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The paper entitled "Antihypertensive effect of sacubitril/valsartan: a meta-analysis" by Renato De Vecchis et al., which was published in Minerva Cardioangiologica 2019 June;67(3):214-22, has been retracted by the Publisher due to self-plagiarism.
The paper entitled "Ablation, rate or rhythm control strategies for patients with atrial fibrillation: how do they affect mid-term clinical outcomes?" by Renato De Vecchis et al., which was published in Minerva Cardioangiologica 2019 August;67(4):272-9, has been retracted by the Publisher due to self-plagiarism.
The paper entitled "Aldosterone receptor antagonists decrease mortality and cardiovascular hospitalizations in chronic heart failure with reduced left ventricular ejection fraction, but not in chronic heart failure with preserved left ventricular ejection fraction: a meta-analysis of randomized controlled trials" by Renato De Vecchis et al., which was published in Minerva Cardioangiologica 2017 August;65(4):427-42, has been retracted by the Publisher due to self-plagiarism.
The paper entitled "Differential effects of the phosphodiesterase inhibition in chronic heart failure depending on the echocardiographic phenotype (HFREF or HFpEF): a meta-analysis" by Renato De Vecchis et al., which was published in Minerva Cardioangiologica 2018 October;66(5):659-70, has been retracted by the Publisher due to plagiarism.
The paper entitled "Sacubitril/valsartan improves left ventricular longitudinal deformation in heart failure patients with reduced ejection fraction" by Renato De Vecchis et al., which was published in Minerva Cardioangiologica 2019 December;67(6):456-63, has been retracted by the Publisher due to self-plagiarism.
Cardiovascular medicine is facing several challenges in the current era, dominated by the rapid spread of a previously unknown virus around the world. Indeed, the 2020 COVID-19 pandemic set the course of cardiovascular science and education in an extraordinary way, hogging the attention of the medical community. Notably, while COVID-19 impacted research progress, there has been considerable effort in exploring topics of great interest, from the management of acute coronary syndromes to new horizons in the treatment of heart failure, from novelties in the surgical treatment of cardiovascular disease to new data on implantable cardiac devices, and from new diagnostic applications of multimodal imaging techniques to relevant basic science findings. Minerva Cardiology and Angiology, formerly Minerva Cardioangiologica, has strived to inform its readers on these topics and novelties, aiming for a succinct yet poignant melding of timeliness and accuracy. Accordingly, the purpose of this narrative review is to highlight and summarize the major research and review articles published during 2020. In particular, we provide a broad overview of the novelties identifying six major areas of interest in the field of cardiovascular sciences in which new evidences have contributed to improving prevention, diagnosis and treatment of heart and vessels diseases.
Several novel technological developments and surgical approaches have characterized the field of aortic surgery in the recent decade. The progressive introduction of endovascular procedures, minimally invasive surgical techniques and hybrid approaches have changed the practice in aortic surgery and generated new trends and questions. Also, the advancements in the manufacturing of tissue engineered vascular grafts as substitutes for aortic replacements are enlightening new avenues in the treatment of aortic disease. This review will provide an overview of the current novel perspectives, debates and trends in major thoracic aortic surgery.
The aim of this study was to evaluate the effects of the standardized supplement Robuvit® (oak wood extract) in defined diffuse, minimal lymphatic "retention" (DMLR). Robuvit® has already been investigated in both primary and secondary (post-surgical, post chemo-radiotherapy) lymphatic insufficiency. This registry included subjects with diffuse, minimal lymphatic "retention" (DMLR). The registry management groups included women with mild-moderate limb swelling using standard management (SM) as controls. A second, comparable group used prevention with Robuvit® at the dosage of 3 cp/day (300 mg/day) for 4 weeks. No tolerability problems or side effects were observed with the preventive supplementation. The management groups (34 women in total), including 18 women in Robuvit® and 16 in SM were comparable in age and baseline evaluations. After 4 weeks, in the Robuvit® group, edema scale values derived from ultrasound observations decreased significantly (P<0.05) at all measurement's sites, from the proximal (inguinal) level to the more distal (ankle-foot) level. No significant changes in edema were observed in control subjects. Generally, in areas with higher level of edema (distal areas at the foot and ankle), the edema decrease was larger than in more proximal, ultrasound measurement sites. Preventive Robuvit® supplementation appears to be safe and effective in controlling DMLR in subjects without significant or apparent clinical conditions. This preventive, concept study should be extended to a larger population for more meaningful observations.
Minimally invasive direct coronary artery bypass grafting (MIDCAB) and totally endoscopic coronary artery bypass grafting (TECAB) are the two existing strategies for robotic-assisted, surgical myocardial revascularization. In this review, we summarize the wide evidence available in the literature regarding the benefits of these two procedures, and detail the technical skills required to master robotic coronary surgery techniques.
The aim is to investigate the predictive value of heart rate variability (HRV), blood pressure variability (BPV), and high-sensitivity C-reactive protein (hs-CRP) levels in patients with stable coronary artery disease (SCAD) to assess whether these variables predict the Gensini score. Five hundred and eighty-eight patients with SCAD were enrolled. Normal coronary angiography (102 patients) and healthy physical examination patients (104 patients) were enrolled as control group for HRV. Dynamic electrocardiogram, ambulatory blood pressure, and hs-CRP were measured in SCHD, and Gensini scores were calculated. The relationship between the level of Gensini scores and HRV, BPV and hs-CRP in SCAD was analyzed. We assessed the predictive value of non-invasive markers for the degree of coronary artery disease in SCAD. HRV was negatively correlated with coronary lesions Gensini scores, and BPV was positively correlated with them. The correlation coefficients of SDNN, PNN50, SDANN, RMSSD, and TRIA in HRV are -0.327, -0.489, -0.153 -0.206, -0.292, respectively (P<0.01); while 24hSBPV, 24hDBPV, dSBPV, dDBPV, nSBPV and nSBPdrinBPV were 0.286, 0.233, 0.141, 0.139, 0.218, 0.113, respectively (P<0.01). hs-CRP was positively correlated with the Gensini scores of coronary lesions (0.325, P<0.01), HRV decreased (PNN50<14.97, TRIA<160.86) and BPV increased (24hSBPV>20%, nSBPV>20%) combined with hs-CRP positive (hs-CR >3.0 mg/L) performance can effectively predict coronary lesions in SCAD. HRV, BPV and hs-CRP are all significantly associated with coronary lesions. And these variables can predict the Gensini score in SCAD.
The aim of this open registry study was to evaluate the effects of Robuvit® in subjects with hangover after acute alcohol consumption also measuring changes in levels of oxidative stress. A group using standard management (SM) and a group using SM and Robuvit® 300 mg/day for 3 days were compared. Nineteen male subjects with hangover were included in the SM group and 22 in the Robuvit® + SM group. The groups were comparable at baseline. No side effects were observed. Fatigue scores - as the main observable symptom in these subjects, in both groups - were significantly lower in the group using Robuvit® (P<0.05) than in the control group after 24 hours. The scores of other symptoms like weakness, thirst, headache, muscle aches and body pain were significantly lower at 24 hours (P<0.05) with the supplement than in the control group. The scores of residual gastrointestinal symptoms (nausea, vomiting and stomach pain) were also significantly lower at 24 hours with Robuvit® (P<0.05). Sleep and rest were significantly better with Robuvit® (P<0.05). Sensory symptoms and cognitive functions were also significantly better with supplementation in comparison with SM only (P<0.05). Finally, scores of mood, concentration, depression, anxiety, irritability were significantly lower (P<0.05) with Robuvit® though these symptoms need a more specific and complete evaluation. Signs of sympathetic activity, tremor, sweating, increased heart rate improved significantly better with the supplement at 24 hours (P<0.05). Oxidative stress was increased at inclusion in all subjects; in the Robuvit® group, oxidative stress decreased significantly (P<0.05) at 24 hours; in controls (SM) oxidative stress showed minimal changes at 24 hours and it remained elevated above normal values (>330 CU). Most symptoms almost disappeared at 24 hours in the Robuvit® group. Significant symptoms were still observed in 11 out of 19 subjects in the SM group in comparison with four of 22 subjects using the supplementation with Robuvit® (P<0.05). Blood tests were normal in all subjects (hematocrit and kidney and liver functional test at 24 hours). In conclusion, Robuvit® supplementation appears to improve hangover and relieved symptoms faster. More studies are needed to confirm this association between acute alcohol consumption and a possible hepatic dysfunction.
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Coronary artery disease among women presents differences in terms of clinical presentation and pathophysiology. To date, women present worse prognoses with more events and higher mortality rate. One the one hand, they are less likely addressed for invasive therapy. One the other hand, revascularization procedures, whether by bypass or by percutaneous coronary intervention, are associated with higher rates of complications and poorer prognosis. Despite higher risk factor burden and comorbidity, women are less affected by obstructive disease and plaque characteristics are more favorable than among men. Abnormalities of endothelial function and micro vascular flow reserve could explain part of the high prevalence of symptoms of angina observed among women. Due to the worse prognosis of microvascular dysfunction, particularly in women, proper diagnosis is mandatory and deserve invasive management. Outcome following ST elevation myocardial infarction is still more severe among women with higher in-hospital mortality, but sex discrepancies are observed even in elective percutaneous coronary intervention. However, improvement of techniques, drugs and devices benefited to both men and women and tend to decrease gender gap. Especially, changes in the design of newer-generation drug-eluting stents (DES) may be particularly important for women. Female sex remains a potent predictor of higher risk of bleeding and vascular complication; thus important efforts should be promoted to develop bleeding avoidance strategies. Sex-based differences still deserve dedicated investigations in terms of physiopathology, particular hormonal impacts, and specific responses to drugs and devices.
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The paper entitled "The unanimity of fluid restriction is still debating in patients with heart failure" by Chen et al., which was published online on April 21, 2020, has been withdrawn by the Publisher because it commented an article by Dr. De Vecchis et al. entitled “Effects of a restricted water intake on various clinical and laboratory outcomes in patients with heart failure: a meta-analysis of randomized controlled trials” which has been retracted due to self-plagiarism.
We aimed to assess the clinical and echocardiographic characteristics of patients who underwent surgery for degenerative mitral valve prolapse (MVP) in our center, and its relation to outcomes. We enrolled 117 consecutive patients from North-East China with an echocardiographic diagnosis of MVP related mitral regurgitation (MR) between April 2018 and November 2019. A complexity scoring system was used for valve anatomy, and patients were re-evaluated at 3-6 months after surgery. Most patients (57.3%) were 40-59 years old. Ejection fraction was <60% in one third, and pulmonary hypertension was present in 64.3% of operated patients. Etiology was myxomatous in 58.9%, with flail as main lesion. Leaflet involvement was posterior in 59.8% patients, anterior in 32.5%, bileaflet in 6%, and commissural in 25.6%. Lesion score was intermediate in >50% of patients, and myxomatous lesions scored higher compared to fibroelastic deficiency (FED). Degree of MR left atrial volume and estimated wedge pressure were significantly higher in intermediate and complex lesions. Repair was performed in 93/101 patients (95.8% success rate). No in-hospital major adverse events, nor deaths at follow-up were reported. Residual MR was ≤ mild in 86.7% of patients at follow-up and was associated with FED etiology and complex lesions. Compared to Western countries, in our sample of Chinese population degenerative severe MR occurred in younger patients. The MVP lesion characteristics are similar, can be accurately detected by non-invasive preoperative evaluation, allowing predictable results. Advanced tailored repair techniques allow excellent immediate and short-term results regardless of the underlying complexity.
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Physical activity is worldwide recommended for its benefits on cardiovascular system. There is an increasing number of people of all ages that approach sport activity both as leisure time physical activity and as competitive sport. It is always more frequent the request even from older subjects and cardiac patients to be allowed to practice physical activity. Some problems could arise when these subjects present or develop pathologic conditions that require specific pharmacological treatment, in particular an anticoagulation therapy. This review focalizes on the management of oral anticoagulant therapy (OAT) in patients practicing sport activity, especially due to atrial fibrillation and deep vein thrombosis, which represent two highly prevalent conditions, particularly with increasing age. Official recommendations in this field may appear limiting for patients, forbidding in the majority of cases sports at risk of trauma and consequent bleeding. These recommendations still resent the heritage of the "traditional" management of OAT, mainly represented by vitamin-K antagonists (VKAs). The non-vitamin K antagonist oral anticoagulants, with their more favorable pharmacokinetic-pharmacodynamic profile compare to VKAs, may now represent an opportunity to modify the approach to sport activity in patients with an indication to OAT. This review of the literature deals with possible strategies to overcome the present limitations for OAT subjects willing to pursue a healthy lifestyle, that include sport activity, minimizing at the same time their risk of bleeding.