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Multimodality imaging in COVID-19 patients:A key role from diagnosis to prognosis

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World Journal of Radiology 2020年第11期12卷 261-271页

作者： Antonello D'Andrea Juri Radmilovic Andreina Carbone Alberto Forni Ercole Tagliamonte lucia riegler Biagio Liccardo Fabio Crescibene Cesare Sirignano Giovanna Esposito Eduardo Bossone Department of Cardiology Chair of Cardiology–Luigi Vanvitelli University–Monaldi Hospital-Association of Operating Room Nurses Ospedali Dei Colli–NaplesNaples 80131Italy Department of Cardiology and Intensive Coronary Unit “Umberto I”HospitalNocera Inferiore 84014SalernoItaly Department of Cardiology University of Campania“Luigi Vanvitelli”Monaldi HospitalNaples 80131Italy M.Scarlato COVID Hospital Scafati HospitalScafati 84018Italy Institute of Biostructures and Bioimaging of National Research Council National research CouncilNaples 80145Italy Division of Cardiology Cardarelli HospitalNaples 80131Italy

The integrated clinical,laboratory and ultrasound approach is essential for the diagnosis,evaluation and monitoring of the patient's therapy in coronavirus disease 2019 *** ideal imaging approach in this context is not yet well *** X-ray is characterized by low sensitivity in identifying earlier lung ***"bedside"pulmonary ultrasound has an undeniable series of advantages in the patient at high infectious risk and can provide incremental data in the respiratory intensive care for the serial control of the individual patient as well as for the home delivery of the stabilized *** computed tomography shows high sensitivity but should not be routinely performed in all patients,because in the first 48 h it can be absolutely negative and in the late phase the imaging findings may not change the therapeutic *** should be limited to patients with hemodynamic instability to assess ventricular function and pulmonary pressures.

关键词： COVID-19 Interstitial pneumonia Pulmonary computed tomography Echocardiography Lung ultrasound Thromboembolism

Patient selection for transcatheter aortic valve replacement:A combined clinical and multimodality imaging approach

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World Journal of Cardiology 2017年第3期9卷 212-229页

作者： Rosangela Cocchia Antonello D’Andrea Marianna Conte Massimo Cavallaro lucia riegler Rodolfo Citro Cesare Sirignano Massimo Imbriaco Maurizio Cappelli Giovanni Gregorio Raffaele Calabrò Eduardo Bossone Department of Cardiology and Cardiac Surgery San Giovanni di Dio Hospital00733 SalernItaly Integrated Diagnostic Cardiology Second University of NaplesAORN“dei Colli”Monaldi Hospital80121 NaplesItaly Institute of Biostructure and Bioimaging National Research Council 80121 NaplesItaly Department of Advanced Biomedical Sciences University Federico II80121 NaplesItaly Department of Cardiology San Luca HospitalVallo della Lucania00733 SalernItaly

Transcatheter aortic valve replacement(TAVR) has been validated as a new therapy for patients affected by severe symptomatic aortic stenosis who are not eligible for surgical intervention because of major contraindication or high operative risk. Patient selection for TAVR should be based not only on accurate assessment of aortic stenosis morphology, but also on several clinical and functional data. Multi-Imaging modalities should be preferred for assessing the anatomy and the dimensions of the aortic valve and annulus before TAVR. Ultrasounds represent the first line tool in evaluation of this patients giving detailed anatomic description of aortic valve complex and allowing estimating with enough reliability the hemodynamic entity of valvular stenosis. Angiography should be used to assess coronary involvement and plan a revascularization strategy before the implant. Multislice computed tomography play a central role as it can give anatomical details in order to choice the best fitting prosthesis, evaluate the morphology of the access path and detect other relevant comorbidities. Cardiovascular magnetic resonance and positron emission tomography are emergent modality helpful in aortic stenosis evaluation. The aim of this review is to give an overview onTAVR clinical and technical aspects essential for adequate selection.

关键词： Aortic stenosis Doppler echocardiography Cardiac computed tomography Two-dimensional strain Three dimensional echocardiography Cardiac magnetic resonance Transcatheter aortic valve replacement

Adipose tissue and vascular inflammation in coronary artery disease

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World Journal of Cardiology 2014年第7期6卷 539-554页

作者： Enrica Golia Giuseppe Limongelli Francesco Natale Fabio Fimiani Valeria Maddaloni Pina Elvira Russo lucia riegler Renatomaria Bianchi Mario Crisci Gaetano Di Palma Paolo Golino Maria Giovanna Russo Raffaele Calabrò Paolo Calabrò Division of Cardiology Cardio-thoracic and Respiratory Sciences DepartmentSecond University of NaplesAO Dei Colli-Monaldi Hospital

Obesity has become an important public health issue in Western and developing countries,with well known metabolic and cardiovascular *** the last decades,evidence have been growing about the active role of adipose tissue as an endocrine organ in determining these pathological *** a consequence of the expansion of fat depots,in obese subjects,adipose tissue cells develope a phenotypic modification,which turns into a change of the secretory *** produced by both adipocytes and adipose stromal cells are involved in the modulation of glucose and lipid handling,vascular biology and,moreover,participate to the systemic inflammatory response,which characterizes obesity and metabolic *** might represent an important pathophysiological link with atherosclerotic complications and cardiovascular events.A great number of adipocytokines have been described recently,linking inflammatory mileu and vascular *** understanding of these pathways is crucial not only from a pathophysiological point of view,but also to a better cardiovascular disease risk stratification and to the identification of possible therapeutic *** aim of this paper is to review the role of Adipocytokines as a possible link between obesity and vascular disease.

关键词： Adipocytokines Obesity Metabolic syndrome Coronary artery disease Inflammation

Transcranial Doppler ultrasonography: From methodology to major clinical applications

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World Journal of Cardiology 2016年第7期8卷 383-400页

作者： Antonello D'Andrea Marianna Conte Massimo Cavallaro Raffaella Scarafile lucia riegler Rosangela Cocchia Enrica Pezzullo Andreina Carbone Francesco Natale Giuseppe Santoro Pio Caso Maria Giovanna Russo Eduardo Bossone Raffaele Calabrò Integrated Diagnostic Cardiology Second University of NaplesAORN "dei Colli"Monaldi Hospital Department of Cardiology and Cardiac Surgery University Hospital

Non-invasive Doppler ultrasonographic study of cerebral arteries [transcranial Doppler(TCD)] has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency(≤ 2 MHz) transducer on the scalp of the patient over specific acoustic windows, in order to visualize the intracranial arterial vessels and to evaluate the cerebral blood flow velocity and its alteration in many different conditions. Nowadays the most widespread indication for TCD in outpatient setting is the research of right to left shunting, responsable of so called "paradoxical embolism", most often due to patency of foramen ovale which is responsable of the majority of cryptogenic strokes occuring in patients younger than 55 years old. TCD also allows to classify the grade of severity of such shunts using the so called "microembolic signal grading score". In addition TCD has found many useful applications in neurocritical care practice. It is useful on both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoidal haemorrhage(caused by aneurysm rupture or traumatic injury), traumatic brain injury, brain stem death. It is used also to evaluate cerebral hemodynamic changes after stroke. It also allows to investigate cerebral pressure autoregulation and for the clinical evaluation of cerebral autoregulatory reserve.

关键词： Transcranial Doppler ultrasonography Lindegaard ratio Paradoxical embolism Microembolic signals Middle cerebral artery Patent foramen ovale Cryptogenic STroke Vasospasm Acute subarachnoid hemorrhage Ischemic stroke