Pub Date : 2020-09-25DOI: 10.23736/S0026-4725.20.05429-8
R. De Vecchis, C. Ariano
{"title":"Authorship growth and self- citations: a scholarly expedient that demonstrates that the use of the metrics for career decisions generates malpractice and misbehaviour?","authors":"R. De Vecchis, C. Ariano","doi":"10.23736/S0026-4725.20.05429-8","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05429-8","url":null,"abstract":"","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81858472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.23736/S0026-4725.20.05295-0
J. Heizer, S. Carbone, Hayley E. Billingsley, B. V. Van Tassell, R. Arena, A. Abbate, J. Canada
BACKGROUND Left ventricular (LV) concentric remodeling refers to a process by which increased LV relative wall thickness alters myocardial geometry, resulting in reduced LV end-diastolic volume (LVEDV) and stroke volume (SV). While the degree of concentric remodeling is a negative prognostic factor in heart failure with preserved ejection fraction (HFpEF), it is not known how it contributes to cardiorespiratory fitness (CRF). METHODS We performed a retrospective analysis of patients with HFpEF who underwent treadmill single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) and cardiopulmonary exercise testing (CPX). From exercise SPECT-MPI, we recorded post-exercise LVEDVi, LVESVi, SVi, LVEF, the presence and extent of perfusion defects, and perfusion reversibility. Peak oxygen consumption (VO2), the oxygen uptake efficiency slope (OUES), oxygen (O2) pulse, ventilatory efficiency (VE/VCO2 slope), ventilatory anaerobic threshold, respiratory exchange ratio, exercise time, and maximum heart rate were obtained from CPX. Data are expressed as mean (±standard deviation). Univariate and multivariate linear regression was performed. RESULTS We identified 23 subjects who had completed both an exercise SPECT-MPI and a CPX. Patients were more commonly women (83%), black (65%), middle-age (50 [±7.3] years), and obese (body mass index [BMI] 39.7 [±6.0] kg/m2). Greater LVEDVi and LVESVi correlated positively with peak VO2 (R=+0.648, p=0.001; R=+0.601, p=0.002), O2 pulse (R=+0.686, p<0.001; R=+0.625, p=0.001) and OUES (R=+0.882, p<0.001; R=+0.779, p<0.001). The LVEF correlated inversely with peak VO2 and OUES (R=-0.450, p=0.031; R=-0.485, p=0.035). Perfusion defect area, grade of severity, and presence of reversibility were not associated with CRF variables. CONCLUSIONS Post-exercise reduced LV volumes correlate with measures of impaired CRF in patients with HFpEF, thus supporting a pathophysiologic role of concentric remodeling in impaired CRF in HFpEF.
背景左室(LV)同心重构是指左室相对壁厚增加改变心肌几何形状的过程，导致左室舒张末期容积(LVEDV)和卒中容积(SV)降低。虽然同心重构程度是保留射血分数(HFpEF)心力衰竭的一个负面预后因素，但尚不清楚它如何影响心肺健康(CRF)。方法我们对接受跑步机单光子发射计算机断层心肌灌注成像(SPECT-MPI)和心肺运动试验(CPX)的HFpEF患者进行回顾性分析。通过运动SPECT-MPI记录运动后LVEDVi、LVESVi、SVi、LVEF、灌注缺损的存在及程度、灌注可逆性。CPX测得峰值耗氧量(VO2)、摄氧效率斜率(OUES)、氧(O2)脉冲、通气效率(VE/VCO2斜率)、通气无氧阈值、呼吸交换比、运动时间、最大心率。数据以平均值(±标准差)表示。进行单因素和多因素线性回归。结果我们确定了23名完成了SPECT-MPI和CPX练习的受试者。患者多为女性(83%)、黑人(65%)、中年(50[±7.3]岁)和肥胖(体重指数[BMI] 39.7[±6.0]kg/m2)。较大的LVEDVi和LVESVi与峰值VO2呈正相关(R=+0.648, p=0.001);R=+0.601, p=0.002)， O2脉搏(R=+0.686, p<0.001;R=+0.625, p=0.001)和OUES (R=+0.882, p<0.001;+ R = 0.779, p < 0.001)。LVEF与峰值VO2和OUES呈负相关(R=-0.450, p=0.031;R = -0.485, p = 0.035)。灌注缺损的面积、严重程度和可逆性与CRF变量无关。结论运动后左室容量减少与HFpEF患者的CRF受损相关，因此支持同心重构在HFpEF患者CRF受损中的病理生理作用。
{"title":"Left ventricular concentric remodeling and impaired cardiorespiratory fitness in patients with heart failure and preserved ejection fraction.","authors":"J. Heizer, S. Carbone, Hayley E. Billingsley, B. V. Van Tassell, R. Arena, A. Abbate, J. Canada","doi":"10.23736/S0026-4725.20.05295-0","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05295-0","url":null,"abstract":"BACKGROUND\u0000Left ventricular (LV) concentric remodeling refers to a process by which increased LV relative wall thickness alters myocardial geometry, resulting in reduced LV end-diastolic volume (LVEDV) and stroke volume (SV). While the degree of concentric remodeling is a negative prognostic factor in heart failure with preserved ejection fraction (HFpEF), it is not known how it contributes to cardiorespiratory fitness (CRF).\u0000\u0000\u0000METHODS\u0000We performed a retrospective analysis of patients with HFpEF who underwent treadmill single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) and cardiopulmonary exercise testing (CPX). From exercise SPECT-MPI, we recorded post-exercise LVEDVi, LVESVi, SVi, LVEF, the presence and extent of perfusion defects, and perfusion reversibility. Peak oxygen consumption (VO2), the oxygen uptake efficiency slope (OUES), oxygen (O2) pulse, ventilatory efficiency (VE/VCO2 slope), ventilatory anaerobic threshold, respiratory exchange ratio, exercise time, and maximum heart rate were obtained from CPX. Data are expressed as mean (±standard deviation). Univariate and multivariate linear regression was performed.\u0000\u0000\u0000RESULTS\u0000We identified 23 subjects who had completed both an exercise SPECT-MPI and a CPX. Patients were more commonly women (83%), black (65%), middle-age (50 [±7.3] years), and obese (body mass index [BMI] 39.7 [±6.0] kg/m2). Greater LVEDVi and LVESVi correlated positively with peak VO2 (R=+0.648, p=0.001; R=+0.601, p=0.002), O2 pulse (R=+0.686, p<0.001; R=+0.625, p=0.001) and OUES (R=+0.882, p<0.001; R=+0.779, p<0.001). The LVEF correlated inversely with peak VO2 and OUES (R=-0.450, p=0.031; R=-0.485, p=0.035). Perfusion defect area, grade of severity, and presence of reversibility were not associated with CRF variables.\u0000\u0000\u0000CONCLUSIONS\u0000Post-exercise reduced LV volumes correlate with measures of impaired CRF in patients with HFpEF, thus supporting a pathophysiologic role of concentric remodeling in impaired CRF in HFpEF.","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84744258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.23736/S0026-4725.20.05212-3
A. Bayramoglu, G. Bayramoglu, Meral Urhan Kucuk, H. Guler, A. Arpacı
BACKGROUND Genetic predisposition is an important risk factor in coronary artery disease (CAD).This study was conducted to determine the polymorphism frequencies of the plasminogen activator inhibitor-1(PAI-1) gene 4G/5G, Angiotensin-converting enzyme (ACE) gene I/D,and Angiotensin II type 1 receptor (AT1) gene A1166C genotypes and to examine the role of these polymorphisms in CAD. METHODS Genomic DNAs obtained from 260 subjects(130 CAD patients and 130 control) were used in the study. ACE I/D and PAI-1 4G/5G polymorphism genotypes were determined using polymerase chain reaction (PCR) and electrophoresis. AT-1 A1166C polymorphism was determined using the PCR, restriction fragment length polymorphism (RFLP) and electrophoresis. The products amplified from AT1 gene by PCR were cut with HindIII restriction endonuclease and then analyzed by 2% agarose gel electrophoresis. The results were statistically analyzed with the chi-square test, Mann-Whitney U test, and independent two-sample t-test. RESULTS Allele frequencies showed statistically significant differences between the patient and control groups. There was no statistically significant difference in ACEI/D genotype frequencies between the twogroups. Likewise, no statistically significant difference was found in the AT1 A1166C genotype frequencies; however, a statistically significant difference was found in allele frequencies.The PAI-1 4G/5G genotype frequency was significantly higher in the patient group. CONCLUSIONS While there is a relationship between of PAI-1 gene 4G/5G polymorphism and CAD, ACE gene I/D and AT1 gene A1166C polymorphisms are not related. PAI-1 gene homozygous genotypes may be considered as a prognostic marker for CAD patients.
{"title":"Genetic variations of Renin-angiontensin and Fibrinolytic systems and susceptibility to coronary artery disease: a population genetics perspective.","authors":"A. Bayramoglu, G. Bayramoglu, Meral Urhan Kucuk, H. Guler, A. Arpacı","doi":"10.23736/S0026-4725.20.05212-3","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05212-3","url":null,"abstract":"BACKGROUND\u0000Genetic predisposition is an important risk factor in coronary artery disease (CAD).This study was conducted to determine the polymorphism frequencies of the plasminogen activator inhibitor-1(PAI-1) gene 4G/5G, Angiotensin-converting enzyme (ACE) gene I/D,and Angiotensin II type 1 receptor (AT1) gene A1166C genotypes and to examine the role of these polymorphisms in CAD.\u0000\u0000\u0000METHODS\u0000Genomic DNAs obtained from 260 subjects(130 CAD patients and 130 control) were used in the study. ACE I/D and PAI-1 4G/5G polymorphism genotypes were determined using polymerase chain reaction (PCR) and electrophoresis. AT-1 A1166C polymorphism was determined using the PCR, restriction fragment length polymorphism (RFLP) and electrophoresis. The products amplified from AT1 gene by PCR were cut with HindIII restriction endonuclease and then analyzed by 2% agarose gel electrophoresis. The results were statistically analyzed with the chi-square test, Mann-Whitney U test, and independent two-sample t-test.\u0000\u0000\u0000RESULTS\u0000Allele frequencies showed statistically significant differences between the patient and control groups. There was no statistically significant difference in ACEI/D genotype frequencies between the twogroups. Likewise, no statistically significant difference was found in the AT1 A1166C genotype frequencies; however, a statistically significant difference was found in allele frequencies.The PAI-1 4G/5G genotype frequency was significantly higher in the patient group.\u0000\u0000\u0000CONCLUSIONS\u0000While there is a relationship between of PAI-1 gene 4G/5G polymorphism and CAD, ACE gene I/D and AT1 gene A1166C polymorphisms are not related. PAI-1 gene homozygous genotypes may be considered as a prognostic marker for CAD patients.","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84401335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.23736/S0026-4725.20.05346-3
J. Kewcharoen, Chol Tachorueangwiwat, C. Kanitsoraphan, S. Saowapa, Nattapat Nitinai, W. Vutthikraivit, P. Rattanawong, Dipanjan Banerjee
BACKGROUND Heart failure (HF) is one of the world leading causes of admission and readmission. Recent studies have shown that the presence of depression is associated with hospital readmission in patients after an index admission for heart failure (HF). However, there is disagreement between published studies regarding this finding. We performed a systematic review and meta-analysis to evaluate the effect of depression on readmission rates in HF patients. METHODS We searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were published study evaluating readmission rate of HF patients, with and without depression. Data from each study were combined using a random-effects model, generic inverse variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals. RESULTS Ten studies were included in the meta-analysis with a total of 53,165 patients (6,194 patients with depression). The presence of depression was associated with an increased risk of readmission in patients with HF (pooled HR=1.54, 95%CI=1.22-1.94, pvalue<0.001, I2=55.4%). In a subgroup analysis, depression was associated with an increased risk of readmission in patients with HF in both short-term (≤ 90 days) followup (pooled HR=1.75, 95%CI=1.07-2.85, p-value=0.025, I2=76.0%) and long-term (> 90 days) follow-up (pooled HR=1.58, 95% CI =1.32-1.90, p-value<0.001, I2=0.0%). CONCLUSIONS Our meta-analysis demonstrated that depression is associated with an increased risk of hospital readmission in patients with HF.
{"title":"Depression is associated with an increased risk of readmission in patients with heart failure: a systematic review and meta-analysis.","authors":"J. Kewcharoen, Chol Tachorueangwiwat, C. Kanitsoraphan, S. Saowapa, Nattapat Nitinai, W. Vutthikraivit, P. Rattanawong, Dipanjan Banerjee","doi":"10.23736/S0026-4725.20.05346-3","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05346-3","url":null,"abstract":"BACKGROUND\u0000Heart failure (HF) is one of the world leading causes of admission and readmission. Recent studies have shown that the presence of depression is associated with hospital readmission in patients after an index admission for heart failure (HF). However, there is disagreement between published studies regarding this finding. We performed a systematic review and meta-analysis to evaluate the effect of depression on readmission rates in HF patients.\u0000\u0000\u0000METHODS\u0000We searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were published study evaluating readmission rate of HF patients, with and without depression. Data from each study were combined using a random-effects model, generic inverse variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals.\u0000\u0000\u0000RESULTS\u0000Ten studies were included in the meta-analysis with a total of 53,165 patients (6,194 patients with depression). The presence of depression was associated with an increased risk of readmission in patients with HF (pooled HR=1.54, 95%CI=1.22-1.94, pvalue<0.001, I2=55.4%). In a subgroup analysis, depression was associated with an increased risk of readmission in patients with HF in both short-term (≤ 90 days) followup (pooled HR=1.75, 95%CI=1.07-2.85, p-value=0.025, I2=76.0%) and long-term (> 90 days) follow-up (pooled HR=1.58, 95% CI =1.32-1.90, p-value<0.001, I2=0.0%).\u0000\u0000\u0000CONCLUSIONS\u0000Our meta-analysis demonstrated that depression is associated with an increased risk of hospital readmission in patients with HF.","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73640536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.23736/S0026-4725.20.05247-0
N. Kajdič, A. Zupan Mežnar, M. Šinkovec, D. Žižek
BACKGROUND A significant proportion of patients have syncope of uncertain aetiology. While implantable loop recorder (ILR) has become an important diagnostic tool in diagnosing syncope, its contemporary role in accordance with the recently updated syncope guidelines is not well established. The purpose of this single-centre retrospective study was to determine the diagnostic yield of ILR in patients with unexplained syncope following initial diagnostic work-up as recommended by the guidelines. METHODS Medical records of 100 consecutive patients with syncope or presyncope who received ILR following the recently updated recommended diagnostic work-up were retrospectively evaluated. RESULTS Seven patients were lost to follow-up (7%). During a median follow-up of 12 months (IQR 6.5-27.5), syncope or presyncope recurred in 61 patients (65.6%). In 37 (37/61, 60.7%), correlation between abnormal heart rhythm and symptoms was confirmed by ILR. Syncope was predominantly caused by bradyarrhythmias (33/37, 89.2%). Of the remaining four patients, three (8.1%) had ventricular tachycardia and one had atrial fibrillation with rapid ventricular response. Arrhythmogenic cause of syncope or presyncope was excluded in 24 patients (24/61, 39.3%) as no arrhythmia was recorded at the time of reported symptoms. Median time to establishing diagnosis was 354 days (171-783). CONCLUSIONS The diagnostic yield of ILR after initial inconclusive recommended diagnostic work-up in accordance with the relevant guidelines was high. The findings affirm ILR as an important diagnostic tool in contemporary management of syncope.
{"title":"Diagnostic yield of implantable loop recorders in patients with unexplained syncope: single-centre experience.","authors":"N. Kajdič, A. Zupan Mežnar, M. Šinkovec, D. Žižek","doi":"10.23736/S0026-4725.20.05247-0","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05247-0","url":null,"abstract":"BACKGROUND\u0000A significant proportion of patients have syncope of uncertain aetiology. While implantable loop recorder (ILR) has become an important diagnostic tool in diagnosing syncope, its contemporary role in accordance with the recently updated syncope guidelines is not well established. The purpose of this single-centre retrospective study was to determine the diagnostic yield of ILR in patients with unexplained syncope following initial diagnostic work-up as recommended by the guidelines.\u0000\u0000\u0000METHODS\u0000Medical records of 100 consecutive patients with syncope or presyncope who received ILR following the recently updated recommended diagnostic work-up were retrospectively evaluated.\u0000\u0000\u0000RESULTS\u0000Seven patients were lost to follow-up (7%). During a median follow-up of 12 months (IQR 6.5-27.5), syncope or presyncope recurred in 61 patients (65.6%). In 37 (37/61, 60.7%), correlation between abnormal heart rhythm and symptoms was confirmed by ILR. Syncope was predominantly caused by bradyarrhythmias (33/37, 89.2%). Of the remaining four patients, three (8.1%) had ventricular tachycardia and one had atrial fibrillation with rapid ventricular response. Arrhythmogenic cause of syncope or presyncope was excluded in 24 patients (24/61, 39.3%) as no arrhythmia was recorded at the time of reported symptoms. Median time to establishing diagnosis was 354 days (171-783).\u0000\u0000\u0000CONCLUSIONS\u0000The diagnostic yield of ILR after initial inconclusive recommended diagnostic work-up in accordance with the relevant guidelines was high. The findings affirm ILR as an important diagnostic tool in contemporary management of syncope.","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72974620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.23736/S0026-4725.20.05279-2
H. Akkaya, E. Gunturk
BACKGROUND Coronary artery anomalies (CAA) are found in 0.2% to 1.3% of coronary angiograms. The aim of the presented study is to describe congenital CAA and their variations, also identifying the prevalence of these anomalies and coronary artery dominance in our center. METHODS A total of 7,858 patients were included in the study retrospectively between August 2015 and March 2020. Patients undergoing coronary angiography (CAG) were reviewed by at least 2 independent and experienced observers. The Angelini's CAA Classification method was used to classify patients. Coronary dominance was determined according to the artery from which the posterior desending artery originated. RESULTS CAA was detected in 88 (1.1%) out of 7,858 patients. Of these patients, 73 (82.9%) had anomalies of origination and course called group A, 7 (7.9%) had anomalies of intrinsic coronary arterial anatomy called group B, and 8 (9.1%) had anomalies of coronary termination called group C. Anomalous collateral vessels called group D were not detected. RCA dominance was n:5,579 (70.99%), Cx dominance was n:1,021 (12.99%), and co-dominancy was n:1258 (16.01%). CONCLUSIONS The incidence of CAA was 1.1% in total and is compatible with other major studies. According to the Angelini CAA clasification, group B anomalies are observed more frequently than other studies. Cx dominance is moderately high.
{"title":"Coronary artery anomalies and dominance: data from 7,858 patients in a single center in Turkey.","authors":"H. Akkaya, E. Gunturk","doi":"10.23736/S0026-4725.20.05279-2","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05279-2","url":null,"abstract":"BACKGROUND\u0000Coronary artery anomalies (CAA) are found in 0.2% to 1.3% of coronary angiograms. The aim of the presented study is to describe congenital CAA and their variations, also identifying the prevalence of these anomalies and coronary artery dominance in our center.\u0000\u0000\u0000METHODS\u0000A total of 7,858 patients were included in the study retrospectively between August 2015 and March 2020. Patients undergoing coronary angiography (CAG) were reviewed by at least 2 independent and experienced observers. The Angelini's CAA Classification method was used to classify patients. Coronary dominance was determined according to the artery from which the posterior desending artery originated.\u0000\u0000\u0000RESULTS\u0000CAA was detected in 88 (1.1%) out of 7,858 patients. Of these patients, 73 (82.9%) had anomalies of origination and course called group A, 7 (7.9%) had anomalies of intrinsic coronary arterial anatomy called group B, and 8 (9.1%) had anomalies of coronary termination called group C. Anomalous collateral vessels called group D were not detected. RCA dominance was n:5,579 (70.99%), Cx dominance was n:1,021 (12.99%), and co-dominancy was n:1258 (16.01%).\u0000\u0000\u0000CONCLUSIONS\u0000The incidence of CAA was 1.1% in total and is compatible with other major studies. According to the Angelini CAA clasification, group B anomalies are observed more frequently than other studies. Cx dominance is moderately high.","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78522628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.23736/S0026-4725.20.05347-5
E. Cavarretta, Annachiara Pingitore, Stefania Della Porta, Riccardo Capitani, M. Bernardi, L. Sciarra, A. Saglietto, F. Versaci, C. Autore, F. Perroni, G. Biondi‐Zoccai, G. Frati, M. Peruzzi
INTRODUCTION The impact of the 'International Criteria' for ECG interpretation in athletes has further improved the diagnostic accuracy of the 12-lead ECG use for pre-participation screening (PPS) and these criteria have been evaluated in different populations of athletes and settings proving good results. EVIDENCE ACQUISITION We aim to perform a comprehensive review of the use of the 'International Criteria' for ECG interpretation in athletes, stemming from a systematic review to diagnostic meta-analysis, limiting our inclusion only to observational studies to determine the diagnostic accuracy of ECG for detecting cardiac anomalies related to sudden cardiac death in athletes. EVIDENCE SYNTHESIS This meta-analysis is expected to include several important studies related to PPS on different populations of athletes comparing different ECG criteria and detail important data on the diagnostic accuracy of ECG in PPS. Furthermore, we intend to highlight the advantage of using ECG in PPS. CONCLUSIONS The present diagnostic meta-analysis results will aid sports medicine physicians and cardiologist in adhering to the most accurate criteria for ECG evaluation in athletes and it may help to solve controversies aroused regarding the excess cost of ECG in PPS related to the amount of false positive cases.
{"title":"Accuracy of the \"International Criteria\" for ECG screening in athletes in comparison with previous published criteria: rationale and design of a diagnostic meta-analysis.","authors":"E. Cavarretta, Annachiara Pingitore, Stefania Della Porta, Riccardo Capitani, M. Bernardi, L. Sciarra, A. Saglietto, F. Versaci, C. Autore, F. Perroni, G. Biondi‐Zoccai, G. Frati, M. Peruzzi","doi":"10.23736/S0026-4725.20.05347-5","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05347-5","url":null,"abstract":"INTRODUCTION\u0000The impact of the 'International Criteria' for ECG interpretation in athletes has further improved the diagnostic accuracy of the 12-lead ECG use for pre-participation screening (PPS) and these criteria have been evaluated in different populations of athletes and settings proving good results.\u0000\u0000\u0000EVIDENCE ACQUISITION\u0000We aim to perform a comprehensive review of the use of the 'International Criteria' for ECG interpretation in athletes, stemming from a systematic review to diagnostic meta-analysis, limiting our inclusion only to observational studies to determine the diagnostic accuracy of ECG for detecting cardiac anomalies related to sudden cardiac death in athletes.\u0000\u0000\u0000EVIDENCE SYNTHESIS\u0000This meta-analysis is expected to include several important studies related to PPS on different populations of athletes comparing different ECG criteria and detail important data on the diagnostic accuracy of ECG in PPS. Furthermore, we intend to highlight the advantage of using ECG in PPS.\u0000\u0000\u0000CONCLUSIONS\u0000The present diagnostic meta-analysis results will aid sports medicine physicians and cardiologist in adhering to the most accurate criteria for ECG evaluation in athletes and it may help to solve controversies aroused regarding the excess cost of ECG in PPS related to the amount of false positive cases.","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78011064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01Epub Date: 2020-04-23DOI: 10.23736/S0026-4725.20.05283-4
Giuseppe Sangiorgi, Gaetano Chiricolo, Cristina Nocella, Roberto Carnevale
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Pub Date : 2020-08-01Epub Date: 2020-03-04DOI: 10.23736/S0026-4725.20.05171-3
Armando U Cavallo, Carlo Di Donna, Matteo Presicce, Luca Pugliese, Marco Forcina, Francesca Ricci, Federica Di Tosto, Vincenzo De Stasio, Luigi Spiritigliozzi, Valeria Cammalleri, Federico Zanin, Saverio Muscoli, Leonardo Benelli, Francesca D'Errico, Monia Pasqualetto, Lisa Verna, Francesco Versaci, Francesco Romeo, Roberto Floris, Marcello Chiocchi
Background: Cardiac magnetic resonance is a valuable tool in the diagnosis of acute myocarditis, but dyspnea or chest pain often reduce patient's compliance, so definition of faster magnetic resonance protocols is of paramount importance.
Methods: Short tau inversion recovery (STIR) and phase sensitive inversion recovery images for the assessment of late gadolinium enhancement (LGE)of 22 patients with clinical suspicion of acute myocarditis were retrospectively evaluated. Signal intensity in STIR images was measured by 2 readers by placing region of interests (ROIs) within the area of maximal signal intensity in each myocardial segment derived from the ACC/AHA segmental scheme. Segmental T2 ratio was assessed with the formula: signal intensity of myocardium/signal intensity of muscle. Receiver operating characteristic (ROC) curves were used to compare diagnostic performance of T2 Signal intensity and T2 ratio in predicting the presence of LGE in each myocardial segment. Bland-Altman analysis was used to assess inter reader agreement.
Results: Signal intensity in STIR images showed an area under the curve (AUC) of 0.54 (95% CI: 0.44-0.63) for reader 1 and 0.53(95% CI: 0.44-0.63) for reader 2. Segmental T2 ratio showed an AUC of 0.8 (95% CI: 0.73-0.87) for reader 1 and 0.77 (95% CI: 0.71-0.84) for reader 2. Bland-Altman analysis showed good agreement for both T2 signal intensity (mean difference =-18.5 reader1 vs. reader 2 and 2SD=247.3) and T2 ratio (mean difference=0.03 vs. reader2 and 2SD=0.9).
Conclusions: Segmental T2 ratio showed a good diagnostic accuracy in predicting the presence of LGE in patients with clinical suspicion of acute myocarditis and might be a promising approach in reducing scan times with no reduction in diagnostic accuracy.
背景:心脏磁共振是诊断急性心肌炎的一种有价值的工具，但呼吸困难或胸痛往往会降低患者的依从性，因此确定更快的磁共振方案至关重要。方法:回顾性分析22例临床怀疑为急性心肌炎的患者的短tau反转恢复(STIR)和相敏反转恢复图像对晚期钆增强(LGE)的评价。STIR图像的信号强度由2台读取器测量，通过将感兴趣区域(roi)置于ACC/AHA分段方案得出的每个心肌段的最大信号强度区域内。采用心肌信号强度/肌肉信号强度计算节段T2比值。采用受试者工作特征(ROC)曲线比较T2信号强度和T2比值在预测各心肌节段LGE存在方面的诊断价值。使用Bland-Altman分析来评估读者间的一致性。结果:STIR图像信号强度显示阅读器1的曲线下面积(AUC)为0.54 (95% CI: 0.44-0.63)，阅读器2的AUC为0.53(95% CI: 0.44-0.63)。读取器1节段T2的AUC为0.8 (95% CI: 0.73-0.87)，读取器2的AUC为0.77 (95% CI: 0.71-0.84)。Bland-Altman分析显示T2信号强度(平均差值=-18.5 reader1 vs. reader2, 2SD=247.3)和T2比值(平均差值=0.03 vs. reader2, 2SD=0.9)吻合良好。结论:节段T2比值对临床怀疑为急性心肌炎的LGE患者具有较好的诊断准确性，在不降低诊断准确率的情况下，有望减少扫描次数。
{"title":"Association of segmental T2 ratio and late gadolinium enhancement in patients with acute myocarditis: a feasibility study.","authors":"Armando U Cavallo, Carlo Di Donna, Matteo Presicce, Luca Pugliese, Marco Forcina, Francesca Ricci, Federica Di Tosto, Vincenzo De Stasio, Luigi Spiritigliozzi, Valeria Cammalleri, Federico Zanin, Saverio Muscoli, Leonardo Benelli, Francesca D'Errico, Monia Pasqualetto, Lisa Verna, Francesco Versaci, Francesco Romeo, Roberto Floris, Marcello Chiocchi","doi":"10.23736/S0026-4725.20.05171-3","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05171-3","url":null,"abstract":"<p><strong>Background: </strong>Cardiac magnetic resonance is a valuable tool in the diagnosis of acute myocarditis, but dyspnea or chest pain often reduce patient's compliance, so definition of faster magnetic resonance protocols is of paramount importance.</p><p><strong>Methods: </strong>Short tau inversion recovery (STIR) and phase sensitive inversion recovery images for the assessment of late gadolinium enhancement (LGE)of 22 patients with clinical suspicion of acute myocarditis were retrospectively evaluated. Signal intensity in STIR images was measured by 2 readers by placing region of interests (ROIs) within the area of maximal signal intensity in each myocardial segment derived from the ACC/AHA segmental scheme. Segmental T2 ratio was assessed with the formula: signal intensity of myocardium/signal intensity of muscle. Receiver operating characteristic (ROC) curves were used to compare diagnostic performance of T2 Signal intensity and T2 ratio in predicting the presence of LGE in each myocardial segment. Bland-Altman analysis was used to assess inter reader agreement.</p><p><strong>Results: </strong>Signal intensity in STIR images showed an area under the curve (AUC) of 0.54 (95% CI: 0.44-0.63) for reader 1 and 0.53(95% CI: 0.44-0.63) for reader 2. Segmental T2 ratio showed an AUC of 0.8 (95% CI: 0.73-0.87) for reader 1 and 0.77 (95% CI: 0.71-0.84) for reader 2. Bland-Altman analysis showed good agreement for both T2 signal intensity (mean difference =-18.5 reader1 vs. reader 2 and 2SD=247.3) and T2 ratio (mean difference=0.03 vs. reader2 and 2SD=0.9).</p><p><strong>Conclusions: </strong>Segmental T2 ratio showed a good diagnostic accuracy in predicting the presence of LGE in patients with clinical suspicion of acute myocarditis and might be a promising approach in reducing scan times with no reduction in diagnostic accuracy.</p>","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":" ","pages":"326-331"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37709461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01Epub Date: 2020-04-21DOI: 10.23736/S0026-4725.20.05266-4
Marco Lombardi, Fabio Infusino, Sara Cimino
{"title":"Impact of social media and applications on everyday cardiovascular practice.","authors":"Marco Lombardi, Fabio Infusino, Sara Cimino","doi":"10.23736/S0026-4725.20.05266-4","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05266-4","url":null,"abstract":"","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":" ","pages":"288-290"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37859920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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