Publications by authors named "Salvatore De Rosa"

There is a growing interest in the potential use of intracardiac fluid dynamic analysis to better understand cardiac mechanics and identify novel imaging biomarkers of cardiovascular disease. Abnormalities of vortex formation and shape may in fact play a critical role in cardiac function, affecting both efficiency and myocardial workload. Recent advances in imaging technologies have significantly improved our ability to analyze these dynamic flow patterns in vivo, offering new insights into both normal and pathological cardiac conditions.

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Vascular calcification (VC) is a biological phenomenon characterized by an accumulation of calcium and phosphate deposits within the walls of blood vessels causing the loss of elasticity of the arterial walls. VC plays a crucial role in the incidence and progression of chronic kidney disease (CKD), leading to a significant increase in cardiovascular mortality in these patients. Different conditions such as age, sex, dyslipidemia, diabetes, and hypertension are the main risk factors in patients affected by chronic kidney disease.

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Acute coronary syndromes (ACSs) represent a significant global health challenge arising from atherosclerotic cardiovascular disease (ASCVD), with elevated low-density lipoprotein cholesterol (LDL-C) levels being a primary contributor. Despite standard statin therapy, individuals with ACS remain at high risk for recurrent cardiovascular events, particularly in the initial post-ACS period. Monoclonal antibodies targeting proprotein convertase subtilisin/kexin type 9 (PCSK9), such as evolocumab and alirocumab, offer a potential strategy to reduce LDL-C levels further and mitigate this residual risk.

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Article Synopsis
  • A meta-analysis was conducted to evaluate the long-term risks of transient new-onset atrial fibrillation (AF) in patients who experienced acute coronary syndrome (ACS), finding a significant association with adverse outcomes.
  • The study included seven observational studies with over 151,700 patients, showing that transient new-onset AF notably increased the risk of ischemic stroke, recurrent AF, and all-cause mortality, with hazard ratios indicating substantial risks for these conditions.
  • The findings suggest that patients with transient new-onset AF following ACS may benefit from closer monitoring and the potential use of oral anticoagulants to mitigate risks, highlighting the need for further randomized controlled trials.
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Cardiomyopathies are the structural and functional disorders of the myocardium. Etiopathogenesis is complex and involves an interplay of genetic, environmental, and lifestyle factors eventually leading to myocardial abnormalities. It is known that non-coding (Nc) RNAs, including micro (mi)-RNAs and long non-coding (lnc) RNAs, play a crucial role in regulating gene expression.

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Article Synopsis
  • Chronic total occlusions (CTOs) are a significant challenge in coronary artery disease (CAD) and require advanced diagnostic and treatment methods due to their prevalence in patients undergoing coronary angiography.
  • Traditional coronary angiography has limited ability to provide details on lesions and heart viability, but imaging techniques like optical coherence tomography (OCT), intravascular ultrasound (IVUS), and coronary computed tomography angiography (CCTA) offer valuable insights during percutaneous coronary intervention (PCI).
  • Although each imaging method has its drawbacks, they collectively improve CTO-PCI success rates, lower complications, and enhance patient outcomes, with future advancements such as AI and hybrid imaging expected to further improve precision and personalize patient care.
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  • - The study investigates the relationship between peak high-sensitivity cardiac troponin (hs-cTn) levels and one-year mortality in patients admitted to intensive cardiovascular care units (ICCU) from 2019 to 2023.
  • - A total of 4149 patients were analyzed, revealing that those with hs-cTnI levels ≥100,000 ng/L had a significantly higher risk of mortality compared to lower levels, particularly in non-ST elevation myocardial infarction (NSTEMI) cases.
  • - The findings suggest that while high hs-cTnI levels indicate poor prognosis, the impact on mortality rates varies notably between patients with ST elevation myocardial infarction (STEMI) and NSTEMI, indicating a need
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  • Immunotherapy is a diverse set of cancer treatments that use the immune system to fight cancer and includes methods like immune-checkpoint inhibitors and CAR-T therapy.
  • While these treatments can be highly effective, they have been linked to unexpected side effects, especially cardiovascular issues, which have become more documented in recent years.
  • The review emphasizes the need for specialized guidelines to better manage the unique cardiovascular risks associated with immunotherapy, providing insights into how to evaluate and handle these patients effectively.
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Introduction: Coronary artery disease (CAD) is a main cause of morbidity and mortality. The effectiveness of coronary revascularization in chronic coronary syndromes (CCS) is still debated. Our recent study showed the superiority of coronary revascularization over optimal medical therapy (OMT) in reducing cardiovascular (CV) mortality and myocardial infarction (MI).

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Article Synopsis
  • * Treatment for obstructive CAD focuses on reducing heart events and symptoms, while INOCA requires addressing functional changes in coronary circulation.
  • * A precise diagnosis in patients with INOCA is vital for personalized treatment, and the paper emphasizes combining coronary revascularization, medication, and lifestyle changes for effective angina management.
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  • Primary percutaneous coronary intervention (PCI) is the preferred method for treating acute ST-elevation myocardial infarction (STEMI), helping to restore blood flow in blocked arteries.
  • Some patients, however, suffer from a 'no-reflow' phenomenon, where blood flow remains compromised despite the artery being opened, usually due to microvascular obstruction from thrombus or plaque.
  • There is no clear consensus on preventing or treating no-reflow, and while various medications are used, they only improve blood flow for certain patients; a new idea involving low-dose fibrinolysis during PCI shows promise for enhancing recovery.
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  • International guidelines recommend using direct oral anticoagulants (DOAC) over vitamin K antagonists (VKA) and dual antithrombotic therapy (DAT) over triple antithrombotic therapy (TAT) for patients on oral anticoagulant therapy undergoing percutaneous coronary intervention (PCI) with stents.
  • A study involving 1234 patients on oral anticoagulants assessed the outcomes of DOAC versus VKA and DAT versus TAT, focusing on net adverse clinical events (NACE) at a one-year follow-up.
  • Results showed DOAC resulted in a lower NACE rate compared to VKA (16% vs 23%), and while DAT and TAT had similar NACE rates, DAT led to
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  • Telemonitoring tools help people with chronic diseases manage their health at home and catch problems early, which can save money on hospital visits.
  • Researchers wanted to see how patients with heart issues felt about a special device that tracks their health over time.
  • Twenty-six patients tried the device for a week and answered questions about how easy it was to use, how satisfied they were, and whether it helped their healthcare experience.
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  • "Full moon" calcification in coronary arteries represents a blockage detectable via coronary computed tomography angiography (CCTA) and is linked to poorer outcomes in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
  • In a study of 140 patients undergoing elective CTO-PCI, those with "full moon" calcification were older and exhibited higher cardiovascular risks, with a significantly greater failure rate to cross the lesion compared to patients without this morphology (53.5% vs 12.5%).
  • The study employed multivariable logistic regression to assess factors influencing procedural success, finding full moon calcification significantly correlated with higher incidences of complications like chronic kidney failure and previous coronary artery bypass surgery.
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  • Cardiovascular calcification leads to calcium buildup in arterial walls, increasing stiffness and reducing elasticity, which raises the risk of heart-related illnesses.
  • Warfarin therapy has been linked to vascular calcification, but the specific mechanisms behind this are still not fully understood, though some pathways have been identified.
  • The review focuses on the latest research about how warfarin affects vascular calcification and considers the potential role of microRNA as biomarkers or targets in this process.
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  • GLP-1 receptor agonists (GLP-1Ra) and SGLT2 inhibitors (SGLT2i) are primarily used to manage blood sugar but also show protective effects on heart health, influencing heart-related illness and death rates.
  • The specific biological reasons for these cardiovascular benefits are still unclear, highlighting the need for better understanding through medical imaging techniques.
  • Cardiovascular magnetic resonance (CMR) imaging is highlighted as a key tool for assessing heart function and structure in diabetic patients and is evolving to include new methods that examine heart metabolism, making it vital for researching the impacts of GLP-1Ra and SGLT2i.
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Background: Embolization of debris can complicate transcatheter aortic valve implantation (TAVI) causing stroke. Cerebral embolism protection (CEP) devices can divert or trap debris.

Purpose: To evaluate the efficacy of CEP during TAVI vs the standard procedure.

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An 80-year-old post-coronary artery bypass graft (CABG) patient had an acute coronary syndrome with non-ST-segment elevation myocardial infarction (ACS-NSTE) with saphenous vein graft (SVG)-obtuse marginal stenosis. High-definition intravascular ultrasound revealed an underexpanded SVG stent with a hyperechoic structure. Optical coherence tomography confirmed surgical clip causing compression, resolved by post-dilation.

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Article Synopsis
  • Pulmonary embolism (PE) is a serious health issue that can be life-threatening, especially in patients at high risk, who need immediate treatment to avoid worsening conditions or death.
  • Recovery from PE can lead to long-term complications, including recurrent cases, bleeding, and psychological issues, which necessitates better management strategies.
  • The paper emphasizes the importance of catheter-directed therapies for unstable PE patients, as these offer quicker and safer recovery options compared to traditional treatments, highlighting the need for a patient-centered approach in managing risk and treatment.
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Cardiac myxoma (CM) is a potentially life-threatening disease because frequently asymptomatic or debuts with aspecific manifestations. Definitive diagnosis is established by histopathological assessment including tumor and endothelial cell markers. To derive a specific panel of circulating cells antigenically detectable, pre-surgery peripheral blood samples of CM patients were analyzed.

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Objective: To provide a quantitative comparison between myocardial revascularization (REVASC) and optimal medical treatment (OMT) alone in patients with chronic coronary syndrome (CCS).

Methods: Pertinent studies were searched for in PubMed/Medline until 12/03/2023. Randomized controlled trials that compare REVASC to OMT reporting clinical outcomes were selected according to PRISMA guidelines.

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Cardiac amyloidosis is caused by the extracellular deposition of amyloid fibrils in the heart, involving not only the myocardium but also any cardiovascular structure. Indeed, this progressive infiltrative disease also involves the cardiac valves and, specifically, shows a high prevalence with aortic stenosis. Misfolded protein infiltration in the aortic valve leads to tissue damage resulting in the onset or worsening of valve stenosis.

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