Publications by authors named "Alberto Marra"

Background: In healthy subjects, sex-differences in right heart function have already been detected for various echocardiographic parameters.

Research Question: The objective of the study was to investigate sex-differences in echocardiographic ESC/ERS risk stratification parameters and their impact on survival estimation in patients with pulmonary arterial hypertension (PAH).

Study Design And Methods: In this retrospective, cross-sectional study with a mean follow-up time of 3.

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Background: Pulmonary hypertension (PH) is a pathophysiological problem that may involve several clinical symptoms and be linked to various respiratory and cardiovascular illnesses. Its diagnosis is made invasively by Right Cardiac Catheterization (RHC), which is difficult to perform routinely. Aim of the current study was to develop a Machine Learning (ML) algorithm based on the analysis of anamnestic data to predict the presence of an invasively measured PH.

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The pulmonary circulation and the right ventricle play a pivotal role in the global hemodynamics of human beings, so much so that their close interaction is encapsulated in the concept of a "morpho-functional unit". In this review we aim to pinpoint the strengths and weaknesses of various noninvasive established techniques. The goal is to detect early morphologic and/or functional changes in the pulmonary circulation and right ventricular unit, which is crucial for tailoring treatments and prognostic assessments.

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Notwithstanding its acknowledged pivotal role for cardiovascular prevention, cardiac rehabilitation (CR) is still largely under prescribed, in almost 25% of patients owing an indication for. In addition, when considering differences concerning the two sexes, female individuals are underrepresented in CR programmes with lower referral rates, participation, and completion as compared to male counterpart. This picture becomes even more tangled with reference to gender, a complex socio-cultural construct characterized by four domains (gender identity, relation, role, and institutionalized gender).

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Calix[n]arenes, macrocycles constituted of 4-8 phenol moieties linked through methylene bridges, are stable molecules that can be selectively functionalised at the upper or lower rim. It has already been demonstrated that calixarene derivatives can be biologically or pharmacologically active compounds. More recently, suitably functionalised calixarenes and calixarene analogues (dihomooxacalixarenes, thiacalixarenes, calix[4]resorcinols, azacalixarenes, calixpyrroles, and pillarenes) were found to act as anticancer agents, at least in in vitro assays.

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: Although long-term COVID-19 symptoms are common, little is known about the management of post-COVID-19 condition. The aim of the current report is to evaluate the effects of a combination of lactoferrin, lysozyme, lactobacillus, resveratrol, vitamins, and oligoelements (PIRV-F20) on the exercise capacity of post-COVID-19 patients. : A retrospective analysis of consecutive patients referred to a specific outpatient clinic dedicated to post-COVID-19 condition from April 2022 to April 2023 was conducted.

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Article Synopsis
  • * Exercise pulmonary hypertension (PH) can be identified through exercise stress echocardiography (ESE) and is significant in predicting symptoms and mortality in HVD patients.
  • * This review seeks to summarize the prognostic importance of exercise PH in valvular diseases and explore its potential integration into the diagnostic and treatment protocols for HVD.*
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  • - Subclinical hypothyroidism (SH) is a condition marked by elevated serum TSH levels with normal free T4, affecting 0.6% to 1.8% of adults, and has been linked to worse outcomes in heart failure patients.
  • - A study analyzed 277 heart failure patients, with 23 having SH, and found no significant demographic or health differences between those with SH and those who were euthyroid (normal thyroid function).
  • - Results indicated that SH is an independent predictor of cardiovascular mortality, emphasizing the need for thyroid testing in heart failure patients to potentially enhance their treatment and outcomes.
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Article Synopsis
  • - The document reviews recent studies and international guidelines to provide updated recommendations for internists managing acute heart failure (AHF) in complex patient scenarios.
  • - Seven key clinical questions (PICOs) were identified regarding diagnosis and treatment, emphasizing the importance of echocardiography and natriuretic peptide evaluations, along with other diagnostic tools.
  • - A total of 51 tailored recommendations were developed to address treatment strategies and improve outcomes for AHF patients, including options for managing low blood pressure and preventing rehospitalization.
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Background: During the past two decades, many nicotinamide phosphoribosyltransferase (NAMPT) inhibitors were prepared and tested because this enzyme is overexpressed in pancreatic cancer. Although FK866 is a well-known, strong NAMPT inhibitor, it suffers severe drawbacks.

Objective: Our work aimed to synthesize efficient NAMPT inhibitors featuring better pharmacokinetic properties than the pyridine-containing FK866.

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Despite guideline recommendations, strategies for implementing cardiac rehabilitation (CR) in patients with acute aortic dissection (AAD) are not well established with little evidence to risk stratify prudent and effective guidelines for the many required variables. We conducted a systematic review of studies (2004-2023) reporting CR following type A (TA) and type B (TB) AAD. Our review is limited to open surgical repair for TA and medical treatment for TB.

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Background: An observational study involving patients recovered from COVID-19 was conducted in order to evaluate the presence/absence of vein wall thickness increasing, according to the severity of pulmonary involvement quantified with a CT-scoring system.

Methods: The venous wall thickness (VWT) of 31 patients (23 males and 8 females) with COVID 19 previously admitted to Federico II University Hospital of Naples was evaluated through ultrasound measurement of the common femoral Vein 1 cm proximal to the saphenous-femoral junction and the popliteal Vein 1 cm distal to the confluence of gemellary veins. Measurements were taken with an automated tool to avoid human error.

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The pathogenesis of complex diseases such as pulmonary arterial hypertension (PAH) is entirely rooted in changes in the expression of some vasoactive factors. These play a significant role in the onset and progression of the disease. Indeed, PAH has been associated with pathophysiologic alterations in vascular function.

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Article Synopsis
  • Exercise echocardiography is vital for evaluating the right ventricle and pulmonary circulation, but there's a need for clearer understanding of normal ranges and disease-specific variations.
  • The study involved 2,228 participants including healthy individuals, athletes, and patients with different heart and lung conditions, who underwent echocardiography at rest and during exercise.
  • Key findings indicate that certain measurements can predict increased mortality risk, highlighting significant differences in responses to exercise between healthy subjects and various patient groups.
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The 2022 guidelines on pulmonary hypertension from the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) provide therapeutic strategies that account for the variability in the clinical presentation of newly diagnosed patients. We summarize treatment recommendations for pulmonary arterial hypertension (PAH) in patients without significant comorbidities, particularly for idiopathic, hereditary, drug/toxin-induced, or connective tissue disease-associated PAH. In this group of patients, multidimensional assessments for short-term mortality risk guide initial treatment decisions and treatment decisions during follow-up.

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Introduction: Friedreich Ataxia (FRDA) is an autosomal recessive neurodegenerative disorder that causes gait and limb ataxia, dysarthria, and impaired vibratory sense, with cardiomyopathy being the predominant cause of death. There is no approved therapy, which results in the use of symptomatic treatments and the chronic support of physiotherapy. Dimethyl fumarate (DMF) is a fumaric acid ester used for the treatment of psoriasis and Multiple Sclerosis (MS).

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Background: Current guidelines recommend treatment with parenteral prostacyclin analogs in patients with severe pulmonary arterial hypertension (PAH), who have insufficient response to treatment. Real-life data are sought to help physicians in treatment decisions and clinical care of patients.

Objective: This study analyzed safety, clinical effects, and long-term outcomes of subcutaneous (sc) and/or intravenous (iv) treprostinil via different pump systems in consecutive patients with PAH.

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The nicotinamide phosphoribosyltransferase (NAMPT) is considered a very promising therapeutic target because it is overexpressed in pancreatic cancer. Although many inhibitors have been prepared and tested, clinical trials have shown that NAMPT inhibition may result in severe haematological toxicity. Therefore, the development of conceptually new inhibitors is an important and challenging task.

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Cardiovascular (CV) diseases (CVD) are a major cause of long-term morbidity and mortality affecting life expectancy amongst cancer survivors. In recent years, because of the possibility of early diagnosis and the increased efficacy of neo-adjuvant and adjuvant systemic treatments (targeting specific molecular pathways), the high percentage of survival from breast cancer led CVD to become the first cause of death among survivors. Therefore, it is mandatory to adopt cardioprotective strategies to minimize CV side effects and CVD in general in breast cancer patients.

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Background: Patients with systemic sclerosis (SSc) are frequently affected by iron deficiency, particularly those with pulmonary hypertension (PH). The first data indicate the prognostic importance of hypochromic red cells (% HRC) > 2% among patients with PH. Hence, the objective of our study was to investigate the prognostic value of % HRC in SSc patients screened for PH.

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Article Synopsis
  • Early detection and treatment of cancer have significantly decreased death and illness rates, but therapies like chemotherapy and radiotherapy can cause cardiovascular side effects that impact overall health and quality of life.
  • Healthcare teams need to maintain a high level of awareness to conduct specific tests (like natriuretic peptides and cardiac troponin) and imaging methods (like echocardiography and various scanning techniques) for timely diagnosis of heart-related issues in cancer patients.
  • Looking ahead, the aim is to personalize patient care more effectively and integrate digital health tools into treatment plans across communities.
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