Natural history of a rare rodent of the Argentinean desert, Salinomys delicatus (Cricetidae: Sigmodontinae)

El ratón delicado de los salares (Salinomys delicatus) es un pequeño roedor endémico de Argentina. Ha sido considerado como vulnerable a la extinción dada su distribución restringida y en parches, tamaño poblacional pequeño y especialización en hábitats salinos. A pesar de que el ratón delicado tiene adaptaciones morfológicas y fi siológicas para la supervivencia en ambientes áridos y salitrosos, poco es lo que se conoce de su historia natural. El presente trabajo tiene como objetivo estudiar la historia natural de S. delicatus, reportar nuevas localidades de ocurrencia, caracterizar el uso de hábitat, su dieta y el ensamble acompañante, y describir su biología reproductiva y morfología. Se registraron dos nuevos sitios de ocurrencia en ambientes de bosques en galería y bajos salinos en la región noreste de la provincia de Mendoza (Argentina), siendo las primeras citas para esta provincia. S. delicatus presenta una dieta omnívora, como es frecuente en otros roedores de desierto, y consume en igual medida semillas, artrópodos y plantas halófi tas. El ensamble acompañante está compuesto por no más de tres especies de pequeños mamíferos que varían según la localidad, siendo esta riqueza similar a otros sitios del Monte. La proporción de sexos y el patrón de dimorfi smo sexual mostraron un marcado desvío hacia las hembras (H:M = 3.6:1.1 y H:M = 1.151 respectivamente). La morfología externa y craneal presenta una importante variabilidad intra e interpoblacional, sugiriendo que el aislamiento juega un rol importante. Cuando se consideraron adultos y juveniles, conjuntamente dos de las seis medidas externas (longitud total y longitud de cabeza y cuerpo) y siete de las 22 medidas craneales resultaron signifi cativamente mayores en hembras que en machos. Cuando se compararon solo los adultos, cuatro características externas (longitud total, longitud de cabeza y cuerpo, largo de la cola y peso) y seis medidas craneales fueron signifi cativamente mayores en hembras que en machos. Este trabajo refuerza la importancia del desarrollo de nuevos estudios más detallados sobre la historia de vida de S. delicatus y permite reafirmar la importancia de conservación de esta especie.The delicate mouse (Salinomys delicatus) is a small rodent endemic of Argentina. It has been considered vulnerable to extinction because of its restricted and patchy distribution, small population size and specialization on salty habitats. Besides its morphological and physiological adaptations to survive in arid and salty habitats, there is still little information about the natural history of the delicate mouse. The objectives of our study are to study the natural history of S. delicatus, report new localities of occurrence, characterize its habitat use, diet and accompanying assemblages and describe its reproductive biology and morphology. We report two new localities of occurrences in gallery woodlands and salt fl ats in the northeast of Mendoza province (Argentina), these being the fi rst records for this province. Like other South American rodents, S. delicatus has an omnivorous diet consisting in similar proportion of seeds, arthropods and halophytic plants. The assemblages are composed by no more than three small mammal species, varying according to the locality. Sex ratio and the pattern of sexual dimorphism shows a strong bias towards females (H:M = 3.6:1.1 and H:M = 1.151 respectively). External and cranial morphology exhibits a clear intra- and interpopulation variability. When considering in the analysis adults and juvenile, two of six external measurements (head and body length and total length) and seven of twenty-two cranial measurements were signifi cantly higher in females than in males. When considering only adults, four external measures (total length, head and body length, tail length and weight) and six cranial measurements were signifi cantly higher in females than in males. This integrative analysis highlights the relevance of conducting further and more detailed studies on the natural history of S. delicatus and allows us to reassert the conservation importance of this species.Fil: Rodriguez, Maria Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Lanzone, Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; Argentina. Universidad Nacional de Misiones; ArgentinaFil: Chillo, María Verónica. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Cuello, Pablo Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Albanese, María Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Ojeda, Agustina Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Ojeda, Ricardo Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; Argentin

Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19.

Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6+/-9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; pPeer reviewe

Integrated analyses of chromosome, molecular and morphological variability in the Andean mice Eligmodontia puerulus and E. moreni (Rodentia, Cricetidae, Sigmodontinae)

Patterns of evolution and systematics of sigmodontine rodents are matters of continuous revision and debate. The silky mouse, Eligmodontia, is a phyllotine rodent adapted to arid environments. Chromosomal and molecular data have identified six species in this genus. Among these E. puerulus and E. moreni are sister taxa from the high Andean and lowland deserts, respectively, with large chromosomal differences and intermediate levels of molecular divergence. The purpose of our study was to quantify the degree of variability (morphological, cytogenetic, and molecular) and to analyze its evolutionary implications within, and between, these sister species in the Monte and Puna biomes of Argentina. Our results show a high variability at the chromosomal and molecular level, but low morphological differentiation among populations of E. puerulus. Diploid numbers vary from 31 to 37 due to a complex Robertsonian system, whereas cytochrome-b distances range from 0.15% to 5.75%. On the other hand, E. moreni shows high morphological differentiation between populations, but low intraspecific differentiation at the molecular (from 0.73% to 1.4%) and chromosomal level (2n = 52). Comparison of E. puerulus with E. moreni reveals high morphological and chromosomal distinction between them, but absence of molecular differentiation. Our results suggest that: (1) the high genetic variability of E. puerulus could be associated to its geographic distribution in the complex topography of the high Andean Puna; (2) the high morphological differentiation between E. moreni and E. puerulus could be the result of natural selection; and (3) molecular polyphyly between E. puerulus and E. moreni could be due to introgression or a recent split of these taxa. Finally, our results emphasize the need to integrate different datasets in the analysis of species variability and diversification, as tools for understanding their evolutionary histories.Fil: Lanzone, Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Ojeda, Agustina Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Ojeda, Ricardo Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Albanese, María Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Rodriguez, Maria Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Dacar, María Ana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; Argentin

Genetic studies in the recently divergent Eligmodontia puerulus and E. moreni (Rodentia, Cricetidae, Sigmodontinae) from Puna and Monte deserts of South America

Eligmodontia is a genus of phyllotine rodents adapted to arid environments with seven recognized species. The sister species E. puerulus and E. moreni are distributed in the adjacent highland Puna and lowland Monte deserts respectively, and show remarkable morphological and chromosomal differences. However, analyses of the cytochrome b gene showed important variability, without reciprocal monophyly between them. In order to study the evolutionary processes involved in the diversification of both taxa, we analyzed 1161 bp of the mitochondrial control region and flanking sequences (N = 60), as well as 759 bp of the first exon of the nuclear gene IRBP (N = 14). Individuals of both species from Jujuy, Catamarca and Mendoza Provinces of Argentina were previously karyotyped. Results showed that the mitochondrial sequences present high haplotype and nucleotide diversity within all population, and no haplotype was shared between both species. FST indicated that populations of both species were moderately structured. The network was constituted by two major haplogroups, one composed by E. puerulus samples from Jujuy, and the other composed of sequences of all studied populations. The Bayesian analysis showed three clusters, matching the network. Phylogenetic analysis recovered two clades with high support, in coincidence with the network groups. There was only one close join between sequences of both species, corresponding to samples from Catamarca. Thus, mitochondrial data suggested hybridization between both species in Catamarca, with asymmetric introgression. The IRBP showed low variability and, in the phylogenetic analysis, the sequences of E. puerulus form a monophyletic group with intermediate support, whereas those of E. moreni collapse into a basal polytomy. Our data indicated a recent divergence and absence of introgression in the nuclear genomes. The results at the population level with mitochondrial sequences, together with integrative taxonomy at the species level in a biogeographic context, suggest that climatic and geologic changes could have had an important role in the determination of genetic variability patterns observed in these rodents.Fil: Armella Sierra, Alicia Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas | Universidad Nacional de Misiones. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas; ArgentinaFil: Castillo, Elio Rodrigo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas | Universidad Nacional de Misiones. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas; ArgentinaFil: Labaroni, Carolina Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas | Universidad Nacional de Misiones. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas; ArgentinaFil: Barrandeguy, Maria Eugenia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas | Universidad Nacional de Misiones. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas; ArgentinaFil: Marti, Dardo Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas | Universidad Nacional de Misiones. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas; ArgentinaFil: Ojeda, Ricardo Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Lanzone, Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas | Universidad Nacional de Misiones. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Posadas; Argentin

Joint document of the SIGiTE-SIM 2013 - Management of hormone replacement therapy in menopausal women [Documento Congiunto SIGiTE-SIM 2013 - Gestione del Trattamento Ormonale Sostitutivo nella donna in menopausa]

none32-mixedDonati Sarti Costante; Lello Stefano; Gallo Mario; Micingrucci Maria; Maffei Silvia; Stomati Massimo; Agostinelli Domenico; Becorpi Annamaria; Nappi Rossella; Nocera Fabio; FiorilloFlavia; Baldi Stefania; Cancellieri Francesco; Leli Pietro; Mapelli Carlo; Cordopatri Alberto; Repetti Fausto; Volpe Annibale; Dessole Salvatore; Lanzone Antonio; CAGNACCI, Angelo; Cicinelli Ettore; Grimaldi Eva; Guaschino Secondo; Maffei Silvia; Massobrio Massimo; Melis Gian Benedetto; Omodei Umberto; Paoletti AnnaMaria; Sciacchitano Salvatore; Venturoli Stefano; Villa PaolaDonati Sarti, Costante; Lello, Stefano; Gallo, Mario; Micingrucci, Maria; Maffei, Silvia; Stomati, Massimo; Agostinelli, Domenico; Becorpi, Annamaria; Nappi, Rossella; Nocera, Fabio; Fiorilloflavia, ; Baldi, Stefania; Cancellieri, Francesco; Leli, Pietro; Mapelli, Carlo; Cordopatri, Alberto; Repetti, Fausto; Volpe, Annibale; Dessole, Salvatore; Lanzone, Antonio; Cagnacci, Angelo; Cicinelli, Ettore; Grimaldi, Eva; Guaschino, Secondo; Maffei, Silvia; Massobrio, Massimo; Melis Gian, Benedetto; Omodei, Umberto; Paoletti, Annamaria; Sciacchitano, Salvatore; Venturoli, Stefano; Villa, Paol

Role of prenatal magnetic resonance imaging in fetuses with isolated severe ventriculomegaly at neurosonography: a multicenter study

none69siObjective: The aim of this study was to report the rate of additional anomalies detected exclusively at prenatal magnetic resonance imaging (MRI) in fetuses with isolated severe ventriculomegaly undergoing neurosonography. Method: Multicenter, retrospective, cohort study involving 20 referral fetal medicine centers in Italy, United Kingdom, Spain and Denmark. Inclusion criteria were fetuses affected by isolated severe ventriculomegaly (> 15 mm), defined as ventriculomegaly with normal karyotype and no other additional central nervous system (CNS) and extra-CNS anomalies on ultrasound. In all cases, a multiplanar assessment of fetal brain as suggested by ISUOG guidelines on fetal neurosonography had been performed. The primary outcome was the rate of additional CNS anomalies detected exclusively at fetal MRI within two weeks from neurosonography. Subgroup analyses according to gestational age at MRI (< vs 24 weeks of gestation) and the laterality of ventriculomegaly (unilateral vs bilateral) were also performed. Univariate and multivariate logistic regression analysis was used to analyze the data. Results: 187 fetuses with a prenatal diagnosis of isolated severe ventriculomegaly on neurosonography were included in the analysis. Additional structural anomalies were detected exclusively at prenatal MRI in 18.1% of cases. When considering the type of anomaly, malformations of cortical development were detected on MRI in 32.4% cases, while midline or acquired (hypoxemic/hemorrhagic) lesions were detected in 26.5% and 14.7% of cases, respectively. There was no difference in the rate of additional anomalies when stratifying the analysis according to either gestational age at MRI or laterality of the lesion. At multivariate logistic regression analysis, the presence of additional anomalies only found at MRI was significantly higher in bilateral compared versus unilateral ventriculomegaly (OR: 4.37, 95% CI 1.21-15.76; p= 0.04), while neither maternal body mass index, age, severity of ventricular dilatation, interval between ultrasound and MRI, nor gestational age at MRI were associated with the likelihood of detecting associated anomalies at MRI. Conclusion: The rate of associated anomalies detected exclusively at prenatal MRI in fetuses with isolated severe ventriculomegaly is lower than previously reported, but higher compared to isolated mild and moderate ventriculomegaly. Fetal MRI should be considered as a part of the prenatal assessment of fetuses presenting with isolated severe ventriculomegaly at neurosonography.openDi Mascio, Daniele; Khalil, Asma; Pilu, Gianluigi; Rizzo, Giuseppe; Caulo, Massimo; Liberati, Marco; Giancotti, Antonella; Lees, Christoph; Volpe, Paolo; Buca, Danilo; Oronzi, Ludovica; D'Amico, Alice; Tinari, Sara; Stampalija, Tamara; Fantasia, Ilaria; Pasquini, Lucia; Masini, Giulia; Brunelli, Roberto; D'Ambrosio, Valentina; Muzii, Ludovico; Manganaro, Lucia; Antonelli, Amanda; Ercolani, Giada; Ciulla, Sandra; Saccone, Gabriele; Maruotti, Giuseppe Maria; Carbone, Luigi; Zullo, Fulvio; Olivieri, Claudiana; Ghi, Tullio; Frusca, Tiziana; Dall'Asta, Andrea; Visentin, Silvia; Cosmi, Erich; Forlani, Francesco; Galindo, Alberto; Villalain, Cecilia; Herraiz, Ignacio; Sileo, Filomena Giulia; Quintero, Olivia Mendez; Salsi, Ginevra; Bracalente, Gabriella; Morales-Roselló, José; Loscalzo, Gabriela; Pellegrino, Marcella; De Santis, Marco; Lanzone, Antonio; Parazzini, Cecilia; Lanna, Mariano; Ormitti, Francesca; Toni, Francesco; Murru, Flora; Di Maurizio, Marco; Trincia, Elena; Garcia, Raquel; Petersen, Olav Bennike Bjørn; Neerup, Lisa; Sandager, Puk; Prefumo, Federico; Pinelli, Lorenzo; Mappa, Ilenia; Martellucci, Cecilia Acuti; Flacco, Maria Elena; Manzoli, Lamberto; Giangiordano, Ilaria; Nappi, Luigi; Scambia, Giovanni; Berghella, Vincenzo; D'Antonio, FrancescoDi Mascio, Daniele; Khalil, Asma; Pilu, Gianluigi; Rizzo, Giuseppe; Caulo, Massimo; Liberati, Marco; Giancotti, Antonella; Lees, Christoph; Volpe, Paolo; Buca, Danilo; Oronzi, Ludovica; D'Amico, Alice; Tinari, Sara; Stampalija, Tamara; Fantasia, Ilaria; Pasquini, Lucia; Masini, Giulia; Brunelli, Roberto; D'Ambrosio, Valentina; Muzii, Ludovico; Manganaro, Lucia; Antonelli, Amanda; Ercolani, Giada; Ciulla, Sandra; Saccone, Gabriele; Maruotti, Giuseppe Maria; Carbone, Luigi; Zullo, Fulvio; Olivieri, Claudiana; Ghi, Tullio; Frusca, Tiziana; Dall'Asta, Andrea; Visentin, Silvia; Cosmi, Erich; Forlani, Francesco; Galindo, Alberto; Villalain, Cecilia; Herraiz, Ignacio; Sileo, Filomena Giulia; Quintero, Olivia Mendez; Salsi, Ginevra; Bracalente, Gabriella; Morales-Roselló, José; Loscalzo, Gabriela; Pellegrino, Marcella; De Santis, Marco; Lanzone, Antonio; Parazzini, Cecilia; Lanna, Mariano; Ormitti, Francesca; Toni, Francesco; Murru, Flora; Di Maurizio, Marco; Trincia, Elena; Garcia, Raquel; Petersen, Olav Bennike Bjørn; Neerup, Lisa; Sandager, Puk; Prefumo, Federico; Pinelli, Lorenzo; Mappa, Ilenia; Martellucci, Cecilia Acuti; Flacco, Maria Elena; Manzoli, Lamberto; Giangiordano, Ilaria; Nappi, Luigi; Scambia, Giovanni; Berghella, Vincenzo; D'Antonio, Francesc

Stress Echocardiography in Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging

Background: The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand the volumes of activity, modalities and stressors used during stress echocardiography (SE) in Italy. Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved through an electronic survey based on a structured questionnaire, uploaded on the SIECVI website. Results: Data were obtained from 228 echocardiographic laboratories, and SE examinations were performed in 179 centers (80.6%): 87 centers (47.5%) were in the northern regions of Italy, 33 centers (18.4%) were in the central regions, and 61 (34.1%) in the southern regions. We annotated a total of 4057 SE. We divided the SE centers into three groups, according to the numbers of SE performed: <10 SE (low-volume activity, 40 centers), between 10 and 39 SE (moderate volume activity, 102 centers) and >= 40 SE (high volume activity, 37 centers). Dipyridamole was used in 139 centers (77.6%); exercise in 120 centers (67.0%); dobutamine in 153 centers (85.4%); pacing in 37 centers (21.1%); and adenosine in 7 centers (4.0%). We found a significant difference between the stressors used and volume of activity of the centers, with a progressive increase in the prevalence of number of stressors from low to high volume activity (P = 0.033). The traditional evaluation of regional wall motion of the left ventricle was performed in all centers, with combined assessment of coronary flow velocity reserve (CFVR) in 90 centers (50.3%): there was a significant difference in the centers with different volume of SE activity: the incidence of analysis of CFVR was significantly higher in high volume centers compared to low - moderate - volume (32.5%, 41.0% and 73.0%, respectively, P < 0.001). The lung ultrasound (LUS) was assessed in 67 centers (37.4%). Furthermore for LUS, we found a significant difference in the centers with different volume of SE activity: significantly higher in high volume centers compared to low - moderate - volume (25.0%, 35.3% and 56.8%, respectively, P < 0.001). Conclusions: This nationwide survey demonstrated that SE was significantly widespread and practiced throughout Italy. In addition to the traditional indication to coronary artery disease based on regional wall motion analysis, other indications are emerging with an increase in the use of LUS and CFVR, especially in high-volume centers