Publications by authors named "Carugo Stefano"

Aim: This meta-analysis aims to evaluate the impact of anthracycline chemotherapy on subclinical right ventricular (RV) dysfunction in breast cancer patients, using traditional echocardiographic parameters and strain-based measures, such as the RV global longitudinal strain (RV GLS) and the RV free-wall longitudinal strain (RV FWLS).

Methods And Results: A systematic search was conducted according to PRISMA guidelines, including 15 studies with a total of 1148 breast cancer patients undergoing anthracycline chemotherapy. The primary outcome was the evaluation of changes in RV GLS and RV FWLS pre- and post-chemotherapy.

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Pulmonary embolism (PE) is commonly treated primarily with pharmacological therapy, while advanced reperfusion therapies (transcatheter or surgical) are considered only in cases of contraindications or failure of standard therapies. Treatment algorithms vary depending on the patient's risk, with patients at intermediate or high risk potentially requiring evaluation for such advanced reperfusion therapies. Critical scenarios, such as contraindications to systemic thrombolysis or failure of pharmacological protocols, necessitate the activation of a multidisciplinary pulmonary embolism response team (PERT) and prompt therapeutic escalation.

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  • An Italian multidisciplinary group met to discuss osteoporosis management and emphasized the importance of calcium and vitamin D supplements in preventing fragility fractures.
  • The paper reviews the requirements for calcium and vitamin D and explores how their combined supplementation is vital for treating osteoporosis.
  • Key findings highlight that low intake of calcium and vitamin D raises fracture risks, and primary care physicians play a crucial role in diagnosing and treating osteoporosis effectively.
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The fact that lipoprotein(a) levels should be regarded as a causal residual risk factor in the atherosclerotic cardiovascular diseases (ASCVD) is now a no-brainer. This review article aims to summarize the latest evidence supporting the causal role of lipoprotein(a) in ASCVD and the potential strategies to reduce the lipoprotein(a) burden until clinical trial results are available. Epidemiological and genetic data demonstrate the causal link between lipoprotein(a) and increased ASCVD risk.

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In the period of increasing prevalence of metabolic disorders such as obesity and diabetes, healthcare professionals are facing significant challenges. Therefore, an accurate global assessment of insulin resistance is of utmost importance. Current medical research is focused on identifying an easily accessible and reproducible gold-standard surrogate marker for insulin resistance.

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  • The rise of advanced microcatheters has improved the success rates of complex heart procedures, but their use can lead to significant complications.
  • A case study highlighted a serious incident where a Turnpike Spiral catheter tip fractured, causing a blockage in the right coronary artery despite its tortuous and calcified nature.
  • To resolve the blockage, a specialized technique called antegrade dissection and re-entry was used, successfully restoring blood flow and avoiding a heart attack by placing stents after navigating around the fractured tip.
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Background: Maintaining low concentrations of plasma low-density lipoprotein cholesterol (LDLc) over time decreases the number of LDL particles trapped within the artery wall, slows the progression of atherosclerosis and delays the age at which mature atherosclerotic plaques develop. This substantially reduces the lifetime risk of atherosclerotic cardiovascular disease (ASCVD) events. In this context, plaque development and vulnerability result not only from lipid accumulation but also from inflammation.

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  • Current guidelines recommend keeping LDL-C levels below 55 mg/100 ml for patients with acute coronary syndromes (ACS), but many patients struggle to reach this target due to poor medication adherence.
  • A study analyzed 963 ACS patients, using the Morisky Medication Adherence Scale to categorize them into high adherence (HA) and low adherence (LA) groups, finding that 28.7% had low adherence.
  • The results showed that HA patients were significantly more likely to achieve the LDL-C target compared to LA patients, indicating that adherence to lipid-lowering therapy plays a crucial role in reaching cholesterol goals.
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Background: Coronary computed tomographic angiography (CCTA) is a non-invasive imaging technique that possesses the ability to provide detailed anatomical information about coronary arteries, avoiding unnecessary invasive procedures. Our aim was to assess the ability of CCTA to identify coronary artery disease compared to invasive coronary angiography (ICA) in a real-life setting.

Methods: We examined 137 consecutive patients who underwent ICA after CCTA.

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  • A meta-analysis was conducted to examine the left ventricular systolic function in acromegaly patients using global longitudinal strain (GLS) measured by speckle tracking echocardiography (STE).
  • The analysis included seven studies and found that while left ventricular ejection fraction (LVEF) was similar between acromegaly patients and healthy controls, the GLS in acromegaly patients indicated a borderline significant impairment.
  • The study suggests the potential of GLS to reveal early systolic function issues in acromegaly, urging further research to confirm its effectiveness compared to LVEF.
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Background: Dilated cardiomyopathy (DCM) is an etiologically heterogeneous group of diseases of the myocardium. With the rapid evolution in laboratory investigations, genetic background is increasingly determined including many genes with variable penetrance and expressivity. Biallelic NEXN variants are rare in humans and associated with poor prognosis: fetal and perinatal death or severe DCMs in infants.

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  • Anorexia nervosa (AN) is associated with cardiac complications, but limited research has examined how it affects heart muscle deformation without overt systolic dysfunction, leading to this meta-analysis for deeper insights.
  • The study involved systematic searches for relevant clinical studies that analyzed left ventricular (LV) mechanics in AN patients versus healthy individuals, focusing on metrics like left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS).
  • The findings showed no significant difference in GLS between AN patients and controls, while apical strain was notably higher in AN patients, suggesting that standard measures may not fully capture subclinical heart issues in those with AN.
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Purpose Of Review: Although the clinical benefit of reducing low-density lipoprotein cholesterol (LDLc) in patients with coronary artery disease (CAD) is well-established, the impact on plaque composition and stability is less clear. Our narrative review aimed to assess the clinical effects of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors on coronary plaque characteristics specifically focusing from atheroma progression to regression and stabilization.

Recent Findings: The combination of statin therapy and PCSK9 inhibitors (evolocumab and alirocumab) promotes plaque stability in patients following an acute coronary syndrome.

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The present study explores the modifications of cardiovascular autonomic control (CAC) during wake and sleep time and the systemic inflammatory profile associated with exposure to indoor air pollution (IAP) in a cohort of healthy subjects. Twenty healthy volunteers were enrolled. Indoor levels of fine particulate matter (PM), nitrogen dioxide (NO) and volatile organic compounds (VOCs) were monitored using a portable detector for 7 days.

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Introduction: Myocardial calcifications (MC) represent a relatively rare pathological process, which may accompany different cardiovascular conditions and can be broadly categorized as dystrophic or metastatic. Myocardial infarction (MI) has been traditionally regarded as the main cause of MC overall; however, no updated comprehensive data on the relative incidence of different forms of MC is available. The purpose of this systematic review of the literature is to analyze the currently available evidence on MC in terms of pathophysiology, diagnosis, and clinical presentation.

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  • * Anthracyclines, particularly doxorubicin, are effective in fighting tumors but can cause serious heart damage, known as cardiotoxicity.
  • * Understanding how doxorubicin affects heart function is essential for creating new protective strategies against its harmful impacts on the cardiovascular system.
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According to current guidelines, only clinical surveillance is recommended for patients with moderate aortic valve stenosis (AS), while aortic valve replacement may be considered in patients undergoing surgery for other indications. Recent studies have shown that moderate AS is associated with a high risk of adverse cardiovascular events, including death, especially in patients with left ventricular dysfunction. In this context, multimodality imaging can help to improve the accuracy of moderate AS diagnosis and to assess left ventricular remodeling response.

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Aims: Patients with heart failure (HF) remain often undertreated for multiple reasons, including treatment inertia, contraindications, and intolerance. The OPTIimal PHARMacological therapy for patients with Heart Failure (OPTIPHARM-HF) registry is designed to evaluate the prevalence of evidence-based medical treatment prescription and titration, as well as the causes of its underuse, in a broad real-world population of consecutive patients with HF across the whole ejection fraction spectrum and among different clinical phenotypes.

Methods: The OPTIPHARM-HF registry (NCT06192524) is a prospective, multicenter, observational, national study of adult patients with symptomatic HF, as defined by current international guidelines, regardless of ejection fraction.

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Aims: Many studies evaluated the functional response in post-Covid-19 patients; however, they systematically excluded patients with concomitant acute coronary syndrome (ACS). We evaluated the long-term functional capacity assessed by cardiopulmonary exercise test (CPET) in patients hospitalized for ACS and concomitant SARS-CoV2 infection. The secondary aim was to investigate the functional response in patients with symptoms related to "long COVID-19 syndrome" (LCS).

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