Giovanni Russo

Pulmonary Vein Vestibule Ablation for the Control of Atrial Fibrillation in Patients with Impaired Left Ventricular Function

Introduction: Congestive heart failure (CHF) and atrial fibrillation (AF) are frequently linked, and when associated produce additive deleterious effects. In this prospective study, the effects of catheter ablation for AF in patients with impaired left ventricular (LV) function are presented.

Epoxidation of exoxyclic glycals: A new access to glycosides of ketosugars

Abstract A novel approach to the synthesis of glycosides and disaccharides of ketofuranoses and ketopyranoses by epoxidation of exocyclic glycals and reaction of the intermediate epoxides with different alcohols is described.

Capsular polysaccharide of Streptococcus pneumoniae type 19F: synthesis of the repeating unit

A new and more versatile synthesis of beta-D-ManpNAc-(1-->4)-alpha-D-Glcp-(1-->2)-alpha-L-Rhap, the trisaccharide repeating unit of the Streptococcus pneumoniae type 19F capsular polysaccharide, is described. The present approach allows a simple access to different fragments containing the trisaccharide and the conjugation of the product(s) to a protein through the selective manipulation of the anomeric position at the reducing end and of the HO-4 function at the nonreducing end. The synthetic scheme shows an efficient application of the sulfoxide method for the stereoselective and high yielding formation of the glycosidic linkages.

Synthesis of C-glycosyl compounds by the wittig iodocyclization procedure. Differences from mercuriocyclization

Abstract Various sugars were C -glycosylated by treatment with methylenetriphenyl-phosphorane and subsequent iodocyclization of the resulting hept- and hex-enitols. In all cases, a C glycofuranosyl compound was obtained, except for 3,4,5,7-tetra- O -benzyl-1,2-dideoxy- d - manno -hept-1-enitol which yielded a C -pyranosyl compound. High stereoselectoin, with formation of the 1,2- cis adduct as major product, was observed when an asymmetric center was present in the position adjacent to the double bond.

Efficacy of Low Interatrial Septum and Right Atrial Appendage Pacing for Prevention of Permanent Atrial Fibrillation in Patients with Sinus Node Disease: Results from the Electrophysiology-Guided Pacing Site Selection (EPASS) Study

Background— The role of pacing sites and atrial electrophysiology on the progression of atrial fibrillation (AF) to the permanent form in patients with sinus node dysfunction (SND) has never been investigated. The aim of the study was to investigate the relationship between atrial electrophysiology and the efficacy of atrial pacing at the low interatrial septum (IAS) or at the right atrial appendage (RAA) to prevent persistent/permanent AF in patients with SND. Methods and Results— The Electrophysiology-Guided Pacing Site Selection (EPASS) Study was a prospective, controlled, randomized study. Atrial refractoriness, basal and incremental conduction times from the RAA to the coronary sinus ostium were measured before implantation, and the difference (&Dgr;CTos) was calculated. Patients with &Dgr;CTos ≥50 ms (study group) and those with &Dgr;CTos <50 ms (control group) were randomly assigned to RAA or IAS with algorithms for continuous atrial stimulation “on.” The primary end point was time to development of permanent or persistent AF within a 2-year follow-up in the study group, IAS versus RAA. Data were analyzed by intention to treat. One hundred two patients (77±7 years, 44 mol/L) were enrolled, 69 (68%) in the study group and 33 (32%) in the control group. Of these, 97 ended the study, respectively, randomly assigned: 29 IAS versus 36 RAA and 18 IAS versus 14 RAA. After a mean follow-up of 15±7 (median, 17) months, 11 (16.6%) patients in the study group met the primary end point: 2 IAS versus 9 RAA (log rank=3.93, P=0.047). Conclusions— In patients with SND and intra-atrial conduction delay, low IAS pacing was superior to RAA pacing in preventing progression to persistent or permanent AF. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00239226.

A new nonfluoroscopic navigation system to guide pulmonary vein isolation

Different techniques have been proposed to treat atrial fibrillation (AF) by catheter ablation. This study compares a new three‐dimensional (3D) nonfluoroscopic navigation system with conventional fluoroscopy to guide pulmonary vein (PV) isolation. A total of 60 consecutive patients with paroxysmal or persistent AF were randomly assigned to 3D‐guided ablation (group 1, n = 30), versus conventional fluoroscopy guidance ablation (group 2, n = 30). Complete PV isolation was achieved in both groups. The mean duration of fluoroscopy exposure (22 ± 8 vs 56 ± 10 minutes), and radiofrequency delivery (5 ± 1 vs 10 ± 3 minutes) were significantly shorter in group 1 than in group 2, P < 0.05 for both comparisons). The mean procedural time in group 1 was longer (225 ± 15 minutes) than in group 2 (156 ± 10 minutes, P < 0.05) due to the learning curve and time spent to generate the 3D maps. Over a mean follow‐up of 7 ± 2 months, 6 patients (20%) in group 2 had AF recurrences compared to 3 patients (10%) in group 1 (ns). The new nonfluoroscopic 3D system allows a high‐resolution reconstruction of the left atrium and PVs. It significantly reduces the mean radiofrequency delivery and fluoroscopy times as opposed to ablation performed under fluoroscopy guidance.

C-glycosides through the Wittig-cyclization procedure: observations on the influence of the nature of the substrate

Abstract The Moffatt C-glycosidation procedure was examined on different pyranoses; in glycopyranoses competitive elimination was observed in the Wittig reaction; all the other glycopyranoses investigated gave the Wittig product without elimination.

Synthesis of disaccharidic sub-units of a new series of heparin related oligosaccharides

The chemical synthesis of disaccharides1 and2, useful building-blocks for the preparation of a new series of heparin related oligosaccharides containing the unusual sequence (GlcN-IdoA)n, is described. In addition, the orthogonality of the protective groups would allow access to a wide array of differently sulfated oligosaccharides. As the simplest members of this new class of oligomer, the synthesis of sulfated disaccharides3 and4 fully deprotected is reported. Compounds1 and2 have been synthesised as building blocks for a new family of heparin related oligosaccharides containing the unusual sequence (GlcN-IdoA)n. In addition, the orthogonality of the protective groups would allow access to a wide array of differently sulfated oligosaccharides. Download full-size image

Selective lipase-catalyzed acylation of 4,6-O-benzylidene-D-glucopyranosides to synthetically useful esters

Abstract Simple and regioselective lipase-catalyzed acylation of compounds 1 and 4 with synthetically useful esters such as benzoates, chloroacetates, pivaloates and levulinates is described.

Synthesis of building blocks of human milk oligosaccharides. Fucosylated derivatives of the lacto- and neolacto-series

The synthesis of protected fucosylated derivatives of a Galbeta(1-->3)GlcNAc and of lactosamine Galbeta(1-->4)GlcNAc building blocks contained in human milk oligosaccharides is described. Both chemical and enzymatic methods have been exploited for selective protection of the disaccharide. Fucosylation of the appropriate derivatives allowed an easy and relatively short access to different products from common precursors.