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Anna Vittoria MATTIOLI

Professore Associato
Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto

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Pubblicazioni

2023 - Cardiovascular prevention in women: an update by the Italian Society of Cardiology working group on 'Prevention, hypertension and peripheral disease' [Articolo su rivista]
Mattioli, Anna Vittoria; Moscucci, Federica; Sciomer, Susanna; Maffei, Silvia; Nasi, Milena; Pinti, Marcello; Bucciarelli, Valentina; Dei Cas, Alessandra; Parati, Gianfranco; Ciccone, Marco Matteo; Palmiero, Pasquale; Maiello, Maria; Pedrinelli, Roberto; Pizzi, Carmine; Barillà, Francesco; Gallina, Sabina
abstract

: The recent pandemic has substantially changed the approach to the prevention of cardiovascular diseases in women. Women have been significantly impacted by the changes that occurred during the pandemic and the quarantine adopted to prevent the spread of the disease. Changes involved prevention both through the reduction of visits and preventive screening and through social and economic changes. It is necessary to adopt new cardiovascular prevention approaches focused on returning to healthy lifestyles, reducing stress and depression also using modern tools such as telemedicine, mobile phone applications and the web. These tools convey messages in a persuasive way especially in young and adult women. There is less impact of these new tools on older women towards whom it is important to adopt a more traditional approach. This review focuses on the new approach to cardiovascular prevention in women in light of the lifestyle changes recorded during the pandemic and which led to an increase in obesity examines the effects on the cardiovascular system induced by stress and depression and analyses the new high blood pressure guidelines and indications that are specific to women.

2023 - Changes in food during the COVID-19 pandemic: The different roles of stress and depression in women and men [Articolo su rivista]
Coppi, Francesca; Farinetti, Alberto; Stefanelli, Claudio; Mattioli, Anna Vittoria
abstract

2023 - Circadian Variations in Sympathetic Vasoconstriction in Older Adults with and Without Type 2 Diabetes [Articolo su rivista]
Gentilin, Alessandro; Moghetti, Paolo; Cevese, Antonio; Mattioli, Anna Vittoria; Schena, Federico; Tarperi, Cantor
abstract

Introduction An impact of the sympathetic nervous system in the higher rate of cardiovascular events in the early morning compared to the evening has been claimed. Augmented sympathetic vasoconstriction increases cardiovascular risk by augmenting pulse pressure and cardiac afterload. Type 2 diabetes (T2DM) further increases sympathetic neurovascular transduction and cardiovascular risk.Aim We assessed whether peripheral vasoconstriction triggered by a standardized sympathetic stressor is augmented at 6am vs 9pm in adults between 50-80 years with type 2 diabetes (T2DM50-80) vs healthy ones (H50-80).Methods Mean values of sympathetic vasoconstrictor responsiveness (SVR), vascular conductance (VC), brachial artery blood flow, and mean arterial pressure were measured on the contralateral forearm over two 5-minute bouts of rest and handgrip-mediated sympathetic stimulation, respectively.Results Although baseline VC values were lower (p < 0.01) in the morning vs evening in both groups, SVR values in response to sympathoexcitation were similar in H50-80 (- 0.43 +/- 12.44 vs - 2.57 +/- 11.63 %, p = 0.73) and T2DM50-80 (+6.64 +/- 10.67 vs +5.21 +/- 7.64 %, p = 0.90), but higher (p < 0.01) in T2DM50-80 vs H50-80 at both day hours. Individuals with T2DM reported positive SVR values and VC change-scores, while healthy individuals reported statistically different (p < 0.02) negative SVR values and VC change-scores.Conclusion Peripheral vasoconstriction triggered by a standardized sympathetic stressor is similar between morning and evening, regardless of T2DM and different baseline VC values. However, peripheral vasoconstriction responsiveness is blunted in individuals with T2DM as handgrip-mediated sympathoexcitation induces vasodilation in the contralateral forearm in adults with T2DM and vasoconstriction in healthy age-matched controls, highlighting a neurovascular response altered by T2DM.

2023 - Circadian and sex differences in post-ischemic vasodilation and reactive hyperemia in young individuals and elderly with and without type 2 diabetes [Articolo su rivista]
Gentilin, Alessandro; Moghetti, Paolo; Cevese, Antonio; Mattioli, Anna Vittoria; Schena, Federico; Tarperi, Cantor
abstract

ObjectiveCardiovascular events show morning preference and sex differences, and are related to aging and type 2 diabetes. We assessed circadian variations and sex differences in vascular conductance (VC) and blood flow (BF) regulations following a brief bout of forearm ischemia. MethodsYoung healthy individuals (H18-30) and elderly without (H50-80) and with type 2 diabetes (T2DM50-80) of both sexes were included. Forearm VC and BF, and mean arterial pressure (MAP) at baseline and following circulatory reperfusion were measured at 6 a.m. and 9 p.m. ResultsIn the morning compared to evening, following reperfusion, the VC and BF increments were similar in H18-30 (p>.71), but lower in H50-80 (p<.001) and T2DM50-80 (p<.01). VC and BF following circulatory reperfusion were higher in men than women in H18-30 (p<.001), but similar between sexes in the older groups (p>.23). ConclusionsForearm vasodilation following reperfusion is attenuated in the morning in the elderly, impairing BF towards an ischemic area. Diabetes does not affect the circadian regulation of VC and BF, but that of MAP. There are sex differences in VC and BF at baseline and after circulatory reperfusion at a young age, being greater in men, which disappear with aging without being affected by diabetes.

2023 - Common iliac artery aneurysm: imaging-guided pathophysiology [Articolo su rivista]
Manenti, Antonio; Roncati, Luca; Farinetti, Alberto; Manco, Gianrocco; Mattioli, Anna Vittoria; Coppi, Francesca
abstract

2023 - Deepening Hemodynamics of Iliac Artery Tortuosity [Articolo su rivista]
Manenti, Antonio; Roncati, Luca; Farinetti, Alberto; Manco, Gianrocco; Mattioli, Anna Vittoria; Coppi, Francesca
abstract

2023 - Diet and Women: A Complex Relationship That We Need to Know Better [Letter] [Articolo su rivista]
Mattioli, A. V.; Gallina, S.
abstract

2023 - Distance Monitoring of Advanced Cancer Patients with Impaired Cardiac and Respiratory Function Assisted at Home: A Study Protocol in Italy [Articolo su rivista]
Ostan, Rita; Varani, Silvia; Giannelli, Andrea; Malavasi, Italo; Pannuti, Francesco; Pannuti, Raffaella; Biasco, Guido; Mattioli, Anna Vittoria; On Behalf Of The Ant Collaborative Group, Null
abstract

: During the pandemic, telemedicine and telehealth interventions have been leading in maintaining the continuity of care independently of patients' physical location. However, the evidence available about the effectiveness of the telehealth approach for advanced cancer patients with chronic disease is limited. This interventional randomized pilot study aims to evaluate the acceptability of a daily telemonitoring of five vital parameters (heart rate, respiratory rate, blood oxygenation, blood pressure, and body temperature) using a medical device in advanced cancer patients with relevant cardiovascular and respiratory comorbidities assisted at home. The purpose of the current paper is to describe the design of the telemonitoring intervention in a home palliative and supportive care setting with the objective of optimizing the management of patients, improving both their quality of life and psychological status and the caregiver's perceived care burden. This study may improve scientific knowledge regarding the impact of telemonitoring. Moreover, this intervention could foster continuous healthcare delivery and closer communication among the physician, patient and family, enabling the physician to have an updated overview of the clinical trajectory of the disease. Finally, the study may help family caregivers to maintain their habits and professional position and to limit financial consequences.

2023 - Editorial: Women in cardiovascular imaging [Articolo su rivista]
Mattioli, A. V.; Doltra, A.; Prieto, C.; Gallina, S.
abstract

2023 - Impact of COVID-19 on the cardiovascular health of women: A review by the Italian Society of Cardiology Working Group on 'gender cardiovascular diseases' [Articolo su rivista]
Moscucci, F.; Gallina, S.; Bucciarelli, V.; Aimo, A.; Pelà, G.; Cadeddu-Dessalvi, C.; Nodari, S.; Maffei, S.; Meloni, A.; Deidda, M.; Mercuro, G.; Pedrinelli, R.; Penco, M.; Sciomer, S.; Mattioli, A. V.
abstract

The coronavirus disease 19 (COVID-19), due to coronavirus 2 (SARS-CoV-2) infection, presents with an extremely heterogeneous spectrum of symptoms and signs. COVID-19 susceptibility and mortality show a significant sex imbalance, with men being more prone to infection and showing a higher rate of hospitalization and mortality than women. In particular, cardiovascular diseases (preexistent or arising upon infection) play a central role in COVID-19 outcomes, differently in men and women. This review will discuss the potential mechanisms accounting for sex/gender influence in vulnerability to COVID-19. Such variability can be ascribed to both sex-related biological factors and sex-related behavioural traits. Sex differences in cardiovascular disease and COVID-19 involve the endothelial dysfunction, the innate immune system and the renin-angiotensin system (RAS). Furthermore, the angiotensin-converting enzyme 2 (ACE2) is involved in disease pathogenesis in cardiovascular disease and COVID-19 and it shows hormone-dependent actions. The incidence of myocardial injury during COVID-19 is sex-dependent, predominantly in association with a greater degree of inflammation and coagulation disorders among men. Its pathogenesis is not fully elucidated, but the main theories foresee a direct role for the ACE2 receptor, the hyperimmune response and the RAS imbalance, which may also lead to isolated presentation of COVID-19-mediated myopericarditis. Moreover, the latest evidence on cardiovascular diseases and their relationship with COVID-19 during pregnancy will be discussed. Finally, authors will analyse the prevalence of the long-covid syndrome between the two sexes and its impact on the quality of life and cardiovascular health.

2023 - Labile plasma iron and echocardiographic parameters are associated to cardiac events in beta-thalassemic patients [Articolo su rivista]
Ferrara, F; Coppi, F; Riva, R; Ventura, P; Ricci, A; Mattioli, Av; Talarico, M; Garuti, C; Bevini, M; Rochira, V; Buzzetti, E; Pietrangelo, A; Corradini, E
abstract

Background and aim: Notwithstanding the improvement in therapies, patients affected by thalassemia major (TM) and intermedia (TI) are still at high risk of cardiac complications. This study aimed at evaluating the incidence and predictive factors for developing cardiac events in adult β-TM and TI patients. Population andmethods: Data on diagnosis and clinical historywere collected retrospectively; prospective data on new-onset cardiac failure and arrhythmias, echocardiographic parameters, biochemical variables including non-transferrin-bound iron (NTBI) and labile plasma iron (LPI), magnetic resonance imaging (MRI) T2* measurement of hepatic and cardiac iron deposits, and iron chelation therapy were recorded during a 6 year follow-up. Results: Thirty-seven patients, 29 TM and 8 TI, were included. At baseline, 8 TM patients and 1 TI patient had previously experienced a cardiac event (mainly heart failure). All patients were on chelation therapy and only 3 TM patients had mild-to-severe cardiac siderosis. During follow-up, 11 patients (29.7%) experienced a new cardiac event. The occurrence of cardiac events was correlated to high LPI levels (OR 12.0, 95% CI 1.56-92.3, p 0.017), low mean pre-transfusion hemoglobin (OR 0.21, 95% C.I. 0.051-0.761, p 0.21), and echocardiographic parameters suggestive of myocardial hypertrophy. Multivariate analysis disclosed high LPI and left ventricle mass index (LVMI) as independent variables significantly associated with cardiac events. Cardiac iron deposits measured by MRI T2* failed to predict cardiac events. Conclusion: LPI, Hb levels, and echocardiographic parameters assessing cardiac remodeling are associated to cardiac events in adult TM and TI patients. LPI might represent both a prognostic marker and a potential target for novel treatment strategies. Further studies are warranted to confirm our findings on larger populations

2023 - Mitochondrial DNA as inflammatory DAMP: a warning of an aging immune system? [Articolo su rivista]
Zanini, Giada; Selleri, Valentina; Lopez Domenech, Sandra; Malerba, Mara; Nasi, Milena; Mattioli, Anna Vittoria; Pinti, Marcello
abstract

Senescence of the immune system is characterized by a state of chronic, subclinical, low-grade inflammation termed 'inflammaging', with increased levels of proinflammatory cytokines, both at the tissue and systemic levels. Age-related inflammation can be mainly driven by self-molecules with immunostimulant properties, named Damage/death Associated Molecular Patterns (DAMPs), released by dead, dying, injured cells or aged cells. Mitochondria are an important source of DAMPs, including mitochondrial DNA - the small, circular, double-stranded DNA molecule found in multiple copies in the organelle. mtDNA can be sensed by at least three molecules: the Toll-like receptor 9, the NLRP3 inflammasomes, and the cyclic GMP-AMP synthase (cGAS). All these sensors can lead to the release of proinflammatory cytokines when engaged. The release of mtDNA by damaged or necrotic cells has been observed in several pathological conditions, often aggravating the course of the disease. Several lines of evidence indicate that the impairment of mtDNA quality control and of the organelle homeostasis associated with aging determines an increase in the leakage of mtDNA from the organelle to the cytosol, from the cell to the extracellular space, and into plasma. This phenomenon, mirrored by an increase in mtDNA circulating levels in elderly people, can lead to the activation of different innate immune cell types, sustaining the chronic inflammatory status that is characteristic of aging.

2023 - Monitoring Caffeine Intake: The Relevance of Adequate Assessment in the Population [Articolo su rivista]
Mattioli, Anna Vittoria; Manenti, Antonio; Farinetti, Alberto
abstract

: The present letter to editor comments on the manuscript "Bulczak EM, Chmurzyńska AU. Caffeine Consumption in Polish Adults: Development and Validation of a Polish Questionnaire for Assessing Caffeine Intake. J Am Nutr Assoc. 2023 Feb 1:1-7. doi:10.1080/27697061.2023.2172749. Epub ahead of print. PMID: 36725370." regarding adequate monitoring of the consumption of caffeine.

2023 - Myocardial infarction with nonobstructive coronary arteries: from pathophysiology to therapeutic strategies [Articolo su rivista]
Foà, Alberto; Canton, Lisa; Bodega, Francesca; Bergamaschi, Luca; Paolisso, Pasquale; De Vita, Antonio; Villano, Angelo; Mattioli, Anna Vittoria; Tritto, Isabella; Morrone, Doralisa; Lanza, Gaetano Antonio; Pizzi, Carmine
abstract

: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a heterogeneous group of clinical entities characterized by clinical evidence of acute myocardial infarction (AMI) with normal or near-normal coronary arteries on coronary angiography (stenosis < 50%) and without an over the alternative diagnosis for the acute presentation. Its prevalence ranges from 6% to 11% among all patients with AMI, with a predominance of young, nonwhite females with fewer traditional risks than those with an obstructive coronary artery disease (MI-CAD). MINOCA can be due to either epicardial causes such as rupture or fissuring of unstable nonobstructive atherosclerotic plaque, coronary artery spasm, spontaneous coronary dissection and cardioembolism in-situ or microvascular causes. Besides, also type-2 AMI due to supply-demand mismatch and Takotsubo syndrome must be considered as a possible MINOCA cause. Because of the complex etiology and a limited amount of evidence, there is still some confusion around the management and treatment of these patients. Therefore, the key focus of this condition is to identify the underlying individual mechanisms to achieve patient-specific treatments. Clinical history, electrocardiogram, echocardiography, and coronary angiography represent the first-level diagnostic investigations, but coronary imaging with intravascular ultrasound and optical coherent tomography, coronary physiology testing, and cardiac magnetic resonance imaging offer additional information to understand the underlying cause of MINOCA. Although the prognosis is slightly better compared with MI-CAD patients, MINOCA is not always benign and depends on the etiopathology. This review analyzes all possible pathophysiological mechanisms that could lead to MINOCA and provides the most specific and appropriate therapeutic approach in each scenario.

2023 - Prognostic immune markers identifying patients with severe COVID-19 who respond to tocilizumab [Articolo su rivista]
DE BIASI, Sara; Mattioli, Marco; Meschiari, Marianna; LO TARTARO, Domenico; Paolini, Annamaria; Borella, Rebecca; Neroni, Anita; Fidanza, LUCIA MICHELA PIA; Busani, Stefano; Girardis, Massimo; Coppi, Francesca; Mattioli, Anna Vittoria; Guaraldi, Giovanni; Mussini, Cristina; Cossarizza, Andrea; Gibellini, Lara
abstract

Introduction: A growing number of evidences suggest that the combination of hyperinflammation, dysregulated T and B cell response and cytokine storm play a major role in the immunopathogenesis of severe COVID-19. IL-6 is one of the main pro-inflammatory cytokines and its levels are increased during SARS-CoV-2 infection. Several observational and randomized studies demonstrated that tocilizumab, an IL-6R blocker, improves survival in critically ill patients both in infectious disease and intensive care units. However, despite transforming the treatment options for COVID-19, IL-6R inhibition is still ineffective in a fraction of patients. Methods: In the present study, we investigated the impact of two doses of tocilizumab in patients with severe COVID-19 who responded or not to the treatment by analyzing a panel of cytokines, chemokines and other soluble factors, along with the composition of peripheral immune cells, paying a particular attention to T and B lymphocytes. Results: We observed that, in comparison with non-responders, those who responded to tocilizumab had different levels of several cytokines and different T and B cells proportions before starting therapy. Moreover, in these patients, tocilizumab was further able to modify the landscape of the aforementioned soluble molecules and cellular markers. Conclusions: We found that tocilizumab has pleiotropic effects and that clinical response to this drug remain heterogenous. Our data suggest that it is possible to identify patients who will respond to treatment and that the administration of tocilizumab is able to restore the immune balance through the re-establishment of different cell populations affected by SARS-COV-2 infection, highlighting the importance of temporal examination of the pathological features from the diagnosis.

2023 - Reply to: Letter on the Recent Paper "Vascular 'Long COVID': A New Vessel Disease?" [Articolo su rivista]
Zanini, Giada; Selleri, Valentina; Roncati, Luca; Coppi, Francesca; Nasi, Milena; Farinetti, Alberto; Manenti, Antonio; Pinti, Marcello; Mattioli, Anna Vittoria
abstract

2023 - Sex Differences in Heart Failure: What Do We Know? [Articolo su rivista]
Arata, Allegra; Ricci, Fabrizio; Khanji, Mohammed Y; Mantini, Cesare; Angeli, Francesco; Aquilani, Roberta; Di Baldassarre, Angela; Renda, Giulia; Mattioli, Anna Vittoria; Nodari, Savina; Gallina, Sabina
abstract

: Heart failure (HF) remains an important global health issue, substantially contributing to morbidity and mortality. According to epidemiological studies, men and women face nearly equivalent lifetime risks for HF. However, their experiences diverge significantly when it comes to HF subtypes: men tend to develop HF with reduced ejection fraction more frequently, whereas women are predominantly affected by HF with preserved ejection fraction. This divergence underlines the presence of numerous sex-based disparities across various facets of HF, encompassing aspects such as risk factors, clinical presentation, underlying pathophysiology, and response to therapy. Despite these apparent discrepancies, our understanding of them is far from complete, with key knowledge gaps still existing. Current guidelines from various professional societies acknowledge the existence of sex-based differences in HF management, yet they are lacking in providing explicit, actionable recommendations tailored to these differences. In this comprehensive review, we delve deeper into these sex-specific differences within the context of HF, critically examining associated definitions, risk factors, and therapeutic strategies. We provide a specific emphasis on aspects exclusive to women, such as the impact of pregnancy-induced hypertension and premature menopause, as these unique factors warrant greater attention in the broader HF discussion. Additionally, we aim to clarify ongoing controversies and knowledge gaps pertaining to the pharmacological treatment of HF and the sex-specific indications for cardiac implantable electronic devices. By shining a light on these issues, we hope to stimulate a more nuanced understanding and promote the development of more sex-responsive approaches in HF management.

2023 - Sex Differences in Repolarization Markers: Telemonitoring for Chronic Heart Failure Patients [Articolo su rivista]
Moscucci, Federica; Sciomer, Susanna; Maffei, Silvia; Meloni, Antonella; Lospinuso, Ilaria; Carnovale, Myriam; Corrao, Andrea; Di Diego, Ilaria; Caltabiano, Cristina; Mezzadri, Martina; Mattioli, Anna Vittoria; Gallina, Sabina; Rossi, Pietro; Magrì, Damiano; Piccirillo, Gianfranco
abstract

Unlabelled: Aging and chronic heart failure (CHF) are responsible for the temporal inhomogeneity of the electrocardiogram (ECG) repolarization phase. Recently, some short period repolarization-dispersion parameters have been proposed as markers of acute decompensation and of mortality risk in CHF patients. Some important differences in repolarization between sexes are known, but their impact on ECG markers remains unstudied. The aim of this study was to evaluate possible differences between men and women in ECG repolarization markers for the telemonitoring of CHF patients. Method: 5 min ECG recordings were collected to assess the mean and standard deviation (SD) of the following variables: QT end (QTe), QT peak (QTp), and T peak to T end (Te) in 215 decompensated CHF (age range: from 49 to 103 years). Thirty-day mortality and high levels of NT-pro BNP (<75 percentile) were considered markers of decompensated CHF. Results: A total of 34 patients (16%) died during the 30-day follow-up, without differences between sexes. Women showed a more preserved ejection fraction and higher LDL and total cholesterol levels. Among female patients, implantable cardioverter devices, statins, and antiplatelet agents were less used. Data for Te mean showed increased values among deceased men and women compared to survival, but TeSD was shown to be the most reliable marker for CHF reacutization in both sexes. Conclusion: TeSD could be considered a risk factor for CHF worsening and complications for female and male patients, but different cut offs should be taken into account. (ClinicalTrials.gov number, NCT04127162.).

2023 - The Impact of Physical Activity and Inactivity on Cardiovascular Risk across Women's Lifespan: An Updated Review [Articolo su rivista]
Bucciarelli, Valentina; Mattioli, Anna Vittoria; Sciomer, Susanna; Moscucci, Federica; Renda, Giulia; Gallina, Sabina
abstract

Physical inactivity (PI) represents a significant, modifiable risk factor that is more frequent and severe in the female population worldwide for all age groups. The physical activity (PA) gender gap begins early in life and leads to considerable short-term and long-term adverse effects on health outcomes, especially cardiovascular (CV) health. Our review aims to highlight the prevalence and mechanisms of PI across women's lifespan, describing the beneficial effects of PA in many physiological and pathological clinical scenarios and underlining the need for more awareness and global commitment to promote strategies to bridge the PA gender gap and limit PI in current and future female generations.

2023 - The Role of Congestion Biomarkers in Heart Failure with Reduced Ejection Fraction [Articolo su rivista]
Correale, Michele; Fioretti, Francesco; Tricarico, Lucia; Croella, Francesca; Brunetti, Natale Daniele; Inciardi, Riccardo M; Mattioli, Anna Vittoria; Nodari, Savina
abstract

: In heart failure with reduced ejection fraction, edema and congestion are related to reduced cardiac function. Edema and congestion are further aggravated by chronic kidney failure and pulmonary abnormalities. Furthermore, together with edema/congestion, sodium/water retention is an important sign of the progression of heart failure. Edema/congestion often anticipates clinical symptoms, such as dyspnea and hospitalization; it is associated with a reduced quality of life and a major risk of mortality. It is very important for clinicians to predict the signs of congestion with biomarkers and, mainly, to understand the pathophysiological findings that underlie edema. Not all congestions are secondary to heart failure, as in nephrotic syndrome. This review summarizes the principal evidence on the possible roles of the old and new congestion biomarkers in HFrEF patients (diagnostic, prognostic, and therapeutic roles). Furthermore, we provide a description of conditions other than congestion with increased congestion biomarkers, in order to aid in reaching a differential diagnosis. To conclude, the review focuses on how congestion biomarkers may be affected by new HF drugs (gliflozins, vericiguat, etc.) approved for HFrEF.

2023 - Vascular "Long COVID": A New Vessel Disease? [Articolo su rivista]
Zanini, Giada; Selleri, Valentina; Roncati, Luca; Coppi, Francesca; Nasi, Milena; Farinetti, Alberto; Manenti, Antonio; Pinti, Marcello; Mattioli, Anna Vittoria
abstract

: Vascular sequelae following (SARS-CoV-2 coronavirus disease) (COVID)-19 infection are considered as "Long Covid (LC)" disease, when occurring 12 weeks after the original infection. The paucity of specific data can be obviated by translating pathophysiological elements from the original Severe Acute Respiratory Syndrome-Corona Virus (SARS-CoV-2) infection (In a microcirculatory system, a first "endotheliitis," is often followed by production of "Neutrophil Extracellular Trap," and can evolve into a more complex leukocytoklastic-like and hyperimmune vasculitis. In medium/large-sized vessels, this corresponds to endothelial dysfunction, leading to an accelerated progression of pre-existing atherosclerotic plaques through an increased deposition of platelets, circulating inflammatory cells and proteins. Associated dysregulated immune and pro-coagulant conditions can directly cause thrombo-embolic arterial or venous complications. In order to implement appropriate treatment, physicians need to consider vascular pathologies observed after SARS-Cov-2 infections as possible "LC" disease.

2022 - Adherence to an adapted physical activity program in sedentary adults [Articolo su rivista]
Maffei, Francesca; Nasi, Milena; Natalia Vittori, Leydi; Bragonzoni, Laura; Toselli, Stefania; Tripi, Ferdinando; Mattioli, Anna Vittoria; Maietta-Latessa, Pasqualino
abstract

Background/Objective. Physical exercise plays a key role in the prevention and prognosis of chronic diseases. Despite this evidence, a low percentage of patients regularly perform physical activity. A better understanding of the variables associated with poor adherence may help to develop some strategies to encourage people to participate in exercise interventions. This study investigated the factors influencing adherence to an Adapted Physical Activity (APA) program in subjects suffering from Acute Coronary Syndrome (ACS) clinically stable, Type 2 diabetes, or metabolic syndrome. Secondary end point was to test the efficacy of the exercise training on fitness parameters (VO2, Speed and Time) by 1 km tes

2022 - Aortoaortic bypass pathophysiology [Articolo su rivista]
Manenti, A.; Roncati, L.; Farinetti, A.; Manco, G.; Mattioli, A. V.
abstract

2022 - Cardiovascular Effects of Whole-Body Cryotherapy in Non-professional Athletes [Articolo su rivista]
Coppi, Francesca; Pinti, Marcello; Selleri, Valentina; Zanini, Giada; D'Alisera, Roberta; Latessa, Pasqualino Maietta; Tripi, Ferdinando; Savino, Gustavo; Cossarizza, Andrea; Nasi, Milena; Mattioli, Anna Vittoria
abstract

2022 - Cardiovascular Risk Perception and Knowledge among Italian Women: Lessons from IGENDA Protocol [Articolo su rivista]
Maffei, Silvia; Meloni, Antonella; Deidda, Martino; Sciomer, Susanna; Cugusi, Lucia; Cadeddu, Christian; Gallina, Sabina; Franchini, Michela; Scambia, Giovanni; Mattioli, Anna Vittoria; Surico, Nicola; Mercuro, Giuseppe
abstract

2022 - Changed pathophysiology of thoracic aorta after aortic arch repair [Articolo su rivista]
Farinetti, A.; Roncati, L.; Manco, G.; Manenti, A.; Mattioli, A. V.
abstract

2022 - Circadian and sex differences in carotid-femoral pulse wave velocity in young individuals and elderly with and without type 2 diabetes [Articolo su rivista]
Gentilin, Alessandro; Moghetti, Paolo; Cevese, Antonio; Mattioli, Anna Vittoria; Schena, Federico; Tarperi, Cantor
abstract

The incidence of cardiovascular events is higher in the morning than in the evening and differs between sexes. We tested the hypothesis that aortic stiffness, a compelling cardiovascular risk factor, increases in the morning than in the evening in young, healthy individuals between 18 and 30 years (H18-30) or in older individuals between 50 and 80 years, either healthy (H50-80) or with type 2 diabetes (T2DM50-80). Sex differences were also investigated. Carotid-femoral pulse wave velocity (cf-PWV) recorded via Doppler Ultrasound, blood pressure and heart rate were checked at 6 a.m. and 9 p.m., at rest and during acute sympathetic activation triggered by handgrip exercise. Cf-PWV values were lower in the morning compared to the evening in all groups (p < 0.01) at rest and lower (p = 0.008) in H18-30 but similar (p > 0.267) in the older groups during sympathetic activation. At rest, cf-PWV values were lower in young women compared to young men (p = 0.001); however, this trend was reversed in the older groups (p < 0.04). During sympathetic activation, the cf-PWV was lower in women in H18-30 (p = 0.001), similar between sexes in H50-80 (p = 0.122), and higher in women in T2DM50-80 (p = 0.004). These data do not support the hypothesis that aortic stiffness increases in the morning compared to the evening within any of the considered groups in both rest and sympathetic activation conditions. There are differences between the sexes, which vary according to age and diabetes status. In particular, aortic stiffness is higher in older women than in men with diabetes during acute stress.

2022 - Coffee consumption effects on bioelectrical impedance parameters: does gender matter? [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

2022 - Development and Validation of a Diagnostic Echocardiographic Mass Score in the Approach to Cardiac Masses [Articolo su rivista]
Paolisso, Pasquale; Foà, Alberto; Magnani, Ilenia; Bergamaschi, Luca; Graziosi, Maddalena; Angeli, Francesco; Chiti, Chiara; Fabrizio, Michele; Rinaldi, Andrea; Stefanizzi, Andrea; Armillotta, Matteo; Sansonetti, Angelo; Gallinoro, Emanuele; Maietti, Elisa; Rucci, Paola; Biagini, Elena; Mattioli, Anna Vittoria; Galiè, Nazzareno; Pizzi, Carmine
abstract

2022 - Differential Expression of Lonp1 Isoforms in Cancer Cells [Articolo su rivista]
Zanini, Giada; Selleri, Valentina; De Gaetano, Anna; Gibellini, Lara; Malerba, Mara; Mattioli, Anna Vittoria; Nasi, Milena; Apostolova, Nadezda; Pinti, Marcello
abstract

Lonp1 is a mitochondrial protease that degrades oxidized and damaged proteins, assists protein folding, and contributes to the maintenance of mitochondrial DNA. A higher expression of LonP1 has been associated with higher tumour aggressiveness. Besides the full-length isoform (ISO1), we identified two other isoforms of Lonp1 in humans, resulting from alternative splicing: Isoform-2 (ISO2) lacking aa 42-105 and isoform-3 (ISO3) lacking aa 1-196. An inspection of the public database TSVdb showed that ISO1 was upregulated in lung, bladder, prostate, and breast cancer, ISO2 in all the cancers analysed (including rectum, colon, cervical, bladder, prostate, breast, head, and neck), ISO3 did not show significant changes between cancer and normal tissue. We overexpressed ISO1, ISO2, and ISO3 in SW620 cells and found that the ISO1 isoform was exclusively mitochondrial, ISO2 was present in the organelle and in the cytoplasm, and ISO3 was exclusively cytoplasmatic. The overexpression of ISO1 and, at a letter extent, of ISO2 enhanced basal, ATP-linked, and maximal respiration without altering the mitochondria number or network, mtDNA amount. or mitochondrial dynamics. A higher extracellular acidification rate was observed in ISO1 and ISO2, overexpressing cells, suggesting an increase in glycolysis. Cells overexpressing the different isoforms did not show a difference in the proliferation rate but showed a great increase in anchorage-independent growth. ISO1 and ISO2, but not ISO3, determined an upregulation of EMT-related proteins, which appeared unrelated to higher mitochondrial ROS production, nor due to the activation of the MEK ERK pathway, but rather to global metabolic reprogramming of cells.

2022 - Do the Current Guidelines for Heart Failure Diagnosis and Treatment Fit with Clinical Complexity? [Articolo su rivista]
Severino, P.; D'Amato, A.; Prosperi, S.; Dei Cas, A.; Mattioli, A. V.; Cevese, A.; Novo, G.; Prat, M.; Pedrinelli, R.; Raddino, R.; Gallina, S.; Schena, F.; Poggesi, C.; Pagliaro, P.; Mancone, M.; Fedele, F.
abstract

Heart failure (HF) is a clinical syndrome defined by specific symptoms and signs due to structural and/or functional heart abnormalities, which lead to inadequate cardiac output and/or increased intraventricular filling pressure. Importantly, HF becomes progressively a multisystemic disease. However, in August 2021, the European Society of Cardiology published the new Guidelines for the diagnosis and treatment of acute and chronic HF, according to which the left ventricular ejection fraction (LVEF) continues to represent the pivotal parameter for HF patients’ evaluation, risk stratification and therapeutic management despite its limitations are well known. Indeed, HF has a complex pathophysiology because it first involves the heart, progressively becoming a multisystemic disease, leading to multiorgan failure and death. In these terms, HF is comparable to cancer. As for cancer, surviving, morbidity and hospitalisation are related not only to the primary neoplastic mass but mainly to the metastatic involvement. In HF, multiorgan involvement has a great impact on prognosis, and multiorgan protective therapies are equally important as conventional cardioprotective therapies. In the light of these considerations, a revision of the HF concept is needed, starting from its definition up to its therapy, to overcome the old and simplistic HF perspective.

2022 - Effects of Energy Drink Acute Assumption in Gastrointestinal Tract of Rats [Articolo su rivista]
Nasi, Milena; De Gaetano, Anna; Carnevale, Gianluca; Bertoni, Laura; Selleri, Valentina; Zanini, Giada; Pisciotta, Alessandra; Caramaschi, Stefania; Reggiani Bonetti, Luca; Farinetti, Alberto; Cossarizza, Andrea; Pinti, Marcello; Manenti, Antonio; Mattioli, Anna Vittoria
abstract

...

2022 - Energy drink consumption in young subjects: a growing problem [Articolo su rivista]
Mattioli, A. V.; Manenti, A.; Farinetti, A.
abstract

2022 - Energy drinks and heart damage in young people [Articolo su rivista]
Mattioli, A. V.; Manenti, A.; Farinetti, A.
abstract

2022 - Estimation of carotid-femoral pulse wave velocity from finger photoplethysmography signal [Articolo su rivista]
Gentilin, Alessandro; Tarperi, Cantor; Cevese, Antonio; Mattioli, Anna Vittoria; Schena, Federico
abstract

Objective. This project compared a new method to estimate the carotid-femoral pulse wave velocity (cf-PWV) to the gold-standard cf-PWV technique.Approach. The cf-PWV was estimated from the pulse transit time (FPS-PTT) calculated by processing the finger photoplethysmographic signal of Finapres (FPS) and subject's height only (brief mode) as well as along with other variables (age, heart rate, arterial pressure, weight; complete mode). Doppler ultrasound cf-PWVs and FPS-PTTs were measured in 90 participants equally divided into 3 groups (18-30; 31-59; 60-79 years). Predictions were performed using multiple linear regressions (MLR) and with the best regression model identified by using MATLAB Regression Learner App. A validation set approach (60 training datasets, 30 testing datasets; VSA) and leave-one-out cross-validation (LOOCV) were used.Main results. With MLR, the discrepancies were: 0.01 ± 1.21 m s-1(VSA) and 0.001 ± 1.11 m s-1(LOOCV) in brief mode; -0.02 ± 0.83 m s-1(VSA) and 0.001 ± 0.84 m s-1(LOOCV) in complete mode. Using a linear support vector machine model (SVM) in brief mode, the discrepancies were: 0.01 ± 1.19 m s-1(VSA) and -0.01 ± 1.06 m s-1(LOOCV). Using an Exponential Gaussian process regression model (GPR) in complete mode, the discrepancies were: -0.03 ± 0.79 m s-1(VSA) and 0.01 ± 0.75 m s-1(LOOCV).Significance. The cf-PWV can be estimated by processing the FPS-PTT and subjects' height only, but the inclusion of other variables improves the prediction performance. Predictions through MLR qualify as acceptable in both brief and complete modes. Predictions via linear SVM in brief mode improve but still qualify as acceptable. Interestingly, predictions through Exponential GPR in complete mode improve and qualify as excellent.

2022 - From coronavirus disease 2019 to long coronavirus disease 2019 in vascular pathology [Articolo su rivista]
Farinetti, Alberto; Manenti, Antonio; Manco, Gianrocco; Roncati, Luca; Coppi, Francesca; Mattioli, Anna Vittoria
abstract

2022 - Impact of the COVID-19 pandemic on dental hygiene students in the Italian region of Emilia-Romagna [Articolo su rivista]
Bellini, P.; Iani, C.; Zucchelli, G.; Franchi, M.; Mattioli, A. V.; Consolo, U.
abstract

BACKGROUND: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new coronavirus detected in China at the end of 2019. Because SARS-CoV-2 is highly infectious due to contamination in the air, there is a high risk of infection in the dental environment which is represents a serious problem for professionals and students (dentistry and dental hygiene). In Italy, since February 23, 2020, the government has suspended all teaching activities of schools and universities. METHODS: An anonymous questionnaire was administered to the students of the degree courses in Dental Hygiene of the Emilia Romagna Region, one of the most affected regions in Italy. The survey was intended to highlight the practical and emotional consequences of the emergency of COVID-19 on educational activities and in the training of students. RESULTS: The survey was sent to the 150 students enrolled in the universities of Bologna, Ferrara and Modena and Reggio Emilia; 141 of them completed it (94%). Since the start of the COVID-19 pandemic, several surveys have been proposed to measure the impact of this emergency situation on dental professionals; at present, however, there are still no assessments for dental hygiene degree courses, in particular aimed at assessing the psychological impact on students. CONCLUSIONS: Students consider the dental hygienist as a risky profession, while the risk taken by patients is considered as low. Given the concern reported the students, it would be useful to address the issue of proper assessment of risk during the university training of dental hygienists.

2022 - Innate immunity changes in soccer players after whole-body cryotherapy [Articolo su rivista]
Selleri, Valentina; Mattioli, Marco; Lo Tartaro, Domenico; Paolini, Annamaria; Zanini, Giada; De Gaetano, Anna; D'Alisera, Roberta; Roli, Laura; Melegari, Alessandra; Maietta, Pasqualino; Tripi, Ferdinando; Guerra, Emanuele; Chester, Johanna; Savino, Gustavo; Trenti, Tommaso; Cossarizza, Andrea; Mattioli, Anna Vittoria; Pinti, Marcello; Nasi, Milena
abstract

Whole-body cryotherapy (WBC) consists of short exposure (up to 2-3 min) to dry air at cryogenic temperatures (up to -190 degrees C) and has recently been applied for muscle recovery after injury to reduce the inflammation process. We aimed to determine the impact of cryotherapy on immunological, hormonal, and metabolic responses in non-professional soccer players (NPSPs). Nine male NPSPs (age: 20 +/- 2 years) who trained regularly over 5 consecutive days, immediately before and after each training session, were subjected to WBC treatment (WBC-t). Blood samples were collected for the evaluation of fifty analytes including hematologic parameters, serum chemistry, and hormone profiles. Monocytes phenotyping (Mo) was performed and plasmatic markers, usually increased during inflammation [CCL2, IL-18, free mitochondrial (mt)DNA] or with anti-inflammatory effects (IL2RA, IL1RN), were quantified. After WBC-t, we observed reduced levels of ferritin, mean corpuscular hemoglobin, mean platelet volume, testosterone, and estradiol, which however remain within the normal ranges. The percentage of the total, intermediates and non-classical Mo increased, while classical Mo decreased. CXCR4 expression decreased in each Mo subset. Plasma IL18 and IL2RA levels decreased, while IL1RN only exhibited a tendency to decrease and CCL2 showed a tendency to increase. Circulating mtDNA levels were not altered following WBC-t. The differences observed in monocyte subsets after WBC-t may be attributable to their redistribution into the surrounding tissue. Moreover, the decrease of CXCR4 in Mo subpopulations could be coherent with their differentiation process. Thus, WBC through yet unknown mechanisms could promote their differentiation having a role in tissue repair.

2022 - Insegnare le differenze di genere alla facoltà di medicina: uno strumento per migliorare la sicurezza e l'efficacia della prescrizione dell’attività fisica personalizzata [Articolo su rivista]
Pinti, Marcello; Mattioli, Anna Vittoria; Nasi, Milena; Selleri, Valentina; Palumbo, Carla
abstract

ender medicine is defined by the World Health Organization (WHO) as the study of the influence of biological differences, defined by sex, and socioeconomic and cultural differences, defined by gender, on each person's health and disease status. Since gender bias is still strongly present and entrenched in medicine, recent studies indicate how crucial the teaching of gender medicine is in the training of doctors and health professionals to create not only a positive learning environment, but also a more equitable and organized healthcare system. Therefore, the aim of the following article is to highlight the importance of systematic teaching of gender medicine to improve the safety and effectiveness of prescribing personalized physical activity and sports.

2022 - Inside hemodynamics of bifurcated aortic graft [Articolo su rivista]
Manenti, Antonio; Farinetti, Alberto; Manco, Gianrocco; Mattioli, Anna Vittoria; Coppi, Francesca
abstract

2022 - Intraluminal thrombus and abdominal aortic aneurysm complications [Articolo su rivista]
Manenti, Antonio; Farinetti, Alberto; Manco, Gianrocco; Mattioli, Anna Vittoria
abstract

2022 - Lifestyle changes during the first and second waves of the COVID-19 pandemic in medical college students: are there gender-related differences? [Articolo su rivista]
Coppi, Francesca; Nasi, Milena; Sabatini, Silvia; Bellini, Pierantonio; Generali, Luigi; Mecugni, Daniela; Farinetti, Alberto; Consolo, Ugo; Mattioli, Anna Vittoria
abstract

Background and aims: The COVID-19 pandemic has seriously affected young people. The present study aims to explore the effects of COVID-19 on lifestyle in 500 undergraduate students both during the acute phase of the pandemic (so-called “first wave”) and during the second spread of infections (so-called “second wave”). Gender differences were also explored. Methods and results: During the first wave we found weight gain in 48.6% of subjects, a switch to an unhealthy diet (43%), and an increase in the amount of food introduced (35%). Interestingly, women showed higher intake of food in order to cope, while men privileged higher wine consumption as a coping mechanism. We observed a sharp reduction in physical activity, increased sedentary behaviours and deterioration in sleep quality. Stress correlates with eating to cope (r=0.86; p<0.001); drinking to cope (r=0.83; p<0.001). Contrary to expectations, the second wave led to a situation similar to the first. We have detected a further deterioration in quality of sleep (67% vs 77%; p<0.01) and also a reduction in sleeping time (68.6% vs 77.7; p<0.01). Conclusions: The long pandemic has led to unhealthy lifestyle changes in the student population of our municipality in Northern Italy. There are gender differences in lifestyle modifications developed during the pandemic that suggest a different response to stress. Moreover, the persistence of pandemic-related stress due to the “second wave” has severely affected the lifestyle habits of undergraduate student. (www.actabiomedica.it)

2022 - Long COVID: A New Challenge for Prevention of Obesity in Women [Articolo su rivista]
Mattioli, A. V.; Coppi, F.; Nasi, M.; Pinti, M.; Gallina, S.
abstract

2022 - Molecular and cellular immune features of aged patients with severe COVID-19 pneumonia [Articolo su rivista]
Lo Tartaro, D.; Neroni, A.; Paolini, A.; Borella, R.; Mattioli, M.; Fidanza, L.; Quong, A.; Petes, C.; Awong, G.; Douglas, S.; Lin, D.; Nieto, J.; Gozzi, L.; Franceschini, E.; Busani, S.; Nasi, M.; Mattioli, A. V.; Trenti, T.; Meschiari, M.; Guaraldi, G.; Girardis, M.; Mussini, C.; Gibellini, L.; Cossarizza, A.; De Biasi, S.
abstract

Aging is a major risk factor for developing severe COVID-19, but few detailed data are available concerning immunological changes after infection in aged individuals. Here we describe main immune characteristics in 31 patients with severe SARS-CoV-2 infection who were >70 years old, compared to 33 subjects <60 years of age. Differences in plasma levels of 62 cytokines, landscape of peripheral blood mononuclear cells, T cell repertoire, transcriptome of central memory CD4+ T cells, specific antibodies are reported along with features of lung macrophages. Elderly subjects have higher levels of pro-inflammatory cytokines, more circulating plasmablasts, reduced plasmatic level of anti-S and anti-RBD IgG3 antibodies, lower proportions of central memory CD4+ T cells, more immature monocytes and CD56+ pro-inflammatory monocytes, lower percentages of circulating follicular helper T cells (cTfh), antigen-specific cTfh cells with a less activated transcriptomic profile, lung resident activated macrophages that promote collagen deposition and fibrosis. Our study underlines the importance of inflammation in the response to SARS-CoV-2 and suggests that inflammaging, coupled with the inability to mount a proper anti-viral response, could exacerbate disease severity and the worst clinical outcome in old patients.

2022 - Oral health habits during COVID-19 pandemic in university medical students [Articolo su rivista]
Bellini, Pierantonio; Sabatini, Silvia; Nasi, Milena; Dall’Olio, Lucia; Generali, Luigi; Mecugni, Daniela; Consolo, Ugo; Mattioli, Anna Vittoria
abstract

2022 - Physical Activity and Diet in Older Women: A Narrative Review [Articolo su rivista]
Mattioli, Anna Vittoria; Selleri, Valentina; Zanini, Giada; Nasi, Milena; Pinti, Marcello; Stefanelli, Claudio; Fedele, Francesco; Gallina, Sabina
abstract

2022 - Physical Activity and Hormonal Cycles in Women: The Need for a More Active Life in the Post-Pandemic Era [Articolo su rivista]
Coppi, F.; Mattioli, A. V.
abstract

2022 - Polyphenols, Olive oil and Colonrectal cancer: the effect of Mediterranean Diet in the prevention [Articolo su rivista]
Mattioli, Anna Vittoria; Serra, Francesco; Spatafora, Francesco; Toni, Silvia; Farinetti, Alberto; Gelmini, Roberta
abstract

: In recent years, scientific research has shown that the incidence of various diseases, including some cancers, is relatively low in the Mediterranean Countries compared to that of other European countries or North America. This support the hypothesis that the Mediterranean diet, rich in bioactive food components, including methyl group donors, polyphenols, and fatty acids has efficacy in terms of prevention. Few studies evaluated the efficacy of Med Diet on colon cancer however they all support the beneficial effects of this Diet in preventing cancer.

2022 - Stress and cardiovascular risk burden after the pandemic: current status and future prospects [Articolo su rivista]
Mattioli, Anna Vittoria; Coppi, Francesca; Nasi, Milena; Gallina, Sabina
abstract

Introduction: The recent COVID-19 pandemic has induced an increase in anxiety, stress and depression in the world population, prompting a re-evaluation of these well-known risk factors on cardiovascular burden. Areas covered: This short report analyzes the impact of the pandemic on stress and depression, highlighting how the phenomenon has particularly affected women and highlights the strategies that can be undertaken after the pandemic to reduce stress and depression. We have analyzed the pandemic because it has completely changed the scenario of cardiovascular risk factors with an important increase in socio-economic stressors. Expert opinion: It is still difficult to assess the damage produced on cardiovascular risk just as it is almost impossible to predict how the overwhelming and important increase in Long-Covid Syndromes will impact the population. Strong action is needed to support critical situations and to implement social campaigns aimed at restoring healthy lifestyles. Physical activity can be an easy and inexpensive tool to help cope with stress and depression.

2022 - Teaching Gender Differences at Medical School Could Improve the Safety and Efficacy of Personalized Physical Activity Prescription [Articolo su rivista]
Mattioli, Anna Vittoria; Nasi, Milena; Pinti, Marcello; Palumbo, Carla
abstract

2022 - The need to teach gender medicine in medical school [Articolo su rivista]
Mattioli, Anna Vittoria; Palumbo, Carla
abstract

..

2022 - Thrombocytopenia after Thoraco-Abdominal Aortic Endografting: Pathophysiological Observations [Articolo su rivista]
Manenti, A.; Roncati, L.; Farinetti, A.; Manco, G.; Mattioli, A. V.
abstract

2022 - To the Editor: Pathophysiology of Splenic Arteriovenous Fistula [Articolo su rivista]
Manenti, A.; Roncati, L.; Manco, G.; Farinetti, A.; Mattioli, A. V.
abstract

A splenic arteriovenous fistula causes a “prehepatic” hypertension in the portal venous system with the double mechanism of an increased blood amount and mainly its high pressure inflow. It aggravates for a secondary fibrosis of the portal vein branches and “capillarization” of the hepatic sinusoids, adding a further “intra-hepatic” component. The subsequent development of portosystemic collaterals induces the risk of gastrointestinal hemorrhages All this suggests to perform a close monitoring of every case of splanchnic aneurysm or pseudo-aneurysm, through the current cross-section imaging tools, for their possible evolution in an arteriovenous fistula, and to consider an early therapy, also endovascular, before any secondary damage of the liver parenchyma. In this case the treatment of the portal vein hypertension can be “ethiological” and resolutive.

2021 - COVID-19 thromboembolic complications: Deepening immunoinflammatory features [Articolo su rivista]
Roncati, Luca; Manenti, Antonio; Manco, Gianrocco; Farinetti, Alberto; Mattioli, Anna Vittoria
abstract

2021 - Cardiovascular disease prevention and therapy in women with Type 2 diabetes [Articolo su rivista]
Cocchi, Camilla; Coppi, Francesca; Farinetti, Alberto; Mattioli, Anna Vittoria
abstract

2021 - Changes in energy drink consumption during the COVID-19 quarantine [Articolo su rivista]
Mattioli, Anna Vittoria; Sabatini, Silvia
abstract

2021 - Coffee and Platelets: An Unsolved Problem [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

2021 - Comment on "Western Dietary Pattern Antioxidant Intakes and Oxidative Stress: Importance during the SARS-CoV-2/COVID-19 Pandemic" [Articolo su rivista]
Mattioli, Anna V; Farinetti, Alberto
abstract

2021 - Deep inside pathology of Cor Triatriatum Sinister [Articolo su rivista]
Manenti, Antonio; Sighinolfi, Pamela; Mattioli, Anna Vittoria
abstract

2021 - Depression pandemic and cardiovascular risk in the COVID-19 era and long COVID syndrome: gender makes a difference [Articolo su rivista]
Bucciarelli, Valentina; Nasi, Milena; Bianco, Francesco; Seferovic, Jelena; Ivkovic, Vladimir; Gallina, Sabina; Mattioli, Anna Vittoria
abstract

The ongoing COVID-19 pandemic highlighted a significant interplay between cardiovascular disease (CVD), COVID-19 related inflammatory status, and depression. Cardiovascular (CV) injury is responsible for a substantial percentage of COVID-19 deaths while COVID-19 social restrictions emerged as a non-negligible risk factor for CVD as well as a variety of mental health issues, and in particular, depression. Inflammation seems to be a shared condition between these two disorders. Gender represents a potential modifying factor both in CVD and depression, as well as in COVID-19 short- and long-term outcomes, particularly in cases involving long-term COVID complications. Results from emerging studies indicate that COVID-19 pandemic affected male and female populations in different ways. Women seem to experience less severe short-term complications but suffer worse long-term COVID complications, including depression, reduced physical activity, and deteriorating lifestyle habits, all of which may impact CV risk. Here, we summarize the current state of knowledge about the interplay between COVID-19, depression, and CV risk in women.

2021 - Energy drinks and medical students: Bad drinking during COVID-19 quarantine [Articolo su rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto
abstract

2021 - Importance of physical activity during and after the SARS-CoV-2 / COVID-19 pandemic: a strategy for women to cope with stress [Articolo su rivista]
Mattioli, Anna Vittoria; Coppi, Francesca; Gallina, Sabina
abstract

We have read with interest the article "Gender issues during the times of Covid-19 pandemic" by Grisold W [1] and we found it significant in the context of the present pandemic. The current SARS-CoV-2/COVID-19 pandemic is associated with an increase of emotional stress and fear that have strongly affected women's mental health. [2] Stay-at-home measures together with financial and security concerns can lead to high stress levels.

2021 - Letter: Does obesity affect the severity of exercise-induced muscle injury? (j obes metab syndr 2021;30:132-40) [Articolo su rivista]
Mattioli, A. V.; Coppi, F.; Nasi, M.; Pinti, M.
abstract

2021 - Mitochondrial DNA and exercise: Implications for health and injuries in sports [Articolo su rivista]
Zanini, G.; De Gaetano, A.; Selleri, V.; Savino, G.; Cossarizza, A.; Pinti, M.; Mattioli, A. V.; Nasi, M.
abstract

Recently, several studies have highlighted the tight connection between mitochondria and physical activity. Mitochondrial functions are important in high-demanding metabolic activities, such as endurance sports. Moreover, regular training positively affects metabolic health by increasing mitochondrial oxidative capacity and regulating glucose metabolism. Exercise could have multiple effects, also on the mitochondrial DNA (mtDNA) and vice versa; some studies have investigated how mtDNA polymorphisms can affect the performance of general athletes and mtDNA haplogroups seem to be related to the performance of elite endurance athletes. Along with several stimuli, including pathogens, stress, trauma, and reactive oxygen species, acute and intense exercise also seem to be responsible for mtDNA release into the cytoplasm and extracellular space, leading to the activation of the innate immune response. In addition, several sports are characterized by a higher frequency of injuries, including cranial trauma, associated with neurological consequences. However, with regular exercise, circulating cell-free mtDNA levels are kept low, perhaps promoting cf-mtDNA removal, acting as a protective factor against inflammation.

2021 - Molecular mechanisms of mtdna-mediated inflammation [Articolo su rivista]
De Gaetano, A.; Solodka, K.; Zanini, G.; Selleri, V.; Mattioli, A. V.; Nasi, M.; Pinti, M.
abstract

Besides their role in cell metabolism, mitochondria display many other functions. Mitochondrial DNA (mtDNA), the own genome of the organelle, plays an important role in modulating the inflammatory immune response. When released from the mitochondrion to the cytosol, mtDNA is recognized by cGAS, a cGAMP which activates a pathway leading to enhanced expression of type I interferons, and by NLRP3 inflammasome, which promotes the activation of pro-inflammatory cytokines Interleukin-1beta and Interleukin-18. Furthermore, mtDNA can be bound by Toll-like receptor 9 in the endosome and activate a pathway that ultimately leads to the expression of pro-inflammatory cytokines. mtDNA is released in the extracellular space in different forms (free DNA, protein-bound DNA fragments) either as free circulating molecules or encapsulated in extracellular vesicles. In this review, we discussed the latest findings concerning the molecular mechanisms that regulate the release of mtDNA from mitochondria, and the mechanisms that connect mtDNA misplacement to the activation of inflammation in different pathophysiological conditions.

2021 - NLRP3 and IL-1β gene expression is elevated in monocytes from HIV treated patients with neurocognitive disorders [Articolo su rivista]
Mazaheri-Tehrani, Elham; Mohraz, Minoo; Nasi, Milena; Chester, Johanna; De Gaetano, Anna; Lo Tartaro, Domenico; Seyedalinaghi, Seyedahmad; Gholami, Mohammad; De Biasi, Sara; Gibellini, Lara; Mattioli, Anna Vittoria; Pinti, Marcello; Mussini, Cristina; Cossarizza, Andrea
abstract

Systemic immune activation and inflammation in chronic HIV infection are driving factors of non-AIDS related events, including neurocognitive impairment. The role of inflammasome in monocytes from patients with HIV infection has been extensively studied but its association with the extent of neurocognitive dysfunction has been poorly investigated.

2021 - Physical Activity, Sedentary Behaviour, and Diet in Menopausal Women: Comparison Between COVID19 “first wave” and “second wave” of pandemic in Italy [Articolo su rivista]
Coppi, Francesca; Nasi, Milena; Farinetti, Alberto; Manenti, Antonio; Gallina, Sabina; Mattioli, Anna Vittoria
abstract

The COVID-19 pandemic has strongly affected young population all over the world. The present study explores the effects of COVID-19 on physical activity, sedentary behaviour, and diet in a population of 435 menopausal women during the first phase of the pandemic (so-called the “first wave”) and during the second spread of infections, after the summer release (so-called “second wave”). Women reported an increase in perceived stress and emotional distress which led to an increase in amount of food (42%), an increase in the consumption of snacks and junk food (48%) and to a switch to an unhealthy diet (46%) and weight gain in 51% of subjects. Most women stopped any physical

2021 - Sex Difference in Access to Sports: A 1-Year Retrospective Study [Articolo su rivista]
Nasi, M.; D'Alisera, R.; Cossarizza, A.; Guerra, E.; Savino, G.; Mattioli, A. V.
abstract

Purpose. Regular physical activity is a cornerstone in the prevention and treatment of cardiovascular disease thanks to its anti-inflammatory effects. Thus, favoring the access to sports is of importance for promoting well-being. The aim of the present study was to investigate how the practice of different sports is distributed among different age groups and between men and women, by taking a picture of the medical certificate request in 2017 for sports in the population of the province of Modena, Italy. Methods. We analyzed the difference in distribution of requested medical certificate from 18 874 males and 7625 females stratified for age (<18 years, 18-40 years, and >40 years) and for different sporting disciplines (athletics, football, bike, swimming, basketball, volleyball, tennis, other team sports, other individual sports, and disabled sports). Results. Men requested medical certificates more than women (more than 2.5 times). The distribution of requested certificates differs significantly (chi-square test P <.0001) at different ages and between males and females of same age. Certificate for men aged less than 18 years were 7550 and for women were 4131 and the difference increase with age. Conclusions. In order to decrease the imbalance between men and women access to sports, it is mandatory to promote a healthy lifestyle and reduce, as consequence, cardiovascular risks, mostly in women after 40 years.

2021 - Slow and steady wins the race: Better walking than running. The turtle's lesson in the times of COVID-19 [Articolo su rivista]
Sciomer, S; Gallina, S; Mattioli, A V; Agostoni, P G; Moscucci, F
abstract

2021 - Subclinical Atherosclerosis at Peripheral Arteries in Obese Individuals. [Articolo su rivista]
Farinetti, A; Castaniere, I; Clini, E; Migaldi, M; Gelmini, R; Scaringi Raspagliesi, F; Ara, N; Serra, F; Spatafora, F; Genazzani, A; Mattioli, Av.
abstract

Evidence on relationship between obesity and peripheral arterial disease (PAD) are controversial. The aim of the present study is to evaluate the presence of subclinical atherosclerosis at all level of the explorable vascular segments with a systematic method in a selected population of young obese submitted to a comprehensive rehabilitation course. A group of 50 consecutive morbidly obese (BMI>30) was included. All patients underwent Doppler evaluation including intima media thickness (IMT) and presence/absence of plaques. We found that vessels in the upper segment of the body demonstrate the presence of thickening and/or plaques at the level of the carotid segments but not of the subclavian arteries. The IMT of the right Common Carotid Artery (CCA) (1.49 + 1.38 versus 0.62 + 0.23; p=0.037) and of the left CCA (1.66 + 1.89 versus 0.45 + 0.26; p=0.034) was greater in patients. Vessels of the lower segment demonstrate the presence of thickening and/or plaques at the iliac but not at femoral level. The control group did not present vessel thickening at any level. In conclusions asymptomatic vascular damage may be present in different segment of peripheral vessels, thus suggesting an early risk for developing an overt vascular disease over time in obese.

2021 - Subclinical vascular damage: Current insights and future potential [Articolo su rivista]
Mattioli, A. V.; Coppi, F.; Manenti, A.; Farinetti, A.
abstract

The cardiovascular risk assessment must be carried out during all the different phases of life because the cardiovascular risk and the related prevention actions are dynamic and constantly evolving. As patients age, they change their exposure to various risk factors and accumulate comorbidities by changing their subjective cardiovascular risk, so it is necessary to undertake personalized early and preventive diagnostic actions. The main approach to asympto-matic vascular disease is based on primary prevention with the adoption of a healthy lifestyle. Indeed, lifestyle influences most of the traditional risk factors. In recent years, important differences between the sexes regarding cardiovascular risk factors have emerged and in particular, risk factors specific for female sex have been identified. Women are more likely to be categorized into lower risk categories for cardiovascular disease and, as a result, receive less lifestyle counseling than men, as well as less intensive prevention. This narrative review aims to analyze CVD risk prevention in asymptomatic atherosclerosis with a look at new emerging factors. In the end, we quickly analyzed the effects of the recent pandemic on lifestyle and cardiovascular risk and the potential negative effects in the long term.

2021 - THE COMPLEX RELATIONSHIP BETWEEN CAFFEINE AND ARRHYTHMIAS [Articolo su rivista]
Mattioli, Anna Vittoria; Nasi, Milena; Toni, Silvia; Farinetti, Alberto
abstract

2021 - The COVID-19 Arterial Thromboembolic Complications: From Inflammation to Immunothrombosis Through Antiphospholipid Autoantibodies [Articolo su rivista]
Roncati, Luca; Manenti, Antonio; Manco, Gianrocco; Farinetti, Alberto; Mattioli, Anna Vittoria
abstract

2021 - Toward a unified pathophysiology in COVID-19 acute aortopathies [Articolo su rivista]
Roncati, L.; Manenti, A.; Farinetti, A.; Manco, G.; Mattioli, A. V.
abstract

2021 - Understanding Patho-physiology of the Superior Mesenteric Artery Endarterectomy [Articolo su rivista]
Manenti, Antonio; Farinetti, Alberto; Manco, Gianrocco; Mattioli, Anna Vittoria
abstract

2021 - Vasculitis and aortitis: Covid-19 challenging complications [Articolo su rivista]
Manenti, Antonio; Farinetti, Alberto; Manco, Gianrocco; Mattioli, Anna Vittoria
abstract

2021 - When should cardiovascular prevention begin? The importance of antenatal, perinatal and primordial prevention [Articolo su rivista]
D'Ascenzi, F.; Sciaccaluga, C.; Cameli, M.; Cecere, A.; Ciccone, M. M.; Di Francesco, S.; Ganau, A.; Imbalzano, E.; Liga, R.; Palermo, P.; Palmiero, P.; Parati, G.; Pedrinelli, R.; Scicchitano, P.; Zito, A.; Mattioli, A. V.
abstract

Cardiovascular diseases represent a major health problem, being one of the leading causes of morbidity and mortality worldwide. Therefore, in this scenario, cardiovascular prevention plays an essential role although it is difficult to establish when promoting and implementing preventive strategies. However, there is growing evidence that prevention should start even before birth, during pregnancy, aiming to avoid the onset of cardiovascular risk factors, since events that occur early in life have a great impact on the cardiovascular risk profile of an adult. The two pillars of this early preventive strategy are nutrition and physical exercise, together with prevention of cardio-metabolic diseases during pregnancy. This review attempts to gather the growing evidence of the benefits of antenatal, perinatal and primordial prevention, discussing also the possibility to reverse or to mitigate the cardiovascular profile developed in the initial stages of life. This could pave the way for future research, investigating the optimal time and duration of these preventing measures, their duration and maintenance in adulthood, and the most effective interventions according to the different age and guiding in the next years, the best clinical practice and the political strategies to cope with cardiovascular disease.

2021 - Worldwide Survey of COVID-19 Associated Arrhythmias [Articolo su rivista]
Coromilas, Ellie J; Kochav, Stephanie; Goldenthal, Isaac; Biviano, Angelo; Garan, Hasan; Goldbarg, Seth; Kim, Joon-Hyuk; Yeo, Ilhwan; Tracy, Cynthia; Ayanian, Shant; Akar, Joseph; Singh, Avinainder; Jain, Shashank; Zimerman, Leandro; Pimentel, Maurício; Osswald, Stefan; Twerenbold, Raphael; Schaerli, Nicolas; Crotti, Lia; Fabbri, Daniele; Parati, Gianfranco; Li, Yi; Atienza, Felipe; Zatarain, Eduardo; Tse, Gary; Leung, Keith Sai Kit; Guevara-Valdivia, Milton E; Rivera-Santiago, Carlos A; Soejima, Kyoko; De Filippo, Paolo; Ferrari, Paola; Malanchini, Giovanni; Kanagaratnam, Prapa; Khawaja, Saud; Mikhail, Ghada W; Scanavacca, Mauricio; Hajjar, Ludhmila Abrahão; Rizerio Gomes, Brenno; Sacilotto, Luciana; Mollazadeh, Reza; Eslami, Masoud; Laleh Far, Vahideh; Mattioli, Anna Vittoria; Boriani, Giuseppe; Migliore, Federico; Cipriani, Alberto; Donato, Filippo; Compagnucci, Paolo; Casella, Michela; Dello Russo, Antonio; Coromilas, James; Aboyme, Andrew; O'Brien, Connor Galen; Rodriguez, Fatima; Wang, Paul J; Naniwadekar, Aditi; Moey, Melissa; Know, Chia Siang; Cheah, Wee Kooi; Auricchio, Angelo; Conte, Giulio; Hwang, Jongmin; Han, Seongwook; Lazzerini, Pietro Enea; Franchi, Federico; Santoro, Amato; Capecchi, Pier Leopoldo; Joglar, Jose A; Rosenblatt, Anna G; Zardini, Marco; Bricoli, Serena; Bonura, Rosario; Echarte-Morales, Julio; Benito-González, Tomás; Minguito-Carazo, Carlos; Fernández-Vázquez, Felipe; Wan, Elaine Y
abstract

Background - COVID-19 has led to over 1 million deaths worldwide and has been associated with cardiac complications including cardiac arrhythmias. The incidence and pathophysiology of these manifestations remain elusive. In this worldwide survey of patients hospitalized with COVID-19 who developed cardiac arrhythmias, we describe clinical characteristics associated with various arrhythmias, as well as global differences in modulations of routine electrophysiology practice during the pandemic. Methods - We conducted a retrospective analysis of patients hospitalized with COVID-19 infection worldwide with and without incident cardiac arrhythmias. Patients with documented atrial fibrillation (AF), atrial flutter (AFL), supraventricular tachycardia (SVT), non-sustained or sustained ventricular tachycardia (VT), ventricular fibrillation (VF), atrioventricular block (AVB), or marked sinus bradycardia (HR<40bpm) were classified as having arrhythmia. De-identified data was provided by each institution and analyzed. Results - Data was collected for 4,526 patients across 4 continents and 12 countries, 827 of whom had an arrhythmia. Cardiac comorbidities were common in patients with arrhythmia: 69% had hypertension, 42% diabetes mellitus, 30% had heart failure and 24% coronary artery disease. Most had no prior history of arrhythmia. Of those who did develop an arrhythmia, the majority (81.8%) developed atrial arrhythmias, 20.7% developed ventricular arrhythmias, and 22.6% had bradyarrhythmia. Regional differences suggested a lower incidence of AF in Asia compared to other continents (34% vs. 63%). Most patients in in North America and Europe received hydroxychloroquine, though the frequency of hydroxychloroquine therapy was constant across arrhythmia types. Forty-three percent of patients who developed arrhythmia were mechanically ventilated and 51% survived to hospital discharge. Many institutions reported drastic decreases in electrophysiology procedures performed. Conclusions - Cardiac arrhythmias are common and associated with high morbidity and mortality among patients hospitalized with COVID-19 infection. There were significant regional variations in the types of arrhythmias and treatment approaches.

2020 - AB0611 STRAIN ANALYSIS OF THE RIGHT VENTRICLE USING 2D-SPECKLE TRACKING ECHOCARDIOGRAPHY IN A COHORT OF PATIENTS WITH SYSTEMIC SCLEROSIS [Abstract in Rivista]
Spinella, A; Macripo, P; Cocchiara, E; Galli, E; Lumetti, F; Magnani, L; Coppi, F; Mattioli, Av; Rossi, R; Boriani, G; Salvarani, C; Giuggioli, D
abstract

Background: Systemic Sclerosis (SSc) is a rare and life-threatening connective tissue disease with multiple organ impairment. Cardio-pulmonary involvement is common: pulmonary fibrosis, pulmonary hypertension (PH), and electrical disorders are the most serious complications and causes of increased mortality. Objectives: We evaluated features related with the onset and development of PH in a cohort of SSc patients. We further studied ecocardiographic abnormalities, by means of 2D-speckle tracking echocardiography (STE) with specific reference to the right ventricular strain measure (RV-strain). Methods: We analyzed data from 50 SSc patients (pts) referred to our University-based Rheumatology Centre and SSc Unit from January 2007 to June 2019 (F/M 45/5; lc/dcSSc 45/5; mean age 59.20±14.357 years; mean disease duration 12.08±8.75 years). All pts underwent general and cardio-pulmonary …

2020 - An unusual case of bowel obstruction in emergency surgery: The heterotopic mesenteric ossification [Articolo su rivista]
Ricciardolo, Andrea Aurelio; De Ruvo, Nicola; Caramaschi, Stefania; Serra, Francesco; Farinetti, Alberto; Mattioli, Anna Vittoria; Gelmini, Roberta
abstract

The heterotopic mesenteric ossification, also known as myositis ossificans, is a rare form of heterotopic ossification, a metaplastic phenomenon where new bone is formed in the mesenteric base, generally after abdominal trauma (surgical or other). The pathophysiology of heterotopic mesenteric ossification is unknown; clinical presentation is not specific, with vague abdominal symptoms, uncertain radiological findings, and often regular laboratory exams. No consensus exists on the best possible approach, although it might well be both medical and surgical. We reviewed the clinical history of a 28-year-old man with a recent motor vehicle accident who was admitted to our surgical unit with symptoms consistent with a small bowel obstruction; after surgery, a diagnosis of myositis ossificans was surprisingly made.

2020 - COVID 19 outbreak: impact of the quarantine-induced stress on cardiovascular disease risk burden [Articolo su rivista]
Mattioli, Anna Vittoria; Nasi, Milena; Cocchi, Camilla; Farinetti, Alberto
abstract

“emotional eating and reduction of physical activity lead to obesity and metabolic syndrome, both risk factors has a pivotal role in cardiovascular risk. Obesity is also associated with an increase risk of Type 2 diabetes

2020 - COVID-19 pandemic: the effects of quarantine on cardiovascular risk [Articolo su rivista]
Mattioli, Anna Vittoria; Ballerini Puviani, Matteo; Nasi, Milena; Farinetti, Alberto
abstract

2020 - COVID-19 pandemic: usefulness of telemedicine in management of arrhythmias in elderly people [Articolo su rivista]
Mattioli, Anna Vittoria; Cossarizza, Andrea; Boriani, Giuseppe
abstract

In March 2020, the WHO defined the diffusion of novel coronavirus, Severe Acute Respiratory Syndrome-Coronavirus- 2 (SARS-CoV-2) as pandemic.[13] As a consequence, the Italian Government among others has enforced quarantine on the population to contain the diffusion of the infection.

2020 - Circulating Mitochondrial DNA and Lipopolysaccharide-Binding Protein but Not Bacterial DNA Are Increased in Acute Human Immunodeficiency Virus Infection. [Articolo su rivista]
Nasi, Milena; Pecorini, Simone; DE BIASI, Sara; Digaetano, Margherita; Chester, JOHANNA MARY; Aramini, Beatrice; Lo Tartaro, Domenico; Pinti, Marcello; De Gaetano, Anna; Gibellini, Lara; Mattioli, Anna Vittoria; Mussini, Cristina; Cossarizza, Andrea
abstract

Microbial translocation has been suggested as a major driver of chronic immune activation HIV infection. Thus, we compared the extent of microbial translocation in patients with acute HIV infection and patients followed after CD4-guided structured treatment interruption (STI) by measuring different circulating markers: (1) lipopolysaccharide (LPS)-binding protein (LBP), (2) bacterial DNA, (3) soluble CD14 (sCD14), and (4) mitochondrial DNA (mtDNA). Bacterial DNA and sCD14 levels were similar in all groups. Patients in acute phase showed higher levels of LBP and mtDNA. In STI, we found a positive correlation between the percentage of CD8+ T cells and bacterial DNA levels. Considering all patients, LBP was positively correlated with the percentage and the absolute count of CD8+ T cells, and with mtDNA stressing the importance of mitochondrial products in sustaining chronic immune activation.

2020 - Coffee and cardiovascular risk burden in women [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

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2020 - Effects of Caffeine on Colon: A Potential Clinical Use of Coffee in Surgical Patients [Articolo su rivista]
Mattioli, Anna Vittoria; Nasi, Milena; Farinetti, Alberto; Gelmini, Roberta
abstract

...

2020 - Effects of whole-body cryotherapy on the innate and adaptive immune response in cyclists and runners [Articolo su rivista]
Nasi, Milena; Bianchini, Elena; Lo Tartaro, Domenico; De Biasi, Sara; Mattioli, Marco; Paolini, Annamaria; Gibellini, Lara; Pinti, Marcello; De Gaetano, Anna; D’Alisera, Roberta; Roli, Laura; Chester, Johanna; Mattioli, Anna Vittoria; Polverari, Tomassina; Maietta, Pasqualino; Tripi, Ferdinando; Stefani, Omar; Guerra, Emanuele; Savino, Gustavo; Trenti, Tommaso; Cossarizza, Andrea
abstract

2020 - Espresso coffee, caffeine and colon cancer [Articolo su rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto
abstract

2020 - Identification of cardiac organ damage in arterial hypertension: Insights by echocardiography for a comprehensive assessment [Articolo su rivista]
Cameli, M.; Lembo, M.; Sciaccaluga, C.; Bandera, F.; Ciccone, M. M.; D Andrea, A.; D Ascenzi, F.; Esposito, R.; Evola, V.; Liga, R.; Mandoli, G. E.; Palmiero, P.; Santoro, C.; Scicchitano, P.; Sorrentino, R.; Zito, A.; Pedrinelli, R.; Mondillo, S.; Mattioli, A. V.; Galderisi, M.
abstract

Arterial hypertension, a widespread disease, whose prevalence increases with age, represents a major risk factor for cardiovascular events, causing damage in several organs, including the heart. In this context, echocardiography has a clear and pivotal role, being able to assess cardiac morphology and detect haemodynamic changes induced by this disease. 2018 European Society of Cardiology/European Society of Hypertension guidelines on AH identified main echo parameters such as left ventricular mass, relative wall thickness and left atrial volume, for detecting cardiac organ damage. The present review highlights the advantage of additional echocardiographic parameters such as diastolic measurement and both thoracic and abdominal aortic dimensions. An overlook on aortic valve should also be suggested to detect aortic regurgitation and stenosis, both frequent complications in hypertensive patients. In this kind of comprehensive assessment, the combination of standard and advanced echocardiography (speckle tracking echocardiography and, with a lesser extent, threedimensional echocardiography) could be considered to improve the diagnostic accuracy, stratify prognosis and address management in arterial hypertension.

2020 - Identification of cardiac organ damage in arterial hypertension: insights by echocardiography for a comprehensive assessment [Articolo su rivista]
Cameli, Matteo; Lembo, Maria; Sciaccaluga, Carlotta; Bandera, Francesco; Ciccone, Marco M; D'Andrea, Antonello; D'Ascenzi, Flavio; Esposito, Roberta; Evola, Vincenzo; Liga, Riccardo; Mandoli, Giulia E; Palmiero, Pasquale; Santoro, Ciro; Scicchitano, Pietro; Sorrentino, Regina; Zito, Annapaola; Pedrinelli, Roberto; Mondillo, Sergio; Mattioli, Anna V; Galderisi, Maurizio
abstract

: Arterial hypertension, a widespread disease, whose prevalence increases with age, represents a major risk factor for cardiovascular events, causing damage in several organs, including the heart. In this context, echocardiography has a clear and pivotal role, being able to assess cardiac morphology and detect haemodynamic changes induced by this disease. 2018 European Society of Cardiology/European Society of Hypertension guidelines on AH identified main echo parameters such as left ventricular mass, relative wall thickness and left atrial volume, for detecting cardiac organ damage. The present review highlights the advantage of additional echocardiographic parameters such as diastolic measurement and both thoracic and abdominal aortic dimensions. An overlook on aortic valve should also be suggested to detect aortic regurgitation and stenosis, both frequent complications in hypertensive patients. In this kind of comprehensive assessment, the combination of standard and advanced echocardiography (speckle tracking echocardiography and, with a lesser extent, three-dimensional echocardiography) could be considered to improve the diagnostic accuracy, stratify prognosis and address management in arterial hypertension.

2020 - Increased plasma levels of mitochondrial DNA and pro-inflammatory cytokines in patients with progressive multiple sclerosis [Articolo su rivista]
Nasi, M.; Bianchini, E.; De Biasi, S.; Gibellini, L.; Neroni, A.; Mattioli, Marco; Pinti, M.; Iannone, A.; Mattioli, A. V.; Simone, A. M.; Ferraro, D.; Vitetta, F.; Sola, P.; Cossarizza, A.
abstract

The role of damage-associated molecular patterns in multiple sclerosis (MS) is under investigation. Here, we studied the contribution of circulating high mobility group box protein 1 (HMGB1) and mitochondrial DNA (mtDNA) to neuroinflammation in progressive MS. We measured plasmatic mtDNA, HMGB1 and pro-inflammatory cytokines in 38 secondary progressive (SP) patients, 35 primary progressive (PP) patients and 42 controls. Free mtDNA was higher in SP than PP. Pro-inflammatory cytokines were increased in progressive patients. In PP, tumor necrosis factor-α correlated with MS Severity Score. Thus, in progressive patients, plasmatic mtDNA and pro-inflammatory cytokines likely contribute to the systemic inflammatory status.

2020 - Lifestyle and Stress Management in Women During COVID-19 Pandemic: Impact on Cardiovascular Risk Burden [Articolo su rivista]
Mattioli, Anna Vittoria; Sciomer, Susanna; Maffei, Silvia; Gallina, Sabina
abstract

2020 - Lifestyle at Time of COVID-19: How Could Quarantine Affect Cardiovascular Risk [Articolo su rivista]
Mattioli, A. V.; Ballerini Puviani, M.
abstract

COVID-19 is causing a global pandemic with a high number of deaths and infected people. To contain the diffusion of COVID-19 virus, governments have enforced restrictions on outdoor activities or even collective quarantine on the population. Quarantine carries some long-term effects on cardiovascular disease, mainly related to unhealthy lifestyle and anxiety.

2020 - Mediterranean Diet as a model of sustainable, resilient and healthy diet [Articolo su rivista]
Letizia Truzzi, Maria; Ballerini Puviani, Matteo; Tripodi, Alberto; Toni, Silvia; Farinetti, Alberto; Nasi, Milena; Mattioli, Anna Vittoria
abstract

2020 - Mitochondrial damage-associated molecular patterns stimulate reactive oxygen species production in human microglia [Articolo su rivista]
Nasi, Milena; De Gaetano, Anna; Bianchini, Elena; De Biasi, Sara; Gibellini, Lara; Neroni, Anita; Mattioli, Marco; Pinti, Marcello; Tartaro, Domenico Lo; Borella, Rebecca; Mattioli, Anna Vittoria; Chester, Johanna; Melegari, Alessandra; Simone, Anna Maria; Ferraro, Diana; Vitetta, Francesca; Sola, Patrizia; Cossarizza, Andrea
abstract

Microglia are the resident innate immune cells of the central nervous system and exert functions of host defence and maintenance of normal tissue homeostasis, along with support of neuronal processes in the healthy brain. Chronic and dysregulated microglial cell activation has increasingly been linked to the status of neuroinflammation underlying many neurodegenerative diseases, including multiple sclerosis (MS). However, the stimulus (or stimuli) and mechanisms by which microglial activation is initiated and maintained MS are still debated. The purpose of our research was to investigate whether the endogenous mitochondrial (mt)-derived damage-associated molecular patterns (MTDs) mtDNA, N-formyl peptides and cardiolipin (CL) contribute to these phenomena. We characterized the effects of the abovementioned MTDs on microglia activation in vitro (i.e. using HMC3 cells) by evaluating the expression of gene coding for proteins involved in their binding and coupled to downstream signaling pathways, the up-regulation of markers of activation on the cell surface and the production of pro-inflammatory cytokines and reactive oxygen species. At the transcriptional level, significant variations in the mRNA relative expression of five of eleven selected genes were observed in response to stimulation. No changes in activation of antigenic profile or functional properties of HMC3 cells were observed; there was no up-regulation of HLA-DR expression or increased secretion of tumor necrosis factor-α and interleukin-6. However, after stimulation with mtDNA and CL, an increase in cellular oxidative stress, but not in the mt ROS O2-, compared to control cells, were observed. There were no effects on cell viability. Overall, our data suggest that MTDs could cause a failure in microglial activation toward a pro-inflammatory phenotype, possibly triggering an endogenous regulatory mechanism for the resolution of neuroinflammation. This could open a door for the development of drugs selectively targeting microglia and modulating its functionality to treat MS and/or other neurodegenerative conditions in which MTDs have a pathogenic relevance.

2020 - Obesity risk during collective quarantine for the COVID-19 epidemic [Articolo su rivista]
Mattioli, Anna Vittoria; Pinti, Marcello; Farinetti, Alberto; Nasi, Milena
abstract

In March 2020, when COVID-19 epidemics involved several countries, the WHO defined the infection as a pandemic. Government adopted measures to prevent the diffusion of infection; i.e. quarantine and isolation. One of the consequences of quarantine-induced stress is a change in lifestyle and eating habits leading to obesity. The present commentary briefly analyzes the effects of quarantine on obesity.

2020 - Practical tips for prevention of cardiovascular disease in women after quarantine for COVID-19 disease. [Articolo su rivista]
Mattioli, A. V.; Toni, S.; Coppi, F.; Farinetti, A.
abstract

2020 - Quarantine and Isolation during COVID-19 outbreak: A case of online diagnosis of supraventricular arrhythmia through telemedicine [Articolo su rivista]
Mattioli, A. V.; Ballerini Puviani, M.; Malagoli, A.
abstract

2020 - Recommendations for Physical Inactivity and Sedentary Behavior During the Coronavirus Disease (COVID-19) Pandemic [Articolo su rivista]
Ricci, Fabrizio; Izzicupo, Pascal; Moscucci, Federica; Sciomer, Susanna; Maffei, Silvia; Di Baldassarre, Angela; Mattioli, Anna Vittoria; Gallina, Sabina
abstract

2020 - Relationship between socioeconomic status and asymptomatic peripheral arterial disease: a retrospective study [Articolo su rivista]
Mattioli, Anna V; Nasi, Milena; Coppi, Francesca; Gelmini, Roberta; Farinetti, Alberto
abstract

2020 - Secondary lymphatic insufficiency in chronic varicose veins [Articolo su rivista]
Manenti, Antonio; Farinetti, Alberto; Manco, Gianrocco; Mattioli, Anna Vittoria
abstract

2020 - Secondary prevention medical therapy and outcomes in patients with myocardial infarction with non-obstructive coronary artery disease [Articolo su rivista]
Paolisso, P.; Bergamaschi, L.; Saturi, G.; D'Angelo, E. C.; Magnani, I.; Toniolo, S.; Stefanizzi, A.; Rinaldi, A.; Bartoli, L.; Angeli, F.; Donati, F.; Rucci, P.; Mattioli, A. V.; Taglieri, N.; Pizzi, C.; Galie, N.
abstract

Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous entity with relevant long-term major cardiovascular events. Several trials have demonstrated that dual antiplatelet therapy (DAPT), b-blocker, renin-angiotensin-aldosterone system (RAAS) inhibitor and statin therapy improve the prognosis in patients with obstructive myocardial infarction (ob-MI). However, evidence on the best medical therapy for secondary prevention in MINOCA patients is lacking. Purpose: To investigate the effects of secondary prevention treatments at discharge on mid-term outcomes in MINOCA. Methods: Patients with acute myocardial infarction (MI) undergoing early coronary angiography between 2016 and 2018 were extracted from a clinical database. The diagnosis of MINOCA was made according to 2016 ESC MINOCA Position Paper criteria. Second-level diagnostic work-up including cardiac magnetic resonance was performed to exclude non-ischemic troponin elevation cause. The relationship between treatments and outcomes was evaluated by using Kaplan-Meier survival analysis and Cox regression models. All confirmed MINOCA were followed in our outpatient clinics. The primary endpoints were all-cause mortality, re-hospitalization for MI and a composite outcome including all-cause mortality, hospitalization for MI and ischemic stroke (MACE). Results: Out of 1,141 AMI who underwent coronary angiography, 134 were initially diagnosed as MINOCA. Patients with MINOCA were less likely to receive secondary prevention treatments than patients with obstructive coronary artery disease (CAD) MI (respectively, 42.1% vs 81.8% for DAPT; 75.5% vs 89.6% for b-blockers; 64.7% vs 80.3% for RAAS inhibitor and 63.9% vs 83% for statins). Based on the diagnostic work-up completed during the first month after discharge, a final sample of 88 patients had confirmed MINOCA. During an average follow-up of 19.35 ± 10.65 months, all-cause mortality occurred in 11 (12.5%) patients, recurrence of MI in 4 (4.5%), and MACE in 15 (17.0%) patients. Patients treated with RAAS inhibitors and statins had a significantly longer survival. On the contrary, no increase in survival was found in patients treated with b-blockers or DAPT. Cox multivariable analysis, including all secondary prevention drugs, showed that only RAAS inhibitors were associated with reduced all cause-mortality and MACE. Conclusion: This prospective study suggests that RAAS inhibitor therapy provides midterm beneficial effects on outcomes in MINOCA patients; in contrast, dual antiplatelet, b-blocker and statin therapy had no effects on mortality and MACE. These results should be considered preliminary and warrant confirmation from larger studies.

2020 - “Quarantine during COVID-19 outbreak: changes in Diet and physical activity increase the risk of cardiovascular disease” [Articolo su rivista]
Mattioli, Anna Vittoria; Sciomer, Susanna; Cocchi, Camilla; Maffei, Silvia; Gallina, Sabina
abstract

Aims. CoV-19/SARS-CoV-2 is a highly pathogenic virus that is causing a global pandemic 53 with a high number of deaths and infected people. To contain the diffusion of infection, 54 several Governments have enforced restrictions on outdoor activities or even collective 55 quarantine on the population. The present commentary briefly analyzes the effects of 56 quarantine on lifestyle, including nutrition and physical activity and the impact of new 57 technologies in dealing with this situation. 58 Data Synthesis. Quarantine is associated with stress and depression leading to unhealthy 59 diet and reduced physical activity. A diet poor in fruit and vegetables is frequent during 60 isolation, with a consequent low intake of antioxidants and vitamins. However, vitamins 61 have recently been identified as a principal weapon in the fight against the Cov-19 virus. 62 Some reports suggest that Vitamin D could exert a protective effect on such infection. 63 During quarantine, strategies to further increase home-based physical activity and to 64 encourage adherence to a healthy diet should be implemented. The WHO has just released 65 guidance for people in self-quarantine, those without any symptoms or diagnosis of acute 66 respiratory illness, which provides practical advice on how to stay active and reduce 67 sedentary behaviour while at home.

2019 - A novel surgical approach with peritonectomy to extranodal multisystemic histiocytic sarcoma: A case report and literature review [Articolo su rivista]
Barbato, Giuseppe; Tarantini, Alessandro; Serra, Francesco; Cabry, Francesca; Farinetti, Alberto; Sorrentino, Lorena; Mattioli, Anna Vittoria; Gelmini, Roberta
abstract

Histiocytic sarcoma (HS) is a very rare malignant histiocytic derivation cancer. The extranodal multisystemic HS has an aggressive clinical course and poor Disease-Free Survival (DFS) and Overall Survival (OS). There are no shared and effective therapeutic protocols; our approach aims to improve the prognosis for advanced diseases.

2019 - Aspirin Use in Patients Undergoing Preoperative Evaluation for Minor Surgery [Articolo su rivista]
Mattioli, A. V.; Farinetti, A.; Gelmini, R.
abstract

We found that 505 patients were treated with aspirin (16.8%), 312 men (61.8%) and 193 women (38.2%) (P < .05). In the group of patients treated with aspirin we found that 379 subjects—254 men (67%) and 125 women (33%)—were treated with aspirin according to guidelines for prevention of cardiovascular disease. In addition, 32 patients (all men) were treated with aspirin outside of guideline indications. Seven hundred ninety-eight patients (26.6%) that needed aspirin or antiplatelet therapy due to their cardiovascular risk were not treated, despite having no contraindication or allergy, and 126 patients discontinued aspirin despite appropriate indication.

2019 - CASE report: Acute hepatic failure secondary to metastatic LIVER’S infiltration by upper tract urothelial carcinoma [Articolo su rivista]
Serra, Francesco; Guidetti, Cristiano; Spatafora, Francesco; Cabry, Francesca; Farinetti, Alberto; Mattioli, Anna Vittoria; Gelmini, Roberta
abstract

INTRODUCTION: Acute liver failure (ALF) secondary to malignant infiltration of the liver from urothelial carcinoma is a very rare clinical condition and is often diagnosed only after death. Upper tract urothelial carcinoma (UTUC) is a rare, from 5% to 10% of all urothelial tumours, but possible cause of ALF when there is extensive liver metastatic involvement. We report the case of a patient who died in the intensive care unit (ICU) of our hospital from multiple organ failure (MOF) secondary to ALF, as a result of infiltration of the liver from UTUC diagnosed after surgery. PRESENTATION OF THE CASE: A 69-year-old Caucasian man was referred to our hospital for hematuria, melena, right upper quadrant (RUQ) pain and jaundice developed over the previous two weeks. After multidisciplinary discussion, he underwent emergency exploratory laparotomy to perform cholecystectomy because of suspected acute cholecystitis considered as a septic focus within the left kidney. He developed MOF and died on the 6thpostoperative day. DISCUSSION: From the diagnosis of the renal mass and the death of the patient, a few days have passed, and the diagnosis of UTUC has been put only at histological examination.The most common sites of metastases from UTUC are lymph nodes, lungs, liver, bones and peritoneum. Moreover, liver metastases have been identified to have an independent negative impact on overall survival in a patient affected by UTUC. CONCLUSION: The authors suggest that this condition should be taken into account when dealing with patients with evidence of a renal mass and simultaneous ALF. KEYWORDS: Acute liver failure, Upper tract urothelial carcinoma (UTUC), emergency surgery

2019 - Caffeine in beverages: Cardiovascular effects [Capitolo/Saggio]
Mattioli, A. V.; Puviani, M. B.; Farinetti, A.
abstract

Caffeine is one of the neuroactive substances most prevalent in western countries. Its cardiovascular effects are well known, as well as different cardiovascular responses were observed in individuals who usually take caffeine-containing beverages and foods regularly than those who take it occasionally. The hypothesis that coffee consumption would lower the risk of cardiovascular disease has been suggested by recent studies. This association is partially mediated by bioactive substances contained in coffee. In recent years there have been widespread use of, especially among young people, beverages called “Energy Drinks” which contain a much higher amount of caffeine. The chapter will explore the cardiovascular effects of caffeine and caffeinated beverages.

2019 - Cardiovascular prevention in women: A narrative review from the Italian Society of Cardiology working groups on 'Cardiovascular Prevention, Hypertension and peripheral circulation' and on 'Women Disease' [Articolo su rivista]
Mattioli, A. V.; Sciomer, S.; Moscucci, F.; Maiello, M.; Cugusi, L.; Gallina, S.; Dei Cas, A.; Lombardi, C.; Pengo, M.; Parati, G.; Barilla, F.; Ciccone, M. M.; Palmiero, P.; Mercuro, G.; Maffei, S.
abstract

: Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in women.Some authors highlighted that the female risk profile consists of traditional and emerging risk factors. Despite the lower prevalence of type 2 diabetes, years of life lost owing to the disease for women are substantially higher compared with men. In addition, pregnancy complicated by gestational diabetes represents a risk factor for CVD. Women with gestational diabetes have a higher prevalence of coronary artery disease that occur at a younger age and are independent of T2DM.Hypertension is an important cardiovascular risk factor in women. Estrogens and progesterone, known to have an impact on blood pressure levels, have also been proposed to be protective against sleep-disordered breathing. It is very difficult to understand whereas obstructive sleep apnea in women is independently associated with hypertension or if many confounders acting at different stages of the woman lifespan mediate this relation.The cardioprotective effect of physical activity in women of all ages is well known. Women are generally more physically inactive than men. During and after menopause, most women tend to reduce their physical activity levels and together with the reduction in basal metabolic rate, women experience loss of skeletal muscle mass with a negative change in the ratio of fat-to-lean mass.In conclusion, sex differences in the cardiovascular system are because of dissimilarities in gene expression and sex hormones; these result in variations in prevalence and presentation of CVD and associated conditions, such as diabetes, hypertension and vascular and cardiac remodeling.Changes in lifestyle and increase in physical activity could help in prevention of cardiovascular disease in women.

2019 - Case report: Acute hepatic failure secondary to metastatic LIVER'S infiltration by upper tract urothelial carcinoma [Articolo su rivista]
Serra, F.; Guidetti, C.; Spatafora, F.; Cabry, F.; Farinetti, A. V.; Mattioli, V.; Gelmini, R.
abstract

Introduction: Acute liver failure (ALF) secondary to malignant infiltration of the liver from urothelial carcinoma is a very rare clinical condition and is often diagnosed only after death. Upper tract urothelial carcinoma (UTUC) is a rare, from 5% to 10% of all urothelial tumours, but possible cause of ALF when there is extensive liver metastatic involvement. We report the case of a patient who died in the intensive care unit (ICU) of our hospital from multiple organ failure (MOF) secondary to ALF, as a result of infiltration of the liver from UTUC diagnosed after surgery.PRESENTATION OF THE CASE: A 69-year-old Caucasian man was referred to our hospital for hematuria, melena, right upper quadrant (RUQ) pain and jaundice developed over the previous two weeks. After multidisciplinary discussion, he underwent emergency exploratory laparotomy to perform cholecystectomy because of suspected acute cholecystitis considered as a septic focus within the left kidney. He developed MOF and died on the 6th postoperative day. Discussion: From the diagnosis of the renal mass and the death of the patient, a few days have passed, and the diagnosis of UTUC has been put only at histological examination.The most common sites of metastases from UTUC are lymph nodes, lungs, liver, bones and peritoneum. Moreover, liver metastases have been identified to have an independent negative impact on overall survival in a patient affected by UTUC. Conclusion: The authors suggest that this condition should be taken into account when dealing with patients with evidence of a renal mass and simultaneous ALF.

2019 - Coffee as a nutraceutical beverage [Articolo su rivista]
Mattioli, A. V.; Coppi, F.; Farinetti, A.
abstract

In a recent paper we found that coffee consumption was associated with a decreased risk of developing asymptomatic PAD in a selected population of pre-menopausal women (Mattioli, Migaldi, & Farinetti, 2018). Women with high coffee consumption had a good adherence to Mediterranean Diet and high levels of physical activity suggesting a healthier lifestyle, a known factor of prevention of atherosclerosis.

2019 - Established coronary artery disease in systemic sclerosis compared to type 2 diabetic female patients: a cross-sectional study [Articolo su rivista]
Colaci, Michele; Giuggioli, Dilia; Spinella, Amelia; Vacchi, Caterina; Lumetti, Federica; Mattioli, Anna Vittoria; Coppi, Francesca; Aiello, Vincenzo; Perticone, Maria; Malatino, Lorenzo; Ferri, Clodoveo
abstract

Introduction: Systemic sclerosis (SSc) is an autoimmune disease characterized by endothelial dysfunction, which is also associated with other disorders, such as atherosclerosis. The direct role of SSc in facilitating cardiovascular events should be clarified. We compared the prevalence of established coronary artery disease (CAD) between SSc and type 2 diabetes, a well-known phenotype associated with high cardiovascular risk. Methods: In this cross-sectional study, we evaluated a cohort of 290 unselected female SSc patients, in comparison with 265 aged-matched female type 2 diabetics. “Established CAD” was defined as previous myocardial infarction, unstable angina or ischemia documented by ECG and troponin elevation, necessity/previous treatment with coronary angioplasty or stenting. Age subgroups < 45 (Q1), 45–54 (Q2), 55–64 (Q3), 65–74 (Q4), and ≥ 75 (Q5) years were considered for SSc and diabetes. Results: CAD prevalence resulted lower in SSc patients than in diabetics (10% (95%CI 6.9–14.1) versus 19.2% (95%CI 14.9–24.4); p = 0.0023). In Q2 patients, CAD never occurred in SSc (95%CI 0–8.4), but in 9.4% of diabetics (95%CI 3.7–20.7, p = 0.0567); in Q3 subjects, CAD was reported in 5.6% (95%CI 1.8–13.8) of SSc, but in 20% (95%CI 12.4–30.5) of diabetics (p = 0.0127). Instead, for Q4 and particularly Q5 patients, CAD prevalence was comparable in SSc and diabetes. Conclusions: The prevalence of established CAD in SSc was lower compared with diabetics. However, in older SSc patients the prevalence of CAD was similar to that observed in diabetics.

2019 - Guidelines for the use of flow cytometry and cell sorting in immunological studies (second edition) [Articolo su rivista]
Cossarizza, A.; Chang, H. -D.; Radbruch, A.; Acs, A.; Adam, D.; Adam-Klages, S.; Agace, W. W.; Aghaeepour, N.; Akdis, M.; Allez, M.; Almeida, L. N.; Alvisi, G.; Anderson, G.; Andra, I.; Annunziato, F.; Anselmo, A.; Bacher, P.; Baldari, C. T.; Bari, S.; Barnaba, V.; Barros-Martins, J.; Battistini, L.; Bauer, W.; Baumgart, S.; Baumgarth, N.; Baumjohann, D.; Baying, B.; Bebawy, M.; Becher, B.; Beisker, W.; Benes, V.; Beyaert, R.; Blanco, A.; Boardman, D. A.; Bogdan, C.; Borger, J. G.; Borsellino, G.; Boulais, P. E.; Bradford, J. A.; Brenner, D.; Brinkman, R. R.; Brooks, A. E. S.; Busch, D. H.; Buscher, M.; Bushnell, T. P.; Calzetti, F.; Cameron, G.; Cammarata, I.; Cao, X.; Cardell, S. L.; Casola, S.; Cassatella, M. A.; Cavani, A.; Celada, A.; Chatenoud, L.; Chattopadhyay, P. K.; Chow, S.; Christakou, E.; Cicin-Sain, L.; Clerici, M.; Colombo, F. S.; Cook, L.; Cooke, A.; Cooper, A. M.; Corbett, A. J.; Cosma, A.; Cosmi, L.; Coulie, P. G.; Cumano, A.; Cvetkovic, L.; Dang, V. D.; Dang-Heine, C.; Davey, M. S.; Davies, D.; De Biasi, S.; Del Zotto, G.; Dela Cruz, G. V.; Delacher, M.; Della Bella, S.; Dellabona, P.; Deniz, G.; Dessing, M.; Di Santo, J. P.; Diefenbach, A.; Dieli, F.; Dolf, A.; Dorner, T.; Dress, R. J.; Dudziak, D.; Dustin, M.; Dutertre, C. -A.; Ebner, F.; Eckle, S. B. G.; Edinger, M.; Eede, P.; Ehrhardt, G. R. A.; Eich, M.; Engel, P.; Engelhardt, B.; Erdei, A.; Esser, C.; Everts, B.; Evrard, M.; Falk, C. S.; Fehniger, T. A.; Felipo-Benavent, M.; Ferry, H.; Feuerer, M.; Filby, A.; Filkor, K.; Fillatreau, S.; Follo, M.; Forster, I.; Foster, J.; Foulds, G. A.; Frehse, B.; Frenette, P. S.; Frischbutter, S.; Fritzsche, W.; Galbraith, D. W.; Gangaev, A.; Garbi, N.; Gaudilliere, B.; Gazzinelli, R. T.; Geginat, J.; Gerner, W.; Gherardin, N. A.; Ghoreschi, K.; Gibellini, L.; Ginhoux, F.; Goda, K.; Godfrey, D. I.; Goettlinger, C.; Gonzalez-Navajas, J. M.; Goodyear, C. S.; Gori, A.; Grogan, J. L.; Grummitt, D.; Grutzkau, A.; Haftmann, C.; Hahn, J.; Hammad, H.; Hammerling, G.; Hansmann, L.; Hansson, G.; Harpur, C. M.; Hartmann, S.; Hauser, A.; Hauser, A. E.; Haviland, D. L.; Hedley, D.; Hernandez, D. C.; Herrera, G.; Herrmann, M.; Hess, C.; Hofer, T.; Hoffmann, P.; Hogquist, K.; Holland, T.; Hollt, T.; Holmdahl, R.; Hombrink, P.; Houston, J. P.; Hoyer, B. F.; Huang, B.; Huang, F. -P.; Huber, J. E.; Huehn, J.; Hundemer, M.; Hunter, C. A.; Hwang, W. Y. K.; Iannone, A.; Ingelfinger, F.; Ivison, S. M.; Jack, H. -M.; Jani, P. K.; Javega, B.; Jonjic, S.; Kaiser, T.; Kalina, T.; Kamradt, T.; Kaufmann, S. H. E.; Keller, B.; Ketelaars, S. L. C.; Khalilnezhad, A.; Khan, S.; Kisielow, J.; Klenerman, P.; Knopf, J.; Koay, H. -F.; Kobow, K.; Kolls, J. K.; Kong, W. T.; Kopf, M.; Korn, T.; Kriegsmann, K.; Kristyanto, H.; Kroneis, T.; Krueger, A.; Kuhne, J.; Kukat, C.; Kunkel, D.; Kunze-Schumacher, H.; Kurosaki, T.; Kurts, C.; Kvistborg, P.; Kwok, I.; Landry, J.; Lantz, O.; Lanuti, P.; Larosa, F.; Lehuen, A.; LeibundGut-Landmann, S.; Leipold, M. D.; Leung, L. Y. T.; Levings, M. K.; Lino, A. C.; Liotta, F.; Litwin, V.; Liu, Y.; Ljunggren, H. -G.; Lohoff, M.; Lombardi, G.; Lopez, L.; Lopez-Botet, M.; Lovett-Racke, A. E.; Lubberts, E.; Luche, H.; Ludewig, B.; Lugli, E.; Lunemann, S.; Maecker, H. T.; Maggi, L.; Maguire, O.; Mair, F.; Mair, K. H.; Mantovani, A.; Manz, R. A.; Marshall, A. J.; Martinez-Romero, A.; Martrus, G.; Marventano, I.; Maslinski, W.; Matarese, G.; Mattioli, A. V.; Maueroder, C.; Mazzoni, A.; Mccluskey, J.; Mcgrath, M.; Mcguire, H. M.; Mcinnes, I. B.; Mei, H. E.; Melchers, F.; Melzer, S.; Mielenz, D.; Miller, S. D.; Mills, K. H. G.; Minderman, H.; Mjosberg, J.; Moore, J.; Moran, B.; Moretta, L.; Mosmann, T. R.; Muller, S.; Multhoff, G.; Munoz, L. E.; Munz, C.; Nakayama, T.; Nasi, M.; Neumann, K.; Ng, L. G.; Niedobitek, A.; Nourshargh, S.; Nunez, G.; O'Connor, J. -E.; Ochel, A.; Oja, A.; Ordonez, D.; Orfao, A.; Orlowski-Oliver, E.; Ouyang, W.; Oxenius, A.; Palankar, R.; Panse, I.; Pattanapanyasat, K.; Paulsen, M.; Pavlinic, D.; Penter,
abstract

These guidelines are a consensus work of a considerable number of members of the immunology and flow cytometry community. They provide the theory and key practical aspects of flow cytometry enabling immunologists to avoid the common errors that often undermine immunological data. Notably, there are comprehensive sections of all major immune cell types with helpful Tables detailing phenotypes in murine and human cells. The latest flow cytometry techniques and applications are also described, featuring examples of the data that can be generated and, importantly, how the data can be analysed. Furthermore, there are sections detailing tips, tricks and pitfalls to avoid, all written and peer-reviewed by leading experts in the field, making this an essential research companion.

2019 - Link between coffee and atrial fibrillation debunked? [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

The relationship between atrial fibrillation (AF) and coffee is controversial, although it carries important clinical implications due to the fact that caffeine is one of the most widely consumed active substances in the world and that AF is the most common arrhythmia in adults.

2019 - Mediterranean Diet and wine intake could improve atrial function in patients with atrial fibrillation [Articolo su rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto; Gelmini, Roberta
abstract

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2019 - Negative pressure wound therapy (NPWT) after cytoreductive surgery (CRS) and intraperitoneal chemotherapy (HIPEC) for peritoneal surface malignancies: preliminary report [Articolo su rivista]
Serra, F; Sergi, W; Spatafora, F; De Ruvo, N; Farinetti, A; Mattioli, A V; Brugioni, L; Gelmini, R
abstract

Surgical site (SSI) infection is a common complication that occurs in the post-operative period because it still has a decisive impact on the morbidity and mortality of patients and the costs associated with therapy and prolongation of hospitalization. In recent years, therefore, several authors have published their experience in the use of negative pressure prevention systems (NPWT) for the management of surgical wounds. Few authors in the literature have discussed the use of NPWT in patients undergoing cytoreductive surgery (CRS) for peritoneal surface malignancies associated with hyperthermic intraperitoneal chemotherapy (HIPEC).

2019 - Polyphenols, Mediterranean diet, and colon cancer [Articolo su rivista]
Mattioli, A. V.; Farinetti, A.; Gelmini, R.
abstract

e have read with great interest the manuscript “Risk factors affecting hospital stay among patients undergoing colon cancer surgery: a prospective cohort study.” by Orive M and coworkers [1] and we found it very important with a view to clinical prevention. The article aimed to identify and validate risk factors that contribute to prolonged length of hospital stay (LOS) in a prospective cohort study that included 1955 patients undergoing resection for colorectal cancer. They found that some of the strongest independent predictors of prolonged LOS, such as surgical infections or open surgery, could be modified to reduce LOS and, in turn, other adverse outcomes.

2019 - Potential negative effects of caffeine in athletes [Articolo su rivista]
Mattioli, A. V.; Sisca, G.; Farinetti, A.
abstract

Letter related to “Rahimi MR, Khabiri P, Faraji H. Effects of caffeine ingestion on resistance exercise-induced apoptosis in athletes: A randomized, double-blind, placebo-controlled, crossover study. PN 2Jul.2018 [cited 20Dec.2018];20(4):563-9.”

2019 - Prevention of cardiovascular risk factors in women: The lifestyle paradox and stereotypes we need to defeat [Articolo su rivista]
Sciomer, S; Moscucci, F; Maffei, S; Gallina, S; Mattioli, Av
abstract

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2019 - Primary Prevention Of Cardiovascular Risk In Octogenarians By Risk Factors Control [Articolo su rivista]
Palmiero, Pasquale; Zito, Annapaola; Maiello, Maria; Cecere, Annagrazia; Mattioli, Anna Vittoria; Pedrinelli, Roberto; Scicchitano, Pietro; Ciccone, Marco Matteo
abstract

Primary prevention of cardiovascular events in older adults is a relevant problem, because of lack of evidence for safe and efficacious therapy, its costs and elderly quality of life, Italy's aging population is constantly increasing, so cardiovascular disease (CVD) primary prevention in the elderly is a prime objective. Life expectancy has dramatically increased over the last 2 decades,the proportion of individuals aged 80 years and older has grown rapidly in Europe and United States,but cost / effective ratio of CVD prevention through risk factors control is debated. It is therefore important to implement cardiovascular risk factors estimation in the elderly to maximize quality of life of patients and to lengthen their healthy life expectancy, choosing the better treatment for each patient sharing the choice with himself when it is possible, always remembering that elderly patients often have multiple co-morbidities that require a high number of concurrent medications; this may increase the risk for drug-drug interactions, thereby reducing the potential benefits of CVD prevention therapy. Anyway CVD are not an inevitable concomitant of aging. Sometimes autopsy in the elderly reveals atheroma-free coronary arteries,a normal-sized heart and unscarred valves. All primary prevention strategy decisions should consider estimated life expectancy and overall function not only cardiovascular event risks, magnitude and time to benefit or harm, potentially altered adverse effect profiles, and informed patient preferences.CVD primary prevention need to be more implemented in the elderly, this might contribute to improve health status and quality of life in this growing population if correctly performed.

2019 - Sporadic and hereditary hemangioblastoma: The role of endothelial cells [Articolo su rivista]
Feletti, A.; Bianchini, E.; De Gaetano, A.; Gibellini, L.; De Biasi, S.; Pavesi, G.; Mattioli, A. V.; Nasi, M.; Cossarizza, A.; Pinti, M.
abstract

2019 - The beneficial effect of Mediterranean Diet on Colon-rectal Cancer [Articolo su rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto; Gelmini, Roberta
abstract

Dear Editor, We have read with great interest the paper “Mediterranean diet adherence and risk of pancreatic cancer: A pooled analysis of two Dutch cohorts.” by Schulpen M and coworkers [1] and we found their conclusion of importance with a view to clinical prevention. They examined the association between Mediterranean Diet (MedD) adherence and pancreatic cancer incidence by pooling data from the Netherlands Cohort Study (NLCS, 120,852 subjects) and the Dutch cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC‐NL 40,011 subjects). MedD adherence was assessed using alternate and modified Mediterranean diet scores including and excluding alcohol. MedD adherence was not significantly associated with pancreatic cancer risk in pooled and study specific analyses, regardless of sex and MedD score. Authors concluded that MedD adherence was not associated with pancreatic cancer risk in a pooled analysis of two Dutch cohorts. With reference to the findings reported in the paper, we would like to make the following contribution to the discussion. In a recent paper we analysed 3 components of the Mediterranean Diet that seems to be associated with reduction of Colon Cancer [2]. We analysed the effects of olive oil (polyphenols), red grapes (resveratrol), and tomatoes (lycopene). Specifically, the consumption of olive oil exerts a protective effect in reducing risk for CRC many other types of cancer, including prostatic and breast. Olive oil may exert its protective effect, influencing polyamine metabolism in cells leading to a reduction in cancerogenesis progression. [3] Accepted Article This article is protected by copyright. All rights reserved. 3 The Mediterranean Diet is characterized by high intake of antioxidants and polyphenols. [4,5] It is well known that these components exert many positive effects on cardiovascular system and prevent the development of atherosclerosis both in men and women [4,5]. Schulpen M and coworkers observed no association between MedD adherence and pancreatic cancer in both women and men. It is well known that the there is a sex differences in oxidative stress and inflammation. [6,7,8] Oxidative stress and inflammation play a crucial role in the pathogenesis of atherosclerosis vascular inflammation leading to infarction and ischemia. Oxidative stress seems to be higher in male than female rats, being that the levels of SOD, GPx and lipid peroxidation are lower and higher in males versus females, respectively. [6] In humans, the biomarkers of oxidative stress are higher in young men than in women of the same age, although this is not a univocal result. Resveratrol has many pleiotropic pharmacologic properties. It promotes protection against damage from reactive oxygen species and from inflammation, resulting in cardiovascular protective benefits and, certainly, anticancer activities. In our review of the literature we concluded that the beneficial effects of Mediterranean Diet in patients with colon cancer belong to the synergistic effects of several components.

2019 - The role of physical activity in individuals with cardiovascular risk factors: an opinion paper from Italian Society of Cardiology-Emilia Romagna-Marche and SIC-Sport [Articolo su rivista]
Nasi, Milena; Patrizi, Giampiero; Pizzi, Carmine; Landolfo, Matteo; Boriani, Giuseppe; Dei Cas, Alessandra; Cicero, Arrigo F G; Fogacci, Federica; Rapezzi, Claudio; Sisca, Giovanbattista; Capucci, Alessandro; Vitolo, Marco; Galiè, Nazzareno; Borghi, Claudio; Berrettini, Umberto; Piepoli, Massimo; Mattioli, Anna V
abstract

: Regular physical activity is a cornerstone in the prevention and treatment of atherosclerotic cardiovascular disease (CVD) due to its positive effects in reducing several cardiovascular risk factors. Current guidelines on CVD suggest for healthy adults to perform at least 150 min/week of moderate intensity or 75 min/week of vigorous intensity aerobic physical activity. The current review explores the effects of physical activity on some risk factors, specifically: diabetes, dyslipidemia, hypertension and hyperuricemia. Physical activity induces an improvement in insulin sensitivity and in glucose control independently of weight loss, which may further contribute to ameliorate both diabetes-associated defects. The benefits of adherence to physical activity have recently proven to extend beyond surrogate markers of metabolic syndrome and diabetes by reducing hard endpoints such as mortality. In recent years, obesity has greatly increased in all countries. Weight losses in these patients have been associated with improvements in many cardiometabolic risk factors. Strategies against obesity included caloric restriction, however greater results have been obtained with association of diet and physical activity. Similarly, the beneficial effect of training on blood pressure via its action on sympathetic activity and on other factors such as improvement of endothelial function and reduction of oxidative stress can have played a role in preventing hypertension development in active subjects. The main international guidelines on prevention of CVD suggest to encourage and to increase physical activity to improve lipid pattern, hypertension and others cardiovascular risk factor. An active action is required to the National Society of Cardiology together with the Italian Society of Sports Cardiology to improve the prescription of organized physical activity in patients with CVD and/or cardiovascular risk factors.

2019 - Women and diabetes: disparity in treatment [Articolo su rivista]
Mattioli, A.; Coppi, F.
abstract

2018 - 4Ts Score and EuroSCORE in cardiac surgery [Articolo su rivista]
Mattioli, Anna Vittoria; Manenti, Antonio; Farinetti, Alberto
abstract

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2018 - A Comment on Griffin et al “My Quest, an Intervention Using Text Messaging to Improve Dietary and Physical Activity Behaviors and Promote Weight Loss in Low-Income Women” [Articolo su rivista]
Mattioli, A. V.; Ballerini Puviani, M.
abstract

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2018 - AB0724 Cardio-pulmonary disease management in patients with systemic sclerosis: cardio-rheumatology clinic and patient care standardisation proposal [Abstract in Rivista]
Spinella, A; Lumetti, F; Mattioli, Av; Coppi, F; Rosario, R; Cocchiara, Emanuele; Colaci, M; Ferri, C; Salvarani, C; Giuggioli, D
abstract

2018 - Alcohol mixed with energy drinks and arrhythmias [Articolo su rivista]
Mattioli, Anna Vittoria; Manenti, Antonio; Farinetti, Alberto
abstract

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2018 - Bacteremia in Cardiac Surgery Patients with Heparin-Induced Thrombocytopenia [Articolo su rivista]
Mattioli, Av; Manenti, A; Farinetti, A.
abstract

We have read with great interest the paper "Characterization of hospitalized cardiovascular patients with suspected heparin-induced thrombocytopenia" by Stoll and co-workers [1] and we found it very important with a view to clinical prevention.

2018 - Cardiac involvement in systemic sclerosis: identification of high-risk patient profiles in different patterns of clinical presentation [Articolo su rivista]
Coppi, Francesca; Giuggioli, Dilia; Spinella, Amelia; Colaci, Michele; Lumetti, Federica; Farinetti, Alberto; Migaldi, Mario; Rossi, Rosario; Ferri, Clodoveo; Boriani, Giuseppe; Mattioli, Anna Vittoria
abstract

Systemic sclerosis (SSc) is a chronic connective tissue disease characterized by widespread microvascular damage, dysregulation of fibroblasts with collagen overproduction and excessive fibrosis of the skin and internal organs, as well as complex immune system abnormalitie….

2018 - Cardio-pulmonary disease management in patients with systemic sclerosis: cardio-rheumatology clinic and patient care standardisation proposal [Abstract in Atti di Convegno]
Spinella, A; Lumetti, F; Mattioli, Av; Coppi, F; Rosario, R; Cocchiara, Emanuele; Colaci, M; Ferri, C; Salvarani, C; Giuggioli, D
abstract

Background Systemic sclerosis (SSc) is a chronic connective tissue disease characterised by endothelial dysfunction, dysregulation of fibroblasts with excessive fibrosis of the skin and internal organs and autoimmune abnormalities. Cardio-pulmonary manifestations are common in SSc and their detection in the early stage of the disease as well as their careful follow-up are mandatory in order to counteract their impact on the overall disease outcome. Despite the need of establishing a proper methodology, literature provides few reports about this issue. Objectives To evaluate the activity of our Cardio-Rheumatology Clinic in order to optimise diagnostic management of cardio-pulmonary disease in SSc patients. Methods We retrospectively analysed data from 350 consecutive SSc patients referred to our University-based Rheumatology Centre and SSc Unit (F/M 308/42; lc/dcSSc 45/305; mean age 50.8±14.7 years; mean disease duration 10.9±7.0 years). All patients underwent general and cardio-pulmonary assessment, in particular they were evaluated in the Cardio-Rheumatology Clinic. The following parameters were considered: physical examination; past and current drugs; blood tests, in particular Erythrocyte sedimentation rate-ESR, C-reactive protein-CRP, CPK enzymes, troponin, NT-pro-BNP, d-dimer, serum autoantibodies, 25-OH-vitamin D; capillaroscopy; pulmonary function tests; high resolution scan of the lungs (HRCT); standard electrocardiogram (ECG) and 24 hour Holter ECG monitoring; Doppler echocardiography; cardiac stress test; coronary angiography and right heart catheterization (RHC); cardiac MRI and CT; vascular ultrasound (intima-media-thickness, carotid-femoral and brachial-ankle pulse-wave-velocity). The clinicians decided to perform these examinations according to clinical picture and current methodologies.Results In the last 12 months we assessed 300 patients with 1st-level screening (cardio-rheumatologic evaluation, standard ECG, Doppler echocardiography, pulmonary function tests, thoracic imaging). Among 2nd-level, 30 procedures of 24 hour Holter ECG and 15 RHC tests were performed. Cardiac MRI, coronary CT angiography and vascular ultrasound were assessed, when requested, as 3rd-level examinations (30 procedures). After 1 year we observed a mean time of 10±5 days between request and clinical cardio-rheumatologic evaluation, 20±12 days to perform 1st-level screening, 25±15 days to execute the 2nd-level examinations. Figure-1 shows Cardio-Rheumatology algorithm for the management of SSc cardio-pulmonary disease. Conclusions The activity of our Cardio-Rheumatology Clinic optimises the cardio-pulmonary SSc assessment, determining an early detection of these harmful complications with reduced waiting times which are critical issues. Screening algorithms are useful to stratify the risk and to establish the most appropriate diagnostic-therapeutic protocols, improving outcome of scleroderma patients. The development of a cardio-pulmonary risk score and the standardisation of a patient care approach, according to international quality indeces, could represent further tools to optimise SSc management.

2018 - Chocolate intake in pre-menopausal women [Articolo su rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto
abstract

With reference to the findings reported in the paper, we would like to make the following contribution to the discussion. In a recent analysis performed on 650 healthy women in pre-menopausal age (age range 45–54 years), we found that chocolate intake was higher in women in the low quartile of adherence to Mediterranean Diet (low Med Score).

2018 - Coffee and caffeine consumption in women affected by hypertension [Articolo su rivista]
Mattioli, Anna Vittoria; Ballerini Puviani, Matteo; Farinetti, Alberto
abstract

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2018 - Coffee in hypertensive women with asymptomatic peripheral arterial disease: a potential nutraceutical effect [Articolo su rivista]
Mattioli, Anna V; Migaldi, Mario; Farinetti, Alberto
abstract

Several studies suggest that coffee is associated with a lower risk of atherosclerosis.1,2 Coffee contains polyphenol antioxidants, which have been hypothesized to act against free oxygen radicals and lipid peroxidation and to improve endothelial function.1–3 Coffee is part of the Mediterranean diet, one of the healthiest diets. The characteristics.....

2018 - Combined Rehabilitation and Nutritional Coaching After Cardiac Surgery: Gender Differences [Articolo su rivista]
Mattioli, Anna Vittoria; Coppi, Francesca; Pennella, Sonia; Farinetti, Alberto
abstract

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2018 - Dietary sugar added to coffee and tea in pre-menopausal women [Articolo su rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto
abstract

...

2018 - Energy drinks and atrial fibrillation in young adults [Articolo su rivista]
Mattioli, Anna Vittoria; Pennella, Sonia; Farinetti, Alberto; Manenti, Antonio
abstract

The present paper evaluates the association between energy Drinks (EDs) and occurrence of atrial fibrillation (AF) in young people. Data from three clinical cases of AF after EDs consumption are reported. All patients presented with palpitations, nausea and anxiety. ECG showed AF with high ventricular response (135-170 bpm range frequency). Anamnestic record reported a high consumption of EDs during the previous eight hours from the onset of AF. In one case ED was associated with a moderate quantity of alcohol. Patients were successfully cardioverted both spontaneously and after pharmacological treatment. After cardioversion: the ECG and echocardiogram appeared normal in all patients; the toxicological tests and the laboratory analyses resulted negative. Our experience suggests that larger consumption of EDs, especially when combined with alcoholic beverages, could act as a trigger in the development of AF in young patients. This action may be caused by the synergic effect of caffeine and other substances present in EDs. Following the increasing consumption of EDs in young people, we suggest a careful attention to cardiac complicati

2018 - Energy drinks and obesity: Preliminary results from a preclinical study [Articolo su rivista]
Mattioli, Anna Vittoria; Manenti, Antonio; Bonetti, Luca Reggiani; Farinetti, Alberto
abstract

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2018 - Fruit and vegetables in hypertensive women with asymptomatic peripheral arterial disease [Articolo su rivista]
Mattioli, Av; Coppi, F; Migaldi, M; Farinetti, A.
abstract

Background and aims: Fruit and vegetables are considered a very healthy diet useful in the prevention of cardiovascular disease. The present study aims to evaluate intake of fruit and vegetables in hypertensive women and its correlation with asymptomatic atherosclerosis. Methods and results: A group of 237 women with hypertension was evaluated. Fruit and vegetables consumption were assessed by a self-administered food frequency validated questionnaire completed by an interviewer administered 24 h diet recall. They all underwent ABI. ABI measurement observed that fruit consumption was inversely associated with pre-clinical atherosclerosis suggesting a protective effect, moreover this association was stronger for vegetables. Increasing intake of vegetables was associated with a lower risk of asymptomatic PAD. Conclusions: Women with a high intake of fruit and vegetables showed less instrumental sign of preclinical peripheral atherosclerosis. Can be suggests that fruit and vegetables play an important role in prevention of atherosclerosis in pre-menopausal women.

2018 - Heparin-Induced Thrombocytopenia in Cardiac Surgery Patients [Articolo su rivista]
Mattioli, Anna Vittoria; Manenti, Antonio; Farinetti, Alberto
abstract

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2018 - Heparin-induced thrombocytopenia and sepsis [Articolo su rivista]
Mattioli, Anna Vittoria; Manenti, Antonio; Farinetti, Alberto
abstract

We retrospectively analyzed data from 600 post-cardiac surgery patients in order to evaluate the incremental value of performing 4Ts Test and EuroSCORE test for prediction of heparin-induced thrombocytopenia.

2018 - Impact of Physical Activity on Preclinical Atherosclerosis in Premenopausal Women [Articolo su rivista]
Mattioli, Av; Coppi, F; Ballerini Puviani, M; Farinetti, A
abstract

...

2018 - Impact of obesity on heparin-induced thrombocytopenia in cardiac surgery patients [Articolo su rivista]
Mattioli, A. V.; Manenti, A.; Farinetti, A.
abstract

2018 - Management of cardiopulmonary disease in patients with systemic sclerosis: cardiorheumatology clinic and patient care standardization proposal [Articolo su rivista]
Spinella, Amelia; Coppi, Francesca; Mattioli, Anna Vittoria; Lumetti, Federica; Rossi, Rosario; Cocchiara, Emanuele; Colaci, Michele; Boriani, Giuseppe; Ferri, Clodoveo; Salvarani, Carlo; Giuggioli, Dilia
abstract

Management of cardiopulmonary disease in patients with systemic sclerosis: cardiorheumatology clinic and patient care standardization proposal

2018 - Physical activity in premenopausal women with asymptomatic peripheral arterial disease [Articolo su rivista]
Mattioli, Av; Coppi, F; Migaldi, M; Farinetti, A
abstract

...

2018 - Pre-clinical atherosclerosis is associated with low coffee consumption and low adherence to Mediterranean Diet in pre-menopausal women [Articolo su rivista]
Mattioli, Anna Vittoria; Ballerini Puviani, Matteo
abstract

In a recent analysis performed on 650 healthy women in premenopausal age we evaluated preclinical atherosclerosis by using the ankle brachial index (ABI) and we correlates with level of adherence to Mediterranean Diet and coffee consumption [2]. We found that ABI was correlated with Mediterranean Diet Score (rho = 0. 41, P < 0.05), indicating

2018 - Propofol: a safe anaesthetic drug in experimental cardiac surgery in rabbits [Articolo su rivista]
Giuliani, Enrico; Manenti, Antonio; Barbieri, Alberto; Farinetti, Alberto; Mattioli, Anna Vittoria
abstract

Experimental surgery needs a pharmacological approach that can interfere with cardiac function.

2018 - Relationship between espresso coffee consumption and preclinical atherosclerosis in a Mediterranean population [Articolo su rivista]
Mattioli, A. V.; Ballerini Puviani, M.; Farinetti, A.
abstract

2018 - Response to: A fifth of surgeons in England are female [Articolo su rivista]
Gelmini, R; Farinetti, A; Mattioli, Av
abstract

During the last decade, the percentage of women graduates in medicine has increased considerably, in Italy and Europe, and therefore inevitably also those who specialize in general surgery and specialized branches. The data provided by the Statistical Office of the Ministry of Education of the University and Research (MIUR) for the academic year 2014/2015 show that 45.3% of those enrolled in schools of specialization in general surgery are women.

2018 - Sex differences in adherence to guidelines in aspirin prescription in a population of low-risk cardiovascular patients [Articolo su rivista]
Mattioli, Anna Vittoria; Manenti, Antonio; Farinetti, Alberto
abstract

Aspirin is widely used in low risk patients with cardiovascular disease to prevent thrombosis, despite the increasing risk of bleeding. We evaluated the adherence to guidelines in aspirin prescription in 2095 patients (960 men (45.8%) and 1135 women (54.2%), mean age 58 ± 12 years) affected by minor rectal hemorrhage.

2018 - Surgery of Moderate Coronary Artery Stenosis [Articolo su rivista]
Mattioli, A. V.; Farinetti, A.; Manenti, A.; Roncati, L.
abstract

2018 - Time trends of dietary and lifestyle factors and their potential impact on diabetes burden in China [Articolo su rivista]
Mattioli, Anna Vittoria; Coppi, Francesca; Farinetti, Alberto
abstract

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2017 - A potential pro-arrhythmic mechanism of energy drinks [Articolo su rivista]
Mattioli, Av
abstract

We have read with great interest the paper “Randomized Controlled Trial of High‐Volume Energy Drink Versus Caffeine Consumption on ECG and Hemodynamic Parameters” by Fletcher and coworkers and we found their conclusion of importance with a view to clinical prevention of arrhythmias in young people.

2017 - Adherence to guideline and aspirin discontinuation [Articolo su rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto
abstract

In a cohort of 3.000 patients, undergoing pre-operative evaluation for minor surgery, we evaluated aspirin intake and the adherence to guideline. We found that 505 patients were treated with aspirin (16.8%), 312 men (61.8%) and 193 women (38.2%), (p&lt;0.05). 379 patients, 254 men (67%) and 125 women (33%), .....

2017 - Chocolate intake and risk of atrial fibrillation [Articolo su rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto; Manenti, Antonio
abstract

With reference to the findings reported in the paper, we would like to make the following contribution to the discussion. In a recent analysis performed on 650 healthy women in pre-menopausal age (age range 45-54 years) chocolate intake was higher in women in the low quartile of adherence to Mediterranean Diet (low Med Score). This subgroup of women showed a lower ABI index compared to women with higher Med Score. The analysis of sources of antioxidants showed a greater intake from fruit and vegetables in the higher quartiles of Med Score. Coffee and tea were similarly distributed among the quartiles of Med Score [2]. Analysis from diet recall had the major limitation of missing data regarding out-of-mealtime snacking and drinking. In Mediterranean countries, wine is a strong antioxidant source and the synergistic effect of drinking wine during meals and antioxidant bioavailability is well known. We clearly understand that nutritional habits in Northern Europe differ from Mediterranean ones. However, we would like to underline that in a Mediterranean lifestyle characterized by high intake of antioxidants,...

2017 - Dark chocolate could prevent pre-clinical atherosclerosis [Articolo su rivista]
Mattioli, Av; Ballerini Puviani, M.
abstract

We have read with great interest the paper “Effects of Dark Chocolate and Almonds on Cardiovascular Risk Factors in Overweight and Obese Individuals: A Randomized Controlled-Feeding Trial” by Lee and coworkers [1] and we found their results of importance in the field of clinical prevention. Authors demonstrate that consumption of almonds alone or combined with dark chocolate under controlled feeding conditions improves lipid profiles. Incorporating almonds, dark chocolate, and cocoa into a typical American diet without exceeding energy needs may reduce the risk of coronary heart disease

2017 - Does stem cell therapy induce myocardial neoangiogenesis? Histological evaluation in an ischemia/reperfusion animal model [Articolo su rivista]
Pennella, Sonia; Bonetti, L. R.; Migaldi, Mario; Manenti, Antonio; Lonardi, Roberto; Giuliani, Enrico; Barbieri, Alberto; Farinetti, Alberto; Mattioli, Anna Vittoria
abstract

Background: In an experimental model in the rabbit, a myocardial ischemia-reperfusion injury was obtained. Subsequently, the effects of homologous bone marrow stem cell (BMSC) administration were studied. Methods: In 21 New Zealand adult rabbits, ischemia/reperfusion damage was induced by temporary occlusion of the anterior descending coronary artery. Homologous BMSCs were isolated, cultured and re-suspended for injection at the level of the ischemic zone. We evaluated the proangiogenetic effect of intramyocardial injections of BMSC at the peri-infarcted area. Histological evaluations were made after 20 days from the surgical procedure. Results: In rabbits treated with intramyocardial BMSC administration, we demonstrated histologically capillary neoangiogenesis, without signs of tissue immunological reaction or of generation of new myocardial cells. On the contrary, only minimal neovascular supply was detected in rabbits treated with intravenous administration of BMSC. Only typical signs of ischemic myocardium injury were observed in the control group. Conclusion: These observations suggest that the effect of direct BMSC administration in ischemic myocardium could promote a capillary neoangiogenesis, which helps to prevent ischemic myocardial damage.

2017 - Influence of energy drinks on obesity: a preliminary experimental study [Articolo su rivista]
Mattioli, Anna Vittoria; Pennella, Sonia; Manenti, Antonio; Ballerini Puviani, Matteo; Farinetti, Alberto
abstract

We performed an experimental research in Sprague-Dawley rats in order to evaluate the effects of different caffeinated beverages on obesity. Animals were divided in 4 groups and received beverages containing different concentration of caffeine: a commercial Energy Drink, a commercial Cola Soda, regular coffee and water. After 15 days we found that Energy Drink and Cola Soda induced body weight gain, on contrary sweetened coffee and water did not influence weight. Besides, an increased reactivity and motility was observed in the Energy Drink supplemented animals. Laboratory tests excluded obesity-correlated dysmetabolism. We supposed a central nervous action of some components of Energy Drink other than caffeine, even if their finest mechanisms are unknown. At long term, degeneration from a condition of body weight gain to obesity cannot be excluded.

2017 - Mediterranean Diet and Colorectal Cancer: a systematic review [Articolo su rivista]
Farinetti, Alberto; Zurlo, Valeria; Manenti, Antonio; Coppi, Francesca; Mattioli, Anna Vittoria
abstract

Colorectal cancer (CRC) is the third most common cancer worldwide, especially in developed countries where an estimated 60% of all cases occur. There is evidence of a higher risk in Western society whose behaviours are characterised by higher consumption of red and processed meat than in people living along Mediterranean coast, who have a decreased overall cancer mortality correlated to eating habits such as Mediterranean Diet. Aim: This review evaluate the correlation between 3 components of MedD (olive oil, red wine and tomatoes) and incidence and progression of CRC.

2017 - Mediterranean diet impact on cardiovascular diseases: a narrative review [Articolo su rivista]
Mattioli, Anna Vittoria; Palmiero, Pasquale; Manfrini, Olivia; Puddu, Paolo E; Nodari, Savina; Dei Cas, Alessandra; Mercuro, Giuseppe; Scrutinio, Domenico; Palermo, Pietro; Sciomer, Susanna; Di Francesco, Simona; Novo, Giuseppina; Novo, Salvatore; Pedretti, Roberto F. E; Zito, Annapaola; Parati, Gianfranco; Pedrinelli, Roberto; Farinetti, Alberto; Maiello, Maria; Moscucci, Federica; Tenaglia, Raffaele L; Sucato, Vincenzo; Triggiani, Marco; Cugusi, Lucia; Scicchitano, Pietro; Saba, Pier S; Ciccone, Marco M.
abstract

: Cardiovascular disease (CVD) accounts for more than 17 million deaths per year worldwide. It has been estimated that the influence of lifestyle on CVD mortality amounts to 13.7% for smoking, 13.2% for poor diet, and 12% for inactive lifestyle. These results deeply impact both the healthy status of individuals and their skills in working. The impact of CVD on productivity loss accounts for the 24% in total costs for CVD management.Mediterranean diet (MedD) can positively impact on natural history of CVD. It is characterized by a relatively high consumption of inexpensive and genuine food such as cereals, vegetables, legumes, nuts, fish, fresh fruits, and olive oil as the principal source of fat, low meat consumption and low-to-moderate consumption of milk, dairy products, and wine.Its effects on cardiovascular health are related to the significant improvements in arterial stiffness. Peripheral artery disease, coronary artery disease, and chronic heart failure are all positively influenced by the MedD. Furthermore, MedD lowers the risk of sudden cardiac death due to arrhythmias.The present narrative review aims to analyze the effects of MedD on CVD.

2017 - Relationship between Mediterranean diet and asymptomatic peripheral arterial disease in a population of pre-menopausal women [Articolo su rivista]
Mattioli, Anna Vittoria; Coppi, Francesca; Migaldi, Mario; Scicchitano, P.; Ciccone, M. M.; Farinetti, Alberto
abstract

...

2017 - The Influence of Health on Gross Domestic Product and National Income [Articolo su rivista]
Mattioli, Av; Ballerini Puviani, M.
abstract

It is beyond question how the Gross Domestic Product (GDP) and the other National Income and Product Accounts (NIPA) have been groundbreaking in the economic studies and researches of the last century, nevertheless they are often targets of criticism as a result of their failure in including non-market activities in their estimates. Since the beginning of the last century the technophysio evolution has enabled a fivefold increase of the average retirement period, an increase of seven times of the portion of individuals who lives to retire and a fourfold increase of the leisure time of those who are still in the labor force.

2016 - Energy drink overconsumption can trigger atrial fibrillation [Articolo su rivista]
Mattioli, Anna Vittoria; Pennella, Sonia; Manenti, Antonio; Farinetti, Alberto
abstract

Many adverse cardiac effects have been reported follow- ing energy drinks consumption, among which atrial arrhythmias, acute coronary syndromes, and even cardiac arrest. These can develop also in the absence of other symptoms related to acute toxicity, such as neurological symptoms. Considering the absence of specific toxico- logical tests, the diagnosis of energy drink intoxication still remains clinica

2016 - Histological and immunohistochemical analysis of meatbased food preparations [Articolo su rivista]
Migaldi, Mario; Giulio, Rossi; Alessandro, Sgambato; Farinetti, Alberto; Mattioli, Anna Vittoria
abstract

This study aimed to verify the possibility to use standard morphologically-based techniques to assess the tissue composition of typical meat-based food preparations. Twenty-six different types of meat-based products were randomly selected and histologically analyzed. A variety of tissues were identified including connective tissue, blood vessels, peripheral nerve, adipose tissue, glandular tissue, skin, bone and cartilage and plant material. Glial fibrillary acidic protein staining was also used to evaluate the presence of brain tissue. The results obtained suggest that most of the analyzed products display a more complex composition than the one suggested by package label. These findings confirms the suitability of standard morphological techniques to examine the histology of meat-based food preparations and suggest their use for the control and quality certification of these types of products

2015 - A comparative analysis between laparoscopy and open colectomy: assessment of perioperative and oncological outcomes [Articolo su rivista]
Farinetti, Alberto; Bonetti, Luca Reggiani; Migaldi, Mario; Mattioli, Anna Vittoria; Pennella, Sonia; Muratori, Simone; Rossi, Aldo
abstract

AIM: Aim of the study was to compare two groups of patients affected by colorectal adenocarcinoma that underwent to open colectomy and laparoscopic colectomy respectively, highlighting the advantage and problems. MATERIAL OF STUDY: This is a retrospective analysis. Between January 2003 and December 2006, 54 patients who underwent colectomy were recruited. Of these, 26 patients underwent open colectomy, and 28 laparoscopy. RESULTS: For open colectomy the average duration of surgery was 177.9 minutes (surgical time) and 280.4 minutes (time of operating room) with a minimum of 110 and a maximum of 360 minutes, with significant differences according to type of surgery performed and the patient’s clinical history. For laparoscopy the average duration was 293 minutes, (range 135 - 520), with significant differences depending on the portion of the intestinal tract removed. DISCUSSION: The comparison of two different surgical techniques, laparoscopic and open colectomy revealed some differences. The duration of the resection was greater for laparoscopy when compared to the traditional technique. CONCLUSIONS: Both approaches are technically feasible, safe and oncologically correct. Laparoscopic technique shows a much more favorable outcome in terms of pain, absence of extensive scarring, the incidence of incisional hernias and hospital stay -surgery compared with surgery laparotomy.

2015 - An unusual case of enoxaparin induced thrombocytopenia in intensive care unit [Articolo su rivista]
Giuliani, Enrico; Melegari, Gabriele; Farinetti, Alberto; Barbieri, Alberto; Mattioli, Anna Vittoria
abstract

OBJECTIVES: To present a case of heparin induced thrombocytopenia in a patient treated with enoxaparin. METHODS: A case of heparin-induced thrombocytopenia was examinated with a detailed platelet count analysis over the time and with detection of platelets antibodies. RESULTS: The detection of platelet antobodies and the recovery of platelet count after cessation of enoxaparin strongly support the diagnosis of heparin-induced thrombocytopenia (HIT). CONCLUSION: HIT is a severe side effects of heparin administration. It is more frequent in patients treated with unfractionated heparin however can also be induced by low molecular weight heparin. Guideline suggests the cessation of heparin administration and the treatment of patients with fondaparinux.

2015 - Caffeine and atrial fibrillation [Capitolo/Saggio]
Mattioli, Anna Vittoria
abstract

Caffeine is the most popular consumed active substance in the world, and almost all caffeine comes from coffee. However, recent reports have suggested an increase in caffeine intake from energy drinks, mainly in adolescent and young adults. The effects of caffeine on atrial fibrillation are controversial, because human studies lead to different results. It depends on the source and on the dose of caffeine. Moderate intake of caffeine seems to have protective effects on arrhythmias; to the contrary, high intake of caffeine seems to be associated with increased risk of atrial fibrillation. A review of literature is presented.

2015 - Caffeine, Energy Drinks and Atrial Fibrillation: A Mini-Review [Articolo su rivista]
Pennella, Sonia; Farinetti, Alberto; Mattioli, Anna Vittoria
abstract

The present mini-review analyzes the relationship between caffeine and atrial fibrillation (AF) and specifically referred to the association between energy drinks (EDs) and occurrence of AF. The topic is very actual whereas data in literature are controversial. The quantity of caffeine in EDs is really high and is often underestimated by users. Several case-reports suggested a risk of AF in subjects assuming high quantity of EDs and it is becoming a social problem due to the wide use of mix drinks (EDs and alcohol) among youth.

2014 - Beverages of daily life: Impact of caffeine on atrial fibrillation [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

In recent years, clinical and observational studies reported that caffeine consumption was associated with cardiac arrhythmias, affected heart rate variability, and subsequently increased cardiovascular risk. The analysis of these paper shows that data are controversial and strongly depends on methodology. Moderate intake of caffeine seems to have protective effects on arrhythmias, on contrary high intake of caffeine seems to be associated with increased risk of atrial fibrillation. There is a deep difference when we analysed intake of caffeine from coffee compared to other sources. In very recent time an increase in caffeinated beverages, namely energy drinks, has been reported in young people and several arrhythmic complications has been observed. A review of literature is presented.

2014 - Endothelial Function in Pre-diabetes, Diabetes and Diabetic Cardiomyopathy: A Review [Articolo su rivista]
Matteo Ciccone, Marco; Scicchitano, Pietro; Cameli, Matteo; Cecere, Annagrazia; Mattioli, Anna Vittoria
abstract

Diabetes mellitus worsens cardiovascular risk profile of affected individuals. Its worldwide increasing prevalence and its negative influences on vascular walls morphology and function are able to induce the expression of several morbidities which worsen the clinical conditions of the patients getting them running towards a reduced survival curve. Although overt diabetes increases the mortality rate of individuals due to its pathogenesis, poor information are in literature about the role of pre-diabetes and family history of diabetes mellitus in the outcome of general population. This emphasizes the importance of early detection of vascular impairment in subjects at risk of developing diabetes. The identification of early stages of atherosclerotic diseases in diabetic persons is a fundamental step in the risk stratification protocols followed-up by physicians in order to have a complete overview about the clinical status of such individuals. Common carotid intima-media thickness, flow-mediated vasodilatation, pulse wave velocity are instrumental tools able to detect the early impairment in cardiovascular system and stratify cardiovascular risk of individuals. The aim of this review is to get a general perspective on the complex relationship between cardiovascular diseases onset, pre-diabetes and family history of diabetes. Furthermore, it points out the influence of diabetes on heart function till the expression of the so-called diabetic cardiomyopathy.

2014 - HEPARIN-INDUCED THROMBOCYTOPENIA:MECHANISMS [Capitolo/Saggio]
Mattioli, Anna Vittoria
abstract

Heparin-induced thrombocytopenia (HIT) is an immune adverse drug-induced reaction characterized by thrombocytopenia and paradoxical thrombosis. HIT is induced by heparin dependent IgG antibodies that bind the PF4 factor and activate platelets. The pathophysiology of HIT is complex, involving platelet activation, the activation of coagulation cascade, and endothelial dysfunction. Clinical suspicion f HIT can be confirm by using two different types of laboratory assay: a platelet activation assays and immunoassays for detection of PF4-heparin antibodies. These latter are most frequently used in clinical practice due to their wide availability. The clinical picture includes severe thrombocytopenia, typically developing between days 4 to day 10 from the exposure to heparin, followed by venous or arterial thrombosis. The most frequent clinical presentations are deep venous thrombosis and pulmonary embolism, however patients affected by cardiovascular disease can develop embolic stroke, recurrent myocardial infarction and arterial thrombosis. The management of HIT includes discontinuation of any kind of heparin drugs, including heparin flushes. Recent 2012 practice guidelines from the ACCP recommended the administration of directs thrombin inhibitors and factor Xa inhibitors in patients with acute HIT and in patients with heparin-induced antibodies even in absence of thrombocytopenia and thrombosis.

2014 - Platelet Activation in Extracorporeal Circulation: Effects of Unfractionated Heparin on Damages Induced by Bio-incompatibility [Poster]
Pennella, Sonia; Corazzari, Tolmino; Fiorito, L.; Mattioli, Anna Vittoria
abstract

Background. Interaction with biomaterials of non-endothelial surfaces of cardiopulmonary bypass circuit caused platelets activation.The aim of study was to evaluate the effects of unfractionated heparin (UH) on platelet activation induced by extracorporeal circulation (ECC). Methods. Analysis were performed on peripheral human blood (PB) obtained from 10 healthy adult blood donors.Markers were evaluated after in-vitro and after ECC stimulation, samples with and without UF were compared. In-vitro stimulation was tested on 10 ml of PB, at 37°C for 2 hours in Orbital Shaker SSL1 stirrer at flat speed. ECC stimulation was carried out on 100 ml of PB circulated 2 hours/37°C at a rate of 1.70 l/min.We tested Annexin V (marker of platelet activation) and CD41a (marker of platelet aggregation). Samples were analyzed on a flow cytometer. Results. We compared samples with UH and samples without (control=ctr) after in-vitro and ECC stimulation.We observed a greater positivity to Annexin V after ECC compared to in-vitro (25.9 vs 8.7%; p<0.01) in ctr samples. Similarly, CD41a+ was greater after ECC than in-vitro stimulation (68 vs 28.3%; p<0.01).In samples with UH, Annexin V was greater after ECC than in-vitro stimulation (25 vs 9%; p<0.001). A similar result was observed for CD41a (66 vs 23%; p<0.01). ECC induced a platelet activation compared to in-vitro stimulation. Addition of UH led to a reduction of platelet activation in vitro, and to a more marked reduction after ECC. Conclusions. ECC act on platelet activation.The addition of UH in the blood and in the circuit reduced activation, suggesting a positive action of the drug on the observed effects induced by biomaterials.

2013 - Adherence To Mediterranean Diet And Intake Of Antioxidants Influence Spontaneous Conversion Of atrial Fibrillation [Articolo su rivista]
Mattioli, Anna Vittoria; Miloro, C; Pennella, Sonia; Pedrazzi, Patrizia; Farinetti, Alberto
abstract

Background and aim The Mediterranean diet (MedD) has long been associated with lower incidence of cardiovascular disease. Little information is available on association between MedD, vitamins intake and arrhythmias. We sought to investigate the relationship between adherence to MedD, antioxidants intake and spontaneous conversion of atrial fibrillation (AF). Methods and Results A group of 800 subjects was included in a case-control study; 400 of them had a first detected episode of AF. Nutritional parameters were assessed by a self-administered food frequency validated questionnaire and completed by an interviewer-administered 7 days diet recall. Adherence to MedD was evaluated using the Mediterranean Score and intake of antioxidants from food was calculated. Adherence to the Med Diet was lower in patients that developed AF compared to control (mean Med Score: 22.3 ± 3.1 vs 27.9 ± 5.6; p < 0.001). The median value was 23.5 (Q1-Q3 range 23–30) in patients with AF and 27.4 (Q1-Q3 range 26–33). The estimated intake of total antioxidants was lower in patients with AF (13.5 ± 8.3 vs 18.2 ± 9.4 mmol/d; p < 0.001). Patients in the highest quartile of Mediterranean Score had higher probability of spontaneous conversion of atrial fibrillation (OR1.9; 95%CI 1.58–2.81). High levels of antioxidants intake were also associated with an increasing probability of spontaneous conversion of arrhythmia (O.R. 1.8; 95%CI 1.56–2.99; P < 0.01). Conclusions Patients with atrial fibrillation had lower adherence to MedD and lower antioxidant intake compared to control population. Moreover patients with arrhythmia showing a higher Med Score had more probability of a spontaneous conversion of atrial fibrillation.

2013 - Clinical use of virally inactived plasma. The experience of Blood Transfusion Unit in Mantova, Italy [Articolo su rivista]
Lepri, D; Capuzzo, E; Mattioli, Anna Vittoria; Dall'Oglio, D; Sgarioto, V; Terenziani, I; Caramaschi, G; Manzato, F; Franchini, M.
abstract

Riassunto. Introduzione. Il plasma fresco congelato (PFC) è un emocomponente il cui utilizzo clinico è molto diffuso in tutto il mondo. La sicurezza trasfusionale di questo prodotto è assicurata da test, obbligatori per legge, che vengono eseguiti su ogni singola donazione, ma può essere ulteriormente incrementata tramite l’utilizzo di alcune procedure tra cui il blu di metilene e la tecnica di inattivazione virale con solvente-detergente. Il Dipartimento di Medicina Trasfusionale ed Ematologia di Mantova, dal 2007, ha introdotto l’utilizzo di plasma di grado farmaceutico virus-inattivato con metodica solvente-detergente (Plasmasafe, Kedrion) in sostituzione al PFC da singolo donatore. Le linee guida per l’utilizzo di entrambi i prodotti sono le medesime. Materiali e metodi. Con l’obiettivo primario di valutare l’efficacia terapeutica e la sicurezza di Plasmasafe, si è deciso di monitorare gli eventi trasfusionali con questo prodotto nei pazienti del reparto di Rianimazione e Terapia Intensiva dell’Ospedale Carlo Poma di Mantova, eseguendo dosaggi di alcuni parametri coagulativi (PT, aPTT, ATIII, fibrinogeno, PC, PS, FV, FVII, FVIII) prima dell’infusione di Plasmasafe e a distanza di 24 ore dalla trasfusione. Risultati. Da un punto di vista clinico è stata confermata l’efficacia di Plasmasafe poiché si è sempre avuto arresto o riduzione dei sanguinamenti in atto; inoltre, non si sono registrate reazioni avverse post-trasfusionali di nessuna entità. I risultati di laboratorio statisticamente più eloquenti riguardano i dosaggi valutati come attività (PC, PS, ATIII, FV, FVII, FVIII) per i quali si è osservato un deciso incremento successivo all’infusione di una dose terapeutica di Plasmasafe. Infine, i pazienti trasfusi con Plasmasafe hanno ricevuto un volume significativamente inferiore rispetto ad una coorte storica di pazienti trattati con il PFC (503 mL con Plasmasafe versus 1549 mL con il PFC, P<0,001). Conclusioni. I risultati del nostro studio hanno chiaramente documentato che il Plasmasafe, un prodotto virus inattivato con un contenuto standard dei fattori della coagulazione, è un prodotto sicuro efficace ed economicamente vantaggioso in grado di correggere rapidamente i difetti emostatici nei pazienti critici.

2013 - Gender differences in adherence to Mediterranean diet and risk of atrial fibrillation [Abstract in Rivista]
Mattioli, Anna Vittoria; Pennella, Sonia; Pedrazzi, P.; Rosi, C.; Farinetti, Alberto
abstract

...

2013 - Surgical approach to intramyocardial administration of bone marrow stem cells in an animal model. [Articolo su rivista]
Farinetti, Alberto; Lonardi, Roberto; Barbieri, Alberto; Giuliani, Enrico; Pennella, Sonia; Pozza, M; Saviano, Massimo; Manenti, Antonio; Mattioli, Anna Vittoria
abstract

Abstract AIM: The aim of the study was to evaluate the surgical approach to intramyocardial (i.m.) injection of Bone Marrow Stem Cells (BMSCs) in a pre-clinical model and its complications. MATERIAL OF STUDY: In New Zealand rabbits an ischemia reperfusion injury lasting 20 min was induced by temporary ligation of anterior descending coronary artery during cardiac surgical procedure. Homologous BMSCs were isolated from the posterior iliac crest, cultured and re-suspended for injection. BMSC were injected at the peri-infarcted area and side effects were evaluated. A control group with myocardial infarction was treated with i.m. injections of saline, to evaluate possible side effects of injection. Comparison of ventricular premature contractions (VPC), ventricular tachycardia and ventricular fibrillation were recorded during surgery and after 7 and 21 days. RESULTS: Seven rabbits developed intractable ventricular fibrillation during the experimental protocol, three during coronary ligation but before cell injections and four following i.m. injections. At day 7, hourly PVC were more frequent in the groups of animals that received i.m. injections of BMSCs (132 +/- 19 beats) compared to saline injections. (54 +/- 14). CONCLUSIONS: Intramyocardial injections of BMSCs induced an electrical instability as shown by a high number of PVC as compared with intramyocardial injections of saline.

2013 - Task force on 'Early markers of atherosclerosis: influence of age and sex' [Articolo su rivista]
Marco Matteo, Ciccone; Elene, Bilianou; Alberto, Balbarini; Michele, Gesualdo; Lorenzo, Ghiadoni; Marco, Metra; Pasquale, Palmiero; Roberto, Pedrinelli; Massimo, Salvetti; Pietro, Scicchitano; Annapaola, Zito; Salvatore, Novo; Mattioli, Anna Vittoria
abstract

Atherosclerosis and its complications are the most important causes of death all over the world, especially in Western countries. Diet habits, modern stress life, smoking, sedentary way of life and an involvement of genetic pattern of individuals lead to a sure degeneration of quality of life increasing the risk of atherosclerosis development. For this reason, the main purpose of actual medicine is to identify all the markers that could allow the physicians to evaluate the first moments of the development of this dangerous pathological process. The aim is to reduce the speed of its evolution, trying to delay indefinitely the risk coming from the morphological alterations of the vessels. 'Endothelium function' could allow physicians to detect the first moment of the natural history of atherosclerosis process. Its impairment is the first step in the degeneration of vascular structures. Many methods [flow-mediated vasodilatation (FMD); antero-posterior abdominal aorta diameter (APAO); intima-media thickness of the common carotid artery (CCA-IMT); arterial stiffness; and so on] try to evaluate its function, but many limitations come from general population characteristics. A standardization of the methods should take into account individuals' peculiarities. Two elements, not modifiable, should be taken into account for vascular evaluation: age and sex. The aim of this review is to outline the linkage among age, sex and instrumental evaluation of patients considered for a noninvasive assessment of their cardiovascular risk profile

2013 - The usefulness of Moynihan questionnaire in the evaluation of knowledge on healthy diet of patients undergoing cardiology rehabilitation [Articolo su rivista]
Rosi, C; Pennella, Sonia; Fantuzzi, Anna Laura; Pedrazzi, P; Passalacqua, M; Gavioli, M; Migaldi, Mario; Farinetti, Alberto; Mattioli, Anna Vittoria
abstract

BACKGROUND: The aim of study was to test the usefulness of Moynihan questionnaire in the evaluation of knowledge on healthy diet of patients undergoing cardiology rehabilitation. METHODS: We enrolled 51 patients (pts): 41 men and 10 women, mean age 67.97 +/-11.2 years. The case study included: 21 pts that underwent coronary bypass surgery, 16 pts replaced plastic tube, 14 pts had surgery for the other reasons. All pts underwent nutritional investigation by a dietitian. Anthropometric and biochemical parameters were detected and, by the end, the Moynihan questionnaire was administrated. Pts underwent nutritional coaching, and questionnaire and dietary assessment were rechecked after 3 months. RESULTS: At baseline, the mean Questionnaire score was 22.4 +/- 3.2 points, decreased to 20.6 +/-3.1 points after 3 months (p&lt;0.05). A detailed analysis of the questions showed that the major informations gaps were related to consumption of fruits and vegetables, consumption of fat and salt. In addition pts have acquired more general knowledge about food composition. CONCLUSIONS: The Moynihan questionnaire is an useful instrument of evaluation of dietary knowledge even in selected patients population. In the present study involving patients after cardiac surgery the main difficulties were related to high age of pts, the low cultural level and, mainly, to the post-surgery stress. However, an increase of correct answers as well as an increased knowledge about food composition were detected after educational intervention performed by the dietitian.

2012 - Adherence to guidelines in Aspirin Administration in Real-Life Patients with Low Cardiovascular risk [Abstract in Rivista]
Pennella, Sonia; Farinetti, Alberto; Migaldi, Mario; Mattioli, Anna Vittoria
abstract

adherence to aspirin

2012 - Analysis of pro-arrhythmic effects induced by different routes of administration of bone marrow stem cells [Articolo su rivista]
Mattioli, Anna Vittoria; Lonardi, Roberto; Giuliani, Enrico; Barbieri, Alberto; S., Pennella; Farinetti, Alberto
abstract

Bone Marrow Stem Cells,Intramyocardial injections,Ischemia/Reperfusion,Pre-Clinical Study,QT interval

2012 - Atrial Remodeling in Pregnant Hypertensive Women: Comparison between Chronic and Gestational Hypertension [Articolo su rivista]
Mattioli, Anna Vittoria; Pennella, Sonia; Demaria, F; Farinetti, Alberto
abstract

Objectives: Left atrial (LA) enlargement is a common finding in hypertensive patients (pts), however little information is available on LA changes during pregnancy. The present study evaluated LA size and function in pregnant women with hypertension.Methods: Patients population included 30 women with chronic hypertension and 30 patients with gestational hypertension.A control group of 16 normotensive pregnant women was selected. Serial echocardiography was performed at 12 and 24 week of gestation in chronic hypertension and at 24 week in gestational hypertension and after delivery. LA diameters andvolumes were measured and compared. LA conduit volume, passive and active emptying volumes were calculated.Patients were divided in 2 groups according to max LAV Index &gt; 32 ml/m2 at 24 week of gestation.Results: Patients with chronic hypertension showed higher LA diameters (42 ± 2.0 vs. 36.5 ± 1.8; p&lt;0.001) and LA volumes (maximal volume 45.5 ± 4.0 vs. 38.1 ± 7.3; p&lt;0.001) compared with patients with gestational hypertension. The median value of max LAVI was 32 + 6.2 ml/m2 in chronic and 26 + 5 ml/m2 in gestational hypertension (p&lt;0.01). During follow-up patients with max LAVI &gt; 32 ml/m2 had more clinical complications evaluated as increase of therapy, fluid retention that need diuretic and hospitalization.Conclusion: Patients with chronic hypertension showed a more marked increased of LA volumes compared to gestationalhypertension due to a remodeling of atrial shape as effect of chronic overload. Patients with more dilated LA volumes developed a greater number of clinical complications suggesting that a dilated LA could be a parameter of hemodynamic instability.

2012 - Impact of Euroscore and 4TS Score in Predicting Thrombosis After Cardiac Surgery [Abstract in Rivista]
Mattioli, Anna Vittoria; Pennella, Sonia; Farinetti, Alberto; G., Ambrosio
abstract

...

2012 - Mediterranean Diet and Pre-clinical Atherosclerosis in Pre-Menopausal Women [Abstract in Rivista]
Pennella, Sonia; Farinetti, Alberto; Pedrazzi, Patrizia; Mattioli, Anna Vittoria
abstract

Mediterranean Diet

2012 - Nutrition and prevention of venous thromboembolism [Articolo su rivista]
Pennella, S; Mattioli, Av
abstract

Prophylaxis of venous thromboembolism is a major health problem in everyday clinical practice. The therapeutic anticoagulants available to clinicians for prophylaxis of VTE is mainly composed by parenteral anticoagulants and oral vitamin K antagonists, warfarin. Oral vitamin K antagonists have several limitations, including a narrow therapeutic window and a metabolism that is affected by multiple drug and herbal interactions, vitamin K intake and genetic polymorphisms. The present review explore causes of poor prevention of thromboembolism and evaluated some new anticoagulants. The main target of new anticoagulants is to replace oral vitamin K antagonists for long-term anticoagulation. Moreover the role of genetics and the novel concept of cell therapy is evaluated. The hypothesis is that the patho-physiology of thrombosis may involve a "physiologic" cell that provides the same repair molecules that are used for treatment of thrombotic disorders.

2012 - Stile di vita e fibrillazione atriale [Articolo su rivista]
Mattioli, Anna Vittoria; Pennella, Sonia; Farinetti, Alberto
abstract

Lifestyle factors, in particular dietary intake, have been recognized as important, modifiable risk factors for cardiovascular disease. Consuming a heart-healthy diet lowers the individual’s risk for CVD. Data on relationship between lifestyle and atrial fibrillation are controversial, however the strong association between obesity, atrial/ventricular dysfunction and a non-healthy lifestyle and atrial fibrillation, suggests that correction of nutritional habits could prevent the development of arrhythmias through reduction of underline cardiac diseases. Today the Mediterranean diet is considered one of the best in term of prevention of cardiovascular disease.

2012 - Ventricular Arrhythmias Following Intramyocardial Injections of Bone Marrow Stem Cells: an Animal Model. [Abstract in Rivista]
Mattioli, Anna Vittoria; Lonardi, Roberto; Pennella, Sonia; E., Giuliani; Farinetti, Alberto
abstract

...

2011 - Aderenza alle linee guida nell'uso dell'aspirina in pazienti con precedente emorragia e malattie cardiovascolari [Abstract in Rivista]
Pennella, S.; Farinetti, Alberto; Lonardi, R.; Giuliani, E.; Tazzioli, Giovanni; Mattioli, Anna Vittoria
abstract

...

2011 - Carotid artery disease from diagnosis to therapy: when medical therapy is appropriate? [Relazione in Atti di Convegno]
Mattioli, Anna Vittoria
abstract

...

2011 - Gender differences in adherence to mediterranean diet and risk of atrial fibrillation [Articolo su rivista]
Mattioli, Anna Vittoria; Pennella, Sonia; Pedrazzi, Patrizia; Farinetti, Alberto
abstract

Adherence to the Mediterranean Diet i associated with a reduction of overall mortality and mortality from cardiovascular disease and cancer.

2011 - Heparin‑ Induced Thromboytopenia: A Misdiagnosed Clinical Syndrome. [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

..Heparin‑induced thrombocytopenia (HIT) is an immune adverse drug‑induced reaction characterized by thrombocytopenia and an increased incidence of thrombosis following subsequent exposure to heparin. Clinical pictures included thrombocytopenia followed by venous thrombosis or arterial thrombosis, the most frequent clinical presentations are deep venous thrombosis and pulmonary embolism.

2011 - Influence of coffee and caffeine consumption on atrial fibrillation in hypertensive patients [Articolo su rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto; Miloro, C; Pedrazzi, Patrizia; Mattioli, Giorgio
abstract

BACKGROUND AND AIMS: Coffee and caffeine are widely consumed in Western countries. Little information is available on the influence of coffee and caffeine consumption on atrial fibrillation (AF) in hypertensive patients. We sought to investigate the relationship between coffee consumption and atrial fibrillation with regard to spontaneous conversion of arrhythmia. METHODS AND RESULTS: A group of 600 patients presenting with a first known episode of AF was investigated, and we identified 247 hypertensive patients. The prevalence of nutritional parameters was assessed with a food frequency questionnaire. Coffee and caffeine intake were specifically estimated. Left ventricular hypertrophy was evaluated by electrocardiogram (ECG) and echocardiogram. Coffee consumption was higher in normotensive patients. High coffee consumers were more frequent in normotensive patients compared with hypertensive patients. On the other hand, the intake of caffeine was similar in hypertensive and normotensive patients, owing to a higher intake in hypertensive patients from sources other than coffee. Within normotensive patients, we report that non-habitual and low coffee consumers showed the highest probability of spontaneous conversion (OR 1.93 95%CI 0.88-3.23; p=0.001), whereas, within hypertensive patients, moderate but not high coffee consumers had the lowest probability of spontaneous conversion (OR 1.13 95%CI 0.67-1.99; p=0.05). CONCLUSION: Coffee and caffeine consumption influence spontaneous conversion of atrial fibrillation. Normotensive non-habitual coffee consumers are more likely to convert arrhythmia within 48h from the onset of symptoms. Hypertensive patients showed a U-shaped relationship between coffee consumption and spontaneous conversion of AF, moderate coffee consumers were less likely to show spontaneous conversion of arrhythmia. Patients with left ventricular hypertrophy showed a reduced rate of spontaneous conversion of arrhythmia.

2011 - Influenza di Diversi Tipi di Eparina Sui Potenziali Bioelettrici Generati Dalla Circolazione Extracorporea [Abstract in Rivista]
Pennella, Sonia; Corazzari, Tolmino; Fiorito, L; Farinetti, Alberto; Mattioli, Anna Vittoria
abstract

n/a

2011 - Lifestyle and atrial fibrillation [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

...

2011 - Pro-arrhythmic effects of intramiyocardial administration of mesenchymal bone marrow stem cells: a pre-clinical study [Abstract in Rivista]
Mattioli, Anna Vittoria; Lonardi, Roberto; E., Giuliani; S., Pennella; Farinetti, Alberto
abstract

...

2011 - Relationship between ventricular arrhythmias and prologed QT time duration after intramyocardial administration of bone marrow stem cells. [Abstract in Rivista]
Mattioli, Anna Vittoria; Pennella, S.; Lonardi, R.; Giuliani, E.; Barbieri, Alberto; Farinetti, A.
abstract

...

2010 - Aderenza alle linee guida nell'uso dell'aspirina in pazienti con precedente emorragia e malattie cardiovascolari [Abstract in Rivista]
S., Pennella; Farinetti, Alberto; Lonardi, Roberto; E., Giuliani; M., Davoli; Tazzioli, Giovanni; Mattioli, Anna Vittoria
abstract

...

2010 - Cardiac arrhythmias after intramyocardial administration of mesenchymal bone marrow stem cells in acute myocardial infarction [Abstract in Atti di Convegno]
Mattioli, Anna Vittoria; Farinetti, Alberto; Lonardi, Roberto; Enrico, Giuliani; Sonia, Pennella; Losi, Lorena; Barbieri, Alberto
abstract

...

2010 - Dieta Mediterranea e Antiossidanti: differenze di genere in pazienti con fibrillazione atriale. [Abstract in Rivista]
S., Pennella; Farinetti, Alberto; Pedrazzi, Patrizia; C., Miloro; Lonardi, Roberto; Mattioli, Anna Vittoria
abstract

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2010 - EuroSCORE and 4Ts score could predict thrombotic complications after cardiac surgery [Abstract in Atti di Convegno]
Mattioli, Anna Vittoria; Farinetti, A.; Barbieri, Alberto; Lonardi, R.; Pennella, S.; Ambrosio, G.
abstract

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2010 - Low adherence to guidelines in aspirin use in patients with previous minor bleeding and cardiovascular disease [Abstract in Rivista]
Mattioli, Anna Vittoria; S., Pennella; Lonardi, Roberto; Tazzioli, Giovanni; Farinetti, Alberto
abstract

...

2010 - Recurrences of stroke in patients with atrial septal aneurysm and patent foramen ovale : long-term follow-up [Abstract in Rivista]
Mattioli, Anna Vittoria; S., Pennella; Farinetti, Alberto; Lonardi, Roberto
abstract

...

2010 - Sub-acute and acute stress could act as trigger for atrial fibrillation [Abstract in Rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto; S., Pennella; S., Bonatti; Giuliani, Enrico
abstract

...

2010 - Valutazione del danno vascolare periferico a livello carotideo in pazienti con anticorpi eparina-indotti:follow-up ad un anno [Abstract in Rivista]
S., Pennella; Farinetti, Alberto; Lonardi, Roberto; Mattioli, Anna Vittoria
abstract

...

2010 - Ventricular Arrhythmias after intramyocardial administration of mesenchymal bone marrow stem cells in acute myocardial infarction: an animal model. [Abstract in Rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto; Lonardi, Roberto; E., Giuliani; S., Pennella
abstract

...

2009 - Adherence to the Mediterranean Diet and risk of atrial fibrillation. [Abstract in Rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto; C., Miloro; Pedrazzi, Patrizia; R., Melotti
abstract

Aims. The Mediterranean diet has long been associated with lower incidence of cardiovascular disease. Little information is available on association between high Mediterranean diet, antioxidant vitamins intake and arrhythmias. We sought to investigate the relationship between adherence to Mediterranean diet and atrial fibrillation (AF). Methods and Results. A group of 800 patients of mean age 54 ± 11 years was included in the study; 400 of them had a first detected episode of AF. Nutritional parameters were assessed by a self-administered food frequency validated questionnaire and completed by an interviewer-administered 7 days diet recall.

2009 - Anticorpi anti eparina/PF4 e placche carotidee: studio mediante Doppler e follow-up ad un anno [Abstract in Atti di Convegno]
U., Carletti; Farinetti, Alberto; Lonardi, Roberto; L., Bonetti; Mattioli, Anna Vittoria
abstract

Premesse.L’eparina è un farmaco ampiamente usato nelle patologie cardiache. La somministrazione di eparina non frazionata può indurre la comparsa di una reazione avversa su base autoimmune nota come trombocitopenia eparina indotta (HIT). La HIT è caratterizzata da trombocitopenia e trombosi paradossa che può colpire sia il sistema venoso che quello arterioso. I pazienti (paz) che sviluppano HIT presentano una trombocitopenia con riduzione della conta piastrinica >50% del valore basale, complicanze tromboemboliche e presenza di anticorpi anti eparina/PF4 nel siero.Nel presente studio abbiamo valutato la presenza di placche carotidee in una popolazione di paz trattati con eparina non frazionata in rapporto agli anticorpi anti eparina/PF4.

2009 - Fenomeni aritmici correlati alla terapia cellulare nell'infarto miocardico acuto: modello sperimentale [Relazione in Atti di Convegno]
Mattioli, Anna Vittoria; Farinetti, Alberto
abstract

Nel nostro laboratorio è in corso di sperimentazione un protocollo che valuta gli effetti della somministrazione di cellule staminali mesenchimali da midollo osseo in un modello animale di infarto miocardico. Le finalità della ricerca sono:1) individuare i meccanismi alla base della differenziazione delle cellule staminali in cardiomiociti2) individuare le eventuali aritmie cardiache riconducibili all'impianto di cellule staminali3) individuare il meccanismo che innesca e sostiene le manifestazioni aritmicheIl modello animale utilizza Conigli New Zealand di sesso maschile. Il protocollo di studio è stato approvato dal Comitato Etico per studi su piccoli animali dell’Università degli studi di Modena e Reggio Emilia.

2009 - Heparin/PF4 antibodies formation after heparin treatment: Temporal aspects and long-term follow-up [Articolo su rivista]
Mattioli, Anna Vittoria; L., Bonetti; M., Zennaro; G., Ambrosio; Mattioli, Giorgio
abstract

BACKGROUND: Heparin-induced thrombocytopenia is characterized by the presence of heparin-induced antibodies against heparin/platelet factor-4 (PF4) complex and paradoxical thrombosis. Little is known on the persistence of antiheparin antibodies in blood. The aim of this study was to evaluate the time course of heparin/PF4 antibodies in patients exposed to heparin. METHODS: We initially enrolled 500 patients treated with unfractionated heparin as part of perioperative management of coronary artery bypass graft; those who developed serologically confirmed heparin/PF4 antibodies were selected for further follow-up. Over 3 years, we repeatedly assessed serum concentration of antibodies (by enzyme-linked immunosorbent assay) and occurrence of thrombotic events. RESULTS: One hundred thirty-one patients (26.2%) developed anti-PF4/heparin antibodies, which persisted for a median time of 90 days (Quartile 1-Quartile 3, 31-186). At 30 days, patients with antibodies had higher incidence of thrombotic events (28.2% vs 14.9%, P < .01) and death/myocardial infarction (14.5% vs 7.8%, P < .001). Of the 131 patients with antiheparin/PF4 antibodies, 78 had already developed antibodies before cardiac surgery; such patients became serologically negative more slowly than patients who developed antibodies after surgery. Over 3 years of follow-up, patients with anti-PF4/heparin antibodies developed 65 thrombotic events, 25 patients developed deep vein thrombosis and/or pulmonary embolism, and 20 patients myocardial infarction. CONCLUSIONS: Patients with heparin-induced antibodies are more likely to develop thrombosis after cardiac surgery. Patients in whom antibodies are present before surgery show longer persistence of antibodies and increased incidence of thrombotic events over time. Persistence of antibodies suggests that these patients may be at risk for developing thrombosis; and therefore, further exposure to heparin should be limited.

2009 - Influenza di diversi tipi di eparina sulla infiammazione indotta dalla circolazione extracorporea: studio dei potenziali bioelettrici [Abstract in Rivista]
Mattioli, Anna Vittoria; Corazzari, Tolmino; U., Carletti; D., Meglioli; Losi, Lorena; Farinetti, Alberto
abstract

...

2009 - Intake di antiossidanti e aderenza alla dieta mediterranea influenzano il rischio di fibrillazione atriale. [Abstract in Rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto; C., Miloro; Pedrazzi, Patrizia; Lonardi, Roberto; Mattioli, Giorgio
abstract

...

2009 - Metabolic Syndrome and Obesity in Peripheral Arterial Disease [Relazione in Atti di Convegno]
Mattioli, Anna Vittoria; Farinetti, Alberto
abstract

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2009 - Recidiva di stroke in pazienti con aneurisma del setto interatriale e patent foramen ovale: influenza della terapia. [Abstract in Rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto; Lonardi, Roberto; U., Carletti; C., Miloro; Mattioli, Giorgio
abstract

...

2009 - Thrombotic Events in Patients with Anti-Platelet Factor 4/Heparin-Antibodies. [Articolo su rivista]
Mattioli, Anna Vittoria; Bonetti, L; Zennaro, M; Ambrosio, G; Mattioli, Giorgio
abstract

BACKGROUND: Antibodies to the heparin/platelet factor 4(PF4)complex are linked to the pathogenesis of heparin-induced thrombocytopenia type II, and to the thrombotic complications associated with this syndrome. We investigated the long-term relationship between antibody concentration and thrombosis. METHODS: Two-hundred and fifty patients who had been treated with unfractionated heparin as part of cardiac surgery management were included in the study. Immunoassay ELISA test was used to detect the presence and the plasma concentration of heparin-PF4 antibodies (as optical density value, O.D.). Follow-up lasted one year and new thrombotic events (myocardial infarction, stroke, pulmonary embolism), and death from any cause, were evaluated. RESULTS: Seventy-nine of 250 patients (31.6%) developed anti-PF4/heparin antibodies after cardiac surgery. Nadir platelet count was significantly lower in patients who developed antibody positivity (82,000+/-31,000/mm(3) versus 105,000+/-52,000/mm(3),P<0.001). At follow up, patients with anti-PF4/heparin antibodies were more likely to die or develop myocardial infarction (25.3% versus 10.5%, P<0.001), pulmonary embolism (20.2% versus 5.8%, P<0.001), or stroke (12.6% versus 5.8%, P<0.001), than patients who were antibody-negative. Patients were categorized in quintiles of antibody concentration according to the O.D. The risk of developing thrombotic events markedly increased with increasing quintile of O.D., with the highest group showing an OR of 7.68(4.04-9.20)(P<0.001). CONCLUSIONS: Patients who develop antibodies to the PF4-heparin complex have a significantly higher rate of thrombotic events during a one year follow-up than those who lack these antibodies; within this group the risk of developing thrombosis increases with increasing plasma concentration of antibodies.

2009 - Thrombotic events in patients with antiplatelet factor 4/Heparin antibodies after cardiac surgery [Abstract in Rivista]
Mattioli, Anna Vittoria; L., Bonetti; U., Carletti; R., Vivoli; G., Ambrosio; Mattioli, Giorgio
abstract

Background. Antibodies to the heparin/platelet factor 4 (PF4) complex are linked to the pathogenesis of heparin-induced thrombocytopenia type II, and to the thrombotic complications associated with this syndrome. Because these antibodies may activate vascular endothelium as well as platelets, their presence may possibly increase the risk of thrombotic events. We investigated the long-term relationship between antibody concentration and thrombosis. Methods and results. Two-hundred and fifty patients who had been treated with unfractionated heparin as part of cardiac surgery management were included in the study. Immunoassay ELISA test was used to detect the presence and the plasma concentration of heparin-PF4 antibodies. Follow-up lasted one year and new thrombotic events (myocardial infarction, stroke, pulmonary embolism), and death from any cause, were evaluated

2009 - Ventricular Arrhythmias After Intramyocardial Administration of Mesenchymal Bone Marrow Stem Cells in Acute Myocardial Infarction: An Animal Model [Abstract in Rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto; Lonardi, Roberto; Losi, Lorena; Barbieri, Alberto; Enrico, Giuliani; Mattioli, Giorgio
abstract

Background. Mesenchymal bone marrow derived cells (MSCs) have been shown to home to injured tissue and produce growth factors that aid angiogenesis. We aim to evaluate ventricular premature contractions (VPCs) and mechanical properties of cardiomyocytes after MSC transplantation using the micro-electrical mechanical systems (MEMS) Technology; these tiny microchips implanted in the heart may be used to monitor heart physiology. Methods. An acute myocardial infarction was induced by ligation of anterior coronary artery in New Zealand rabbits, weighting >3 kg (10 min of ischemia followed by reperfusion). MSCs were isolated, cultured and re-suspended in saline for injection. Injections were done at the peri-infarcted areas, in 5 rabbits we injected MSC whereas in 5 control rabbits we injected saline (to evaluate pro-angiogenic effect of intramyocardial injections i.m.). An arrhythmias recorder was located on the animal and the ECG was recorded for 7 days. Animals were sacrificed and histological and morphological analysis was performed.

2008 - Atrial Stunning, Inflammation and Nutritional Status after cardioversion from atrial fibrillation. [Articolo su rivista]
Mattioli, Anna Vittoria; S., Bonatti; Melotti, R; Mattioli, Giorgio
abstract

BACKGROUND: Conversion of atrial fibrillation (A-Fib) to sinus rhythm is associated with transient mechanical dysfunction of left atrium and appendage, termed atrial stunning. OBJECTIVES: The aim of the present study was to evaluate the relationship between nutritional status and atrial stunning after conversion of A-fib. METHODS: Fifty-eight hemodynamically stable patients referred for cardioversion for lone AF were included in this study. To assess nutritional status and inflammation we measured: hemoglobin, erythrocyte mean cell volume, increased transferrin, decreased percent transferrin saturation and ferritin, albumin, CRP and Fe. Usual dietary intake was assessed with the use of a semi-quantitative food frequency questionnaire. LA function was assessed using peak atrial filling velocity, atrial ejection force and peak of emptying and filling velocities of left atrial appendage. RESULTS: Patients were categorized in 4 groups according to value of CRP and Fe. Patients with normal value of CRP and normal value of Fe and patients with elevated CRP but normal value of Fe showed no difference in parameters of atrial function. On contrary patients with reduced value of Fe showed significantly reduced parameters of atrial function. CONCLUSIONS: Data of the present study showed that patients with a reduction of Fe present a marked dysfunction of atrial contractility in comparison with other groups. We cautiously hypothesize an iron mechanism. The hemodynamic stress due to A-Fib can generate highly toxic hydroxyl radicals. These oxygen free radicals probably damage cells by oxidating various cell components and could be important in inducing myocardial stunning after A-Fib.

2008 - Coffe consumption and atrial fibrillation [Abstract in Rivista]
Mattioli, Anna Vittoria; TARABINI CASTELLANI, Emma; S., Bonatti; C., Miloro; D., Lodi; Mattioli, Giorgio
abstract

Background. Coffee is one of the most popular beverages consumed in a large amount in Western Countries. Coffee contains several hundred different substances but its effects oncardiovascular system have been mainly related to caffeine. Caffeine is the most widely consumed behaviorally active substance in the world. The study evaluated the influence ofhabitual high espresso coffee consumption, nutritional factors and acute stress events on the development and conversion of acute lone atrial fibrillation (LAF). Methods. The study group included 220 patients (pts) with LAF. The coffee consumption, alcool and smoking, and body mass index BMI were investigated. Pts underwent a series of cognitive tests to evaluate acute psycological stress (mean life acute stress score LCU). A control group age- and sex-matched was selected and compared.

2008 - Determinazione dei potenziali elettrici rilevabili in un circuito sperimentale di CEC: dati preliminari su sangue eparinato. [Abstract in Atti di Convegno]
Mattioli, Anna Vittoria; C. M., Mazza; U., Carletti; D., Meglioli; Corazzari, Tolmino; R., Lodi
abstract

...

2008 - Effect of coffee consumption, lifestyle and acute life stress in the development of acute lone atrial fibrillation [Articolo su rivista]
Mattioli, Anna Vittoria; S., Bonatti; M., Zennaro; R., Melotti; Mattioli, Giorgio
abstract

OBJECTIVE: The study evaluated the relationships between acute stress, lifestyle and coffee consumption, and acute lone atrial fibrillation (AF). METHODS: The study group included 400 patients with mean age of 54 +/- 11 years, 205 of whom were men. They all presented with a first episode of AF. Patients underwent a series of cognitive tests to evaluate acute psychological stress (mean life acute stress score). Lifestyle and nutritional parameters (diet, alcohol and espresso coffee consumption, smoking and obesity) were investigated. An age-matched and sex-matched control group was selected and compared. RESULTS: Recent stress, high intake of coffee, and obesity were associated with greater risk of AF. Acute stress induces an increase in coffee consumption and changes in lifestyle. The increase in coffee consumption was more marked in nonhabitual drinkers, leading to a higher risk of developing AF [odds ratio (OR) 4.1; 95% confidence interval (CI): 1.98-4.56; P < 0.001]. Spontaneous conversion of AF to sinus rhythm was observed in 191 patients (47%). Patients who experienced AF after an acute stress showed the highest probability of spontaneous conversion. High espresso coffee consumption (OR 0.86; 95% CI: 0.49-1.21; P < 0.01) and obesity (OR 0.88; 95% CI: 0.84-1.20; P < 0.01) were associated with a significantly greater risk of persistent AF. CONCLUSION: Acute stress induced changes in lifestyle, including an increase in coffee consumption, leading to a higher risk of AF. Patients who developed AF after an acute stress showed the highest probability of spontaneous conversion. High espresso coffee consumption and obesity were associated with an increased risk of persistent AF.

2008 - Effects of early treatment with zofenopril in patients with myocardial infarction and metabolic syndrome: the SMILE Study [Articolo su rivista]
Borghi, Claudio; Cicero, Arrigo F G; Ambrosioni, Ettore; Mattioli, Av
abstract

To evaluate the clinical efficacy of the early administration of zofenopril in a group of patients with and without metabolic syndrome (MS+ and MS-) and anterior myocardial infarction enrolled in the Survival of Myocardial Infarction Long-Term Evaluation (SMILE) Study.

2008 - Heparin/PF4 Antibodies Formation after Heparin Treatment: Temporal Aspects and Long-Term Follow-Up [Abstract in Rivista]
Mattioli, Anna Vittoria; Lorenzo, Bonetti; Mauro, Zennaro; Ines, Castellana; Giuseppe, Ambrosio; Mattioli, Giorgio
abstract

Heparin-induced thrombocytopenia (HIT) is an immunologic drug reaction characterized by the presence of heparin-induced antibodies against heparin-platelets factor4(PF4) complex, thrombocytopenia, and paradoxical thrombosis. Little information is available on the persistence of heparin/PF4 antibody complexes in the plasma.The aim of this study was to evaluate the time course of heparin/PF4 antibodies in patients (pts) exposed to heparin. We enrolled 500 pts treated with i.v. heparin as part of perioperative management of CABG, 131 of them developed serologically confirmed heparin/PF4 antibodies, and were then selected and followed-up. Serum concentration of circulating heparin-induced antibodies was repeatedly assessed over a period of 3 years by an ELISA immunoassay; we also evaluated occurrence of thrombotic events during follow-up. 131 of 500 pts (26.2%) developed anti-PF4/heparin antibodies which persisted for 90 days (median time 95%CI 80 to 156). Baseline platelet count did not differ between the antibody-positive and -negative groups, in contrast the nadir platelet count was significantly lower in antibody-positive pts (85.000 ± 21.000 vs 141.000 ± 41.000, p < 0.001).

2008 - Influenza dell'assunzione di caffeina sulla comparsa di fibrillazione atriale nel paziente iperteso. [Abstract in Rivista]
Mattioli, Anna Vittoria; C., Miloro; Pedrazzi, Patrizia; M., Zennaro; Mattioli, Giorgio
abstract

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2008 - Terapia cellulare e aritmie: il punto della situazione[Cell therapy and arrhythmias: state of the art] [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

Cell therapy is an adjunctive treatment to improve left ventricular function after myocardial injury. Multiple cell types have been tested experimentally in animal models of myocardial disease, with functional improvement as the primary endpoint. Regarding safety, the major concern has been that cell transplantation could generate an arrhythmogenic substrate as reported in clinical studies using myoblasts. The mechanism of these transplantation-related arrhythmias remains elusive but the cellular heterogeneity, resulting from differences in electrical membrane properties between recipient/donor cells, could provide a substrate for reentry circuits. The knowledge achieved from experimental studies on the substrate of arrhythmias in cell therapy gives useful information that could be translated into the development of a biological pacemaker or a non-pharmacological approach to atrial fibrillation. Limitations of current pharmacological and catheter ablation options to achieve rate control in patients with atrial fibrillation have motivated new strategies of cell therapy for non-pharmacological rate control without producing high-degree atrioventricular block. Although several issues remain to be addressed, some aspects of cell therapy are likely to be translated into clinical practice.

2008 - Thrombotic events in patients with anti-platelet factor 4/heparin antibodies [Abstract in Rivista]
Mattioli, Anna Vittoria; Bonetti, L.; Fontanesi, L.; Castellana, N.; Tarabini Castellani, E.; Melotti, R.; Mattioli, Giorgio
abstract

Antibodies to the platelet factor 4/heparin complex are linked to the pathogenesis of heparin-induced thrombocytopenia type II (HIT II) and the thrombotic complications associated with this syndromeThe aim of the study was to evaluate the relationship between thrombotic events and the ELISA optical density.Methods. 140 consecutive patients (pts) with NSTEMI were included in the study. An immunoassay ELISA test was used to detect heparin/PF4 antibodies. Blood samples were taken after 8 ± 2.7 days from heparin. Platelets and nutritional status were measured. Unpaired test or variance analysis was used to compare clinical variables. The primary endpoint was a composite of death from any cause, new myocardial infarction, and new thrombotic events

2008 - Trombocitopenia eparino-indotta: correlazione tra optical density e trombosi. [Abstract in Rivista]
Mattioli, Anna Vittoria; L., Bonetti; M., Zennaro; U., Carletti; Mattioli, Giorgio
abstract

...

2007 - Coffee and caffeine effects on hypertension [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

It is well-known that a dietary intake and lifestyle play an important role in hypertension.Data from a variety of epidemiological studies on the effects of coffee consumption on blood pressure appear to be inconsistent, demonstrating a positive relation, no relation or even an inverse relations (1,2). Interestingly the JNC VII and the 2007 Guidelines for the management of arterial hypertension did not mentioned coffee intake in lifestyle modifications while moderation of alcohol consumption is included and encouraged (3,4).Coffee, an infusion of ground, roasted coffee beans, is one of the most popular beverages consumed in Western Countries. Coffee contains several hundred different substances including, carbohydrates, lipids, vitamins, minerals, phenolic compounds and alkaloids (5). Nevertheless effects of coffee on cardiovascular system have been mainly related to caffeine. Caffeine is the most widely consumed behaviorally active substance in the world and almost all caffeine comes from dietary sources, most of it from coffee and tea (6). Caffeine is a purine alkaloid that is naturally present in coffee beans.

2007 - Effects of caffeine and coffee consumption on cardiovascular disease and risk factors [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

In recent years, clinical and observational studies reported that coffee consumption was associated with cardiac arrhythmia, with increased in serum cholesterol and blood pressure and affected heart rate variability, and subsequently increased cardiovascular risk. The analysis of these paper shows that data are controversial and strongly depends on methodology. Recent reports underline the beneficial effects of coffee consumption due to anti-inflammatory actions mediated by antioxidant compound of the beverages.

2007 - Embolic Events in Patients with Atrial Septal Aneurysm and Patent Foramen Ovale: Long-term Follow-up. [Abstract in Rivista]
Mattioli, Anna Vittoria; TARABINI CASTELLANI, Emma; M., Aquilina; A., Oldani; Mattioli, Giorgio
abstract

Background. The ASAMI Study included 606 pts, enrolled between November 1990 and December 1996: 245 pts with a previous cerebral embolic attack and normal carotid study (Group A) and acontrol group (B) of 316 pts. They all underwent transthoracic and transesophageal echocardiography.TEE showed Atrial Septal Aneurysm (ASA) in 104 pts; 68 pts (27.7%) were from group A and 36 (9.9%) from group B (p<0.001). The prevalence of patent foramen ovale (PFO) was 22.8% in group A and 9.8% in group B (p0.001). PFO was found in 72 pts (69.2) with ASA. Methods. We performed a long-term

2007 - Identificazione di differenti potenziali d'azione nei cardiomiociti in un modello sperimentale di infarto miocardico: valutazione della componente pro-aritmica indotta da cellule staminali mesenchimali. [Abstract in Rivista]
Mattioli, Anna Vittoria; Farinetti, A.; Barbieri, Alberto; Pinna, M. C.; Mattioli, G.
abstract

...

2007 - Identificazione di differenti potenziali d’azione nei cardiomiociti in un modello sperimentale di infarto miocardico valutazione della componente pro-aritmica indotta da cellule staminali mesenchimali Dati preliminari [Abstract in Rivista]
Mattioli, Anna Vittoria; Farinetti, Alberto; M. C., Pinna; Barbieri, Alberto; Mattioli, Giorgio
abstract

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2007 - Influenza della Depressione, della personalità di tipo A e dello stress sulla comparsa di malattia coronarica. [Abstract in Rivista]
Mattioli, Anna Vittoria; E., Sgarbi; C., Miloro; E., Tarabini; Mattioli, Giorgio
abstract

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2007 - Intervento educativo comportamentale in pazienti sottoposti a cardiochirurgia. [Abstract in Rivista]
Mattioli, Anna Vittoria; Pedrazzi, Patrizia; Mattioli, Giorgio
abstract

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2007 - Lo stress acuto ambientale modifica lo stile di vita e facilita la comparsa di fibrillazione atriale. [Abstract in Rivista]
Mattioli, Anna Vittoria; E., Tarabini; R., Melotti; C., Miloro; Mattioli, Giorgio
abstract

...

2007 - Valutazione della componente pro-aritmica indotta da cellule staminali mesenchimali mediante identificazione di diversi potenziale d’azione in cardiomiociti in un modello sperimentale di infarto miocardico: dati preliminari [Abstract in Atti di Convegno]
Mattioli, Anna Vittoria; Farinetti, Alberto; M. C., Pinna; Barbieri, Alberto; Mattioli, Giorgio
abstract

..

2007 - Valutazione della componentepro-aritmica indotta da cellule staminali mesenchimali mediante l'identificazione di differenti potenziali d'azione in cardiomiociti in un modello sperimentale di infarto miocardico: dati preliminari. [Abstract in Atti di Convegno]
Mattioli, Anna Vittoria; Farinetti, A.; Barbieri, Alberto; Pinna, M. C.; Mattioli, G.
abstract

...

2006 - Effect of coffee consumption and nutritional factors in the development of acute lone atrial fibrillation [Abstract in Rivista]
Mattioli, Anna Vittoria; Tarabini Castellani, E.; Bonatti, S.; Zennaro, M.; Mattioli, Giorgio
abstract

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2006 - Effects of early angiotensin-converting enzyme inhibition in patients with non-ST-elevation acute anterior myocardial infarction [Articolo su rivista]
Borghi, C.; Bacchelli, S.; Esposti, D. D.; Ambrosioni, E.; Mattioli, Av
abstract

Background No data are available on the clinical efficacy of the early administration (&lt; 24 hours from onset of chest pain) of angiotensin-converting enzyme inhibitors in non-thrombolysed patients with non-ST-elevation myocardial infarction (NSTEMI). We have addressed this issue in a subgroup of NSTEMI patients enrolled in the SMILE trial.Methods Of the overall population of 1556 patients, 526 (33.8%) had an anterior wall NSTEMI, defined as an ST elevation &lt; 1 mm or an ST depression in at least two contiguous precordial leads with or without new abnormal Q waves. No patient of the SMILE Study received thrombolytic therapy or was reperfused. Patients were randomized, double-blind, to zofenopril (n = 253) or placebo (n = 273) for 6 weeks. The primary end point was the effect of treatment on the 6-week combined occurrence of death and severe congestive heart failure (CHF). Secondary end points included the evaluation of the 6-week rate of severe CHIF as well as the 1-year mortality rate.Results After 6 weeks of treatment, zofenopril significantly reduced both the incidence of the primary end point.(risk reduction 65%, 95% Cl 20-80, 2P =.003) and the 6-week incidence of severe CHF (84%, 95% CI 33-97, 2P = .006) in NSTEMI patients. One-year mortality was also significantly reduced by zofenopril treatment (43%, 95% CI 14-57, 2P = .036).Conclusions Results of this post hoc analysis of the SMILE Study strongly suggest the benefit of the early administration of zofenopril even in patients with an anterior wall NSTEMI.

2006 - Influenza dello stress cronico, della sindrome ORA e della depressione sulla trombosi carotidea. [Abstract in Rivista]
Mattioli, Anna Vittoria; F., Tampieri; R., Melotti; TARABINI CASTELLANI, Emma; F., Tampieri; Mattioli, Giorgio
abstract

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2006 - La trombocitopenia da eparina: implicazioni per il cardiologo.[Heparin-induced thrombocytopenia: implications for cardiologist] [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

Heparin-induced thrombocytopenia (HIT) is one of the most life-threatening adverse effects of heparin administration. It is characterized by thrombocytopenia and may also be associated with venous or arterial thrombosis. HIT type 2 is caused by the binding of antibodies, most likely IgG, to a complex of heparin and platelet factor-4, these complexes IgG/PF4/heparin activate platelets causing the release of pro-thrombotic particles that promote thrombin generation. HIT and HIT-thrombosis are associated with high morbidity and mortality. Thrombotic events are most frequently venous and may manifest as pulmonary embolism or cerebral venous thrombosis. Arterial thrombosis leading to limb damage and amputation and to myocardial infarction or stroke may also occur. HIT is a clinical syndrome that requires clinical and laboratory findings to confirm the diagnosis. All forms of heparin treatment should be stopped once HIT is suspected and patients should be treated with an alternative anticoagulant to treat and prevent thrombotic complications. Available alternative anticoagulants include argatroban and lepirudin, a recombinant form of hirudin.

2006 - Left Atrial Anatomy and Function After Atrial Fibrillation of Brief Duration in Hypertrophic Hearts [Articolo su rivista]
Mattioli, Anna Vittoria; S., Bonatti; Mattioli, Giorgio
abstract

The aim of the study was to evaluate the influence of left ventricular (LV) hypertrophy on left atrial (LA) electrical and mechanical function after cardioversion atrial fibrillation (A-Fib) ofbrief duration. Study group A included 100 patients with a first diagnosis of hypertension who had a moderate LV hypertrophy. The patient population included 64 men and 36 women with a mean age of 55 ±7 years who were hospitalized because of A-Fib and were cardioverted with external DC shock. Control group B included 100 patients without cardiac hypertrophy cardioverted because of lone A-Fib. Atrial function and size were assessed by Doppler echocardiography and the following parameters were measured: transmitral peak A velocity, atrial filling fraction, atrial ejection force, peak E velocity, deceleration time, and isovolumic relaxation time, LA maximal and minimal volume, and LV cardiac mass index. Baseline echocardiography showed that LA diameters and volumes were enlarged in all patients during A-Fib. After the restoration of sinus rhythm LA diameters and volumes decreased and the reduction was more evident in group B compared to group A. LA function as a continuous variable was negatively related to LV mass index (r = –0.77), LA diameter (r = –0.66 and r = –0.69 for the superoinferior diameter), LA maximal volume (r = –0.61) and LA minimal volume (r = –0.55) (all p <0.01).Atrial ejection force as a continuous variable was positively related to age (r = 0.78), peak A wave velocity (r = 0.71), systolic blood pressure (r = 0.51), and IVRT (r =0.41) (all p <0.01).Hypertrophy influenced the recovery of atrial function after cardioversion of A-Fib. Atrial function was reduced in patients with LV hypertrophy even after A-Fib of brief duration.

2006 - Left atrial maximal volume in pregnant women with chronic hypertension long trem follow-up study [Abstract in Rivista]
Mattioli, Anna Vittoria; Tarabini Castellani, E.; Paini, I.; Mattioli, Giorgio
abstract

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2006 - Long term follow-up of Carotid artery intima/media thickness in patients with Heparin induced Antibodies. [Abstract in Rivista]
Mattioli, Anna Vittoria; Tarabini Castellani, E.; Paini, I.; Mattioli, Giorgio
abstract

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2006 - Persistenza di anticorpi-anti eparina in pazienti con trombocitopenia eparino-indotta [Abstract in Rivista]
Mattioli, Anna Vittoria; TARABINI CASTELLANI, Emma; L., Bonetti; L., Fontanesi; N., Castellana; Mattioli, Giorgio
abstract

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2006 - The role of cardiac calcification detected by echocardiography in diagnosis of ischemic dilated cardiomyopathy [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

It is recognized that vascular calcifications, assessed by multiple modalities, including electron-beam computed tomography (CT), echocardiography and magnetic resonance imaging (MRI), are associated with cardiovascular disease. Within the last few years, noninvasive imaging modalities, able to detect atherothrombotic disease in the various stages, have made significant progress. Emerging and promising techniques, CT and MRI, can evaluatecalcification and luminal stenosis in the coronary tree.

2005 - Acute myocardial infarction in young patients: nutritional status and biochemical factors. [Articolo su rivista]
Mattioli, Anna Vittoria; L., Bonetti; M., Zennaro; P., Bertoncelli; Mattioli, Giorgio
abstract

PURPOSE: The aim of this study was to establish whether nutritional status and biochemical factors, C-reactive protein (CRP), serum amyloid A (SAA) protein, serum iron (Fe) and fibrinogen at admission were different in patients with acute myocardial infarction (AMI) at a young age (<40 years) vs. those with AMI at an older age (>60 years). We also investigated whether during the stay in the hospital, the increase in acute-phase reactants was different in young vs. older subjects, and if dyslipidemic aspects were different between the two groups. METHODS: The study population consisted of 40 patients, all males with a mean age of 36.7+/-1.16 years, admitted to our facility with AMI. The control group included 40 patients, all males, mean age of 66.3+/-4.24 years, with AMI. CRP, SAA, Fe and fibrinogen were determined at admission to the hospital and daily for 7 days in the two groups of patients. RESULTS: In young patients the median value of the highest levels were 6.2 mg/l (range 0.7-27.30) for CRP, 13.22 mg/l (range 0.7-130) for SAA, 420 mg/dl (range 76-840) for fibrinogen and 49.1 gamma/ml (range 14-102) for Fe levels. In the older patients, the median value of the highest levels were 5.9 mg/l (range 0.6-28.30) for CRP, 12.12 mg/l (range 0.9-280) for SAA, 480 mg/dl (range 60-780) for fibrinogen and 47.1 gamma/ml (range 12-94) for Fe levels. CONCLUSIONS: In the present study, acute-phase reactants were quantitatively similar in young and old patients. On the contrary, nutritional status, homocysteine, LDL and triglycerides are significantly higher in young patients than in old patients.

2005 - Influence of regression of left ventricular hypertrophy on left atrial size and function in patients with moderate hypertension [Articolo su rivista]
Mattioli, Anna Vittoria; S., Bonatti; D., Monopoli; M., Zennaro; Mattioli, Giorgio
abstract

Objectives. The aim of the study was to evaluate the effect of regression of left ventricular (LV) hypertrophy on left atrial(LA) size and function in patients treated with telmisartan, an angiotensin II receptor blocker. Methods. Patients populationincluded 80 patients with mild–moderate LV hypertrophy treated with telmisartan. Patients were followed over a period of12 months from the start of telmisartan treatment. LA size was measured during systole from the parasternal long-axis viewfrom M-mode. Atrial function was assessed by Doppler-echocardiography and the following parameters were measured:transmitral peak A velocity, atrial filling fraction, atrial ejection force (AEF), peak E velocity, deceleration time andisovolumic relaxation time, LA maximal and minimal volume, and LV cardiac mass index (LVMI). Results. All patients hadan increased LVMI and decrease during follow-up. LA dimensions were greater at baseline and reduced after 1 year oftreatment. LA volume indexes maximal volume, minimal volume and P volume were reduced compared with baseline value(maximal volume from 35¡5 to 32¡5, pv0.05; minimal volumes from 14¡2 to 10¡4, pv0.05). AEF, a parameter ofatrial systolic function, increased from 12¡3 to 15¡2.4 (pv0.01). The reduction of LA volumes correlate with reductionof LVMI (LA maximal volume and LVMI r50.45; pv0.01; LA minimal volume and LVMI r50.34; pv0.05). A positivecorrelation was also found between LV mass index and P volume (r50.41; pv0.01), LV mass index and LA activeemptying volume (r50.39; pv0.01), and LV mass index and LA total emptying volume (r50.38; pv0.05). Conclusions.The present study suggests that regression of LV hypertrophy due to telmisartan is associated with reduction of LA volumesthat expresses variation of LV end-diastolic pressure. The reduction of LV end-diastolic pressure is associated with anincrease in diastolic filling and with a significant reduction of active and passive emptying contribution of left atrium to LVstroke volume.

2005 - Left atrial remodeling after short duration atrial fibrillation in hypertrophic hearts [Articolo su rivista]
Mattioli, Anna Vittoria; S., Bonatti; D., Monopoli; M., Zennaro; Mattioli, Giorgio
abstract

Atrial fibrillation (AF) is the most common sustainedcardiac arrhythmia found in hypertensive patients. AFcauses atrial dilation, and progressive left atrial (LA)enlargement occurs once AF becomes chronic. In theFramingham heart study, LA enlargement was associatedboth with the duration of elevated blood pressure and withthe level of systolic pressure.1 The mechanism by whichhypertension leads to LA enlargement seems to be related tohaemodynamic changes. The LA size is closely related todiastolic filling pressure.METHODSWe investigated 80 consecutive hypertensive

2005 - Left atrial volume in hypertension: a follow-up study [Abstract in Rivista]
Mattioli, Anna Vittoria; S., Bonatti; M., Zennaro; I., Paini; A., Lattanzi; Mattioli, Giorgio
abstract

The aim of the study was to evaluate the effect of regression of left ventricular (LV) hypertrophy on left atrial (LA) size and function in patients (pts) with mild-moderate hypertension treated with telmisartan. Pts population included 85 pts with mild moderateLV hypertrophy (64 men and 21 women of mean age 51 ±10 years, range 43-62). Left atrial size was measured during systole from the parasternal long axis view from M-mode). LA volumes were determined at mitral valve opening (max vol) and at mitral valve closure (min vol). LA volumes were measured from the apical 4- chamber and 2-chamber views by means of the biplane area-length method, and corrected for body surface area

2005 - Polymorphism of the interleukin 1-b gene affect the risk of myocardial infarction and ischemic stroke at young age and the response of mononuclear cells to stimulation in vitro [Articolo su rivista]
L., IACOVIELLO L; Mattioli, Anna Vittoria
abstract

Objectives—To investigate the role of interleukin-1 (IL-1) gene polymorphisms as a link between inflammation,coagulation, and risk of ischemic vascular disease at young age.Methods and Results—A total of 406 patients with myocardial infarction (MI) at young age, frequency-matched for age,sex, and recruitment center, with 419 healthy population-based controls and 134 patients with ischemic stroke at youngage, matched by age and sex, with 134 healthy population-based controls, were studied. Subjects carrying the TTgenotype of the 511C/T IL-1 polymorphism showed a decreased risk of MI (odds ratio [OR], 0.36; 95% CI, 0.20to 0.64) and stroke (OR, 0.32; 95% CI, 0.13 to 0.81) after adjustment for conventional risk factors. In both studies, theT allele showed a codominant effect (P0.0020 in MI; P0.021 in stroke). Mononuclear cells from volunteers carryingthe T allele showed a decreased release of IL-1 and a decreased expression of tissue factor after stimulation withlipopolysaccharide compared with CC homozygotes. The presence of a monoclonal antibody against IL-1 during cellstimulation resulted in a marked reduction of tissue factor activity expression.Conclusions—-511C/T IL-1 gene polymorphism affects the risk of MI and ischemic stroke at young age and the responseof mononuclear cells to inflammatory stimulation.

2005 - The relationship between personality, socio-economic factors, acute life stress and the development, spontaneous conversion and recurrences of acute lone atrial fibrillation. [Articolo su rivista]
Mattioli, Anna Vittoria; S., Bonatti; M., Zennaro; Mattioli, Giorgio
abstract

Aims The present study was designed to establish the relationship between personality factors, socio-economic factors and acute life stress with development, spontaneous cardioversion and recurrences of acute lone atrial fibrillation.Methods The study group consisted of 116 patients with lone atrial fibrillation cardioverted within 48 h of the onset of arrhythmia; they underwent a series of cognitive tests to evaluate acute psychological stress and personality type. The socio-economic status and other covariates (alcohol consumption, smoking, andbody mass index) were investigated. A control group, age- and sex-matched, was selected and compared. In the logistic regression analysis, the presence of spontaneous conversion to sinus rhythm was used as the dependent variable.Independent variables were indicator variables representing categories of stress, Type A behaviour pattern, coffee consumption and body mass index. Variables considered for logistic analysis were only those with independent prognostic value.Results. Type A behaviour pattern was found in 23 (20%) patients with atrial fibrillation and in 11 (9%) controls (P<0.001). The mean score among patients with atrial fibrillation was 8 + 2.7, while in control subjects it was 5.5+ 2. The mean acute life stress score among patients with atrial fibrillation was 56+ 33, while in controls it was 34+27 (P<0.01). Spontaneous conversion of atrial fibrillation to sinus rhythm was observed in 72 patients (63%). In univariate analysis alcohol consumption, income, education and smoking habits did not affect spontaneous conversion. High coffee consumption (OR 0.3 95% CI 0.11-0.49; P=0.008) and high body mass index were associated with a significantly greater risk of atrial fibrillation (OR 1.5 95% CI 1.2-1.7).Conclusions Type A behaviour pattern and acute life stress affect the development and spontaneous conversion of atrial fibrillation. Patients with acute stress showed the highest probability of spontaneous conversion followed by patients with Type A behaviour. Other socio-economic factors affect spontaneousconversion and recurrences of lone atrial fibrillation to a lesser extent.

2004 - Prevalence of anti-PF4/heparin antibodies and the HIT syndrome in cardiovascular medicine [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

Heparin-induced thrombocytopenia (HIT) is a potentially life-threatening adverse effect of heparin treatment. HIT is mediated by antibodies directed at complexes that form between heparin and platelet factor 4 in plasma and are located on the platelet surface and on endothelium. HIT occurs in 1 to 2% of patients receiving unfractionated heparin (UFH) and with lower frequency in patients receiving low-molecular-weight heparins and heparinoids. Despite recent insights into the mechanisms of HIT, there remain important unresolved issues. For example, the reason for the wide difference in the frequency of HIT in patients treated with UFH in various clinical trials is not yet clear. There are patient population-dependent differences in the risk for HIT immunoglobulin G and the development of thrombotic episodes. The complex nature of this syndrome may relate to the composition of the responsible antigen. Patients with HIT need a more accurate evaluation of platelet counts and a better assessment of clinical evidence for thrombosis. Alternative anticoagulant therapy approaches are being studied, but there is at this time no firm clinical evidence for which treatment is best for patients with HIT and HIT-related thromboses.

2004 - Regression of Left Ventricular Hypertrophy and Improvement of Diastolic Function in Hypertensive Patients Treated with Telmisartan [Articolo su rivista]
Mattioli, Anna Vittoria; M., Zennaro; S., Bonatti; L., Bonetti; Mattioli, Giorgio
abstract

Objectives: The study was designed to test whether or not the angiotensin II receptor blocker telmisartan brings about regression of left ventricular (LV) concentric hypertrophy and whether or not these changes are associated with improved diastolic filling. Methods: An echocardiographic follow-up study was performed in 85 hypertensive patients (systolic blood pressure [SBP] &gt;140 mm Hg, diastolic blood pressure [DBP] &gt;90 mm Hg) and mild-to-moderate LV hypertrophy (LV mass index related to body surface area [LVMI] 117–150 g/m2 for men and 105–150 g/m2 for women) treated with telmisartan monotherapy 40–80 mg once daily for 1 year. Blood pressure, LVMI, left atrial (LA) volumes, and diastolic function were determined at baseline and after 3, 6, 9, and 12 months of treatment. Blood pressure was also monitored at all visits. Diastolic function was assessed by examination of transmitral inflow and pulmonary vein flow patterns. Results:Telmisartan reduced blood pressure; after 12 months, the mean FS.D. SBP and DBP were reduced from 144F10 to 126F8 mm Hg (p &lt; 0.001) and from 98F8 to 86F7 mm Hg ( p &lt; 0.001), respectively. The LVMI was decreased from 119F7 to 109F3 g/m2 (p &lt; 0.001) after 12 months’ telmisartan treatment. All patients had diastolic dysfunction at baseline. After 12 months’ telmisartan treatment, a normal pattern of transmitral inflow was present in 21% of patients. The regression of LV hypertrophy observed after 12 months was associated with increased peak early diastolic velocity/peak late diastolic velocity ratio from 0.60F0.18 to 0.83F0.20 ( p &lt; 0.001), shortened isovolumicrelaxation time (IVRT) from 110F13 to 105F13 ms ( p &lt; 0.001), and decreased deceleration time from 229F30 to 215F28 ms( p = 0.002). Univariate analysis showed that shortened IVRT was related to a reduction in the LVMI and LA maximal and minimal volumes.In the multivariate analysis, the reduction in LVMI and the reduction in LA maximal and minimal volumes were independently associated with IVRT reduction. Conclusions: Telmisartan 40–80 mg is effective in LV hypertrophy regression in hypertensive patients. The reduction in LVMI due to telmisartan monotherapy was associated with a significant improvement of diastolic filling parameters and with a significant reduction of LA volumes.

2003 - Aritmie ipercinetiche. [Articolo su rivista]
Barbieri, Alberto; Pinna, C; Mattioli, Anna Vittoria; Sandroni, C.
abstract

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2003 - Association between Atrial Septal Aneurysm and Mitral Valve Prolapse in Patients with Recent Stroke and Normal Carotid Arteries. [Articolo su rivista]
Mattioli, A. V.; Bonetti, L.; Aquilina, M.; Oldani, A.; Longhini, C.; Mattioli, G.; Tarabini, Emma
abstract

Background. The association between mitral valve prolapse (MVP) and cryptogenic stroke is controversial. The Atrial Septal Aneurysm Multicenter Italian (ASA-MI) Study is a prospective multicenter study evaluating the prevalence of atrial septal aneurysm (ASA) in patients with a recent stroke and normal carotid arteries. The aim of the present research was to evaluate the frequency of ASA and its association with MVP in the stroke population and in the subgroup of young patients (&lt; 55 years) included in the ASA-MI Study.Methods. The study group included 245 of the 606 patients referred for transesophageal echocardiography (168 men and 77 women, mean age 65.7 ± 21 years). All patients were selected on the basis of a recent episode of unexplained cerebral ischemia and were included in the study if they had normal carotid arteries. The control population included 245 patients (mean age 64.7 ± 23 years) who underwent transesophageal echocardiographic evaluation during the same period for indications other than cerebral ischemia. The subgroup of young patients (&lt; 55 years) included 90 patients (61 men and 29 women, mean age 49 ± 5 years).Results. The prevalence of MVP was 18% (95% confidence interval 8 to 21%) in the stroke population and 15% (95% confidence interval 7 to 20%) in the control population (chi2 = 2.1, p = NS). The prevalence of MVP did not differ between young stroke patients (28.8%) and young controls (20%) (chi2 = 0.835, p = 0.3). MVP was not significantly associated with stroke. We found an association between ASA and MVP: there was a higher incidence of MVP in stroke patients with an ASA than in patients without stroke or an ASA (40.9 vs 25%, p &lt; 0.05). There was also a higher frequency of MVP associated with ASA in the group of young patients than in all patients of the ASA-MI Study (28.8 vs18%, chi2 = 20.313, p &lt; 0.001). Conclusions. We found an association between ASA and MVP in patients with recent stroke and this association bore a higher risk of cerebral events than in patients without these abnormalities.

2003 - Association between atrial septal aneurysm and patent foramen ovale in young patients with recent stroke and normal carotid arteries [Articolo su rivista]
Mattioli, Anna Vittoria; M., Aquilina; L., Bonetti; A., Oldani; C., Longhini; Mattioli, Giorgio; ON BEHALF OF THE, Investigators
abstract

Background. The atrial septal aneurysm (ASA) has been considered a potential source of cardiogenic embolism for many years. The ASA-MI study evaluated the prevalence and characteristcs of ASA in patients (pts) with stroke and normal carotid arteries compared to control pts without stroke. The purpose of the present study was to evaluate the frequency of ASA and the association with patent foramen ovale (PFO) in the subgroup of younger patients (aged less than 55 years) included in the ASA-MI study.Methods. The ASAMI Study included 606 pts, enrolled between November 1990 and December 1996: 245 pts with a previous cerebral embolic attack and normal carotid study and a control group of 316 pts. They all underwent transthoracic and transesophageal echocardiography. The subgroup of younger patients aged less than 55 years included 90 patients (61 men and 29 women of mean age 49 + 5 years) (Group AY). This group was evaluated and compared with a control population age- and sex-matched (61 men; of mean age 48 + 6 years) (Group BY).Results. The prevalence of ASA was 48.8% (95% confidence interval 40% to 61%) in group AY and 22.2% in the group BY (95% confidence interval 18% to 33%) (X2 5.968 p=0.01). Comparing the 2 group of patients morphological features were similar. ASA involved the entire septum in 52% of pts of group AY, and in 47.2% of group BY. The prevalence of PFO was 58.8% (95% confidence interval 43% to 62%) in group AY and 28.8% in group BY (95% confidence interval 17% to 35%) (X2 5.811 p=0.01). A strong association was found between ASA and PFO. Of the 90 younger pts with stroke, 39 of 44 (88.6%) with ASA had also a PFO, compared with 14 of 46 (30.4%) without ASA (X2 7.370 p=0.007).Conclusion. We found that ASA and PFO were independent predictive factors for stroke in younger patients with stroke and normal carotid arteries and that the association between ASA and PFO bore an increased odds risk

2003 - Effects of regression of left ventricular hypertrophy on left atrial size and function [Abstract in Atti di Convegno]
Mattioli, Av; Bonatti, S; Zennaro, M; Monopoli, D; Mattioli, G
abstract

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2003 - Embolia polmonare in un paziente sottoposto a By pass aorto coronarico in trattamento con eparina non frazionata: un caso di trombosi associata a trombocitopenia eparino-indotta. [Articolo su rivista]
Mattioli, Anna Vittoria; L., Bonetti; F., Tampieri
abstract

L'articolo riporta il caso di un paziente con embolia polmonare da HIT e riassume il quadro clinico e diagnostico della trombocitopenia eparino-indotta

2003 - Infarto miocardico giovanile: eventi aritmici [Capitolo/Saggio]
Mattioli, Anna Vittoria
abstract

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2003 - Left atrial size after cardioversion for atrial fibrillation: effect of external DC shock [Articolo su rivista]
Mattioli, Anna Vittoria; S., Bonatti; L., Bonetti; Mattioli, Giorgio
abstract

OBJECTIVE: The aim of this study was to evaluate the effect of external direct current (DC) shock on left atrial (LA) dimension and volumes after cardioversion for atrial fibrillation, and the relation between LA size and atrial function. METHODS: We evaluated 180 patients who were randomly cardioverted with DC shock (90 patients) or drugs (90 patients). Echocardiographic evaluations included LA size and volumes. LA passive and active emptying volumes were calculated, and LA function was measured as atrial ejection force. Changes in LA diameters and volumes were correlate with atrial systolic function. RESULTS: The LA was dilated in all patients during arrhythmia and decreased after the restoration of sinus rhythm. The entity of reduction was different in the 2 groups of patients. LA maximal and minimal volumes were increased after DC shock as compared with patients treated with drugs (LA maximal volume 34 +/- 4 vs 31 +/- 5; P &lt;.01; LA minimal volume 18 +/- 2.6 vs 15 +/- 3.6; P &lt;.01). The atrial function was also depressed after DC shock and the delay in the recovery of atrial contractility was related to LA dilation. Patients treated with drugs had a higher atrial ejection force that was associated with a more marked reduction in LA maximal volume after the restoration of in sinus rhythm. A relationship between LA volumes and atrial ejection force was observed in the group of patients with depressed atrial mechanic function (r = -0.78; P &lt;.001). The active emptying fraction was lower, although not significantly, in this group, whereas the conduit volume was increased. CONCLUSION: External DC shock induced a depressed atrial mechanic function in many patients and this was associated with a persistence of LA dilation.

2003 - Left atrial size and function after spontaneous cardioversion of atrial fibrillation and their relation to N-terminal atrial natriuretic peptide [Articolo su rivista]
Mattioli, Anna Vittoria; S., Bonatti; L., Bonetti; Borella, Paola; Mattioli, Giorgio
abstract

In conclusion, higher levels of N-ANP during AF were independently associated with spontaneous conversion, as well as with smaller LA volume.An inverse correlation existed between LA volume and N-ANP

2003 - Miglioramento della performance cardiaca con farmaci inotropi in pazienti affetti da insufficienza cardiaca durante ventilazione meccanica. [Articolo su rivista]
Mattioli, Anna Vittoria; Barbieri, Alberto; G., Albertini; A. M., Ghirardini
abstract

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2003 - Regression of hypertrophy influences ventricular performance in patients treated with telmisartan [Abstract in Atti di Convegno]
Mattioli, Av; Bonatti, S; Bonetti, L; Zennaro, M; Monopoli, D; Mattioli, G
abstract

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2003 - Stress acuto ambientale e abitudini di vita nella recidiva di fibrillazione atriale in pazienti senza cardiopatia organica: dati preliminari ad un anno di follow-up. [Abstract in Rivista]
Mattioli, Anna Vittoria; Bonatti, Silvia; L., Bonetti; F., Tampieri; A. M., Viceconte; Farinetti, Alberto; Mattioli, Giorgio
abstract

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2003 - Trattamento delle aritmie in anestesia e rianimazione. [Articolo su rivista]
Mattioli, Anna Vittoria; Barbieri, Alberto; C., Pinna; C., Sandroni
abstract

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2002 - Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients [Articolo su rivista]
Antithrombotic, Trialists; Collaboration, ; Mattioli, Anna Vittoria
abstract

OBJECTIVE: To determine the effects of antiplatelet therapy among patients at high risk of occlusive vascular events. DESIGN: Collaborative meta-analyses (systematic overviews). INCLUSION CRITERIA: Randomised trials of an antiplatelet regimen versus control or of one antiplatelet regimen versus another in high risk patients (with acute or previous vascular disease or some other predisposing condition) from which results were available before September 1997. Trials had to use a method of randomisation that precluded prior knowledge of the next treatment to be allocated and comparisons had to be unconfounded-that is, have study groups that differed only in terms of antiplatelet regimen. STUDIES REVIEWED: 287 studies involving 135 000 patients in comparisons of antiplatelet therapy versus control and 77 000 in comparisons of different antiplatelet regimens. MAIN OUTCOME MEASURE: "Serious vascular event": non-fatal myocardial infarction, non-fatal stroke, or vascular death. RESULTS: Overall, among these high risk patients, allocation to antiplatelet therapy reduced the combined outcome of any serious vascular event by about one quarter; non-fatal myocardial infarction was reduced by one third, non-fatal stroke by one quarter, and vascular mortality by one sixth (with no apparent adverse effect on other deaths). Absolute reductions in the risk of having a serious vascular event were 36 (SE 5) per 1000 treated for two years among patients with previous myocardial infarction; 38 (5) per 1000 patients treated for one month among patients with acute myocardial infarction; 36 (6) per 1000 treated for two years among those with previous stroke or transient ischaemic attack; 9 (3) per 1000 treated for three weeks among those with acute stroke; and 22 (3) per 1000 treated for two years among other high risk patients (with separately significant results for those with stable angina (P=0.0005), peripheral arterial disease (P=0.004), and atrial fibrillation (P=0.01)). In each of these high risk categories, the absolute benefits substantially outweighed the absolute risks of major extracranial bleeding. Aspirin was the most widely studied antiplatelet drug, with doses of 75-150 mg daily at least as effective as higher daily doses. The effects of doses lower than 75 mg daily were less certain. Clopidogrel reduced serious vascular events by 10% (4%) compared with aspirin, which was similar to the 12% (7%) reduction observed with its analogue ticlopidine. Addition of dipyridamole to aspirin produced no significant further reduction in vascular events compared with aspirin alone. Among patients at high risk of immediate coronary occlusion, short term addition of an intravenous glycoprotein IIb/IIIa antagonist to aspirin prevented a further 20 (4) vascular events per 1000 (P<0.0001) but caused 23 major (but rarely fatal) extracranial bleeds per 1000. CONCLUSIONS: Aspirin (or another oral antiplatelet drug) is protective in most types of patient at increased risk of occlusive vascular events, including those with an acute myocardial infarction or ischaemic stroke, unstable or stable angina, previous myocardial infarction, stroke or cerebral ischaemia, peripheral arterial disease, or atrial fibrillation. Low dose aspirin (75-150 mg daily) is an effective antiplatelet regimen for long term use, but in acute settings an initial loading dose of at least 150 mg aspirin may be required. Adding a second antiplatelet drug to aspirin may produce additional benefits in some clinical circumstances, but more research into this strategy is needed.

2002 - Pharmacotherapy of pulmonary embolism. [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

Pulmonary embolism (PE) and deep vein thrombosis are common causes of illness and death. The pharmacological approach to pulmonary embolism includes the use of anticoagulants, unfractionated heparin for the acute phase, and oral anticoagulants for prophylaxis. In massive PE, the use of thrombolytic agents is suggested to reduce systemic hypotension and right ventricular failure and increase cardiac output. Thrombolytic agents act on pulmonary vascular obstruction. In clinical practice, thrombolytic therapy is recommended in case of massive embolism with haemodynamic failure. Recent studies suggest the use of thrombolytic drugs in patients with normal systemic blood pressure who show right ventricular dysfunction at echocardiographic examination. A large randomised trial on lytic agents in submassive PE is therefore needed. Anticoagulants were primarily indicated for prevention of recurrences. Due to the development of low molecular weight heparin, the role of anticoagulants needs to be re-evaluated

2002 - Prognostic value of Iron, Nutritional Status Indexes and Acute Phase Protein in Acute Coronary Syndrome. [Articolo su rivista]
Mattioli, Anna Vittoria; L., Bonetti; M., Zennaro; S., Ripa; Mattioli, Giorgio
abstract

Background. The relation between the inflammatory status during unstable angina and nutritional parameters has not been well described. We sought to investigate the relation between the acute inflammatory status, as evaluated on the basis of high C-reactive protein (CRP) and serum amyloid A levels and laboratory indexes of iron and nutritional status in patients with unstable angina, and whether the variations in iron levels have a prognostic significance.Methods. The study population consisted of 98 patients admitted to our facility with unstable (group 1: 64 consecutive patients, 52 males, 12 females, mean age 66 ± 10 years) or stable angina(group 2: 34 patients, 30 males, 4 females, mean age 65 ± 9 years). The hemoglobin levels, the erythrocyte mean cell volume, serum iron levels, the increase in transferrin levels, the decrease in the percent transferrin saturation, ferritin levels, the nutritional status, and the CRP and serum amyloid A levels were measured.Results. On the basis of a CRP value > 1 mg/dl, 47 patients with unstable angina and 4 patients with stable angina were identified as having active inflammatory disease. The presence of inflammation was associated with significantly lower mean values of hemoglobin, erythrocyte mean cell volume, serum iron and transferrin levels, and percent transferrin saturation in comparison with patients without inflammation. A significant inverse correlation coefficient between a CRP level > 1 mg/dl and hemoglobin, transferrin levels and percent transferrin saturation was observed: the strongest correlation was with serum iron levels. The relative risk of total cardiac events was significantlygreater in patients with low serum iron levels than in those with high serum iron levels.Conclusions. Patients with acute inflammation present altered iron status indexes. Increased CRP levels and reduced serum iron levels are associated with a worse outcome in patients with unstable angina.

2002 - Reply to Transesophageal Echocardiography in Patients with Recent Stroke and Normal Carotid Arteries [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

-non presente

2001 - Atrial septal aneurysm as a cardioembolic source in adult patients with stroke and normal carotid artery. A multicenter study [Articolo su rivista]
Mattioli, Anna Vittoria; M., Aquilina; A., Oldani; C., Longhini; Mattioli, Giorgio
abstract

Background Atrial septal aneurysm has been considered a potential source of cardiogenic embolism for many years.The present study evaluated the prevalence and characteristicsof atrial septal aneurysm in a patient population with stroke and normal carotid arteries compared to a control population without stroke.Methods A total of 606 patients were enrolled between November 1990 and December 1996. The study group included 245 patients who had experienced cerebral ischaemic attack but had normal carotid arteries. The control group included 316 age- and sex-matched patients undergoing transoesophageal echocardiography for indications other than a search for a cardiac source of embolism. The prevalence and morphological characteristics of atrial septal aneurysm were evaluated and compared.Results We reported a higher prevalence of atrial septal aneurysm in the group with cerebral ischaemia; 68 patients (27·7%) vs 36 patients (9·9%) from the control group; P&lt;0·001. A patent foramen ovale was detected with contrast injection in 69·2% of the patients with atrial septal aneurysm. Atrial septal aneurysm predicted the presence of a patent foramen ovale (odds ratio of patent foramen ovale 4·2; 95% CI 1·03–9·8). Multivariate analysis showed that atrial septal aneurysm was an independent predictor of an embolic event. In the 95% of patients with atrial septal aneurysm and cerebral ischaemia aged less than 45 years, transoesophageal echocardiography did not detect a source of embolism other than an associated patent foramen ovale. Conclusions The prevalence of atrial septal aneurysm inpatients with cerebral ischaemia and normal carotid arterieswas 27·7%, higher than the control group. Atrial septalaneurysm was frequently associated with patent foramenovale. In patients less than 45 years old, atrial septalaneurysm was the only potential cardiac source of embolismdetected with transoesophageal echocardiography.

2001 - Efficacia e sicurezza del trattamento farmacologico della fibrillazione atriale in pazienti in terapia intensiva non coronarica. [Articolo su rivista]
Mattioli, Anna Vittoria; Barbieri, Alberto; Bonatti, S; Collioli, F; Bonetti, L; Mattioli, G.
abstract

...

2001 - Frequency of atrial septal aneurysm in Patients with Recent Stroke. Preliminary resulta from a multicenter Study [Articolo su rivista]
Mattioli, Anna Vittoria; M., Aquilina; A., Oldani; C., Longhini; Mattioli, Giorgio
abstract

BACKGROUND: The role of atrial septal aneurysm (ASA) as a risk factor for cerebral ischemia of unknown etiology is controversial. Recent studies have found an association between ASA and focal ischemic events, while results from other studies suggest a low incidence of embolism in patients with ASA. HYPOTHESIS: The present study was designed to evaluate the frequency of ASA, a minor cardioembolic source, in patients with a recent stroke presenting with normal carotid arteries. METHODS: In all, 394 patients with cerebral ischemic stroke were referred to our institutions. Patients underwent transthracic and transesophageal echocardiography and carotid artery ultrasound examination. The study population included 215 patients without significant arterial disease. Frequency and morphologic characteristics of ASA were evaluated. RESULTS: Transthoracic examination showed ASA in 39 patients (18%), while transesophageal echocardiography showed ASA in 61 patients (28%). A patent foramen ovale was found in 47 patients (21.8%) and was associated with ASA in 40 patients (65.5%). We observed an increased thickness of the aneurysmatic wall (3.80 +/- 1.7 mm) in all patients with ASA. CONCLUSIONS: The present study confirms the relationship between ASA and stroke in patients with normal carotid arteries. The most common abnormality associated with ASA was patent foramen ovale. We suggest that patients who have a stroke in the absence of significant carotid disease undergo transesophageal echocardiography to identify possible underlying septal abnormalities

2001 - Transesophageal Echocardiography in Patients with Recent Stroke and Normal Carotid Arteries [Articolo su rivista]
Mattioli, Anna Vittoria; M., Aquilina; L., Bonetti; A., Oldani; C., Longhini; Mattioli, Giorgio
abstract

In conclusion, atrial abnormalities are common findings in patients with recent stroke and normal carotid arteries.

2000 - Clinical, Echocardiographic and Hormonal Factors Influencing Spontaneous Conversion of Recent-Onset Atrial Fibrillation To Sinus Rhythm [Articolo su rivista]
Mattioli, Anna Vittoria; D., Vivoli; Mattioli, Giorgio; Borella, Paola
abstract

In conclusion, we observed that the most importantpredictor of spontaneous conversion in patientswith recent-onset AF was the development ofarrhythmia during sleep. Another relevant predictorwas an increased level of ANP during the arrhythmia.

2000 - Doppler echocardiographic evaluation of Right Ventricular Function in Patients with Right Ventricular Infarction [Articolo su rivista]
Mattioli, Anna Vittoria; R., Vandelli; Mattioli, Giorgio
abstract

The aim of the present study was to assess the utility of the myocardial performance index in patients with right ventricular infarction. During the study period, 120 patients were evaluated: 50 patients had a right ventricular infarction and 70 patients had an inferior left ventricular infarction without right ventricularinvolvement. On admission, an echocardiogramwas obtained from all patients prior to the initiation of thrombolytic therapy. The right ventricular myocardial performance index was calculated, aswere the Doppler-derived parameters of the right side of the heart. All patients with right ventricular infarction had undergone a right ventricular dilation, compared with 70 patients with left ventricular infarction (right ventricular end diastolic diameter32 ± 13 versus 26 ± 24 mm; P < 0.01) and increased areas (diastolic area 24.8 ± 9.9 versus 15.1 ± 6.8 cm2;P < 0.01). Tricuspid regurgitation was detected in 26 patients. The mean peak velocity of tricuspid regurgitation was 3.8 ± 0.8 m/s. The Doppler intervals,isovolumetric contraction times (136 ± 30 versus 49 ± 11 ms; P < 0.01), and relaxation times (71 ± 28 versus 37 ± 9 ms; P < 0.01) were prolonged in patients with right ventricular infarction, whereas the ejection time was significantly reduced (250 ± 31 versus 330 ± 26 ms; P < 0.001). The myocardial performance index was significantly increased in patients with right ventricular infarction (0.85 ± 0.2 versus 0.26 ±0.1; P < 0.01). The inferior vena cava collapse was reduced in all patients with right ventricular infarction (35 ± 20%). The right ventricular myocardial performance index was a useful indicator of right ventricular performance in patients with right ventricularinfarction. The use of echocardiographic parameters of the right side of the heart and Doppler echocardiographic parameters of right ventricular function provides a reliable diagnosis of right ventricular infarction.

2000 - Heparin-induced thrombocytopenia in patients treated with unfractionated heparin: prevalence of thrombosis in a 1 year follow-up [Articolo su rivista]
Mattioli, Anna Vittoria; L., Bonetti; S., Sternieri; Mattioli, Giorgio
abstract

BACKGROUND: Patients with unstable angina are usually treated with unfractionated heparin and aspirin, but very little is known about the prevalence of heparin-induced antibodies and their relation to thrombotic complications some time after the acute phase of unstable angina. The aim of the present study was to establish the prevalence of heparin-induced thrombocytopenia and the prevalence of heparin-dependent platelet-reactive antibodies in patients treated with unfractionated heparin and the occurrence of thrombosis in a 1 year follow-up. METHODS: Patient population included 124 consecutive patients with unstable angina treated with unfractionated heparin for almost 5 days. The prevalence of heparin-dependent platelet-reactive antibodies using an ELISA assay was measured before the beginning of heparin therapy and after 7 and 40 days. The platelet count was measured at the same time and the presence of thrombotic occurrences was checked. Clinical follow-up lasted 1 year. RESULTS: At baseline no one patient was positive for heparin-induced antibodies. On day 6, 38 patients (30%) produced a positive heparin-induced antibody result and 30 patients (24%) had an intermediate result. The majority of patients (74%) who developed antibodies became positive after 6 days of heparin therapy. The combined incidence of death, myocardial infarction, recurrent angina, urgent revascularization and stroke was 66% in patients with antibodies and 44% in patients without antibodies during a 1 year follow-up. The incidence of combined primary end points was statistically higher in patients positive for antibodies. The log-rank test was statistically significant (chi2 = 4.39, p &lt; 0.01). CONCLUSIONS: No one patient developed a clinical evidence of thrombocytopenia. Nevertheless thrombotic events during follow-up were more common in patients who developed heparin-induced antibodies. These patients need a more accurate evaluation and surveillance after hospital discharge.

2000 - Radiographic findings of patients with right ventricular infarction: prognostic evaluation. [Articolo su rivista]
Mattioli, Anna Vittoria; TARABINI CASTELLANI, Emma; M., Camellini; Mattioli, Giorgio
abstract

Background: The clinical course of right ventricular infarction and its management differs substantially from the management of left ventricular infarction: early and accurate diagnosis is very important.Methods: The patient population included 204 consecutive patients: 96 had a right ventricular infarction and 108 a left ventricular inferior infarction. A standard chest radiograph was obtained within 10 and 48 h of onset of symptoms. The width of the azygos vein and the presence of extravascular lung water were evaluated and compared. The in-hospital and long-term course (6 months follow-up) was determined for all patients.Results: The width of the azygos vein was significantly greater in patients with right ventricular infarction than in patients with inferior ventricular infarction. An increase in azygos vein width was greater than 13 mm and showed a diagnostic sensitivity of 90% and a specificity of 94%; the positive predictive value for right ventricular infarction was 94%. A ratio between the azygos vein width and an extravascular lung water score of less than 2 indicated a diagnostic sensitivity of 90% and a specificity of 93%. The positive predictive value for right ventricular infarction was 96%. Patients with right ventricular infarction and an azygos vein width greater than the median (16.59 mm) had more hypotension, bradycardia and heart block and a higher mortality than did patients with an azygos vein width smaller than the median.Conclusions: A chest radiograph has been shown to be sensitive and specific for the diagnosis of right ventricular involvement in patients with inferior left ventricular infarction. All patients admitted to Coronary Care Units (CCU) should have access tochest radiography, which should help in the early diagnosis of right ventricular infarction

2000 - Relationship between mean right atrial pressure and Doppler parameters in patients with right ventricular infarction [Articolo su rivista]
Mattioli, Anna Vittoria; A., Castelli; Mattioli, Giorgio
abstract

....

2000 - Right ventricular dysfunction after thrombolysis in patients with right ventricular infarction [Articolo su rivista]
Mattioli, Anna Vittoria; M., Fini; Mattioli, Giorgio
abstract

...

2000 - Serial Evaluation of Left Atrial Dimension after Cardioversion for Atrial Fibrillation and Relation to Atrial Function. [Articolo su rivista]
Mattioli, Anna Vittoria; S., Sansoni; G., Ricci Lucchi; Mattioli, Giorgio
abstract

The size of the left atrium is usually increased during atrial fibrillation (AF). The aim of the present study was to evaluate changes in left atrial (LA) dimension after cardioversion for AF, and the relation between LA dimension and atrial function. The initial study population included 171 consecutive patients. Patients who had spontaneous cardioversion to sinus rhythm (56 patients)were compared with patients who had random cardioversionwith drugs (50 patients) or direct-current (DC) shock (50 patients). Echocardiographic evaluations included LA size and volume. LA passive and active emptying volumes were calculated, and LA function was assessed. Atrial stunning was observed in 18 patients reverted with DC shock and in 7 patients reverted with drugs. The left atrium was dilated in all patients during AF (48 6 5 mm). The size of the left atrium decreasedafter restoration of sinus rhythm in all patients with spontaneous reversion to sinus rhythm, in 73% of patients reverted with drugs, and in 50% of patients reverted with DC shock. The comparison between patients with a normal mechanical atrial function and patients with reduced atrial function showed that a higher atrialejection force was associated with a more marked reductionin LA size after restoration of sinus rhythm. A relation between LA volumes and atrial ejection force was observed in the group of patients with depressed atrial mechanical function (r 5 20.78; p <0.001). The active emptying fraction was lower, although not significantly, in this group, whereas the conduit volume wasincreased. Thus, a depressed atrial mechanical function after cardioversion for AF was associated with a persistence of LA dilation.

1999 - Atrial ejection force in patients with atrial fibrillation: comparison between DC shock and pharmacological cardioversion. [Articolo su rivista]
Mattioli, Anna Vittoria; A., Castelli; E., Bastia; Mattioli, Giorgio
abstract

...

1999 - Efficacy and tolerability of a very low molecular weight heparin compared with standard heparin in patients with unstable angina: a pilot study [Articolo su rivista]
Mattioli, Anna Vittoria; TARABINI CASTELLANI, Emma; L., Goedecke; L., Sormani; S., Sternieri; Mattioli, Giorgio
abstract

...

1999 - Il ripristino della funzione meccanica atriale dopo cardioversione della fibrillazione atriale: fattori predittivi clinici ed ecocardiografici. [Articolo su rivista]
Mattioli, Anna Vittoria; TARABINI CASTELLANI, Emma; S., Sternieri; Mattioli, Giorgio
abstract

...

1999 - La fibrillazione atriale persistente: cardioversione e anticoagulazione. [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

...

1999 - Organization to Assess Strategies for Ischemic Syndrome (OASIS-2) Investigators. Effects of recombinant hirudin (lepirudin) compared with heparin on preventing death, myocardial infarction, refractory angina and revascularization procedures in patients with acute myocardial ischemia without ST elevation: a randomized trial [Articolo su rivista]
Oasis, 2 Investigators; Mattioli, Anna Vittoria; Mattioli, Giorgio
abstract

....

1999 - Stroke in paced patients with sick sinus syndrome: Influence of left atrial function and size [Articolo su rivista]
Mattioli, Anna Vittoria; TARABINI CASTELLANI, Emma; Mattioli, Giorgio
abstract

....

1998 - Clinical and echocardiographic features influencing recovery of atrial function after cardioversion of atrial fibrillation. [Articolo su rivista]
Mattioli, Anna Vittoria; A., Castelli; A., Andria; Mattioli, Giorgio
abstract

....

1998 - Influence of pacing modalities on the incidence of atrial fibrillation in patients without prior atrial fibrillation: a prospective study. [Articolo su rivista]
Mattioli, Anna Vittoria; D., Vivoli; Mattioli, Giorgio
abstract

.....

1998 - Influenza della ventilazione con pressioni polmonari positive sui parametri di funzione cardiaca destra in giovani vittime "del sabato sera". [Abstract in Rivista]
Mattioli, Anna Vittoria; TARABINI CASTELLANI, E; Bertoncelli, P; Muja, N; Barbieri, Alberto; Siniscalchi, A; Mattioli, G.
abstract

Influenza della ventilazione con pressioni polmonari positive sui parametri di funzione cardiaca destra in giovani vittime "del sabato sera".

1998 - Prevalence of atrial fibrillation and stroke in paced patients without prior atrial fibrillation: a prospective study [Articolo su rivista]
Mattioli, Anna Vittoria; E., Tarabini Castellani; D., Vivoli; F. A., Sgura; Mattioli, Giorgio
abstract

....

1998 - Propafenone versus procainamide for conversion of atrial fibrillation to sinus rhythm [Articolo su rivista]
Mattioli, Anna Vittoria; G., Ricci Lucchi; D., Vivoli; Mattioli, Giorgio
abstract

....

1997 - Comparison of low-molecular weight heparin with unfractionated heparin acutely and with placebo for 6 weeks in the management of unstable coronary artery disease. FRIC [Articolo su rivista]
The FRIC, Investigators; Mattioli, Anna Vittoria
abstract

...Background Low-molecular-weight heparin has a number of pharmacological and pharmacokinetic advantages over unfractionated heparin that make it potentially suitable, when used in combination with aspirin, for the treatment of unstable coronary artery disease. Method and Results Patients with unstable angina or non–Q-wave myocardial infarction (1482) were included in the study, which had two phases. In an open, acute phase (days 1 to 6), patients were assigned either twice-daily weight-adjusted subcutaneous injections of dalteparin (120 IU/kg) or dose-adjusted intravenous infusion of unfractionated heparin. In the double-blind, prolonged treatment phase (days 6 to 45), patients received subcutaneously either dalteparin (7500 IU once daily) or placebo. During the first 6 days, the rate of death, myocardial infarction, or recurrence of angina was 7.6% in the unfractionated heparin-treated patients and 9.3% in the dalteparin-treated patients (relative risk, 1.18; 95% confidence interval [CI], 0.84 to 1.66). The corresponding rates in the two treatment groups for the composite end point of death or myocardial infarction were 3.6% and 3.9%, respectively (relative risk, 1.07; 95% CI, 0.63 to 1.80). Revascularization procedures were undertaken in 5.3% and 4.8% of patients in unfractionated heparin and dalteparin groups, respectively (relative risk, 0.88; 95% CI, 0.57 to 1.35). Between days 6 and 45, the rate of death, myocardial infarction, or recurrence of angina was 12.3% in both the placebo and dalteparin groups (relative risk, 1.01; 95% CI, 0.74 to 1.38). The corresponding rates for death or myocardial infarction were 4.7% and 4.3% (relative risk, 0.92; 95% CI, 0.54 to 1.57). Revascularization procedures were undertaken in 14.2% and 14.3% of patients in the placebo and dalteparin groups, respectively. Conclusions Our results add to previous evidence suggesting that the low-molecular-weight heparin dalteparin administered by twice-daily subcutaneous injection may be an alternative to unfractionated heparin in the acute treatment of unstable angina or non–Q-wave myocardial infarction. Prolonged treatment with dalteparin at a lower once-daily dose in our study did not confer any additional benefit over aspirin (75 to 165 mg) alone.

1997 - Doppler echocardiographic parameters predictive of recurrence of atrial fibrillation of different etiologic origins [Articolo su rivista]
Mattioli, Anna Vittoria; D., Vivoli; E., Bastia
abstract

Atrial fibrillation is a common arrhythmia associated with an increased risk for the occurrence of embolism. Recurrences of atrial fibrillation are very frequent and increase the risk for an embolic event. The aim of the present study was to identify the clinical and echocardiographic parameters that are predictive of the recurrence of atrial fibrillation. One hundred and twenty consecutive patients with nonrheumatic atrial fibrillation were followed for 1 year after cardioversion. The following parameters were evaluated: cause and duration of atrial fibrillation, modality of cardioversion, atrial function after cardioversion (peak A wave velocity and A wave integral), left atrial dimension, peak E wave velocity of the transmitral inflow pattern, acceleration and deceleration times, and the integral of E wave. At 1 year, 72 patients maintained sinus rhythm whereas 48 patients had a recurrence of atrial fibrillation. The univariate analysis revealed that the parameter with the strongest influence on the recurrence of atrial fibrillation was the peak A velocity after cardioversion (P &lt; 0.001). The other parameters associated with recurrences were cause of atrial fibrillation (P &lt; 0.001), duration of arrhythmia (P = 0.002), and left atrial dimension (P = 0.05). The modality of cardioversion and the E wave variables did not influence the recurrence of atrial fibrillation. The peak A velocity was smaller in the group of patients who had a recurrence. We suggest that clinical and echocardiographic parameters, such as A wave variables, be used to identify patients at risk for recurrence. These patients should be monitored more frequently and should eventually be treated with antiarrhythmic drugs.

1997 - Indobufen versus Warfarin in the secondary prevention of major vascular events in nonrheumatic atrial fibrillation [Articolo su rivista]
C., Morocutti; G., Amabile G; Mattioli, Anna Vittoria; for the SIFA, Investigator
abstract

..Background and Purpose The results of a large prospective randomized trial have shown the efficacy of oral anticoagulation in the secondary prevention of major vascular events in patients with nonrheumatic atrial fibrillation (NRAF); less well established is the role of antiplatelet agents. The present study compared the effects of indobufen, a reversible inhibitor of platelet cyclooxygenase, with those of warfarin in this setting. Methods A total of 916 patients with NRAF and a recent (≤15 days) cerebral ischemic episode were admitted to this multicenter, randomized study, during which they were treated with either indobufen (100 or 200 mg BID) or warfarin (to obtain an international normalized ratio of 2.0 to 3.5) for 12 months. The two groups (462 on indobufen and 454 on warfarin) were well balanced in terms of their main baseline characteristics. The primary outcome of the study was the combined incidence of nonfatal stroke (including intracerebral bleeding), pulmonary or systemic embolism, nonfatal myocardial infarction, and vascular death. Results At the end of follow-up, the incidence of primary outcome events was 10.6% in the indobufen group (95% confidence interval, 7.7% to 13.5%) and 9.0% in the warfarin group (95% confidence interval, 6.3% to 11.8%), with no statistically significant difference between treatments. The frequency of noncerebral major bleeding complications was low: only four cases (0.9%) of gastrointestinal bleeding were observed, all of them in the warfarin group. Conclusions We conclude that, within the limitations of its design, this study may help the medical community in devising appropriate antithrombotic strategies for NRAF patients for whom oral anticoagulants are contraindicated or do not represent a feasible approach to treatment.

1997 - Stroke in paced patients with sick sinus syndrome: relevance of atrial mechanical function, of pacing mode and clinical characteristics [Articolo su rivista]
Mattioli, Anna Vittoria; TARABINI CASTELLANI, Emma; C., Paolillo; A., Fusco; Mattioli, Giorgio
abstract

....

1997 - studio del setto interatriale mediante ecocardiografia transtoracica. [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

...

1996 - Effects of the early administration of Zofenopril on onset and progression of congestive heart failure in patients with anterior wall acute myocardial infarction [Articolo su rivista]
C., Borghi; E., Ambrosioni; B., Magnani; Mattioli, Anna Vittoria; on behalf of the SMILE Study, Investigator
abstract

...

1996 - Shortening of atrioventricular interval improves ventricular filling and clinical outcome in patients with DDD pacemaker and left ventricular hypertrophy [L’accorciamento dell’intervallo atrio-ventricolare migliora il riempimento ventricolare e il quadro clinico in pazienti con pace-maker DDD e ipetrofia ventricolare sinistra] [Articolo su rivista]
Rossi, Rosario; Molinari, R; Carcagnì, A; Mattioli, Anna Vittoria; Modena, Maria Grazia
abstract

The influence and clinical consequences of different atrioventricular delays on ventricular filling have been studied in 30 patients (mean age 60 +/- 5 years) who implanted DDD pacemaker for complete A-V block. All patients presented a normal ejection fraction: 63.9 +/- 6.5%. In 18 subjects (Group I) an echo-Doppler examination revealed ventricular hypertrophy (mean end-diastolic wall thickness of 1.4 +/- 0.16 cm; left ventricular mass index 155 +/- 17 g/m2) and an abnormal relaxation pattern (isovolumic relaxation time 124 +/- 11: early to late peak velocity 0.6 +/- 0.03; deceleration time of the early diastolic peak 296 +/- 34 ms). Group II included the remaining 12 patients without left ventricular hypertrophy and normal filling pattern. In all 30 patients the filling pattern was reassessed following modification of the A-V delay (200, 150, 100 and 75 ms). Patients at baseline (200 ms of A-V delay) underwent an exercise test with determination of respiratory gas exchange. In Group I, 13 (72.5%) patients were classified as Weber class B (VO2 max 16.8 +/- 1.7 ml/min/kg) and 5 (27.5%) as class A (VO2 max 22.5 +/- 1.4 ml/min/kg). In Group II, all 12 patients were classified as Weber class A (VO2 max 23.1 +/- 1.1 ml/ min/kg). In Group II, changes in A-V delay caused no homogeneous variation in filling pattern. A-V delay was not modified in this group. In Group I, the reduction of A-V delay to 100 ms resulted in filling normalization. In this group A-V delay was programmed definitely to 100 ms. Graded exercise test repeated at 6 months follow-up showed an improved Weber class in 13 patients (from B to A) and greater VO2 max in the remaining 5 already in class A. We conclude that, in sequential paced patients with normal ejection fraction but abnormal relaxation pattern, a modification of A-V delay can induce filling normalization and improve cardiac functional capacity

1996 - Trattamento inotropo d'emergenza: valutazione emodinamica. [Articolo su rivista]
Barbieri, Alberto; Ghirardini, Am; Mattioli, Anna Vittoria
abstract

Trattamento inotropo d'emergenza: valutazione emodinamica.

1996 - Valutazione ecocardiografica del trattamento inotropo. [Articolo su rivista]
Mattioli, Anna Vittoria; Casali, E; Barbieri, Alberto
abstract

Valutazione ecocardiografica del trattamento inotropo.

1995 - Causes of death in patients with unipolar single chamber ventricular pacing: prevalence and circumstances in dependence on arrhythmias leading to pacemaker implantation. [Articolo su rivista]
Mattioli, Anna Vittoria; Rossi, Rosario; E., Annicchiarico; Mattioli, Giorgio
abstract

analysis of different causes of death in patinets with pacemaker

1995 - Effects of L-Carnitine administration on left ventricular remodeling after Acute Anterior Myocardial Infarction: The L-Carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) Trial [Articolo su rivista]
S., Iliceto; D., Scrutinio; Mattioli, Anna Vittoria; the Cedim, Investigator
abstract

studio multicentrico italiano

1995 - La forza di eiezione atriale - rapporti correlativi in soggetti normali [Articolo su rivista]
Mattioli, Anna Vittoria; Tarabini Castellani, E.; Vivoli, D.; Molinari, R.; Mattioli, Giorgio
abstract

....

1995 - La terapia medica delle sindromi coronariche acute [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

...

1995 - Lo stroke nei portatori di pacemaker per malattia del nodo del seno. Rilevanza della funzione meccanica atriale e delle caratteristiche cliniche [Articolo su rivista]
Mattioli, Anna Vittoria; Tarabini Castellani, E.; Paolillo, C.; Fusco, A.; Molinari, R.; Palladini, G.; Mattioli, Giorgio
abstract

....

1995 - THE EFFECT OF THE ANGIOTENSIN-CONVERTING ENZYME-INHIBITOR ZOFENOPRIL ON MORTALITY AND MORBIDITY AFTER ANTERIOR MYOCARDIAL-INFARCTION [Articolo su rivista]
E., Ambrosioni; C., Borghi; B., Magnani; Mattioli, Anna Vittoria; the SMILE, Investigators
abstract

...

1994 - Beta Blockers and the Big Heart in the treatment of heart failure [Capitolo/Saggio]
Mattioli, Giorgio; Mattioli, Anna Vittoria; L., Masciocco
abstract

Analyzed the effects of many drugs in patients with dilated heart and heart failure

1994 - Hemodynamic modification induced by left bundle branch block [Capitolo/Saggio]
Modena, Maria Grazia; Mattioli, Anna Vittoria; G., Mattioli
abstract

Hemodynamic modification induced by left bundle branch block

1994 - Il ripristino della funzione meccanica atriale dopo fibrillazione atriale [Articolo su rivista]
Mattioli, Anna Vittoria; Tarabini Castellani, E.; Vivoli, D.; Molinari, R.
abstract

....

1994 - L'ecocardiografia transesofagea nella valutazione dei pazienti con fibrillazione atriale e stroke [Articolo su rivista]
Mattioli, Anna Vittoria; Tarabini Castellani, E.; Casali, E.
abstract

...

1994 - Symptomatic achievment of diuretics in congestive heart failure [Articolo su rivista]
Mattioli, Anna Vittoria; TARABINI CASTELLANI, Emma; E., Casali; Mattioli, Giorgio
abstract

Effects of diuretic therapy in patients with congestive heart failure

1994 - Variazioni del flusso nelle vene polmonari da stimolazione elettrica nel blocco atrioventricolare totale. [Articolo su rivista]
Mattioli, Anna Vittoria; D., Vivoli; E., Casali
abstract

....

1993 - Aritmie emboligene [Capitolo/Saggio]
Mattioli, Giorgio; Mattioli, Anna Vittoria; TARABINI CASTELLANI, Emma; P., Carpeggiani
abstract

...

1993 - Cardiopatie congenite [Capitolo/Saggio]
G., Mattioli; Mattioli, Anna Vittoria; F., Cipressi; R. G., Zennaro; Modena, Maria Grazia
abstract

Trattato di Medicina Interna - Cardipatie Congenite

1993 - Clinical therapeutic utility of TEE study in patients with atrial fibrillation. [Relazione in Atti di Convegno]
Mattioli, Anna Vittoria
abstract

...

1993 - Cuore e cervello. [Articolo su rivista]
Mattioli, Giorgio; Mattioli, Anna Vittoria; Tarabini Castellani, E.; Carpeggiani, P.
abstract

....

1993 - Doppler transesofageo del flusso venoso polmonare: ruolo della contrazione atriale. [Articolo su rivista]
Mattioli, Anna Vittoria; G., Masciocco; F., Greco
abstract

....

1993 - Gli effetti del blocco di branca sinistro sul flusso dell vene polmonari e transmitralico [Articolo su rivista]
Mattioli, Anna Vittoria; E., Casali; D., Vivoli
abstract

....

1993 - I pattern del flusso nelle vene polmonari e nella valvola mitrale nel blocco atrio ventricolare totale [Articolo su rivista]
Mattioli, Anna Vittoria; E., Casali
abstract

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1993 - Il flusso venoso polmonare nella fibrillazione atriale valutato mediante ecocardiografia Doppler transesofagea. [Articolo su rivista]
Mattioli, Anna Vittoria; G., Masciocco; D., Vivoli
abstract

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1993 - La terapia trombolitica dell'embolia polmonare [Capitolo/Saggio]
Mattioli, Anna Vittoria
abstract

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1993 - Le cause di morte nei portatori di pacemaker [Capitolo/Saggio]
Mattioli, Anna Vittoria; TARABINI CASTELLANI, Emma; A., Fusco; Mattioli, Giorgio
abstract

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1992 - Attivazione neurormonale [Capitolo/Saggio]
Mattioli, Anna Vittoria; Mattioli, Giorgio
abstract

Descrive i principali sistemi neurormonali che vengono attivati in corso di insufficienza cardiaca

1992 - Diagnosi e valutazione dell'efficacia trombolitica nella trombosi atriale sinistra mediante ecocardiografia transesofagea [Articolo su rivista]
Mattioli, Anna Vittoria; L., Reggianini; G., Masciocco; F., Greco
abstract

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1992 - Effect of antihypertensive treatment with nitrendipine on left ventricular mass and diastolic filling in patients with mild to moderate hypertension [Articolo su rivista]
Modena, Maria Grazia; Mattioli, Anna Vittoria; Parato, Vm; Mattioli, Giorgio
abstract

Nitrendipine is a dihydropyridine calcium antagonist that may be active when administered once daily. The aim of the study was to assess the effect of antihypertensive treatment with nitrendipine (20-40 mg) on left ventricular mass and diastolic function. Forty patients with mild to moderate hypertension (diastolic pressure greater than or equal to 90 and less than or equal to 114 mm Hg) were enrolled; a complete echo Doppler examination was performed at baseline, and 8 and 12 months after treatment in order to measure left ventricular mass and diastolic and systolic function. Only 28 patients completed the study follow-up. At month 8 nitrendipine had already successfully reduced blood pressure (mean 122 +/- 9 to 92 +/- 10 mm Hg) without modifying heart rate, and left ventricular mass index (150 +/- 48 to 123 +/- 34 g/m2), with a further reduction at month 12. Isovolumic relaxation time was reduced at month 8 from 138 +/- 28 to 111 +/- 17 ms, but the diastolic pattern was completely modified only after 1 year, with a normalization of deceleration time (from 220 +/- 35 to 188 +/- 12). Systolic function did not change. Our results indicate that nitrendipine is a powerful antihypertensive agent that reduces left ventricular mass, but requires a longer period of time to improve diastolic filling pattern

1992 - Effectiveness of the antihypertensive action of lisinopril on left ventricular mass and diastolic filling [Articolo su rivista]
Modena, Maria Grazia; Mattioli, Anna Vittoria; Parato, Vm; Mattioli, Giorgio
abstract

The effect of antihypertensive treatment with lisinopril (10 to 20 mg) on left ventricular mass and diastolic function was studied in 35 patients with mild to moderate hypertension. At baseline 6 and 12 months after treatment responders to lisinopril were examined by complete echo Doppler in order to measure left ventricular mass, diastolic and systolic function. Only 30 patients concluded the study follow-up. Lisinopril successfully reduced mean blood pressure (from 122 +/- 10 to 110 +/- 11 mmHg), without modification in heart rate, and left ventricular mass index (from 145 +/- 57 to 116 +/- 42 g.m-2) at month 6, with mild additional reduction at month 12. Isovolumic relaxation time was reduced but still abnormal at months 6 and 12, whereas deceleration time significantly changed only (from 230 +/- 40 to 195 +/- 35 msec) at month 12. Our results indicate that lisinopril is more successful in reducing left ventricular mass than in improving diastolic filling.

1992 - Fisiopatologia dell'insufficienza cardiaca [Capitolo/Saggio]
Mattioli, Anna Vittoria
abstract

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1992 - Influence of the neurohumoral system on left ventricular performance in chronic congestive heart failure [Articolo su rivista]
Mattioli, Anna Vittoria; Modena, Maria Grazia; Masciocco, L; Fantini, G; Mattioli, Giorgio
abstract

The influence of the neurohumoral system, as adrenergic system or renin-angiotensin system, on cardiac performance in heart failure is not yet know. In order to evaluate the influence of neurohumoral activation in chronic heart failure we followed 51 patients, 47 males and 4 females of mean age 58 +/- 10 years. They suffered from chronic heart failure of different origin and were classified according to NYHA classification: 42 patients were in class III and 9 were in class II. They were treated with digoxin and diuretics since long time. Ejection fraction (EF) was obtained by RVG at baseline and 8 months later. In order to test the influence of adrenergic system on EF we checked plasmatic norepinephrine levels and we divided the patients in two groups: Group A with high levels of plasmatic norepinephrine (1114 +/- 594 pg/ml) and Group B with normal level (426 +/- 139 pg/ml). Group A showed a reduction of EF (-3.73 +/- 1.27%) while, Group B showed a small increase of EF (+ 2.57 +/- 4.32%). To test the influence of renin-angiotensin system we also evaluated the patients according to the value of plasmatic renin activity: normal or high level. We did not observe a significant difference between the 2 groups. Patients with high plasmatic norepinephrine value presented a significant reduction of EF compared to those with low plasmatic norepinephrine. The adrenergic system seems to be more important than renin-angiotensin system or cardiac performance

1992 - L'ecocardiografia Doppler transesofagea nella valutazione del flusso venoso polmonare [Articolo su rivista]
Mattioli, Anna Vittoria
abstract

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1992 - L'ipertrofia cardiaca [Capitolo/Saggio]
Mattioli, Anna Vittoria; Mattioli, Giorgio
abstract

I meccanismi dell'ipertrofia ventricolare

1992 - Nitrati e rimodellamento [Capitolo/Saggio]
Mattioli, Anna Vittoria; Mattioli, Giorgio
abstract

Gli effetti dei nitrati sul rimodellamento ventricolare sinistro

1991 - Right ventricular pacing and left ventricular filling pattern. An echo-Doppler study [Articolo su rivista]
Modena, Maria Grazia; Mattioli, Anna Vittoria; Mattioli, Giorgio
abstract

The influence of right ventricular pacing on left ventricular filling has not been completely clarified. The aim of the study was to analyze the possible alteration in and effects on left ventricular filling resulting from right ventricular pacing. The study population consisted of two groups; group A was comprised of 12 patients with a spontaneous left bundle branch block, and group B had 12 patients without left bundle branch block. All the patients underwent an interrogation of the mitral valve inflow by Doppler echocardiography, in order to measure isovolumic relaxation time, early and late peak velocity (E and A wave), E/A ratio and deceleration time. The study was performed at spontaneous rhythm and after, inhibition of the pacemaker. In group A, there were no changes in the Doppler parameters when passing from a spontaneous to an 80/min electrically induced rhythm. Analysis of group B revealed a statistically significant lengthening of IVR and Dec t with electrical stimulation. No statistically significant differences were found when we compared the Doppler parameters of the two populations at the same pacing frequency. Right ventricular pacing causes interventricular asynchrony and abnormalities in diastolic filling times, which resulted in a lengthening of either IVR and Dec t, simulating a pattern of abnormal relaxation.

1990 - Atenolol in dilated cardiomyopathy: a clinical instrumental study [Articolo su rivista]
Mattioli, Anna Vittoria; Modena, Maria Grazia; G., Fantini; Mattioli, Giorgio
abstract

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1990 - Stunned and necrotic areas. Role of MRI. Italian Cooperative Study. [Relazione in Atti di Convegno]
F., Fedele; S., Biasi; F., Cipressi; Mattioli, Giorgio; Mattioli, Anna Vittoria
abstract

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1989 - Anestesia generale e beta-bloccanti: esperienza clinica. [Abstract in Rivista]
Piccinini, P; Morselli, L; Mattioli, Anna Vittoria; Barbieri, Alberto
abstract

Anestesia generale e beta-bloccanti: esperienza clinica.

1989 - Effects of infusions of different doses of dopamine in dilated cardiomyopathy. Observations during and after treatment with beta-blockers [Articolo su rivista]
Modena, Maria Grazia; Mattioli, Anna Vittoria; Fantini, G; Mattioli, Giorgio
abstract

It is well known that there are abnormalities of the sympathetic nervous system in chronic congestive heart failure. The aim of our study was to verify the effects on heart rate, blood pressure and some echocardiographic parameters of performance and inotropic state of iv infusion of dopamine at different dosages in 14 patients affected by dilated cardiomyopathy. The patients were divided into 3 groups: the first one of patients on standard treatment, the second of subjects on standard treatment and beta blockers, the third of patients who stopped beta blocker therapy and remained on standard therapy. In the first group dopamine at low dosage did not significantly modify heart rate, blood pressure, performance and contractile state, while it did decrease end systolic wall stress. In the second group the same dosage significantly decreased blood pressure and stress, maintaining unchanged the other indexes; the same behaviour was presented by the third group. At high dosage dopamine in the first group significantly increased blood pressure, ejection fraction, contractility and stress. No modifications were observed in the second group, probably because of a pharmacological inhibition of beta receptors. The third group showed a significant increase in blood pressure, stress and inotropic state. From our data it appears that dopamine treatment in chronic congestive heart failure may reveal the presence of the so-called "down regulation" phenomenon

1989 - Pazienti con turbe della conduzione ed intervento chirurgico. [Abstract in Rivista]
Mattioli, Anna Vittoria; Barbieri, Alberto; Bettelli, G; Teti, C.
abstract

Pazienti con turbe della conduzione ed intervento chirurgico.

1988 - Cardiomiopatia congestizia: valutazione della capacità di esercizio mediante test a diversa progressione di carico. [Articolo su rivista]
Masciocco, L; Greco, A; Mattioli, Anna Vittoria; Barbieri, Alberto; Mattioli, G.
abstract

Cardiomiopatia congestizia: valutazione della capacità di esercizio mediante test a diversa progressione di carico.

1988 - MYOCARDIAL REPERFUSION - DAMAGES OR BENEFITS [Capitolo/Saggio]
Mattioli, G.; Mattioli, A. V.; Masciocco, L.
abstract

1988 - Myocardial reperfusion: damages or benefit? [Capitolo/Saggio]
Mattioli, Giorgio; Mattioli, Anna Vittoria; L., Masciocco
abstract

Data from a large series of patients with acute myocardal infarction treated with thrombolysis

1988 - Valutazione del consumo di O2 e EF in pazienti con insufficienza cardiaca congestizia cronica. [Abstract in Rivista]
Masciocco, L; Mattioli, Anna Vittoria; Barbieri, Alberto; Modena, Maria Grazia; Mattioli, G.
abstract

Valutazione consumo 02 e EF in pazienti con insufficienza cardiaca congestizia cronica

1987 - Assenza di complicanze cardiache nei pazienti portatori di turbe intraventricolari della conduzione sottoposti ad anestesia per intervento chirurgico. [Articolo su rivista]
Mattioli, Anna Vittoria; Barbieri, Alberto; Bettelli, G; Teti, C.
abstract

Assenza di complicanze cardiache nei pazienti portatori di turbe intraventricolari della conduzione sottoposti ad anestesia per intervento chirurgico.

1987 - Valutazione della capacità di esercizio in pazienti con cardiomiopatia congestizia mediante test all'esercizio a diverso carico. [Abstract in Rivista]
Mattioli, Anna Vittoria; Greco, A; Masciocco, L; Barbieri, Alberto; Mattioli, G.
abstract

Valutazione della capacità di esercizio in pazienti con cardiomiopatia congestizia mediante test all'esercizio a diverso carico.