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Journal of Geriatric Cardiology 2021年第6期18卷 498-504页

作者： Tullio Tesorio Luigi Salemme Sebastiano Verdoliva Marco Ferrone Paola Tesorio Eustaquio Maria Onorato Unitàdi cardiologia Interventistica Emodinamica Casa di Cura MontevergineVia Mario MalzoniMercoglianoItaly Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico(IRCCS)University School of MilanMilanItaly

Secundum atrial septal defect(ASD)repres-ents one of the most common congenital heart diseases,accounting for up to 10%of all congenital heart *** is often diagnosed in adulthood due to the absence of clinical symptoms.[1]By the age of 40 years,90%of untreated patients have symptoms of exertional dyspnea,fatigue,pal-pitation,sustained arrhythmia,or even evidence of heart failure.

关键词： septal sustained atrial

冠状动脉成形术和搭桥术治疗无保护左冠状动脉主干狭窄的比较研究:Bologna注册研究

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世界核心医学期刊文摘（心脏病学分册） 2006年第11期2卷 39-40页

作者： Palmerini T. Marzocchi A. Marrozzini C. 黄浙勇 istituto di cardiologia Policlinico S. Orsola University of Bologna Bologna Italy Dr.

Although great interest exists in the relative efficacy of coronary artery bypass grafting(CABG) versus percutaneous coronary intervention(PCI) for the treatment of unprotected left main coronary artery stenosis, data comparing the 2 strategies are scant. Furthermore, no comparison has ever been performed between CABG and drug-eluting stents in this setting. From January 2002 to June 2005, 154 patients with unprotected left main coronary artery stenosis underwent CABG and 157 underwent PCI. Ninety-four patients received a drug-eluting stent in the left main artery. After a median follow-up of 430 days, the rate of mortality, acute myocardial infarction, and target lesion revascularization was 12.3%, 4.5%, and 2.6%, respectively, in the CABG group and 13.4%, 8.3%, and 25.5%, respectively, in the PCI group(death and myocardial infarction p=NS, target lesion revascularization p=0.0001). Although patients treated with drug-eluting stents had a 25%relative risk reduction in the rate of death, myocardial infarction, and target lesion revascularization compared with patients treated with bare stents, event-free survival was still better for patients treated with CABG. In the multivariate analysis, age ≥70 years, New York Heart Association classes III and IV, acute coronary syndromes, and peripheral vascular disease were the only independent predictors of mortality. In conclusion, our results have indicated that at long-term follow-up no difference exists in the rate of mortality and myocardial infarction between PCI and CABG for the treatment of unprotected left main coronary artery stenosis. However, the rate of target lesion revascularization was higher in the PCI group.

关键词：搭桥术冠状动脉主干冠状动脉成形术 Bologna 靶病变血运重建药物洗脱支架裸金属支架外周

Possible association between hepatitis C virus and malignancies different from hepatocellular carcinoma:A systematic review

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World Journal of Gastroenterology 2015年第45期21卷 12896-12953页

作者： Sirio Fiorino Letizia Bacchi-Reggiani Dario de Biase Adele Fornelli Michele Masetti Andrea Tura Fabio Grizzi Matteo Zanello Laura Mastrangelo Raffaele Lombardi Giorgia Acquaviva Luca di Tommaso Arrigo Bondi Michela Visani Sergio Sabbatani Laura Pontoriero Carlo Fabbri Andrea Cuppini Annalisa Pession Elio Jovine Unità Operativa di Medicina Interna Ospedale di Budrio dipartimento di Medicina Sperimentale Istituto di Cardiologia Policlinico S. Orsola-Malpighi Università degli Studi di Bologna dipartimento di Medicina Sperimentale Università di Bologna Unità Operativa Biologia Molecolare Anatomia Patologica Ospedale Bellaria Servizio di Anatomia Patologica Ospedale Maggiore Unità Operativa di Chirurgia A Ospedale Maggiore Institute of Neuroscience National Research Council Humanitas Clinical and Research Center Rozzano dipartimento di Farmacia e Biotecnologie Università di Bologna istituto di Malattie Infettive Policlinico S. Orsola-Malpighi Università degli Studi di Bologna Unità di Cura Materno-Infantile Distretto Lametino U.O. Endoscopia Ospedale Maggiore

AIM: To summarize the current knowledge about the potential relationship between hepatitis C virus(HCV) infection and the risk of several extra-liver cancers. METHODS: We performed a systematic review of the literature, according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis(PRISMA) Statement. We extracted the pertinent articles, published in MEDLINE and the Cochrane Library, using the following search terms: neoplasm/cancer/malignancy/tumor/carcinoma/adeno-carcinoma and non-Hodgkin lymphomas, kidney/renal-, cholangio-, pancreatic-, thyroid-, breast-,oral-, skin-, prostate-, lung-, colon-, stomach-, haematologic. Case series, case-series with control-group, case-control, cohort-studies as well as meta-analyses, written in English were collected. Some of the main characteristics of retrieved trials, which were designed to investigate the prevalence of HCV infection in each type of the above-mentioned human malignancies were summarised. A main table was defined and included a short description in the text for each of these tumours, whether at least five studies about a specific neoplasm, meeting inclusion criteria, were available in literature. According to these criteria, we created the following sections and the corresponding tables and we indicated the number of included or excluded articles, as well as of meta-analyses and reviews:(1) HCV and haematopoietic malignancies;(2) HCV and cholangiocarcinoma;(3) HCV and pancreatic cancer;(4) HCV and breast cancer;(5) HCV and kidney cancer;(6) HCV and skin or oral cancer; and(7) HCV and thyroid cancer. RESULTS: According to available data, a clear correlation between regions of HCV prevalence and risk of extra-liver cancers has emerged only for a very small group of types and histological subtypes of malignancies. In particular, HCV infection has been associated with:(1) a higher incidence of some B-cell Non-HodgkinLymphoma types, in countries, where an elevated prevalence of this pathogen is de

关键词： Neoplasm Cancer Hepatitis C virus Risk factors Ext

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心脏X综合征患者的异常皮质疼痛过程

世界核心医学期刊文摘（心脏病学分册） 2005年第10期1卷 43-44页

作者： Valeriani M. Sestito A. Le Pera D. G. A. Lanza 滕增辉 istituto di cardiologia Universit Cattolica del Sacro Cuore Largo A. Gemelli 8 00168 Roma Italy

Previous studies suggested that an enhanced pain sensitivity is present in patients with cardiac syndrome X(SX). We investigated whether SX patients present abnormalities in the electrical cerebral signals generated by pain stimuli. Methods and results: Cortical laser evoked potentials(LEPs) were recorded in 16 SX patients, in 10 patients with refractory angina due to obstructive coronary artery disease(CAD) and in 13 healthy controls. LEPs were recorded during stimulation of chest and right hand dorsum. Three sequences of painful stimuli were applied at each site. Subjective pain rating was assessed by a 0- 100 mm visual analogic scale(VAS). Basal LEPs did not differ among groups and there were no differences for most LEP components across the repetitions of stimuli. However, the amplitude of the N2/P2 LEP component, specifically reflecting cortical pain processing, decreased across the three sequences of stimuli in controls and CAD patients, but not in SX patients. Compared with the first sequence, the N2/P2 amplitude during the third sequence of stimuli in the three groups was 77± 16, 56± 24, and 99± 34% , respectively, for chest(P=0.001), and 63± 31, 72± 17, and 98± 46% , respectively, for right hand(P=0.03) stimulation. The changes in VAS pain score across the three sequences paralleled those of N2/P2 amplitude. Conclusion: Our data show that in SX patients, central handling of painful stimuli is characterized by inadequate habituation, which might play a role in determining the peculiar clinical characteristics of anginal chest pain of these patients.

关键词：右手背脑电信号视觉模拟诱发电位特异性

不稳定型心绞痛患者中室性心律失常和心率变异性的预后价值

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世界核心医学期刊文摘（心脏病学分册） 2006年第12期2卷 41-42页

作者： Lanza G.A. Cianflone D. Rebuzzi A.G. 徐永城 istituto di cardiologia Università Cattolica del Sacro Cuore Largo A Gemelli 8 00168 Rome Italy Dr.

Objectives: To assess the prognostic value of ventricular arrhythmias(VA) and heart rate variability(HRV) in patients with unstable angina. Design: Multicentre prospective study. Setting: 17 cardiological centres in Italy. Patients: 543 consecutive patients with unstable angina and preserved left ventricular function(ejection fraction ≥40%) enrolled in the SPAI(Stratificazione Prognostica dell’Angina Instabile) study. Methods: Patients underwent 24 h ECG Holter monitoring within 24 h of hospital admission. Tested variables were frequent ventricular extrasystoles(≥10/h), complex(that is, frequent or repetitive) VA, and bottom quartile values of time-domain and frequency-domainHRV variables. Primary end points were inhospital and six-month total and cardiac deaths. Results: Eight patients died in hospital(1.5%) and 32(5.9%,29 cardiac) during follow up. Both complex VA and frequent extrasystoles were strongly predictive of death in hospital and at follow up, even after adjustment for clinical(age, sex, cardiac risk factors and history of myocardial infarction) and laboratory(troponin I, C reactive protein and transient myocardial ischaemia on Holter monitoring) variables. At univariate analysis bottom quartile values of three HRV variables(standard deviation of RR intervals index, low-frequency amplitude and low to high frequency ratio) were associated with in-hospital death, and bottom quartile values of most HRV variables predicted six-month fatal events. At multivariate Cox survival analysis reduced low-frequency amplitude was consistently found to be independently associated with fatal end points. Conclusion: In patients with unstable angina with preserved myocardial function, both VA and HRV are independent predictors of in-hospital and mediumterm mortality, suggesting that these factors should be taken into account in the risk stratification of these patients.

关键词：不稳定型心绞痛室性心律失常预后价值心率变异性患者

关于维拉帕米对植入频率应答式双腔起搏器的慢-快综合征患者房性快速性心律失常影响的对照研究

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世界核心医学期刊文摘(心脏病学分册) 2006年第2期 60-61页

作者： Boriani G. Bertaglia E. Carboni A. 张宪伟 istituto di cardiologia Universitàdegli Studi di Bologna Azienda Ospedaliera S. Orsola-Malpighi Bologna Via Massarenti 9 40138 Bologna Italy

While verapamil has been proposed as a treatment for reducing electrophysiological remodeling due to atrial fibrillation and atrial tachyarrhythmias, no previous study has tested its effects in brady-tachy patients implanted with a dual-chamber pacemaker. Fourteen patients with frequent episodes of atrial fibrillation(≥ 2 episodes/month) in the setting of brady-tachy syndrome, implanted with a DDDR pacing system with extensive monitor function(Selection 900, Vitatron) were enrolled. Four months after implantation, they were randomly allocated to a 2-month period of treatment with verapamil(240 mg/day) or to no treatment, followed by a crossover. The burden of atrial tachyarrhythmias, the total number of hours spent in atrial tachyarrhythmia and the mean number of hours per day spent in atrial tachyarrhythmia were retrieved from diagnostic devices. The accuracy of atrial tachyarrhythmias detection was confirmed independently by two observers. The main results showed that treatment with verapamil was associated with a trend towards an higher percentage of atrial pacing in comparison with control(mean value± S.D.=63.2± 29.9% vs. 57.3± 30.6% ,median value 53% vs. 49% , P value at Wilcoxon signed rank test=0.069), but without any significant reduction in atrial tachyarrhythmia burden(4.5± 11.8 vs. 3.3± 9.1% )or total hours spent in atrial tachyarrhythmia(65± 161 vs. 48± 131 h). Palpitation episodes were not significantly reduced by verapamil treatment in comparison with control(10.3± 7.8 vs. 6.1± 6.5). In conclusion, verapamil does not exert any beneficial effect on documented episodes of atrial tachyarrhythmia in patients with brady-tachy syndrome implanted with a DDDR device. Moreover, this drug was ineffective in reducing the number of palpitation episodes reported by the patient.

关键词：慢-快综合征维拉帕米异博定抗心律失常药房性快速性心律失常双腔起搏器心脏起搏器应答式患者

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心脏再同步化治疗中的心电重构

世界核心医学期刊文摘（心脏病学分册） 2006年第8期2卷 40-41页

作者： Boriani G. Biffi M. Martignani C. 韩瑞娟(译) 任付先(校) istituto di cardiologia Universit& di Bologna Azienda Ospedaliera Policlinico S. Orsola-Malpighi via Massarenti 9 40138 Bologna Italy 不详

Background: More information is required on the relationship between electrical and structural reverse remodeling in patients treated with cardiac resynchronization theraphy. Methods: QRS and JT intervals were investigated during different pacing modes before and 3 months after implantation of a device for biventricular(BiV) pacing in 20 patients with severe drug refractory heart failure(with left ventricular ejection fraction120 ms); structural remodeling was evaluated by echocardiography. Results: QRS interval was significantly shortened by BiV pacing both acutely(p=0.002) and at 3 months(p=0.007). No significant change was found in the JT interval. The extent of QRS shortening obtained by BiV pacing showed moderate correlations with the reduction of end-systolic and end-diastolic volumes(r=0.53, p=0.016 and r=0.45, p=0.045, respectively) as well as with increase of left ventricular ejection fraction(r=0.49, p=0.028) at 3 months. The widening of QRS observed during right ventricular(RV)pacing was greater after 3 months of BiV pacing(with respect to acute assessments), suggesting accentuation of pacing-induced electrical dyssynchrony after a period of pacing-induced resynchronization. Conclusion: The extent of QRS shortening induced by BiV pacing appears to correlate with the reverse structural remodeling(in terms of reduction in end-systolic volume). The acute changes and the remodeling process occurring at mid-term in the overall population of CRT-treated patients do not appear to involve the JT interval. A period of pacing-induced resynchronization appears to accentuate the potential for RV pacing-driven electrical dyssynchrony.

关键词：心脏再同步化治疗 QRS波群增宽电重构起搏模式左心室射血分数 JT间期心力衰竭患者结构重构左室射血分数收缩末期

MicroRNAs as possible biomarkers for diagnosis and prognosis of hepatitis b- and c-related-hepatocellularcarcinoma

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World Journal of Gastroenterology 2016年第15期22卷 3907-3936页

作者： Sirio Fiorino Maria Letizia Bacchi-Reggiani Michela Visani Giorgia Acquaviva Adele Fornelli Michele Masetti Andrea Tura Fabio Grizzi Matteo Zanello Laura Mastrangelo Raffaele Lombardi Luca di Tommaso Arrigo Bondi Sergio Sabbatani Andrea Domanico Carlo Fabbri Paolo Leandri Annalisa Pession Elio Jovine Dario de Biase Unita Operativa di Medicina C Ospedale Maggiore 40133 Bologna Italy dipartimento di Medicina Sperimentale Istituto di Cardiologia Policlinico S. Orsola-Malpighi Universita degli Studi di Bologna 40138 BolognaItaly dipartimento di Farmacia e Biotecnologie Universita di Bologna 40139 Bologna Italy dipartimento di Medicina Sperimentale Universita di Bologna Ospedale Bellaria 40139 Bologna Italy Servizio di Anatomia Patologica Ospedale Maggiore 40133 Bologna Italy Unita Operativa di Chirurgia A Ospedale Maggiore 40133 Bologna Italy CNR Institute of Neuroscience Padova Italy 35121 Padova Italy Humanitas Clinical and Research Center 20089 Rozzano Milano Italy istituto di Malattie Infettive Policlinico S. Orsola-Malpighi Universita degli Studi di Bologna 40138 Bologna Italy Unita Operativa di Medicina Interna A Ospedale Maggiore 40133 Bologna Italy Unita Operativa di Endoscopia digestiva Ospedale Maggiore 40133 Bologna Italy

Aim of the present review is to summarize the current knowledge about the potential relationship between mi RNAs and hepatitis B virus(HBV)-hepatitis C virus(HCV) related liver diseases. A systematic computerbased search of published articles, according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis Statement, was performed to identify relevant studies on usefulness of serum/plasma/urine mi RNAs, as noninvasive biomarkers for early detection of HBV and HCV-induced hepatocellular carcinoma(HCC) development, as well as for its prognostic evaluation. The used Medical Subject Headings terms and keywords were: "HBV", "HCV", "hepatocellular carcinoma", "micro RNAs", "mi RNAs", "diagnosis", "prognosis", "therapy", "treatment". Some serum/plasma mi RNAs, including mi R-21, mi R-122, mi-125a/b, mi R-199a/b, mi R-221, mi R-222, mi R-223, mi R-224 might serve as biomarkers for early diagnosis/prognosis of HCC, but, to date, not definitive results or well-defined panels of mi RNAs have been obtained. More well-designed studies, focusing on populations of different geographical areas and involving larger series of patients, should be carried out to improve our knowledge on the potential role of mi RNAs for HCC early detection and prognosis.

关键词： Hepatitis B virus Hepatitis C virus Hepatocellular carcinomas Liver diseases MicroRNAs Review

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螺内酯可改善慢性心力衰竭患者的肺弥散功能

世界核心医学期刊文摘（心脏病学分册） 2005年第8期1卷 43-43页

作者： Agostoni P. Magini A. Andreini D. 任付先 Centro Cardiologico Monzino Istituto di Cardiologia Università di Milano via Parea 4 20138 Milan Italy

Aims: To evaluate whether anti- aldosteronic treatment influences lung diffusion(DLco) in chronic heart failure(HF) patients. Spironolactone improves clinical conditions and prognosis in chronic HF and reduces connective tissue matrix turnover; DLco abnormalities in chronic HF are related to increase in fibrosis and connective tissue derangement. Methods and results: Thirty stable chronic HF patients, with reduced DLco(dicted), were randomly assigned to active treatment(25 mg spironolactone daily) or placebo in addition to conventional anti- failure treatment. They were evaluated by quality of life questionnaire, laboratory investigations, cardiopulmonary exercise test, and pulmonary function test, which included DLco and membrane diffusing capacity(DM). The evaluation was done before treatment and 6 months after. Quality of life score and standard pulmonary function tests were not significantly affected by spironolactone, while active treatment increased DLco due to an increase of DM(DLco: 18.3± 3.9 vs. 19.9± 5.5 mL/min/mmHg; DM: 28.1± 7.7 vs. 33.3± 8.6 mL/min/mmHg) and peak oxygen consumption(peak VO2 16.8± 1.9 vs. 18.6± 2.2mL/min/kg). Increments of DLco and peak VO2 were linearly related(R=0.849, Pdiffusion and exercise capacity suggesting a novel mechanism by which anti- aldosteronic drugs improve HF clinical condition and prognosis.

关键词：慢性心力衰竭螺内酯肺弥散功能抗心衰治疗临床状况肺功能试验弥散量运动试验肺功能检查生活质量量表

脊髓刺激对心脏X综合征患者自发性或应激诱发的心绞痛及“缺血样”ST段压低的影响

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世界核心医学期刊文摘（心脏病学分册） 2005年第10期1卷 44-44页

作者： Lanza G. A. Sestito A. Sgueglia G. A. 滕增辉 istituto di cardiologia Università Cattolica del Sacro Cuore L. go A. Gemelli 8 00168 Roma Italy

A significant number of patients with cardiac syndrome X(CSX) present frequent episodes of severe chest pain, refractory to maximal multi-drug therapy. A few, small, uncontrolled data suggested that spinal cord stimulation(SCS) may have favourable clinical benefits in these patients. Methods and results: We studied 10 CSX patients who were being treated by SCS for refractory angina pectoris for 17± 16 months(median 8). Patients were randomized to either continue or withdraw SCS for a period of 3 weeks and were then crossed over to the other condition for a further 3- week period. During each 3- week period patients kept a detailed diary of angina episodes occurring in the last 2 weeks of each phase. Furthermore, at the end of each 3- week period, angina status was also assessed by Seattle Angina Questionnaire(SAQ), a 0- 100 visual analogue scale(VAS), and patients underwent 24- h Holter monitoring(HM) and echocardiographic dobutamine stress test(DST). Compared with the withdrawal phase, SCS reduced the number(P=0.01), duration(P=0.022), and severity(P=0.011) of angina episodes, and nitrate consumption(P=0.042). SAQ scores(P≤ 0.013 for all) and VAS(P< 0.001) were also improved, the number of episodes of ST-segment depression on HM was decreased(P=0.014), and time to angina(P=0.045) and to 1 mm ST-segment depression(P=0.04) during DST were both prolonged by SCS. Conclusions: Our data point out that SCS may be an effective form of treatment in patients with CSX suffering from frequent angina episodes significantly impairing quality of life(QOL) and refractory to maximally tolerated drug therapy.

关键词： ST段压低缺血样负荷超声心动图药物治疗动态心电图监测胸痛多巴酚丁胺临床效应视觉模拟内交叉