Bassi Dott.ssa Ilaria
Pubblicazioni su PubMed
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Arrhythmic Mitral Valve Prolapse Phenotype: An Unsupervised Machine Learning Analysis Using a Multicenter Cardiac MRI Registry.
Radiol Cardiothorac Imaging2024 Jun;6(3):e230247. doi: e230247.
Akyea Ralph Kwame, Figliozzi Stefano, Lopes Pedro M, Bauer Klemens B, Moura-Ferreira Sara, Tondi Lara, Mushtaq Saima, Censi Stefano, Pavon Anna Giulia, Bassi Ilaria, Galian-Gay Laura, Teske Arco J, Biondi Federico, Filomena Domenico, Stylianidis Vasileios, Torlasco Camilla, Muraru Denisa, Monney Pierre, Quattrocchi Giuseppina, Maestrini Viviana, Agati Luciano, Monti Lorenzo, Pedrotti Patrizia, Vandenberk Bert, Squeri Angelo, Lombardi Massimo, Ferreira António M, Schwitter Juerg, Aquaro Giovanni Donato, Pontone Gianluca, Chiribiri Amedeo, Rodríguez Palomares José F, Yilmaz Ali, Andreini Daniele, Florian Anca-Rezeda, Francone Marco, Leiner Tim, Abecasis João, Badano Luigi Paolo, Bogaert Jan, Georgiopoulos Georgios, Masci Pier-Giorgio
Abstract
Purpose To use unsupervised machine learning to identify phenotypic clusters with increased risk of arrhythmic mitral valve prolapse (MVP). Materials and Methods This retrospective study included patients with MVP without hemodynamically significant mitral regurgitation or left ventricular (LV) dysfunction undergoing late gadolinium enhancement (LGE) cardiac MRI between October 2007 and June 2020 in 15 European tertiary centers. The study end point was a composite of sustained ventricular tachycardia, (aborted) sudden cardiac death, or unexplained syncope. Unsupervised data-driven hierarchical -mean algorithm was utilized to identify phenotypic clusters. The association between clusters and the study end point was assessed by Cox proportional hazards model. Results A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 female, 230 male) with two phenotypic clusters were identified. Patients in cluster 2 (199 of 474, 42%) had more severe mitral valve degeneration (ie, bileaflet MVP and leaflet displacement), left and right heart chamber remodeling, and myocardial fibrosis as assessed with LGE cardiac MRI than those in cluster 1. Demographic and clinical features (ie, symptoms, arrhythmias at Holter monitoring) had negligible contribution in differentiating the two clusters. Compared with cluster 1, the risk of developing the study end point over a median follow-up of 39 months was significantly higher in cluster 2 patients (hazard ratio: 3.79 [95% CI: 1.19, 12.12], = .02) after adjustment for LGE extent. Conclusion Among patients with MVP without significant mitral regurgitation or LV dysfunction, unsupervised machine learning enabled the identification of two phenotypic clusters with distinct arrhythmic outcomes based primarily on cardiac MRI features. These results encourage the use of in-depth imaging-based phenotyping for implementing arrhythmic risk prediction in MVP. MR Imaging, Cardiac, Cardiac MRI, Mitral Valve Prolapse, Cluster Analysis, Ventricular Arrhythmia, Sudden Cardiac Death, Unsupervised Machine Learning © RSNA, 2024.
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Early palliative care program in idiopathic pulmonary fibrosis patients favors at-home and hospice deaths, reduces unplanned medical visits, and prolongs survival: A pilot study.
Eur J Intern Med2024 Oct;128():81-86. doi: 10.1016/j.ejim.2024.05.024.
Bassi Ilaria, Pastorello Stefania, Guerrieri Aldo, Giancotti Gilda, Cuomo Anna Maria, Rizzelli Chiara, Coppola Maria, Valenti Danila, Nava Stefano
Abstract
BACKGROUND:
Idiopathic Pulmonary Fibrosis (IPF) is a lethal disease; most patients die in hospitals because palliative care (PC) is not wildly and early available. We aimed to determine the impact of an early PC program in IPF patients on place of death, emergency department (ED) admission, unplanned medical visits and survival before and after its implementation at our clinic.
METHODS:
IPF patients from our ILD clinic who died between January 1st, 2018 and December 31th, 2023 were included in the analysis. Primary outcomes were location of death, number of ED access and unplanned medical visits; secondary outcomes was survival from diagnosis.
RESULTS:
A total of 46 decedents between 2018 and 2023 were analysed: (median age 71,5 ± 5,5 years, 89 % male): 26 died before the implementation of the early PC program and 20 after. Through ? test, location of death resulted significantly different in the two groups, showing the capacity of early PC to favor at home or in hospice death (p = 0,02); similarly, the number of unplanned visits was significantly lower (p = 0,03). Finally, survival was significantly lower in patients not receiving the early PC program (p = 0,01).
CONCLUSION:
The availability of an early PC program since the diagnosis significantly reduced both the death rate in hospital settings, favoring dying in hospice or at home, and the number of unplanned medical visits. Furthermore, IPF patients receiving early PC showed a longer survival than those who did not.
Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.
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Identification of palliative care needs and prognostic factors of survival in tailoring appropriate interventions in advanced oncological, renal and pulmonary diseases: a prospective observational protocol.
BMJ Open2023 May;13(5):e065971. doi: e065971.
Valenti Vanessa, Rossi Romina, Scarpi Emanuela, Dall'Agata Monia, Bassi Ilaria, Cravero Paola, La Manna Gaetano, Magnoni Giacomo, Marchello Martina, Mosconi Giovanni, Nanni Oriana, Nava Stefano, Pallotti Maria Caterina, Rapposelli Ilario Giovanni, Ricci Marianna, Scrivo Anna, Spazzoli Alessandra, Valenti Danila, Zambianchi Loretta, Caraceni Augusto, Maltoni Marco
Abstract
INTRODUCTION:
It is estimated that of those who die in high-income countries, 69%-82% would benefit from palliative care with a high prevalence of advanced chronic conditions and limited life prognosis. A positive response to these challenges would consist of integrating the palliative approach into all healthcare settings, for patients with all types of advanced medical conditions, although poor clinician awareness and the difficulty of applying criteria to identify patients in need still pose significant barriers. The aim of this project is to investigate whether the combined use of the NECPAL CCOMS-ICO and Palliative Prognostic (PaP) Score tools offers valuable screening methods to identify patients suffering from advanced chronic disease with limited life prognosis and likely to need palliative care, such as cancer, chronic renal or chronic respiratory failure.
METHODS AND ANALYSIS:
This multicentre prospective observational study includes three patient populations: 100 patients with cancer, 50 patients with chronic renal failure and 50 patients with chronic pulmonary failure. All patients will be treated and monitored according to local clinical practice, with no additional procedures/patient visits compared with routine clinical practice. The following data will be collected for each patient: demographic variables, NECPAL CCOMS-ICO questionnaire, PaP Score evaluation, Palliative Performance Scale, Edmonton Symptom Assessment System, Eastern Cooperative Oncology Group Performance Status and data concerning the underlying disease, in order to verify the correlation of the two tools (PaP and NECPAL CCOMS-ICO) with patient status and statistical analysis.
ETHICS AND DISSEMINATION:
The study was approved by local ethics committees and written informed consent was obtained from the patient. Findings will be disseminated through typical academic routes including poster/paper presentations at national and international conferences and academic institutes, and through publication in peer-reviewed journals.
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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Endothelial Dysfunction in Patients with Advanced Heart Failure Treated with Levosimendan Periodic Infusion Compared with Optimal Medical Therapy: A Pilot Study.
Life (Basel)2022 Aug;12(9):. doi: 1322.
Maloberti Alessandro, Sun Jinwei, Zannoni Jessica, Occhi Lucia, Bassi Ilaria, Fabbri Saverio, Colombo Valentina, Gualini Elena, Algeri Michela, Varrenti Marisa, Masciocco Gabriella, Perna Enrico, Oliva Fabrizio, Cipriani Manlio, Frigerio Maria, Giannattasio Cristina
Abstract
Endothelial dysfunction (ED) is frequently found in patients with heart failure (HF). Among several pharmacological agents reported to improve endothelial function, levosimendan seems to be a promising one, even though, to date, only two previously published studies have evaluated its effects on ED in these patients. The aim of our pilot study was to further investigate the role of periodic levosimendan infusion on endothelial function in patients affected by advanced HF. In this cross-sectional study, three different groups were enrolled: 20 patients with advanced HF treated with periodic levosimendan (LEVO), 20 patients with HF on optimal medical therapy (OMT), and 20 healthy subjects (control group). ED was evaluated through flow-mediated dilation (FMD) at the level of the brachial artery. The three groups presented similar ages with significant differences in gender distribution, systolic blood pressure, and chronic kidney disease (eGFR
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Myocardial Fibrosis at Cardiac MRI Helps Predict Adverse Clinical Outcome in Patients with Mitral Valve Prolapse.
Radiology2023 Jan;306(1):112-121. doi: 10.1148/radiol.220454.
Figliozzi Stefano, Georgiopoulos Georgios, Lopes Pedro M, Bauer Klemens B, Moura-Ferreira Sara, Tondi Lara, Mushtaq Saima, Censi Stefano, Pavon Anna Giulia, Bassi Ilaria, Servato Maria Luz, Teske Arco J, Biondi Federico, Filomena Domenico, Pica Silvia, Torlasco Camilla, Muraru Denisa, Monney Pierre, Quattrocchi Giuseppina, Maestrini Viviana, Agati Luciano, Monti Lorenzo, Pedrotti Patrizia, Vandenberk Bert, Squeri Angelo, Lombardi Massimo, Ferreira António M, Schwitter Juerg, Aquaro Giovanni Donato, Chiribiri Amedeo, Rodríguez Palomares José F, Yilmaz Ali, Andreini Daniele, Florian Anca, Leiner Tim, Abecasis João, Badano Luigi Paolo, Bogaert Jan, Masci Pier-Giorgio
Abstract
Background Patients with mitral valve prolapse (MVP) may develop adverse outcomes even in the absence of mitral regurgitation or left ventricular (LV) dysfunction. Purpose To investigate the prognostic value of mitral annulus disjunction (MAD) and myocardial fibrosis at late gadolinium enhancement (LGE) cardiac MRI in patients with MVP without moderate-to-severe mitral regurgitation or LV dysfunction. Materials and Methods In this longitudinal retrospective study, 118?144 cardiac MRI studies were evaluated between October 2007 and June 2020 at 15 European tertiary medical centers. Follow-up was from the date of cardiac MRI examination to June 2020; the minimum and maximum follow-up intervals were 6 months and 156 months, respectively. Patients were excluded if at least one of the following conditions was present: cardiomyopathy, LV ejection fraction less than 40%, ischemic heart disease, congenital heart disease, inflammatory heart disease, moderate or worse mitral regurgitation, participation in competitive sport, or electrocardiogram suggestive of channelopathies. In the remainder, cardiac MRI studies were reanalyzed, and patients were included if they were aged 18 years or older, MVP was diagnosed at cardiac MRI, and clinical information and electrocardiogram monitoring were available within 3 months from cardiac MRI examination. The end point was a composite of adverse outcomes: sustained ventricular tachycardia (VT), sudden cardiac death (SCD), or unexplained syncope. Multivariable Cox regression analysis was performed. Results A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 women) were included. Over a median follow-up of 3.3 years, 18 patients (4%) reached the study end point. LGE presence (hazard ratio, 4.2 [95% CI: 1.5, 11.9]; = .006) and extent (hazard ratio, 1.2 per 1% increase [95% CI: 1.1, 1.4]; = .006), but not MAD presence ( = .89), were associated with clinical outcome. LGE presence had incremental prognostic value over MVP severity and sustained VT and aborted SCD at baseline (area under the receiver operating characteristic curve, 0.70 vs 0.62; = .03). Conclusion In contrast to mitral annulus disjunction, myocardial fibrosis determined according to late gadolinium enhancement at cardiac MRI was associated with adverse outcome in patients with mitral valve prolapse without moderate-to-severe mitral regurgitation or left ventricular dysfunction. © RSNA, 2022 See also the editorial by Gerber in this issue.
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Effects of non-invasive respiratory supports on inspiratory effort in moderate-severe COVID-19 patients. A randomized physiological study.
Eur J Intern Med2022 Jun;100():110-118. doi: 10.1016/j.ejim.2022.04.012.
Schifino Gioacchino, Vega Maria L, Pisani Lara, Prediletto Irene, Catalanotti Vito, Comellini Vittoria, Bassi Ilaria, Zompatori Maurizio, Ranieri Marco Vito, Nava Stefano
Abstract
RATIONALE AND OBJECTIVE:
Various forms of Non-invasive respiratory support (NRS) have been used during COVID-19, to treat Hypoxemic Acute Respiratory Failure (HARF), but it has been suggested that the occurrence of strenuous inspiratory efforts may cause Self Induced Lung Injury(P-SILI). The aim of this investigation was to record esophageal pressure, when starting NRS application, so as to better understand the potential risk of the patients in terms of P-SILI and ventilator induced lung injury (VILI).
METHODS AND MEASUREMENTS:
21 patients with early de-novo respiratory failure due to COVID-19, underwent three 30 min trials applied in random order: high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), and non-invasive ventilation (NIV). After each trial, standard oxygen therapy was reinstituted using a Venturi mask (VM). 15 patients accepted a nasogastric tube placement. Esophageal Pressure (?Pes) and dynamic transpulmonary driving pressure (?PLDyn), together with the breathing pattern using a bioelectrical impedance monitor were recorded. Arterial blood gases were collected in all patients.
MAIN RESULTS:
No statistically significant differences in breathing pattern and PaCO were found. PaO/FiO ratio improved significantly during NIV and CPAP vs VM. NIV was the only NRS to reduce significantly ?Pes vs. VM (-10,2 ±5 cmH20 vs -3,9 ±3,4). No differences were found in ?PLDyn between NRS (10,2±5; 9,9±3,8; 7,6±4,3; 8,8±3,6 during VM, HFNC, CPAP and NIV respectively). Minute ventilation (Ve) was directly dependent on the patient's inspiratory effort, irrespective of the NRS applied. 14% of patients were intubated, none of them showing a reduction in ?Pes during NRS.
CONCLUSIONS:
In the early phase of HARF due to COVID-19, the inspiratory effort may not be markedly elevated and the application of NIV and CPAP ameliorates oxygenation vs VM. NIV was superior in reducing ?Pes, maintaining ?PLDyn within a range of potential safety.
Copyright © 2022. Published by Elsevier B.V.
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Intravenous methylprednisolone pulses in hospitalised patients with severe COVID-19 pneumonia: a double-blind, randomised, placebo-controlled trial.
Eur Respir J2022 Oct;60(4):. doi: 2200025.
Salvarani Carlo, Massari Marco, Costantini Massimo, Merlo Domenico Franco, Mariani Gabriella Lucia, Viale Pierluigi, Nava Stefano, Guaraldi Giovanni, Dolci Giovanni, Boni Luca, Savoldi Luisa, Bruzzi Paolo, Turrà Caterina, Catanoso Mariagrazia, Marata Anna Maria, Barbieri Chiara, Valcavi Annamaria, Franzoni Francesca, Cavuto Silvio, Mazzi Giorgio, Corsini Romina, Trapani Fabio, Bartoloni Alessandro, Barisione Emanuela, Barbieri Chiara, Burastero Giulia Jole, Pan Angelo, Inojosa Walter, Scala Raffaele, Burattini Cecilia, Luppi Fabrizio, Codeluppi Mauro, Tarek Kamal Eldin, Cenderello Giovanni, Salio Mario, Foti Giuseppe, Dongilli Roberto, Bajocchi Gianluigi, Negri Emanuele Alberto, Ciusa Giacomo, Fornaro Giacomo, Bassi Ilaria, Zammarchi Lorenzo, Aloè Teresita, Facciolongo Nicola
Abstract
RATIONALE:
Pulse glucocorticoid therapy is used in hyperinflammation related to coronavirus disease 2019 (COVID-19). We evaluated the efficacy and safety of pulse intravenous methylprednisolone in addition to standard treatment in COVID-19 pneumonia.
METHODS:
In this multicentre, randomised, double-blind, placebo-controlled trial, 304 hospitalised patients with COVID-19 pneumonia were randomised to receive 1?g of methylprednisolone intravenously for three consecutive days or placebo in addition to standard dexamethasone. The primary outcome was the duration of patient hospitalisation, calculated as the time interval between randomisation and hospital discharge without the need for supplementary oxygen. The key secondary outcomes were survival free from invasive ventilation with orotracheal intubation and overall survival.
RESULTS:
Overall, 112 (75.4%) out of 151 patients in the pulse methylprednisolone arm and 111 (75.2%) of 150 in the placebo arm were discharged from hospital without oxygen within 30?days from randomisation. Median time to discharge was similar in both groups (15?days, 95% CI 13.0-17.0 days and 16?days, 95% CI 13.8-18.2 days, respectively; hazard ratio (HR) 0.92, 95% CI 0.71-1.20; p=0.528). No significant differences between pulse methylprednisolone and placebo arms were observed in terms of admission to intensive care unit with orotracheal intubation or death (20.0% 16.1%; HR 1.26, 95% CI 0.74-2.16; p=0.176) or overall mortality (10.0% 12.2%; HR 0.83, 95% CI 0.42-1.64; p=0.584). Serious adverse events occurred with similar frequency in the two groups.
CONCLUSIONS:
Methylprenisolone pulse therapy added to dexamethasone was not of benefit in patients with COVID-19 pneumonia.
Copyright ©The authors 2022.
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Determinants of Functional Improvement After Cardiac Rehabilitation in Acute Coronary Syndrome.
High Blood Press Cardiovasc Prev2021 Nov;28(6):579-587. doi: 10.1007/s40292-021-00473-7.
Bianchi Sofia, Maloberti Alessandro, Peretti Alessio, Garatti Laura, Palazzini Matteo, Occhi Lucia, Bassi Ilaria, Sioli Sabrina, Biolcati Marco, Giani Valentina, Monticelli Massimiliano, Leidi Filippo, Ruzzenenti Giacomo, Beretta Giovanna, Giannattasio Cristina, Riccobono Salvatore
Abstract
INTRODUCTION:
Cardiac rehabilitation (CR) is an effective tool for secondary prevention after acute coronary syndrome (ACS).
AIM:
Aim of our study was to find the significant determinants of exercise capacity (evaluated with the six-minute walking test-6-MWT) and functional improvement in patients undergoing CR after an ACS.
METHODS:
The study group included 298 patients (mean age 61.6 ± 10.2 years; males 80.2%) who, after ACS, were enrolled in CR program at Niguarda Hospital in Milan from 2015 to 2018. For all patients, we collected anamnestic, clinical and instrumental cardiological data. All patients performed a 6-MWT at the beginning (6-MWT-1) and at the end (6-MWT-2) of CR program. ? meters were used to represent functional improvement.
RESULTS:
Multiple linear regression models were carried out for 6-MWT-1, 6-MWT-2, ? meters and % ? meters. Standardized regression coefficients showed that age (? = - 0.237; p
CONCLUSIONS:
Our data showed that functional improvement after CR in ACS patients is mainly related to non-cardiological variables. Instead it is related to intrinsic factors, both modifiable (BMI) and non-modifiable (age, sex).
© 2021. The Author(s).
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Low Awareness of Cardiovascular Risk Factor Among Patients Admitted in Cardiac Rehabilitation: New Data for Further Implementation of Cardiovascular Rehabilitation Program.
High Blood Press Cardiovasc Prev2021 May;28(3):253-254. doi: 10.1007/s40292-021-00451-z.
Maloberti Alessandro, Monticelli Massimiliano, Bassi Ilaria, Riccobono Salvatore, Giannattasio Cristina
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Early awake proning in critical and severe COVID-19 patients undergoing noninvasive respiratory support: A retrospective multicenter cohort study.
Pulmonology2022 ;28(3):181-192. doi: 10.1016/j.pulmoe.2021.03.002.
Tonelli Roberto, Pisani Lara, Tabbì Luca, Comellini Vittoria, Prediletto Irene, Fantini Riccardo, Marchioni Alessandro, Andrisani Dario, Gozzi Filippo, Bruzzi Giulia, Manicardi Linda, Busani Stefano, Mussini Cristina, Castaniere Ivana, Bassi Ilaria, Carpano Marco, Tagariello Federico, Corsi Gabriele, d'Amico Roberto, Girardis Massimo, Nava Stefano, Clini Enrico
Abstract
BACKGROUND/MATERIALS AND METHODS:
This retrospective cohort study was conducted in two teaching hospitals over a 3-month period (March 2010-June 2020) comparing severe and critical COVID-19 patients admitted to Respiratory Intensive Care Unit for non-invasive respiratory support (NRS) and subjected to awake prone position (PP) with those receiving standard care (SC). Primary outcome was endotracheal intubation (ETI) rate. In-hospital mortality, time to ETI, tracheostomy, length of RICU and hospital stay served as secondary outcomes. Risk factors associated to ETI among PP patients were also investigated.
RESULTS:
A total of 114 patients were included, 76 in the SC and 38 in the PP group. Unadjusted Kaplan-Meier estimates showed greater effect of PP compared to SC on ETI rate (HR?=?0.45 95% CI [0.2-0.9], p?=?0.02) even after adjustment for baseline confounders (HR?=?0.59 95% CI [0.3-0.94], p?=?0.03). After stratification according to non-invasive respiratory support, PP showed greater significant benefit for those on High Flow Nasal Cannulae (HR?=?0.34 95% CI [0.12-0.84], p?=?0.04). Compared to SC, PP patients also showed a favorable difference in terms of days free from respiratory support, length of RICU and hospital stay while mortality and tracheostomy rate were not significantly different.
CONCLUSIONS:
Prone positioning in awake and spontaneously breathing Covid-19 patients is feasible and associated with a reduction of intubation rate, especially in those patients undergoing HFNC. Although our results are intriguing, further randomized controlled trials are needed to answer all the open questions remaining pending about the real efficacy of PP in this setting.
Copyright © 2021 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.
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Real-life comparison of pirfenidone and nintedanib in patients with idiopathic pulmonary fibrosis: A 24-month assessment.
Respir Med2019 Nov;159():105803. doi: 10.1016/j.rmed.2019.105803.
Cerri Stefania, Monari Matteo, Guerrieri Aldo, Donatelli Pierluigi, Bassi Ilaria, Garuti Martina, Luppi Fabrizio, Betti Sara, Bandelli Gianpiero, Carpano Marco, Bacchi Reggiani Maria Letizia, Tonelli Roberto, Clini Enrico, Nava Stefano
Abstract
BACKGROUND:
Real-life data on the use of pirfenidone and nintedanib to treat patients with idiopathic pulmonary fibrosis (IPF) are still scarce.
METHODS:
We compared the efficacy of either pirfenidone (n?=?78) or nintedanib (n?=?28) delivered over a 24-month period in patients with IPF, followed at two regional clinic centers in Italy, with a group of patients who refused the treatment (n?=?36), and who were considered to be controls. All patients completed regular visits at 1- to 3-month intervals, where primary [forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO)] and secondary outcomes (side effects, treatment compliance, and mortality) were recorded.
RESULTS:
Over time, the decline in FVC and DLCO was significantly higher (p?=?0.0053 and p?=?0.037, respectively) in controls when compared with the combined treated group, with no significant difference between the two treated groups. Compared to patients with less advanced disease (GAP (Gender, Age, Physiology) stage I), those in GAP stages II and III showed a significantly higher decline in both FVC and DLCO irrespective of the drug taken. Side effects were similarly reported in patients receiving pirfenidone and nintedanib (5% and 7%, respectively), whereas mortality did not differ among the three groups.
CONCLUSION:
This real-life study demonstrated that both pirfenidone and nintedanib were equally effective in reducing the decline of FVC and DLCO versus non-treated patients after 24 months of treatment; however, patients with more advanced disease were likely to show a more rapid decline in respiratory function.
Copyright © 2019 Elsevier Ltd. All rights reserved.
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Getting to the heart of the matter in a multisystem disorder: Erdheim-Chester disease.
Lancet2019 Aug;394(10198):e19. doi: 10.1016/S0140-6736(19)31787-8.
Buono Andrea, Bassi Ilaria, Santolamazza Caterina, Moreo Antonella, Pedrotti Patrizia, Sacco Alice, Morici Nuccia, Giannattasio Cristina, Oliva Fabrizio, Ammirati Enrico
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Vascular Aging and Disease of the Large Vessels: Role of Inflammation.
High Blood Press Cardiovasc Prev2019 Jun;26(3):175-182. doi: 10.1007/s40292-019-00318-4.
Maloberti Alessandro, Vallerio Paola, Triglione Nicola, Occhi Lucia, Panzeri Francesco, Bassi Ilaria, Pansera Francesco, Piccinelli Enrico, Peretti Alessio, Garatti Laura, Palazzini Matteo, Sun Jinwei, Grasso Enzo, Giannattasio Cristina
Abstract
Structural and functional arterial properties commonly impair with aging process. These effects on vasculature could act at many levels from microcirculation to large vessels. Above normal aging process classic cardio-vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, etc.) accelerate the physiological process leading to premature structural and functional alterations that has also been termed early vascular aging. Target organ damage evaluation could be clinically important since these alterations precede by many years' cardiovascular events and so their assessment can predict the onset of more serious and costly events giving the opportunity to prevent CV events by earlier therapeutic intervention. This review will focus on large artery functional properties and particularly on the role of inflammation on the aortic stiffening process.
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In healthy normotensive subjects age and blood pressure better predict subclinical vascular and cardiac organ damage than atherosclerosis biomarkers.
Blood Press2018 Oct;27(5):262-270. doi: 10.1080/08037051.2018.1461010.
Maloberti Alessandro, Farina Francesca, Carbonaro Marco, Piccinelli Enrico, Bassi Ilaria, Pansera Francesco, Grassi Guido, Mancia Giuseppe, Palestini Paola, Giannattasio Cristina
Abstract
PURPOSE:
Only few studies evaluated biomarkers useful for defining the cardiovascular risk of a subject in a pre-clinical condition (i.e. healthy subjects). In this context we sought to determine the relationships of Plasminogen activator inhibitor type 1 (PAI-1), P-Selectin, Tissue Inhibitors Metalloproteinases type 1 (TIMP-1) and Cystatin-C with subclinical Target Organ Damage (TOD) in normotensive and normoglycemic subjects without known cardiovascular and kidney diseases.
MATERIALS AND METHODS:
480 blood donors participated at the present analysis. TOD was evaluated as Pulse Wave Velocity (PWV), Left Ventricular Hypertrophy (LVH) and Intima Media Thickness (IMT) and carotid plaque presence) grouped together under carotid TOD.
RESULTS:
3.1% of the subjects showed a PWV higher than 10?m/sec with those subjects exerting significantly lower values of P-Selectine (0.068?±?0.015 vs 0.08?±?0.036?mg/L, p?=?.014). 8.8% of the subjects showed carotid TOD that was associated with higher Cystatin-C values (0.67?±?0.17 vs 0.63?±?0.14?mg/L, p?=?.045). Finally 23.8% of the subjects showed LVH with no significant differences regarding biomarkers. Despite some significant correlations between biomarkers and TOD, at the multivariate analysis none came out to be as significant predictor of the assessed TOD.
CONCLUSIONS:
in normotensive and normoglycemic healthy subjects, the evaluated biomarkers of atherosclerotic process didn't show any significant association with cardiac, carotid and vascular TOD while age and BP are its principal predictors.
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Pulmonary involvement in adult Still's disease: Case report and brief review of literature.
Respir Med Case Rep2017 ;22():91-94. doi: 10.1016/j.rmcr.2017.07.001.
Guerrieri Aldo, Angeletti Giulia, Mazzolini Massimiliano, Bassi Ilaria, Nava Stefano
Abstract
BACKGROUND:
Adult onset Still disease (AOSD) is a rare condition characterized by elevated fever along with arthritic symptoms, elevated polymorphonuclear neutrophil count, evanescent rash, and hyperferritinemia. Diagnosis can be made only after have ruled out more frequent conditions, and Yamagouchi or Fautrel criteria should be applied. Parenchimal lung involvement (PLI) is present in less than 5% of AOSD cases and ranges from aspecific reticular interstitial opacities to life threatening conditions, such as acute respiratory distress syndrome (ARDS).
CASE:
We report the case of a 59 years old man who was referred to our ward because of high fever treated as a pneumonia with antibiotic but not responding to medical treatment, and findings suggestive of interstitial lung disease prevalent in the lower zone on high resolution computed tomography (HRCT). AOSD was diagnosed when the diagnostic Yamaguchi criteria were fulfilled and our suspect was confirmed by the rheumatologist; the patient was then successfully treated with corticosteroids.
CONCLUSIONS:
PLI in AOSD is very rare but must be considered among differential diagnosis in patients with high fever and aspecific interstial parenchimal lung involvement.
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