Thesis defence “A systematic review and meta-analysis on the association between exposure to environmental pollutants and left ventricular dysfunction” for Horizon 2020 research project ALTERNATIVE

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On January 12, 2023, a post-doctoral research fellow working for Project ALTERNATIVE, Dr Gabriele Donzelli presented her thesis work entitled “Systematic review and meta-analysis on the association between exposure to environmental pollutants and left ventricular dysfunction at the 13th edition of the II level Master in Epidemiology.

This Master is a structured study program in Modern Epidemiology aimed at imparting knowledge and skills appropriate to design and conduct epidemiologic studies as well as analyse, interpret, model, and report on data from public health, health care, biomedical, clinical and population-based studies.

The thesis work is part of Work Package 3 on Epidemiology and toxicology of the ALTERNATIVE project, which aims to collect existing evidence and suggest compounds or mixtures of potential interest for testing toxicity in the experimental laboratory.

With Task 3.1: Epidemiological evidence – the objective was to gather evidence on the association of left ventricular function markers, before the development of heart failure, when exposed to environmental chemicals. The work evolved through the multidiscipline collaborations, including epidemiology, physiology, cardiology, and statistics.

Dr Nunzia Linzalone and Dr Maria Aurora Morales, researchers at the Institute of Clinical Physiology of the National Research Council (CNR-IFC) of Pisa, guided the work that resulted in the draft of the thesis. In addition, Dr Francesco Sera, a researcher at the Department of Statistics from the University of Florence, supported the experiment of the meta-analysis and helped in interpreting the findings.

Dr Roberto Calisti and Dr Emilio Gianicolo nominated as discussants of the thesis, provided positive feedback on the work presented, specifically on the “mode of action” where different chemicals were included. They suggested to review the chemicals with an eye to understand the limitations of the meta-analyses, which is mainly due to the small number of studies and the high heterogeneity in the design and methods of the investigations. Integrating these results with the toxicological ones is the next step to elucidate the relationship between chemical exposure and cardiotoxicity.


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