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7 results on '"Lotrionte M"'

1. Prediction of functional capacity by low-dose dobutamine stress echocardiography in chronic heart failure.

Author

Natali R, Lotrionte M, Marchese N, Di Giannuario G, Brugaletta S, Pisanello C, Comerci G, Savino M, Lombardo A, Forni F, Vigna C, and Loperfido F

Subjects
Aged, Chronic Disease, Female, Heart Failure diagnostic imaging, Humans, Male, Myocardial Contraction physiology, Natriuretic Peptide, Brain blood, Oxygen Consumption physiology, Peptide Fragments blood, Prospective Studies, Respiratory Function Tests, Ventricular Dysfunction, Left diagnosis, Adrenergic beta-Agonists, Dobutamine, Echocardiography methods, Exercise Test, Heart Failure diagnosis
Abstract

Aim: The aim of this study was to determine if low-dose dobutamine stress echocardiography (LD-DSE) is associated with functional capacity in unselected elderly patients with chronic heart failure., Methods: This was a prospective trial. Thirty five consecutive patients were included, with age >65 years and left ventricular dysfunction (12 ischemic), by blindly assessed LD-DSE and cardiopulmonary exercise testing (CPT). Contractile reserve was defined as a change (D) in wall motion score index (WMSI) = or <0.2 at peak dose dobutamine. At CPT treadmill exercise time, peak VO2, %Vo2 and VE/VCO2 slope were determined. Preserved functional capacity was defined as percent of maximal predicted O2 consumption (%VO2) >80%. Baseline NT-proBNP plasma levels were assessed., Results: CPT variables were not related to clinical and baseline echocardiography characteristics but were related to DWMSI (exercise time, P=0.004; peak VO2, P=0.008; %VO2, P<0.001; VE/Vco2, P<0.001). Contractile reserve was present in 16 of 17 patients with preserved functional capacity (sensitivity=94%) and in 2 of 13 patients without (specificity=85%). Baseline NT-proBNP levels were lower in patients with contractile reserve (476+/-365 pg/mL) than in those without (1 345+/-1 219 pg/mL) (P=0.019), but were mildly related to CPT variables (P=0.049 and 0.027 with exercise time and %VO2, respectively)., Conclusion: Contractile reserve elicited at LD-DSE is associated with functional capacity in unselected elderly patients with chronic heart failure.

Published
2008

2. Assessment of left ventricular systolic dysfunction by tissue Doppler imaging to detect subclinical cardiomyopathy early after anthracycline therapy.

Author

Lotrionte M, Palazzoni G, Natali R, Comerci G, Abbate A, Loperfido F, and Biondi-Zoccai G

Subjects
Adult, Cardiomyopathies diagnosis, Cardiomyopathies diagnostic imaging, Data Interpretation, Statistical, Diastole, Female, Follow-Up Studies, Humans, Male, Middle Aged, Systole, Time Factors, Anthracyclines adverse effects, Breast Neoplasms drug therapy, Cardiomyopathies chemically induced, Echocardiography, Ventricular Dysfunction, Left diagnosis
Abstract

Aim: Anthracycline (ANT) chemotherapy for breast cancer, while associated with high response rates, is fraught by risks of irreversible cardiotoxicity. Unfortunately means to detect such cardiotoxicity early on and at a sublinical stage are lacking. We evaluated the role of systolic tissue Doppler imaging (TDI) in appraising postchemotherapy left ventricular (LV) remodelling., Methods: Patients undergoing ANT-chemotherapy for breast cancer were enrolled, and underwent baseline and >6-months echocardiography (standard and TDI). According to the pattern of LV-TDI systolic remodelling from baseline to follow-up, patients were stratified in: group 1 (no LV-TDI worsening), group 2 (minor LV-TDI worsening), and group 3 (major LV-TDI worsening). Fifty-six patients were included (follow-up 9+/-6 months)., Results: At baseline, no patient had abnormal LV ejection fraction (LVEF), LV-TDI systolic dysfunction or New York Heart Association (NYHA) >1. Follow-up overall analysis showed significant deterioration in LVEF, end-diastolic diameter (EDD) end-systolic diameter (ESD), and TDI-systolic parameters (all P<0.05). Specifically, 29 (51.8%) patients showed no adverse LV-TDI systolic remodelling, while 17 (30.4%) were in group 2, and 10 (17.9%) in group 3. All groups shared similar conditions at baseline. Patients with adverse LV-TDI remodelling had significant increases in EDD and ESD, as well as a significantly decreased LVEF (all P<0.05). No patient in group 1 had abnormal LVEF at follow-up, while 1 patient in group 2 and 2 patients in group 3 had abnormal LVEF (P<0.05)., Conclusion: Subclinical systolic dysfunction occurs in almost 50% of patients early after chemotherapy for breast cancer, with a more adverse by LV-TDI remodelling implying a more pronounced deterioration of standard echocardiographic parameters.

Published
2007

3. Inaccuracy of dipyridamole echocardiography or scintigraphy for the diagnosis of coronary artery disease in patients with both left bundle branch block and left ventricular dysfunction.

Author

Vigna C, Stanislao M, De Rito V, Russo A, Santoro T, Fusilli S, Valle G, Natali R, Fanelli R, Lotrionte M, Biondi-Zoccai G, and Loperfido F

Subjects
Aged, Bundle-Branch Block complications, Chest Pain etiology, Coronary Angiography, Electrocardiography, Exercise Test, Female, Humans, Male, Middle Aged, Sensitivity and Specificity, Technetium Tc 99m Sestamibi, Tomography, Emission-Computed, Single-Photon, Ventricular Dysfunction, Left complications, Bundle-Branch Block diagnostic imaging, Coronary Artery Disease diagnosis, Dipyridamole, Echocardiography methods, Vasodilator Agents, Ventricular Dysfunction, Left diagnostic imaging
Abstract

Non-invasive diagnosis of coronary artery disease (CAD) in patients with left ventricular (LV) dysfunction and left bundle branch block (LBBB) remains challenging, and there is no consensus on the role of myocardial sesta-MIBI perfusion scintigraphy with pharmacological stress (dip-MIBI) or dipiridamole echocardiography (dip-ECHO). We thus performed a prospective study to test the diagnostic accuracy of such non-invasive tests. 27 consecutive patients with both LV dysfunction and LBBB undergoing diagnostic work-up for CAD were studied simultaneously with dip-ECHO and dip-MIBI. The sensitivity for CAD for dip-ECHO and dip-MIBI was respectively 42% and 67%, with specificity 93% and 53%, and likelihood ratio (LR)-positive 6.3 and LR-negative 0.6 for both. Given the low accuracy of both dip-ECHO and dip-MIBI in detecting CAD in patients with concomitant LV dysfunction and LBBB, coronary angiography should be performed as the default diagnostic strategy in such patients.

Published
2006
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4. Appraising cardiotoxicity associated with liposomal doxorubicin by means of tissue Doppler echocardiography end-points: rationale and design of the LITE (Liposomal doxorubicin-Investigational chemotherapy-Tissue Doppler imaging Evaluation) randomized pilot study

Author

Lotrionte, M., Palazzoni, G., Natali, R., Comerci, G., Abbate, A., Di Persio, S., and BIONDI ZOCCAI, Giuseppe

Subjects
Antibiotics, Antineoplastic, cardiotoxicity, Breast Neoplasms, Pilot Projects, anthracycline, randomized clinical trial, Echocardiography, Doppler, Doxorubicin, echocardiography, tissue doppler imaging, Liposomes, Humans, Female, Cardiomyopathies
Abstract

Cardiomyopathy following anthracycline chemotherapy may have ominous clinical implications in cancer patients treated with this effective yet potentially toxic therapy. Early detection at subclinical stage is pivotal to minimize the risk of overt cardiotoxicity. Liposomal anthracyclines have the potential for more selective uptake by cancer cells and reduced cardiac toxicity.We designed a single-center randomized clinical trial, the Liposomal doxorubicin-Investigational chemotherapy-Tissue Doppler imaging Evaluation (LITE) pilot study to compare the safety of liposomal doxorubicin vs standard epirubicin in terms of clinical and subclinical cardiotoxicity.Whereas diagnostic and prognostic instruments effective at early recognition of cardiomyopathy are lacking, promising data have been reported for tissue Doppler imaging (TDI) echocardiography. The study will enroll 80 patients with breast cancer and indication to anthracycline chemotherapy, randomizing them in a 1:1 ratio to liposomal doxorubicin or standard epirubicin. The primary end-point will be the comparison of changes from baseline to 12-month follow-up of left ventricular TDI systolic function parameters, and the co-primary end-point will be based instead on changes in TDI diastolic function parameters. Among secondary end-points, we will adjudicate changes in standard 2-dimensional echocardiography parameters, including ejection fraction, peak values of biochemical markers of cardiac damage and heart failure, ie cardiac troponin T and BNP, overall survival, functional class, freedom from cancer recurrence, and adverse effects of chemotherapy.Results of the LITE pilot study should provide important clinical and mechanistic insights on the promising role of liposomal anthracyclines in patients with breast cancer and indication to anthracycline chemotherapy (ClinicalTrials.gov identifier NCT00531973).

Published
2007

5. Assessment of left ventricular systolic dysfunction by tissue Doppler imaging to detect subclinical cardiomyopathy early after anthracycline therapy

Author

Lotrionte, M., Palazzoni, G., Natali, R., Comerci, G., Abbate, A., Loperfido, F., and Giuseppe Biondi-Zoccai

Subjects
Adult, Male, anthracyclines, Time Factors, Systole, echocardiography, toxicity, Breast Neoplasms, Middle Aged, Ventricular Dysfunction, Left, Diastole, Data Interpretation, Statistical, Humans, Female, Cardiomyopathies, Follow-Up Studies
Abstract

Anthracycline (ANT) chemotherapy for breast cancer, while associated with high response rates, is fraught by risks of irreversible cardiotoxicity. Unfortunately means to detect such cardiotoxicity early on and at a sublinical stage are lacking. We evaluated the role of systolic tissue Doppler imaging (TDI) in appraising postchemotherapy left ventricular (LV) remodelling.Patients undergoing ANT-chemotherapy for breast cancer were enrolled, and underwent baseline and6-months echocardiography (standard and TDI). According to the pattern of LV-TDI systolic remodelling from baseline to follow-up, patients were stratified in: group 1 (no LV-TDI worsening), group 2 (minor LV-TDI worsening), and group 3 (major LV-TDI worsening). Fifty-six patients were included (follow-up 9+/-6 months).At baseline, no patient had abnormal LV ejection fraction (LVEF), LV-TDI systolic dysfunction or New York Heart Association (NYHA)1. Follow-up overall analysis showed significant deterioration in LVEF, end-diastolic diameter (EDD) end-systolic diameter (ESD), and TDI-systolic parameters (all P0.05). Specifically, 29 (51.8%) patients showed no adverse LV-TDI systolic remodelling, while 17 (30.4%) were in group 2, and 10 (17.9%) in group 3. All groups shared similar conditions at baseline. Patients with adverse LV-TDI remodelling had significant increases in EDD and ESD, as well as a significantly decreased LVEF (all P0.05). No patient in group 1 had abnormal LVEF at follow-up, while 1 patient in group 2 and 2 patients in group 3 had abnormal LVEF (P0.05).Subclinical systolic dysfunction occurs in almost 50% of patients early after chemotherapy for breast cancer, with a more adverse by LV-TDI remodelling implying a more pronounced deterioration of standard echocardiographic parameters.

Published
2007

6. Impaired coronary and myocardial flow in severe aortic stenosis is associated with increased apoptosis: a transthoracic Doppler and myocardial contrast echocardiography study.

Author

Galiuto, L., Lotrionte, M., Crea, F., Anselmi, A., Biondi-Zoccai, G. G. L., De Giorgio, F., Baldi, A., Baldi, F., Possati, G., Gaudino, M., Vetrovec, G. W., and Abbate, A.

Subjects
*CORONARY circulation, *BLOOD circulation, *BLOOD flow, *HEMODYNAMICS, *MUSCLE cells, *APOPTOSIS, *LEFT heart ventricle, *AORTIC stenosis, *AORTIC valve diseases, *ECHOCARDIOGRAPHY
Abstract

Objective: To test the hypothesis that impaired coronary and myocardial blood flow are linked with increased myocyte apoptosis, thus establishing a link between pressure overload and left ventricular (LV) remodelling. Methods and results: Peak diastolic coronary blood flow velocity (CBFV) was evaluated at transthoracic Doppler echocardiography, and signal intensity (SI) and the rate of SI rise (β) were measured at myocardial contrast echocardiography in 11 patients with severe aortic stenosis and LV hypertrophy. In the same patients, biopsies were obtained from the anterolateral LV free wall during surgery and analysed for cardiomyocyte apoptosis. LV mass corrected CBFV (CBFVI) was significantly lower in patients than in controls (median 0.100 cm g/s (interquartile range 0.07–0.115) v 0.130 cm g/s (0.130–0.160), p = 0.002). Similarly, SI*β was significantly lower in patients than in controls (11 1/s (8–66) v 83 1/s (73–95), p = 0.001). Apoptotic rate was increased in aortic stenosis more than 100-fold versus controls (1.2% (0.8–1.4) v 0.01% (0.01–0.01), p < 0.001) and inversely correlated with lower CBFVI and SI*β (r = -0.77, p = 0.001 for both). Conclusions: Patients with severe aortic stenosis and LV hypertrophy have impaired myocardial perfusion, which is associated with enhanced cardiomyocyte apoptosis. Impaired myocardial perfusion and the ensuing oxygen demand-supply imbalance may, at least partially, be responsible for increased apoptosis and possible transition to heart failure, thus establishing a link between pressure overload, LV remodelling, and heart failure. [ABSTRACT FROM AUTHOR]

Published
2006
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7. Impaired coronary and myocardial flow in severe aortic stenosis is associated with invreased apoptosis: a transthoracic Doppler and myocardial contrast echocardiography study

Author

Giuseppe Biondi-Zoccai, Gianfederico Possati, F. Crea, Antonio Abbate, F De Giorgio, Mario Gaudino, George W. Vetrovec, Alfonso Baldi, Marzia Lotrionte, Leonarda Galiuto, Feliciano Baldi, Amedeo Anselmi, Galiuto, L, Lotrionte, M, Crea, F, Anselmi, A, BIONDI ZOCCAI, Gg, DE GIORGIO, F, Baldi, Alfonso, Baldi, F, Possati, G, Gaudino, M, Vetrovec, Gw, and Abbate, A.

Subjects
Male, medicine.medical_specialty, myocardial flow, Diastole, apoptosis, aortic stenosis, Cardiovascular Medicine, Doppler echocardiography, Coronary circulation, Coronary Circulation, Internal medicine, medicine, Humans, Myocytes, Cardiac, Aged, Pressure overload, medicine.diagnostic_test, business.industry, Microcirculation, Aortic Valve Stenosis, medicine.disease, Echocardiography, Doppler, Stenosis, medicine.anatomical_structure, Echocardiography, Aortic valve stenosis, Heart failure, Circulatory system, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Blood Flow Velocity
Abstract

Objective: To test the hypothesis that impaired coronary and myocardial blood flow are linked with increased myocyte apoptosis, thus establishing a link between pressure overload and left ventricular (LV) remodelling. Methods and results: Peak diastolic coronary blood flow velocity (CBFV) was evaluated at transthoracic Doppler echocardiography, and signal intensity (SI) and the rate of SI rise (β) were measured at myocardial contrast echocardiography in 11 patients with severe aortic stenosis and LV hypertrophy. In the same patients, biopsies were obtained from the anterolateral LV free wall during surgery and analysed for cardiomyocyte apoptosis. LV mass corrected CBFV (CBFVI) was significantly lower in patients than in controls (median 0.100 cm·g/s (interquartile range 0.07–0.115) v 0.130 cm·g/s (0.130–0.160), p = 0.002). Similarly, SI*β was significantly lower in patients than in controls (11 1/s (8–66) v 83 1/s (73–95), p = 0.001). Apoptotic rate was increased in aortic stenosis more than 100-fold versus controls (1.2% (0.8–1.4) v 0.01% (0.01–0.01), p r = −0.77, p = 0.001 for both). Conclusions: Patients with severe aortic stenosis and LV hypertrophy have impaired myocardial perfusion, which is associated with enhanced cardiomyocyte apoptosis. Impaired myocardial perfusion and the ensuing oxygen demand–supply imbalance may, at least partially, be responsible for increased apoptosis and possible transition to heart failure, thus establishing a link between pressure overload, LV remodelling, and heart failure.

Published
2005

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