Benedetta Matrone - Academia.edu (original) (raw)

Papers by Benedetta Matrone

Research paper thumbnail of The Gla D313Y Mutation in Fabry Disease: Diagnostic Dilemmas and Therapeutic Considerations

European heart journal supplements, Apr 1, 2024

Research paper thumbnail of Telecuore: Feasibility of a Hospital–Territorial Telemedicine Project in Chronic Heart Failure

European heart journal supplements, Apr 1, 2024

Research paper thumbnail of P260 Incidence, Characteristics, and Outcomes of Out–Of–Hospital Cardiac Arrest Due to Ventricular Fibrillation in the General Population: Data from a Single–Center Long–Term Registry

European Heart Journal Supplements, May 1, 2023

Research paper thumbnail of Plasma Levels of Soluble Receptor for Advanced Glycation End Products and Coronary Atherosclerosis: Possible Correlation with Clinical Presentation

Disease Markers, 2013

Receptor for Advanced Glycation End-products (RAGE) is a multi-ligand receptor ubiquitous present... more Receptor for Advanced Glycation End-products (RAGE) is a multi-ligand receptor ubiquitous present on epithelial, neuronal, vascular and inflammatory cells, usually expressed at low levels in homeostasis and to increased degrees at sites of stress or injury. The aim of the present study was to evaluate sRAGE plasma levels in patients with Acute Coronary Syndrome (ACS) and to assess its diagnostic efficacy in identification of patients with acute events. Plasma levels of sRAGE were determined in 860 patients with Coronary Artery Disease (CAD): 530 patients presented stable angina and 330 were observed during acute ischemic event (147 with unstable angina and 183 with myocardial infarction). sRAGE plasma levels were significantly lower in patients with ACS than in patients with stable angina: [median 584 pg/mL (IQR: 266-851 pg/mL) in MI patients, median 769 pg/mL (IQR: 394-987 pg/mL) in patients with unstable angina, median 834 pg/mL (IQR 630-1005 pg/mL) in patients with stable angina; < 0.001]. sRAGE levels did not differ among ACS patients stratified by the extent of coronary artery disease. In conclusion, this study confirm the role of sRAGE in activation and progression of inflammatory process and suggests the possibility that sRAGE can be considered an indicator of destabilization of vulnerable plaque.

Research paper thumbnail of P431 "Telecuore": Experimental Pilot Project for the Integrated Management of 250 Patients with Chronic Heart Failure Through the Use of Telemedicine in Piacenza Ausl

European Heart Journal Supplements, May 1, 2023

Background: Heart failure (HF) has an high social-health impact that requires frequent checks and... more Background: Heart failure (HF) has an high social-health impact that requires frequent checks and urgent hospital visits. The management of chronicity through telemedicine, integration of hospital-territory care and multidisciplinarity represents a goal of the italian PNRR. Objectives: The project tests the feasibility of an organizational model of integrated management of heart-failure patients based on multidisciplinary integration and the use of telemedicine. Materials and Methods: 250 heart failure patients will be selected by the Heart Failure Outpatient Department of AUSL Piacenza, with the following characteristics: positive technological anamnesis, NYHA functional class II-III, clinical instability (hospital access for heart failure/need to boost diuretics in the previous 12 months) and management complexity. We will use Aditech devices, which through mobile-app will send the following parameters to the platform on a daily basis: blood pressure, weight, ECG (single track) and saturation. A QoL Assessment Questionnaire (KCCQ) will be administered. 10 GPs will be selected to view the data on the platform and be able to carry out a cardiological Teleconsultation. The Case manager (CM) and a cardiovascular technician (TFCPC) will explain the functioning of the device to groups of 2-3 patients and, in collaboration with the nursing staff, the baseline control of the parameters and blood tests will be carried out. Pre-set alerts will be activated based

Research paper thumbnail of Cardiovascular Risk Factors and Sympatho-vagal Balance: Importance of Time-domain Heart Rate Variability

Journal of Clinical & Experimental Cardiology, 2014

Objective: Cardiovascular Disease (CVD) is the leading cause of death and disability worldwide. D... more Objective: Cardiovascular Disease (CVD) is the leading cause of death and disability worldwide. Dysregulation of the autonomic nervous system associated with various pathological conditions often occurs in presence of cardiovascular risk factors. Heart Rate Variability (HRV) may be used to assess autonomic imbalances. The aim of our study is to evaluate the correlation between HRV and the main cardiovascular risk factors in subject who underwent digital ambulatory 24 hours Holter ECG monitoring for clinical investigations. Methods: We evaluated time domain parameters of HRV by Holter ECG monitoring in a large population categorized based on the presence or absence of the major cardiovascular risk factors. Results: We found significant differences in time domain parameters of HRV in patients with and without common risk factor for CVD such as diabetes, family history for Coronary Artery Disease and dyslipidemia. We also analyzed our study population based on age and we found a positive correlation with the standard deviation of all NN intervals (SDNN), square root of the mean of the sum of the square of the differences between adjacent NN intervals (RMSSD), mean R-R intervals and by the number of adjacent NN intervals differing by more than 50 ms divided by the total number of all NN intervals (pNN50) and an inverse correlation for the others parameters. Conclusion: Non-modifiable risk factors (age, gender, family history) along with dyslipidemia and diabetes, are related to a change in HRV, while modifiable risk factors (smoking, hypertension, overweight, hyperhomocysteinemia) showed no correlation. This would seem to indicate that the genetic components more than lifestyle habits and behavior act on the nervous control of the heart. Our study shows the possibility to find interesting clinical-prognostic data, analyzing simple parameters obtained from instrumental methods of investigation performed for other clinical reasons.

Research paper thumbnail of High-Frame-Rate Coherence Imaging of the Heart with Ultrasound Diverging Waves

2020 IEEE International Ultrasonics Symposium (IUS), 2020

Several techniques have been proposed up to now to achieve higher temporal resolution in echocard... more Several techniques have been proposed up to now to achieve higher temporal resolution in echocardiography. Among these, the use of diverging beams, which insonify a large region of interest, allows to significantly increase the frame-rate, but at the cost of a reduced signal-to-noise ratio. For this reason, in this paper we propose to combine high-frame-rate imaging, by transmitting diverging waves (DWs), to the Short-Lag Spatial Coherence (SLSC) technique in reception, which provides images of the coherence of backscattered echoes and is known to yield improved contrast in scenarios with high-clutter. We test this combined method first on phantom acquisitions and then on in vivo cardiac scans, i.e. on apical views of the heart. Results show that SLSC can provide improved contrast ratio (CR) and generalized contrast-to-noise ratio (GCNR) with respect to the classic Delay and Sum (DAS) as the number of transmitted DWs increases, particularly when clutter is present. Indeed, cardiac images show improved apex visibility and artifact suppression in the heart chambers with SLSC, achieving high contrast and high frame-rate at the same time.

Research paper thumbnail of Article Possible Role of −374T/A Polymorphism of RAGE Gene in Longevity

Abstract: Demographic and social changes in the last decades have resulted in improvements in hea... more Abstract: Demographic and social changes in the last decades have resulted in improvements in health and longevity. The survival of elderly people has improved significantly and thus centenarians are becoming the fastest growing population group. Environmental, genetic, and accidental factors have influenced the human life span. Researchers have gained substantial evidence that advanced glycation end products may play an important role in the processes of physiological aging. The aim of the present study was to investigate any differences in the frequencies of −374T/A polymorphism in subjects aged>90 years and in middle-aged individuals. We observed association between the A allele and genotype homozygous for this allele (AA) with a longer life expectancy in the male population. In particular, there was a prevalence of AA genotype and A allele in long-living subjects and a prevalence of the allele T in middle-aged subjects, indicating a possible protective role of the allele A to...

Research paper thumbnail of Malattia coronarica e depressione: il possibile ruolo dei polimorfismi del brain-derived neurotrophic factor e del gene del trasportatore della serotonina

Le malattie cardiovascolari e la depressione sono due tra i piu diffusi problemi di salute nel mo... more Le malattie cardiovascolari e la depressione sono due tra i piu diffusi problemi di salute nel mondo. I pazienti con depressione hanno un rischio aumentato di sviluppare patologie cardiovascolari. Scopi di questo studio caso-controllo sono valutare il possibile ruolo dei polimorfismi Val66Met nel gene per il BDNF, HTTLPR nel gene per il trasportatore della serotonina e -1438 G/A nel promotore del gene per il recettore 2A della serotonina nello sviluppo della malattia coronarica (CAD), in pazienti con e senza depressione. I nostri dati suggeriscono un coinvolgimento del genotipo AA del BDNF nella patogenesi della CAD nelle donne e nella predisposizione alla CAD associata alla depressione. Nei soggetti con malattia coronarica abbiamo anche osservato un significativo incremento del genotipo LL del trasportatore della serotonina e una riduzione del genotipo SL rispetto ai controlli. Sebbene non sia stata trovata alcuna differenza per genotipo e frequenza allelica dei polimorfismi del ge...

Research paper thumbnail of Ruolo del polimorfismo del gene RAGE in pazienti affetti da Scompenso Cardiaco con e senza evidenza angiografica di aterosclerosi coronarica emodinamicamente significativa

Nello scompenso cardiaco (SC), malattia multifattoriale in cui giocano un ruolo diversi fattori, ... more Nello scompenso cardiaco (SC), malattia multifattoriale in cui giocano un ruolo diversi fattori, varianti genetiche possono influenzarne lo sviluppo, la progressione e la risposta alla terapia farmacologica. Poco si sa circa il ruolo del sistema AGE-RAGE nello SC. Al fine di identificare i possibili rapporti tra il polimorfismo -374 T/A del gene RAGE e lo SC abbiamo quindi arruolato 386 pazienti con SC sia post-ischemico sia secondario a causa non ischemica e 639 con Coronary Artery Disease (CAD). Dalla nostra analisi e emerso che le frequenze del genotipo AA e dell’allele A erano significativamente piu basse nei pazienti con SC post-ischemico rispetto a quelli con SC secondario a cause non-ischemiche e fra i pazienti con almeno una lesione coronarica emodinamicamente significativa, sia tra quelli con SC che tra quelli con CAD, rispetto a quelli a coronarie indenni. In conclusione, la nostra ricerca suggerisce che il polimorfismo -374 T/A sia legato alla genesi della malattia ateros...

Research paper thumbnail of Studio dei polimorfismi nel gene del recettore dell’apelina in pazienti con e senza ipertensione arteriosa

Apelina e un peptide endogeno che aumenta l’inotropismo cardiaco attraverso l’interazione con il ... more Apelina e un peptide endogeno che aumenta l’inotropismo cardiaco attraverso l’interazione con il suo recettore APJ. Alcuni risultati indicano che il sistema apelinergico possa avere un ruolo fisiopatologico nell’ambito delle malattie cardiovascolari e ci sono prove che mostrano il ruolo del sistema apelinergico nella regolazione della pressione sanguigna in vitro e in modelli animali. Il ruolo di apelina-APJ nella fisiologia del sistema cardiovascolare e la sua interazione con altri processi neuroendocrini non e stato completamente chiarito. Tuttavia, gli studi riportati indicano che la trasmissione del segnale mediata da apelina possa essere coinvolta nella regolazione della pressione arteriosa, funzione contrattile cardiaca, bilancio idrico, l’angiogenesi e l’inibizione dell’apoptosi. Abbiamo valutato la possibile relazione tra i polimorfismi G212A e A445C di APJ e la presenza di malattia coronarica (CAD) in pazienti italiani e nei controlli sani mediante RFLP-PCR. Abbiamo analizz...

Research paper thumbnail of Preventing heart failure: a position paper of the Heart Failure Association in collaboration with the European Association of Preventive Cardiology

European Journal of Preventive Cardiology, 2021

The heart failure epidemic is growing and its prevention, in order to reduce associated hospital ... more The heart failure epidemic is growing and its prevention, in order to reduce associated hospital readmission rates and its clinical and economic burden, is a key issue in modern cardiovascular medicine. The present consensus document aims to provide practical evidence-based information to support the implementation of effective preventive measures. After reviewing the most common risk factors, an overview of the population attributable risks in different continents is presented, to identify potentially effective opportunities for prevention and to inform preventive strategies. Finally, potential interventions that have been proposed and have been shown to be effective in preventing HF are listed.

Research paper thumbnail of Air pollution and out-of-hospital cardiac arrest risk

European Heart Journal, 2020

Introduction Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide; it acco... more Introduction Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide; it accounts for up to 50% of all cardiovascular deaths.It is well established that ambient air pollution triggers fatal and non-fatal cardiovascular events. However, the impact of air pollution on OHCA is still controversial. The objective of this study was to investigate the impact of short-term exposure to outdoor air pollutants on the incidence of OHCA in the urban area of Piacenza, Italy, one of the most polluted area in Europe. Methods From 01/01/2010 to 31/12/2017 day-by-day PM10 and PM2.5 levels, as well as climatic data, were extracted from Environmental Protection Agency (ARPA) local monitoring stations. OHCA were extracted from the prospective registry of Community-based automated external defibrillator Cardiac arrest “Progetto Vita”. OHCA data were included: audio recordings, event information and ECG tracings. Logistic regression analysis was used to estimate the association between...

Research paper thumbnail of P4535Right ventricular response to stress in pulmonary arterial hypertension

European Heart Journal, 2018

need for heart transplantation (HTX). Multiple Cox regression analysis revealed perforin above th... more need for heart transplantation (HTX). Multiple Cox regression analysis revealed perforin above the calculated the cutoff point of 2.9/mm 2 as a strong predictor of impaired survival with hazard ratio (HR) of 1.881, 95% confidence interval (CI) 1.177-3.008, p=0.008, independent of LV function and other myocardial inflammation markers (CD3, Mac-1, LFA-1, HLA-1, and ICAM-1). Unexpectedly, male sex emerged as another strong adverse predictor of survival in CMi (HR 1.863, CI 1.096-3.168, p=0.022). Whereas LVEF course is adversely affected by myocardial perforin, multivariate analysis indicates that LVEF explains only part of the observed overall mortality. Conclusion: Perforin-positive cardiac cell infiltration and male gender are interacting adverse predictors of long term-mortality in CMi, independent of LV function and other myocardial inflammation markers. Furthermore, exact quantification of immune cells is necessary to assess the prognosis.

Research paper thumbnail of P1317 Very late onset of platypnoea orthodeoxia syndrome as first clinical scenario of patent foramen ovale

European Heart Journal - Cardiovascular Imaging, 2020

We report a case of a 83-year-old female, who had an admission for dyspnea. Laboratory showed D-d... more We report a case of a 83-year-old female, who had an admission for dyspnea. Laboratory showed D-dimer 1000 ng/ml, haemoglobin 12.4 mg/dL, CPR 0.08mg/dl whereas on Arterial Blood Gas test she had hypoxia with respiratory alkalosis. In view of suspected pulmonary embolism, she underwent Thoracic Computed Tomography scan that excluded it. During the stay the patient seemed more symptomatic while in standing position(with SpO2s 89% while supine plunging to 50% while standing): ABGs were performed both standing (reservoir 15 l/min pH 7.50, pO2 37.2 mmHg, pCO2 37.1 mmHg, HCO3 28.9 mmol/l) and recumbent position (reservoir 15 l/min pH 7.47, pO2 65.5 mmHg, pCO2 35.1 mmHg, HCO3 25.6 mmol), showing a difference of 28 mmHg. Subsequently the patient underwent v/p pulmonary scintigraphy: no signs of pulmonary embolism though it revealed a multiple focus of capitation Tc-99m macro aggregated albumin in brain, thyroid and kidneys (IMG top), compatible for veno-arterial shunt. Trans-esophageal echo...

Research paper thumbnail of Rage Gene Polymorphism in Heart Failure Patients with and without Angiographic Evidence of Significant Coronary Atherosclerosis

International Journal of Immunopathology and Pharmacology, 2013

Heart failure (HF) is a multifactorial disorder in which clinical, environmental and genetic comp... more Heart failure (HF) is a multifactorial disorder in which clinical, environmental and genetic components take part. For this reason it is possible that common gene variants could affect development, progression and response to pharmacological therapy. In recent years the role of AGEs in the pathogenesis of cardiovascular diseases has become recognized but little is known about the role of the AGE-RAGE system in heart failure. The aim of the present study was to identify possible relationship between -374 T/A RAGE gene polymorphism with heart failure. The population in this study consists of 386 subjects with HF, selected according to the presence of depressed Left Ventricular Ejection Fraction (LVEF) <45%, and 639 patients with CAD documented at coronary angiography. Within the population with HF there are 228 patients with disease secondary to not ischemic cause and 158 with post-ischemic condition. The sample of AA genotype was significantly lower in patients with post-ischemic ...

Research paper thumbnail of Time-Domain Heart Rate Variability in Coronary Artery Disease Patients Affected by Thyroid Dysfunction

International Heart Journal, 2014

Subclinical hypothyroidism and hyperthyroidism have been recognized as clinical entities with neg... more Subclinical hypothyroidism and hyperthyroidism have been recognized as clinical entities with negative effects on the cardiovascular system. Moreover, the effect of treated thyroid dysfunction on parameters associated with the cardiovascular control system has been poorly investigated. In the present study we analyzed time-domain heart rate variability in coronary artery disease (CAD) patients with known thyroid diseases. Twenty-four hour ECG monitoring was performed in 344 patients with coronary artery disease (174 with thyroid dysfunction and 170 without thyroid dysfunction used as a control group), using a 3-channel tape recorder. Time domain parameters of heart rate variability (HRV) were defi nitely lower both in patients with subclinical hypothyroidism and subclinical hyperthyroidism than in the control group, with statistically signifi cant differences in SDNN, RMSSD, TINN, and mean RR for both subgroups. Furthermore, patients on L-thyroxine treatment and restored euthyroidism had generally higher HRV values than patients with subclinical hypothyroidism, nevertheless SDNN, RMSSD, SDNN index, TINN, and mean RR were signifi cantly lower when compared to those of the control group. Signifi cant differences in HRV were also found between hyperthyroid patients under treatment and control group subjects with respect to RMSSD, TINN, and mean RR values. In conclusion, patients with cardiac disease and known thyroid disease, even when the disease is in the subclinical range or despite treatment, should be regarded as patients at additional risk conveyed by thyroid hormone disturbances.

Research paper thumbnail of Associazione tra due polimorfismi del gene HLA-G e patologia coronarica

L’aterosclerosi e le sue complicanze rappresentano la piu frequente causa di morbilita e mortalit... more L’aterosclerosi e le sue complicanze rappresentano la piu frequente causa di morbilita e mortalita nei paesi industrializzati. Risulta dunque di preminente importanza approfondire le ricerche riguardo le molecole coin-volte nei processi infiammatori a livello del sistema cardiovascolare. In letteratura e dimostrato che il ruolo fisiologico dell’espressione tissutale del gene HLA-G e delle proteine ad esso correlate e influenzato da due polimorfismi: (Inserzione/Delezione (Ins/Del) di 14 bp (rs16375 ed rs1632933). Nel nostro studio le frequenze alleliche, genotipiche ed aplotipiche dei due polimorfismi sono state analizzate in una popolazione di 664 pazienti con patologia coronarica (CAD) ed in 345 soggetti di controllo. Le tecniche utilizzate sono PCR-RFLP e real-time PCR. La frequenza del genotipo Ins/Ins e risultata significativamente maggiore nei pazienti CAD rispetto ai controlli (p=0.018). Dopo attenta analisi dei fattori confondenti, i risultati hanno mostrato che la condizion...

Research paper thumbnail of Preventing heart failure: a position paper of the Heart Failure Association in collaboration with the European Association of Preventive Cardiology

European Journal of Heart Failure, 2022

The heart failure epidemic is growing and its prevention, in order to reduce associated hospital ... more The heart failure epidemic is growing and its prevention, in order to reduce associated hospital readmission rates and its clinical and economic burden, is a key issue in modern cardiovascular medicine. The present position paper aims to provide practical evidence‐based information to support the implementation of effective preventive measures. After reviewing the most common risk factors, an overview of the population attributable risks in different continents is presented, to identify potentially effective opportunities for prevention and to inform preventive strategies. Finally, potential interventions that have been proposed and have been shown to be effective in preventing heart failure are listed.

Research paper thumbnail of Dobutamine stress echocardiography in pulmonary arterial hypertension

International Journal of Cardiology

Research paper thumbnail of The Gla D313Y Mutation in Fabry Disease: Diagnostic Dilemmas and Therapeutic Considerations

European heart journal supplements, Apr 1, 2024

Research paper thumbnail of Telecuore: Feasibility of a Hospital–Territorial Telemedicine Project in Chronic Heart Failure

European heart journal supplements, Apr 1, 2024

Research paper thumbnail of P260 Incidence, Characteristics, and Outcomes of Out–Of–Hospital Cardiac Arrest Due to Ventricular Fibrillation in the General Population: Data from a Single–Center Long–Term Registry

European Heart Journal Supplements, May 1, 2023

Research paper thumbnail of Plasma Levels of Soluble Receptor for Advanced Glycation End Products and Coronary Atherosclerosis: Possible Correlation with Clinical Presentation

Disease Markers, 2013

Receptor for Advanced Glycation End-products (RAGE) is a multi-ligand receptor ubiquitous present... more Receptor for Advanced Glycation End-products (RAGE) is a multi-ligand receptor ubiquitous present on epithelial, neuronal, vascular and inflammatory cells, usually expressed at low levels in homeostasis and to increased degrees at sites of stress or injury. The aim of the present study was to evaluate sRAGE plasma levels in patients with Acute Coronary Syndrome (ACS) and to assess its diagnostic efficacy in identification of patients with acute events. Plasma levels of sRAGE were determined in 860 patients with Coronary Artery Disease (CAD): 530 patients presented stable angina and 330 were observed during acute ischemic event (147 with unstable angina and 183 with myocardial infarction). sRAGE plasma levels were significantly lower in patients with ACS than in patients with stable angina: [median 584 pg/mL (IQR: 266-851 pg/mL) in MI patients, median 769 pg/mL (IQR: 394-987 pg/mL) in patients with unstable angina, median 834 pg/mL (IQR 630-1005 pg/mL) in patients with stable angina; < 0.001]. sRAGE levels did not differ among ACS patients stratified by the extent of coronary artery disease. In conclusion, this study confirm the role of sRAGE in activation and progression of inflammatory process and suggests the possibility that sRAGE can be considered an indicator of destabilization of vulnerable plaque.

Research paper thumbnail of P431 "Telecuore": Experimental Pilot Project for the Integrated Management of 250 Patients with Chronic Heart Failure Through the Use of Telemedicine in Piacenza Ausl

European Heart Journal Supplements, May 1, 2023

Background: Heart failure (HF) has an high social-health impact that requires frequent checks and... more Background: Heart failure (HF) has an high social-health impact that requires frequent checks and urgent hospital visits. The management of chronicity through telemedicine, integration of hospital-territory care and multidisciplinarity represents a goal of the italian PNRR. Objectives: The project tests the feasibility of an organizational model of integrated management of heart-failure patients based on multidisciplinary integration and the use of telemedicine. Materials and Methods: 250 heart failure patients will be selected by the Heart Failure Outpatient Department of AUSL Piacenza, with the following characteristics: positive technological anamnesis, NYHA functional class II-III, clinical instability (hospital access for heart failure/need to boost diuretics in the previous 12 months) and management complexity. We will use Aditech devices, which through mobile-app will send the following parameters to the platform on a daily basis: blood pressure, weight, ECG (single track) and saturation. A QoL Assessment Questionnaire (KCCQ) will be administered. 10 GPs will be selected to view the data on the platform and be able to carry out a cardiological Teleconsultation. The Case manager (CM) and a cardiovascular technician (TFCPC) will explain the functioning of the device to groups of 2-3 patients and, in collaboration with the nursing staff, the baseline control of the parameters and blood tests will be carried out. Pre-set alerts will be activated based

Research paper thumbnail of Cardiovascular Risk Factors and Sympatho-vagal Balance: Importance of Time-domain Heart Rate Variability

Journal of Clinical & Experimental Cardiology, 2014

Objective: Cardiovascular Disease (CVD) is the leading cause of death and disability worldwide. D... more Objective: Cardiovascular Disease (CVD) is the leading cause of death and disability worldwide. Dysregulation of the autonomic nervous system associated with various pathological conditions often occurs in presence of cardiovascular risk factors. Heart Rate Variability (HRV) may be used to assess autonomic imbalances. The aim of our study is to evaluate the correlation between HRV and the main cardiovascular risk factors in subject who underwent digital ambulatory 24 hours Holter ECG monitoring for clinical investigations. Methods: We evaluated time domain parameters of HRV by Holter ECG monitoring in a large population categorized based on the presence or absence of the major cardiovascular risk factors. Results: We found significant differences in time domain parameters of HRV in patients with and without common risk factor for CVD such as diabetes, family history for Coronary Artery Disease and dyslipidemia. We also analyzed our study population based on age and we found a positive correlation with the standard deviation of all NN intervals (SDNN), square root of the mean of the sum of the square of the differences between adjacent NN intervals (RMSSD), mean R-R intervals and by the number of adjacent NN intervals differing by more than 50 ms divided by the total number of all NN intervals (pNN50) and an inverse correlation for the others parameters. Conclusion: Non-modifiable risk factors (age, gender, family history) along with dyslipidemia and diabetes, are related to a change in HRV, while modifiable risk factors (smoking, hypertension, overweight, hyperhomocysteinemia) showed no correlation. This would seem to indicate that the genetic components more than lifestyle habits and behavior act on the nervous control of the heart. Our study shows the possibility to find interesting clinical-prognostic data, analyzing simple parameters obtained from instrumental methods of investigation performed for other clinical reasons.

Research paper thumbnail of High-Frame-Rate Coherence Imaging of the Heart with Ultrasound Diverging Waves

2020 IEEE International Ultrasonics Symposium (IUS), 2020

Several techniques have been proposed up to now to achieve higher temporal resolution in echocard... more Several techniques have been proposed up to now to achieve higher temporal resolution in echocardiography. Among these, the use of diverging beams, which insonify a large region of interest, allows to significantly increase the frame-rate, but at the cost of a reduced signal-to-noise ratio. For this reason, in this paper we propose to combine high-frame-rate imaging, by transmitting diverging waves (DWs), to the Short-Lag Spatial Coherence (SLSC) technique in reception, which provides images of the coherence of backscattered echoes and is known to yield improved contrast in scenarios with high-clutter. We test this combined method first on phantom acquisitions and then on in vivo cardiac scans, i.e. on apical views of the heart. Results show that SLSC can provide improved contrast ratio (CR) and generalized contrast-to-noise ratio (GCNR) with respect to the classic Delay and Sum (DAS) as the number of transmitted DWs increases, particularly when clutter is present. Indeed, cardiac images show improved apex visibility and artifact suppression in the heart chambers with SLSC, achieving high contrast and high frame-rate at the same time.

Research paper thumbnail of Article Possible Role of −374T/A Polymorphism of RAGE Gene in Longevity

Abstract: Demographic and social changes in the last decades have resulted in improvements in hea... more Abstract: Demographic and social changes in the last decades have resulted in improvements in health and longevity. The survival of elderly people has improved significantly and thus centenarians are becoming the fastest growing population group. Environmental, genetic, and accidental factors have influenced the human life span. Researchers have gained substantial evidence that advanced glycation end products may play an important role in the processes of physiological aging. The aim of the present study was to investigate any differences in the frequencies of −374T/A polymorphism in subjects aged>90 years and in middle-aged individuals. We observed association between the A allele and genotype homozygous for this allele (AA) with a longer life expectancy in the male population. In particular, there was a prevalence of AA genotype and A allele in long-living subjects and a prevalence of the allele T in middle-aged subjects, indicating a possible protective role of the allele A to...

Research paper thumbnail of Malattia coronarica e depressione: il possibile ruolo dei polimorfismi del brain-derived neurotrophic factor e del gene del trasportatore della serotonina

Le malattie cardiovascolari e la depressione sono due tra i piu diffusi problemi di salute nel mo... more Le malattie cardiovascolari e la depressione sono due tra i piu diffusi problemi di salute nel mondo. I pazienti con depressione hanno un rischio aumentato di sviluppare patologie cardiovascolari. Scopi di questo studio caso-controllo sono valutare il possibile ruolo dei polimorfismi Val66Met nel gene per il BDNF, HTTLPR nel gene per il trasportatore della serotonina e -1438 G/A nel promotore del gene per il recettore 2A della serotonina nello sviluppo della malattia coronarica (CAD), in pazienti con e senza depressione. I nostri dati suggeriscono un coinvolgimento del genotipo AA del BDNF nella patogenesi della CAD nelle donne e nella predisposizione alla CAD associata alla depressione. Nei soggetti con malattia coronarica abbiamo anche osservato un significativo incremento del genotipo LL del trasportatore della serotonina e una riduzione del genotipo SL rispetto ai controlli. Sebbene non sia stata trovata alcuna differenza per genotipo e frequenza allelica dei polimorfismi del ge...

Research paper thumbnail of Ruolo del polimorfismo del gene RAGE in pazienti affetti da Scompenso Cardiaco con e senza evidenza angiografica di aterosclerosi coronarica emodinamicamente significativa

Nello scompenso cardiaco (SC), malattia multifattoriale in cui giocano un ruolo diversi fattori, ... more Nello scompenso cardiaco (SC), malattia multifattoriale in cui giocano un ruolo diversi fattori, varianti genetiche possono influenzarne lo sviluppo, la progressione e la risposta alla terapia farmacologica. Poco si sa circa il ruolo del sistema AGE-RAGE nello SC. Al fine di identificare i possibili rapporti tra il polimorfismo -374 T/A del gene RAGE e lo SC abbiamo quindi arruolato 386 pazienti con SC sia post-ischemico sia secondario a causa non ischemica e 639 con Coronary Artery Disease (CAD). Dalla nostra analisi e emerso che le frequenze del genotipo AA e dell’allele A erano significativamente piu basse nei pazienti con SC post-ischemico rispetto a quelli con SC secondario a cause non-ischemiche e fra i pazienti con almeno una lesione coronarica emodinamicamente significativa, sia tra quelli con SC che tra quelli con CAD, rispetto a quelli a coronarie indenni. In conclusione, la nostra ricerca suggerisce che il polimorfismo -374 T/A sia legato alla genesi della malattia ateros...

Research paper thumbnail of Studio dei polimorfismi nel gene del recettore dell’apelina in pazienti con e senza ipertensione arteriosa

Apelina e un peptide endogeno che aumenta l’inotropismo cardiaco attraverso l’interazione con il ... more Apelina e un peptide endogeno che aumenta l’inotropismo cardiaco attraverso l’interazione con il suo recettore APJ. Alcuni risultati indicano che il sistema apelinergico possa avere un ruolo fisiopatologico nell’ambito delle malattie cardiovascolari e ci sono prove che mostrano il ruolo del sistema apelinergico nella regolazione della pressione sanguigna in vitro e in modelli animali. Il ruolo di apelina-APJ nella fisiologia del sistema cardiovascolare e la sua interazione con altri processi neuroendocrini non e stato completamente chiarito. Tuttavia, gli studi riportati indicano che la trasmissione del segnale mediata da apelina possa essere coinvolta nella regolazione della pressione arteriosa, funzione contrattile cardiaca, bilancio idrico, l’angiogenesi e l’inibizione dell’apoptosi. Abbiamo valutato la possibile relazione tra i polimorfismi G212A e A445C di APJ e la presenza di malattia coronarica (CAD) in pazienti italiani e nei controlli sani mediante RFLP-PCR. Abbiamo analizz...

Research paper thumbnail of Preventing heart failure: a position paper of the Heart Failure Association in collaboration with the European Association of Preventive Cardiology

European Journal of Preventive Cardiology, 2021

The heart failure epidemic is growing and its prevention, in order to reduce associated hospital ... more The heart failure epidemic is growing and its prevention, in order to reduce associated hospital readmission rates and its clinical and economic burden, is a key issue in modern cardiovascular medicine. The present consensus document aims to provide practical evidence-based information to support the implementation of effective preventive measures. After reviewing the most common risk factors, an overview of the population attributable risks in different continents is presented, to identify potentially effective opportunities for prevention and to inform preventive strategies. Finally, potential interventions that have been proposed and have been shown to be effective in preventing HF are listed.

Research paper thumbnail of Air pollution and out-of-hospital cardiac arrest risk

European Heart Journal, 2020

Introduction Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide; it acco... more Introduction Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide; it accounts for up to 50% of all cardiovascular deaths.It is well established that ambient air pollution triggers fatal and non-fatal cardiovascular events. However, the impact of air pollution on OHCA is still controversial. The objective of this study was to investigate the impact of short-term exposure to outdoor air pollutants on the incidence of OHCA in the urban area of Piacenza, Italy, one of the most polluted area in Europe. Methods From 01/01/2010 to 31/12/2017 day-by-day PM10 and PM2.5 levels, as well as climatic data, were extracted from Environmental Protection Agency (ARPA) local monitoring stations. OHCA were extracted from the prospective registry of Community-based automated external defibrillator Cardiac arrest “Progetto Vita”. OHCA data were included: audio recordings, event information and ECG tracings. Logistic regression analysis was used to estimate the association between...

Research paper thumbnail of P4535Right ventricular response to stress in pulmonary arterial hypertension

European Heart Journal, 2018

need for heart transplantation (HTX). Multiple Cox regression analysis revealed perforin above th... more need for heart transplantation (HTX). Multiple Cox regression analysis revealed perforin above the calculated the cutoff point of 2.9/mm 2 as a strong predictor of impaired survival with hazard ratio (HR) of 1.881, 95% confidence interval (CI) 1.177-3.008, p=0.008, independent of LV function and other myocardial inflammation markers (CD3, Mac-1, LFA-1, HLA-1, and ICAM-1). Unexpectedly, male sex emerged as another strong adverse predictor of survival in CMi (HR 1.863, CI 1.096-3.168, p=0.022). Whereas LVEF course is adversely affected by myocardial perforin, multivariate analysis indicates that LVEF explains only part of the observed overall mortality. Conclusion: Perforin-positive cardiac cell infiltration and male gender are interacting adverse predictors of long term-mortality in CMi, independent of LV function and other myocardial inflammation markers. Furthermore, exact quantification of immune cells is necessary to assess the prognosis.

Research paper thumbnail of P1317 Very late onset of platypnoea orthodeoxia syndrome as first clinical scenario of patent foramen ovale

European Heart Journal - Cardiovascular Imaging, 2020

We report a case of a 83-year-old female, who had an admission for dyspnea. Laboratory showed D-d... more We report a case of a 83-year-old female, who had an admission for dyspnea. Laboratory showed D-dimer 1000 ng/ml, haemoglobin 12.4 mg/dL, CPR 0.08mg/dl whereas on Arterial Blood Gas test she had hypoxia with respiratory alkalosis. In view of suspected pulmonary embolism, she underwent Thoracic Computed Tomography scan that excluded it. During the stay the patient seemed more symptomatic while in standing position(with SpO2s 89% while supine plunging to 50% while standing): ABGs were performed both standing (reservoir 15 l/min pH 7.50, pO2 37.2 mmHg, pCO2 37.1 mmHg, HCO3 28.9 mmol/l) and recumbent position (reservoir 15 l/min pH 7.47, pO2 65.5 mmHg, pCO2 35.1 mmHg, HCO3 25.6 mmol), showing a difference of 28 mmHg. Subsequently the patient underwent v/p pulmonary scintigraphy: no signs of pulmonary embolism though it revealed a multiple focus of capitation Tc-99m macro aggregated albumin in brain, thyroid and kidneys (IMG top), compatible for veno-arterial shunt. Trans-esophageal echo...

Research paper thumbnail of Rage Gene Polymorphism in Heart Failure Patients with and without Angiographic Evidence of Significant Coronary Atherosclerosis

International Journal of Immunopathology and Pharmacology, 2013

Heart failure (HF) is a multifactorial disorder in which clinical, environmental and genetic comp... more Heart failure (HF) is a multifactorial disorder in which clinical, environmental and genetic components take part. For this reason it is possible that common gene variants could affect development, progression and response to pharmacological therapy. In recent years the role of AGEs in the pathogenesis of cardiovascular diseases has become recognized but little is known about the role of the AGE-RAGE system in heart failure. The aim of the present study was to identify possible relationship between -374 T/A RAGE gene polymorphism with heart failure. The population in this study consists of 386 subjects with HF, selected according to the presence of depressed Left Ventricular Ejection Fraction (LVEF) <45%, and 639 patients with CAD documented at coronary angiography. Within the population with HF there are 228 patients with disease secondary to not ischemic cause and 158 with post-ischemic condition. The sample of AA genotype was significantly lower in patients with post-ischemic ...

Research paper thumbnail of Time-Domain Heart Rate Variability in Coronary Artery Disease Patients Affected by Thyroid Dysfunction

International Heart Journal, 2014

Subclinical hypothyroidism and hyperthyroidism have been recognized as clinical entities with neg... more Subclinical hypothyroidism and hyperthyroidism have been recognized as clinical entities with negative effects on the cardiovascular system. Moreover, the effect of treated thyroid dysfunction on parameters associated with the cardiovascular control system has been poorly investigated. In the present study we analyzed time-domain heart rate variability in coronary artery disease (CAD) patients with known thyroid diseases. Twenty-four hour ECG monitoring was performed in 344 patients with coronary artery disease (174 with thyroid dysfunction and 170 without thyroid dysfunction used as a control group), using a 3-channel tape recorder. Time domain parameters of heart rate variability (HRV) were defi nitely lower both in patients with subclinical hypothyroidism and subclinical hyperthyroidism than in the control group, with statistically signifi cant differences in SDNN, RMSSD, TINN, and mean RR for both subgroups. Furthermore, patients on L-thyroxine treatment and restored euthyroidism had generally higher HRV values than patients with subclinical hypothyroidism, nevertheless SDNN, RMSSD, SDNN index, TINN, and mean RR were signifi cantly lower when compared to those of the control group. Signifi cant differences in HRV were also found between hyperthyroid patients under treatment and control group subjects with respect to RMSSD, TINN, and mean RR values. In conclusion, patients with cardiac disease and known thyroid disease, even when the disease is in the subclinical range or despite treatment, should be regarded as patients at additional risk conveyed by thyroid hormone disturbances.

Research paper thumbnail of Associazione tra due polimorfismi del gene HLA-G e patologia coronarica

L’aterosclerosi e le sue complicanze rappresentano la piu frequente causa di morbilita e mortalit... more L’aterosclerosi e le sue complicanze rappresentano la piu frequente causa di morbilita e mortalita nei paesi industrializzati. Risulta dunque di preminente importanza approfondire le ricerche riguardo le molecole coin-volte nei processi infiammatori a livello del sistema cardiovascolare. In letteratura e dimostrato che il ruolo fisiologico dell’espressione tissutale del gene HLA-G e delle proteine ad esso correlate e influenzato da due polimorfismi: (Inserzione/Delezione (Ins/Del) di 14 bp (rs16375 ed rs1632933). Nel nostro studio le frequenze alleliche, genotipiche ed aplotipiche dei due polimorfismi sono state analizzate in una popolazione di 664 pazienti con patologia coronarica (CAD) ed in 345 soggetti di controllo. Le tecniche utilizzate sono PCR-RFLP e real-time PCR. La frequenza del genotipo Ins/Ins e risultata significativamente maggiore nei pazienti CAD rispetto ai controlli (p=0.018). Dopo attenta analisi dei fattori confondenti, i risultati hanno mostrato che la condizion...

Research paper thumbnail of Preventing heart failure: a position paper of the Heart Failure Association in collaboration with the European Association of Preventive Cardiology

European Journal of Heart Failure, 2022

The heart failure epidemic is growing and its prevention, in order to reduce associated hospital ... more The heart failure epidemic is growing and its prevention, in order to reduce associated hospital readmission rates and its clinical and economic burden, is a key issue in modern cardiovascular medicine. The present position paper aims to provide practical evidence‐based information to support the implementation of effective preventive measures. After reviewing the most common risk factors, an overview of the population attributable risks in different continents is presented, to identify potentially effective opportunities for prevention and to inform preventive strategies. Finally, potential interventions that have been proposed and have been shown to be effective in preventing heart failure are listed.

Research paper thumbnail of Dobutamine stress echocardiography in pulmonary arterial hypertension

International Journal of Cardiology