361 results match your criteria: "First Clinic of Internal Medicine[Affiliation]"

Functional mitral regurgitation (MR) is associated with increased cardiovascular morbidity and mortality and over the past decade, the diagnosis of atrial functional mitral regurgitation (aFMR) has been increasingly observed in the elderly, especially in those with atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF). Annular enlargement, perturbations of annular contraction, and atriogenic leaflet tethering distinguish the pathophysiology of aFMR from the one of ventricular origin. However, no consensus provides recommendations regarding the differential diagnosis and the subsequent management of aFMR.

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Qu and Li emphasize a fundamental aspect of metabolic dysfunction-associated fatty liver disease in their manuscript, focusing on the critical need for non-invasive diagnostic tools to improve risk stratification and predict the progression to severe liver complications. Affecting approximately 25% of the global population, metabolic dysfunction-associated fatty liver disease is the most common chronic liver condition, with higher prevalence among those with obesity. This letter stresses the importance of early diagnosis and intervention, especially given the rising incidence of obesity and metabolic syndrome.

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Background: The global impact of the COVID-19 pandemic has prompted the search for strategies to improve outcomes in affected individuals, including those initially managed in outpatient settings. Thromboembolic events have been reported as a concerning complication.

Objectives: The aim of this study was to evaluate efficacy and safety of primary thromboprophylaxis in outpatients with COVID-19.

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Background/objectives: Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are significant public health issues, with cardiovascular morbidity and mortality being the leading causes of death in hemodialysis patients. Osteopontin (OPN), a multifunctional glycoprotein, has emerged as a potential biomarker for vascular disease in CKD due to its role in inflammation, tissue remodeling, and calcification.

Methods: This cohort study included 1124 hemodialysis patients from the PROGREDIRE study, a registry involving 35 dialysis units in Southern Italy.

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This letter comments on the recently published manuscript by Huang in the , which focused on the immunomodulatory effect of on hepatocellular carcinoma (HCC) tumor microenvironments (TME) by inhibiting M2-tumor-associated macrophage (M2-TAM) polarization Wnt/β-catenin pathway modulation. Recent research highlights the crucial role of TAMs and their polarization towards the M2 phenotype in promoting HCC progression. Epigenetic regulation, particularly through microRNAs (miR), has emerged as a key factor in modulating immune responses and TAM polarization in the TME, influencing treatment responses and tumor progression.

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How the brain impacts the heart: lessons from ischaemic stroke and other neurological disorders.

Heart

January 2025

Department of Neurology with Experimental Neurology and Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany

Cardiovascular alterations are common in patients who had ischaemic stroke, haemorrhagic stroke and other acute brain disorders such as seizures. These cardiac complications are important drivers of morbidity and mortality and comprise blood-based detection of cardiomyocyte damage, ECG changes, heart failure and arrhythmia. Recently, the concept of a distinct 'stroke-heart syndrome' has been formulated as a pathophysiological framework for poststroke cardiac complications.

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Precision medicine in intestinal ischemia: the emerging role of biomarkers.

Intern Emerg Med

November 2024

First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy.

Intestinal ischemia (IIs) is a significant gastrointestinal condition characterized by reduced blood flow to the bowel, leading to inflammation and injury. Early diagnosis and management are crucial for preventing severe complications. Under this point of view, circulating biomarkers can enhance patient stratification and guide therapeutic decisions.

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Article Synopsis
  • The study investigates the significance of cardiac troponin (cTn) levels in predicting mortality in patients with Takotsubo syndrome (TTS), analyzing data from the International Takotsubo Registry.
  • It identifies that a cTn increase greater than 28.8 times the upper reference limit signals clinically relevant myocardial injury, correlating with a higher risk of mortality over 5 years (adjusted HR 1.58).
  • The findings enhance understanding of patient risk profiles in TTS, emphasizing the need for increased monitoring and follow-up for those with significant troponin elevations.
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Venous thrombosis and obesity: from clinical needs to therapeutic challenges.

Intern Emerg Med

September 2024

First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy.

Weight bias and stigma have limited the awareness of the systemic consequences related to obesity. As the narrative evolves, obesity is emerging as a driver and enhancer of many pathological conditions. Among these, the risk of venous thromboembolism (VTE) is a critical concern linked to obesity, ranking as the third most common cardiovascular condition.

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Biomarker-enhanced cardiovascular risk prediction in patients with cancer: a prospective cohort study.

J Thromb Haemost

November 2024

Department of Medicine I, Clinical Division of Haematology and Haemostaseology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria; Department of Internal Medicine, Division of Oncology, Medical University of Graz, Graz, Austria. Electronic address: https://twitter.com/FlorianMoik.

Background: Continuously improving cancer-specific survival puts a growing proportion of cancer patients at risk of major adverse cardiovascular events (MACE), but tailored tools for cardiovascular risk prediction remain unavailable.

Objectives: To assess a broad panel of cardiovascular biomarkers and risk factors for the prediction of MACE and cardiovascular death in cancer patients.

Methods: In total, 2192 patients with newly diagnosed or recurrent cancer were followed prospectively for the occurrence of 2-year MACE and 5-year cardiovascular death.

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Temporal Trends in Takotsubo Syndrome: Results From the International Takotsubo Registry.

J Am Coll Cardiol

September 2024

Department of Cardiology and Internal Medicine B, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany; First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.

Article Synopsis
  • The study investigated changes in demographics, risk factors, clinical presentations, and outcomes of takotsubo syndrome (TTS) patients from 2004 to 2021, using data from the InterTAK registry.
  • Over the years, the proportion of male patients increased, and there was a rise in cases of midventricular TTS as well as significant growth in the incidence of physical triggers.
  • There was also a notable increase in 60-day mortality rates, although no significant change in 1-year mortality when excluding early deaths was observed, indicating a complex evolution of TTS and its management in recent years.
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Article Synopsis
  • Cardiogenic shock (CS) is a major cause of in-hospital deaths after acute coronary syndromes (ACS), with nearly 50% mortality, highlighting the need for personalized risk prediction.
  • The ORBI score, designed to predict in-hospital CS in ACS patients undergoing percutaneous coronary intervention (PCI), has shown varying effectiveness between genders, necessitating improved risk assessment methods.
  • A new score called SEX-SHOCK was developed, incorporating key health indicators, and demonstrated better predictive ability for both sexes compared to the ORBI score, thus advancing risk prediction strategies in ACS management.
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Background And Aims: Circulating proenkephalin (PENK) is a stable endogenous polypeptide with fast response to glomerular dysfunction and tubular damage. This study examined the predictive value of PENK for renal outcomes and mortality in patients with acute coronary syndrome (ACS).

Methods: Proenkephalin was measured in plasma in a prospective multicentre ACS cohort from Switzerland (n = 4787) and in validation cohorts from the UK (n = 1141), Czechia (n = 927), and Germany (n = 220).

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The Need to Identify Novel Markers for Early Renal Injury in Cardiorenal Syndrome.

Cells

July 2024

First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132 Genoa, Italy.

The term "Cardiorenal Syndrome" (CRS) refers to the complex interplay between heart and kidney dysfunction. First described by Robert Bright in 1836, CRS was brought to its modern view by Ronco et al. in 2008, who defined it as one organ's primary dysfunction leading to secondary dysfunction in the other, a view that led to the distinction of five different types depending on the organ of primary dysfunction and the temporal pattern (acute vs.

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Article Synopsis
  • - Takotsubo syndrome (TTS) resembles acute coronary syndrome but is a separate condition that can sometimes lead to serious issues like cardiogenic shock.
  • - Cardiogenic shock occurs in 1-20% of TTS cases and can be caused by multiple factors, such as pump failure and complications in heart function.
  • - Accurate and early identification of the mechanism behind cardiogenic shock is crucial for providing the right treatment and improving patient outcomes in TTS cases.
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Hutchinson-Gilford progeria syndrome mice display accelerated arterial thrombus formation and increased platelet reactivity.

Thromb Res

September 2024

Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland; Department of Research and Education, University Hospital Zurich, Zurich, Switzerland. Electronic address:

Article Synopsis
  • - Hutchinson-Gilford Progeria Syndrome (HGPS) is a rare genetic disorder caused by a mutation in the lamin A gene (LMNA), leading to premature aging and increased risk of cardiovascular events in affected children.
  • - Research using Lmna mutant mice showed that these animals formed blood clots more quickly than normal mice, with higher platelet activation and altered factors involved in blood clotting.
  • - The study suggests that the LMNA mutation contributes to faster thrombus formation due to enhanced platelet reactivity, highlighting the need for further research on antiplatelet treatments for children with HGPS to reduce their risk of cardiovascular complications.
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Plasma levels of myeloperoxidase and resistin independently predict mortality in dialysis patients.

Eur J Intern Med

November 2024

IRCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, 10 Largo Rosanna Benzi, 16132 Genoa, Italy; First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy. Electronic address:

Background: In patients with kidney failure (KF) undergoing dialysis, neutrophils are dysfunctionally activated. Such chronic activation does not correspond to increased protection against infections and is thought to cause direct vascular damage accounting for the higher incidence of cardiovascular (CV) events. We hypothesized that circulating levels of neutrophil degranulation products (i.

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Clonal hematopoiesis, NETosis and arterial thrombosis: A deadly combination.

Int J Cardiol

September 2024

First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascular Network, Genoa, Italy. Electronic address:

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Zinc alpha 2-glycoprotein associates with features of plaque stability in patients with carotid atherosclerosis.

Vascul Pharmacol

September 2024

First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; IRCCS Ospedale Policlinico San Martino Genoa, Italian Cardiovascular Network, 10 Largo Benzi, 16132 Genoa, Italy. Electronic address:

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Aims: Obesity and type 2 diabetes (T2D) are major risk factors for cardiovascular (CV) diseases. Dysregulated pro-apoptotic ceramide synthesis reduces β-cell insulin secretion, thereby promoting hyperglycaemic states that may manifest as T2D. Pro-apoptotic ceramides modulate insulin sensitivity and glucose tolerance while being linked to poor CV outcomes.

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Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9), a factor accelerating the degradation of LDL receptors, was associated with a gender-dependent risk for cardiovascular (CV) events in the general population and with all-cause and CV mortality in two relatively small studies in black Africans and South Korean haemodialysis patients. The effect modification by gender was untested in these studies.

Methods: The study enrolled 1188 dialysis patients from the Prospective Registry of The Working Group of Epidemiology of Dialysis Region Calabria (PROGREDIRE) cohort.

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Cardiac biomarkers for diagnosing Takotsubo syndrome.

Eur Heart J

July 2024

Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.

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Baseline urinary osteopontin levels are associated with the improvement of metabolic syndrome.

Nutr Metab Cardiovasc Dis

August 2024

First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, Genoa, Italy. Electronic address:

Background And Aims: While serum osteopontin (OPN)'s established role in cardiometabolic risk is recognized, its potential as a predictor of metabolic syndrome (MetS) improvement through a urine assay has not yet been demonstrated. In this study, we propose its potential predictive role over a 12-month period of standard care, with the ability to complement anthropometric measures.

Methods And Results: Hierarchical clustering revealed a notable association of urinary OPN (uOPN) with MetS criteria and overcame anthropometric measures in predicting the improvement at 12 months (OR of 2.

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