Article
Cardiac & Cardiovascular Systems
Li Deng, Qingping Xia, Liwei Diao, Fei Lin, Yong Cao, Hongguang Han, Mowei Song
Summary: This study aimed to evaluate the diagnostic performance of the aortic dissection detection risk score (ADD-RS) plus D-dimer for acute aortic syndrome (AAS) in Chinese patients. The study found that ADD-RS > 1 and D-dimer > 2000 ng/mL were optimal thresholds for diagnosing AAS in the Chinese population. However, confirmative MSCT results are necessary.
JOURNAL OF CARDIOVASCULAR TRANSLATIONAL RESEARCH
(2023)
Article
Medicine, General & Internal
Thierry Carrel, Thoralf M. Sundt, Yskert von Kodolitsch, Martin Czerny
Summary: Despite advancements in the prevention, diagnosis, and treatment of acute aortic dissection, it remains a complex cardiovascular event with high mortality and morbidity rates. Recent research has improved our understanding of the disease's pathophysiology and led to reevaluations of existing classifications. There is a shift towards a unified naming system based on morphology and function. The location and extent of the initial tear, as well as the affected aortic segments, determine the appropriate management approach - emergency surgery, endovascular intervention, or medical treatment. Ongoing scientific evidence continues to shape the management and follow-up of acute aortic dissection, the most severe form of acute aortic syndrome.
Article
Radiology, Nuclear Medicine & Medical Imaging
Horacio Murillo, Lior Molvin, Anne S. Chin, Dominik Fleischmann
Summary: Acute aortic dissection is the prototype of acute aortic syndromes, and diagnostic imaging, particularly CT, is crucial for accurate diagnosis and intervention planning. Involvement of the ascending aorta carries the most rapid lethal complications and requires surgical intervention, while lesions not involving the ascending aorta have a lesser rate of complications in the acute phase.
Review
Medicine, General & Internal
Fulvio Morello, Paolo Bima, Matteo Castelli, Peiman Nazerian
Summary: Acute aortic syndromes (AASs) are severe conditions characterized by dissection, hemorrhage, ulceration or rupture of the thoracic aorta. The clinical signs and symptoms are nonspecific and require comprehensive differential diagnosis. Physicians need to integrate clinical probability assessment, bedside imaging techniques, and blood test results to evaluate patients with AAS-compatible symptoms. The natural history of AASs is dominated by engagement of ischemic, coagulative and inflammatory pathways, causing multiorgan damage. Internal medicine plays a key role in non-surgical management of AASs.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2022)
Article
Emergency Medicine
Abdulrhman Alghamdi, Mark Hann, Edward Carlton, Jamie G. Cooper, Eloise Cook, Angela Foulkes, Aloysius N. Siriwardena, John Phillips, Alexander Thompson, Steve Bell, Kim Kirby, Andy Rosser, Richard Body
Summary: This study evaluated the diagnostic accuracy of clinical pathways in the out-of-hospital environment for identifying patients at low risk of acute myocardial infarction (AMI). Using point-of-care cardiac troponin testing and decision aids, paramedics were able to accurately identify low-risk AMI patients in the prehospital setting when used in conjunction with clinical judgment and appropriate training.
ANNALS OF EMERGENCY MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Eduardo Bossone, Martin Czerny, Stamatios Lerakis, Jose Rodriguez-Palomares, Nina Kukar, Brigida Ranieri, Valentina Russo, Bruna Punzo, Rosangela Cocchia, Filippo Cademartiri, Toru Suzuki, Arturo Evangelista
Summary: Acute aortic syndrome is a life-threatening condition that requires timely and accurate diagnosis and treatment through a comprehensive multiparametric approach. The combination of echocardiography and CTA is the best imaging strategy for diagnosing AAS and its complications.
CURRENT PROBLEMS IN CARDIOLOGY
(2021)
Article
Respiratory System
Luojia Tang, Yundi Hu, Dong Pan, Chun Yang, Cheng Tang, Yunchuan Huang, Jianyong Gu, Min Min, Xiaolei Lin, Chaoyang Tong
Summary: The Pulmonary Embolism Comprehensive Screening Score (PECSS), constructed through retrospective data collection, has lower failure rates and a better balance between sensitivity and specificity compared to existing pretest probability scores for pulmonary embolism. PECSS calculation is easy and all predictors are readily available upon emergency department admission, making it widely applicable in clinical settings.
BMC PULMONARY MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Deli Wang, Jie Chen, Jianhua Sun, Hongmei Chen, Fang Li, Junfeng Wang
Summary: The serum D-dimer level was evaluated in patients with different types of aortic dissection, and it was found that the level was significantly higher in Stanford type A group compared to Stanford type B group, and it was associated with patient prognosis.
JOURNAL OF CARDIOTHORACIC SURGERY
(2022)
Review
Cardiac & Cardiovascular Systems
Jian Yao, Tao Bai, Bo Yang, Lizhong Sun
Summary: The meta-analysis included 16 clinical studies with a total of 1135 patients. The results revealed that D-dimer has an excellent diagnostic value for AAD, with high sensitivity and specificity. Meta-regression and subgroup analyses identified publication year, sample size, and cutoff value as sources of heterogeneity, while D-dimer <= 500 ng/ml significantly increased sensitivity in diagnosing suspected AAD patients.
JOURNAL OF CARDIOTHORACIC SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Vitali Koch, Moritz Biener, Matthias Mueller-Hennessen, Mershad Vafaie, Ingo Staudacher, Hugo A. Katus, Evangelos Giannitsis
Summary: D-dimers are useful for ruling out venous thromboembolism and acute aortic dissection, and also have a moderate discriminatory ability for both cancer and non-cancer patients.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2021)
Article
Emergency Medicine
Drew A. Long, Samuel M. Keim, Michael D. April, Alex Koyfman, Brit Long, Felix Ankel
Summary: A negative D-dimer combined with an ADD-RS < 1 may be sufficient to rule out acute aortic dissection, but clinical judgment should take precedence when deciding whether to pursue a diagnosis.
JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Biotechnology & Applied Microbiology
Renjie Song, Nana Xu, Lan Luo, Tianxi Zhang, Haizhen Duan
Summary: This study aimed to investigate the diagnostic value of AD risk score, coagulation function, and laboratory indicators in AAD. The results showed that the AD screening scale, TN-C, and FDP had the highest diagnostic value.
BIOMED RESEARCH INTERNATIONAL
(2022)
Article
Cardiac & Cardiovascular Systems
Takayuki Otani, Toshihisa Ichiba, Kenichiro Kashiwa, Hiroshi Naito
Summary: This study evaluated the potential of unenhanced computed tomography (CT) as a screening tool for acute aortic syndromes (AAS), finding that misdiagnosis may occur in younger patients and those with a patent false lumen. The combination of the aortic dissection detection risk score (ADD-RS) plus D-dimer with unenhanced CT could help minimize misdiagnosis of AAS while avoiding over-testing with contrast-enhanced CT.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2021)
Article
Gastroenterology & Hepatology
Adrien Patenotte, Clara Yzet, Timothee Wallenhorst, Fabien Subtil, Sarah Leblanc, Marion Schaefer, Thomas Walter, Thomas Lambin, Tanguy Fenouil, Pierre Lafeuille, Jean-Baptiste Chevaux, Romain Legros, Florian Rostain, Jerome Rivory, Jeremie Jacques, Vincent Lepilliez, Mathieu Pioche
Summary: This study evaluated the feasibility and effectiveness of ESD for lesions with a suspicion of focal deep invasion. It found that ESD is feasible and safe for colorectal lesions with an FDIP <= 15 mm. It achieved high resection and en bloc resection rates, making it a potential valid option for low-risk T1 cancer patients.
Article
Emergency Medicine
Dayeon Lee, Yong Won Kim, Tae Youn Kim, Sanghun Lee, Han Ho Do, Jun Seok Seo, Jeong Hun Lee
Summary: This study suggests that an age-adjusted D-dimer cutoff may increase the specificity and positive predictive value for ruling out acute aortic syndrome compared to the conventional method, while maintaining high sensitivity.
EMERGENCY MEDICINE INTERNATIONAL
(2022)
Review
Cardiac & Cardiovascular Systems
Andreina Carbone, Brigida Ranieri, Rossana Castaldo, Monica Franzese, Salvatore Rega, Antonio Cittadini, Martin Czerny, Eduardo Bossone
Summary: A systematic review and meta-analysis were conducted to investigate sex differences in patients with type A acute aortic dissection (AAD). The study found that female sex phenotype is evident in type A AAD, suggesting the need for personalized management and tailored preventive strategies. Interestingly, while in-hospital surgical mortality did not differ between sexes, 5- and 10-year survival was higher among men. More sex-specific data from international clinical registries and trials are needed.
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
(2023)
Article
Peripheral Vascular Disease
Fabrizio Vallelonga, Marco Cesareo, Leonardo Menon, Dario Leone, Enrico Lupia, Fulvio Morello, Silvia Totaro, Carlo Aggiusti, Massimo Salvetti, Antonella Ioverno, Alessandro Maloberti, Ilaria Fucile, Franco Cipollini, Nicola Nesti, Costantino Mancusi, Aldo Pende, Cristina Giannattasio, Maria Lorenza Muiesan, Alberto Milan
Summary: Hypertensive urgencies (HU) and hypertensive emergencies (HE) are challenges in the Emergency Department. A prospective multicentre study is ongoing to characterize patients with acute hypertensive disorders and assess the prevalence of subclinical hypertension-mediated organ damage (HMOD) and short- and long-term prognosis. This preliminary report includes 122 patients, with 14.8% diagnosed with HE and 88.5% with HU. The study found that patients with HE had greater cardiac, renal, and cerebral subclinical HMOD compared to HU patients.
HYPERTENSION RESEARCH
(2023)
Editorial Material
Medicine, General & Internal
Fulvio Morello, Emanuele Pivetta, Enrico Lupia
INTERNAL AND EMERGENCY MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Artur Evangelista, Marta Sitges, Guillaume Jondeau, Robin Nijveldt, Mauro Pepi, Hug Cuellar, Gianluca Pontone, Eduardo Bossone, Maarten Groenink, Marc R. Dweck, Jolien W. Roos-Hesselink, L. Mazzolai, Roland van Kimmenade, Victor Aboyans, Jose Rodriguez-Palomares
Summary: Imaging techniques are crucial for diagnosing, monitoring, and managing aortic diseases. Different imaging modalities, including echocardiography, computed tomography, cardiovascular magnetic resonance, and nuclear imaging, each have their own strengths and limitations in assessing the aorta. This consensus document aims to review the contribution, methodology, and indications of each technique for effective management of thoracic aortic diseases, emphasizing the importance of regular imaging follow-up in assessing cardiovascular risk factors and blood pressure control in patients with diseased aorta.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
(2023)
Review
Medicine, General & Internal
Filippo Cademartiri, Antonella Meloni, Laura Pistoia, Giulia Degiorgi, Alberto Clemente, Carmelo De Gori, Vincenzo Positano, Simona Celi, Sergio Berti, Michele Emdin, Daniele Panetta, Luca Menichetti, Bruna Punzo, Carlo Cavaliere, Eduardo Bossone, Luca Saba, Riccardo Cau, Ludovico La Grutta, Erica Maffei
Summary: Photon-counting detector (PCD) is a novel computed tomography detector technology that has many advantages in the neurovascular field, such as increased spatial resolution, reduced radiation exposure, and optimization of contrast agents and material decomposition. This overview of literature on PCCT describes the principles, advantages, and disadvantages of conventional detectors and PCDs, and focuses specifically on its implementation in the neurovascular field.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Michele Arcopinto, Roberta D'Assante, Renata Simona Auriemma, Rosa Pirchio, Rosario Pivonello, Eduardo Bossone, Annamaria Colao, Antonio Cittadini
Summary: This study examines the effects of chronic hyperprolactinemia on cardiac structure and function in humans. It finds that hyperprolactinemic patients show a slight impairment of diastolic filling and a worse exercise capacity, particularly in a subgroup of females. However, there are no significant abnormalities in left ventricular structure and systolic function.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Medicine, General & Internal
Antonella Meloni, Filippo Cademartiri, Laura Pistoia, Giulia Degiorgi, Alberto Clemente, Carmelo De Gori, Vincenzo Positano, Simona Celi, Sergio Berti, Michele Emdin, Daniele Panetta, Luca Menichetti, Bruna Punzo, Carlo Cavaliere, Eduardo Bossone, Luca Saba, Riccardo Cau, Ludovico La Grutta, Erica Maffei
Summary: Photon-counting computed tomography (PCCT) is an emerging technology that is expected to revolutionize clinical CT imaging. PCCT offers various advantages over conventional CT, which can be utilized to enhance and broaden the diagnostic capabilities of CT angiography. This article discusses the potential opportunities and promising future applications of PCCT in vascular imaging.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Medicine, General & Internal
Ciro Mauro, Valentina Capone, Rosangela Cocchia, Filippo Cademartiri, Ferdinando Riccardi, Michele Arcopinto, Maie Alshahid, Kashif Anwar, Mariano Carafa, Andreina Carbone, Rossana Castaldo, Salvatore Chianese, Giulia Crisci, Roberta D'Assante, Mariarosaria De Luca, Monica Franzese, Domenico Galzerano, Vincenzo Maffei, Alberto M. Marra, Valeria Valente, Federica Giardino, Alfredo Mazza, Brigida Ranieri, Anna D'Agostino, Salvatore Rega, Luigia Romano, Sarah Scagliarini, Chiara Sepe, Olga Vriz, Raffaele Izzo, Antonio Cittadini, Eduardo Bossone, Andrea Salzano
Summary: Cardiovascular diseases are a major cause of morbidity and mortality among cancer survivors, particularly breast cancer survivors. The use of certain chemotherapeutics in breast cancer treatment can lead to cardiac dysfunction. Therefore, it is important to have a multidisciplinary approach for preventing, detecting, and treating cardiotoxicity in breast cancer patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Medicine, General & Internal
Filippo Cademartiri, Antonella Meloni, Laura Pistoia, Giulia Degiorgi, Alberto Clemente, Carmelo De Gori, Vincenzo Positano, Simona Celi, Sergio Berti, Michele Emdin, Daniele Panetta, Luca Menichetti, Bruna Punzo, Carlo Cavaliere, Eduardo Bossone, Luca Saba, Riccardo Cau, Ludovico La Grutta, Erica Maffei
Summary: The photon-counting detector (PCD) is a new technology that provides significant benefits for cardiac and coronary artery imaging. Compared with conventional CT, PCCT has improved capabilities such as multi-energy capability, increased spatial resolution, reduced radiation exposure, and optimized use of contrast agents. It also overcomes limitations of traditional CCT/CCTA, such as reducing artifacts and enabling more precise assessment of stenosis and plaque characteristics. PCCT also has potential applications in characterizing myocardial tissue using a double-contrast agent.
JOURNAL OF CLINICAL MEDICINE
(2023)
Letter
Cardiac & Cardiovascular Systems
Maria Angela Losi, Eduardo Bossone, Raffaele Piccolo, Grazia Canciello, Daniela Pacella, Giulia Crisci, Andreina Carbone, Francesco Ferrara, Raffaele Izzo, Giovanni Esposito, Antonio Cittadini
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
(2023)
Article
Chemistry, Multidisciplinary
Patrizia Toia, Ludovico La Grutta, Salvatore Vitabile, Bruna Punzo, Carlo Cavaliere, Carmelo Militello, Leonardo Rundo, Domenica Matranga, Clarissa Filorizzo, Erica Maffei, Massimo Galia, Massimo Midiri, Roberto Lagalla, Luca Saba, Eduardo Bossone, Filippo Cademartiri
Summary: This study proposes an advanced computer-assisted approach to analyze epicardial adipose tissue (EAT) in patients undergoing Cardiac CT (CCT) during statin administration, and examines its relation to body mass index (BMI). The study finds that statins can lead to significant quantitative and qualitative changes in EAT detected by CCT, and BMI influences the composition of EAT.
APPLIED SCIENCES-BASEL
(2023)
Article
Medicine, General & Internal
Paolo Bima, Jacopo Davide Giamello, Paolo Rubiolo, Francesca Risi, Paolo Balzaretti, Giuseppe Lauria, Domenico Vallino, Enrico Lupia, Fulvio Morello
Summary: The impact of COVID-19 on acute aortic syndromes (AASs) has been evaluated in a study conducted in three hub hospitals in Northern Italy. The study found that COVID-19 had a marginal effect on the presentation and care of AASs in the emergency departments. Efforts are needed to ensure efficient patient transfer and prevent mortality, especially during pandemic peaks.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Antonella Meloni, Filippo Cademartiri, Vicenzo Positano, Simona Celi, Sergio Berti, Alberto Clemente, Ludovico La Grutta, Luca Saba, Eduardo Bossone, Carlo Cavaliere, Bruna Punzo, Erica Maffei
Summary: Photon-counting computed tomography (PCCT) is an emerging technology that offers several advantages over conventional CT, including improved spatial resolution and signal behavior, reduced noise and artifacts, decreased radiation dose, and enhanced material discrimination. This review highlights the potential diagnostic capabilities of PCCT in cardiovascular applications, such as detection of coronary artery calcifications and evaluation of coronary plaque extent and composition.
JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE
(2023)
Article
Medicine, General & Internal
Fulvio Morello, Marco Santoro, Francesca Giachino, Francesca Caciolli, Elisa Capretti, Matteo Castelli, Emanuele Pivetta, Peiman Nazerian, Enrico Lupia
Summary: Acute aortic syndromes (AASs) are emergencies with high morbidity and mortality rates. The diagnostic workup for AASs is based on pre-test probability assessment (PPA) and d-dimer testing. However, the performance of PPA and d-dimer in patients with previous AAS (pAAS) has not been studied. The study showed that d-dimer had high sensitivity but low specificity in diagnosing new AAS.
MEDICINA-LITHUANIA
(2023)