Papers by Oronzo Catalano
International Journal of Molecular Sciences
The SARS-CoV-2 infection determines the COVID-19 syndrome characterized, in the worst cases, by s... more The SARS-CoV-2 infection determines the COVID-19 syndrome characterized, in the worst cases, by severe respiratory distress, pulmonary and cardiac fibrosis, inflammatory cytokine release, and immunosuppression. This condition has led to the death of about 2.15% of the total infected world population so far. Among survivors, the presence of the so-called persistent post-COVID-19 syndrome (PPCS) is a common finding. In COVID-19 survivors, PPCS presents one or more symptoms: fatigue, dyspnea, memory loss, sleep disorders, and difficulty concentrating. In this study, a cohort of 117 COVID-19 survivors (post-COVID-19) and 144 non-infected volunteers (COVID-19-free) was analyzed using pyrosequencing of defined CpG islands previously identified as suitable for biological age determination. The results show a consistent biological age increase in the post-COVID-19 population, determining a DeltaAge acceleration of 10.45 ± 7.29 years (+5.25 years above the range of normality) compared with 3...
BioMed Research International
Aims. Cardiovascular magnetic resonance (CMR) permits a comprehensive evaluation of stable corona... more Aims. Cardiovascular magnetic resonance (CMR) permits a comprehensive evaluation of stable coronary artery disease (CAD). We sought to assess whether, in a large contemporaneous population receiving optimal medical therapy, CMR independently predicts prognosis beyond conventional cardiovascular risk factors (RF). Methods. We performed a single centre, observational prospective study that enrolled 465 CAD patients (80% males; 63±11 years), optimally treated with ACE-inhibitors/ARB, aspirin, and statins (76-85%). Assessments included conventional evaluation (clinical history, atherosclerosis RF, electrocardiography, and echocardiography) and a comprehensive CMR with LV dimensions/function, late gadolinium enhancement (LGE), and stress perfusion CMR (SPCMR). Results. During a median follow-up of 62 months (IQR 23-74) there were 50 deaths and 92 major adverse cardiovascular events (MACE). CMR variables improved multivariate model prediction power of mortality and MACE over traditional R...
Journal of the American College of Cardiology, 2016
Journal of cardiovascular medicine (Hagerstown, Md.), 2007
Cardiac magnetic resonance (CMR) allows quick and non-invasive evaluation both of right ventricle... more Cardiac magnetic resonance (CMR) allows quick and non-invasive evaluation both of right ventricle (RV) volume and function, which are important in many heart diseases. We have evaluated CMR intra- and interobserver reproducibility in different conditions of RV dimension and function. We have analysed CMR exams of 45 subjects, randomly selected from our database according to RV end-diastolic volume (EDV; 15-subject groups with EDV < 25th, 25-75th and > 75th percentiles of a normal control population). Selected subjects were of both sexes (male/female 33/12) and of variable age (8-83 years) and body surface (0.9-2.3 m). RV end-diastolic and end-systolic volumes (ESV), ejection fraction (EF) and mass were blindly evaluated by two operators. Bland-Altman bias and coefficient of variability (CoV) were used to assess intra- and interobserver reproducibility. A wide range of EDV (range = 46-239 ml), ESV (20-129 ml) and EF (6-64%) was observed. The intra-observer bias was -5 ml for ED...
Italian heart journal : official journal of the Italian Federation of Cardiology, 2005
In the assessment of myocardial infarction (MI) mass, contrast-enhanced magnetic resonance imagin... more In the assessment of myocardial infarction (MI) mass, contrast-enhanced magnetic resonance imaging (CE-MRI) is comparable to single-photon emission computed tomography (SPECT). The aim of the present study was to determine whether the MI area, as assessed at CE-MRI and SPECT, is comparable to mass evaluation. We also compared CE-MRI and SPECT estimates of the MI area with functional evaluations made at echocardiography and kinetic MRI (cine-MRI). We used a 1.0 Tesla MRI scanner and an inversion-recovery turboFLASH sequence, a tomographic gamma-camera and second-harmonic ultrasound systems. Two blinded operators assessed the extent of scarring, expressed as a percentage of the whole left ventricle (LV), using a 16-segment model. We studied 55 consecutive patients with a clinically stable healed MI (50 Q wave, 5 non-Q wave). The scar mass was 19+/-23% of the LV at CE-MRI and 21+/-25% at SPECT; the scar area was 29+/-23% of the LV at CE-MRI, 41+/-28% at SPECT, 29+/-31% at cine-MRI, and...
Italian heart journal : official journal of the Italian Federation of Cardiology, 2000
In this part the most updated indications for evidence-based counseling of cardiac patients durin... more In this part the most updated indications for evidence-based counseling of cardiac patients during pregnancy, labor and the postpartum period are reviewed. Moreover, indications and contraindications for the use of some cardiac drugs during pregnancy and lactation are provided.
Journal of human hypertension, 1996
Low density lipoproteins (LDL) from hypertensive patients are more prone to in vitro oxidation an... more Low density lipoproteins (LDL) from hypertensive patients are more prone to in vitro oxidation and undergo a more pronounced oxidation in vivo. Due to the pro-atherogenic activity of oxidatively modified LDL, the correlation between the carotid intima-media thickening (IMT) and the markers of in vivo LDL oxidation was investigated in hypertensive patients. A cross-sectional study on 101 normocholesterolemic patients with newly diagnosed and untreated essential hypertension was performed. The occurrence of in vivo LDL oxidation was evaluated by measuring the titers of autoantibodies against Cu(2+)-oxidised LDL (oxLDL) and malondialdehyde-derivatised LDL (MDA-LDL). The extent and degree of atherosclerosis and the IMT were measured by means of carotid and femoral ultrasonography with a duplex scanner equipped with a high resolution probe. We did not find significant correlations between in vivo LDL oxidation parameters and the extent of atherosclerotic lesion in the entire group of hyp...
Journal of human hypertension, 1994
Metabolic disturbances such as hyperinsulinaemia, dislipoproteinaemia and glucose intolerance are... more Metabolic disturbances such as hyperinsulinaemia, dislipoproteinaemia and glucose intolerance are often associated with essential hypertension and markedly affect cardiovascular morbidity in hypertensive patients. In order to shed some light on the prognostic significance of white coat hypertension (raised clinic and normal ambulatory blood pressure), we compared the metabolic profile in a group of white coat and sustained previously untreated hypertensives. We studied 84 newly detected hypertensive patients (49 men, 35 women, 47 +/- 8 years, range 28-59 years). Subjects with obesity (BMI > 30), NIDDM and target organ damage were excluded. Ambulatory blood pressure monitoring was performed by SpaceLabs 90207-31. Total cholesterol and triglycerides, LDL-cholesterol, HDL-cholesterol (HDL-C) and subclasses HDL2 and HDL3 cholesterol as well as apolipoprotein A1 and B were measured in fasting plasma. Glucose and insulin were determined in fasting and postload (glucose 75 g plasma. Twe...
The Breast, 2011
Treatment of breast cancer (BC) has changed over the last decade with the advent of targeted ther... more Treatment of breast cancer (BC) has changed over the last decade with the advent of targeted therapies. Whereas traditional chemotherapy was directed toward all rapidly dividing cells (cancerous or not), several new anti-cancer drugs are mainly tailored to specific genetic pathways of cancer cells. Ideally, the goal of these new therapies is to improve the management of cancer with a specific targeting of the malignant cell and fewer side effects than traditional chemotherapy. Due to the initial success of this approach, an increasing number of targeted drugs entered into clinical development. However, unanticipated side effects of the new drugs, such as cardiotoxicity and heart failure, emerged from several clinical trials. The mechanisms of cardiotoxicity due to traditional chemotherapy and the one due to new drugs seem to be inherently different. In the case of BC, available targeted therapies are probably associated with the abrogation of normal molecular pathways involved in cardiomyocytes and endothelial cells survival/proliferation. The cardiac safety profile of these new drugs asks for a careful patient monitoring and follow up. Herein we will review the cardiotoxicity of BC patients receiving antiERBB2 treatment (Trastuzumab, Lapatinib), VEGF inhibitors (Bevacizumab) and tirosin-kinase inhibitors (Sorafenib, Sunitinib). We will discuss the molecular mechanisms that underlie the risk of cardiotoxicity, and we will examine the molecular tools useful for prediction of heart failure and for identification of subgroups of BC patients more susceptible to cardiac side effects induced by targeted therapies. Attention will be paid in particular to ERBB2 gene and its polymorphisms, as well as to the possible genetic risk stratification of BC patients. Finally, we will discuss the possible clinical strategies to prevent and minimizing the cardiotoxicity of targeted therapies in BC patients, focusing in particular on new drugs combination and on the emerging role of a tight partnership between cardiologists and oncologists.
Journal of the American College of Cardiology, 1996
This study in patients with coronary artery disease (CAD) sought to 1) determine the dental pain ... more This study in patients with coronary artery disease (CAD) sought to 1) determine the dental pain threshold and reaction to tooth pulp stimulation; 2) correlate the clinical, ergometric and angiographic features of patients with and without pain during percutaneous transluminal coronary angioplasty (PTCA) to pulpal test response; 3) verify whether reactivity to dental pulp stimulation could help to identify patients particularly prone to perceiving angina during myocardial ischemia. Silent myocardial ischemia is frequently observed in patients with CAD. Higher pain thresholds have been documented in asymptomatic subjects, suggesting a generalized hyposensitivity to pain. Eighty-six consecutive male patients with reproducible exercise-induced myocardial ischemia and CAD documented by angiography underwent PTCA. A pulpal test was performed in all patients by means of an electrical tooth pulp stimulator. Seventy-one patients (82.6%) with and 15 (17.4%) without angina during daily life were studied. During the pulpal test, 57 patient (66.2%) reported dental pain, whereas 29 (33.7%) were asymptomatic, even at maximal stimulation of 500 mA. The study cohort was classified into two groups according to the presence (58 patients [group 1]) or absence (28 patients [group 2]) of angina during myocardial ischemia induced by PTCA. Ergometric variables, extent of CAD, presence of ST segment elevation during PTCA, number of inflations, inflation time and maximal inflation pressure were similar in the two patient groups. Dental pain was provoked by pulpal test in 81% of patients with and 36% of patients without symptoms during PTCA (p = 0.0004). The absence of dental pain even at maximal tooth pulp stimulation (500 mA) was observed in 11 (18.9%) patients in group 1 and 18 (64.2%) in group 2. Patients who were asymptomatic during PTCA had a higher mean dental pain threshold, lower mean threshold reaction and lower mean maximal reaction than those who were symptomatic during both PTCA and the pulpal test. A correlation between the prevalence of symptoms during pulpal test, daily life, exercise-induced myocardial ischemia and PTCA was found. A higher dental pain threshold and lower reactivity characterized those subjects who were prone to silent ischemia both during daily life and during PTCA. Ergometric variables, extent of CAD and techniques used during PTCA were unrelated to the tendency to perceive pain during myocardial ischemia. Response to the pulpal test and the presence of symptoms during daily life were highly related to the presence of angina during PTCA.
European Journal of Pain, 1997
Asymptomatic myocardial ischaemia is frequently observed in patients with coronary artery disease... more Asymptomatic myocardial ischaemia is frequently observed in patients with coronary artery disease (CAD), both during daily life and during stressor tests. Psychological mechanisms seem to be involved in the lack of pain during myocardial ischaemia. The aim of this study was to verify in a selected population of CAD patients whether mental status might influence the pain perception during different stressor tests. The study population contained 73 male patients (mean age 52+/-8 years) with stable angina during daily life, reproducible exercise-induced myocardial ischaemia during ergometric stress test (EST) and angiographically documented CAD. All patients underwent cold pressor test (CPT), mental arithmetic stress test (MST), hyperventilation test (HT) and mental stress in association with cold pressor test (combined test, MST + CPT). During the stressor tests, myocardial ischaemia was induced in 15/73 (21%) patients by CPT, in 18/73 (25%) by MST, in 15/73 (21%) by HT and in 19/73 (26%) by MST + CPT. Out of the patients with stressor test-induced myocardial ischaemia, silent ischaemia was observed in 43/73 (59%) during EST, in 10/15 (67%) during CPT, in 16/18 (89%) during MST, in 7/15 (47%) during HT and in all patients during MST+CPT (100%). Among the ischaemic symptomatic patients during stressor tests, the lowest anginal pain intensity was experienced during MST (4.0+/-2.2) and the highest during EST, both at peak exercise and at the ischaemia threshold (6.6+/-2.9 and 5.9+/-2.7, respectively, p&lt;0.05). During MST, the prevalence of silent ischaemia was higher than was observed during the other tests. All study patients remained asymptomatic when myocardial ischaemia was induced by MST + CPT. Even the intensity of CPT induced hand pain was significantly higher during CPT alone than during MST+CPT. These results confirm that mental status may influence pain modulation.
Cardiovascular Ultrasound, 2009
Background: Recent studies have shown that real-time three-dimensional (3D) echocardiography (RT3... more Background: Recent studies have shown that real-time three-dimensional (3D) echocardiography (RT3DE) gives more accurate and reproducible left ventricular (LV) volume and ejection fraction (EF) measurements than traditional two-dimensional methods. A new semi-automated tool (4DLVQ) for volume measurements in RT3DE has been developed. We sought to evaluate the accuracy and repeatability of this method compared to a 3D echo standard. Methods: LV end-diastolic volumes (EDV), end-systolic volumes (ESV), and EF measured using 4DLVQ were compared with a commercially available semi-automated analysis tool (TomTec 4D LV-Analysis ver. 2.2) in 35 patients. Repeated measurements were performed to investigate interand intra-observer variability. Results: Average analysis time of the new tool was 141s, significantly shorter than 261s using TomTec (p < 0.001). Bland Altman analysis revealed high agreement of measured EDV, ESV, and EF compared to TomTec (p = NS), with bias and 95% limits of agreement of 2.1 ± 21 ml,-0.88 ± 17 ml, and 1.6 ± 11% for EDV, ESV, and EF respectively. Intra-observer variability of 4DLVQ vs. TomTec was 7.5 ± 6.2 ml vs. 7.7 ± 7.3 ml for EDV, 5.5 ± 5.6 ml vs. 5.0 ± 5.9 ml for ESV, and 3.0 ± 2.7% vs. 2.1 ± 2.0% for EF (p = NS). The inter-observer variability of 4DLVQ vs. TomTec was 9.0 ± 5.9 ml vs. 17 ± 6.3 ml for EDV (p < 0.05), 5.0 ± 3.6 ml vs. 12 ± 7.7 ml for ESV (p < 0.05), and 2.7 ± 2.8% vs. 3.0 ± 2.1% for EF (p = NS). Conclusion: In conclusion, the new analysis tool gives rapid and reproducible measurements of LV volumes and EF, with good agreement compared to another RT3DE volume quantification tool.
Journal of the American College of Cardiology, Jan 13, 2016
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a leading cause of sudden cardiac death... more Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a leading cause of sudden cardiac death, but its progression over time and predictors of arrhythmias are still being defined. This study sought to describe the clinical course of ARVC and occurrence of life-threatening arrhythmic events (LAE) and cardiovascular mortality; identify risk factors associated with increased LAE risk; and define the response to therapy. We determined the clinical course of 301 consecutive patients with ARVC using the Kaplan-Meier method adjusted to avoid the bias of delayed entry. Predictors of LAE over 5.8 years of follow-up were determined with Cox multivariable analysis. Treatment efficacy was assessed comparing LAE rates during matched time intervals. A first LAE occurred in 1.5 per 100 person-years between birth and age 20 years, in 4.0 per 100 person-years between ages 21 and 40 years, and in 2.4 per 100 person-years between ages 41 and 60 years. Cumulative probability of a first LAE at follo...
This study aims to assess whether an alternative method, that is based on volumetric surface dete... more This study aims to assess whether an alternative method, that is based on volumetric surface detection (VoSD) without tracing and is totally free of geometric assumptions, can improve the reproducibility of right ventricular (RV) volume quantification from cardiac magnetic resonance (CMR) images, in comparison with a conventional disk-area technique. In a sample of 23 patients, with wide variability of RV end-diastolic volume (EDV: 47-131 ml), endsystolic volume (ESV: 20 -76 ml), and ejection fraction (EF: 29 -73%), using the standard method (Argus, Siemens) as the reference, the VoSD method showed good agreement for EDV, ESV, and EF estimations (correlation coefficient: 0.91, 0.94, and 0.94; Bland-Altman biases: 1 ml, 1 ml, and 0%; limits of agreement: ؎16 ml, ؎11 ml, and ؎11%, respectively). An analysis of the reproducibility of the two methods showed lower intraobserver variability for the VoSD method than for the conventional method, as evidenced by the coefficient of variability (CoV) values (2-6% vs. 8 -15%; P < 0.05). In addition, the VoSD method showed improved interobserver reproducibility (7-10% vs. 8 -15%), but the difference was statistically significant only for EF estimation variability (8 vs. 15%, P < 0.05). In conclusion, the newly developed VoSD technique allows accurate measurements of RV volumes and function, and appears to be more reproducible than the conventional methodology. Magn Reson Med 57:600 -605, 2007.
Computers in Cardiology, 2005, 2005
Right ventricular (RV) volume quantification from cardiac magnetic resonance imaging is based on ... more Right ventricular (RV) volume quantification from cardiac magnetic resonance imaging is based on manual tracing of endocardial boundaries and application of geometric modeling. This procedure is subjective, timeconsuming and may bias volume measurements since the right ventricle is a complex structure that is not well suited to a geometric model. We developed a technique for RV endocardial surface detection and direct volumes and ejection fraction (EF) quantification. Our technique was validated against conventional manual tracing and intra-and inter-observer variability were computed to test its reproducibility. Volumes and EF measurements showed high correlations with no significant biases and narrow limits of agreement compared to values derived from manual tracing. Intra-and inter-observer variability were smaller for the proposed method with respect to the reference technique. Our method resulted in fast, reliable and more reproducible measurements of RV volumes and EF when compared to conventional manual tracing.
Journal of Cardiovascular Medicine, 2007
Objectives Cardiac magnetic resonance (CMR) allows quick and non-invasive evaluation both of righ... more Objectives Cardiac magnetic resonance (CMR) allows quick and non-invasive evaluation both of right ventricle (RV) volume and function, which are important in many heart diseases. We have evaluated CMR intra-and interobserver reproducibility in different conditions of RV dimension and function.
Magnetic Resonance in Medicine, 2007
This study aims to assess whether an alternative method, that is based on volumetric surface dete... more This study aims to assess whether an alternative method, that is based on volumetric surface detection (VoSD) without tracing and is totally free of geometric assumptions, can improve the reproducibility of right ventricular (RV) volume quantification from cardiac magnetic resonance (CMR) images, in comparison with a conventional disk-area technique. In a sample of 23 patients, with wide variability of RV end-diastolic volume (EDV: 47-131 ml), endsystolic volume (ESV: 20 -76 ml), and ejection fraction (EF: 29 -73%), using the standard method (Argus, Siemens) as the reference, the VoSD method showed good agreement for EDV, ESV, and EF estimations (correlation coefficient: 0.91, 0.94, and 0.94; Bland-Altman biases: 1 ml, 1 ml, and 0%; limits of agreement: ؎16 ml, ؎11 ml, and ؎11%, respectively). An analysis of the reproducibility of the two methods showed lower intraobserver variability for the VoSD method than for the conventional method, as evidenced by the coefficient of variability (CoV) values (2-6% vs. 8 -15%; P < 0.05). In addition, the VoSD method showed improved interobserver reproducibility (7-10% vs. 8 -15%), but the difference was statistically significant only for EF estimation variability (8 vs. 15%, P < 0.05). In conclusion, the newly developed VoSD technique allows accurate measurements of RV volumes and function, and appears to be more reproducible than the conventional methodology. Magn Reson Med 57:600 -605, 2007.
Journal of Cardiovascular Magnetic Resonance, 2011
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Papers by Oronzo Catalano