiography, Echocardiography, Humans, Female, and 14 moreFeasibility Studies, Male, Follow-up studies, Risk factors, Aged, Myocardial Infarction, Public health systems and services research, Time Factors, Prognosis, Risk Factors, Exercise Test, Predictive value of tests, Elderly patient, and Cardiovascular medicine and haematology
Research Interests: Cardiology, Stress, Comparative Study, Medicine, Echocardiography, and 13 moreProspective studies, Humans, Internal Medicine, Exploration, Anesthesia, Sensitivity, Public health systems and services research, Angina pectoris, Coronary Artery Disease, Atropine, The American, Stress echocardiography, and Cardiovascular medicine and haematology
Research Interests: Cardiology, International Cooperation, Medicine, Prospective studies, Humans, and 15 moreInternal Medicine, Female, Male, Aged, Middle Aged, Prognosis, Diagnostic Accuracy, Indexation, Coronary Artery Disease, Atropine, Exercise Test, Predictive value of tests, Positive predictive value, Relative Risk, and Cardiovascular medicine and haematology
Research Interests: Cardiology, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Adolescent, Medicine, and 15 moreHumans, Internal Medicine, Female, Male, Fibrosis, Left Ventricular Dysfunction, Aged, Middle Aged, Adult, Gadolinium, Disease Progression, Hypertrophic Cardiomyopathy, Cardiac magnetic resonance, IQR, and Cardiovascular medicine and haematology
Research Interests:
Lipoprotein(a)-Lp(a), which retains proatherogenic and prothrombotic properties, may be modified by hormonal and metabolic factors. However, few studies have focused on differences related to sex and cardiometabolic risk factors in the... more
Lipoprotein(a)-Lp(a), which retains proatherogenic and prothrombotic properties, may be modified by hormonal and metabolic factors. However, few studies have focused on differences related to sex and cardiometabolic risk factors in the relationship between Lp(a) and cardiovascular disease, especially in terms of prognosis. This study aimed at evaluating the predictive value of Lp(a) (cut-off 30 mg/dL) for hard events (HEs: mortality and non-fatal myocardial infarction) according to sex and cardiometabolic risk factors in 2110 patients (1501 males, mean age: 68 ± 9 years) undergoing coronary angiography for known or suspected coronary artery disease. There were 211 events over a median follow-up period of 33 months. Lp(a) > 30 mg/dL did not confer a worse prognosis on the overall population. However, Kaplan–Meier subgroup analysis evidenced a worse prognosis in type 2 diabetes (T2D) females with elevated Lp(a) (log-rank test: p = 0.03) vs. T2D males and no-T2D patients, but not in...
Research Interests:
Research Interests:
Background: In recent years, the use of middle-aged and old animals of both sexes has become preferential in experimental studies involving the models of cardiovascular diseases to better reflect a human population. However, the evidence... more
Background: In recent years, the use of middle-aged and old animals of both sexes has become preferential in experimental studies involving the models of cardiovascular diseases to better reflect a human population. However, the evidence showing the extent of sex-related differences in cardiac aging of laboratory animals remains obscure. Accordingly, we designed our study to determine whether the male and female rats differ during aging with regard to left ventricular (LV) geometry and systolic function. Methods: We performed transthoracic echocardiographic examinations in 12-month-old (12mo) and 24 month-old (24mo) male and female Sprague-Dawley rats (Charles River, Wilmington, MA) under 1.5% isoflurane anesthesia using a linear (Matrix) array transducer probe GE M12L (5.5-14.0 MHz) and a GE Vivid 7 Dimension ultrasound system. Two-dimensional short-axis views and M-mode tracings of the LV at the papillary muscle level were recorded and used to estimate various LV parameters. Resul...
Research Interests:
ABSTRACT Our previous study on post-MI male and female middle-aged rats has revealed the regional sex-specific differences in the adaptive changes of the left ventricular (LV) cardiac myocytes and coronary vessels. However, the impact of... more
ABSTRACT Our previous study on post-MI male and female middle-aged rats has revealed the regional sex-specific differences in the adaptive changes of the left ventricular (LV) cardiac myocytes and coronary vessels. However, the impact of such structural alterations on LV systolic properties remained unclear. Therefore, our current study is aimed to determine whether post-MI cardiac remodeling in middle-aged rats associates with sex-related differences in LV systolic performance, function or contractility. A large MI was induced in 12-month-old male (M-MI) and female (F-MI) Sprague-Dawley rats by ligation of the left coronary artery. Two months after the surgery, the various LV parameters were compared between the sexes using echocardiography, hemodynamics and morphometry. We found that although both sexes had a similar scale of global post-MI LV remodeling, the F-MI rats showed a significantly lesser degree of cardiac myocyte hypertrophy in the epimyocardium compared to males (353.3±21.4 vs. 479.0±20.6 μm², P≤0.01). Nevertheless, rats in M-MI and F-MI groups demonstrated comparable values of stroke volume (0.23±0.03 vs. 0.17±0.02 mL), ejection fraction (28.1±3.9 vs. 38.68±4.74 %) and peak dP/dt (3068.3±240.6 vs. 3307.0±214.1 mmHg/sec). Thus, our data reveal that male and female middle-aged rats have a similar degree of deterioration in LV systolic properties associated with cardiac remodeling after a large MI.
Research Interests:
ABSTRACT Our previous study on post-MI male and female middle-aged rats has revealed that although both sexes had a similar scale of LV remodeling, the females showed a greater density of cardiac myocytes in the epimyocardium. However,... more
ABSTRACT Our previous study on post-MI male and female middle-aged rats has revealed that although both sexes had a similar scale of LV remodeling, the females showed a greater density of cardiac myocytes in the epimyocardium. However, the mechanism of this structural alteration, as well as its impact on LV function, remained unclear. Our current study was aimed at determining whether the sex-specific difference in the density of cardiac myocytes is related to the rate of their death and whether it affects the cardiac performance in post-MI rats. A large MI was induced in 12-month-old male (M-MI) and female (F-MI) Sprague-Dawley rats by ligation of the left coronary artery. The cardiac function was monitored for two months post-MI. At the end of the experiment, various LV parameters were compared between sexes. We found that although both groups had a similar pattern of decline in LV function, the F-MI rats exhibited a less deteriorated cardiac performance compared to M-MI rats, as indicated by the values of stroke volume (0.18±0.01 vs. 0.14±0.02 mL, P<0.05), ejection fraction (39.9±3.4 vs. 26.7±7.7 %, P<0.05) and cardiac output (57.8±3.1 vs. 44.6±8.7 mL/min, P<0.05). Moreover, the F-MI rats displayed a higher density of cardiac myocytes in the epimyocardium than the males (2383.8±242.6 vs. 1785.7±55.9 cells/mm2, P<0.05). This was associated with a lower rate of myocyte apoptosis in the F-MI rats (0.18±0.08 vs. 0.91±0.30 apoptotic cells/mm2, P<0.01). Thus, our data showed that the F-MI rats had a better preserved LV function compared to M-MI rats, and that this might be caused by an increased myocyte survival in females.
Research Interests:
Background and Aims: Vitamin D counteracts the reduction in the peripheral conversion of tiroxine (T4) into triiodothyronine (T3), which is the mechanism of low T3 syndrome (LT3) in acute myocardial infarction (AMI). The aim of this study... more
Background and Aims: Vitamin D counteracts the reduction in the peripheral conversion of tiroxine (T4) into triiodothyronine (T3), which is the mechanism of low T3 syndrome (LT3) in acute myocardial infarction (AMI). The aim of this study was to assess the relationship between LT3 and hypovitaminosis D in AMI patients. Methods and Results: One hundred and twenty-four AMI patients were enrolled. Blood samples were taken at admission, and at 3, 12, 24, 48, and 72 h after admission. LT3 was defined as a value of fT3 ≤ 2.2 pg/mL, occurring within 3 days of hospital admission. Levels were defined as follows: sufficiency as a value of ±30 ng/mL, vitamin D insufficiency as 25-hydroxyvitamin D (25(OH)D) between 21 and 29 ng/mL, deficiency in 25(OH)D as below 20 ng/mL, and severe deficiency as values under 10 ng/mL. The percentage of subjects with severe 25(OH)D deficiency was significantly higher in the LT3 group (33% vs. 13%, p < 0.01). When LT3S was evaluated as a dependent variable, s...
Research Interests:
AimsArrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with a high risk of sudden cardiac death. Three different prediction models for the indication of implanted cardioverter defibrillator (ICD) are now available: the 5... more
AimsArrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with a high risk of sudden cardiac death. Three different prediction models for the indication of implanted cardioverter defibrillator (ICD) are now available: the 5 year ARVC risk score, the International Task Force Consensus (ITFC) criteria, and the Heart Rhythm Society (HRS) criteria. We compared these three prediction models in a validation cohort of patients with definite ARVC.Methods and resultsIn a cohort of 140 patients with definite ARVC, the 5 year ARVC risk score and the ITFC and HRS criteria were compared for the prediction of a major combined endpoint of sudden cardiac death, appropriate ICD intervention, resuscitated cardiac arrest, and sustained ventricular tachycardia. During the follow‐up, 65 major events occurred. The 5 year ARVC risk score with a threshold >10%, derived from the maximally selected rank statistic, predicted 62 (95%) events [odds ratio (OR) 9.1, 95% confidence interval (CI) ...
Research Interests:
Background: Oxidative stress is crucial in the pathogenesis of atherosclerosis and acute myocardial infarction (AMI). Under the generic terms “oxidative stress” (OS), many biomarkers belonging to different pathways have been proposed.... more
Background: Oxidative stress is crucial in the pathogenesis of atherosclerosis and acute myocardial infarction (AMI). Under the generic terms “oxidative stress” (OS), many biomarkers belonging to different pathways have been proposed. Aim: To compare the levels of recently proposed OS-related parameters in acute coronary syndromes (ACS) and stable coronary artery disease (CAD), to evaluate their effectiveness as additive risk or illness indicators of stable and acute ischemic events, and their response over time during the course of AMI. Methods: 76 ACS, 77 CAD patients, and 63 controls were enrolled in the study. Different OS-related biomarkers, including reactive oxygen metabolites (ROM), the total antioxidant capacity (OXY), nitrite/nitrate (final nitric oxide products, NOx), and Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), were evaluated. Moreover, time response during AMI course (admission, and 6, 12, 18, 24, 36, and 48 hours after, T0-T6, respectively) and ...
Research Interests:
Research Interests:
Research Interests:
Thyroid hormone (TH) receptors are present in the myocardium and vascular tissue, and minor alterations in TH concentration can affect cardiovascular (CV) physiology. The potential mechanisms that link CV disease with thyroid dysfunction... more
Thyroid hormone (TH) receptors are present in the myocardium and vascular tissue, and minor alterations in TH concentration can affect cardiovascular (CV) physiology. The potential mechanisms that link CV disease with thyroid dysfunction are endothelial dysfunction, changes in blood pressure, myocardial systolic and diastolic dysfunction, and dyslipidemia. In addition, cardiac disease itself may lead to alterations in TH concentrations (notably, low triiodothyronine syndrome) that are associated with higher morbidity and mortality. Experimental data and small clinical trials have suggested a beneficial role of TH in ameliorating CV disease. The aim of this review is to provide clinicians dealing with CV conditions with an overview of the current knowledge of TH perturbations in CV disease.
Research Interests:
Research Interests:
Research Interests:
Myocardial hibernation (MH) is a well‐known feature of human ischaemic cardiomyopathy (ICM), whereas its presence in human idiopathic dilated cardiomyopathy (DCM) is still controversial. We investigated the histological and molecular... more
Myocardial hibernation (MH) is a well‐known feature of human ischaemic cardiomyopathy (ICM), whereas its presence in human idiopathic dilated cardiomyopathy (DCM) is still controversial. We investigated the histological and molecular features of MH in left ventricle (LV) regions of failing DCM or ICM hearts. We examined failing hearts from DCM (n = 11; 41.9 ± 5.45 years; left ventricle‐ejection fraction (LV‐EF), 18 ± 3.16%) and ICM patients (n = 12; 58.08 ± 1.7 years; LVEF, 21.5 ± 6.08%) undergoing cardiac transplantation, and normal donor hearts (N, n = 8). LV inter‐ventricular septum (IVS) and antero‐lateral free wall (FW) were transmurally (i.e. sub‐epicardial, mesocardial and sub‐endocardial layers) analysed. LV glycogen content was shown to be increased in both DCM and ICM as compared with N hearts (P < 0.001), with a U‐shaped transmural distribution (lower values in mesocardium). Capillary density was homogenously reduced in both DCM and ICM as compared with N (P < 0.05 ...
Research Interests: Cardiology, Apoptosis, Heart Failure, Humans, Internal Medicine, and 15 moreCapillaries, Hemodynamics, Female, Dilated cardiomyopathy, Clinical Sciences, Adult, Cardiomyopathy, Cellular and Molecular Medicine, Connexin, Ejection Fraction, Heart Transplantation, Heart Ventricles, Biochemistry and cell biology, Cell Size, and Collagen type I
Research Interests:
Research Interests: Cardiology, Medicine, Thyroid, Pathophysiology, Heart Failure, and 15 moreHumans, Internal Medicine, Heart rate, Thyroid Hormones, Hypothyroidism, Hormone, Prognosis, Prospective Study, Pathological, Thyroid Function, Cardiac function, Contractility, Thyroid hormone, Cardiovascular medicine and haematology, and Thyrotropin
Research Interests: Cardiology, Risk assessment, Medicine, Echocardiography, Humans, and 15 moreInternal Medicine, Myocardial Infarction, Myocardium, Public health systems and services research, Time Factors, Survival Rate, Risk Stratification, Risk Assessment, Ejection Fraction, Sensitivity and Specificity, Exercise Test, Predictive value of tests, Revascularization, Stress echocardiography, and Cardiovascular medicine and haematology
Research Interests:
Research Interests:
A neoprene wetsuit is widely used to reduce thermal dispersion during diving. Recent observations have pointed out that elastic recoil of the wetsuit might have significant compressive effects, able to affect water and electrolyte... more
A neoprene wetsuit is widely used to reduce thermal dispersion during diving. Recent observations have pointed out that elastic recoil of the wetsuit might have significant compressive effects, able to affect water and electrolyte homeostasis during both dry and immersed conditions. The aim of this study was to evaluate the possible cardiovascular and respiratory effects of the neoprene wetsuit in dry conditions in a sample of experienced divers. Twenty-four (24) healthy divers were evaluated by Doppler-echocardiography and by spirometry in basal conditions and while wearing a full neoprene wetsuit. During wetsuit conditions, we observed a significant decrease in heart rate (-5%; p ⟨ 0.05) and cardiac output (-12%; p ⟨ 0.05), and a significant increase in total peripheral resistances (15%; p ⟨ 0.05). Moreover, a significant reduction of right ventricular early diastolic filling was observed (-15%; p ⟨ 0.05). As concerns pulmonary function, a significant reduction of vital capacity (...
Research Interests:
Environmental pollution is associated with morbidity and mortality for chronic-degenerative diseases. Recent data points out a relationship between proximity to industrial plants and mortality due to neoplasms. The aim of this study has... more
Environmental pollution is associated with morbidity and mortality for chronic-degenerative diseases. Recent data points out a relationship between proximity to industrial plants and mortality due to neoplasms. The aim of this study has been to compare mortality due to chronic-degenerative diseases in the area of Tuscany (Bassa Val di Cecina), Italy, characterized by the presence of 2 neighboring municipalities similar in terms of size but with substantial differences in industrial activities: Rosignano (the site of chemical, energy production and waste processing industries) and Cecina (with no polluting activity). Standardized mortality rates for the 2001-2010 decade were calculated; the data of the whole Tuscany was assumed as reference. Environmental levels of pollutants were obtained by databases of the Environmental Protection Agency of Tuscany Region (Agenzia Regionale per la Protezione Ambientale della Toscana - ARPAT). Maximum tolerated pollutant levels set by national laws...
Research Interests: Environmental Pollution, Neurodegenerative Diseases, Italy, Heavy metals, Humans, and 13 moreChronic Disease, Mesothelioma, Seawater, Risk factors, Clinical Sciences, Ozone, Public health systems and services research, Particulate Matter, Risk Factors, Alzheimer Disease, Cerebrovascular Disorders, Myocardial Ischemia, and lung neoplasms
To evaluate the accuracy of late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) and imaging stress test in predicting significant coronary artery disease (CAD) in left ventricular (LV) dysfunction. We enrolled 187... more
To evaluate the accuracy of late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) and imaging stress test in predicting significant coronary artery disease (CAD) in left ventricular (LV) dysfunction. We enrolled 187 consecutive out-patients (61±17years) with new evidence of depressed (&amp;amp;amp;amp;lt;45%) ejection fraction and no history of previous heart diseases and absence of Q-waves. All patients underwent coronary angiography (CA) and to LGE-CMR examination to identify ischemic and non-ischemic LGE. All patients underwent stress imaging to determine the presence of myocardial ischemia. Ischemic-LGE was found in 83 patients and non-ischemic-LGE in 104. Significant CAD on CA was found in 86/187 patients. Ischemic-LGE showed a specificity of 94%, a sensitivity of 89% and an accuracy of 92% in identifying significant CAD. Imaging stress test was negative in 98/105 patients without CAD, and positive in 42/82 with significant CAD, showing a specificity of 93%, a sensitivity of 51% and an accuracy of 75% in identifying CAD. Combining CMR and stress test imaging, 94 patients had ischemic-LGE pattern and/or positive stress test for ischemia; of these 81/94 had significant CAD on CA and 13 had no CAD. Among the 93 patients with both tests negative, significant CAD was found in 5/93 patients. The combination of LGE and stress respect to only LGE did not improve the diagnostic accuracy (90 vs 92% respectively). LGE-CMR had high accuracy in predicting significant CAD in ischemic LV dysfunction or as a bystander in non ischemic dysfunction.
Research Interests:
Research Interests:
Background: In recent years, the use of middle-aged and old animals of both sexes has become preferential in experimental studies involving the models of cardiovascular diseases to better reflect a human population. However, the evidence... more
Background: In recent years, the use of middle-aged and old animals of both sexes has become preferential in experimental studies involving the models of cardiovascular diseases to better reflect a human population. However, the evidence showing the extent of sex-related differences in cardiac aging of laboratory animals remains obscure. Accordingly, we designed our study to determine whether the male and female rats differ during aging with regard to left ventricular (LV) geometry and systolic function. Methods: We performed transthoracic echocardiographic examinations in 12-month-old (12mo) and 24 month-old (24mo) male and female Sprague-Dawley rats (Charles River, Wilmington, MA) under 1.5% isoflurane anesthesia using a linear (Matrix) array transducer probe GE M12L (5.5-14.0 MHz) and a GE Vivid 7 Dimension ultrasound system. Two-dimensional short-axis views and M-mode tracings of the LV at the papillary muscle level were recorded and used to estimate various LV parameters. Results: We found that 24mo-Female rats had a significant increase in LV chamber dimensions associated with a reduction in its systolic performance as compared to 12mo-Female rats (Table 1). In contrast, LV parameters remained similar between 12mo- and 24mo-Male rats. Table 1. Echocardiographic parameters of LV chamber geometry and systolic performance Values are means ± SE. Arrow indicates a significant difference between age groups ( P ≤ 0.05). Conclusion: Our data demonstrate that during cardiac aging female rats have a different pattern of LV changes compared to males that must be considered in the design of future experimental studies.
Research Interests:
Heart failure (HF) is an intriguing model of chronic disease. It starts as an organ disorder developing, in its progression, into a systemic disease in which the dysfunction of other organs plays a relevant clinical and prognostic impact.... more
Heart failure (HF) is an intriguing model of chronic disease. It starts as an organ disorder developing, in its progression, into a systemic disease in which the dysfunction of other organs plays a relevant clinical and prognostic impact. Furthermore, continuous activation of systemic pathways plays a role in disease progression, switching their effect from protective to harmful. In this combination of organ dysfunction and systemic derangement, thyroid hormone (TH) have an important regulative impact from cardiovascular to systemic level and from molecular/cellular processes to clinical setting. Whether it is accepted to include TH and thyroid stimulating hormone assessment in the clinical HF course, the next challenge will be to ascertain the benefit of TH replacement therapy in HF patients, taking into consideration the type of hormone to administer, dosage and treatment schedule.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
The purpose was to evaluate the blood flow redistribution in the neck vessels of patients with internal carotid artery (ICA) stenosis. Eighty-six patients with ICA stenosis underwent contrast-enhanced magnetic resonance angiography... more
The purpose was to evaluate the blood flow redistribution in the neck vessels of patients with internal carotid artery (ICA) stenosis. Eighty-six patients with ICA stenosis underwent contrast-enhanced magnetic resonance angiography (CEMRA) and fast 2D phase contrast (2D-PC) sequence to measure the mean blood flow (MBF) of ICA, basilar artery (BA) and middle cerebral artery (MCA). CEMRA revealed 53 severe stenoses, 45 moderate stenoses and 3 occluded vessels. Patients with a unilateral severe ICA stenosis had a significantly reduced MBF of the ICA compared to the control group; the MBF reduction of the severely stenosed ICA was less conspicuous if associated with a controlateral severe stenosis. The MBF of the BA increased significantly in the presence of the bilateral severe ICA stenosis and in the ICA occlusion. The MBF of the MCA was unchanged in the presence of various degrees of ICA stenosis. Measurement of MBF with fast PC MRA permits cerebropethal blood flow assessment and gives additional information in grading ICA stenosis. The reduced MBF of a severe ICA stenosis has to be considered with caution since it depends also on the status of the controlateral ICA and may be considered a confident parameter only in case of unilateral carotid stenosis.
Research Interests: Humans, Female, Male, Magnetic Resonance, Clinical Sciences, and 15 moreEuropean, Aged, Middle Aged, Blood Flow, MR Angiography, Blood Flow Velocity, Basilar Artery, Contrast Media, Middle Cerebral Artery, Internal Carotid Artery, Control Group, Carotid Stenosis, Carotid Artery Stenosis, Case Control Studies, and Magnetic resonance angiography
The scientific assessment of diagnostic tests should not be based upon a small series of results published by the best academic institutions, but ought to require large scale, multicentre validation founded on grass roots institutions... more
The scientific assessment of diagnostic tests should not be based upon a small series of results published by the best academic institutions, but ought to require large scale, multicentre validation founded on grass roots institutions with real doctors, real patients and real problems. To this purpose, an international network of stress echo laboratories has been organized, and within a few years has collected data from thousands of studies using pharmacological stress echocardiography, performed with either dipyridamole (EPIC: Echo Persantine International Cooperative Study) or dobutamine (EDIC: Echo Dobutamine International Cooperative Study) stresses. In a widely deregulated field, all network laboratories have agreed: to pass a quality control examination on stress echo reading before entering the study; to adopt an identical drug infusion protocol; to code similarly the LV segments; and to adopt a common scoring system for wall motion analysis. A minimum amount of historical, clinical, and-when available-stress electrocardiographic, angiographic and follow-up data have been collected on each patient, and disseminated in the various centres, facilitating the creation of an international stress echo language that will help, not only the production of high quality scientific data, but also the build up of a common stress echo lab, with a standardized way of making the studies, unifying the methods and terminology, and archiving data. To date, we have 50 echo laboratories from 15 nations across four continents (Europe, America, Asia and Africa) actively involved in this project. These data will ultimately fill the gap between the academic theory of journals and the pragmatic experience of daily life in a busy echocardiographic laboratory.
Research Interests:
Research Interests:
Research Interests:
Research Interests: Risk assessment, Humans, Female, Male, Risk factors, and 10 moreMiddle Aged, Myocardial Infarction, Prognosis, Sudden Cardiac Death, Risk Factors, Risk Assessment, Implantable defibrillators-cardioverters, SECONDARY PREVENTION, Magnetic resonance angiography, and Cardiovascular medicine and haematology
Flow in the common carotid artery is normally quasisteady with flow never approaching zero during diastole. With total occlusion of the internal carotid artery, flow in the common carotid assumes the pattern observed in the external... more
Flow in the common carotid artery is normally quasisteady with flow never approaching zero during diastole. With total occlusion of the internal carotid artery, flow in the common carotid assumes the pattern observed in the external carotid, which supplies a relatively high-resistance vascular bed. In 34 instances of total internal carotid obstruction, flow went to zero in diastole in 33 cases and also demonstrated flow reversal in 22. In addition, there was a significant reduction in peak systolic velocity when the low-resistance internal carotid was obstructed. These observations, which are simple to determine using an ultrasonic duplex scanner, are of value in suspecting total occlusion of the internal carotid artery, thus obviating the need for arteriography in some cases.
Research Interests:
Cited Here...: Areas of delayed contrast enhancement (which reflects myocardial necrosis) were present in 15 ± 9% of left ventricular myocardium. Infarct size was not influenced by patient age, gender, history of arterial hypertension,... more
Cited Here...: Areas of delayed contrast enhancement (which reflects myocardial necrosis) were present in 15 ± 9% of left ventricular myocardium. Infarct size was not influenced by patient age, gender, history of arterial hypertension, hypercholesterolaemia, ...
Research Interests:
Physical exercise represents a eustress condition that promotes rapid coordinated adjustments in the immune, stress-related hormonal and cardiovascular systems, for maintaining homeostasis in response to increased metabolic demands.... more
Physical exercise represents a eustress condition that promotes rapid coordinated adjustments in the immune, stress-related hormonal and cardiovascular systems, for maintaining homeostasis in response to increased metabolic demands. Compared to the tight multisystem coordination during exercise, evidence of between-systems cross talk in the early post exercise is still lacking. This study was aimed at identifying possible interactions between multiple systems following strenuous physical exercise (Ironman race) performed by twenty well-trained triathletes. Cardiac hemodynamics, left ventricle systolic and diastolic function and heart rate variability were measured along with plasma concentrations of immune messengers (cytokines and C-reactive protein) and stress-related hormones (catecholamines and cortisol) both 24h before and within 20 min after the race. Observed changes in antiinflammatory pathways, stress-related hormones and cardiovascular function were in line with previous f...
Research Interests:
Research Interests:
Myocardial hibernation (MH) is a well-known feature of human ischaemic cardiomyopathy (ICM), whereas its presence in human idiopathic dilated cardiomyopathy (DCM) is still controversial. We investigated the histological and molecular... more
Myocardial hibernation (MH) is a well-known feature of human ischaemic cardiomyopathy (ICM), whereas its presence in human idiopathic dilated cardiomyopathy (DCM) is still controversial. We investigated the histological and molecular features of MH in left ventricle (LV) regions of failing DCM or ICM hearts. We examined failing hearts from DCM (n = 11; 41.9 ± 5.45 years; left ventricle-ejection fraction (LV-EF), 18 ± 3.16%) and ICM patients (n = 12; 58.08 ± 1.7 years; LVEF, 21.5 ± 6.08%) undergoing cardiac transplantation, and normal donor hearts (N, n = 8). LV inter-ventricular septum (IVS) and antero-lateral free wall (FW) were transmurally (i.e. sub-epicardial, mesocardial and sub-endocardial layers) analysed. LV glycogen content was shown to be increased in both DCM and ICM as compared with N hearts (P < 0.001), with a U-shaped transmural distribution (lower values in mesocardium). Capillary density was homogenously reduced in both DCM and ICM as compared with N (P < 0.05 ...