Programma MD-PhD della Scuola di Medicina

Implications of Atrial Fibrillation on systemic and cerebral blood flow dynamics; evaluation of the invasive methods (catheter ablation) and their effects on both patients and operators (radiation exposure). Instructor prof. Matteo Anselmino

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Programma

Atrial Fibrillation (AF), the most common cardiac tachyarrhythmia, has become one of the most relevant public health problems. This growing epidemiological burden warrants answers to currently pending questions regarding AF. In particular, it has emerged that AF is associated with an increased risk of dementia and cognitive impairment, even in the absence of clinical strokes. Several mechanisms have been proposed to clarify this association, such as silent cerebral ischemia, microbleeds, altered cerebral blood flow dynamics and pro-inflammatory conditions. Among these possible contributors, the hypothesis of an altered cerebral blood flow dynamics during AF has been the least investigated, with scant and dated evidences. Given these premises, the project will focus, based on a joint collaboration with the “Politecnico di Torino” (Prof. Ridolfi), on a large-scale computational investigation of systemic and cerebral hemodynamics. AF conditions will be simulated in different cerebrovascular validated models (zero-dimensional and one-dimensional), comparing the outputs with corresponding sinus rhythm (SR) simulations, in order to assess the direct impact of the arrhythmia on the circulatory dynamics. On top of the mathematical approach, the project includes design of clinical studies to investigate in vivo potential clinical consequences by innovative scientific methods (e.g. Near Infrared Spectroscopy, cerebral Magnetic Resonance).

More specifically concerning the invasive methods to suppress AF, the project will focus on evaluation of current and future invasive tools, verifying measurable in vivo tissue effects. For cryothermal energy, for example, an efficient an largely used energy source to create ablation lesions in the heart, little is known about extension and progression over time of lesions performed to achieve pulmonary veins isolation. In this perspective, cardiac Magnetic Resonance, an imaging technique able to detect both the acute edema and the subsequent scar induced by ablation, deepens our knowledge on tissue lesions and the consequent effects on clincal progression of the arrhthymia. Eventually, since fluoroscopy is the pivotal tool used in interventional Cardiology, as for cardiac radiofrequency ablations, the project will also assess radation exposure risks to the operators. In fact, long-term cancer and non-cancer consequences are all known consequences of X-ray professional exposure. The effects on the reproductive system after exposure to repetitive low-dose radiations related to interventional Cardiology is, instead, surely less known and matter of concern. The project will focus on gonads (e.g. spermatogenesis) and the hypothalamic-pituitary-gonadal axis in exposed health workers.

Attività di supporto

Co-workers: Federico Ferraris, Massimo Magnano, Andrea Saglietto

Note

Progetto del corso: Imaging avanzato che sostituisce procedure diagnostiche invasive.

Scientific qualification of the PI: Entrez-PubMed Link to publications of Prof. Anselmino:  

Laboratory/Clinical Division, Department, Address, contacts

Division of Cardiology, "Città della Salute e della Scienza di Torino" Hospital, Department of Medical Sciences, University of Turin, Italy

tel. 011.6336763 – 5572 - 6565

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