6 results on '"Alessandro Maloberti"'
Search Results
2. Determinants of Functional Improvement After Cardiac Rehabilitation in Acute Coronary Syndrome
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Ilaria Bassi, A. Peretti, Alessandro Maloberti, Laura Garatti, Valentina Giani, Marco Biolcati, Giovanna Beretta, Matteo Palazzini, S. Riccobono, Lucia Occhi, Filippo Leidi, Massimiliano Monticelli, Sofia Bianchi, Sabrina Sioli, Cristina Giannattasio, Giacomo Ruzzenenti, Bianchi, S, Maloberti, A, Peretti, A, Garatti, L, Palazzini, M, Occhi, L, Bassi, I, Sioli, S, Biolcati, M, Giani, V, Monticelli, M, Leidi, F, Ruzzenenti, G, Beretta, G, Giannattasio, C, and Riccobono, S
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Male ,medicine.medical_specialty ,Acute coronary syndrome ,medicine.medical_treatment ,Internal medicine ,Heart rate ,Linear regression ,Internal Medicine ,medicine ,Humans ,In patient ,Aged ,Secondary prevention ,Rehabilitation ,Cardiac Rehabilitation ,business.industry ,Functional improvement ,Mean age ,Exercise capacity ,Middle Aged ,Physical Functional Performance ,medicine.disease ,Treatment Outcome ,Cardiology ,Original Article ,Female ,Cardiology and Cardiovascular Medicine ,business ,human activities - Abstract
Introduction Cardiac rehabilitation (CR) is an effective tool for secondary prevention after acute coronary syndrome (ACS). Aim Aim of our study was to find the significant determinants of exercise capacity (evaluated with the six-minute walking test—6-MWT) and functional improvement in patients undergoing CR after an ACS. Methods The study group included 298 patients (mean age 61.6 ± 10.2 years; males 80.2%) who, after ACS, were enrolled in CR program at Niguarda Hospital in Milan from 2015 to 2018. For all patients, we collected anamnestic, clinical and instrumental cardiological data. All patients performed a 6-MWT at the beginning (6-MWT-1) and at the end (6-MWT-2) of CR program. Δ meters were used to represent functional improvement. Results Multiple linear regression models were carried out for 6-MWT-1, 6-MWT-2, Δ meters and % Δ meters. Standardized regression coefficients showed that age (β = − 0.237; p < 0.001), BMI (β = − 0.116; p = 0.006) and heart rate (β = − 0.082; p = 0.040) were determinants of exercise capacity (6MWT-1 and 2), whereas age (β = −.231; p = 0.004), sex (β = − 0.187; p = 0.008) and BMI (β = − 0.164; p = 0.022) were determinants of functional improvement (Δ meters). Conclusions Our data showed that functional improvement after CR in ACS patients is mainly related to non-cardiological variables. Instead it is related to intrinsic factors, both modifiable (BMI) and non-modifiable (age, sex). Supplementary Information The online version contains supplementary material available at 10.1007/s40292-021-00473-7.
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- 2021
3. Predictors of Success of Transcatheter Aortic Valve Implantation
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Giannattasio Cristina, Andrea Buono, Alessandro Maloberti, Domenico Sirico, Maloberti, A, Buono, A, Sirico, D, and Giannattasio, C
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medicine.medical_specialty ,education.field_of_study ,business.industry ,Population ,EuroSCORE ,medicine.disease ,Stenosis ,medicine.anatomical_structure ,Aortic valve replacement ,Quality of life ,Cardiothoracic surgery ,Predictors of success, Transcatheter Aortic Valve Implantation ,Internal medicine ,Cardiology ,Medicine ,Heart valve ,business ,education ,Complication - Abstract
The role of transcatheter aortic valve implantation (TAVI) or replacement (TAVR) as an alternative to surgical aortic valve replacement (SAVR) is established in patient with symptomatic severe aortic stenosis (AS) who are at high surgical risk. However, current selection of patients undergoing TAVR relies on risk stratification models derived from surgical patient population (EuroSCORE and Society of Thoracic Surgery score), and many concerns regarding the suitability of these models in predicting TAVR mortality or complication risks have been raised. In fact, the evaluation of survival, as well as the incidence of major or minor complications, is of paramount importance and contributes to decision-making in interventions for severe AS. This chapter will review predictors of mortality and principal complications such as cerebrovascular events, conduction disturbances, paravalvular leak and vascular and bleeding complication. Nevertheless, the assessment of individual patient’s prognosis after TAVR is challenging because heart valve team should take into consideration a variety of predictors, which could be divided into three main groups: pre-procedural, procedural, and post-procedural. The former ones are patient-related including clinical history, comorbidities, and cardiovascular morphological and functional variables; procedural predictors are represented by technique-related issues (i.e., vascular access, type of implanted valve, pre- and post-dilation, etc.); and the latter ones could represent, on the one hand, minor or major complications and on the other being predictors of major events such as mortality (i.e., conduction disturbance, paravalvular leaks, etc.).
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- 2019
4. Arterial Stiffness in Aortic Stenosis: Relationship with Severity and Echocardiographic Procedures Response
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G. Colombo, Antonella Moreo, Paola Sormani, Silvio Klugmann, Claudio Russo, Cristina Giannattasio, Giuseppe Bruschi, Alessandro Maloberti, Stefano Nava, Bruno Merlanti, P. Vallerio, Fabrizio Oliva, Francesca Casadei, Jolie Bruno, Bruschi, G, Maloberti, A, Sormani, P, Colombo, G, Nava, S, Vallerio, P, Casadei, F, Bruno, J, Moreo, A, Merlanti, B, Russo, C, Oliva, F, Klugmann, S, and Giannattasio, C
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Male ,medicine.medical_specialty ,Time Factors ,Aortic stenosi ,Population ,Pulse Wave Analysis ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Echocardiographic Procedures ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,Vascular Stiffness ,0302 clinical medicine ,Aortic valve replacement ,Predictive Value of Tests ,Internal medicine ,Internal Medicine ,medicine ,Humans ,In patient ,030212 general & internal medicine ,education ,Pulse wave velocity ,Aorta ,Aged ,Aged, 80 and over ,education.field_of_study ,Transcatheter aortic valve implantation ,business.industry ,Patient Selection ,Hemodynamics ,Aortic Valve Stenosis ,Recovery of Function ,medicine.disease ,Echocardiography, Doppler ,Stenosis ,Arterial stiffne ,Treatment Outcome ,Aortic Valve ,cardiovascular system ,Ventricular pressure ,Cardiology ,Arterial stiffness ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Introduction: Aortic stenosis (AS) is more than only a degenerative disease, it could be also an atherosclerotic-like process involving the valve instead of the vessels. Little is known about the relation of arterial stiffness and AS. Aim: We sought to determine wether pulse wave velocity (PWV), is related to AS severity and to the procedures response, both as surgical aortic-valve-replacement (AVR) and trascatheter-aortic-valve-implantation (TAVI). Methods: 30 patients with severe AS were treated (15 AVR, 15 TAVI). Before the procedures (t0) and after 1 week (t1) echocardiography and PWV were evaluated. Results: On the whole population, subjects with higher PWV showed higher transvalvular pressure gradient at baseline (mean: 56.5 ± 15.1 vs 45.4 ± 9.5; peak: 93.3 ± 26.4 vs 73.3 ± 14.9, p = 0.02) and, a significantly greater response to the procedures (mean: −42.9 ± 17.2 vs −27.9 ± 10.1, peak: −68.7 ± 29.2 vs −42.8 ± 16.4, p = 0.02). When the two different procedures groups were separated, data were confirmed only in the TAVI subgroup. Conclusions: In patients undergoing procedures for AS, PWV is correlated with transvalvular gradient and, in TAVI subjects, is able to predict the echocardiographic response. Baseline evaluation of PWV in patients candidates to TAVI can help the selection of subjects, even if larger and longer studies are needed before definitive conclusion can be drawn.
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- 2017
5. Effects of Renal Sympathetic Denervation on Arterial Stiffness and Blood Pressure Control in Resistant Hypertensive Patients: A Single Centre Prospective Study
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A. Agrati, Cristina Giannattasio, Silvio Klugmann, Marisa Varrenti, Francesco Soriano, Matteo Baroni, Giovanni Ferraro, Paola Colombo, Luca Giupponi, F. Panzeri, Paolo Meani, Giuseppe Mancia, Alessandro Maloberti, Stefano Nava, F. Colombo, Antonio Rampoldi, Baroni, M, Nava, S, Giupponi, L, Meani, P, Panzeri, F, Varrenti, M, Maloberti, A, Soriano, F, Agrati, A, Ferraro, G, Colombo, F, Rampoldi, A, Mancia, G, Colombo, P, Klugmann, S, and Giannattasio, C
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Male ,medicine.medical_specialty ,Time Factors ,Drug Resistance ,Blood Pressure ,Pulse Wave Analysis ,Essential hypertension ,Kidney ,Carotid Intima-Media Thickness ,Vascular Stiffness ,Internal medicine ,medicine ,Internal Medicine ,Humans ,Prospective Studies ,Sympathectomy ,Pulse wave velocity ,Antihypertensive Agents ,Aged ,Denervation ,Aged, 80 and over ,business.industry ,Middle Aged ,medicine.disease ,Cardiovascular risk ,Surgery ,Arterial stiffne ,Resistant hypertension ,medicine.anatomical_structure ,Blood pressure ,Treatment Outcome ,Intima-media thickness ,Italy ,Renal sympathetic denervation ,Hypertension ,Arterial stiffness ,Cardiology ,Female ,business ,Cardiology and Cardiovascular Medicine - Abstract
Renal denervation (RD) is an intriguing treatment strategy for resistant hypertension. However, limited data are available about its long time efficacy as well as its effects on intermediate phenotypes like arterial stiffness and carotid IMT. 12 patients (9 males, mean 69 years) with resistant hypertension underwent bilateral RDN (Medtronic System) since April 2012 in Niguarda Ca’ Granda Hospital (Milan). Patients were studied before intervention, and at 1, 3, 6 and 12 months after RD. Carotid intima media thickness (Esaote Mylab) and carotid-femoral pulse wave velocity (Complior, Alam medical) were assessed at each step. Compared to baseline, patients showed a marked reduction of office systolic blood pressure at each follow-up step (p
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- 2015
6. Structural and Functional Abnormalities of Carotid Artery and Their Relation with EVA Phenomenon
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P. Vallerio, Miriam Stucchi, Paolo Meani, Marisa Varrenti, L. Giupponi, Cristina Giannattasio, Alessandro Maloberti, Maloberti, A, Meani, P, Varrenti, M, Giupponi, L, Stucchi, M, Vallerio, P, and Giannattasio, C
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Adult ,Carotid Artery Diseases ,medicine.medical_specialty ,Carotid arteries ,macromolecular substances ,Vascular Remodeling ,Carotid Intima-Media Thickness ,EVA Phenomenon ,Young Adult ,Vascular Stiffness ,Central blood pressure ,Predictive Value of Tests ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Arterial Pressure ,Risk factor ,biology ,business.industry ,Ultrasound ,Age Factors ,Middle Aged ,medicine.disease ,Elastin ,Carotid Arteries ,Intima-media thickness ,Cardiology ,Arterial stiffness ,biology.protein ,Vascular aging ,Collagen ,Carotid Artery ,Cardiology and Cardiovascular Medicine ,business - Abstract
Early vascular aging is a process characterized by a reduction in arterial elastin with an increase in collagen that has been related to cardiovascular risk factor and can determine an increased arterial stiffness and central blood pressure. It can be measured by several non invasive methods and in different arterial segment. The present paper will focus on functional (local stiffness parameter) and structural (intima media thickness) carotid arteries alterations typically evaluated by ultrasound methods. Methodological, research and clinical issue has been reviewed.
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- 2015
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