Medical Area
Department of Medicine
Division of Cardiology Carlo CIPOLLA, MD Director
STAFF Senior Deputy Directors: Maurizio Civelli, MD, Giuseppina Lamantia, MD Deputy Directors: Nicola Colombo, MD, Carlo Meroni, MD Senior Assistants: Alessandro Colombo, MD, Giulia Bacchiani, MD Consultant: Cesare Fiorentini, MD, PhD, University of Milan Fellows: Marta Beggiato, Student Medical School, Riccardo Ficco, Student Medical School, Damiano Pongan, Student Medical School Secretary: Fabio Farina Chief Nurse: Arnaldo Zanelotti Data Manager: Ines Tedeschi OTA: Maria Iannitelli Consultants Smoke Cessation Center: Elena Calvi, MD, Psychologist and Pneumologist; Mrs Natalia Pozzi (Fondazione Umberto Veronesi). CARDIOLOGY Director: Daniela Cardinale, MD, PhD, FESC UNIT Fellow Research Assistant: Lisa Guzzi, Doctorate Foreign Languages
Activities 2011.
Cardiology Division’s activities relate to pre and postoperative cardiologic assessment, respiratory function evaluations, general internal medicine consultations, antismoking activities, extensive clinical monitoring and therapy for internal wards and treatment of emergencies. The specific cardiological activity is strongly oriented to the diagnosis and therapy of cardiac disorders in order to detect and treat co morbidities (46% of EIO cancer patients present concomitant cardiovascular diseases) as well as potential or evident consequences of oncologic treatments (cardiotoxicity). Cardiological evaluations, either clinical or instrumental, are present in over 140 scientific research protocols of the Institute. In 2011 the Division performed: a) cardiological assessment of 15.413 internal and outpatients; b) complete echocardiographic and Doppler colour evaluations in 3767 patients; c) respiratory physiopathology diagnostic and assistance (2239); d) 343 antismoking activities for patients and employees; e) clinical consultations and/or echocardiographic examinations for over 1700 patients enrolled in different Division’s scientific protocols: f) Overall 54000 written official reports. During 2011 over 1000 patients were treated in urgency/ emergency setting, 79% internal cases, 21% outpatients; the increasing number of treated cases will be one of the elements that will lead the Institute to the opportunity of opening in 2012 a new and original structure: a 24/24 hours ambulatory ward for continued oncologic assistance.
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IEO — Scientific Report 2011 — Ongoing research 2012
Cardiology Specific Activities Diagnosis of cardiotoxicity Cardiotoxicity is a common complication of chemotherapy (CT). The clinical manifestation of cardiotoxicity can range, in its more typical form chronic cardiotoxicity - from transient asymptomatic left ventricular dysfunction to cardiac death. This is a growing problem in the setting of clinical oncology due to the tendency in using progressively higher doses of anthracyclines, as well as combined treatments with synergistic cardiac toxic properties. Also newer compounds, as thyroxin kinesis inhibitors, antiangiogenic
drug, and monoclonal antibodies potentially deserve cardiotoxic implications. The clinical implications of cardiotoxicity are particularly relevant in those cancer patients in which onset of cardiac dysfunction, even asymptomatic, seriously limits their therapeutic opportunities and negatively impacts on clinical outcome. At present oncologic guide-lines recommend regular cardiac function assessment (generally by echocardiography or MUGA scan) to detect CT-induced cardiac damage in an early phase. Cardiologic surveillance is required during CT to allow administration of the highest dose without inducing cardiac injury, and after completion of CT to identify
IEO — Scientific Report 2011 — Ongoing research 2012
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