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15,733 results for “article”
Dataset related to article "Glecaprevir/Pibrentasvir is safe and effective in Italian patients with chronic hepatitis C aged 75 years or older: A multicentre study"
<p>This record contains raw data related to article "Glecaprevir/Pibrentasvir is safe and effective in Italian patients with chronic hepatitis C aged 75 years or older: A multicentre study"</p><p>Abstract</p><p><strong>Background: </strong>Glecaprevir and Pibrentasvir (G/P) determine high rates of sustained virological response (SVR) with optimal safety profile in patients with chronic hepatitis C virus (HCV) infection. The efficacy and safety of G/P in Caucasian patients aged 75 years and older have not been widely analysed.</p><p><strong>Methods: </strong>This is a retrospective multicentre real-world study enrolling all consecutive patients 75 years and older who received G/P between October 2017 and January 2022 at five referral centres in Italy. SVR was analysed by intention-to-treat (ITT) and per-protocol analyses (PP).</p><p><strong>Results: </strong>A total of 570 patients met the inclusion criteria and were analysed: mean age was 80 (75-97) years, 356 (62%) were females, 52% (298/570) had HCV-1, 44% (252/570) had HCV-2 and 137 (24%) patients had liver cirrhosis. Four hundred and sixty-three (81%) patients were taking at least one concomitant drug, with 144 (25%) taking ≥5 concomitant drugs. G/P was given for 8 weeks in 488 patients (86%). During treatment, 48 patients (8%) reported side effects, with 10 (2%) patients discontinuing treatment prematurely. Two patients developed treatment-unrelated serious adverse events. Overall, the SVR rate was 97.9% (558/570) by ITT analysis and 99.6% (558/560) by PP analysis. SVR rates remained consistently high among subgroup analysis stratified by genotype, treatment duration, fibrosis stage and concomitant medications.</p><p><strong>Conclusions: </strong>Treatment with G/P achieved 97.9% SVR rates in HCV patients older than 75 years of age. Safety was optimal with only 2% of patients discontinuing early.</p>
Dataset related to article "EUS-guided gastroenterostomy using a novel electrocautery lumen apposing metal stent for treatment of gastric outlet obstruction (with video)"
<p>This record contains raw data related to article "EUS-guided gastroenterostomy using a novel electrocautery lumen apposing metal stent for treatment of gastric outlet obstruction (with video)"</p><p>Abstract</p><p><strong>Background and aim: </strong>Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) for the treatment of gastric outlet obstruction (GOO) has been actually performed only with one type of electrocautery lumen-apposing metal stents (EC-LAMS). We aimed to evaluate the safety, technical and clinical effectiveness of EUS-GE using a newly available EC-LAMS in patients with malignant and benign GOO.</p><p><strong>Materials and methods: </strong>Consecutive patients who underwent EUS-GE for GOO using the new EC-LAMS at five endoscopic referral centers were retrospectively evaluated. Clinical efficacy was determined utilizing the Gastric Outlet Obstruction Scoring System (GOOSS).</p><p><strong>Results: </strong>Twenty-five patients (64% male, mean age 68.7 ± 9.3 years) met the inclusion criteria; 21 (84%) had malignant etiology. Technically, EUS-GE was successful in all patients, with a mean procedural time of 35 ± 5 min. Clinical success was 68% at 7 days and 100% at 30 days. The mean time to resume oral diet was 11.4 ± 5.8 h, with an improvement of at least one point of GOOSS score observed in all patients. The median hospital stay was 4 days. No procedure-related adverse events occurred. After a mean follow-up of 7.6 months (95% CI 4.6-9.2), no stent dysfunctions were observed.</p><p><strong>Conclusion: </strong>This study suggests EUS-GE can be performed safely and successfully using the new EC-LAMS. Future large multicenter prospective studies are needed to confirm our preliminary data.</p>
Dataset related to article "Multimodal Treatments for Brain Metastases from Renal Cell Carcinoma: Results of a Multicentric Retrospective Study "
<p>This record contains raw data related to article "Multimodal Treatments for Brain Metastases from Renal Cell Carcinoma: Results of a Multicentric Retrospective Study"</p><p>Abstract</p><p>The aim of this study was to evaluate the clinical outcomes of a large series of brain metastatic renal cell carcinoma (BMRCC) patients treated in three Italian centers.</p><p><strong>Methods: </strong>A total of 120 BMRCC patients with a total of 176 lesions treated were evaluated. Patients received surgery plus postoperative HSRS, single-fraction SRS, or hypofractionated SRS (HSRS). Local control (LC), brain distant failure (BDF), overall survival (OS), toxicities, and prognostic factors were assessed.</p><p><strong>Results: </strong>The median follow-up time was 77 months (range 16-235 months). Surgery plus HSRS was performed in 23 (19.2%) cases, along with SRS in 82 (68.3%) and HSRS in 15 (12.5%). Seventy-seven (64.2%) patients received systemic therapy. The main total dose and fractionation used were 20-24 Gy in single fraction or 32-30 Gy in 4-5 daily fractions. Median LC time and 6 month and 1, 2 and 3 year LC rates were nr, 100%, 95.7% ± 1.8%, 93.4% ± 2.4%, and 93.4% ± 2.4%. Median BDF time and 6 month and 1, 2 and 3 year BDF rates were n.r., 11.9% ± 3.1%, 25.1% ± 4.5%, 38.7% ± 5.5%, and 44.4% ± 6.3%, respectively. Median OS time and 6 month and 1, 2 and 3 year OS rates were 16 months (95% CI: 12-22), 80% ± 3.6%, 58.3% ± 4.5%, 30.9% ± 4.3%, and 16.9% ± 3.6, respectively. No severe neurological toxicities occurred. Patients with a favorable/intermediate IMDC score, a higher RCC-GPA score, an early occurrence of BMs from primary diagnosis, absence of EC metastases, and a combined local treatment (surgery plus adjuvant HSRS) had a better outcome.</p><p><strong>Conclusions: </strong>SRS/HSRS is proven to be an effective local treatment for BMRCC. A careful evaluation of prognostic factors is a valid step to manage the optimal therapeutic strategy for BMRCC patients.</p>
Dataset related to article "Radiosurgery of limited brain metastases from primary solid tumor: results of the randomized phase III trial (NCT02355613) comparing treatments executed with a specialized or a C-arm linac-based platform"
<p>This record contains raw data related to article "Radiosurgery of limited brain metastases from primary solid tumor: results of the randomized phase III trial (NCT02355613) comparing treatments executed with a specialized or a C-arm linac-based platform"</p><p>Abstract</p><p>Background: Comparative prospective data regarding different radiosurgery (SRS) modalities for treating brain metastases (BMs) from solid tumors are not available. To investigate with a single institute phase III randomized trial whether SRS executed with linac (Arm-B) is superior to a dedicated multi-source gamma-ray stereotactic platform (Arm-A).</p><p>Methods: Adults patients with 1-4 BMs from solid tumors up to 30 mm in maximum diameter were randomly assigned to arms A and B. The primary endpoint was cumulative incidence of symptomatic (grade 2-3) radionecrosis (CIRN). Secondary endpoints were local progression cumulative incidence (CILP), distant brain failure, disease-free survival (DFS), and overall survival (OS).</p><p>Results: A total of 251 patients were randomly assigned to Arm-A (121) or Arm-B (130). The 1-year RN cumulative incidence was 6.7% in whole cohort, 3.8% (95% CI 1.9-7.4%) in Arm-B, and 9.3% (95% CI 6.2-13.8%) in the Arm-A (p = 0.43). CIRN was influenced by target volume irradiated only for the Arm-A (p << 0.001; HR 1.36 [95% CI 1.25-1.48]). Symptomatic RN occurred in 56 cases at a median time of 10.3 months (range 1.15-54.8 months), 27 in the Arm-B at a median time of 15.9 months (range 4.9-54.8 months), and 29 in the Arm-A at a median time of 6.9 months (1.2-32.3 months), without statistically significant differences between the two arms. No statistically significant differences were recorded between the two arms in CILP, BDF, DFS or OS. The mean beam-on time to deliver SRS was 49.0 ± 36.2 min in Arm-A, and 3.1 ± 1.6 min in Arm-B.</p><p>Conclusions: Given the technical differences between the treatment platforms investigated in this single-institution study, linac-based SRS (Arm-B) did not lead to significantly lower grade 2-3 RN rates versus the multi-source gamma-ray system (Arm-A) in a population of patients with limited brain metastases of small volume. No significant difference in local control was observed between both arms. For Arm-B, the treatment delivery time was significantly lower than for Arm-A.</p><p> </p><p>Trial registration: ClinicalTrials.gov Identifier NCT02355613.</p><p> </p>
Dataset related to article "Prevalence of Germline Mutations in Cancer Predisposition Genes in Patients with Pancreatic Cancer or Suspected Related Hereditary Syndromes: Historical Prospective Analysis"
<p>This record contains raw data related to article "Prevalence of Germline Mutations in Cancer Predisposition Genes in Patients with Pancreatic Cancer or Suspected Related Hereditary Syndromes: Historical Prospective Analysis"</p><p> Abstract</p><p>We investigate the prevalence of germline mutations in cancer predisposition genes in patients with pancreatic ductal adenocarcinoma (PDAC) or suspected related hereditary syndromes.</p><p>Methods: we enrolled for NGS with an Illumina TrueSight Cancer panel comprising 19 CPGs and 113 consecutive subjects referred to cancer genetic clinics for metastatic PDAC, early onset PDAC, suspected hereditary syndrome, or positive family history.</p><p>Results: Overall, 23 (20.1%) subjects were carriers of 24 pathogenetic variants (PVs). We found 9 variants in BRCA2 (37.5%), 6 in CDKN2A (25%), 3 in ATM (12.5%), 2 in BRCA1 (8.3%), 1 in CHEK2 (4.1%), 1 in PALB2 (4.1%), 1 in MITF (4.1%), and 1 in FANCM (4.1%). A double PV (BRCA1 plus BRCA2) was found in 1 subject. We observed a nearly 30% (16/55) mutational rate in the subgroup of subjects tested for the suspected syndromes (PDAC and other synchronous or metachronous tumors or an indicative family history), and the frequency was significantly higher than that in patients with only metastatic PDAC (p = 0.05). In our cohort, 39 variants of unknown significance (VUS) were identified, most of which (16/39, 41%) in genes belonging to the Lynch syndrome spectrum.</p><p>Conclusion: A clinically relevant proportion of pancreatic cancer is associated with mutations in known predisposition genes. Guidelines instructing on an adequate selection for accessing genetic testing are eagerly needed. The heterogeneity of mutations identified in this study reinforces the value of using a multiple-gene panel in pancreatic cancer.</p><p> </p>
Dataset related to article: "THE NEVERENDING DEBATE ON PROGESTERONE ELEVATION: POSSIBLE SOLUTIONS."
<p><strong>Background.</strong> The association between serum progesterone (P) levels, measured on the day of ovulation trigger, and the outcome of in vitro fertilization cycles, has been one of the major controversies in the field of ovarian stimulation endocrinology.</p> <p><strong>Objective.</strong> The aim is to review the dataset of a single tertiary care academic center in order to evaluate the impact of premature high serum P levels on the outcome of embryo transfer (ET) cycles in terms of Clinical Pregnancy Rates (CPR) and Live Birth Rates (LBR). Furthermore, the present study retrospectively investigates whether the transfer on day 5 post-fertilization may improve the CPR and the LBR in patients with P rise</p> <p><strong>Methods.</strong> This is a single-center retrospective cohort study. All fresh ET both at cleavage stage and blastocyst stage, performed from January 2012 to December 2016, were included. Main clinical features were analyzed and the impact of P level on CPR and LBR was explored using a multivariable logistic regression.</p> <p><strong>Results.</strong> During the study period 8,034 ET were performed: 7,597 cleavage-stage transfers and 437 blastocyst transfers. Serum P levels demonstrated to be inversely related to CPR (OR 0.72, p<0.001) and LBR (OR 0.73, p<0.001). The decrease already started when P levels were ³1 ng/mL, and a further decrease was observed with P levels ³1.75 ng/mL. Analyzing the day of embryo transfer: in the day 3 group, a P level ≥1ng/mL significantly reduced CPR and LBR. With a P level ≥1.75 ng/mL CPR and LBR decreased even more. The relationship between serum P level and CPR and LBR in the day 5 group instead is not particularly evident when the values are <1.75 ng/mL; on the other hand, CPR and LBR are half their value when P level is ≥1.75 ng/mL. To evaluate eventual differences in CPR depending on different P thresholds, the analysis was subsequently performed separately in different subgroups. In the cleavage ET subgroup patients with good prognosis, the effect of P increase was found to be significant for P values >1 ng/mL, while in patients with worse prognosis it appeared to be significant only for P values ≥1.75 ng/mL. In the blastocyst ET subgroup, the negative effect of P elevation on LBR and CPR was reported only if P was >1.75 ng/mL. CPR and LBR in thawed cycles resulted statistically significantly higher than in fresh cycles. Considering the cleavage subgroup, the thawed cycles group resulted in better CPR and LBR, even compared with patients with P level <1 ng/mL. In the blastocyst group, no significant difference resulted between thawed and fresh cycles, independently of P levels.</p> <p><strong>Conclusion.</strong> High P levels decrease CPR as well as LBR in both cleavage and blastocyst ET. Interestingly, a different impact of P levels elevation was observed in different patient categories. In the cleavage group, for P levels below 1.75 ng/mL, it could be recommended to wait until day 5 for ET, and if P level is ≥1.75 ng/mL it should be considered to freeze all embryos and postpone the ET until P levels normalize.</p>
Dataset related to the article "Coronary artery mechanics induces human saphenous vein remodelling via recruitment of adventitial myofibroblast-like cells mediated by Thrombospondin-1"
<p>This record contains graph data related to the article “<strong>Coronary artery mechanics induces human saphenous vein remodelling via recruitment of adventitial myofibroblast-like cells mediated by Thrombospondin-1</strong>”</p> <p> </p> <p>Abstract</p> <p><strong>Rationale</strong> - Despite the preferred application of arterial conduits, the greater saphenous vein (SV) remains indispensable for coronary bypass grafting (CABG), especially in multi-vessel coronary artery disease (CAD). The objective of the present work was to address the role of mechanical forces in the activation of maladaptive vein bypass remodeling, a process determining progressive occlusion and recurrence of ischemic heart disease.</p> <p><strong>Methods </strong>- We employed a custom bioreactor to mimic the coronary shear and wall mechanics in human SV vascular conduits and reproduce experimentally the biomechanical conditions of coronary grafting and analyzed vein remodeling process by histology, histochemistry and immunofluorescence. We also subjected vein-derived cells to cyclic uniaxial mechanical stimulation in culture, followed by phenotypic and molecular characterization using RNA and proteomic methods. We finally validated our results <em>in vitro</em> and using a model of SV carotid interposition in pigs.</p> <p><strong>Results - </strong>Exposure to pulsatile flow determined a remodeling process of the vascular wall involving reduction in media thickness. Smooth muscle cells (SMCs) underwent conversion from contractile to synthetic phenotype. A time-dependent increase in proliferating cells expressing mesenchymal (CD44) and early SMC (SM22α) markers, apparently recruited from the SV adventitia, was observed especially in CABG-stimulated vessels. Mechanically stimulated SMCs underwent transition from contractile to synthetic phenotype. MALDI-TOF-based secretome analysis revealed a consistent release of Thrombospondin-1 (TSP-1), a matricellular protein involved in TGF-β-dependent signaling. TSP-1 had a direct chemotactic effect on SV adventitia resident progenitors (SVPs); this effects was inhibited by blocking TSP-1 receptor CD47. The involvement of TSP-1 in adventitial progenitor cells differentiation and graft intima hyperplasia was finally contextualized in the TGF-β-dependent pathway, and validated in a saphenous vein into carotid interposition pig model.</p> <p><strong>Conclusions -</strong> Our results provide the evidence of a matricellular mechanism involved in the human vein arterialization process controlled by alterations in tissue mechanics, and open the way to novel potential strategies to block VGD progression based on targeting cell mechanosensing-related effectors.</p>
Data set from the article Cairo B, De Maria B, Bari V, Vaini E, Heusser K, Tank J, Jordan J, Barbic F, Furlan R, Marinou K, Dalla Vecchia L, Porta A. Information-domain method for the quantification of the complexity of the sympathetic baroreflex regulation in healthy subjects and amyotrophic lateral sclerosis patients. Physiol Meas. 2019 Apr 4;40(3):034004. doi: 10.1088/1361-6579/ab0d4b. PMID: 30840931.
<p>Data set from the article Cairo B, De Maria B, Bari V, Vaini E, Heusser K, Tank J, Jordan J, Barbic F, Furlan R, Marinou K, Dalla Vecchia L, Porta A. Information-domain method for the quantification of the complexity of the sympathetic baroreflex regulation in healthy subjects and amyotrophic lateral sclerosis patients. Physiol Meas. 2019 Apr 4;40(3):034004. doi: 10.1088/1361-6579/ab0d4b. PMID: 30840931.</p> <p>this is the abstract:</p> <p><strong>Background: </strong>The sympathetic baroreflex (sBR) adjusts muscle sympathetic nerve activity (MSNA) in response to arterial pressure changes but the relevance of assessing sBR control complexity is unclear.</p> <p><strong>Objective: </strong>We propose a method for the evaluation of sBR control complexity.</p> <p><strong>Approach: </strong>The approach comprises the quantification of complexity of the sBR latency regulation and the assessment of complexity of the relationship linking MSNA burst to R-wave peak regardless of the variability of the sBR latency. The Shannon entropy (SE) of the sBR latency distribution is taken as an estimate of complexity of the sBR latency regulation. The conditional entropy (CE) of the beat-to-beat binary series obtained by coding the presence/absence of the MSNA burst after an R-wave peak is taken as an estimate of complexity of the sBR control regardless of the sBR latency variability. Surrogate analysis was utilized to set the level of inactive or impaired sBR. The approach was applied to 10 young healthy subjects undergoing head-up tilt (HUT) followed by lower body negative pressure to evoke presyncope (preSYNC) before and after 21 d head-down bed rest (HDBR), and to five amyotrophic lateral sclerosis (ALS) patients undergoing HUT.</p> <p><strong>Main results: </strong>In healthy subjects the surrogate analysis suggested that HUT and preSYNC significantly activated the sBR control but its response was weakened after 21 d HDBR. During preSYNC sBR latency increased significantly only after 21 d HDBR. In ALS patients the complexity of the sBR latency regulation was close to the level set by surrogate analysis and HUT did not trigger any sBR control response.</p> <p><strong>Significance: </strong>The proposed method for sBR control complexity quantification was useful in detecting the impairment of the sBR control after 21 d HDBR in healthy subjects and the dysfunction of the sBR regulation in ALS patients.</p>
Data set from the article Dozio E, Vianello E, Bandera F, Longhi E, Brizzola S, Nebuloni M, Corsi Romanelli MM. Soluble Receptor for Advanced Glycation End Products: A Protective Molecule against Intramyocardial Lipid Accumulation in Obese Zucker Rats? Mediators Inflamm. 2019 Feb 28;2019:2712376. doi: 10.1155/2019/2712376. PMID: 30944546; PMCID: PMC6421753.
<p>Data Set on the article: Dozio E, Vianello E, Bandera F, Longhi E, Brizzola S, Nebuloni M, Corsi Romanelli MM. Soluble Receptor for Advanced Glycation End Products: A Protective Molecule against Intramyocardial Lipid Accumulation in Obese Zucker Rats? Mediators Inflamm. 2019 Feb 28;2019:2712376. doi: 10.1155/2019/2712376. PMID: 30944546; PMCID: PMC6421753.</p> <p>This is the abrasct:</p> <p>Most of the obesity-related complications are due to ectopic fat accumulation. Recently, the activation of the cell-surface receptor for advanced glycation end products (RAGE) has been associated with lipid accumulation in different organs. Nevertheless, the role of RAGE and sRAGE, the soluble form that prevents ligands to activate RAGE, in intramyocardial lipid accumulation is presently unknown. To this aim, we analyzed whether, in obesity, intramyocardial lipid accumulation and lipid metabolism-related transcriptome are related to RAGE and sRAGE. Heart and serum samples were collected from 10 lean (L) and 10 obese (OB) Zucker rats. Oil red staining was used to detect lipids on frozen heart sections. The lipid metabolism-related transcriptome (84 genes) was analyzed by a specific PCR array. Heart RAGE expression was explored by real-time RT-PCR and Western blot analyses. Serum levels of sRAGE (total and endogenous secretory form (esRAGE)) were quantified by ELISA. Genes promoting fatty acid transport, activation, and oxidation in mitochondria/peroxisomes were upregulated in OB hearts. Intramyocardial lipid content did not differ between OB and L rats, as well as RAGE expression. A slight increase in epicardial adipose tissue was observed in OB hearts. Total sRAGE and esRAGE concentrations were significantly higher in OB rats. sRAGE may protect against obesity-induced intramyocardial lipid accumulation by preventing RAGE hyperexpression, therefore allowing lipids to be metabolized. EAT also played a protective role by working as a buffering system that protects the myocardium against exposure to excessively high levels of fatty acids. These observations reinforce the potential role of RAGE pathway as an interesting therapeutic target for obesity-related complications, at least at the cardiovascular level.</p>
Dataset related to the article "Reduced Cardiorenal Function Accounts for Most of the In-Hospital Morbidity and Mortality Risk Among Patients With Type 2 Diabetes Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction"
<p>This record contains raw data related to the article "Reduced Cardiorenal Function Accounts for Most of the In-Hospital Morbidity and Mortality Risk Among Patients With Type 2 Diabetes Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction"</p> <p><strong>ABSTRACT</strong> ST-segment elevation myocardial infarction (STEMI) patients with diabetes mellitus<br> (DM) have higher in-hospital mortality than those without. Since cardiac and renal<br> functions are the main variables associated with outcome in STEMI, we hypothesized<br> that this prognostic disparity may depend on a higher rate of cardiac and<br> renal dysfunction in DM patients.<br> RESEARCH DESIGN AND METHODS<br> We retrospectively analyzed 5,152 STEMI patients treated with primary angioplasty.<br> Left ventricular ejection fraction (LVEF) and estimated glomerular filtration rate<br> (eGFR) were evaluated at hospital admission. The primary end point was in-hospital<br> mortality. A composite of in-hospital mortality, cardiogenic shock, and acute kidney<br> injury was the secondary end point.<br> RESULTS<br> There were 879 patients (17%) with DM. The incidence of LVEF £40% (30% vs. 22%),<br> eGFR £60 mL/min/1.73m2 (27% vs. 18%), or both (12% vs. 6%) was higher (P < 0.001<br> for all comparisons) inDMpatients. In-hospital mortality was higher inDMpatients<br> than in non-DM patients (6.1% vs. 3.5%; P = 0.002), with an unadjusted odds ratio<br> (OR) of 1.81 (95% CI 1.31–2.49; P < 0.001). However, DM was no longer associated<br> with an increased mortality risk after adjustment for cardiac and renal function (OR<br> 1.03, 95% CI 0.68–1.56; P = 0.89). A similar behavior was observed for the secondary<br> end point, with an unadjusted OR for DM of 1.52 (95% CI 1.25–1.85; P < 0.001) and<br> an OR after adjustment for cardiac and renal function of 1.07 (95% CI 0.85–1.36;<br> P = 0.53).<br> CONCLUSIONS<br> The study indicates that the increased in-hospital mortality and morbidity of DM<br> patients with STEMI is mainly driven by their underlying cardiorenal dysfunction.</p>
Dataset related to the article "High sensitivity C-reactive protein and acute kidney injury in patients wit acute myocardial infarction: a prospective observational study"
<p>This record contains raw data related to the article "High sensitivity C-reactive protein and acute kidney injury in patients wit acute myocardial infarction: a prospective observational study"</p> <p><strong>Abstract:</strong> Background. Accumulating evidence suggests that inflammation plays a key role in acute<br> kidney injury (AKI) pathogenesis. We explored the relationship between high-sensitivity C-reactive<br> protein (hs-CRP) and AKI in acute myocardial infarction (AMI). Methods. We prospectively included<br> 2,063 AMI patients in whom hs-CRP was measured at admission. AKI incidence and a clinical<br> composite of in-hospital death, cardiogenic shock, and acute pulmonary edema were the study<br> endpoints. Results. Two-hundred-thirty-four (11%) patients developed AKI. hs-CRP levels were<br> higher in AKI patients (45 87 vs. 16 41 mg/L; p < 0.0001). The incidence and severity of AKI, as well<br> as the rate of the composite endpoint, increased in parallel with hs-CRP quartiles (p for trend <0.0001<br> for all comparisons). A significant correlation was found between hs-CRP and the maximal increase<br> of serum creatinine (R = 0.23; p < 0.0001). The AUC of hs-CRP for AKI prediction was 0.69 (p < 0.001).<br> At reclassification analysis, addition of hs-CRP allowed to properly reclassify 14% of patients when<br> added to creatinine and 8% of patients when added to a clinical model. Conclusions. In AMI,<br> admission hs-CRP is closely associated with AKI development and severity, and with in-hospital<br> outcomes. Future research should focus on whether prophylactic renal strategies in patients with<br> high hs-CRP might prevent AKI and improve outcome.</p>
Dataset related to the article "Iron deficiency in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention"
<p>This record contains raw data related to the article "Iron deficiency in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention"</p> <p><strong>ABSTRACT</strong> Background: Iron deficiency (ID) is a known co-morbidity and a potential therapeutic target in heart failure.<br> Whether ID is frequent also in ST-segment elevation acute myocardial infarction (STEMI) patients and is associated<br> with worse in-hospital outcomes has never been evaluated.<br> Methods: We defined ID as a serum ferritin b 100 μg/L or transferrin saturation b 20% at hospital admission.We<br> assessed the association between ID and the primary endpoint (a composite of in-hospital mortality and Killip<br> class ≥ 3). We explored the potential association between ID, circulating cell-free mitochondrial DNA<br> (mtDNA), and cardiac magnetic resonance (CMR) parameters.<br> Results: Four-hundred-twenty STEMI patients undergoing primary percutaneous coronary intervention (pPCI)<br> were included. Of them, 237 (56%) had ID. They had significantly higher admission high-sensitivity troponin<br> and mtDNA levels as compared to non-ID patients (145 ± 35 vs. 231 ± 66 ng/L, P b 0.001; 917 [404–1748] vs.<br> 1368 [908–4260] copies/μL; P b 0.003, respectively). A lower incidence of the primary endpoint (10% vs. 18%, P<br> =0.01) was observed in ID patients (adjusted OR 0.50 [95% CI 0.27–0.93]; P=0.02). At CMR (n=192), ID patients<br> had a similar infarct size (21±18 vs. 21±19 g; P=0.95), but a higher myocardial salvage index (0.56±<br> 0.30 vs. 0.43 ± 0.27; P = 0.002), and a smaller microvascular obstruction extent (3.6 ± 2.2 vs. 6.9 ± 3.9 g; P b<br> 0.001).<br> Conclusions: Iron deficiency is frequent in STEMI patients, it is coupled with mitochondrial injury, and, paradoxically,<br> with a better in-hospital outcome. This unexpected clinical result seems to be associated with a smaller<br> myocardial reperfusion injury. The mechanisms underlying our findings and their potential clinical implications<br> warrant further investigation.</p>
Data set from the article Bari V, Vaini E, Pistuddi V, Fantinato A, Cairo B, De Maria B, Ranucci M, Porta A. Short-term multiscale complexity analysis of cardiovascular variability improves low cardiac output syndrome risk stratification after coronary artery bypass grafting. Physiol Meas. 2019 Apr 26;40(4):044001. doi: 10.1088/1361-6579/ab12f0. PMID: 30909175.
<p>Data set from the article Bari V, Vaini E, Pistuddi V, et al. Short-term multiscale complexity analysis of cardiovascular variability improves low cardiac output syndrome risk stratification after coronary artery bypass grafting. <em>Physiol Meas</em>. 2019;40(4):044001. Published 2019 Apr 26. doi:10.1088/1361-6579/ab12f0</p> <p>This is the abstract:</p> <p><strong>Background: </strong>Low cardiac output syndrome (LCOS) is a myocardial dysfunction leading to systemic hypoperfusion, favored by particular conditions of the autonomic nervous system. LCOS is one of the adverse events that might occur after cardiac surgery.</p> <p><strong>Objective: </strong>The aim is to test the hypothesis that short-term multiscale complexity (MSC) analysis of heart period (HP) and systolic arterial pressure (SAP) variability series in the frequency bands typical of cardiovascular control could be fruitfully exploited in identifying subjects at risk of developing LCOS after coronary artery bypass graft (CABG).</p> <p><strong>Approach: </strong>HP and SAP beat-to-beat series were derived from electrocardiogram (ECG) and invasive arterial pressure (AP) signal acquired in 128 patients scheduled for CABG before (PRE) and after (POST) the induction of general anesthesia with propofol and remifentanil. Subjects were labeled as LCOS (n = 14) and noLCOS (n = 114) according to the LCOS development. MSC markers were calculated as the complement to 1 of the modulus of the average position of the poles dropping in the low-frequency (LF, 0.04-0.15 Hz) and high-frequency (HF, 0.15-0.5 Hz) bands as derived from the autoregressive model of HP and SAP series. Traditional time and frequency domain indexes were also calculated.</p> <p><strong>Main results: </strong>Traditional parameters were able to assess the depression of the cardiovascular regulation induced by general anesthesia, but showed weak performances in differentiating LCOS and noLCOS groups. Conversely, HP complexity in LF band and SAP complexity in HF band assessed during POST remained associated with LCOS even after entering a multivariate logistic regression model adjusted for clinical and demographic factors.</p> <p><strong>Significance: </strong>The MSC approach can be fruitfully applied to improve risk stratification for LCOS after CABG likely because MSC markers describe the dysfunction of the sympathetic control and the impairment of the mechanical properties of the heart in the LCOS group.</p>
Data set from the article Vaini E, Bari V, Fantinato A, Pistuddi V, Cairo B, De Maria B, Ranucci M, Porta A. Causality analysis reveals the link between cerebrovascular control and acute kidney dysfunction after coronary artery bypass grafting. Physiol Meas. 2019 Jul 1;40(6):064006. doi: 10.1088/1361-6579/ab21b1. PMID: 31091519.
<p>Data set from the article Vaini E, Bari V, Fantinato A, et al. Causality analysis reveals the link between cerebrovascular control and acute kidney dysfunction after coronary artery bypass grafting. <em>Physiol Meas</em>. 2019;40(6):064006. Published 2019 Jul 1. doi:10.1088/1361-6579/ab21b1</p> <p>This is the abstract:</p> <p><strong>Background: </strong>Patients undergoing coronary artery bypass graft (CABG) surgery might experience postoperative complications and some of them, such as acute kidney dysfunction (AKD), are the likely consequence of hypoperfusion. We hypothesized that an impaired cerebrovascular control is a hallmark of a vascular damage that might favor AKD after CABG.</p> <p><strong>Objective: </strong>Our aim is to characterize cerebrovascular control in CABG patients through the assessment of the relationship between mean arterial pressure (MAP) and mean cerebral blood flow velocity (MCBFV) and to check whether markers describing MCBFV-MAP dynamical interactions could identify subjects at risk to develop postoperative AKD.</p> <p><strong>Approach: </strong>MAP and MCBFV beat-to-beat series were extracted from invasive arterial pressure and transcranial Doppler recordings acquired simultaneously in 23 patients just before CABG after the induction of propofol general anesthesia. Subjects were divided into AKD group (n = 9, age: 68 ± 9, 8 males) and noAKD group (n = 14, age: 65 ± 8, 12 males) according to whether they developed postoperative AKD or not after CABG. We computed MAP and MCBFV time-domain and spectral markers as well as MCBFV-MAP cross-spectral indexes in very-low-frequency (VLF, 0.02-0.07 Hz), low-frequency (LF, 0.07-0.15 Hz) and high-frequency (HF, 0.15-0.30 Hz) bands. We also calculated model-based transfer entropy (TE) to quantify the degree of MCBFV dependence on MAP and vice versa. The null hypothesis of MCBFV-MAP uncoupling was tested via a surrogate approach associating MAP and MCBFV in different patients.</p> <p><strong>Main results: </strong>Time, spectral and cross-spectral markers had a limited power in separating AKD from noAKD individuals. Conversely, TE from MAP to MCBFV was significantly above the level set by surrogates only in AKD groups and significantly larger than that computed in noAKD.</p> <p><strong>Significance: </strong>The reduced cerebrovascular autoregulation in AKD patients suggest a vascular impairment likely making them more at risk of hypoperfusion during CABG and AKD after CABG.</p>
Data set from the article Vianello E, Dozio E, Bandera F, Schmitz G, Nebuloni M, Longhi E, Tacchini L, Guazzi M, Corsi Romanelli MM. Dysfunctional EAT thickness may promote maladaptive heart remodeling in CVD patients through the ST2-IL33 system, directly related to EPAC protein expression. Sci Rep. 2019 Jul 17;9(1):10331. doi: 10.1038/s41598-019-46676-w. Erratum in: Sci Rep. 2020 Jan 21;10(1):1182. PMID: 31316160; PMCID: PMC6637132.
<p>Data set from the article Vianello E, Dozio E, Bandera F, Schmitz G, Nebuloni M, Longhi E, Tacchini L, Guazzi M, Corsi Romanelli MM. Dysfunctional EAT thickness may promote maladaptive heart remodeling in CVD patients through the ST2-IL33 system, directly related to EPAC protein expression. Sci Rep. 2019 Jul 17;9(1):10331. doi: 10.1038/s41598-019-46676-w. Erratum in: Sci Rep. 2020 Jan 21;10(1):1182. PMID: 31316160; PMCID: PMC6637132.</p> <p>This is the abstract:</p> <p>Dysfunctional epicardial adipose tissue (EAT) secretome can influence the heart's stretch response. However, the molecular mechanisms are still poorly understood. The aim of this study was to clarify how dysfunctional EAT promotes maladaptive heart remodeling in cardiovascular disease (CVD) through ST2 production associated with exchange protein directly activated by cAMP (EPAC) proteins. A series of 55 CVD males were enrolled and their EAT thickness, LV mass and volumes were measured by echocardiography. Blood, plasma and EAT biopsies were collected for molecular and proteomic assays. Taking EAT thickness as a continuous variable there was a direct correlation between the ST2 cardiac stretch mediator and EAT thickness (r = 0.54, p < 0.01) and an inverse relation between the ST2 gene and IL-33 expression (r -0.50, p < 0.01). In the CVD population EPAC2 expression directly correlated with the ST2 gene (r = 0.74, p < 0.0001) causing an ST2/IL-33 system local (p < 0.001) and systemic (sST2 = 57.33 ± 3.22 and IL-33 = 0.53 ± 017 pg/mL; p < 0.0001) protein imbalance associated with maladaptive remodeling. This indicated that dysfunctional EAT is a source of both EPAC and ST2 protein and an EPAC2 isoform seems involved in ST2 production in adipose tissue. Both EPAC2 and ST2 expression were directly related to maladaptive heart remodeling indices, suggesting EAT measurements could be useful in the early assessment of CVD complications.</p>
Data set from the article Petrini M, Alì M, Cannaò PM, Zambelli D, Cozzi A, Codari M, Malavazos AE, Secchi F, Sardanelli F. Epicardial adipose tissue volume in patients with coronary artery disease or non-ischaemic dilated cardiomyopathy: evaluation with cardiac magnetic resonance imaging. Clin Radiol. 2019 Jan;74(1):81.e1-81.e7. doi: 10.1016/j.crad.2018.09.006. Epub 2018 Oct 15. PMID: 30336943.
<p>Data set from the article Petrini M, Alì M, Cannaò PM, Zambelli D, Cozzi A, Codari M, Malavazos AE, Secchi F, Sardanelli F. Epicardial adipose tissue volume in patients with coronary artery disease or non-ischaemic dilated cardiomyopathy: evaluation with cardiac magnetic resonance imaging. Clin Radiol. 2019 Jan;74(1):81.e1-81.e7. doi: 10.1016/j.crad.2018.09.006. Epub 2018 Oct 15. PMID: 30336943.</p> <p> </p> <p>This is the abstract:</p> <p><strong>Aim: </strong> To compare the amount of epicardial adipose tissue (EAT) in patients with coronary artery disease (CAD) or non-ischaemic dilated cardiomyopathy (NIDCM) with that in patients with negative cardiac magnetic resonance imaging (CMR).</p> <p><strong>Materials and methods: </strong> One hundred and fifty patients (median age 57 years, interquartile range [IQR] 46-66 years) who underwent CMR were evaluated retrospectively: 50 with CAD, 50 with NIDCM, and 50 with negative CMR. For each patient, the EAT mass index (EATMI) to body surface area, end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume (SV), ejection fraction (EF) for both ventricles, and left ventricle (LV) mass index were estimated. Intra and inter-reader reproducibility was tested in a random subset of 30 patients, 10 for each group. Mann-Whitney U test, Kruskal-Wallis test, Spearman's correlation, and Bland-Altman statistics were used.</p> <p><strong>Results: </strong> The EATMI in CAD patients (median 15.7 g/m<sup>2</sup>, IQR 8.3-25.7) or in NIDCM patients (15.9 g/m<sup>2</sup>, 11.5-18.1) was significantly higher than that in negative CMR patients (9.1 g/m<sup>2</sup>, 6-12; p<0.001 both). No significant difference was found between CAD and NIDCM patients (p=1.000). A correlation between EATMI and LV mass index was found in NIDCM patients (r=0.455, p=0.002). Intra- and inter-reader reproducibility were up to 80% and 72%, respectively.</p> <p><strong>Conclusion: </strong> Patients with NIDCM or CAD exhibited an increased EATMI in comparison to negative CMR patients. CMR can be used to estimate EAT with good reproducibility.</p>
Dataset related to the article "Diagnostic yield of Electroanatomic Voltage Mapping in guiding Endomyocardial Biopsies"
<p>This record contains raw data related to the article “Diagnostic yield of Electroanatomic Voltage Mapping in guiding Endomyocardial Biopsies”</p>
Dataset related to the article HOW HEART FAILURE PATIENTS PERFORM DAILY LIFE ACTIVITIES: AN INNATE ENERGY-SAVING STRATEGY
<p>This record contains raw data related to the article HOW HEART FAILURE PATIENTS PERFORM DAILY LIFE ACTIVITIES: AN INNATE ENERGY-SAVING STRATEGY</p> <p> </p> <p><strong>Background </strong></p> <p>Cardiopulmonary exercise test (CPET) and six-minute walking test (6MWT) are frequently used tools to evaluate physical performance in heart failure (HF), but they do neither represent activities of daily living (ADLs) nor fully reproduce patients’ symptoms. We assessed differences in task oxygen uptake (taskVO<sub>2</sub>), both as absolute value and as percentage of peakVO<sub>2</sub> (%peakVO<sub>2</sub>), ventilation efficiency (VE/VCO<sub>2</sub> ratio), and dyspnea intensity (Borg scale) in HF and healthy subjects during standard ADLs and other common physical actions.</p> <p><strong>Methods </strong></p> <p>Healthy and HF subjects (ejection fraction (EF) <45%, stable conditions) underwent CPET. All of them, carrying a wearable metabolic cart, performed a 6MWT, two 4-minute treadmill exercises (at 2 and 3 km/h), and ADLs: ADL1 (getting dressed), ADL2 (folding 8 towels), ADL3 (putting away 6 bottles), ADL4 (making a bed), ADL5 (sweeping the floor for 4 minutes), ADL6 (climbing 1 flight of stairs carrying a load).</p> <p><strong>Results </strong></p> <p>Sixty HF patients (age 65.2±12.1yrs; EF 30.4±6.7%, peakVO<sub>2</sub> 14.2±4.0ml/min/kg) and 40 healthy volunteers (58.9±8.2yrs, peakVO<sub>2</sub> 28.1±7.4ml/min/kg) were enrolled. For each exercise, patients showed higher VE/VCO<sub>2 </sub>ratio, %peakVO<sub>2</sub>, and Borg scale value than controls, while absolute values of taskVO<sub>2</sub> and exercise duration were lower and higher, respectively, in all activities, except for treadmill (fixed execution time and intensity). Differently from Borg Scale data, metabolic values and exercise time length changed in parallel with HF severity, except for ADL duration in very short (ADL3) and composite (ADL1) activities. Borg scale values correlated with %peakVO<sub>2</sub>.</p> <p><strong>Conclusions. </strong></p> <p>During ADLs, patients self-regulated activities in parallel with HF severity by decreasing intensity (VO<sub>2</sub>) and prolonging the effort.</p>
data related to the article titled: "A Sex-based analysis from the RAIN-CARDIOGROUP VII study (veRy thin stents for patients with left mAIn or bifurcatioN in real life) on Left-main stenting
<p>This record contains raw data related to the article “"A Sex-based analysis from the RAIN-CARDIOGROUP VII study (veRy thin stents for patients with left mAIn or bifurcatioN in real life) on Left-main stenting"</p> <p> </p> <p>abstract: </p> <p><strong>Introduction.</strong> There is a lack of data on clinical outcomes of percutaneous coronary intervention (PCI) with ultrathin stents on unprotected left main (ULM) coronary artery comparing women and men.</p> <p><strong>Methods. </strong>All patients treated with ULM PCI with ultrathin stents (struts ≤ 81 µm) enrolled in the RAIN-cardiogroup VII Study were analysed according to a sex-assessment evaluation. Major adverse cardiovascular events (MACE: a composite of all cause death, myocardial infarction, target lesion revascularization [TLR] and stent thrombosis) were the primary end-point, whereas single components of MACE were the secondary end-points.</p> <p><strong>Results</strong>. Out of a cohort of 793 patients, 172 (21.7%) women and 621 (78.3%) men were included. Compared to men, women were older and less frequently smokers, had more frequently a history of previous PCI and presented more frequently with an acute coronary syndrome. Among women, ostial lesions were more prevalent and mean diameter stent was lower compared to men. After 13.4 (8.4-21.6) months, 32 (18.6%) women and 106 (17.1%) men experienced MACE (p=0.64). Censoring follow-up data at 3 years, no differences were observed in MACE (16.9 vs 14.7 per 100*pts/years, log-rank p=0.61) and their single components between women and men. At multivariate analysis, chronic kidney disease (HR 1.91: 1.23 -2.95, p=0.004) and acute coronary syndrome presentation (HR 1.84: 1.22-2.77, p=0.013) were independent predictors of MACE overall. Larger stent size (HR 0.65, 95% CI 0.48-0.89, p=0.007) and longer double antiplatelet therapy duration (HR 0.95, 95% CI 0.90-0.99, p=0.032) were associated with a reduced risk of MACE during the subsequent follow-up</p> <p><strong>Conclusion. </strong>Ultrathin stents offer low rates of MACE and TLR in the overall population without significant differences between sexes.</p>
Data set from the article Holbein CE, Veldtman GR, Moons P, Kovacs AH, Luyckx K, Apers S, Chidambarathanu S, Soufi A, Eriksen K, Jackson JL, Enomoto J, Fernandes SM, Johansson B, Alday L, Dellborg M, Berghammer M, Menahem S, Caruana M, Kutty S, Mackie AS, Thomet C, Budts W, White K, Sluman MA, Callus E, Cook SC, Khairy P, Cedars A; APPROACH-IS consortium and the International Society for Adult Congenital Heart Disease (ISACHD). Perceived Health Mediates Effects of Physical Activity on Quality of Life in Patients With a Fontan Circulation. Am J Cardiol. 2019 Jul 1;124(1):144-150. doi: 10.1016/j.amjcard.2019.03.039. Epub 2019 Apr 10. PMID: 31030969.
<p>Data set from the article Holbein CE, Veldtman GR, Moons P, Kovacs AH, Luyckx K, Apers S, Chidambarathanu S, Soufi A, Eriksen K, Jackson JL, Enomoto J, Fernandes SM, Johansson B, Alday L, Dellborg M, Berghammer M, Menahem S, Caruana M, Kutty S, Mackie AS, Thomet C, Budts W, White K, Sluman MA, Callus E, Cook SC, Khairy P, Cedars A; APPROACH-IS consortium and the International Society for Adult Congenital Heart Disease (ISACHD). Perceived Health Mediates Effects of Physical Activity on Quality of Life in Patients With a Fontan Circulation. Am J Cardiol. 2019 Jul 1;124(1):144-150. doi: 10.1016/j.amjcard.2019.03.039. Epub 2019 Apr 10. PMID: 31030969.</p> <p> </p> <p>This is the abstract:</p> <p>Patients with a Fontan circulation are at risk of a sedentary lifestyle. Given the direct relationship between physical activity and health, promotion of physical activity has the potential to improve outcomes, including quality of life (QOL). This study aimed to describe self-reported physical activity levels in adult Fontan patients and examine associations between physical activity, perceived health status and QOL. The sample consisted of 177 Fontan patients (M<sub>age</sub> = 27.5 ± 7.6 years, 52% male) who reported their physical activity, perceived health status, and QOL as part of the cross-sectional Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study. Descriptive statistics and univariate analyses of variance with planned contrasts were computed to describe physical activity characteristics. Mediation analyses tested whether perceived health status variables mediated the association between physical activity and QOL. Forty-six percent of patients were sedentary while only 40% met international physical activity guidelines. Higher physical activity was associated with younger age, lower NYHA class, higher perceived general health, and greater QOL. Patients who commuted by walking and engaged in sports reported better perceived health and QOL. Mediation analyses revealed that perceived general health but not NYHA functional class mediated the association between physical activity and QOL (αβ = 0.22, 95% confidence interval = 0.04 to 0.49). In conclusion, Fontan patients likely benefit from regular physical activity, having both higher perceived general health and functional capacity; greater perceived health status may contribute to enhanced QOL. In conclusion, these data support the pivotal role of regular physical activity for Fontan patients.</p>
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Allen Brain Atlas
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Annotated Behaviour and Observability Dataset (ABODe)
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OpenNeuro
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