Publications by authors named "Segreti A"

Endurance sports have witnessed an increase in female participation, demanding a constant and evolving reassessment of the specific physiological and health implications of female athletes. In the present review, we analyze cardiovascular, hematological adaptations and anthropometry and hormonal fluctuations highlighting sex-specific differences in response to exercise, with estrogen playing a fundamental role in modulating body composition and metabolic processes. Nutritional aspects, in particular energy availability, macronutrient distribution and hydration, are fundamental in supporting training demands and menstrual function.

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Cardiovascular (CV) disease remains the leading cause of morbidity and mortality worldwide, highlighting the necessity of understanding its underlying molecular and pathophysiological pathways. Conversely, physical activity (PA) and exercise are key strategies in reducing CV event risks. Detecting latent CV conditions in apparently healthy individuals, such as athletes, presents a unique challenge.

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Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, accounting for over 9 million deaths annually. The prevalence of CAD continues to rise, driven by ageing and the increasing prevalence of risk factors such as hypertension, diabetes, and obesity. Current clinical guidelines emphasize the importance of functional tests in the diagnostic pathway, particularly for assessing the presence and severity of ischemia.

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Article Synopsis
  • Athletes often show changes in their electrocardiograms (ECGs) due to heart adaptations from regular training, known as the athlete's heart, but these changes can sometimes mimic heart disease signs.
  • Misdiagnosis can lead to serious consequences, including sudden cardiac death, which is a major risk for young athletes.
  • This review aims to help cardiologists and sports doctors differentiate between normal exercise-related ECG changes and those indicating potential heart problems, guiding further investigations when needed.
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This proof-of-concept study aimed to assess the diagnostic potential of gas chromatography-mass spectrometry (GC-MS) in profiling volatile organic compounds (VOCs) from exhaled breath as a diagnostic tool for the chronic coronary syndrome (CCS). Exhaled air was collected from patients undergoing invasive coronary angiography (ICA), with all samples obtained prior to ICA. Post hoc, patients were divided into groups based on coronary lesion severity and indications for revascularization.

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  • A study evaluated 22 non-professional athletes aged 18-52 post-knee surgery, comparing their cardiovascular parameters and functional capacity before and after surgery using transthoracic echocardiography and cardiopulmonary exercise testing (CPET).
  • Results showed a significant increase in resting heart rate after surgery, while blood pressure and lung function measurements remained unchanged.
  • Although global work efficiency improved and global wasted work decreased, these changes did not significantly affect exercise performance metrics like peak oxygen consumption post-surgery.
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  • - Physical activity is generally beneficial for heart health, but recent research indicates that high-volume endurance exercise might actually worsen coronary atherosclerosis, leading to concerns in treating coronary artery disease (CAD) in athletes.
  • - CAD is a major cause of sudden cardiac death in athletes over 35, prompting studies to assess the prevalence of CAD in this group and its implications for health outcomes.
  • - While earlier beliefs suggested that coronary plaques in elite athletes were harmless, recent studies challenge this view, highlighting potential risks associated with exercise-induced coronary calcification and the need for better evaluation and management strategies.
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Background: Supraventricular extra beats (SVEB) are frequently observed in athletes but data on significance, prognostic role and correlation with cardiac remodeling are contrasting. It is uncertain whether SVEB may indicate the development of more complex arrhythmias and the need for closer monitoring is undetermined. The aim was to assess the prevalence and clinical significance of BESV in Olympic athletes of different sporting disciplines, evaluating potential correlations with cardiac remodeling and clinical features.

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Environmental factors such as extreme temperatures, humidity, wind, pollution, altitude, and diving can significantly impact athletes' cardiovascular systems, potentially hindering their performance, particularly in outdoor sports. The urgency of this issue is heightened by the increasing prevalence of climate change and its associated conditions, including fluctuating pollution levels, temperature variations, and the spread of infectious diseases. Despite its critical importance, this topic is often overlooked in sports medicine.

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Dyslipidemia is a major contributor to the development of atherosclerotic cardiovascular disease. Despite high level of physical activity, athletes are not immune from dyslipidemia, but longitudinal data on the variation of lipids are currently lacking. We sought to assess lipid profile changes over time in Olympic athletes practicing different sports disciplines (power, skills, endurance, and mixed).

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Article Synopsis
  • Athletes often face interruptions in training due to injuries, such as a knee injury, and advanced testing methods like echocardiography and cardiopulmonary exercise testing (CPET) can help evaluate their heart and lung functions during recovery.
  • The study involved 28 non-professional athletes with knee issues undergoing pre-surgery assessments, measuring factors like heart strain and oxygen consumption, revealing specific correlations between their physical activity and cardiac efficiency.
  • Despite being less active due to injury, athletes can still achieve maximal CPET results; however, decreased heart and lung performance may contribute to, or result from, their injuries, indicating a need for careful functional evaluation before surgery.
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Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, and its incidence has grown within several years, quickly becoming the third leading cause of mortality. The disease is characterized by alveolar destruction, air-trapping, and chronic inflammation due to persistent exposure to a large spectrum of harmful particles. The diagnosis of COPD is made by demonstration of persistent and not fully reversible airflow limitation, and different phenotypes may be recognized based on pathophysiological, clinical, and radiological features.

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Although it is known that exercise improves cardiovascular health and extends life expectancy, a significant number of people may also experience an elevation in cardiac troponin levels as a result of exercise. For many years, researchers have argued whether exercise-induced cardiac troponin rises are a consequence of a physiological or pathological reaction and whether they are clinically significant. Differences in cardiac troponin elevation and cardiac remodeling can be seen between athletes participating in different types of sports.

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We describe the case of a 45-year-old female affected by asthma and nasal polyposis who presented to the emergency department because of worsening dyspnea and paresthesia of the left lower limb. Comprehensive instrumental examinations revealed the presence of severe left ventricle dysfunction, intra-cardiac thrombus, deep vein thrombosis, pulmonary embolism, lung infiltrates, polyserositis, and neurological involvements. Finally, the patient was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA), formerly Churg-Strauss syndrome, a rare vasculitis of small-medium blood vessels with several organ involvements.

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Dyslipidemia is the most frequent cardiovascular (CV) risk factor in able-bodied athletes and is frequently undertreated, resulting in an underestimated risk of atherosclerosis-related diseases. Data on lipid profile in Paralympic athletes are lacking. Our study aimed to identify the prevalence of dyslipidemia and the influence of disability type and sporting discipline in Paralympic athletes.

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  • The study explored the presence of cardiac remodelling, specifically eccentric hypertrophy (EH), in 309 endurance athletes and sought to identify those without this adaptation, known as normal geometry (NG).
  • Among athletes studied, 67% of males and 68.5% of females exhibited EH, while a notable number (31.3% of males and 31.4% of females) showed NG characteristics.
  • Athletes with NG demonstrated lower peak power outputs and higher resting heart rates compared to those with EH; however, both groups did not show significant differences in their athletic achievements.
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Myocarditis is a polymorphic and potentially life-threatening disease characterized by a large variability in clinical presentation and prognosis. Within the broad spectrum of etiology, eosinophilic myocarditis represents a rare condition characterized by eosinophilic infiltration of the myocardium, usually associated with peripheral eosinophilia. Albeit uncommon, eosinophilic myocarditis could be potentially life-threatening, ranging from mild asymptomatic disease to multifocal widespread infiltrates associated with myocardial necrosis, thrombotic complications, and endomyocardial fibrosis.

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Chronic obstructive pulmonary disease (COPD) is a significant preventable and treatable clinical disorder defined by a persistent, typically progressive airflow obstruction. This disease has a significant negative impact on mortality and morbidity worldwide. However, the complex interaction between the heart and lungs is usually underestimated, necessitating more attention to improve clinical outcomes and prognosis.

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Background: Congenital left ventricular diverticula (LVDs) and aneurysms (LVAs) are rare, developmental, cardiac anomalies, which are often asymptomatic. Sometimes they can cause life-threatening complications like arrhythmias, syncope, embolic events, ventricular wall rupture, valvular regurgitation, congestive heart failure, and various symptoms. Diagnosis is usually made after exclusion of acquired causes, from cardiac or non-cardiac disorders.

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  • Uricemia is linked to cardiovascular disease and is elevated in 4.4% of Olympic athletes, lower than the general population; males show higher levels than females.
  • The study categorizes athletes into four disciplines and measures various health indicators, finding correlations between hyperuricemia and factors like hypertension and body fat.
  • Despite being generally healthy, the presence of multiple cardiovascular risk factors in athletes suggests that monitoring uric acid levels is important for assessing their overall cardiovascular health.
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  • The study examined right ventricular (RV) changes in 370 elite athletes during the Tokyo and Beijing Olympics, focusing on differences based on gender and type of exercise (isometric vs. isotonic).
  • Isotonic athletes displayed greater RV remodeling with notable differences in size measurements compared to isometric athletes, while males generally had larger RV and right atrium sizes but with lower RV TDI velocities.
  • Although RV morphological changes varied by exercise type, functional differences were minimal, with female athletes showing unique RV profiles in terms of specific velocity measurements.
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Red yeast rice (RYR) is an entirely natural product that originates from the fermentation of white rice (Oryza sativa) with a yeast, mainly Monascus Purpureus, and has been part of traditional Chinese medicine and diet since ancient times. It has generated great interest in recent years in the context of cardiovascular (CV) prevention due to its ability to inhibit endogenous cholesterol production, helping to achieve and maintain optimal plasma lipid concentrations. This review aims to make an extensive 360-degree assessment and summary of the whole currently available scientific evidence about RYR, starting with its biochemical composition, passing through a historical reconstruction of all the studies that have evaluated its efficacy and safety in cholesterol-lowering action, with a focus on CV outcomes, and ultimately addressing its other relevant clinical effects.

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  • Bilirubin is thought to have protective effects on cardiovascular and metabolic health, with mild hyperbilirubinemia potentially providing benefits against diseases related to oxidative stress, particularly in individuals with Gilbert syndrome (GS).
  • A study involving 1,492 elite Italian athletes revealed that GS was present in 6% of participants, predominantly males, and athletes with GS showed specific hematological differences such as lower platelet counts and higher iron levels compared to those without GS.
  • No significant differences were noted in cardiac health or exercise capacity among GS athletes, although endurance athletes exhibited higher levels of total and indirect bilirubin.
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  • Heart failure (HF) remains a significant global health challenge despite improvements in diagnosis and treatment options.
  • Sodium-glucose co-transporter 2 inhibitors (SGLT2i), like dapagliflozin and empagliflozin, are now recommended as foundational therapy for HF, shown to reduce cardiovascular death and hospitalizations.
  • Barriers to their use include low prescription rates, awareness gaps, and concerns about safety, highlighting the need for better education and practical guidance for clinicians.
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