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Article: In-vivo evaluation of silk fibroin small-diameter vascular grafts: state of art of preclinical studies and animal models.

Settembrini, Alberto / Buongiovanni, Gianluca / Settembrini, Piergiorgio / Alessandrino, Antonio / Freddi, Giuliano / Vettor, Giulia / Martelli, Eugenio

Frontiers in surgery

2023 Volume 10, Page(s) 1090565

Abstract: Autologous vein and artery remains the first choice for vascular grafting procedures in small-diameter vessels such as coronary and lower limb districts. Unfortunately, these vessels are often found to be unsuitable in atherosclerotic patients due to the ...

Abstract	Autologous vein and artery remains the first choice for vascular grafting procedures in small-diameter vessels such as coronary and lower limb districts. Unfortunately, these vessels are often found to be unsuitable in atherosclerotic patients due to the presence of calcifications or to insufficient size. Synthetic grafts composed of materials such as expanded polytetrafluoroethylene (ePTFE) are frequently employed as second choice, because of their widespread availability and success in the reconstruction of larger arteries. However, ePTFE grafts with small diameter are plagued by poor patency rates due to surface thrombogenicity and intimal hyperplasia, caused by the bioinertness of the synthetic material and aggravated by low flow conditions. Several bioresorbable and biodegradable polymers have been developed and tested to exploit such issues for their potential stimulation to endothelialization and cell infiltration. Among these, silk fibroin (SF) has shown promising pre-clinical results as material for small-diameter vascular grafts (SDVGs) because of its favorable mechanical and biological properties. A putative advantage in graft infection in comparison with synthetic materials is plausible, although it remains to be demonstrated. Our literature review will focus on the performance of SF-SDVGs
Language	English
Publishing date	2023-05-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2023.1090565
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Article ; Online: Sudden Cardiac Death in Athletes: From the Basics to the Practical Work-Up.

Kochi, Adriano Nunes / Vettor, Giulia / Dessanai, Maria Antonietta / Pizzamiglio, Francesca / Tondo, Claudio

Medicina (Kaunas, Lithuania)

2021 Volume 57, Issue 2

Abstract: Sudden cardiac death in athletes is a relatively rare event, but due to the increasing number of individuals practicing high-performance sports, in absolute terms, it has become an important issue to be addressed. Since etiologies are many and the ... ...

Abstract	Sudden cardiac death in athletes is a relatively rare event, but due to the increasing number of individuals practicing high-performance sports, in absolute terms, it has become an important issue to be addressed. Since etiologies are many and the occurrence is rare, tracing the ideal preparticipation screening program is challenging. So far, as screening tools, a comprehensive clinical evaluation and a simple 12-lead electrocardiogram (ECG) seem to be the most cost-effective strategy. Recent technological advances came to significantly help as second-line investigation tools, especially the cardiac magnetic resonance, which allows for a more detailed ventricular evaluation, cardiac tissue characterization, and eliminates the poor acoustic window problem. This article aims to review all aspects related to sudden cardiac death in athletes, beginning with definitions and epidemiology, passing through etiology and clinical characteristics, then finishing with a discussion about the best ambulatory investigational approach.
MeSH term(s)	Athletes ; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/etiology ; Death, Sudden, Cardiac/prevention & control ; Electrocardiography ; Humans ; Mass Screening
Language	English
Publishing date	2021-02-14
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina57020168
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Zs.A 6270: Show issues

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Article ; Online: Pulsed-field ablation of pulmonary vein and left atrial posterior wall combined with left atrial appendage occlusion as single procedure.

Bianchini, Lorenzo / Moltrasio, Massimo / Fassini, Gaetano / Cellucci, Selene / Sicuso, Rita / Ribatti, Valentina / Dessanai, Maria Antonietta / Pizzamiglio, Francesca / Vettor, Giulia / Majocchi, Benedetta / Tundo, Fabrizio / Riva, Stefania / Carbucicchio, Corrado / Tondo, Claudio

Pacing and clinical electrophysiology : PACE

2023 Volume 47, Issue 5, Page(s) 691–693

Abstract: Pulmonary vein isolation and left atrial posterior wall ablation using the Farapulse system, followed by left atrial appendage occlusion, have been achieved as single combined procedure to treat long-standing persistent atrial fibrillation in a patient ... ...

Abstract	Pulmonary vein isolation and left atrial posterior wall ablation using the Farapulse system, followed by left atrial appendage occlusion, have been achieved as single combined procedure to treat long-standing persistent atrial fibrillation in a patient at high hemorrhagic risk.
MeSH term(s)	Humans ; Atrial Fibrillation/surgery ; Pulmonary Veins/surgery ; Atrial Appendage/surgery ; Catheter Ablation/methods ; Male ; Middle Aged ; Heart Atria/surgery
Language	English
Publishing date	2023-09-14
Publishing country	United States
Document type	Journal Article ; Case Reports
ZDB-ID	424437-0
ISSN	1540-8159 ; 0147-8389
ISSN (online)	1540-8159
ISSN	0147-8389
DOI	10.1111/pace.14823
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Zs.A 1466: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: What's behind your eosinophilic myocarditis? A case of Churg-Strauss syndrome diagnosed during acute heart failure.

Amelotti, Nicola / Mapelli, Massimo / Guglielmo, Marco / Pires, Maria Inês Fiuza Branco / Campodonico, Jeness / Majocchi, Benedetta / Ribatti, Valentina / Vettor, Giulia / Baggiano, Andrea / Catto, Valentina / Basso, Cristina / Pontone, Gianluca / Agostoni, Piergiuseppe

ESC heart failure

2022 Volume 10, Issue 1, Page(s) 709–715

Abstract: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare multisystem disorder; cardiac involvement may include eosinophilic myocarditis. A 67-year-old woman presented with 1-week history of dyspnoea and orthopnoea. She had a history of adult-onset ... ...

Abstract	Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare multisystem disorder; cardiac involvement may include eosinophilic myocarditis. A 67-year-old woman presented with 1-week history of dyspnoea and orthopnoea. She had a history of adult-onset asthma and peripheral eosinophilia. The investigations showed T-wave inversion on lateral leads, peripheral eosinophilia, elevated troponin and BNP values, and severe biventricular systolic dysfunction with diffuse hypokinesia and apical akinesia. Computed tomography excluded coronary disease and showed bilateral basal ground-glass opacities, air-space consolidation, and bilateral reticular-nodular pattern. Cardiac magnetic resonance findings were compatible with active myocardial inflammation. An endomyocardial biopsy (EMB) confirmed the diagnosis of eosinophilic myocarditis, and a therapy with oral corticosteroids and heart failure medications was started.
MeSH term(s)	Aged ; Female ; Humans ; Churg-Strauss Syndrome/diagnosis ; Churg-Strauss Syndrome/drug therapy ; Eosinophilia/diagnosis ; Granulomatosis with Polyangiitis/diagnosis ; Granulomatosis with Polyangiitis/drug therapy ; Heart Failure ; Myocarditis/diagnosis
Language	English
Publishing date	2022-10-19
Publishing country	England
Document type	Case Reports
ZDB-ID	2814355-3
ISSN	2055-5822 ; 2055-5822
ISSN (online)	2055-5822
ISSN	2055-5822
DOI	10.1002/ehf2.14172
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Article ; Online: Syncope as a Warning Symptom of Sudden Cardiac Death in Athletes.

Vettor, Giulia / Zorzi, Alessandro / Basso, Cristina / Thiene, Gaetano / Corrado, Domenico

Cardiology clinics

2015 Volume 33, Issue 3, Page(s) 423–432

Abstract: Clinical evaluation of syncope in the athlete remains a challenge. Although benign mechanisms predominate, syncope may be arrhythmic and precede SCD. Exercise-induced syncope should be regarded as an important alarming symptom of an underlying cardiac ... ...

Abstract	Clinical evaluation of syncope in the athlete remains a challenge. Although benign mechanisms predominate, syncope may be arrhythmic and precede SCD. Exercise-induced syncope should be regarded as an important alarming symptom of an underlying cardiac disease predisposing to arrhythmic cardiac arrest. All athletes with syncope require a focused and detailed workup for underlying cardiac causes, either structural or electrical. Major aim is to identify athletes at risk and to protect them from SCD. Athletes with potentially life-threatening etiologies of syncope should be restricted from competitive sports.
MeSH term(s)	Athletes ; Death, Sudden, Cardiac/etiology ; Electrocardiography ; Heart Rate/physiology ; Humans ; Syncope/complications ; Syncope/diagnosis ; Syncope/physiopathology
Language	English
Publishing date	2015-08
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1196385-2
ISSN	1558-2264 ; 0733-8651
ISSN (online)	1558-2264
ISSN	0733-8651
DOI	10.1016/j.ccl.2015.04.010
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Article ; Online: Excess TGF-β1 Drives Cardiac Mesenchymal Stromal Cells to a Pro-Fibrotic Commitment in Arrhythmogenic Cardiomyopathy.

Maione, Angela Serena / Stadiotti, Ilaria / Pilato, Chiara Assunta / Perrucci, Gianluca Lorenzo / Saverio, Valentina / Catto, Valentina / Vettor, Giulia / Casella, Michela / Guarino, Anna / Polvani, Gianluca / Pompilio, Giulio / Sommariva, Elena

International journal of molecular sciences

2021 Volume 22, Issue 5

Abstract: Arrhythmogenic Cardiomyopathy (ACM) is characterized by the replacement of the myocardium with fibrotic or fibro-fatty tissue and inflammatory infiltrates in the heart. To date, while ACM adipogenesis is a well-investigated differentiation program, ACM- ... ...

Abstract	Arrhythmogenic Cardiomyopathy (ACM) is characterized by the replacement of the myocardium with fibrotic or fibro-fatty tissue and inflammatory infiltrates in the heart. To date, while ACM adipogenesis is a well-investigated differentiation program, ACM-related fibrosis remains a scientific gap of knowledge. In this study, we analyze the fibrotic process occurring during ACM pathogenesis focusing on the role of cardiac mesenchymal stromal cells (C-MSC) as a source of myofibroblasts. We performed the ex vivo studies on plasma and right ventricular endomyocardial bioptic samples collected from ACM patients and healthy control donors (HC). In vitro studies were performed on C-MSC isolated from endomyocardial biopsies of both groups. Our results revealed that circulating TGF-β1 levels are significantly higher in the ACM cohort than in HC. Accordingly, fibrotic markers are increased in ACM patient-derived cardiac biopsies compared to HC ones. This difference is not evident in isolated C-MSC. Nevertheless, ACM C-MSC are more responsive than HC ones to TGF-β1 treatment, in terms of pro-fibrotic differentiation and higher activation of the SMAD2/3 signaling pathway. These results provide the novel evidence that C-MSC are a source of myofibroblasts and participate in ACM fibrotic remodeling, being highly responsive to ACM-characteristic excess TGF-β1.
MeSH term(s)	Adult ; Arrhythmogenic Right Ventricular Dysplasia/blood ; Arrhythmogenic Right Ventricular Dysplasia/pathology ; Arrhythmogenic Right Ventricular Dysplasia/physiopathology ; Cell Differentiation ; Endocardium/metabolism ; Endocardium/pathology ; Female ; Fibrosis ; Humans ; Male ; Mesenchymal Stem Cells/metabolism ; Mesenchymal Stem Cells/pathology ; Middle Aged ; Myofibroblasts/pathology ; RNA, Messenger/biosynthesis ; Signal Transduction/physiology ; Smad2 Protein/physiology ; Smad3 Protein/physiology ; Transforming Growth Factor beta1/blood ; Transforming Growth Factor beta1/physiology
Chemical Substances	RNA, Messenger ; SMAD2 protein, human ; SMAD3 protein, human ; Smad2 Protein ; Smad3 Protein ; Transforming Growth Factor beta1
Language	English
Publishing date	2021-03-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms22052673
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Article ; Online: Cryoballoon atrial fibrillation ablation: Single-center safety and efficacy data using a novel cryoballoon technology compared to a historical balloon platform.

Kochi, Adriano N / Moltrasio, Massimo / Tundo, Fabrizio / Riva, Stefania / Ascione, Ciro / Dessanai, Maria A / Pizzamiglio, Francesca / Vettor, Giulia / Cellucci, Selene / Gasperetti, Alessio / Tondo, Claudio / Fassini, Gaetano

Journal of cardiovascular electrophysiology

2021 Volume 32, Issue 3, Page(s) 588–594

Abstract: Introduction: Catheter ablation is superior to drugs regarding atrial fibrillation (AF) recurrence, symptoms improvement, and mortality reduction in heart failure. POLARx™ is a novel cryoballoon, with technical improvements seeking to improve outcomes. ... ...

Abstract	Introduction: Catheter ablation is superior to drugs regarding atrial fibrillation (AF) recurrence, symptoms improvement, and mortality reduction in heart failure. POLARx™ is a novel cryoballoon, with technical improvements seeking to improve outcomes. So far, its clinical evidence is restricted to a case report. Methods: To compare the POLARx™ cryoballoon procedural safety and efficacy to the already established Arctic Front Advance PRO™ (AFAP) in a single-center cohort study, consecutive patients undergoing AF cryoablation with the POLARx™ were enrolled. Data were prospectively gathered. POLARx™ patients were compared with a historical cohort of patients submitted to AF cryoablation with the AFAP. Results: Seventy patients were analyzed, 20 in POLARx™, and 50 in the AFAP group. They all underwent first-time pulmonary vein isolation, 77% were male, 94% had paroxysmal AF, median age was 62.5 years, median CHA Conclusion: The novel POLARx™ cryoballoon had similar efficacy and safety compared with the AFAP. It was also associated with longer procedural times, similar TTI, and lower minimum temperature reached.
MeSH term(s)	Atrial Fibrillation/diagnosis ; Atrial Fibrillation/surgery ; Catheter Ablation/adverse effects ; Cohort Studies ; Cryosurgery/adverse effects ; Humans ; Male ; Middle Aged ; Pulmonary Veins/diagnostic imaging ; Pulmonary Veins/surgery ; Recurrence ; Technology ; Treatment Outcome
Language	English
Publishing date	2021-02-10
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1025989-2
ISSN	1540-8167 ; 1045-3873
ISSN (online)	1540-8167
ISSN	1045-3873
DOI	10.1111/jce.14930
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Zs.A 2863: Show issues

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Article ; Online: Benefits of electroanatomic ablation of conventional cardiac arrhytmias: from fluoroscopy to zero X-ray mapping.

Casella, Michela / Ribatti, Valentina / Catto, Valentina / Vettor, Giulia / Fassini, Gaetano / Biagioli, Viviana / Dello Russo, Antonio / Tondo, Claudio

Minerva cardioangiologica

2018 Volume 66, Issue 1, Page(s) 49–62

Abstract: Electrophysiology procedures are traditionally performed under fluoroscopic guidance. Nowadays a growing interest in the radiation risk associated to these procedures has been cultivated, since radiation exposure has non-negligible stochastic and ... ...

Abstract	Electrophysiology procedures are traditionally performed under fluoroscopic guidance. Nowadays a growing interest in the radiation risk associated to these procedures has been cultivated, since radiation exposure has non-negligible stochastic and deterministic effects on health. A correlation between radiation exposure and lifetime malignancy effect is difficult to establish and the threshold of a completely safe exposure dose is unknown. Thus, electrophisiologists have become aware of the use of fluoroscopy and they have tried to use all the complementary imaging technologies available in order to reduce the radiological exposure. This review is aimed at evaluating the radiation exposure risk, both for the patients and the operators. We describe electroanatomical mapping systems and technologies, which allow the reduction of radiation exposure. We review the main literature based on different catheter ablation procedures with the use of the abovementioned technologies, specifically focusing on feasibility, safety, and radiation exposure. Finally, we highlight the necessity of increasing the radiological risk awareness among operators and cardiological scientific societies.
MeSH term(s)	Arrhythmias, Cardiac/diagnostic imaging ; Arrhythmias, Cardiac/surgery ; Catheter Ablation/methods ; Fluoroscopy/adverse effects ; Fluoroscopy/methods ; Humans ; Radiation Dosage ; Radiation Exposure ; Radiography/adverse effects ; Radiography/methods
Language	English
Publishing date	2018-02
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	123583-7
ISSN	1827-1618 ; 0026-4725
ISSN (online)	1827-1618
ISSN	0026-4725
DOI	10.23736/S0026-4725.17.04478-4
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Article ; Online: Cardiac magnetic resonance features of left dominant arrhythmogenic cardiomyopathy: differential diagnosis with myocarditis.

Andreini, Daniele / Conte, Edoardo / Casella, Michela / Mushtaq, Saima / Pontone, Gianluca / Dello Russo, Antonio / Nicoli, Flavia / Carità, Patrizia / Catto, Valentina / Vettor, Giulia / Gasperetti, Alessio / Sommariva, Elena / Rizzo, Stefania / Basso, Cristina / Tondo, Claudio / Pepi, Mauro

The international journal of cardiovascular imaging

2021 Volume 38, Issue 2, Page(s) 397–405

Abstract: Cardiac magnetic resonance (CMR) findings suggesting a suspected left-dominant arrhythmogenic cardiomyopathy (LDAC) may be difficult to distinguish from those related to previous myocarditis; however, especially in patients with ventricular arrhythmias ( ... ...

Abstract	Cardiac magnetic resonance (CMR) findings suggesting a suspected left-dominant arrhythmogenic cardiomyopathy (LDAC) may be difficult to distinguish from those related to previous myocarditis; however, especially in patients with ventricular arrhythmias (VA) with ECG morphology consistent with a left ventricle (LV) origin differential diagnosis is fundamental. Aim of the study was to identify potential imaging features at CMR specific for LDAC diagnosis. Between January 2011 and December 2019, we enrolled 15 consecutive stable patients with a recent diagnosis of significant VA and ECG morphology consistent with a LV origin, detection of potential LV arrhythmic substrate at CMR and undergoing a clinically-indicated LV endomyocardial biopsy showing tissue abnormalities consistent with the diagnosis of LDAC. From the same CMR-endomyocardial biopsy registry, a second group of 30 consecutive patients who underwent CMR and biopsy with a histological diagnosis of previous myocarditis were identified. (1) Subepicardial LGE at the level of the posterolateral wall of the LV was detected in 13 cases of LDAC vs. 21 cases of myocarditis; (2) fat infiltration, and particularly subepicardial posterolateral fat infiltration, was found in almost all LDAC patients vs. one myocarditis only (p < 0.01). (3) No differences in other CMR findings or in any clinical or echocardiographic parameters were found between patients with a biopsy consistent with LDAC vs. myocarditis. In patients with significant VA and ECG morphology consistent with a LV origin, the presence of morpho-functional involvement of the subepicardial layer of LV posterolateral wall at CMR (LGE, fat infiltration, wall dyskinesis) supports LDAC diagnosis.
MeSH term(s)	Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Imaging, Cine ; Magnetic Resonance Spectroscopy ; Myocarditis/diagnostic imaging ; Predictive Value of Tests
Language	English
Publishing date	2021-09-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2055311-0
ISSN	1875-8312 ; 1573-0743 ; 1569-5794 ; 0167-9899
ISSN (online)	1875-8312 ; 1573-0743
ISSN	1569-5794 ; 0167-9899
DOI	10.1007/s10554-021-02408-8
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Article ; Online: Novel risk calculator performance in athletes with arrhythmogenic right ventricular cardiomyopathy.

Gasperetti, Alessio / Dello Russo, Antonio / Busana, Mattia / Dessanai, Mariantonietta / Pizzamiglio, Francesca / Saguner, Ardan Muammer / Te Riele, Anneline S J M / Sommariva, Elena / Vettor, Giulia / Bosman, Laurens / Duru, Firat / Zeppilli, Paolo / Di Biase, Luigi / Natale, Andrea / Tondo, Claudio / Casella, Michela

Heart rhythm

2020 Volume 17, Issue 8, Page(s) 1251–1259

Abstract: Background: Disease progression and ventricular arrhythmias (VAs) in arrhythmogenic right ventricular cardiomyopathy (ARVC) are correlated with physical exercise, and clinical detraining and avoidance of competitive sport practice are suggested for ARVC ...

Abstract	Background: Disease progression and ventricular arrhythmias (VAs) in arrhythmogenic right ventricular cardiomyopathy (ARVC) are correlated with physical exercise, and clinical detraining and avoidance of competitive sport practice are suggested for ARVC patients. An algorithm assessing primary arrhythmic risk in ARVC patients was recently developed by Cadrin-Tourigny et al. Data regarding its transferability to athletes are lacking. Objective: The purpose of this study was to assess the reliability of the Cadrin-Tourigny risk prediction algorithm in a cohort of athletes with ARVC and to describe the impact of clinical detraining on disease progression. Methods: All athletes undergoing clinical detraining after ARVC diagnosis at our institution were enrolled. Baseline and follow-up clinical characteristics and data on VA events occurring during follow-up were collected. The Cadrin-Tourigny algorithm was used to calculate the a priori predicted VA risk, which was compared with the observed outcomes. Results: Twenty-five athletes (age 36.1 ± 14.0 years; 80% male) with definite ARVC who were undergoing clinical detraining were enrolled. Over median (interquartile range) follow-up of 5.3 (3.2-6.6) years, a reduction in premature ventricular complex (PVC) burden (P = .001) was assessed, and 10 VA events (40%) were recorded. The a priori algorithm-predicted risk seemed to fit with the observed cohort arrhythmic risk [mean observed-predicted risk difference over 5 years -0.85% (interquartile range -4.8% to +3.1%); P = .85]. At 1-year follow-up, 11 patients (44%) had an improved stress ECG response, and no significant changes in right ventricular ejection fraction were observed. Conclusion: Clinical detraining is associated with PVC burden reduction in athletes with ARVC. The novel risk prediction algorithm does not seem to require any correction for its application to ARVC athletes.
MeSH term(s)	Aged ; Arrhythmogenic Right Ventricular Dysplasia/physiopathology ; Athletes ; Electrocardiography ; Exercise/physiology ; Female ; Humans ; Male ; Reproducibility of Results ; Stroke Volume/physiology ; Ventricular Function, Right/physiology
Language	English
Publishing date	2020-03-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2229357-7
ISSN	1556-3871 ; 1547-5271
ISSN (online)	1556-3871
ISSN	1547-5271
DOI	10.1016/j.hrthm.2020.03.007
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