Publications by authors named "E Caiazza"
Pulmonary arterial hypertension with left to right shunts: When to treat and/or close?
Int J Cardiol Congenit Heart Dis
September 2024
Pulmonary arterial hypertension (PAH) is defined as increase in mean pulmonary arterial pressure and pulmonary vascular resistance (PVR). It can be associated with congenital heart disease (CHD) with the following subtypes: 1) uncorrected left-to-right (L-R) intracardiac shunt leading to overload of the pulmonary circulation and a progressive increase of PVR; 2) Eisenmenger syndrome, appearing when a large post-tricuspid shunt is left uncorrected and pulmonary vascular disease (PVD) is severe, so the shunt becomes bidirectional or right-to-left, causing cyanosis; 3) PAH after shunt closure, when PVR arises after a defect correction; and 4) PAH associated with small or coincidental defects. While the treatment of patients with Eisenmenger syndrome is well established, the treatment of patients with PAH in whom there is a L-R shunt (with no cyanosis) remains unclear and requires expertise.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to assess the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) among children and adolescents with type 1 diabetes (T1D) and its relationship with glycaemic control indicators.
- Out of 244 participants, 27.5% were found to have MASLD; those diagnosed exhibited higher blood pressure, cholesterol levels, and HbA1c, indicating poorer glycaemic control.
- Key factors independently linked to MASLD included mean HbA1c values since diabetes onset, time spent above glycaemic range, and LDL cholesterol levels, suggesting significant health implications for affected individuals.
Article Synopsis
- In systemic sclerosis (SSc), severe aortic stenosis (AS) occurs in about 4.3% of patients, often linked to poor health outcomes and requiring careful monitoring.
- In a study of 234 SSc patients from 2007 to 2022, ten had severe AS, with a notable progression rate over a mean period of 3.2 years, impacting heart function significantly.
- Treatment options included transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR), with most patients surviving long-term, highlighting the importance of screening for AS in SSc patients.
Article Synopsis
- The study investigated the prevalence of out-of-range plasma levels of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) who underwent elective cardiac procedures, focusing on proper timing of DOAC withdrawal.
- Out of 90 AF patients evaluated, 82.22% had DOAC concentrations outside expected ranges; about 41% had levels below the trough, which is the minimum effective concentration of the drug.
- Key predictors for low DOAC levels included inappropriate withdrawal periods and increased kidney function (creatinine clearance), while diabetes was linked to higher DOAC levels above the trough range.
Article Synopsis
- Recent research indicates that lung ultrasound can detect hidden pulmonary congestion in patients with pulmonary arterial hypertension (PAH), revealing a relationship between right heart failure and increased lung water content.
- A study involving 102 PAH patients demonstrated that 75% had pulmonary congestion indicated by B-lines on lung ultrasound, with various factors such as sex, age, and NT-proBNP levels correlating with these findings.
- The results suggest that pulmonary congestion is tied to right ventricular dysfunction and increased central venous pressure, which may hinder lymphatic drainage.