Publications by authors named "J Pacella"

Background: There exists clinical equipoise regarding whether and when an invasive approach should be preferred over conservative treatment in the management of stable late ST-elevation myocardial infarction (STEMI) presenting within 12 to 72 h of symptom onset.

Objective: To perform a systematic review to identify the most effective treatment strategy between percutaneous coronary intervention (PCI) and medical therapy in stable late STEMI presenters by comparing their respective outcomes as well as determine the optimal timing of PCI by evaluating the outcomes of urgent versus non-urgent PCI approach in this patient population.

Methods: PubMed, Embase, and Cochrane databases were queried from inception until March 2024 for studies comparing the outcomes of PCI versus medical therapy, as well as urgent versus non-urgent PCI, in stable late STEMI patients presenting with symptom onset within 12-72 h.

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Article Synopsis
  • A 16-year-old female, who had been diagnosed with bilateral sub-segmental pulmonary emboli, experienced cardiogenic shock due to weakened heart function.
  • Cardiac MRI revealed signs of possible microvascular injury to her coronary arteries.
  • She was ultimately diagnosed with ischaemic cardiomyopathy caused by catastrophic antiphospholipid antibody syndrome, which might be linked to an underlying autoimmune connective tissue disease.
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Objective: Perfluoropropane droplets (PD) are nanometer-sized particles that can be formulated from commercially available contrast agents. The preferential retention of PDs in diseased microvascular beds can be detected by ultrasound imaging techniques after acoustic activation and offers an opportunity for the detection of such processes as scar formation or inflammation. We hypothesized that in the presence of ischemia/reperfusion (I/R) injury, retention of intravenously injected PDs would be enhanced.

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Hypertension represents the major risk factor in the onset of cardiovascular disease worldwide. Preclinically, several mouse models of hypertension have been developed to investigate the pathophysiological link between hypertension and vascular impairment. Specifically, angiotensin-II infusion, transverse aortic constriction, deoxycorticosterone acetate salt, and N(ω)-nitro-L-arginine methyl ester (L-NAME) administration as hypertensive stimuli at the preclinical level permit the unveiling of a proinflammatory response driven by the innate and adaptive immune system and leads to vascular injury in terms of structural and functional alterations.

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Article Synopsis
  • Acoustically activated perfluoropropane droplets (PD) are used to enhance imaging of heart tissue, particularly in infarct zones, but their activation can be influenced by body temperature (BT).
  • The study analyzed the effects of BT during intravenous injection of PDs in rats, comparing temperatures above and below 36.5°C on myocardial contrast intensity (MCI) and microvascular retention.
  • Results showed that lower BT (<36.5°C) led to effective MCI enhancement in infarct zones, while higher BT inhibited activation and resulted in adverse effects on lung tissue.
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