Monaldi Archives for Chest Disease 2019-07-16T23:14:53+02:00 Nadia Moscato Open Journal Systems <p><strong>Monaldi Archives for Chest Disease</strong> is an international scientific journal of the <em>Istituti Clinici Scientifici Maugeri</em>, Pavia, Italy, dedicated to the advancement of knowledge in all fields of cardiopulmonary medicine and rehabilitation. <!--It is published in two series: the “Cardiac Rehabilitation and Prevention Series” (volume, even numbers) which, since 2002, is the official journal of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR); and the “Pulmonary Medicine and Rehabilitation Series” (volume, odd numbers).--></p> <p><strong>Monaldi Archives for Chest Disease</strong> publishes original articles, new methodological approaches, reviews, opinions, editorials, position papers on all aspects of cardiac and pulmonary medicine and rehabilitation, and, in addition, provides a forum for the inter-exchange of information, experiences and views on all issues of the cardiology profession, including education. Accordingly, original contributions on nursing, exercise treatment, health psychology, occupational medicine, care of the elderly, health economics and other fields related to the treatment, management, rehabilitation and prevention of cardiac and respiratory disease are welcome.</p> <p><strong>Monaldi Archives for Chest Disease</strong> promotes excellence in the profession of cardiology and pneumology through its commitment to the publication of research, support to continuous education, and encouragement and dissemination of ‘best practice’.</p> <p>This journal does not apply charge for publication to Authors as it is supported by institutional funds.</p> Aortic root and valve proportions: an example of the golden ratio? 2019-07-16T23:14:50+02:00 Nikoloz Koshkelashvili Mauricio Jalife Bucay Igor Goykhman Gregg S. Pressman <p>Calcific aortic stenosis is the most common lesion requiring valve replacement. Transcutaneous procedures (TAVR) are rapidly increasing yet detailed information on aortic valve and root anatomy are sparse.&nbsp; This study examined gated cardiac CT scans to make observations regarding the size and proportions of the valve leaflets, sinuses of Valsalva, and sinotubular junction. One hundred and fifty gated cardiac CT scans were performed for a variety of clinical indications. Area of each cusp (short axis plane) was measured along with sinus height (from leaflet base to sinotubular junction), sinus width (from central coaptation point to outer sinus edge), annular perimeter, perimeter at mid-sinus level, and perimeter at the sinotubular junction. The right coronary cusp was largest, the left cusp smallest, and the non-coronary cusp intermediate in size. Each cusp was larger in men than women, even after indexing for body surface area.&nbsp; By contrast, indexed sinus width and height did not differ between genders. No significant differences were noted between races. Annular perimeter did not vary by age while the mid-sinus perimeter and sinotubular junction perimeter increased with age (p=0.01, r<sup>2</sup> =0.05 and p=0.002, r<sup>2</sup> =0.07).&nbsp; Interestingly, the ratio of sinus height (average): annular radius was 1.69±0.18, very close to the “golden ratio” of 1.62 found throughout the natural world.&nbsp; This might be important for proper vortex formation in the sinuses.</p> 2019-07-15T08:34:32+02:00 ##submission.copyrightStatement## Splenic artery aneurysm in Sjögren’s syndrome 2019-07-16T23:14:51+02:00 Cuneyt Tetikkurt Zeynep Ferhan Ozseker Fatma Gülsüm Karakaş <p>A 40-year-old female presented with cough, exertional dyspnea, abdominal pain with distention, fatigue, dry eyes and dry mouth. Past history revealed asthma. Physical examination was normal except for tachypnea. We found leukocytosis, azygos fissure on chest X-ray along with normal pulmonary function tests and arterial blood gases. &nbsp;Thorax computed tomography (CT) revealed bronchiectasis and ground glass opacities in both lungs. Abdominal CT demonstrated thrombosed proximal splenic artery aneurysm. Further diagnostic procedures were done and according to the positive Schirmer test and compatible histopathologic findings of the salivary gland, diagnosis of primary Sjögren’s syndrome was established. Splenic artery aneurysm is rare occurring in less than 1% of the population that usually appears as an incidental finding. This is the first case in literature that introduces Sjögren’s syndrome as a risk factor for splenic artery aneurysm. The silent presentation of the splenic artery aneurysm should previse the clinicians that such an occurrence may cause a significant diagnostic dilemma.</p> 2019-07-08T09:36:02+02:00 ##submission.copyrightStatement## Extended dual antiplatelet therapy after acute myocardial infarction. Current evidence and future perspectives 2019-07-16T23:14:52+02:00 Nicola Cosentino Jeness Campodonico Valentina Milazzo Katia Celentano Marco Moltrasio Pompilio Faggiano Giancarlo Marenzi <p>Patients with acute myocardial infarction (AMI) are at increased risk of recurrent ischemic events after hospital discharge, despite optimal medical therapy. Current practice guidelines strongly encourage the early assessment of the residual ischemic risk in post-AMI patients, in order to identify those who may benefit from a prolonged dual antiplatelet therapy. To this end, some scoring systems have been proposed. However, most scores were developed for patients with stable coronary artery disease undergoing percutaneous coronary intervention. Moreover, nearly all failed to be implemented in everyday clinical practice, probably because of the perceived complexity due to the large number of incorporated variables. Therefore, the identification of the ideal AMI patient who can benefit from a prolonged (beyond 1 year after the index event) dual antiplatelet therapy remains to be clarified, especially when the bleeding risk associated with such therapy is considered. In this review, we summarize the current evidence on the prolonged use of dual antiplatelet therapy after AMI, with a special focus on recent advances regarding the identification of high-risk patients who may derive a favorable net clinical benefit from such a therapeutic strategy.</p> 2019-07-04T13:20:48+02:00 ##submission.copyrightStatement## Monaldi Archives for Chest Disease - Cardiology Area: An essential instrument for the Italian Association of Cardiac Prevention and Rehabilitation (GICR-IACPR) 2019-07-16T23:14:53+02:00 The Editors - Cardiology Area <p>At the beginning of the triennium 2019-2022, as Editors of the Monaldi Archives for Chest Disease - Cardiology Area, we&nbsp; would like to share with all cardiologists and allied health &nbsp;professionals working in cardiovascular prevention and &nbsp;rehabilitation the status of our Journal, which is the official Journal of the Italian Association of Cardiac Prevention and Rehabilitation (GICR-IACPR), and has contributed in these past years, thanks to effort and dedication of all Editors who have preceded us, to the advancement of our profession, and to an enrichment and dissemination of its scientific contents.</p> 2019-06-20T11:21:12+02:00 ##submission.copyrightStatement##