Antonella Lombardo

Publications (54) View all

• Article: Colon-like right coronary artery.

  Francesco Fracassi, Giampaolo Niccoli, Nicola Cosentino, Maura Giammarinaro, Riccardo Marano, Biagio Merlino, Antonella Lombardo, Filippo Crea
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  ABSTRACT: Coronary aneurysmatic dilatation may be localized to a segment or may involve multiple segments. We herein report a case of a diffuse aneurysmatic dilatation of the right coronary artery.
  Journal of Cardiovascular Medicine 08/2012; · 1.51 Impact Factor
• Article: Predictors of myocardial microvascular obstruction in patients treated by primary percutaneous coronary intervention and a short ischemic time.

  Giampaolo Niccoli, Cristina Spaziani, Nicola Cosentino, Antonella Lombardo, Francesco Fracassi, Leonardo Cataneo, Valentina Loria, Carlo Trani, Francesco Burzotta, Italo Porto, Antonio Maria Leone, Filippo Crea
  International journal of cardiology 11/2011; 153(1):113-5. · 7.08 Impact Factor
• Article: Angiographic patterns of myocardial reperfusion after primary angioplasty and ventricular remodeling.

  Giampaolo Niccoli, Nicola Cosentino, Antonella Lombardo, Gregory A Sgueglia, Cristina Spaziani, Francesco Fracassi, Leonardo Cataneo, Silvia Minelli, Francesco Burzotta, Antonio Maria Leone, Italo Porto, Carlo Trani, Filippo Crea
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  ABSTRACT: No reflow after primary percutaneous coronary intervention is a dynamic process and its reversibility may affect left ventricular (LV) remodeling. We aimed at assessing in-hospital evolution of angiographic no reflow, predictors of its reversibility, and its impact on LV function at follow-up (FU). Fifty-three consecutive patients (age, 60±10 years; male sex, 79%) presenting with ST-elevation myocardial infarction and undergoing primary percutaneous coronary intervention within 12 h of symptom onset were enrolled. No reflow was defined as a final thrombolysis in myocardial infarction (TIMI) flow of 2 or final TIMI flow of 3 with myocardial blush grade (MBG) of less than 2. The evolution of angiographic no reflow was assessed by repeat in-hospital coronary angiography. Patients with no reflow found to have an improvement of TIMI and/or MBG leading to a final TIMI 3 and MBG of greater than or equal to 2 were classified as reversible no reflow; the remaining patients were classified as sustained no reflow. Variables predicting the patterns of no reflow, recorded on admission, were assessed among clinical, angiographic and laboratory data. FU echocardiographic data (at 6 months) were compared with those obtained in-hospital according to no reflow evolution. Thirty-six patients (68%) exhibited myocardial reperfusion; 17 patients (32%) showed no reflow. Among these, six patients (age, 58±10 years; male sex, 83%) showed sustained no reflow, whereas 11 patients (age, 55±8 years; male sex, 82%) showed reversible no reflow. Patients with sustained no reflow had longer time to percutaneous coronary intervention (261±80 min) compared with those with myocardial reperfusion (216±94 min) or reversible no reflow (237±76 min; P=0.008 and 0.05, respectively). Moreover, patients with sustained no reflow had a higher peak troponin-T levels (14.5 ng/ml; range, 7.5-20.2 ng/ml) compared with those presenting with myocardial reperfusion (3.9 ng/ml; range, 3.3-9.1 ng/ml) and reversible no reflow (7.7 ng/ml; range, 3.6-29.9 ng/ml; P=0.03 and 0.07, respectively). At multivariate ordinal logistic regression, time pre-PCI retained its statistical significant association with angiographic no reflow evolution (odds ratio=2.54; 95% confidence interval: 1.45-6.53; P=0.04), with troponin T levels showing a borderline statistical significance (odds ratio=3.12; 95% confidence interval: 1.07-6.23; P=0.09). Finally, in patients with sustained no reflow only both end-diastolic and end-systolic volumes significantly increased at FU (P<0.001 and 0.001, respectively). Sustained no reflow is associated with a longer ischemic time and predicts worse LV remodeling. No reflow, however, shows an in-hospital reversibility calling for therapeutic interventions when its prevention fails.
  Coronary artery disease 08/2011; 22(7):507-14. · 1.56 Impact Factor
• Article: Impact of microvascular obstruction and infarct size on left ventricular remodeling in reperfused myocardial infarction: a contrast-enhanced cardiac magnetic resonance imaging study.

  Antonella Lombardo, Giampaolo Niccoli, Luigi Natale, Antonio Bernardini, Nicola Cosentino, Lorenzo Bonomo, Filippo Crea
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  ABSTRACT: Infarct size (IS) and microvascular obstruction (MO) following ST-elevation myocardial infarction (STEMI) reperfusion may affect left ventricular (LV) remodeling. We evaluated the impact of extent and transmurality of IS and MO in LV remodeling using contrast-enhanced cardiac magnetic resonance imaging (MRI). Thirty-six consecutive patients presenting with a first STEMI and undergoing contrast-enhanced cardiac MRI within 5 days of successful primary percutaneous coronary intervention (PPCI) were enrolled. Gadolinium-enhanced MRI at first passage and in delayed imaging was performed to assess MO and IS. LV remodeling was evaluated by echocardiography at 6-month-follow-up and defined as a percent increase in the LV end-diastolic volume >20%. Thirteen patients (36%) developed LV remodeling. IS and MO extent score was associated with LV remodeling (OR 1.5, 95% CI 1.02-2.38, P = 0.04, and OR 3.1, 95% CI 1.45-6.64, P = 0.003, respectively), along with IS and MO trasmurality (OR 1.4, 95% CI 1.007-2.12, P = 0.046, and OR 3.1, 95% CI 1.24-7.89, P = 0.016, respectively). Importantly, IS and MO extent score combination gave an OR of 3.4 (95% CI 1.4-7.9, P = 0.004) and the combination of IS and MO transmurality increased the OR to 4.8 (95% CI 1.5-15.2, P = 0.007). Finally, when combining simultaneously IS and MO extent score and transmurality the OR reached 5.3 (95% CI 3.34-18.2, P = 0.0008). The evaluation of both IS and MO extent and transmurality by MRI is of prognostic utility in patients undergoing PPCI. Importantly, IS and MO transmurality significantly increases the risk of adverse remodeling and should be routinely assessed in post-STEMI patients.
  The international journal of cardiovascular imaging 06/2011; 28(4):835-42. · 2.15 Impact Factor
• Article: Giant coronary sinus aneurysm secondary to right coronary arteriovenous fistula leading to pseudo-mitral stenosis.

  Mario Gaudino, Amedeo Anselmi, Antonella Lombardo, Riccardo Marano, Gianfederico Possati
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  ABSTRACT: We herein report a case in which a right coronary to coronary sinus arteriovenous fistula determined progressive aneurysmatic dilatation of the coronary sinus. Severe compression of the left atrium ensued. This led to a clinical and instrumental picture similar to that observed in severe mitral stenosis.
  Archives of medical science : AMS. 06/2011; 7(3):533-5.