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Artikel: How to Manage Beta-Blockade in Older Heart Failure Patients: A Scoping Review.

Parrini, Iris / Lucà, Fabiana / Rao, Carmelo Massimiliano / Cacciatore, Stefano / Riccio, Carmine / Grimaldi, Massimo / Gulizia, Michele Massimo / Oliva, Fabrizio / Andreotti, Felicita

Journal of clinical medicine

2024 Band 13, Heft 7

Abstract: Beta blockers (BBs) play a crucial role in enhancing the quality of life and extending the survival of patients with heart failure and reduced ejection fraction (HFrEF). Initiating the therapy at low doses and gradually titrating the dose upwards is ... ...

Abstract	Beta blockers (BBs) play a crucial role in enhancing the quality of life and extending the survival of patients with heart failure and reduced ejection fraction (HFrEF). Initiating the therapy at low doses and gradually titrating the dose upwards is recommended to ensure therapeutic efficacy while mitigating potential adverse effects. Vigilant monitoring for signs of drug intolerance is necessary, with dose adjustments as required. The management of older HF patients requires a case-centered approach, taking into account individual comorbidities, functional status, and frailty. Older adults, however, are often underrepresented in randomized clinical trials, leading to some uncertainty in management strategies as patients with HF in clinical practice are older than those enrolled in trials. The present article performs a scoping review of the past 25 years of published literature on BBs in older HF patients, focusing on age, outcomes, and tolerability. Twelve studies (eight randomized-controlled and four observational) encompassing 26,426 patients were reviewed. The results indicate that BBs represent a viable treatment for older HFrEF patients, offering benefits in symptom management, cardiac function, and overall outcomes. Their role in HF with preserved EF, however, remains uncertain. Further research is warranted to refine treatment strategies and address specific aspects in older adults, including proper dosing, therapeutic adherence, and tolerability.
Sprache	Englisch
Erscheinungsdatum	2024-04-05
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13072119
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Congenital Ventricular Diverticulum.

Rao, Carmelo Massimiliano / Lucà, Fabiana / Franzutti, Claudio / Scappatura, Giuseppe / Arcadi, Nicola / Fratto, Pasquale / Benedetto, Francesco Antonio / Gelsomino, Sandro

Journal of clinical medicine

2023 Band 12, Heft 9

Abstract: Herein, we describe a 54-year-old patient with a congenital ventricular diverticulum (CVD), referred to our emergency department for presyncope episodes and multiple re-entrant ventricular tachycardias (VT). Significantly, echocardiographic findings were ...

Abstract	Herein, we describe a 54-year-old patient with a congenital ventricular diverticulum (CVD), referred to our emergency department for presyncope episodes and multiple re-entrant ventricular tachycardias (VT). Significantly, echocardiographic findings were not clear, and the diagnosis was made by cardiac magnetic resonance imaging (CMRI), which showed the presence of an apical accessory cavity connected to the ventricle and contracting synchronously. CMRI allowed the differential diagnosis with other outpouching cardiac defects. The patient underwent a subcutaneous implantable cardioverter defibrillator (S-ICD) implant and was referred for heart transplantation (HT). The diagnosis, treatment, and main findings of the CVD are discussed in this case report.
Sprache	Englisch
Erscheinungsdatum	2023-04-27
Erscheinungsland	Switzerland
Dokumenttyp	Case Reports
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12093153
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Coagulation Tests and Reversal Agents in Patients Treated with Oral Anticoagulants: The Challenging Scenarios of Life-Threatening Bleeding and Unplanned Invasive Procedures.

Pozzi, Andrea / Lucà, Fabiana / Gelsomino, Sandro / Abrignani, Maurizio Giuseppe / Giubilato, Simona / Di Fusco, Stefania Angela / Rao, Carmelo Massimiliano / Cornara, Stefano / Caretta, Giorgio / Ceravolo, Roberto / Parrini, Iris / Geraci, Giovanna / Riccio, Carmine / Grimaldi, Massimo / Colivicchi, Furio / Oliva, Fabrizio / Gulizia, Michele Massimo

Journal of clinical medicine

2024 Band 13, Heft 9

Abstract: In clinical practice, the number of patients treated with direct oral anticoagulants (DOACs) has consistently increased over the years. Since anticoagulant therapy has been associated with an annual incidence of major bleeding (MB) events of ... ...

Abstract	In clinical practice, the number of patients treated with direct oral anticoagulants (DOACs) has consistently increased over the years. Since anticoagulant therapy has been associated with an annual incidence of major bleeding (MB) events of approximately 2% to 3.5%, it is of paramount importance to understand how to manage anticoagulated patients with major or life-threatening bleeding. A considerable number of these patients' conditions necessitate hospitalization, and the administration of reversal agents may be imperative to manage and control bleeding episodes effectively. Importantly, effective strategies for reversing the anticoagulant effects of DOACs have been well recognized. Specifically, idarucizumab has obtained regulatory approval for the reversal of dabigatran, and andexanet alfa has recently been approved for reversing the effects of apixaban or rivaroxaban in patients experiencing life-threatening or uncontrolled bleeding events. Moreover, continuous endeavors are being made to develop supplementary reversal agents. In emergency scenarios where specific reversal agents might not be accessible, non-specific hemostatic agents such as prothrombin complex concentrate can be utilized to neutralize the anticoagulant effects of DOACs. However, it is paramount to emphasize that specific reversal agents, characterized by their efficacy and safety, should be the preferred choice when suitable. Moreover, it is worth noting that adherence to the guidelines for the reversal agents is poor, and there is a notable gap between international recommendations and actual clinical practices in this regard. This narrative review aims to provide physicians with a practical approach to managing specific reversal agents.
Sprache	Englisch
Erscheinungsdatum	2024-04-23
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13092451
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Effectiveness of CAR-T treatment toward the potential risk of second malignancies.

Martino, Massimo / Porto, Gaetana / Policastro, Giorgia / Alati, Caterina / Loteta, Barbara / Micó, Maria Caterina / Argiró, Clizia / Altomonte, Maria / Moscato, Tiziana / Labate, Demetrio / Dattola, Vincenzo / Rao, Carmelo Massimiliano / Cogliandro, Francesca / Canale, Filippo Antonio / Naso, Virginia / Filippelli, Gianfranco / Iaria, Antonino / Pitea, Martina

Frontiers in immunology

2024 Band 15, Seite(n) 1384002

Mesh-Begriff(e)	Humans ; Immunotherapy, Adoptive/adverse effects ; Immunotherapy, Adoptive/methods ; Receptors, Chimeric Antigen/immunology ; Neoplasms, Second Primary/etiology ; Treatment Outcome
Sprache	Englisch
Erscheinungsdatum	2024-05-02
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2024.1384002
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: The Importance of Ultrasound in a Case of Stroke Caused by Left Atrial Myxoma.

Tripodi, Vincenzo Francesco / Rao, Carmelo Massimiliano / Covino, Angelo / Fratto, Pasquale / Benedetto, Frank Antonio

Journal of cardiovascular echography

2020 Band 30, Heft 2, Seite(n) 113–115

Abstract: Myxoma is one of the most common cardiac tumors. It is relatively straightforward to diagnose by echocardiography. Sometimes, It can causes cardiac syncope and thromboembolic events. A woman without comorbidities was admitted to our hospital with stroke ... ...

Abstract	Myxoma is one of the most common cardiac tumors. It is relatively straightforward to diagnose by echocardiography. Sometimes, It can causes cardiac syncope and thromboembolic events. A woman without comorbidities was admitted to our hospital with stroke symptoms: left-sided hemiplegia and dysarthria. After brain computed tomography (CT) and angio-CT value, she was initially treated with pharmacological thrombolysis. Due to persisting symptoms, cerebral angiography and thrombectomy were then performed. At the end of this procedure, the patient had a complete neurological recovery, but she developed new symptoms, such as dyspnea and orthopnea. Transthoracic echocardiogram and transesophageal echocardiogram showed an atrial mobile mass. Therefore, an urgent cardiac surgery was performed in order to remove the mass. Histological examination confirmed cardiac myxoma. Our experience could show the importance of echocardiography to early diagnosis.
Sprache	Englisch
Erscheinungsdatum	2020-08-17
Erscheinungsland	India
Dokumenttyp	Case Reports
ZDB-ID	2734045-4
ISSN	2347-193X ; 2211-4122
ISSN (online)	2347-193X
ISSN	2211-4122
DOI	10.4103/jcecho.jcecho_51_20
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Late-onset fabry disease due to the p.Phe113Leu variant: the first italian cluster of five families.

Cianci, Vittoria / Pascarella, Angelo / Manzo, Lucia / Gasparini, Sara / Marsico, Oreste / Mammì, Anna / Rao, Carmelo Massimiliano / Franzutti, Claudio / Aguglia, Umberto / Ferlazzo, Edoardo

Metabolic brain disease

2023 Band 38, Heft 6, Seite(n) 1905–1912

Abstract: Background: The GLA c.337T > C (p.Phe113Leu) is a known pathogenic variant associated to late-onset Fabry disease phenotype with predominant cardiac manifestations. A founder effect was demonstrated in a large cohort in the Portuguese region of ... ...

Abstract	Background: The GLA c.337T > C (p.Phe113Leu) is a known pathogenic variant associated to late-onset Fabry disease phenotype with predominant cardiac manifestations. A founder effect was demonstrated in a large cohort in the Portuguese region of Guimarães. Herein we report an in-depth phenotype description of a cluster of five Southern Italy families. Methods: Family pedigrees of five index males with the p.Phe113Leu variant were obtained and all at-risk relatives underwent biochemical and genetical screening test. Carriers of GLA p.Phe113Leu variant underwent subsequent multidisciplinary clinical and instrumental evaluation. Results: Thirty-one (16 M, 15 F) individuals with p.Phe113Leu pathogenic variant were identified. Sixteen out of 31 patients (51.6%) had cardiac manifestations. Notably, myocardial fibrosis was found in 7/8 patients, of whom 2 were under 40 years. Stroke occurred in 4 patients. White matter lesions were detected in 12/19 patients and occurred in 2/10 of subjects under 40 years. Seven females complained of acroparesthesias. Renal involvement occurred in 10 patients. Angiokeratomas were evident in 9 subjects. Eyes, ear, gastrointestinal and pulmonary involvement occurred in the minority of subjects. Conclusion: This study demonstrates that a cluster of subjects with p.Phe113Leu pathogenic variant is also present in Southern Italy. Disease manifestations are frequent in both sexes and may occur early in life. Cardiac involvement represents the core manifestation, but neurological and renal involvement is also frequent, suggesting that extra-cardiac complications deserve clinical attention.
Mesh-Begriff(e)	Female ; Humans ; Male ; alpha-Galactosidase/genetics ; Fabry Disease/epidemiology ; Fabry Disease/genetics ; Heterozygote ; Phenotype ; Stroke/genetics
Chemische Substanzen	alpha-Galactosidase (EC 3.2.1.22) ; GLA protein, human (EC 3.2.1.22)
Sprache	Englisch
Erscheinungsdatum	2023-04-25
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632824-6
ISSN	1573-7365 ; 0885-7490
ISSN (online)	1573-7365
ISSN	0885-7490
DOI	10.1007/s11011-023-01216-4
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Anderson-Fabry Disease: Red Flags for Early Diagnosis of Cardiac Involvement.

Iorio, Annamaria / Lucà, Fabiana / Pozzi, Andrea / Rao, Carmelo Massimiliano / Chimenti, Cristina / Di Fusco, Stefania Angela / Rossini, Roberta / Caretta, Giorgio / Cornara, Stefano / Giubilato, Simona / Di Matteo, Irene / Di Nora, Concetta / Pilleri, Anna / Gelsomino, Sandro / Ceravolo, Roberto / Riccio, Carmine / Grimaldi, Massimo / Colivicchi, Furio / Oliva, Fabrizio /

Gulizia, Michele Massimo / The Cardiac Rare Diseases Working Group Associazione Nazionale Medici Cardiologi Ospedalieri Anmco

Diagnostics (Basel, Switzerland)

2024 Band 14, Heft 2

Abstract: Anderson-Fabry disease (AFD) is a lysosome storage disorder resulting from an X-linked inheritance of a mutation in the galactosidase A (GLA) gene encoding for the enzyme alpha-galactosidase A (α-GAL A). This mutation results in a deficiency or absence ... ...

Abstract	Anderson-Fabry disease (AFD) is a lysosome storage disorder resulting from an X-linked inheritance of a mutation in the galactosidase A (GLA) gene encoding for the enzyme alpha-galactosidase A (α-GAL A). This mutation results in a deficiency or absence of α-GAL A activity, with a progressive intracellular deposition of glycosphingolipids leading to organ dysfunction and failure. Cardiac damage starts early in life, often occurring sub-clinically before overt cardiac symptoms. Left ventricular hypertrophy represents a common cardiac manifestation, albeit conduction system impairment, arrhythmias, and valvular abnormalities may also characterize AFD. Even in consideration of pleiotropic manifestation, diagnosis is often challenging. Thus, knowledge of cardiac and extracardiac diagnostic "red flags" is needed to guide a timely diagnosis. Indeed, considering its systemic involvement, a multidisciplinary approach may be helpful in discerning AFD-related cardiac disease. Beyond clinical pearls, a practical approach to assist clinicians in diagnosing AFD includes optimal management of biochemical tests, genetic tests, and cardiac biopsy. We extensively reviewed the current literature on AFD cardiomyopathy, focusing on cardiac "red flags" that may represent key diagnostic tools to establish a timely diagnosis. Furthermore, clinical findings to identify patients at higher risk of sudden death are also highlighted.
Sprache	Englisch
Erscheinungsdatum	2024-01-18
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article ; Review
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics14020208
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Heart Failure with Preserved Ejection Fraction: How to Deal with This Chameleon.

Journal of clinical medicine

2024 Band 13, Heft 5

Abstract: Heart failure with preserved ejection fraction (HFpEF) is characterized by a notable heterogeneity in both phenotypic and pathophysiological features, with a growing incidence due to the increase in median age and comorbidities such as obesity, arterial ... ...

Abstract	Heart failure with preserved ejection fraction (HFpEF) is characterized by a notable heterogeneity in both phenotypic and pathophysiological features, with a growing incidence due to the increase in median age and comorbidities such as obesity, arterial hypertension, and cardiometabolic disease. In recent decades, the development of new pharmacological and non-pharmacological options has significantly impacted outcomes, improving clinical status and reducing mortality. Moreover, a more personalized and accurate therapeutic management has been demonstrated to enhance the quality of life, diminish hospitalizations, and improve overall survival. Therefore, assessing the peculiarities of patients with HFpEF is crucial in order to obtain a better understanding of this disorder. Importantly, comorbidities have been shown to influence symptoms and prognosis, and, consequently, they should be carefully addressed. In this sense, it is mandatory to join forces with a multidisciplinary team in order to achieve high-quality care. However, HFpEF remains largely under-recognized and under-treated in clinical practice, and the diagnostic and therapeutic management of these patients remains challenging. The aim of this paper is to articulate a pragmatic approach for patients with HFpEF focusing on the etiology, diagnosis, and treatment of HFpEF.
Sprache	Englisch
Erscheinungsdatum	2024-02-28
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13051375
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Appropriateness of Dyslipidemia Management Strategies in Post-Acute Coronary Syndrome: A 2023 Update.

Lucà, Fabiana / Oliva, Fabrizio / Rao, Carmelo Massimiliano / Abrignani, Maurizio Giuseppe / Amico, Antonio Francesco / Di Fusco, Stefania Angela / Caretta, Giorgio / Di Matteo, Irene / Di Nora, Concetta / Pilleri, Anna / Ceravolo, Roberto / Rossini, Roberta / Riccio, Carmine / Grimaldi, Massimo / Colivicchi, Furio / Gulizia, Michele Massimo

Metabolites

2023 Band 13, Heft 8

Abstract: It has been consistently demonstrated that circulating lipids and particularly low-density lipoprotein cholesterol (LDL-C) play a significant role in the development of coronary artery disease (CAD). Several trials have been focused on the reduction of ... ...

Abstract	It has been consistently demonstrated that circulating lipids and particularly low-density lipoprotein cholesterol (LDL-C) play a significant role in the development of coronary artery disease (CAD). Several trials have been focused on the reduction of LDL-C values in order to interfere with atherothrombotic progression. Importantly, for patients who experience acute coronary syndrome (ACS), there is a 20% likelihood of cardiovascular (CV) event recurrence within the two years following the index event. Moreover, the mortality within five years remains considerable, ranging between 19 and 22%. According to the latest guidelines, one of the main goals to achieve in ACS is an early improvement of the lipid profile. The evidence-based lipid pharmacological strategy after ACS has recently been enhanced. Although novel lipid-lowering drugs have different targets, the result is always the overexpression of LDL receptors (LDL-R), increased uptake of LDL-C, and lower LDL-C plasmatic levels. Statins, ezetimibe, and PCSK9 inhibitors have been shown to be safe and effective in the post-ACS setting, providing a consistent decrease in ischemic event recurrence. However, these drugs remain largely underprescribed, and the consistent discrepancy between real-world data and guideline recommendations in terms of achieved LDL-C levels represents a leading issue in secondary prevention. Although the cost-effectiveness of these new therapeutic advancements has been clearly demonstrated, many concerns about the cost of some newer agents continue to limit their use, affecting the outcome of patients who experienced ACS. In spite of the fact that according to the current recommendations, a stepwise lipid-lowering approach should be adopted, several more recent data suggest a "strike early and strike strong" strategy, based on the immediate use of statins and, eventually, a dual lipid-lowering therapy, reducing as much as possible the changes in lipid-lowering drugs after ACS. This review aims to discuss the possible lipid-lowering strategies in post-ACS and to identify those patients who might benefit most from more powerful treatments and up-to-date management.
Sprache	Englisch
Erscheinungsdatum	2023-08-04
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article ; Review
ZDB-ID	2662251-8
ISSN	2218-1989
ISSN	2218-1989
DOI	10.3390/metabo13080916
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Breast Cancer and Atrial Fibrillation.

Mauro, Emanuela / Lucà, Fabiana / Tetta, Cecilia / Parise, Orlando / Parrini, Iris / Parise, Gianmarco / Rao, Carmelo Massimiliano / Matteucci, Francesco / Micali, Linda Renata / Gulizia, Michele Massimo / La Meir, Mark / Gelsomino, Sandro

Journal of clinical medicine

2022 Band 11, Heft 5

Abstract: This study aims to establish the incidence of atrial fibrillation (AF) in breast cancer (BC) patients, focusing on staging and anti-cancer treatment. A meta-analysis was conducted to investigate the incidence of AF in BC patients and compare this ... ...

Abstract	This study aims to establish the incidence of atrial fibrillation (AF) in breast cancer (BC) patients, focusing on staging and anti-cancer treatment. A meta-analysis was conducted to investigate the incidence of AF in BC patients and compare this incidence to other cancers. Furthermore, we evaluated the occurrence of AF as an adverse effect of biological therapies vs. non-biological therapies vs. biological therapies + non-biological therapies in BC. Finally, we compared the incidence of AF in early BC and metastatic BC. Thirty studies were included. Twenty-two studies focused on BC, encompassing 166,271 patients. In the BC group, 2.7% of patients developed AF, while in the "all cancer" group, 5.8% of patients developed AF. In addition, there was no difference between different types of therapies (
Sprache	Englisch
Erscheinungsdatum	2022-03-04
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11051417
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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