Publications by authors named "Angelica Bibiana Delogu"

15 Publications

  • Page 1 of 1

Telemedicine for adult congenital heart disease patients during the first wave of COVID-19 era: a single center experience.

J Cardiovasc Med (Hagerstown) 2021 Apr 20. Epub 2021 Apr 20.

Dipartimento di Scienze Cardiovascolari e Toraciche, Fondazione Policlinico Universitario A. Gemelli IRCCS Catholic University of the Sacred Heart Department of Pediatric Cardiology and Cardiac Surgery - Bambino Gesù Hospital, Rome, Italy.

Aim: To summarize our experience on the implementation of a telemedicine service dedicated to adult congenital heart disease (ACHD) patients during the lockdown for the first wave of COVID-19.

Methods: This is a prospective study enrolling all ACHD patients who answered a questionnaire dedicated telematic cardiovascular examination.

Results: A total of 289 patients were enrolled, 133 (47%) were male, 25 (9%) were affected by a genetic syndrome. The median age was 38 (29-51) years, whereas the median time interval between the last visit and the telematic follow-up was 9.5 (7.5-11.5) months. Overall, 35 patients (12%) reported a worsening of fatigue in daily life activity, 17 (6%) experienced chest pain, 42 (15%) had presyncope and 2 (1%) syncope; in addition, 28 patients (10%) presented peripheral edema and 14 (5%) were orthopneic. A total of 116 (40%) patients reported palpitations and 12 had at least one episode of atrial fibrillation and underwent successful electrical (8) or pharmacological (4) cardioversion. One patient was admitted to the emergency department for uncontrolled arterial hypertension, five for chest pain, and one for heart failure. Two patients presented fever but both had negative COVID-19 nasal swab.

Conclusion: During the COVID-19 pandemic, the use of telemedicine dramatically increased and here we report a positive experience in ACHD patients. The postpandemic role of telemedicine will depend on permanent regulatory solutions and this early study might encourage a more systematic telematic approach for ACHD patients.
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http://dx.doi.org/10.2459/JCM.0000000000001195DOI Listing
April 2021

Smith-Magenis syndrome: Report of morphological and new functional cardiac findings with review of the literature.

Am J Med Genet A 2021 Apr 3. Epub 2021 Apr 3.

Rare Diseases Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Rome, Italy.

Smith-Magenis syndrome (SMS) is a genetic disorder characterized by multiple congenital anomalies, sleep disturbance, behavioral impairment, and intellectual disability. Its genetic cause has been defined as an alteration in the Retinoic Acid-Induced 1 gene. Cardiac anomalies have been reported since the first description of this condition in patients with 17p11.2 deletion. Variable cardiac defects, including ventricular septal defects, atrial septal defects, tricuspid stenosis, mitral stenosis, tricuspid and mitral regurgitation, aortic stenosis, pulmonary stenosis, mitral valve prolapse, tetralogy of Fallot, and total anomalous pulmonary venous connection, have been anecdotally reported and systematic case series are still lacking. Herein, we define the spectrum of the cardiac phenotype and describe for the first time the cardiac function in a large cohort of pediatric patients with SMS. Revision of the literature and correlations between genotype and cardiac phenotype was performed.
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http://dx.doi.org/10.1002/ajmg.a.62196DOI Listing
April 2021

Successful Transcatheter Treatment of Left Pulmonary Artery to Left Atrium Communication Diagnosed in Adulthood.

Circ Cardiovasc Imaging 2020 11 6;13(11):e010668. Epub 2020 Nov 6.

Department of Cardiovascular and Thoracic Sciences (R.L., F.G., F.B., G.L., C.A., E.R., M.G., E.P., R.S., F.I., M.M., C.T.) Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

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http://dx.doi.org/10.1161/CIRCIMAGING.120.010668DOI Listing
November 2020

Undiagnosed Severe Late Complications of Repaired Tetralogy of Fallot.

Circ Cardiovasc Imaging 2020 06;13(6):e010273

Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (R.L., E.P., F.G., A.M.L., M.G., F.C., M.M.).

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http://dx.doi.org/10.1161/CIRCIMAGING.119.010273DOI Listing
June 2020

A possible still role for colchicine in children with idiopathic recurrent acute pericarditis?

Intern Emerg Med 2019 03 5;14(2):331-332. Epub 2018 Dec 5.

Institute of Pediatrics, Università Cattolica Sacro Cuore, Rome, Italy.

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http://dx.doi.org/10.1007/s11739-018-1997-5DOI Listing
March 2019

Evaluation of Adults With Congenital Heart Disease.

World J Pediatr Congenit Heart Surg 2016 Mar;7(2):185-91

Department of Pediatrics, Pediatric Cardiology Unit, Catholic University of the Sacred Heart, Rome, Italy

The clinical approach to adults with congenital heart diseases (ACHDs) is unique in cardiovascular medicine because these patients encompass a broad range of presentations. Each patient, despite having similar diagnosis, will be anatomically and physiologically unlike others within ACHD population, in relation to the type of repair, age at repair, associated defects, with specific long-term risk factors and complications. Furthermore, as many patients will not complain of symptoms, clinical evaluation and diagnostic testing must also be based on the underlying main diagnostic category, with complete standardized lesion-specific clinical protocols, investigating all known risk factors specific for each congenital heart disease and performed as part of screening for significant long-term complications. The first part of this review will focus on clinical history, physical examination, and the most important diagnostic testing in ACHD population. The second part of the article will focus on some clinical issues we have to face in our daily practice, such as heart failure, cyanosis, and pulmonary hypertension. Furthermore, as survival rates of ACHD population continue to improve and patients with this condition live longer, we will briefly report on a new clinical concern regarding the impact of acquired morbidities like coronary artery disease that appear to be of greater importance in defining outcome in older patients with ACHD.
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http://dx.doi.org/10.1177/2150135115623285DOI Listing
March 2016

Cardiac function in types II and III spinal muscular atrophy: should we change standards of care?

Neuropediatrics 2015 Feb 24;46(1):33-6. Epub 2014 Dec 24.

Department of Paediatric Neurology, Catholic University, Rome, Italy.

Objective: In the last years, there has been increasing evidence of cardiac involvement in spinal muscular atrophy (SMA). Autonomic dysfunction has been reported in animal models and in several patients with types I and III SMA, these findings raising the question whether heart rate should be routinely investigated in all SMA patients. The aim of our study was to detect possible signs of autonomic dysfunction and, more generally, of cardiac involvement in types II and III SMA.

Patients And Methods: We retrospectively reviewed 24-hour electrocardiography (ECG) in 157 types II and III SMA patients (age range, 2-74 years). Of them, 82 also had echocardiography.

Results: None of the patients had signs of bradycardia, atrial fibrillation, or the other previously reported rhythm disturbances regardless of the age at examination or the type of SMA. Echocardiography was also normal. There were no signs of congenital cardiac defects with the exception of one patient with a history of ventricular septal defects.

Conclusions: Our results suggest that cardiac abnormalities are not common in type II and type III SMA. These findings provide no evidence to support a more accurate cardiac surveillance or changes in the existing standards of care.
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http://dx.doi.org/10.1055/s-0034-1395348DOI Listing
February 2015

Isolated pericardial agenesis revealed by bradycardia and heart MRI in a healthy 5-year-old child.

Turk J Pediatr 2011 Sep-Oct;53(5):583-5

Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Rome, Italy.

We present a five-year-old boy with an unremarkable medical history who was incidentally found to have bradycardia and electrocardiographic signs of right axial deviation. Initial echocardiogram showed left displacement of the cardiac apex with slight enlargement of the right ventricle, while frontal chest radiograph showed a lucent area between the aorta and pulmonary artery. Cardiac magnetic resonance imaging finally revealed a partial left pericardial agenesis and abnormal displacement of the heart into the left hemithorax.
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February 2012

Delayed diagnosis of Kawasaki syndrome and thrombosis of a medium-sized aneurysm of the anterior descending coronary artery: case report and literature review.

Rheumatol Int 2012 Mar 16;32(3):809-14. Epub 2011 Feb 16.

Section of Pediatric Cardiology, Università Cattolica Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy.

A 7-year-old child was first admitted for persistent fever of 15-day duration and suspected meningitis. Kawasaki syndrome was lately diagnosed upon the recognition of an extensive diffuse coronary artery damage characterized by medium-sized aneurysms of the epicardial vessels. An eccentric thrombus along the inferior wall of the left anterior descending artery suspected at transthoracic echocardiography was confirmed by coronary computed tomography angiography scan, without significant segmental stenosis. Strict cardiac surveillance and anticoagulant therapy were maintained, and no ischemic complications occurred at a short-term follow-up. This report emphasizes that thrombosis can be observed even in medium-sized aneurysms when the diagnosis of Kawasaki syndrome is delayed.
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http://dx.doi.org/10.1007/s00296-011-1814-1DOI Listing
March 2012

Kawasaki syndrome and concurrent Coxsackie virus B3 infection.

Rheumatol Int 2012 Dec 30;32(12):4037-40. Epub 2010 Oct 30.

Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy.

We describe two previously healthy children who were hospitalized in the same period in different departments of our University with clinical signs of Kawasaki syndrome, which were treated with intravenous immunoglobulins and acetylsalicylic acid: in both cases, Coxsackie virus infection was concurrently demonstrated by enzyme-linked immunosorbent assay, and complement fixation test identified antibodies to serotype B3. In the acute phase, both patients presented hyperechogenic coronary arteries, but no cardiologic sequels in the mid term. The etiological relationship between Kawasaki syndrome and Coxsackie viruses is only hypothetical; however, the eventual identification of ad hoc environmental triggers is advisable in front of children with Kawasaki syndrome, with the aim of optimizing epidemiological surveillance and understanding the intimate biological events of this condition.
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http://dx.doi.org/10.1007/s00296-010-1613-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080020PMC
December 2012

Systematic review and meta-analysis of currently available clinical evidence on migraine and patent foramen ovale percutaneous closure: much ado about nothing?

Catheter Cardiovasc Interv 2010 Mar;75(4):494-504

Department of Pediatric Cardiology and GUCH unit, Policlinico San Donato, IRCCS, San Donato Milanese, Italy.

Objectives: To investigate the role of transcatheter closure of patent foramen ovale on the occurrence of migraine.

Background: In recent years, a potential relationship between, migraine, stroke, and patent foramen ovale (PFO) has emerged.

Methods: BioMedCentral, Google Scholar, and PubMed from January 2000 to December 2008 were systematically searched for pertinent clinical studies. Secondary sources were also used. Secondary prevention studies of transcatheter closure for patent foramen ovale were required to include at least more than 10 patients followed for more than 6 months. The primary end-point was the rate of cured or significantly improved migraine after percutaneous PFO closure.

Results: After excluding 637 citations, we finally included a total of 11 studies for a total of 1,306 patients. Forty percent of the subjects included suffered from migraine, while most had a previous history of transient ischemic attack/stroke and were investigated retrospectively. Quantitative synthesis showed that complete cure of migraine in 46% (95% C.I.25-67%), while resolution or significant improvement of migraine occurred in 83% (95% C.I. 78-88%) of cases.

Conclusions: Notwithstanding the limitations inherent in the primary studies, this systematic review suggests that a significant group of subjects with migraine, in particular if treated after a neurological event, may benefit from percutaneous closure of their patent foramen ovale. However, many questions remain unsolved.
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http://dx.doi.org/10.1002/ccd.22232DOI Listing
March 2010

Responsiveness to intravenous immunoglobulins and occurrence of coronary artery abnormalities in a single-center cohort of Italian patients with Kawasaki syndrome.

Rheumatol Int 2010 Apr 5;30(6):841-6. Epub 2010 Jan 5.

Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy.

Clues to predict the response to intravenous immunoglobulins (IVIG) and the development of coronary artery abnormalities (CAA) in children with Kawasaki syndrome (KS) are still undefined. We examined retrospectively the medical charts of children hospitalized between February 1990 and April 2009 with diagnosis of KS. A total of 32 Italian patients with a mean age of 23.8 months were analyzed and all received IVIG according to two schemes: 0.4 g/(kg day) for 5 days or 2 g/kg in a single infusion, combined with oral acetylsalicylic acid. General, clinical and laboratory data were registered. Each patient was evaluated with echocardiography at admission, then with 3-day and weekly frequency, respectively, during hospital stay and for the first 6-8 weeks since onset, and finally with a regular 6-12 month follow-up over time, according to patient risk stratification. Five patients showing significantly higher values of C-reactive protein (CRP) at admission were IVIG-resistant after the first infusion (P = 0.04) in comparison with the remaining 27. Five patients out of 32 developed CAA, with no statistical significance when analyzed for IVIG dosage or IVIG-resistance. The demonstration of CAA was significantly higher in children aged <12 months (P = 0.037). Our experience, limited to a single-center cohort of 32 patients with KS, though treated with two different IVIG schemes, has shown that higher values of CRP and younger age at onset are nodal points in determining, respectively, a failure in the response to IVIG and an increased occurrence of CAA.
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http://dx.doi.org/10.1007/s00296-009-1337-1DOI Listing
April 2010

Incomplete Kawasaki syndrome followed by systemic onset-juvenile idiopathic arthritis mimicking Kawasaki syndrome.

Rheumatol Int 2010 Feb 20;30(4):535-9. Epub 2009 May 20.

Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Largo A. Gemelli no. 8, Rome, Italy.

A 3-month-old child was first treated for incomplete Kawasaki syndrome with three cycles of intravenous immunoglobulins and aspirin, then with methylprednisolone which led to fever remission. The same child was re-hospitalized after a 10-month-period of well-being for the suspicion of a new episode of Kawasaki syndrome, which appeared to be immunoglobulin-resistant: extensive testing failed to provide an alternative diagnosis of any infectious or infiltrative disease. Diagnosis of systemic onset-juvenile idiopathic arthritis was postulated upon the long persistence of fever and inflammatory signs, which subsided only after starting corticosteroid treatment.
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http://dx.doi.org/10.1007/s00296-009-0960-1DOI Listing
February 2010

Recombinant interferon gamma lb and low dose steroid in two pediatric cases of nonspecific interstitial pneumonia.

Mt Sinai J Med 2004 Mar;71(2):139-42

Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Policlinico A. Gemelli, Largo A. Gemelli, 8 00168 Rome, Italy.

We report two young girls, the first almost 18 years old and the second 12 1/2 years old, affected with nonspecific interstitial pneumonia, both diagnosed at the age of 11 by open lung biopsy and both being treated with low-dose steroid. Due to insufficient response to conventional therapy and based on positive therapeutic results following the use of subcutaneous recombinant interferon gamma-1b in fibrosing interstitial pneumonias of adults, they were given a 1-year trial of subcutaneous recombinant interferon gamma-lb in association with a steroid. Our experience with these two young patients suggests that interferon gamma-lb cannot be considered as stabilizing or a curative therapy to control or reverse nonspecific interstitial pneumonia unresponsive to steroids alone.
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March 2004