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Functional assessment in angina and non-obstructive coronary arteries: from microvascular resistance reserve to subtypes of coronary microvascular dysfunction.
J Cardiovasc Med (Hagerstown)
February 2025
Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina, Gemelli Isola.
Aims: Coronary microvascular dysfunction (CMD) is a heterogeneous condition defined by reduced coronary flow reserve (CFR). The new index 'microvascular resistance reserve' (MRR) has been developed, but its role is unclear. We investigate the relationships between functional indices in ANOCA (angina and non-obstructive coronary arteries) patients and evaluate the hemodynamic features of different CMD subtypes.
View Article and Find Full Text PDFFractional flow reserve (FFR) and index of microcirculatory resistance (IMR) relationship in patients with chronic or stabilized acute coronary syndromes.
Int J Cardiol
January 2025
Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina, Gemelli Isola, Via di Ponte Quattro Capi, 39, 00186 Rome, Italy; Department of Cardiovascular and Pneumological Sciences, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy. Electronic address:
Aims: To investigate the influence of index of microcirculatory resistance (IMR) on fractional flow reserve (FFR) and adenosine-induced hyperemia (ΔPd/Pa-FFR) in patients with chronic (CCS) or stabilized acute coronary syndromes (ACS), utilizing various IMR threshold values.
Methods: Data were extracted from two ongoing Italian registries involving patients with CCS or stabilized ACS who underwent a #FullPhysiology approach [Pd/Pa, FFR, IMR, coronary flow reserve (CFR)] by bolus thermodilution technique in the left anterior descending artery. Correlations between IMR and both FFR and ΔPd/Pa-FFR were analyzed both globally and within three IMR-defined groups: Group 1 (IMR <25), Group 2 (25 ≤ IMR <40), and Group 3 (IMR ≥40).
The use of the psoas-to-lumbar vertebrae index and modified frailty index in predicting postoperative complications in degenerative spine surgery: can sarcopenia or frailty be underestimated?
Eur Spine J
January 2025
1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Article Synopsis
- Degenerative spine disease (DSD) is becoming more common, particularly in older adults, leading to more surgeries and complications, which require thorough preoperative assessments of patient frailty.
- This study evaluated 286 patients undergoing lumbar spine fusion, using modified Frailty Indexes and assessing sarcopenia through imaging, to determine their impact on postoperative complications.
- Results showed that frailty is a strong predictor of complications post-surgery, while sarcopenia had little effect, indicating that evaluating frailty may be more critical for assessing surgical risks.
A Systematic Review of Metabolic Syndrome: Key Correlated Pathologies and Non-Invasive Diagnostic Approaches.
J Clin Med
October 2024
Department of Internal Medicine, Hospital Universitario La Paz, Paseo Castellana 241, 28046 Madrid, Spain.
Metabolic syndrome (MetS) is a condition marked by a complex array of physiological, biochemical, and metabolic abnormalities, including central obesity, insulin resistance, high blood pressure, and dyslipidemia (characterized by elevated triglycerides and reduced levels of high-density lipoproteins). The pathogenesis develops from the accumulation of lipid droplets in the hepatocyte (steatosis). This accumulation, in genetically predisposed subjects and with other external stimuli (intestinal dysbiosis, high caloric diet, physical inactivity, stress), activates the production of pro-inflammatory molecules, alter autophagy, and turn on the activity of hepatic stellate cells (HSCs), provoking the low grade chronic inflammation and the fibrosis.
View Article and Find Full Text PDFAge and Vasodilator Response to Different Hyperemic Agents: Adenosine versus Contrast Medium.
Rev Cardiovasc Med
July 2024
Diagnostic, Interventional and Acute Cardiac Care Unit, Ospedale Isola Tiberina - Gemelli Isola, 00186 Rome, Italy.
Background: Age-related remodelling has the potential to affect the microvascular response to hyperemic stimuli. However, its precise effects on the vasodilatory response to adenosine and contrast medium, as well as its influence on fractional flow reserve (FFR) and contrast fractional flow reserve (cFFR), have not been previously investigated. We investigate the impact of age on these indices.
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