Review
Cardiac & Cardiovascular Systems
Rebecca Sorber, Caitlin W. Hicks
Summary: This review summarizes the current management strategies for acute aortic syndromes, emphasizing the importance of early identification and appropriate algorithm. Recent trials suggest the increasing usefulness of TEVAR in stabilizing pathology, while considering the potential complications.
CURRENT CARDIOLOGY REPORTS
(2022)
Article
Cardiac & Cardiovascular Systems
Lyufan Chen, Fan Yang, Jitao Liu, Songyuan Luo, Hui Yuan, Ruixin Fan, Hongke Zeng, Qingshan Geng, Jianfang Luo
Summary: This study investigated the morphological evolution and risk stratification of ulcer-like projection (ULP) in patients with uncomplicated acute type B aortic intramural haematoma. The findings suggest that high-risk ULP, with characteristics of depth ≥ 5.0 mm and located in the proximal aortic segments, is associated with a significantly higher rate of adverse aortic events (AAE).
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2021)
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.
Article
Cardiac & Cardiovascular Systems
Hsu-Ting Yen, Chia-Chen Wu, Yi-Wei Lee, Chien-Ming Lo, Yen-Yu Chen
Summary: By analyzing clinical outcomes and imaging features of patients with acute type A aortic intramural hematoma (TAIMH), it was found that penetrating atherosclerotic ulcers (PAUs) or ulcer-like projections (ULPs) and pericardial effusion were independent predictors of high-risk acute aortic syndrome.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Medicine, General & Internal
Xiuchun Xu, Feng Lu, Li Li
Summary: This study compared the safety and efficacy of thoracic endovascular aortic repair (TEVAR) and optimal medical treatment (OMT) for type B penetrating aortic ulcer (PAU) associated with intramural hematoma (IMH). The results showed that TEVAR significantly promoted favorable aortic remodeling and resulted in lower aortic-related mortality compared to OMT during mid-term follow-up.
Review
Medicine, General & Internal
Elda Chiara Colacchio, Francesco Squizzato, Michele Piazza, Mirko Menegolo, Franco Grego, Michele Antonello
Summary: This review focuses on the recent literature on penetrating aortic ulcers and intramural hematomas, aiming to identify clinical and imaging factors associated with aortic-related adverse events. The study findings suggest that minimum depth and diameter are markers for adverse events in PAUs, while maximum aortic diameter and ulcer-like projection are markers for adverse events in IMHs.
Article
Cardiac & Cardiovascular Systems
Giacomo Murana, Gregorio Gliozzi, Paola Rucci, Daniela Votano, Valentina Orioli, Simona Rosa, Gianluca Folesani, Francesco Buia, Luigi Lovato, Davide Pacini
Summary: This study analyzed trends in volumes and outcomes of acute aortic syndromes from 2000 to 2021. The findings showed an increase in patient volumes over time, but improvements in treatment and surgical techniques have led to a decrease in early mortality and reoperation rates. However, long-term mortality remains high.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Gen Li, Xia Xu, Jun Li, Sizheng Xiong
Summary: This study evaluated the effects of TEVAR in patients with retrograde TAIMH and found that TEVAR led to significant improvements in aortic remolding and overall survival rates. However, post-intervention complications should not be overlooked.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Review
Cardiac & Cardiovascular Systems
R. Wilson King, Marc P. Bonaca
Summary: Acute aortic syndromes encompass various life-threatening aortic pathologies, with prompt diagnosis and proper management playing a crucial role in reducing mortality and morbidity. Type A dissections necessitate urgent surgical treatment, while treatment for Type B dissections depends on whether they are complicated or uncomplicated.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2021)
Article
Cardiac & Cardiovascular Systems
Charles DeCarlo, Christopher A. Latz, Laura T. Boitano, Young Kim, Adam Tanious, Samuel Schwartz, Rushad Patell, Jahan Mohebali, Anahita Dua
Summary: The study found that asymptomatic penetrating aortic ulcers (PAUs) exhibit slow growth and rare complications, including rupture. Asymptomatic PAUs can be conservatively managed with serial imaging and modification of risk factors.
Article
Surgery
Rae S. Rokosh, Caron B. Rockman, Virendra Patel, Ross Milner, Nicholas H. Osborne, Neal S. Cayne, Glenn R. Jacobowitz, Karan Garg
Summary: This study retrospectively analyzed patients who underwent TEVAR for PAUs and/or IMHs, finding significantly higher morbidity and mortality in symptomatic patients compared to asymptomatic patients, despite similar baseline characteristics.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Myeong Su Kim, Tae-Hoon Kim, Ha Lee, Suk-Won Song, Kyung-Jong Yoo
Summary: A study was conducted on 60 patients with acute type A intramural hematoma. The occurrence of descending aortic ulcer (dPAU) was significantly higher in the group with major adverse aortic events (MAAEs). The MAAE (+) group had lower measurements of the ascending aorta and higher measurements of the descending aorta than the MAAE (-) group. Risk factors for MAAE included dPAU, hematoma thickness ratio of the ascending and descending aortae, and descending aorta hematoma thickness >8.58 mm. Protective factors for MAAE included intraoperative detection of intimal tear and ascending aorta hematoma thickness >10.25 mm.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Surgery
Xia Xu, Daoquan Wang, Ningxin Hou, Hongmin Zhou, Jun Li, Liang Tian
Summary: Thoracic endovascular aortic repair (TEVAR) is a promising treatment option for patients with combined aberrant subclavian artery (aSCA) and type B intramural hematoma (TBIMH). Regular follow-up is recommended to exclude Kommerell's diverticulum (KD) or preserve the blood flow of aSCA according to the size of the diverticulum.
FRONTIERS IN SURGERY
(2022)
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
Multidisciplinary Sciences
Junfu Luo, Wenpeng Zhao, Jiasheng Xu, Rui Zou, Kaihua Zhang, Yanhua Wan, Shasha Wan, Riwei Wang, Qingfu Zeng
Summary: This study investigated the difference in efficacy between different treatment modalities for aortic intramural hematoma (IMH). The results showed that patients with Stanford A and B type IMH could benefit from endovascular treatment in reducing complications and mortality.
SCIENTIFIC REPORTS
(2021)
Editorial Material
Medicine, General & Internal
Antonello D'Andrea, Eduardo Bossone, Stefano Palermi
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Medicine, General & Internal
Emanuele Monda, Federica Verrillo, Marta Rubino, Giuseppe Palmiero, Adelaide Fusco, Annapaola Cirillo, Martina Caiazza, Natale Guarnaccia, Alfredo Mauriello, Michele Lioncino, Alessia Perna, Gaetano Diana, Antonello D'Andrea, Eduardo Bossone, Paolo Calabro, Giuseppe Limongelli
Summary: Thoracic aortic dilatation is a progressive condition associated with aging and various pathological conditions. While regular exercise training can lead to mild aortic root enlargement in athletes, high-intensity physical activity in individuals with genetic substrates may cause excessive aortic enlargement and trigger acute aortic dissection. Evaluating aortic valve and root diameters, as well as detecting disease-causing mutations, is important for determining sport eligibility in individuals with inherited aortic disease. However, assessing the risk of aortic complications related to sports in these patients is challenging.
Review
Health Care Sciences & Services
Eduardo Bossone, Andreina Carbone, Kim A. Eagle
Summary: Cardiovascular disease (CVD) is the leading cause of death and morbidity worldwide, and there are differences in the epidemiology and management of CVD between male and female patients. In the case of acute aortic dissection (AAD), women are typically older than men at the time of diagnosis and have a less abrupt onset of pain, leading to delayed presentation to the emergency department. Women also have a higher prevalence of hypertension and chronic obstructive pulmonary disease. In type A AAD, women are more prone to pleural effusion and coronary artery compromise, but experience fewer neurological and malperfusion symptoms. They undergo surgical treatment less frequently and have higher in-hospital mortality rates. In contrast, there are no significant differences in in-hospital mortality between genders in type B AAD. Further studies are needed to develop gender-specific strategies for preventive, diagnostic, and therapeutic approaches to AAD.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Health Care Sciences & Services
Francesco Ferrara, Valentina Capone, Filippo Cademartiri, Olga Vriz, Rosangela Cocchia, Brigida Ranieri, Monica Franzese, Rossana Castaldo, Antonello D'Andrea, Rodolfo Citro, Salvatore Chianese, Roberto Annunziata, Flavio Marullo, Mario Siniscalchi, Marianna Conte, Chiara Sepe, Renato Maramaldi, Salvatore Rega, Giuseppe Russo, Massimo Majolo, Eliana Raiola, Andrea Salzano, Ciro Mauro, Bruno Trimarco, Raffaele Izzo, Eduardo Bossone
Summary: This study established normal non-invasive myocardial mechano-energetic efficiency (MEE) and indexed MEE reference values, which can improve the global assessment of left ventricular cardiac mechanics and serve as a reference to identify phenotypes at high risk of cardiovascular events.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Review
Medicine, General & Internal
Liberatore Tramontano, Bruna Punzo, Alberto Clemente, Sara Seitun, Luca Saba, Eduardo Bossone, Erica Maffei, Carlo Cavaliere, Filippo Cademartiri
Summary: The CAC score provides valuable prognostic information for predicting CAD risk in asymptomatic individuals.
JOURNAL OF CLINICAL MEDICINE
(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
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)
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)