Appropriate use criteria implementation with modified Haller index for predicting stress echocardiographic results and outcome in a population of patients with suspected coronary artery disease

Sonaglioni, Andrea; Rigamonti, Elisabetta; Nicolosi, Gian Luigi; Lombardo, Michele

doi:10.1007/s10554-021-02274-4

Cited by 11 publications

(7 citation statements)

References 54 publications

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“…An increased MHI, due to a narrow A-P chest diameter, was found to be the main anthropometric determinant of the significant reduction in myocardial deformation indices, particularly at the level of basal segments, detected in healthy individuals with a concave-shaped chest wall and/or pectus excavatum (PE) (as noninvasively defined by a MHI > 2.5) [144], in absence of any intrinsic myocardial dysfunction [145][146][147][148][149]. Moreover, individuals with MHI > 2.5 have been found to receive excellent prognoses over mid-to-long term follow-up [150][151][152]. The correlation between MHI and strain parameters is strictly correlated to the degree of the anterior chest wall deformity in subjects with MHI > 2.5, whereas this has not been observed in individuals with normal chest conformation (MHI ≤ 2.5) [145].…”

Section: Technical Limitation Of 2d-ste Analysismentioning

confidence: 99%

Molecular Approaches and Echocardiographic Deformation Imaging in Detecting Myocardial Fibrosis

Sonaglioni

Nicolosi²,

Rigamonti

et al. 2022

IJMS

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The pathological remodeling of myocardial tissue is the main cause of heart diseases. Several processes are involved in the onset of heart failure, and the comprehension of the mechanisms underlying the pathological phenotype deserves special attention to find novel procedures to identify the site of injury and develop novel strategies, as well as molecular druggable pathways, to counteract the high degree of morbidity associated with it. Myocardial fibrosis (MF) is recognized as a critical trigger for disruption of heart functionality due to the excessive accumulation of extracellular matrix proteins, in response to an injury. Its diagnosis remains focalized on invasive techniques, such as endomyocardial biopsy (EMB), or may be noninvasively detected by cardiac magnetic resonance imaging (CMRI). The detection of MF by non-canonical markers remains a challenge in clinical practice. During the last two decades, two-dimensional (2D) speckle tracking echocardiography (STE) has emerged as a new non-invasive imaging modality, able to detect myocardial tissue abnormalities without specifying the causes of the underlying histopathological changes. In this review, we highlighted the clinical utility of 2D-STE deformation imaging for tissue characterization, and its main technical limitations and criticisms. Moreover, we focalized on the importance of coupling 2D-STE examination with the molecular approaches in the clinical decision-making processes, in particular when the 2D-STE does not reflect myocardial dysfunction directly. We also attempted to examine the roles of epigenetic markers of MF and hypothesized microRNA-based mechanisms aiming to understand how they match with the clinical utility of echocardiographic deformation imaging for tissue characterization and MF assessment.

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Section: Technical Limitation Of 2d-ste Analysismentioning

confidence: 99%

Molecular Approaches and Echocardiographic Deformation Imaging in Detecting Myocardial Fibrosis

Sonaglioni

Nicolosi²,

Rigamonti

et al. 2022

IJMS

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“…We also demonstrated that great majority of individuals with a narrow A-P thoracic diameter (MHI > 2.5) have a significantly reduced probability of adverse cardiovascular events over a mid-term follow-up. 68,69 In light of these findings, a preliminary chest shape assessment by the MHI method might help the clinicians to identify, among the individuals with TSA, those with increased probability of MVP due to mitral valve 360 Journal of Cardiovascular Medicine 2024, Vol 25 No 5 distortion, nonspecific ST-T-wave abnormalities and benign ventricular arrhythmias on resting ECG, atypical chest pain and palpitations, increased probability of FP-ESE result and finally reduced magnitude of longitudinal and circumferential strain at the level of the basal myocardial segments (Fig. 4).…”

Section: Discussionmentioning

confidence: 99%

The relationship between mitral valve prolapse and thoracic skeletal abnormalities in clinical practice: a systematic review

Sonaglioni,

Nicolosi,

Lombardo

2024

Journal of Cardiovascular Medicine

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Background Literature data suggest high inter-study variability in mitral valve prolapse (MVP) prevalence among individuals with thoracic skeletal abnormalities (TSA). This systematic review aimed at estimating the overall prevalence of MVP in individuals with the most common TSA, including not only the oldest studies (before the year 2000) but also the most recent ones (after the year 2000). Methods PubMed and EMBASE databases were systematically reviewed in November 2023. Studies assessing the relationship between MVP and TSA and estimating the MVP prevalence in pectus excavatum (PE), pectus carinatum (PC), scoliosis, straight back syndrome (SBS) and Marfan syndrome (MS) were included. There was no limitation on time periods. Results Twenty-five studies with a total of 2800 patients (27.9 ± 13.9 years, 48.2% females) were analyzed. The highest prevalence of MVP was observed among MS patients (47.3%), while the lowest was detected in PC individuals (23%). Prevalence of MVP was similar among PE (30.8%), scoliosis (26.3%) and SBS (25.5%) patients. When dividing the studies on the basis of temporal period, the average MVP prevalence was approximately two-fold higher in all studies conducted before the year 2000 in comparison with the most recent ones, regardless of TSA type. This discrepancy might be primarily ascribed to relevant differences in the echocardiographic criteria employed for MVP diagnosis before (less specific) and after (more specific) the year 2000, respectively. Conclusions The estimated MVP prevalence in TSA individuals is significantly higher than that observed in the general population. Individuals with TSA should be screened for MVP presence on transthoracic echocardiography.

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“…Much of the data were based on recall and subjective responses, which carry a certain amount of bias. One significant disadvantage of the study is that it did not include certain anthropometric chest measurements, which have a substantial correlation with ACP [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Patients With Atypical Chest Pain: Epidemiology and Reported Consequences

Bahall,

Kissoon,

Islam

et al. 2024

Cureus

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Background: Approximately a quarter of the global population experiences chest pain during their lifetime worldwide. Although largely non-life-threatening, many patients experience mental, physical, social, and financial consequences. Aim: This study aimed to describe and determine the epidemiology and consequences of patients presenting with atypical chest pain (ACP). Method: Data were obtained from 102 participants, from a desired sample size of 166. The target population was patients who presented with ACP at the Accident and Emergency Department of a Teaching Hospital in Trinidad during a two-year period, from January 2021 to December 2022. The data collection instrument used was a 34-item online questionnaire. Data were analyzed using both descriptive and inferential statistical methods. Results: Participants were predominantly women (63.7%; n = 65), between 31 and 50 years of age (74.5%; n = 76), in full-time employment (n = 58; 56.9%), who lived with at least one person (90.2%; n = 92) at the time of the episode. Overall, 61.8% (n = 63) reported having a stressful life. Hypertension (30.4%; n = 31) and diabetes (18.6%; n = 19) were the leading comorbidities. Participants experienced mild to severe anxiety (53.9%; n = 55), moderate to severe depression (25.5%; n = 26), moderate stress (65.7%; n = 67), and loneliness (25.5%; n = 26). A stressful life was associated with, and was a predictor of, both anxiety and loneliness. No sociodemographic variables were associated with depression or stress. The most common self-reported consequences were "fear as a result of the pain" (68.6%; n = 69), "interruptions to daily life" (60.8%; n = 61), "reduction in time spent on hobbies" (62.7%; n = 63), and costly diagnostic/investigative tests (62.7%; n = 64). The majority of patients (52.9%; n = 53) reported reduced quality of life. The most common treatment prescribed was paracetamol (53.9%; n = 55) and exercise (23.5%; n = 24). Conclusion: The study participants were mainly women, 31-50 years old, who had experienced anxiety, stress, or depression. They mainly experienced fear and self-reported a reduced quality of life.

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Appropriate use criteria implementation with modified Haller index for predicting stress echocardiographic results and outcome in a population of patients with suspected coronary artery disease

Cited by 11 publications

References 54 publications

Molecular Approaches and Echocardiographic Deformation Imaging in Detecting Myocardial Fibrosis

Molecular Approaches and Echocardiographic Deformation Imaging in Detecting Myocardial Fibrosis

The relationship between mitral valve prolapse and thoracic skeletal abnormalities in clinical practice: a systematic review

Patients With Atypical Chest Pain: Epidemiology and Reported Consequences

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