Minerva cardioangiologica最新文献

{"title":"Robotic-assisted coronary artery bypass grafting: current knowledge and future perspectives.","authors":"Andrea Amabile,&nbsp;Gianluca Torregrossa,&nbsp;Husam H Balkhy","doi":"10.23736/S0026-4725.20.05302-5","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05302-5","url":null,"abstract":"<p><p>Minimally invasive direct coronary artery bypass grafting (MIDCAB) and totally endoscopic coronary artery bypass grafting (TECAB) are the two existing strategies for robotic-assisted, surgical myocardial revascularization. In this review, we summarize the wide evidence available in the literature regarding the benefits of these two procedures, and detail the technical skills required to master robotic coronary surgery techniques.</p>","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"68 5","pages":"497-510"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38573434","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}

{"title":"Early versus late tracheal intubation in COVID-19 patients: a pro-con debate also considering heart-lung interactions.","authors":"L. Cabrini, L. Ghislanzoni, P. Severgnini, G. Landoni, M. Baiardo Redaelli, F. Franchi, S. Romagnoli","doi":"10.23736/S0026-4725.20.05356-6","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05356-6","url":null,"abstract":"The best timing of orotracheal intubation and invasive ventilation in COVID-19 patients with acute respiratory distress syndrome is unknown. The use of non-invasive ventilation, a life-saving technique in many medical conditions, is debated in patients with ARDS since prolonged NIV and delayed intubation may be harmful. Shortage of intensive care beds and ventilators during a respiratory pandemic can trigger a widespread use of early non-invasive ventilation in many hospitals but which is the best way to ventilate patients with severe bilateral pneumonia and severely increased spontaneous ventilation is controversial. Moreover, viral spreading to health-care workers and other hospitalized patients is an issue for any device used to administer oxygen. Even if protective mechanical ventilation is currently the gold standard for the management of acute respiratory distress syndrome, tracheal intubation is not without risks and is associated with delirium, hemodynamic instability, immobilization and post intensive care syndrome. Both invasive and non-invasive ventilation are associated with advantages and limitations that should be carefully considered when patients with COVID-19-ARDS need our attention. In the absence of strong evidence , in this review we highlight all the pro and con of these two different approaches.","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85757095","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}

{"title":"Marijuana influence on cardiac modulation and heart rate: novel hypotheses and gaps in evidence.","authors":"G. Iannaccone, I. Porto","doi":"10.23736/S0026-4725.20.05497-3","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05497-3","url":null,"abstract":"","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88546856","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}

{"title":"Correlation of heart rate and blood pressure variability as well as hs-CRP with the burden of stable coronary artery disease.","authors":"Xiong Peng,&nbsp;Dingfeng Peng,&nbsp;Yongjun Hu,&nbsp;Hongsheng Gang,&nbsp;Yijun Yu,&nbsp;Shaoyong Tang","doi":"10.23736/S0026-4725.20.05153-1","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05153-1","url":null,"abstract":"<p><strong>Background: </strong>The aim is to investigate the predictive value of heart rate variability (HRV), blood pressure variability (BPV), and high-sensitivity C-reactive protein (hs-CRP) levels in patients with stable coronary artery disease (SCAD) to assess whether these variables predict the Gensini score.</p><p><strong>Methods: </strong>Five hundred and eighty-eight patients with SCAD were enrolled. Normal coronary angiography (102 patients) and healthy physical examination patients (104 patients) were enrolled as control group for HRV. Dynamic electrocardiogram, ambulatory blood pressure, and hs-CRP were measured in SCHD, and Gensini scores were calculated. The relationship between the level of Gensini scores and HRV, BPV and hs-CRP in SCAD was analyzed. We assessed the predictive value of non-invasive markers for the degree of coronary artery disease in SCAD.</p><p><strong>Results: </strong>HRV was negatively correlated with coronary lesions Gensini scores, and BPV was positively correlated with them. The correlation coefficients of SDNN, PNN50, SDANN, RMSSD, and TRIA in HRV are -0.327, -0.489, -0.153 -0.206, -0.292, respectively (P<0.01); while 24hSBPV, 24hDBPV, dSBPV, dDBPV, nSBPV and nSBPdrinBPV were 0.286, 0.233, 0.141, 0.139, 0.218, 0.113, respectively (P<0.01). hs-CRP was positively correlated with the Gensini scores of coronary lesions (0.325, P<0.01), HRV decreased (PNN50<14.97, TRIA<160.86) and BPV increased (24hSBPV>20%, nSBPV>20%) combined with hs-CRP positive (hs-CR >3.0 mg/L) performance can effectively predict coronary lesions in SCAD.</p><p><strong>Conclusions: </strong>HRV, BPV and hs-CRP are all significantly associated with coronary lesions. And these variables can predict the Gensini score in SCAD.</p>","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"68 5","pages":"376-382"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37865399","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}

{"title":"Extracorporeal membrane oxygenation for COVID-19: effective weapon or futile effort?","authors":"Natalia Pavone,&nbsp;Francesco Burzotta,&nbsp;Massimo Massetti","doi":"10.23736/S0026-4725.20.05377-3","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05377-3","url":null,"abstract":"","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"68 5","pages":"365-367"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38573435","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}

{"title":"Implantable loop recorder for syncope: essential tool or double-edged weapon?","authors":"E. Ebrille, P. Crea","doi":"10.23736/S0026-4725.20.05498-5","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05498-5","url":null,"abstract":"","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88342028","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}

{"title":"Dual antiplatelet therapy duration after percutaneous coronary intervention with drug-eluting stents: how short can we go?","authors":"Fausto Roccasalva,&nbsp;Giuseppe Ferrante","doi":"10.23736/S0026-4725.20.05196-8","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05196-8","url":null,"abstract":"<p><p>Current guidelines recommend a duration of dual antiplatelet therapy (DAPT) with aspirin and oral P2Y<inf>12</inf> receptor inhibitors following percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES) of 6 months for most patients with stable coronary disease and of 12 months for most patients with acute coronary syndromes. Large evidence from randomised clinical trials of shorter DAPT regimens after PCI with newer-generation DES is now emerging in heterogenous patient population not selected on the basis of high bleeding risk as well as in patients at high bleeding risk. The scope of this review is to provide an update on the benefits and harms of these short DAPT regimens and to discuss future directions in DAPT strategies after PCI with newer generation DES.</p>","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"68 5","pages":"436-450"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38431249","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}

{"title":"Left main coronary artery disease: when and how to perform PCI?","authors":"Mauro Chiarito,&nbsp;Julinda Mehilli","doi":"10.23736/S0026-4725.20.05198-1","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05198-1","url":null,"abstract":"<p><p>Left main coronary artery (LMCA) disease has been reported in up to 10% of all patients with coronary artery disease (CAD) and in the majority of cases are associated with severe three-vessel CAD. Among patients with chronic coronary syndrome revascularization of significant LMCA disease improves prognosis, while there is a debate about which revascularization strategy, CABG surgery or percutaneous coronary interventions to use. We do a review of the available evidence about the impact of LMCA lesions on patient prognosis according to CAD extension and clinical presentation, the outcome after percutaneous or surgical revascularization, the procedural challenges of LMCA PCI and the available armamentarium to optimally treat this relevant population.</p>","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"68 5","pages":"405-414"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37685728","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}

{"title":"Further advancement in the percutaneous revascularization of coronary chronic total occlusions: the redefined \"Minimalistic Hybrid Approach\" algorithm.","authors":"G. Vescovo, C. Zivelonghi, B. Scott, P. Agostoni","doi":"10.23736/S0026-4725.20.05381-5","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05381-5","url":null,"abstract":"A careful angiographic assessment of a chronic total occlusion (CTO) is essential for optimal procedural planning. In the classic Hybrid Approach, the insertion of two guiding catheters at the beginning of the intervention is recommended. This is fundamental to perform simultaneous double injection, to achieve complete visualization of the coronary circulation and to choose the best starting strategy between antegrade wire escalation (AWE), antegrade dissection and re-entry (ADR) and the retrograde techniques (retrograde wire escalation [RWE] and retrograde dissection and re-entry [RDR]). In the Hybrid Algorithm the set-up is the same, regardless of the chosen first strategy, and therefore routinely uses double access. Because revascularizations of CTOs commonly require large bore catheters (7-8 French) to ensure high back up support, the femoral arterial access is preferred by most of the operators. However, the use of a double access, large introducer sheaths and femoral approach are associated with a greater risk of access-related complications and even the occurrence of major adverse cardiovascular events. We have previously proposed an algorithm, called \"Minimalistic Hybrid Approach\", which aims to limit the routine use of dual injection, and to favour the use of trans-radial access and smaller (6-7 French) guiding catheters. In this algorithm the chosen starting strategy depends on the complexity of the lesion assessed by J-CTO score and on the presence of favourable contralateral interventional collateral circulation. However, this novel algorithm proved to have some limitations, such as the non-specific evaluation of CTOs with ipsilateral collateral circulation and the too arbitrary choice of the starting strategy based on a J-CTO score cut-off. These considerations led to the development of an \"updated\" Minimalistic Hybrid Approach algorithm that takes into account the type of collaterals (ipsilateral or contralateral) and the \"a priori\" choice of the hybrid technique, with the highest chance of success in that specific CTO lesion (independently from the J-CTO score). One important aspect that makes this algorithm unique is its \"dynamicity\": not only for the technique to be used, as in the classic hybrid algorithm (shifting between AWE, ADR, RWE and RDR), but also for the set-up, with access site and French size to be adapted during the PCI to the technique adopted. We believe that this novel approach could further improve the safety of CTO-PCI without losing its current efficacy.","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72958912","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}

{"title":"Long-term prognostic potential of microRNA-150-5p in optimally treated heart failure patients with reduced ejection fraction. A pilot study.","authors":"D. Scrutinio, F. Conserva, P. Guida, A. Passantino","doi":"10.23736/S0026-4725.20.05366-9","DOIUrl":"https://doi.org/10.23736/S0026-4725.20.05366-9","url":null,"abstract":"BACKGROUND\u0000In a previous study, we found that miR-150-5p was specifically downregulated in patients with advanced heart failure (HF). Here, we investigated the long-term prognostic potential of miR-150-5p.\u0000\u0000\u0000METHODS\u0000We studied optimally treated HF outpatients with reduced ejection fraction. The primary outcome comprised the composite of death, urgent heart transplantation (HT) and ventricular assist device (VAD) implantation within 30 months. We used recursive partitioning analysis to identify the optimal log miR-150-5p cut-off. The association of log miR-150-5p with the primary outcome was examined using Cox regression analysis. We used the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score for adjustment in multivariable analysis. Finally, we compared the global fit of three models (MAGGIC score+miR-150-5p, MAGGIC score+NT-proBNP, and NT-proBNP+miR-150-5p) using Akaike Information Criterion.\u0000\u0000\u0000RESULTS\u0000Recursive partitioning analysis identified the value of -2.22 as the optimal cut-off for log miR-150-5p. Thirty-month survival free of urgent HT/VAD implantation was 31% among the patients with log miR-150-5p <-2.22 and 86% among those with log miR-150-5p >-2.22. Crude hazard ratio (HR) of the primary outcome for log miR-150-5p expression level < -2.22 was 6.70 (95%CI:2.31-19.38;p<.001). After adjusting for the MAGGIC score in multivariable analysis, the HR was 4.40 (95%CI:1.52-12.77;p=.006). Adding log miR-150-5p to the MAGGIC score led to an increase of 0.047 in C-index. The model combining miR-150-5p and MAGGIC score had a 73% likelihood of representing the best-fit model of those evaluated.\u0000\u0000\u0000CONCLUSIONS\u0000Our data generate the hypothesis that miR-150-5p may represent a novel risk marker in HF with reduced ejection fraction.","PeriodicalId":18565,"journal":{"name":"Minerva cardioangiologica","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78832998","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}