A. Gallino - Academia.edu (original) (raw)
Papers by A. Gallino
<b><i>Background:</i></b> Carotid plaque neovascularization (<i>vas... more <b><i>Background:</i></b> Carotid plaque neovascularization (<i>vasa vasorum</i> [VV]) may be useful for detecting high-risk atherosclerotic plaques. Contrast-enhanced ultrasound (CEUS) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are 2 commonly used techniques for imaging VV of the carotid plaque, yet the relationship between their measurements remains unknown. <b><i>Objectives:</i></b> We aimed to blindly evaluate the correlation between CEUS and DCE-MRI in measuring carotid plaque VV. <b><i>Methods:</i></b> We recruited subjects with asymptomatic carotid stenosis (≥50%). VV was graded by CEUS, based on richness of contrast signal, according to 3 different methods named CEUS_A, CEUS_B and CEUS_C on different point scales (the higher the values, the higher the estimated VV). A 3.0 T MRI scanner was used for VV quantification by DCE-MRI using gadolinium contrast kinetic modelling for computing the fractional plasma volume (<i>vp</i>) and transfer constant (<i>K</i><sup><i>trans</i></sup>). <b><i>Results:</i></b> The analysis included 30 patients. A significant correlation between CEUS and DCE-MRI findings was observed when CEUS_C was used for neovessel grading and DCE-MRI was used to determine adventitial (<i>r</i> = 0.460, <i>p</i> = 0.010) and plaque (<i>r</i> = 0.374, <i>p</i> = 0.042) <i>Ktrans</i> values. CEUS_B (<i>r</i> = 0.416, <i>p</i> = 0.022) and CEUS_C (<i>r</i> = 0.443, <i>p</i> = 0.014) grading showed a significant correlation with regard to the maximal <i>K</i><sup><i>trans</i></sup>. <b><i>Conclusions:</i></b> We found a positive but weak correlation and a moderate diagnostic agreement between neovessels as visually graded by CEUS and adventitial neovessels assessed by DCE-MRI <i>K</i><sup><i>trans</i></sup> in carotid atherosclerosis. These findings may help in understanding how VV density, flow, and permeability influence in vivo measurements by CEUS and DCE-MRI as well as in selecting the most appropriate variables and imaging method in future research and potentially in c [...]
European Cardiology Review, 2020
We hypothesised that takotsubo syndrome (TTS) and primary microvascular angina (MVA) may exhibit ... more We hypothesised that takotsubo syndrome (TTS) and primary microvascular angina (MVA) may exhibit peculiar functional organisation of the central autonomic nervous system network (CAN) at rest, as well as specific psychological patterns, when compared to patients with acute MI (AMI). Design and methods: We prospectively enrolled patients in three groups: MVA, after TTS or AMI. Subjects underwent a clinical-diagnostic interview, Million Clinical Multiaxial Inventory III, State-Trait Anxiety Inventory form Y and short form (SF-36) Health Survey quality of life questionnaire. Patients underwent a blinded resting state functional MRI (RS-fMRI), to compare the intrinsic connectivity strength among the CAN nodes. Results: We evaluated 50 matched patients (46 women; 16 MVA, 17 TTS, 17 AMI). There was a high prevalence of obsessive-compulsive personality disorder. MVA showed a significantly lower SF-36 Body-Pain score than AMI (p=0.046) and a significantly higher SF-36 Mental-Health score than AMI (p=0.039). RS-fMRI in TTS showed stronger connectivity between two nodes of the sympathetic (midcingulate cortex) and parasympathetic (sub-central motor area) CAN (F 6.25, p=0.005). Conclusion: The peculiar self-reported body pain and mental health in MVA, as well as the increased level of functional integration between areas of the CAN subdivisions in TTS, may link psychosocial distress with clinical manifestations. These data are hypothesis-generating for future potential endorsement of psychotherapy and stress-reducing techniques as therapeutic strategies. n
European Heart Journal, 1987
In this study we present the results of 105 consecutive patients with pure mitral regurgitation w... more In this study we present the results of 105 consecutive patients with pure mitral regurgitation who underwent surgical treatment. In all patients mitral regurgitation was associated with mitral valve prolapse: 54 patients underwent mitral valvuloplasty and 51 patients mitral valve replacement. Clinical assessment and echocardiography were used as follow-up criteria at one year after surgery. After mitral valvuloplasty, NYH A decreased from 2.7±0.8 to 1.1±0.7 (P<0.01) and workload capacity increased from 65±28% to 96±25% (P<0.001); left endsystolic atrial dimension and enddiastolic dimension decreased from 6.2±0.8 to 4.8±1.2 cm (P<0.001) and from 7.2±1.3 to 5.9±0.8 cm (P<0.01); ventricular contraction fraction did not change significantly. After mitral valve replacement, clinical and echocardiographic improvement was significant but less remarkable than after valvuloplasty; ventricular contraction fraction fell from 39±7% to 29±8% in contrast to patients undergoing mitral valvuloplasty in whom no significant change occurred. Complications were rare in both groups though only a minority of patients undergoing mitral valvuloplasty received anticoagulants. We conclude that mitral valvuloplasty in patients with pure mitral regurgitation associated with mitral valve prolapse gives excellent results, particularly regarding left ventricular function when compared with the patients after mitral valve replacement
Helvetica chirurgica acta, 1991
The postoperative prophylactic cytolytic therapy with rabbit-ATG and OKT3 after heart transplanta... more The postoperative prophylactic cytolytic therapy with rabbit-ATG and OKT3 after heart transplantation are compared. The first 20 recipients were treated with ATG (5 days), the next 20 with OKT3 (14 days). The medium histological rejection grade (Texas classification) was significantly higher after 2 weeks in ATG group and after 4 weeks in OKT3 group. The linearised rejection rate was 7.1 (ATG) vs. 0.7 (OKT3) (p less than 0.005) at 2 weeks, resp. 3.6 vs. 8.6 (p less than 0.05) and 1.3 vs. 2.9 (p less than 0.005) at 4 weeks and 2 months. After 3 months there was no difference in histological rejection grade (3.6 +/- 1.5 vs. 3.3 +/- 1.7) and linearised rejection rate (2.4 vs. 2.6 per 100 days and patient) between the two groups. Severe rejections are more frequent after OKT3 (6 vs. 11) and probability of rejection free survival is higher after ATG (25% vs. 0%, resp. 21% vs. 0% after 2 resp. 3 months; p less than 0.05). In this study we find no short and medium term benefit of a rejecti...
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
The use of cyclosporine therapy for heart transplant recipients has been associated with a signif... more The use of cyclosporine therapy for heart transplant recipients has been associated with a significant improvement of graft survival. Renal function impairment is a frequent finding in patients chronically treated with cyclosporine. The purpose of this prospective randomized study was to establish renal function in a group of heart transplant recipients receiving chronic cyclosporine treatment and to test the hypothesis of reversibility of cyclosporine-induced nephropathy by late reduction of cyclosporine. A total of 28 patients who underwent operation at least 18 months before this study began were randomly assigned to either group A (n = 14), in which the whole-blood polyclonal cyclosporine target trough level was reduced from 400 to 600 micrograms/L to 200 to 400 micrograms/L, and group B (n = 14), in which the level was maintained at 400 to 600 micrograms/L. Renal and cardiac function were assessed by paraaminohippuric acid, inulin and lithium clearances and heart catheterizatio...
European Heart Journal, 2013
Conclusions: The correlation between J point elevation and increased interventricular septum thic... more Conclusions: The correlation between J point elevation and increased interventricular septum thickness supports a possible role for exercise induced left ventricular hypertrophy as a structural basis for the electrocardiographic evidence of J point elevation. 1904 | BEDSIDE The characteristics of infero-lateral early repolarisation are different between young males and females athletes
Japanese Heart Journal, 1997
Three cases of cardiac papillary fibroelastomas are described. Two-dimensional echocardiography d... more Three cases of cardiac papillary fibroelastomas are described. Two-dimensional echocardiography detected the tumors in the mitral valve, the cordae tendinae and in the apex of the left ventricle-a unique location. The tumor excisions were combined with bypass operation, mitral valve reconstruction, repair of cordae tendinae and Maze-procedure. The three patients are doing well after surgery.
European Journal of Vascular and Endovascular Surgery, 2002
Introduction: to assess the outcome of endovascular aortic aneurysm repair (EVAR) using intravasc... more Introduction: to assess the outcome of endovascular aortic aneurysm repair (EVAR) using intravascular ultrasound (IVUS) without angiography. Materials/methods: eighty consecutive patients (median age 69 years (range 25±90): male 72 (90%), female 8 (10%)) underwent endovascular aneurysm repair (AAA 68 (85%), TAA 12 (15%)) using either angiography in 31/80 patients (39%) or IVUS in 49/80 patients (61%) in accordance to the surgeons preference. Results: hospital mortality was 2/80 (3%), 1/68 for AAA (2%), 1/12 for TAA (8%), 2/31 for angiography (7%), and 0/49 for IVUS (0.0%: NS). Median quantity of contrast medium was 190 ml (range: 20±350) for angiography versus 0 ml for IVUS (p 5 0.01). Median X-ray exposure time 24 min (range 9±65 min) versus 8 min (range 0±60 min) for IVUS (p 5 0.05). No coverage of renal or suprarenal artery orifices occurred in either group. Conversion to open surgery was necessary in 4/80 patients (5%), 1/31 for angiography (3%) and 3/49 patients for IVUS (6%: NS). Early endoleaks were observed in 13/80 patients (16%): 8/31 patients for angiography (26%) versus 5/49 for IVUS (10%: p 5 0.05): 5/13 endoleaks resolved spontaneously (39%) whereas 8/13 (61%) required additional procedures. Conclusions: IVUS is a reliable tool for EVAR. In most cases, perprocedural angiography is not necessary.
European Heart Journal, 1997
European Heart Journal, 1987
In this study, betathromboglobulin (BTG) and fibrinopeptide A (FPA) in peripheral venous blood we... more In this study, betathromboglobulin (BTG) and fibrinopeptide A (FPA) in peripheral venous blood were measured in 20 patients with stable angina pectoris before and immediately after exerciseinduced myocardial ischaemia; in 5 of the 20 patients stable angina was associated with typical peripheral artery disease. A total of 10 patients with angiographically documented peripheral artery disease without angina and 10 normal volunteers were taken as control groups. BTG and FPA in the 15 patients with stable angina before exercise were 41±14 ng ml-1 and 2.3±09 ng ml-1 and were not statistically different from the values in normal controls; after exercise-induced myocardial ischaemia no significant increase occurred in these patients. Conversely, in the 5 patients with stable angina associated with peripheral artery disease BTG and FPA before exercise were 6l±10 ng ml-1 and 3.5±0.8 ng ml-1 and increased to 114±14 ng ml-1 (P<0.001) and 4.l±0.5 ng ml-1 (P<0.01): These results were similar to those found in the 10 patients with isolated peripheral artery disease. We conclude that BTG and FPA in peripheral venous blood in patients with stable angina are not elevated either at rest or after exercise-induced myocardial ischaemia. Elevated values of BTG and FPA in patients with stable angina may reflect a major interaction between blood and atherosclerotic vessel wall, suggesting the presence of associated atherosclerotic lesions in peripheral artery disease
Circulation, 2004
Background— Percutaneous transluminal angioplasty (PTA) of severely stenotic peripheral vascular ... more Background— Percutaneous transluminal angioplasty (PTA) of severely stenotic peripheral vascular lesions is hampered by a higher restenosis rate. The effects of PTA on vascular wall as well as the effects of the antirestenotic properties of endovascular brachytherapy (EVBT) remain unclear. MRI allows in vivo noninvasive assessment of the vascular effects of such treatment strategies. We sought to elucidate the vascular effect of PTA and PTA+EVBT by serial MRI. Methods and Results— Twenty symptomatic patients with severe stenosis of the femoropopliteal artery were randomly assigned to PTA (n=10) or PTA+EVBT (n=10; 14 Gy by γ-irradiation source) and imaged by high-resolution MRI before and 24 hours and 3 months after intervention. An independent observer blinded to the procedure analyzed the MRI data. At 24 hours, cross-sectional MRI revealed that lumen area (86% and 67%) and total vessel area (47% and 34%) increased similarly in the PTA and PTA+EVBT groups, respectively. All patients...
American Heart Journal, 1993
American Heart Journal, 1986
European Heart Journal, 2011
The time course of atherosclerosis burden in distinct vascular territories remains poorly underst... more The time course of atherosclerosis burden in distinct vascular territories remains poorly understood. We longitudinally evaluated the natural history of atherosclerotic progression in two different arterial territories using high spatial resolution magnetic resonance imaging (HR-MRI), a powerful, safe, and non-invasive tool. Methods and results We prospectively studied a cohort of 30 patients (mean age 68.3, n ¼ 9 females) with high Framingham general cardiovascular disease 10-year risk score (29.5%) and standard medical therapy with mild-to-moderate atherosclerosis intra-individually at the level of both carotid and femoral arteries. A total of 178 HR-MRI studies of carotid and femoral arteries performed at baseline and at 1-and 2-year follow-up were evaluated in consensus reading by two experienced readers for lumen area (LA), total vessel area (TVA), vessel wall area (VWA ¼ TVA 2 LA), and normalized wall area index (NWI ¼ VWA/TVA). At the carotid level, LA decreased (23.19%/year, P ¼ 0.018), VWA increased (+3.83%/year, P ¼ 0.019), and TVA remained unchanged. At the femoral level, LA remained unchanged, VWA and TVA increased (+5.23%/year and +3.11%/year, both P , 0.01), and NWI increased for both carotid and femoral arteries (+2.28%/year, P ¼ 0.01, and +1.8%/year, P ¼ 0.033). Conclusion The atherosclerotic burden increased significantly in both carotid and femoral arteries. However, carotid plaque progression was associated with negative remodelling, whereas the increase in femoral plaque burden was compensated by positive remodelling. This finding could be related to anatomic and flow differences and/or to the distinct degree of obstruction in the two arterial territories.
The European Journal of Public Health, 2014
<b><i>Background:</i></b> Carotid plaque neovascularization (<i>vas... more <b><i>Background:</i></b> Carotid plaque neovascularization (<i>vasa vasorum</i> [VV]) may be useful for detecting high-risk atherosclerotic plaques. Contrast-enhanced ultrasound (CEUS) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are 2 commonly used techniques for imaging VV of the carotid plaque, yet the relationship between their measurements remains unknown. <b><i>Objectives:</i></b> We aimed to blindly evaluate the correlation between CEUS and DCE-MRI in measuring carotid plaque VV. <b><i>Methods:</i></b> We recruited subjects with asymptomatic carotid stenosis (≥50%). VV was graded by CEUS, based on richness of contrast signal, according to 3 different methods named CEUS_A, CEUS_B and CEUS_C on different point scales (the higher the values, the higher the estimated VV). A 3.0 T MRI scanner was used for VV quantification by DCE-MRI using gadolinium contrast kinetic modelling for computing the fractional plasma volume (<i>vp</i>) and transfer constant (<i>K</i><sup><i>trans</i></sup>). <b><i>Results:</i></b> The analysis included 30 patients. A significant correlation between CEUS and DCE-MRI findings was observed when CEUS_C was used for neovessel grading and DCE-MRI was used to determine adventitial (<i>r</i> = 0.460, <i>p</i> = 0.010) and plaque (<i>r</i> = 0.374, <i>p</i> = 0.042) <i>Ktrans</i> values. CEUS_B (<i>r</i> = 0.416, <i>p</i> = 0.022) and CEUS_C (<i>r</i> = 0.443, <i>p</i> = 0.014) grading showed a significant correlation with regard to the maximal <i>K</i><sup><i>trans</i></sup>. <b><i>Conclusions:</i></b> We found a positive but weak correlation and a moderate diagnostic agreement between neovessels as visually graded by CEUS and adventitial neovessels assessed by DCE-MRI <i>K</i><sup><i>trans</i></sup> in carotid atherosclerosis. These findings may help in understanding how VV density, flow, and permeability influence in vivo measurements by CEUS and DCE-MRI as well as in selecting the most appropriate variables and imaging method in future research and potentially in c [...]
European Cardiology Review, 2020
We hypothesised that takotsubo syndrome (TTS) and primary microvascular angina (MVA) may exhibit ... more We hypothesised that takotsubo syndrome (TTS) and primary microvascular angina (MVA) may exhibit peculiar functional organisation of the central autonomic nervous system network (CAN) at rest, as well as specific psychological patterns, when compared to patients with acute MI (AMI). Design and methods: We prospectively enrolled patients in three groups: MVA, after TTS or AMI. Subjects underwent a clinical-diagnostic interview, Million Clinical Multiaxial Inventory III, State-Trait Anxiety Inventory form Y and short form (SF-36) Health Survey quality of life questionnaire. Patients underwent a blinded resting state functional MRI (RS-fMRI), to compare the intrinsic connectivity strength among the CAN nodes. Results: We evaluated 50 matched patients (46 women; 16 MVA, 17 TTS, 17 AMI). There was a high prevalence of obsessive-compulsive personality disorder. MVA showed a significantly lower SF-36 Body-Pain score than AMI (p=0.046) and a significantly higher SF-36 Mental-Health score than AMI (p=0.039). RS-fMRI in TTS showed stronger connectivity between two nodes of the sympathetic (midcingulate cortex) and parasympathetic (sub-central motor area) CAN (F 6.25, p=0.005). Conclusion: The peculiar self-reported body pain and mental health in MVA, as well as the increased level of functional integration between areas of the CAN subdivisions in TTS, may link psychosocial distress with clinical manifestations. These data are hypothesis-generating for future potential endorsement of psychotherapy and stress-reducing techniques as therapeutic strategies. n
European Heart Journal, 1987
In this study we present the results of 105 consecutive patients with pure mitral regurgitation w... more In this study we present the results of 105 consecutive patients with pure mitral regurgitation who underwent surgical treatment. In all patients mitral regurgitation was associated with mitral valve prolapse: 54 patients underwent mitral valvuloplasty and 51 patients mitral valve replacement. Clinical assessment and echocardiography were used as follow-up criteria at one year after surgery. After mitral valvuloplasty, NYH A decreased from 2.7±0.8 to 1.1±0.7 (P<0.01) and workload capacity increased from 65±28% to 96±25% (P<0.001); left endsystolic atrial dimension and enddiastolic dimension decreased from 6.2±0.8 to 4.8±1.2 cm (P<0.001) and from 7.2±1.3 to 5.9±0.8 cm (P<0.01); ventricular contraction fraction did not change significantly. After mitral valve replacement, clinical and echocardiographic improvement was significant but less remarkable than after valvuloplasty; ventricular contraction fraction fell from 39±7% to 29±8% in contrast to patients undergoing mitral valvuloplasty in whom no significant change occurred. Complications were rare in both groups though only a minority of patients undergoing mitral valvuloplasty received anticoagulants. We conclude that mitral valvuloplasty in patients with pure mitral regurgitation associated with mitral valve prolapse gives excellent results, particularly regarding left ventricular function when compared with the patients after mitral valve replacement
Helvetica chirurgica acta, 1991
The postoperative prophylactic cytolytic therapy with rabbit-ATG and OKT3 after heart transplanta... more The postoperative prophylactic cytolytic therapy with rabbit-ATG and OKT3 after heart transplantation are compared. The first 20 recipients were treated with ATG (5 days), the next 20 with OKT3 (14 days). The medium histological rejection grade (Texas classification) was significantly higher after 2 weeks in ATG group and after 4 weeks in OKT3 group. The linearised rejection rate was 7.1 (ATG) vs. 0.7 (OKT3) (p less than 0.005) at 2 weeks, resp. 3.6 vs. 8.6 (p less than 0.05) and 1.3 vs. 2.9 (p less than 0.005) at 4 weeks and 2 months. After 3 months there was no difference in histological rejection grade (3.6 +/- 1.5 vs. 3.3 +/- 1.7) and linearised rejection rate (2.4 vs. 2.6 per 100 days and patient) between the two groups. Severe rejections are more frequent after OKT3 (6 vs. 11) and probability of rejection free survival is higher after ATG (25% vs. 0%, resp. 21% vs. 0% after 2 resp. 3 months; p less than 0.05). In this study we find no short and medium term benefit of a rejecti...
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
The use of cyclosporine therapy for heart transplant recipients has been associated with a signif... more The use of cyclosporine therapy for heart transplant recipients has been associated with a significant improvement of graft survival. Renal function impairment is a frequent finding in patients chronically treated with cyclosporine. The purpose of this prospective randomized study was to establish renal function in a group of heart transplant recipients receiving chronic cyclosporine treatment and to test the hypothesis of reversibility of cyclosporine-induced nephropathy by late reduction of cyclosporine. A total of 28 patients who underwent operation at least 18 months before this study began were randomly assigned to either group A (n = 14), in which the whole-blood polyclonal cyclosporine target trough level was reduced from 400 to 600 micrograms/L to 200 to 400 micrograms/L, and group B (n = 14), in which the level was maintained at 400 to 600 micrograms/L. Renal and cardiac function were assessed by paraaminohippuric acid, inulin and lithium clearances and heart catheterizatio...
European Heart Journal, 2013
Conclusions: The correlation between J point elevation and increased interventricular septum thic... more Conclusions: The correlation between J point elevation and increased interventricular septum thickness supports a possible role for exercise induced left ventricular hypertrophy as a structural basis for the electrocardiographic evidence of J point elevation. 1904 | BEDSIDE The characteristics of infero-lateral early repolarisation are different between young males and females athletes
Japanese Heart Journal, 1997
Three cases of cardiac papillary fibroelastomas are described. Two-dimensional echocardiography d... more Three cases of cardiac papillary fibroelastomas are described. Two-dimensional echocardiography detected the tumors in the mitral valve, the cordae tendinae and in the apex of the left ventricle-a unique location. The tumor excisions were combined with bypass operation, mitral valve reconstruction, repair of cordae tendinae and Maze-procedure. The three patients are doing well after surgery.
European Journal of Vascular and Endovascular Surgery, 2002
Introduction: to assess the outcome of endovascular aortic aneurysm repair (EVAR) using intravasc... more Introduction: to assess the outcome of endovascular aortic aneurysm repair (EVAR) using intravascular ultrasound (IVUS) without angiography. Materials/methods: eighty consecutive patients (median age 69 years (range 25±90): male 72 (90%), female 8 (10%)) underwent endovascular aneurysm repair (AAA 68 (85%), TAA 12 (15%)) using either angiography in 31/80 patients (39%) or IVUS in 49/80 patients (61%) in accordance to the surgeons preference. Results: hospital mortality was 2/80 (3%), 1/68 for AAA (2%), 1/12 for TAA (8%), 2/31 for angiography (7%), and 0/49 for IVUS (0.0%: NS). Median quantity of contrast medium was 190 ml (range: 20±350) for angiography versus 0 ml for IVUS (p 5 0.01). Median X-ray exposure time 24 min (range 9±65 min) versus 8 min (range 0±60 min) for IVUS (p 5 0.05). No coverage of renal or suprarenal artery orifices occurred in either group. Conversion to open surgery was necessary in 4/80 patients (5%), 1/31 for angiography (3%) and 3/49 patients for IVUS (6%: NS). Early endoleaks were observed in 13/80 patients (16%): 8/31 patients for angiography (26%) versus 5/49 for IVUS (10%: p 5 0.05): 5/13 endoleaks resolved spontaneously (39%) whereas 8/13 (61%) required additional procedures. Conclusions: IVUS is a reliable tool for EVAR. In most cases, perprocedural angiography is not necessary.
European Heart Journal, 1997
European Heart Journal, 1987
In this study, betathromboglobulin (BTG) and fibrinopeptide A (FPA) in peripheral venous blood we... more In this study, betathromboglobulin (BTG) and fibrinopeptide A (FPA) in peripheral venous blood were measured in 20 patients with stable angina pectoris before and immediately after exerciseinduced myocardial ischaemia; in 5 of the 20 patients stable angina was associated with typical peripheral artery disease. A total of 10 patients with angiographically documented peripheral artery disease without angina and 10 normal volunteers were taken as control groups. BTG and FPA in the 15 patients with stable angina before exercise were 41±14 ng ml-1 and 2.3±09 ng ml-1 and were not statistically different from the values in normal controls; after exercise-induced myocardial ischaemia no significant increase occurred in these patients. Conversely, in the 5 patients with stable angina associated with peripheral artery disease BTG and FPA before exercise were 6l±10 ng ml-1 and 3.5±0.8 ng ml-1 and increased to 114±14 ng ml-1 (P<0.001) and 4.l±0.5 ng ml-1 (P<0.01): These results were similar to those found in the 10 patients with isolated peripheral artery disease. We conclude that BTG and FPA in peripheral venous blood in patients with stable angina are not elevated either at rest or after exercise-induced myocardial ischaemia. Elevated values of BTG and FPA in patients with stable angina may reflect a major interaction between blood and atherosclerotic vessel wall, suggesting the presence of associated atherosclerotic lesions in peripheral artery disease
Circulation, 2004
Background— Percutaneous transluminal angioplasty (PTA) of severely stenotic peripheral vascular ... more Background— Percutaneous transluminal angioplasty (PTA) of severely stenotic peripheral vascular lesions is hampered by a higher restenosis rate. The effects of PTA on vascular wall as well as the effects of the antirestenotic properties of endovascular brachytherapy (EVBT) remain unclear. MRI allows in vivo noninvasive assessment of the vascular effects of such treatment strategies. We sought to elucidate the vascular effect of PTA and PTA+EVBT by serial MRI. Methods and Results— Twenty symptomatic patients with severe stenosis of the femoropopliteal artery were randomly assigned to PTA (n=10) or PTA+EVBT (n=10; 14 Gy by γ-irradiation source) and imaged by high-resolution MRI before and 24 hours and 3 months after intervention. An independent observer blinded to the procedure analyzed the MRI data. At 24 hours, cross-sectional MRI revealed that lumen area (86% and 67%) and total vessel area (47% and 34%) increased similarly in the PTA and PTA+EVBT groups, respectively. All patients...
American Heart Journal, 1993
American Heart Journal, 1986
European Heart Journal, 2011
The time course of atherosclerosis burden in distinct vascular territories remains poorly underst... more The time course of atherosclerosis burden in distinct vascular territories remains poorly understood. We longitudinally evaluated the natural history of atherosclerotic progression in two different arterial territories using high spatial resolution magnetic resonance imaging (HR-MRI), a powerful, safe, and non-invasive tool. Methods and results We prospectively studied a cohort of 30 patients (mean age 68.3, n ¼ 9 females) with high Framingham general cardiovascular disease 10-year risk score (29.5%) and standard medical therapy with mild-to-moderate atherosclerosis intra-individually at the level of both carotid and femoral arteries. A total of 178 HR-MRI studies of carotid and femoral arteries performed at baseline and at 1-and 2-year follow-up were evaluated in consensus reading by two experienced readers for lumen area (LA), total vessel area (TVA), vessel wall area (VWA ¼ TVA 2 LA), and normalized wall area index (NWI ¼ VWA/TVA). At the carotid level, LA decreased (23.19%/year, P ¼ 0.018), VWA increased (+3.83%/year, P ¼ 0.019), and TVA remained unchanged. At the femoral level, LA remained unchanged, VWA and TVA increased (+5.23%/year and +3.11%/year, both P , 0.01), and NWI increased for both carotid and femoral arteries (+2.28%/year, P ¼ 0.01, and +1.8%/year, P ¼ 0.033). Conclusion The atherosclerotic burden increased significantly in both carotid and femoral arteries. However, carotid plaque progression was associated with negative remodelling, whereas the increase in femoral plaque burden was compensated by positive remodelling. This finding could be related to anatomic and flow differences and/or to the distinct degree of obstruction in the two arterial territories.
The European Journal of Public Health, 2014