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Albani S, Stolfo D, Venkateshvaran A, Chubuchny V, De Scordilli M, Biondi F, De Luca A, Pinamonti B, Lo Giudice F, Pasanisi EM, Petersen C, Airò E, Bauleo C, Ciardetti M, Coaceani M, Formnichi B, Spiesshoefer J, Savarese G, Lund LH, Emdin M, Sinagra G, Manouras A, Giannoni A. 297 Echocardiographic biventricular coupling index to predict pre-capillary pulmonary hypertension. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab132.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aims
Pulmonary hypertension (PH) affects millions of people worldwide. Right heart catheterization (RHC) is the gold standard to correctly classify the subtype of PH. Biventricular coupling index (BCI) is a new echocardiographic index defined as the ratio between non-invasive right ventricular stroke work index (RVSWI) and E/E′ ratio. Due to his comprehensive functional characterization of the right heart physiology, we hypothesized it might correctly identify pre-capillary PH.
Methods and results
BCI was derived in a cohort of 334 patients from the University Hospital of Trieste (Italy) and Karolinska University Hospital (Sweden) who underwent transthoracic echocardiography and RHC for all indications (<6 h between the exams). The accuracy of BCI to identify pre-capillary PH was high in the derivation cohort (AUC: 0.82, P < 0.001, CI: 0.78–0.88). Subsequently BCI was tested in a large validation cohort of 1349 patients with available transthoracic echocardiography and RHC from the Fondazione Toscana G. Monasterio of Pisa (Italy). Among patients with PH, BCI showed a high accuracy to correctly identify pre-capillary PH (AUC = 0.91, 95% CI: 0.89–0.93, P < 0.001), with an optimal cut-off of 1.9 providing a sensitivity of 82% and a specificity of 89%, PPV 77%, and a NPV 92%. BCI outperformed previous indexes, such as the D’Alto score (Z coefficient 3.56, difference between areas 0.05 95% CI: 0.02–0.07, P < 0.001) and the echocardiographic Pulmonary to Left Atrial Ratio (ePLAR) index (Z coefficient 2.88, difference between areas 0.02 95% CI: 0.01–0.04, P < 0.004).
Conclusions
BCI is a new non-invasive index based on standard echocardiographic parameters that allows, with high accuracy, the identification of patients with pre-capillary PH, outperforming previously proposed indexes. Routine use of BCI index could be implemented in the screening work-up of pre-capillary PH.
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Affiliation(s)
- Stefano Albani
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
- Division of Cardiology, Ospedale Umberto Parini, Aosta, Italy
| | - Davide Stolfo
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Marco De Scordilli
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Federico Biondi
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Antonio De Luca
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Bruno Pinamonti
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Francesco Lo Giudice
- Pulmonary Hypertension National Service, Hammersmith Hospital Imperial College NHS Trust, London, UK
| | | | | | - Edoardo Airò
- Fondazione CNR—Regione Toscana G. Monasterio, Pisa, Italy
| | | | | | | | | | - Jens Spiesshoefer
- Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Pneumology and Intensive Care Medicine, University Hospital of Aachen, Aachen, Germany
| | | | - Lars H Lund
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Michele Emdin
- Fondazione CNR—Regione Toscana G. Monasterio, Pisa, Italy
- Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | | | - Alberto Giannoni
- Fondazione CNR—Regione Toscana G. Monasterio, Pisa, Italy
- Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
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2
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Restivo L, De Luca A, Pinamonti B, Grilli G, Bussani R, Cominotto F, Crisafulli C, Dore F, Sinagra G, Pappalardo A. A case of primary cardiac sarcoma with an acute presentation: The role of multimodality imaging. Clin Case Rep 2021; 9:e04219. [PMID: 34178334 PMCID: PMC8212016 DOI: 10.1002/ccr3.4219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 11/12/2022] Open
Abstract
The case highlights the value of contrast echocardiography in raising clinical suspicion of malignancy, allowing a diagnostic work-up and the treatment of the primitive heart tumors.
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Affiliation(s)
- Luca Restivo
- Division of CardiologyCardiothoracovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Antonio De Luca
- Division of CardiologyCardiothoracovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Bruno Pinamonti
- Division of CardiologyCardiothoracovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Giulia Grilli
- Division of CardiologyCardiothoracovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Rossana Bussani
- Pathology DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Franco Cominotto
- Emergency Medicine DepartmentAzienda Sanitaria Universitaria Giuliano‐IsontinaTriesteItaly
| | - Carmelo Crisafulli
- Nuclear Medicine DepartmentAzienda Sanitaria Universitaria Giuliano‐IsontinaTriesteItaly
| | - Franca Dore
- Nuclear Medicine DepartmentAzienda Sanitaria Universitaria Giuliano‐IsontinaTriesteItaly
| | - Gianfranco Sinagra
- Division of CardiologyCardiothoracovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐Isontina and University of TriesteTriesteItaly
| | - Aniello Pappalardo
- Division of Cardiac SurgeryCardiovascular DepartmentAzienda Sanitaria Universitaria Giuliano‐IsontinaTriesteItaly
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3
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Bardelli M, Cavressi M, Furlanis G, Pinamonti B, Leone M, Albani S, Korcova R, Fabris B, Sinagra G. Relationship between aortic valve stenosis and the hemodynamic pattern in the renal circulation, and restoration of the flow wave profile after correction of the valvular defect. J Int Med Res 2021; 48:300060520956907. [PMID: 32967509 PMCID: PMC7521054 DOI: 10.1177/0300060520956907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The index of maximal systolic acceleration ([AImax]: maximal systolic acceleration of the Doppler waveform divided by peak systolic velocity) shows diagnostic accuracy in screening of renal artery stenosis. This study aimed to determine whether an upstream factor of resistance, such as aortic valve stenosis (AVS), can affect Doppler parameters detected in the peripheral arteries. METHODS In this prospective study, we measured the AImax in non-stenotic renal interlobar arteries of 62 patients with AVS. Patients were divided into three groups on the basis of severity of valvulopathy as follows: mild-to-moderate AVS (M-AVS; n = 24), intermediate AVS (I-AVS; n = 15), and severe AVS (S-AVS; n = 23) based on Nishimura's criteria. RESULTS The AImax in the renal parenchymal arteries was significantly lower in the S-AVS group (8.9 ± 3.6 s-1) than in the M-AVS (15.3 ± 3.8 s-1) and I-AVS groups (16.7 ± 5.2 s-1). The AImax was positively correlated with the aortic valve area and inversely correlated with the tranvalvular aortic pressure gradient. After aortic valve replacement, the AImax significantly increased from 10.7 ± 4.0 s-1 at baseline to 19.3 ± 4.4 s-1. CONCLUSIONS Proximal resistance can lead to diagnostic bias of Doppler parameters that are applied in the diagnosis of peripheral vasculopathies, particularly in renal artery stenosis.
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Affiliation(s)
- Moreno Bardelli
- Dipartimento di Scienze Mediche Chirurgiche e della Salute - Università di Trieste, Trieste, Italy.,Dipartimento Assistenziale Integrato di Medicina Interna e Nefrologia - Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Monica Cavressi
- Dipartimento di Scienze Mediche Chirurgiche e della Salute - Università di Trieste, Trieste, Italy
| | - Giulia Furlanis
- Dipartimento di Scienze Mediche Chirurgiche e della Salute - Università di Trieste, Trieste, Italy
| | - Bruno Pinamonti
- Dipartimento Assistenziale Integrato Cardiotoracovascolare - Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Mariafontana Leone
- Dipartimento di Scienze Mediche Chirurgiche e della Salute - Università di Trieste, Trieste, Italy
| | - Stefano Albani
- Dipartimento di Scienze Mediche Chirurgiche e della Salute - Università di Trieste, Trieste, Italy
| | - Renata Korcova
- Dipartimento Assistenziale Integrato Cardiotoracovascolare - Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Bruno Fabris
- Dipartimento di Scienze Mediche Chirurgiche e della Salute - Università di Trieste, Trieste, Italy.,Dipartimento Assistenziale Integrato di Medicina Interna e Nefrologia - Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Gianfranco Sinagra
- Dipartimento di Scienze Mediche Chirurgiche e della Salute - Università di Trieste, Trieste, Italy.,Dipartimento Assistenziale Integrato Cardiotoracovascolare - Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
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Albani S, Stolfo D, Venkateshvaran A, Chubuchny V, Biondi F, De Luca A, De Scordilli M, Pinamonti B, Giudice FL, Pasanisi E, Petersen C, Airo’ E, Bauleo C, Lund LH, Emdin M, Manouras A, Sinagra G, Giannoni A. ECHOCARDIOGRAPHIC BIVENTRICULAR COUPLING INDEX TO PREDICT PRE-CAPILLARY PULMONARY HYPERTENSION. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02736-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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5
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Albani S, Rocotti A, Berchialla P, Bongioanni S, Mabritto B, Luceri S, Parrini I, Tommasello A, Pizzuti A, Bianchi F, Buongiorno A, De Luca A, Grilli G, Pinamonti B, Merlo M, Zecchin M, Grossi S, Sinagra G, Musumeci G. PROGNOSTIC IMPACT OF TRANS-CATHETER ATRIAL FIBRILLATION ABLATION ON HYPERTROPHIC CARDIOMYOPATHY OUTCOME: A MULTICENTER RETROSPECTIVE LONG-TERM FOLLOW UP STUDY. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01699-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Caiffa T, Castrichini M, Biagini E, De Luca A, Compagnone M, Berardini A, Merlo M, Fabris E, Vitrella G, Pinamonti B, Korcova R, Barbati G, Saia F, Stolfo D, Sinagra G. Impact on clinical outcomes of right ventricular response to percutaneous correction of secondary mitral regurgitation. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background. Right ventricular function (RVF) is a strong determinant of prognosis in patients with reduced ejection fraction heart failure (HFrEF) and secondary mitral regurgitation (SMR). Percutaneous mitral valve repair (pMVR) can promote the recovery of RVF.
Purpose. We sought to characterize the RV response to pMVR in HFrEF with SMR and to assess the influence of improved RVF after pMVR in this specific setting of patients.
Methods. We included all the patients with HFrEF and SMR≥3+ successfully treated with pMVR between April 2012 and January 2020 in two tertiary care centers for HF. Improved RVF was defined as DRVFAC≥5% at early follow-up (median time 4 months). The primary endpoint was a composite of death/heart transplant (D/HT).
Results. In total, 110 patients were included. Mean age was 67 ± 12 years, mean LVEF was 31 ± 8% and mean RVFAC was 31 ± 10%. DRVFAC≥5% occurred in 54 (49%) patients and was independent from the measures of left ventricle recovery. During a median follow-up of 36 months (IQR 19-52), 40 patients (36%) died or were transplanted. After adjustment for other significant covariates, DRVFAC≥5% was significantly associated with lower risk of D/HT (HR 0.49, 95% CI 0.24 – 0.98 p < 0.042) along with M2+ at follow-up (HR 0.36; 95% CI 0.17-0.74 p 0.005).
Conclusions. In patients with HFrEF and SMR, the improvement of RVF is frequent after pMVR and is associated with better long-term survival free from HT.
Abstract Figure.
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Affiliation(s)
- T Caiffa
- UNITED HOSPITALS OF TRIESTE University hospital, Trieste, Italy
| | - M Castrichini
- UNITED HOSPITALS OF TRIESTE University hospital, Trieste, Italy
| | - E Biagini
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - A De Luca
- UNITED HOSPITALS OF TRIESTE University hospital, Trieste, Italy
| | - M Compagnone
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - A Berardini
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - M Merlo
- UNITED HOSPITALS OF TRIESTE University hospital, Trieste, Italy
| | - E Fabris
- UNITED HOSPITALS OF TRIESTE University hospital, Trieste, Italy
| | - G Vitrella
- UNITED HOSPITALS OF TRIESTE University hospital, Trieste, Italy
| | - B Pinamonti
- UNITED HOSPITALS OF TRIESTE University hospital, Trieste, Italy
| | - R Korcova
- UNITED HOSPITALS OF TRIESTE University hospital, Trieste, Italy
| | - G Barbati
- University of Trieste, Trieste, Italy
| | - F Saia
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - D Stolfo
- UNITED HOSPITALS OF TRIESTE University hospital, Trieste, Italy
| | - G Sinagra
- UNITED HOSPITALS OF TRIESTE University hospital, Trieste, Italy
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7
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Merlo M, Cappelletto C, De Angelis G, Porcari A, Caiffa T, Lardieri G, Pagnan L, Severini GM, Dal Ferro M, Stolfo D, Vitrella G, De Luca A, Korkova R, Massa L, Tavcˇar I, Aleksova A, Barbati G, Zanchi C, Ramani F, Di Lenarda A, Perkan A, Mestroni L, Zecchin M, Pinamonti B, Bussani R, Sinagra G. [Diagnostic work-up and clinical management of cardiomyopathies: the operative protocol from the Cardiothoracovascular Department of Trieste, Italy]. G Ital Cardiol (Rome) 2020; 21:935-953. [PMID: 33231213 DOI: 10.1714/3472.34548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cardiomyopathies are primary myocardial disorders, genetically determined, with clinical onset between the third and the fifth decade of life. They represent the main causes of sudden cardiac death and heart failure in the youth. The more common myocardial diseases in clinical practice are dilated cardiomyopathy, arrhythmogenic cardiomyopathy and hypertrophic cardiomyopathy. Next generation sequencing techniques, recently available for genetics researches, together with the diffusion of advanced imaging techniques, permitted in the last years a deeper knowledge of these pathologies. Nevertheless, diagnosis, etiology and several aspects of patients' clinical management remain complex and controversial. This review paper aims to propose some operative flow-charts, derived from scientific evidences and the internal protocol of the Cardiothoracovascular Department of Trieste Hospital, Italian referral Center for cardiomyopathies and heart failure, with more than 30 years of experience in diagnosis and management of patients who suffer from primary myocardial disorders.
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Affiliation(s)
- Marco Merlo
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Chiara Cappelletto
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Giulia De Angelis
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Aldostefano Porcari
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Thomas Caiffa
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Gerardina Lardieri
- Cardiologia, Ospedale di Gorizia e Monfalcone, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste
| | - Lorenzo Pagnan
- S.C. Radiologia Diagnostica ed Interventistica, Dipartimento di Diagnostica per Immagini, Ospedale di Cattinara, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | | | - Matteo Dal Ferro
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste - Centro di Cardiologia Traslazionale, Laboratorio di Cardiologia Molecolare, Ospedale di Cattinara, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste
| | - Davide Stolfo
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Giancarlo Vitrella
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Antonio De Luca
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Renata Korkova
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Laura Massa
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Irena Tavcˇar
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Aneta Aleksova
- Centro di Cardiologia Traslazionale, Laboratorio di Cardiologia Molecolare, Ospedale di Cattinara, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste
| | - Giulia Barbati
- Unità di Biostatistica, Dipartimento di Scienze Mediche, Chirurgiche e della Salute, Università degli Studi di Trieste
| | - Cristiana Zanchi
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Federica Ramani
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Andrea Di Lenarda
- Centro Cardiovascolare, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste
| | - Andrea Perkan
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Luisa Mestroni
- Cardiovascular Institute and Adult Medical Genetics Program, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Massimo Zecchin
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Bruno Pinamonti
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
| | - Rossana Bussani
- S.S. Patologia Cardiovascolare, Anatomia e Istologia Patologica, Ospedale di Cattinara, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste
| | - Gianfranco Sinagra
- S.C. Cardiologia, Dipartimento Cardiotoracovascolare, Centro per la Diagnosi e Cura delle Cardiomiopatie, Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste
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Sinagra G, Cappelletto C, DE Luca A, Romani S, Paldino A, Korcova R, Ferro MD, Vitrella G, Pagnan L, Pinamonti B. Focus on arrhythmogenic right ventricular cardiomyopathy. Eur Heart J Suppl 2020; 22:L129-L135. [PMID: 33239987 PMCID: PMC7673615 DOI: 10.1093/eurheartj/suaa152] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Arrhythmogenic right ventricular cardiomyopathy is a myocardial disease generally caused by desmosomal mutations and characterized by progressive replacement of cardiomyocites with fibro-adipose tissue. In the classic form of the disease right ventricle is predominantly affected. However, biventricular and left-dominant variants have been recently recognized, leading to the new nosological definition of arrhythmogenic cardiomyopathy. The condition affects mostly young adults and athletes and is clinically characterized by ventricular arrhythmias, heart failure and sudden cardiac death. The diagnosis is based on clinical-instrumental criteria, including family history, morpho-functional and electrocardiographic abnormalities, ventricular arrhythmias and genetic defects (Task Force Criteria, 2010). The main goal in the management of patients is the prevention of sudden cardiac death, where implantable cardioverter-defibrillator is the only effective therapeutic strategy. Many arrhythmic risk factors have been described. Recently, an on-line calculator has been proposed, but it needs further validation.
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Affiliation(s)
- Gianfranco Sinagra
- Dipartimento Cardiotoracovascolare e Unità Clinico Operativa di Radiologia Diagnostica ed Interventistica; Azienda Sanitaria Universitaria Giuliano Isontina, Università degli Studi di Trieste
| | - Chiara Cappelletto
- Dipartimento Cardiotoracovascolare e Unità Clinico Operativa di Radiologia Diagnostica ed Interventistica; Azienda Sanitaria Universitaria Giuliano Isontina, Università degli Studi di Trieste
| | - Antonio DE Luca
- Dipartimento Cardiotoracovascolare e Unità Clinico Operativa di Radiologia Diagnostica ed Interventistica; Azienda Sanitaria Universitaria Giuliano Isontina, Università degli Studi di Trieste
| | - Simona Romani
- Dipartimento Cardiotoracovascolare e Unità Clinico Operativa di Radiologia Diagnostica ed Interventistica; Azienda Sanitaria Universitaria Giuliano Isontina, Università degli Studi di Trieste
| | - Alessia Paldino
- Dipartimento Cardiotoracovascolare e Unità Clinico Operativa di Radiologia Diagnostica ed Interventistica; Azienda Sanitaria Universitaria Giuliano Isontina, Università degli Studi di Trieste
| | - Renata Korcova
- Dipartimento Cardiotoracovascolare e Unità Clinico Operativa di Radiologia Diagnostica ed Interventistica; Azienda Sanitaria Universitaria Giuliano Isontina, Università degli Studi di Trieste
| | - Matteo Dal Ferro
- Dipartimento Cardiotoracovascolare e Unità Clinico Operativa di Radiologia Diagnostica ed Interventistica; Azienda Sanitaria Universitaria Giuliano Isontina, Università degli Studi di Trieste
| | - Giancarlo Vitrella
- Dipartimento Cardiotoracovascolare e Unità Clinico Operativa di Radiologia Diagnostica ed Interventistica; Azienda Sanitaria Universitaria Giuliano Isontina, Università degli Studi di Trieste
| | - Lorenzo Pagnan
- Dipartimento Cardiotoracovascolare e Unità Clinico Operativa di Radiologia Diagnostica ed Interventistica; Azienda Sanitaria Universitaria Giuliano Isontina, Università degli Studi di Trieste
| | - Bruno Pinamonti
- Dipartimento Cardiotoracovascolare e Unità Clinico Operativa di Radiologia Diagnostica ed Interventistica; Azienda Sanitaria Universitaria Giuliano Isontina, Università degli Studi di Trieste
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Paldino A, De Angelis G, Dal Ferro M, Faganello G, Porcari A, Barbati G, Korcova R, Gentile P, Artico J, Cannatà A, Gigli M, Pinamonti B, Merlo M, Sinagra G. High prevalence of subtle systolic and diastolic dysfunction in genotype-positive phenotype-negative relatives of dilated cardiomyopathy patients. Int J Cardiol 2020; 324:108-114. [PMID: 32949639 DOI: 10.1016/j.ijcard.2020.09.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/13/2020] [Accepted: 09/10/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND The early diagnosis of genetically determined dilated cardiomyopathy (DCM) could improve the prognosis in mutation carriers. Left ventricular global longitudinal strain (LV GLS) and peak left atrial longitudinal strain (PALS) are promising techniques for the detection of subtle systolic and diastolic dysfunction. We sought to evaluate the prevalence of subtle systolic and diastolic dysfunction by LV GLS and PALS in a cohort of genotype-positive phenotype-negative (GPFN) DCM relatives. METHODS AND RESULTS In this retrospective study, we analyzed echocardiograms of forty-one GPFN relatives of DCM patients. They were compared with age and sex matched healthy individuals (control group). Reduced LV GLS and PALS were defined as >18% and <23.1%, respectively. GPFN relatives (37 ± 14 years, 48.8% male) and controls were similar according to standard echocardiographic measurements. Conversely, LV GLS was -18.8 ± 2.7% in the GPFN group vs. -24.0 ± 1.8% in the control group (p < 0.001). Twenty subjects (48.8%) in the GPFN group and no subjects in the control group had a reduced LV GLS. PALS was 29.2 ± 6.7% in the GPFN group vs. 40.8 ± 8.5% in the control group (p < 0.001). Seven subjects (18.4%) in the GPFN group and one (2%) in the control group had a reduced PALS. A cohort of 17 genotype-negative phenotype-negative relatives showed higher values of LV GLS compared to GPFN. CONCLUSIONS Despite standard echocardiographic parameters are within the normal range, LV GLS and PALS are lower in GPFN relatives of DCM patients when compared to healthy individuals, suggesting a consistent proportion of subtle systolic and diastolic dysfunction in this population.
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Affiliation(s)
- Alessia Paldino
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Giulia De Angelis
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Matteo Dal Ferro
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Giorgio Faganello
- Cardiovascular Center, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Aldostefano Porcari
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Giulia Barbati
- Biostatistics Unit, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Renata Korcova
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Piero Gentile
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Jessica Artico
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Antonio Cannatà
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Marta Gigli
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Bruno Pinamonti
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Marco Merlo
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.
| | - Gianfranco Sinagra
- Cardiothoracic Department, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
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10
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Merlo M, Cannatà A, Pio Loco C, Stolfo D, Barbati G, Artico J, Gentile P, De Paris V, Ramani F, Zecchin M, Gigli M, Pinamonti B, Korcova R, Di Lenarda A, Giacca M, Mestroni L, Camici PG, Sinagra G. Contemporary survival trends and aetiological characterization in non‐ischaemic dilated cardiomyopathy. Eur J Heart Fail 2020; 22:1111-1121. [DOI: 10.1002/ejhf.1914] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/23/2020] [Accepted: 05/22/2020] [Indexed: 12/19/2022] Open
Affiliation(s)
- Marco Merlo
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
| | - Antonio Cannatà
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
- Department of Cardiovascular Sciences, Faculty of Life Sciences & Medicine King's College London London UK
| | - Carola Pio Loco
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
| | - Davide Stolfo
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
| | | | - Jessica Artico
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
| | - Piero Gentile
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
| | - Valerio De Paris
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
| | - Federica Ramani
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
| | - Massimo Zecchin
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
| | - Marta Gigli
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
| | - Bruno Pinamonti
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
| | - Renata Korcova
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
| | - Andrea Di Lenarda
- Cardiovascular Centre Azienda Sanitaria Universitaria Integrata of Trieste (ASUITS), University of Trieste Trieste Italy
| | - Mauro Giacca
- Department of Cardiovascular Sciences, Faculty of Life Sciences & Medicine King's College London London UK
| | - Luisa Mestroni
- Cardiovascular Institute and Adult Medical Genetics Program University of Colorado Anschutz Medical Campus Aurora CO USA
| | - Paolo G. Camici
- Vita Salute University and San Raffaele Hospital Milan Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, Centre for Diagnosis and Management of Cardiomyopathies Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), University of Trieste Trieste Italy
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11
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Zacchigna S, Paldino A, Falcão-Pires I, Daskalopoulos EP, Dal Ferro M, Vodret S, Lesizza P, Cannatà A, Miranda-Silva D, Lourenço AP, Pinamonti B, Sinagra G, Weinberger F, Eschenhagen T, Carrier L, Kehat I, Tocchetti CG, Russo M, Ghigo A, Cimino J, Hirsch E, Dawson D, Ciccarelli M, Oliveti M, Linke WA, Cuijpers I, Heymans S, Hamdani N, de Boer M, Duncker DJ, Kuster D, van der Velden J, Beauloye C, Bertrand L, Mayr M, Giacca M, Leuschner F, Backs J, Thum T. Towards standardization of echocardiography for the evaluation of left ventricular function in adult rodents: a position paper of the ESC Working Group on Myocardial Function. Cardiovasc Res 2020; 117:43-59. [PMID: 32365197 DOI: 10.1093/cvr/cvaa110] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 01/28/2020] [Accepted: 04/24/2020] [Indexed: 12/11/2022] Open
Abstract
Echocardiography is a reliable and reproducible method to assess non-invasively cardiac function in clinical and experimental research. Significant progress in the development of echocardiographic equipment and transducers has led to the successful translation of this methodology from humans to rodents, allowing for the scoring of disease severity and progression, testing of new drugs, and monitoring cardiac function in genetically modified or pharmacologically treated animals. However, as yet, there is no standardization in the procedure to acquire echocardiographic measurements in small animals. This position paper focuses on the appropriate acquisition and analysis of echocardiographic parameters in adult mice and rats, and provides reference values, representative images, and videos for the accurate and reproducible quantification of left ventricular function in healthy and pathological conditions.
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Affiliation(s)
- Serena Zacchigna
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina, strada di Fiume 447, 34149 Trieste (TS), Italy.,International Center for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Alessia Paldino
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina, strada di Fiume 447, 34149 Trieste (TS), Italy
| | - Inês Falcão-Pires
- Cardiovascular Research and Development Center, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Evangelos P Daskalopoulos
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Belgium, Brussels
| | - Matteo Dal Ferro
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina, strada di Fiume 447, 34149 Trieste (TS), Italy
| | - Simone Vodret
- International Center for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Pierluigi Lesizza
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina, strada di Fiume 447, 34149 Trieste (TS), Italy
| | - Antonio Cannatà
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina, strada di Fiume 447, 34149 Trieste (TS), Italy
| | - Daniela Miranda-Silva
- Cardiovascular Research and Development Center, Faculty of Medicine, University of Porto, Porto, Portugal
| | - André P Lourenço
- Cardiovascular Research and Development Center, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Bruno Pinamonti
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina, strada di Fiume 447, 34149 Trieste (TS), Italy
| | - Gianfranco Sinagra
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina, strada di Fiume 447, 34149 Trieste (TS), Italy
| | - Florian Weinberger
- Institute of Experimental Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Germany
| | - Thomas Eschenhagen
- Institute of Experimental Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Germany
| | - Lucie Carrier
- Institute of Experimental Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Germany
| | - Izhak Kehat
- Department of Physiology, Biophysics and System Biology, The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Carlo G Tocchetti
- Department of Translational Medical Sciences, Federico II University, Naples, Italy.,Interdepartmental Center of Clinical and Translational Research (CIRCET), Federico II University, Naples, Italy
| | - Michele Russo
- Department of Translational Medical Sciences, Federico II University, Naples, Italy.,Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Torino, Torino, Italy
| | - Alessandra Ghigo
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Torino, Torino, Italy
| | - James Cimino
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Torino, Torino, Italy
| | - Emilio Hirsch
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Torino, Torino, Italy
| | - Dana Dawson
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| | | | | | - Wolfgang A Linke
- Institute of Physiology 2, University of Muenster, Muenster, Germany
| | - Ilona Cuijpers
- Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands.,Center of Molecular and Vascular Biology (CMVB), KU Leuven, Leuven, Belgium
| | - Stephane Heymans
- Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands.,Center of Molecular and Vascular Biology (CMVB), KU Leuven, Leuven, Belgium
| | - Nazha Hamdani
- Department of Molecular and Experimental Cardiology, Division Cardiology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.,Institute of Physiology, Ruhr University Bochum, Bochum, Germany
| | - Martine de Boer
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dirk J Duncker
- Division of Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Diederik Kuster
- Department of Physiology, Amsterdam UMC, Vrije Universiteit, Amsterdam Cardiovascular Sciences Institute, Amsterdam, The Netherlands
| | - Jolanda van der Velden
- Department of Physiology, Amsterdam UMC, Vrije Universiteit, Amsterdam Cardiovascular Sciences Institute, Amsterdam, The Netherlands
| | - Christophe Beauloye
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Belgium, Brussels.,Division of Cardiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Luc Bertrand
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Belgium, Brussels
| | - Manuel Mayr
- King's College London, British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine & Sciences, London, UK
| | - Mauro Giacca
- Department of Medicine, Surgery and Health Sciences and Cardiovascular Department, Centre for Translational Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina, strada di Fiume 447, 34149 Trieste (TS), Italy.,International Center for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy.,King's College London, British Heart Foundation Centre of Research Excellence, School of Cardiovascular Medicine & Sciences, London, UK
| | - Florian Leuschner
- Institute of Experimental Cardiology, Department of Cardiology, Angiology & Pulmology, Heidelberg University Hospital, Heidelberg, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg, Germany
| | - Johannes Backs
- Institute of Experimental Cardiology, Department of Cardiology, Angiology & Pulmology, Heidelberg University Hospital, Heidelberg, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Heidelberg, Germany
| | - Thomas Thum
- Institute for Molecular and Translational Therapeutic Strategies (IMTTS), Hannover Medical School, Hannover, Germany.,REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany
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12
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Castrichini M, Albani S, Pinamonti B, Sinagra G. Atrial thrombi or cardiac tumours? The image-challenge of intracardiac masses: a case report. Eur Heart J Case Rep 2020; 4:1-6. [PMID: 32352050 PMCID: PMC7180525 DOI: 10.1093/ehjcr/ytaa026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/11/2019] [Accepted: 01/23/2020] [Indexed: 11/14/2022]
Abstract
BACKGROUND Cardiac masses (CM) encompass a broad set of lesions that can be either neoplastic or non-neoplastic. A stepwise diagnostic strategy through multimodality imaging evaluation is the cornerstone for the appropriate approach. CASE SUMMARY We report the case of an 83-year-old man presenting at the emergency department for acute heart failure showing bilateral atrial masses without unequivocal aetiological aspects at several imaging techniques, emphasizing the critical aspects in the differential diagnosis. DISCUSSION In the complex field of CM, a proper differential diagnosis is very important in order to start the appropriate treatment; however, sometimes it could be challenging despite a multimodality imaging approach, therefore still requiring histologic examination.
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Affiliation(s)
- Matteo Castrichini
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Via Valdoni, 7, 34149, Trieste, Italy
| | - Stefano Albani
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Via Valdoni, 7, 34149, Trieste, Italy
- Corresponding author. Tel: +39 3285999910,
| | - Bruno Pinamonti
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Via Valdoni, 7, 34149, Trieste, Italy
| | - Gianfranco Sinagra
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Via Valdoni, 7, 34149, Trieste, Italy
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13
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Albani S, Pinamonti B, Giovinazzo T, de Scordilli M, Fabris E, Stolfo D, Perkan A, Gregorio C, Barbati G, Geri P, Confalonieri M, Lo Giudice F, Aquaro GD, Pasquero P, Porta M, Sinagra G, Mesin L. Accuracy of right atrial pressure estimation using a multi-parameter approach derived from inferior vena cava semi-automated edge-tracking echocardiography: a pilot study in patients with cardiovascular disorders. Int J Cardiovasc Imaging 2020; 36:1213-1225. [PMID: 32193772 DOI: 10.1007/s10554-020-01814-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 03/07/2020] [Indexed: 01/05/2023]
Abstract
The echocardiographic estimation of right atrial pressure (RAP) is based on the size and inspiratory collapse of the inferior vena cava (IVC). However, this method has proven to have limits of reliability. The aim of this study is to assess feasibility and accuracy of a new semi-automated approach to estimate RAP. Standard acquired echocardiographic images were processed with a semi-automated technique. Indexes related to the collapsibility of the vessel during inspiration (Caval Index, CI) and new indexes of pulsatility, obtained considering only the stimulation due to either respiration (Respiratory Caval Index, RCI) or heartbeats (Cardiac Caval Index, CCI) were derived. Binary Tree Models (BTM) were then developed to estimate either 3 or 5 RAP classes (BTM3 and BTM5) using indexes estimated by the semi-automated technique. These BTMs were compared with two standard estimation (SE) echocardiographic methods, indicated as A and B, distinguishing among 3 and 5 RAP classes, respectively. Direct RAP measurements obtained during a right heart catheterization (RHC) were used as reference. 62 consecutive 'all-comers' patients that had a RHC were enrolled; 13 patients were excluded for technical reasons. Therefore 49 patients were included in this study (mean age 62.2 ± 15.2 years, 75.5% pulmonary hypertension, 34.7% severe left ventricular dysfunction and 51% right ventricular dysfunction). The SE methods showed poor accuracy for RAP estimation (method A: misclassification error, ME = 51%, R2 = 0.22; method B: ME = 69%, R2 = 0.26). Instead, the new semi-automated methods BTM3 and BTM5 have higher accuracy (ME = 14%, R2 = 0.47 and ME = 22%, R2 = 0.61, respectively). In conclusion, a multi-parametric approach using IVC indexes extracted by the semi-automated approach is a promising tool for a more accurate estimation of RAP.
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Affiliation(s)
- Stefano Albani
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy.
| | - Bruno Pinamonti
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Tatiana Giovinazzo
- Mathematical Biology and Physiology, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Marco de Scordilli
- Department of Medical Science, Surgery and Health (DCSMCS), University of Trieste, Trieste, Italy
| | - Enrico Fabris
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Davide Stolfo
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Andrea Perkan
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Caterina Gregorio
- Department of Medical Sciences, Biostatistics Unit, University of Trieste, Trieste, Italy
- Department of Statistical Sciences, University of Padova, Padua, Italy
| | - Giulia Barbati
- Department of Medical Sciences, Biostatistics Unit, University of Trieste, Trieste, Italy
| | - Pietro Geri
- Cardiothoracic Department, Division of Pneumology and Respiratory Intermediate Care Unit, ASUITS, Trieste, Italy
| | - Marco Confalonieri
- Cardiothoracic Department, Division of Pneumology and Respiratory Intermediate Care Unit, ASUITS, Trieste, Italy
| | - Francesco Lo Giudice
- Pulmonary Hypertension National Service, Hammersmith Hospital Imperial College NHS Trust, London, UK
| | | | - Paolo Pasquero
- Department of Internal Medicine, Internal Medicine 1, University of Turin, Turin, Italy
| | - Massimo Porta
- Department of Internal Medicine, Internal Medicine 1, University of Turin, Turin, Italy
| | - Gianfranco Sinagra
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Luca Mesin
- Mathematical Biology and Physiology, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
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14
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Nardi F, Pino PG, Gabrielli D, Colivicchi F, Abrignani MG, Amico AF, Aspromonte N, Benedetto FA, Bertella E, Boccardi LM, Bucciarelli Ducci C, Caldarola P, Campana M, Caso P, Citro R, Costante AM, De Chiara BC, Di Cesare E, Di Fusco SA, Domenicucci S, Enea I, Erba P, Faganello G, Favilli S, Geraci G, Giubbini R, Giunta N, Guido V, Imazio M, Khoury G, La Canna G, Mele D, Moreo AM, Mercuro GG, Musumeci G, Neglia D, Parrini I, Pinamonti B, Pollarolo L, Pontone G, Privitera C, Riccio C, Sinagra G, Urbinati S, Varbella F, Berisso MZ, Zuin G, Di Lenarda A, Gulizia MM. [ANMCO/SICI-GISE/SIC/SIECVI/SIRM Consensus document: Appropriateness of multimodality imaging in cardiovascular disease]. G Ital Cardiol (Rome) 2020; 21:34-88. [PMID: 31960833 DOI: 10.1714/3285.32588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The complexity of cardiovascular diseases has led to an extensive use of technological instruments and the development of multimodality imaging. This extensive use of different cardiovascular imaging tests in the same patient has increased costs and waiting times.The concept of appropriateness has changed over time. Appropriateness criteria address the need for specific cardiovascular imaging tests in well-defined clinical scenarios, and define the kind of cardiovascular imaging that is appropriated for each clinical scenario in different stages of the disease. The concept of appropriateness criteria has replaced the old idea of appropriate use criteria and reflects the increasing effort of the international Scientific Societies to create and review in a critical way the management of diagnostic tests used by clinicians.The aim of this Italian consensus document is to address the use of multimodality imaging in the diagnosis and management of the major cardiovascular clinical scenarios, taking into consideration not only the international guidelines and scientific documents already published, but also the reality of Italian laws as well as the various professional profiles involved in patient management and availability of technological diagnostic instruments.
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Affiliation(s)
- Federico Nardi
- S.C. Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL)
| | - Paolo Giuseppe Pino
- U.O.S.D. Diagnostica Cuore, Dipartimento Cardiovascolare, Ospedale San Camillo, A.O. San Camillo-Forlanini, Roma
| | | | - Furio Colivicchi
- U.O.C. Cardiologia-UTIC, Presidio Ospedaliero San Filippo Neri, ASL Roma 1, Roma
| | | | | | | | | | | | | | | | | | - Marco Campana
- U.O. Cardiologia, Istituto Ospedaliero Fondazione Poliambulanza, Brescia
| | - Pio Caso
- U.O.C. Cardiologia, A.O.R.N. Ospedale dei Colli, P.O. Vincenzo Monaldi, Napoli
| | - Rodolfo Citro
- U.O.C. Cardiologia, Dipartimento Cuore, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Anna Maria Costante
- S.C. Cardiologia, Ospedale Civile SS. Antonio e Biagio e Cesare Arrigo, Alessandria
| | - Benedetta Carla De Chiara
- Cardiologia 4 - Diagnostica e Riabilitativa, ASST Grande Ospedale Metropolitano Niguarda, Milano - Dipartimento di Medicina e Chirurgia, Università degli Studi di Milano-Bicocca, Milano
| | - Ernesto Di Cesare
- Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'Ambiente, Sezione di Medicina Clinica e Molecolare, Università degli Studi, L'Aquila
| | | | | | - Iolanda Enea
- U.O.C. Medicina e Chirurgia d'Urgenza, A.O. Sant'Anna e San Sebastiano, Caserta
| | - Paola Erba
- Centro Regionale di Medicina Nucleare, Azienda Ospedaliero-Universitaria Pisana, Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina, Università degli Studi, Pisa
| | - Giorgio Faganello
- S.C. Cardiovascolare e Medicina dello Sport, Azienda Sanitaria Universitaria Integrata di Trieste
| | | | - Giovanna Geraci
- U.O. Cardiologia, A.O.R. Villa Sofia-Cervello, P.O. Cervello, Palermo
| | - Raffaele Giubbini
- Dipartimento Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Divisione di Medicina Nucleare, Università degli Studi, Brescia
| | - Nicola Giunta
- U.O.C. Cardiologia-UTIC, Azienda di Rilievo Nazionale e Alta Specializzazione, P.O. Civico e Benfratelli, Palermo
| | | | - Massimo Imazio
- Cardiologia, Presidio Molinette, A.O.U. Città della Salute e della Scienza di Torino, Torino
| | | | | | - Donato Mele
- S.S.D. Cardiologia Non Invasiva, Azienda Ospedaliero-Universitaria di Ferrara, Arcispedale Sant'Anna, Ferrara
| | - Antonella Maurizia Moreo
- Cardiologia 4 - Diagnostica e Riabilitativa, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | | | | | - Danilo Neglia
- Cardiologia e Medicina Cardiovascolare, Fondazione Toscana Gabriele Monasterio, Pisa
| | - Iris Parrini
- S.C. Cardiologia, Ospedale Mauriziano Umberto I, Torino
| | - Bruno Pinamonti
- S.C. Cardiologia, DAI Cardiovascolare, Azienda Sanitaria Universitaria Integrata di Trieste, Università degli Studi, Trieste
| | - Luigi Pollarolo
- S.C. Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL)
| | - Gianluca Pontone
- U.O. Risonanza Magnetica, Centro Cardiologico Monzino, IRCCS, Milano
| | | | - Carmine Riccio
- U.O.S.D. Follow-Up del Paziente Post-Acuto, A.O. Sant'Anna e San Sebastiano, Caserta
| | - Gianfranco Sinagra
- S.C. Cardiologia, DAI Cardiovascolare, Azienda Sanitaria Universitaria Integrata di Trieste, Università degli Studi, Trieste
| | | | | | | | | | - Andrea Di Lenarda
- S.C. Cardiovascolare e Medicina dello Sport, Azienda Sanitaria Universitaria Integrata di Trieste
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania - Presidente Fondazione per il Tuo cuore
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Paldino A, De Angelis G, Dal Ferro M, Faganello G, Porcari A, Barbati G, Korcova R, Gentile P, Artico J, Pinamonti B, Merlo M, Sinagra G. 1040 Unexpected prevalence of subtle systolic and diastolic dysfunction in genotype-positive phenotype-negative relatives of dilated cardiomyopathy patients. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
None
Background
Left ventricular global longitudinal strain (LV-GLS) and peak left atrial longitudinal strain (PALS) are promising techniques for the detection of a subtle systolic and diastolic dysfunction for an early diagnosis of genetically determined dilated cardiomyopathy (DCM). Purpose. We sought to evaluate the prevalence of subtle systolic and diastolic dysfunction by LV-GLS and PALS in a cohort of genotype-positive phenotype-negative (GPFN) DCM relatives. Methods. We analysed echocardiograms (including LV-GLS and PALS) of 41 GPFN relatives of DCM patients (GPFN group - 37 ± 14 years, 48.8% male). They were compared with a matched group of 52 healthy individuals (control group). Reduced LV-GLS and PALS were defined as >-18% and <23.1%, respectively, according to literature data. Results. GPFN and control groups were grossly similar according to standard echocardiographic measurements. Conversely, mean LV-GLS was -18.8 ± 2.7% in the GPFN group vs. -24.0 ± 1.8% in the control group (p < 0.001). 20 subjects (48.8%) in the GPFN group and no subjects in the control group had a reduced LV-GLS. The mean PALS was 29.2 ± 6.7% in the GPFN group vs. 40.8 ± 8.5% in the control group (p < 0.001). 7 subjects (18.4%) in the GPFN group and one (2%) in the control group had a reduced PALS. During a median follow-up of 27 months, 6 (14.6%) GPFN relatives developed a LV ejection fraction <50%. Among them, 4 (66%) had a reduced LV-GLS at initial evaluation. Conclusions. LV-GLS and PALS are impaired in GPFN relatives of DCM patients compared to healthy individuals, when standard echocardiographic parameters are normal. Further studies are warranted to add prognostic significance to this result, which may lead in the future to an early therapy initiation.
Abstract 1040 Figure. Mean LV-GLS and PALS in GPFN and control
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Affiliation(s)
- A Paldino
- Ospedale Cattinara, Cardiovascular department, Trieste, Italy
| | - G De Angelis
- Ospedale Cattinara, Cardiovascular department, Trieste, Italy
| | - M Dal Ferro
- Ospedale Cattinara, Cardiovascular department, Trieste, Italy
| | - G Faganello
- Cardiovascular Center A.S.S. 1 of Trieste, Trieste, Italy
| | - A Porcari
- Ospedale Cattinara, Cardiovascular department, Trieste, Italy
| | - G Barbati
- University of Trieste, Biostatistics Unit, Department of Medical Sciences, Trieste, Italy
| | - R Korcova
- Ospedale Cattinara, Cardiovascular department, Trieste, Italy
| | - P Gentile
- Ospedale Cattinara, Cardiovascular department, Trieste, Italy
| | - J Artico
- Ospedale Cattinara, Cardiovascular department, Trieste, Italy
| | - B Pinamonti
- Ospedale Cattinara, Cardiovascular department, Trieste, Italy
| | - M Merlo
- Ospedale Cattinara, Cardiovascular department, Trieste, Italy
| | - G Sinagra
- Ospedale Cattinara, Cardiovascular department, Trieste, Italy
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Castrichini M, Albani S, Pinamonti B, Bussani R, Belgrano M, Sinagra G. 1111 Atrial thrombi or cardiac tumors? The challenge of multimodality imaging of intracardiac masses. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
A 83-year-old man with hypertensive cardiomyopathy with left ventricular dysfunction diagnosed 5 years before (without coronary artery disease) in permanent atrial fibrillation since 8 years, was admitted to the ER for heart failure. He was not in anticoagulation therapy because contraindication for the presence of cerebral venous angiomas found several years before.
An urgent ultrasound scan was performed that showed bilateral intra-atrial masses. UFH was started.
The echocardiography(Fig. 1 panel A)show within the left atrium an isoechoic, not pedunculated mass, 8x5 cm, with lobulated margins, attached to the anterior wall and left atrial appendage, and expanding in the atrial cavity. Within the right atrium a smaller mass with the same characteristics was attached to the anterior wall, 4 x 3 cm (Fig. 1 panel B). TEE confirmed these characteristics and showed also vacuolated aspects inside the masses (Fig. 1 panel C).
MDCT was then performed, the atrial masses appeared morphologically very similar to atrial myxomas, but they didn’t enhance iodine contrast agent resembling a typical thrombus behavior (Fig. 1 Panel D). No systemic emboli nor extracardiac tumors were found. CMR could not be performed due to patient claustrophobia.
Considering intra-atrial thrombi as a main hypothesis, the treatment with UFH was continued and the masses were monitored by TTE. However, after more than one week the masses volume did not change.
A contrast echocardiography with IV Sonovue was performed. A mild contrast enhancement of left atrial mass was seen, thus suggesting the diagnostic hypothesis of cardiac tumor (Fig. 1 Panel E).
In this context we decided to perform transvenous biopsy of right atrial mass under intracardiac echocardiography guidance. The biopsy samples from the outer wall of the right atrial mass showed thrombotic features.
After a long discussion in heart team, patient underwent to surgical resection of the masses through atrial approach and the surgical inspection was suggestive of neoplastic origin.
The histological examination was performed showing thrombotic material with several phases of organization and mild aspects of neo-angiogenesis combined with mild lymphocyte infiltration and necrosis areas (Fig. 1 Panel F).
We hypothesized that the histological features of the lesion, with the presence of vessel within the mass could explain the mild late contrast enhancement at Sonovue echocardiography simulating the features of cardiac tumor.
In summary, in this case, despite a multimodal imaging approach, the nature of the bilateral intra-atrial masses could not be defined and the histological examination after surgical removal had a key diagnostic role showing organized thrombotic material. A proper differential diagnosis is extremely important in order to decide the appropriate treatment, but sometimes it is extremely challenging.
Abstract 1111 Figure 1
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Affiliation(s)
| | - S Albani
- Ospedale Cattinara, Trieste, Italy
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Albani S, Pinamonti B, De Scordilli M, Fabris E, Perkan A, Geri P, Gregori C, Barbati G, Sinagra G, Mesin L. P892 Accuracy of right atrial pressure estimation using a multi-parameter approach derived from Inferior vena cava semi-automated edge-tracking echocardiography. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In clinical practice, as stated in the ASE guidelines, the echocardiographic estimation of right atrial pressure (RAP) is based on the size of the inferior vena cava (IVC) and its inspiratory collapse. However, this method has proven to have limits of reliability and reproducibility. The use of a recently developed software that with a semi-automatic technique highlight the edges of the IVC could help to standardize the echocardiographic assessment of RAP.
Aim of the study: The aim of the study was to assess feasibility and accuracy of a new semi-automated approach to estimate the RAP.
Standard acquired echocardiographic images were processed with a semi-automatic technique, indexes related to the collapsibility of the vessel during inspiration (Caval Index, CI), during the whole respiratory cycle (Respiratory Caval Index, RCI) and through the heart cycle transmitted movements’ (Cardiac Caval Index (CCI) were derived (figure 1).
Using these indexes, we developed two models:
a) the Binary Tree Model (BTM), further divided in BTM3 and BTM5 (RAP estimated in 3 and 5 classes, respectively);
b) the Regression Model (RM), further divided in RM linear (continuous model) and RM3 and RM5 (RAP estimated in 3 and 5 classes respectively).
RAP assessed using these innovative techniques were compared with two standard estimation (SE) echocardiographic methods A and B.
Direct RAP measurements obtained during a right heart catheterization (RHC), performed within 6 hours, were used as reference.
Results
62 consecutive ‘all-comers’ patients that had a RHC were enrolled; 13 patients were excluded for technical reasons. Therefore 49 patients were included in this study (26 males and 23 females; mean age of 62.2 ± 15.2 years, 75.5% pulmonary hypertension, 34.7% severe left ventricular dysfunction and 51% right ventricular dysfunction). The two SE methods showed poor accuracy for RAP estimation (method A: ME = 51%, R2= 0.22; method B: ME = 69%, R2= 0.26). Instead, the new semi-automatic methods BTM3 and BTM5 based on parameters derived from IVC edge tracking (mean IVC diameter, CI, CCI and RCI) had a misclassification error of only 14% (R2 = 0.47) and 22% (R2 = 0.61), respectively, to classify RAP. The accuracy was lower for RM than BTM (RM3: ME = 61%, R2 = 0.39; RM5: ME = 55%, R2 = 0.39). However, the RM showed the lowest mean bias in estimating RAP: 0.23 [-8.34; 8.81] mmHg.
Conclusions
A multi-parametric approach using the new indexes, such as CCI and RCI, derived from a semi-automated edge tracking of the IVC is a promising tool for a more accurate estimation of RAP. This study proposes an innovative method for the non-invasive estimation of the RAP, which requires confirmation on larger population.
Abstract P892 Figure 1
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Affiliation(s)
- S Albani
- Postgraduate School in Cardiovascular Sciences, Cardiovascular Department, University Hospital of Trieste, Trieste, Italy
| | - B Pinamonti
- Postgraduate School in Cardiovascular Sciences, Cardiovascular Department, University Hospital of Trieste, Trieste, Italy
| | - M De Scordilli
- University of Trieste, Department of Medical Science, Surgery and Health (DCSMCS), Trieste, Italy
| | - E Fabris
- Postgraduate School in Cardiovascular Sciences, Cardiovascular Department, University Hospital of Trieste, Trieste, Italy
| | - A Perkan
- Postgraduate School in Cardiovascular Sciences, Cardiovascular Department, University Hospital of Trieste, Trieste, Italy
| | - P Geri
- University of Trieste, Department of Pneumology and Respiratory Intermediate Care Unit, ASUITS, Trieste, Italy
| | - C Gregori
- University of Trieste, Department of Medical Sciences, Biostatistics Unit, University of Trieste, Trieste, Italy, Trieste, Italy
| | - G Barbati
- University of Trieste, Department of Medical Sciences, Biostatistics Unit, University of Trieste, Trieste, Italy, Trieste, Italy
| | - G Sinagra
- Postgraduate School in Cardiovascular Sciences, Cardiovascular Department, University Hospital of Trieste, Trieste, Italy
| | - L Mesin
- Politecnico di Torino, Mathematical Biology and Physiology - Department of Electronics and Telecommunications, Turin, Italy
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de Scordilli M, Pinamonti B, Albani S, Gregorio C, Barbati G, Daneluzzi C, Korcova R, Perkan A, Fabris E, Geri P, Biolo M, Lo Giudice F, Confalonieri M, Sinagra G. Reliability of noninvasive hemodynamic assessment with Doppler echocardiography. J Cardiovasc Med (Hagerstown) 2019; 20:682-690. [DOI: 10.2459/jcm.0000000000000841] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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De Luca A, Stolfo D, Caiffa T, Korcova R, Barbati G, Vitrella G, Rakar S, Perkan A, Secoli G, Pinamonti B, Merlo M, Sinagra G. Prognostic Value of Global Longitudinal Strain-Based Left Ventricular Contractile Reserve in Candidates for Percutaneous Correction of Functional Mitral Regurgitation: Implications for Patient Selection. J Am Soc Echocardiogr 2019; 32:1436-1443. [PMID: 31551186 DOI: 10.1016/j.echo.2019.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/03/2019] [Accepted: 07/04/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Patients with symptomatic heart failure (HF), reduced left ventricular ejection fraction (LVEF), and high-grade functional mitral regurgitation (MR) may benefit from percutaneous edge-to-edge mitral valve repair (PMVR). However, patient selection still remains a central issue. We sought to investigate the potential role of the global longitudinal strain- (GLS-) based left ventricular contractile reserve (LVCR) at dobutamine stress echocardiography (DSE) in this setting. METHODS Thirty-three stable HF patients (MR grade ≥ 3+; median LVEF, 29%; median GLS, -8.3%) who were candidates for PMVR were prospectively enrolled. All patients underwent DSE to assess LVCR (LVEF increase ≥ 5%; GLS increase ≥ 2%; stroke volume [SV] increase ≥ 20% of the measured SV value). RESULTS After DSE, a positive LVCRLVEF was detected in 21 patients (64%), positive LVCRGLS in 12 patients (36%), and positive LVCRSV in 14 patients (42%). LVCRGLS was associated with better symptom relief, MR improvement, and LV reverse remodeling in a short-term follow-up. A significant improvement of GLS during DSE (hazard ratio [HR], 0.549; 95% CI, 0.395-0.765; P < .001), along with history of HF hospitalization (HR, 1.48; 95% CI, 1.119-1.967; P = .006) and beta-blocker therapy (HR, 0.146; 95% CI, 0.046-0.462; P = .001), were independently associated with risk of death/heart transplantation/HF-related hospitalizations. CONCLUSIONS LVCR, assessed by speckle-tracking DSE, is associated with better results after PMVR in the setting of advanced HF. Improvement of longitudinal function emerged, beyond the ejection fraction, as an independent predictor of outcomes and could improve the selection of best candidates for the percutaneous correction of functional MR.
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Affiliation(s)
- Antonio De Luca
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy.
| | - Davide Stolfo
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Thomas Caiffa
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Renata Korcova
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Giulia Barbati
- Biostatistics Unit, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Giancarlo Vitrella
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Serena Rakar
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Andrea Perkan
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Gabriele Secoli
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Bruno Pinamonti
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Marco Merlo
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Gianfranco Sinagra
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
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Gentile P, Merlo M, Cannatà A, Gobbo M, Artico J, Stolfo D, Gigli M, Ramani F, Barbati G, Pinamonti B, Sinagra G. Dilated Cardiomyopathy With Mid-Range Ejection Fraction at Diagnosis: Characterization and Natural History. J Am Heart Assoc 2019; 8:e010705. [PMID: 31431100 PMCID: PMC6755837 DOI: 10.1161/jaha.118.010705] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Limited data are available on mid-range ejection fraction (mrEF) patients with dilated cardiomyopathy. We sought to define the characteristics, evolution, and long-term prognosis of dilated cardiomyopathy patients with mrEF at diagnosis. Methods and Results We analyzed all dilated cardiomyopathy patients consecutively evaluated in the Trieste Heart Muscle Disease Registry from 1988 to 2013. mrEF and reduced ejection fraction (rEF) were defined as baseline left ventricular (LV) ejection fraction values between 40% and 49% and <40%, respectively. All-cause mortality or heart transplantation, sudden cardiac death, or major ventricular arrhythmias were considered as outcome measures. Worsening LV ejection fraction (reduction to <40%) during follow-up was also considered to identify possible predictors of adverse remodeling. Among 812 enrolled patients, 175 (22%) presented with mrEF at presentation. At baseline, as compared with the rEF group, mrEF patients had lower rates of moderate-severe mitral regurgitation and restrictive LV filling pattern. During a median follow-up period of 120 (60-204) months, the mrEF group presented a lower rate of death/heart transplantation (9% versus 36%, P<0.001) and sudden cardiac death or major ventricular arrhythmias (4.5% versus 15%, P<0.001) than rEF patients. Moreover, 29 out of 175 mrEF patients (17%) evolved to rEF. Restrictive LV filling pattern emerged as the strongest predictor of rEF development following multivariable analysis. Conclusions mrEF identified a consistent subgroup of dilated cardiomyopathy patients diagnosed in an earlier stage with subsequent apparent better long-term evolution. However, 17% of these patients evolved into rEF despite the use of medical therapy. A baseline restrictive LV filling pattern was independently associated with subsequent evolution to rEF.
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Affiliation(s)
- Piero Gentile
- Cardiothoracic Department Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste Italy
| | - Marco Merlo
- Cardiothoracic Department Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste Italy
| | - Antonio Cannatà
- Cardiothoracic Department Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste Italy
| | - Marco Gobbo
- Cardiothoracic Department Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste Italy
| | - Jessica Artico
- Cardiothoracic Department Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste Italy
| | - Davide Stolfo
- Cardiothoracic Department Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste Italy
| | - Marta Gigli
- Cardiothoracic Department Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste Italy
| | - Federica Ramani
- Cardiothoracic Department Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste Italy
| | - Giulia Barbati
- Biostatistics Unit Department of Medical Sciences University of Trieste Italy
| | - Bruno Pinamonti
- Cardiothoracic Department Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste Italy
| | - Gianfranco Sinagra
- Cardiothoracic Department Azienda Sanitaria Universitaria Integrata di Trieste and University of Trieste Italy
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Merlo M, Stolfo D, Gobbo M, Gabassi G, Barbati G, Naso P, Secoli G, Boscutti A, Ramani F, Gigli M, Pinamonti B, Sinagra G. Prognostic impact of short‐term changes of E/E' ratio and left atrial size in dilated cardiomyopathy. Eur J Heart Fail 2019; 21:1294-1296. [DOI: 10.1002/ejhf.1543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/01/2019] [Indexed: 11/06/2022] Open
Affiliation(s)
- Marco Merlo
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata University of Trieste (ASUITS) Trieste Italy
| | - Davide Stolfo
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata University of Trieste (ASUITS) Trieste Italy
| | - Marco Gobbo
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata University of Trieste (ASUITS) Trieste Italy
| | - Giacomo Gabassi
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata University of Trieste (ASUITS) Trieste Italy
| | - Giulia Barbati
- Biostatistics Unit, Department of Medical Sciences University of Trieste Trieste Italy
| | - Paola Naso
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata University of Trieste (ASUITS) Trieste Italy
| | - Gabriele Secoli
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata University of Trieste (ASUITS) Trieste Italy
| | - Andrea Boscutti
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata University of Trieste (ASUITS) Trieste Italy
| | - Federica Ramani
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata University of Trieste (ASUITS) Trieste Italy
| | - Marta Gigli
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata University of Trieste (ASUITS) Trieste Italy
| | - Bruno Pinamonti
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata University of Trieste (ASUITS) Trieste Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata University of Trieste (ASUITS) Trieste Italy
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De Luca A, Caiffa T, Albani S, Vitrella G, Rakar S, Perkan A, Pinamonti B, Sinagra G. Complex MitraClip procedure for a complex patient: the challenge of commissural flail. J Cardiovasc Med (Hagerstown) 2019; 20:566-568. [PMID: 31246701 DOI: 10.2459/jcm.0000000000000821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Antonio De Luca
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste.,Post Graduated School of Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Thomas Caiffa
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste.,Post Graduated School of Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Stefano Albani
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste.,Post Graduated School of Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Giancarlo Vitrella
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste
| | - Serena Rakar
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste
| | - Andrea Perkan
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste
| | - Bruno Pinamonti
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste
| | - Gianfranco Sinagra
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste.,Post Graduated School of Cardiovascular Sciences, University of Trieste, Trieste, Italy
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Dal Ferro M, De Paris V, Collia D, Stolfo D, Caiffa T, Barbati G, Korcova R, Pinamonti B, Zovatto L, Zecchin M, Sinagra G, Pedrizzetti G. Left Ventricular Response to Cardiac Resynchronization Therapy: Insights From Hemodynamic Forces Computed by Speckle Tracking. Front Cardiovasc Med 2019; 6:59. [PMID: 31139633 PMCID: PMC6527774 DOI: 10.3389/fcvm.2019.00059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/24/2019] [Indexed: 11/13/2022] Open
Abstract
Aims: Despite continuous efforts in improving the selection process, the rate of non-responders to cardiac resynchronization therapy (CRT) remains high. Recent studies on intraventricular blood flow suggested that the alignment of hemodynamic forces (HDFs) may be a reproducible biomarker of mechanical dyssynchrony. We aimed to explore the relationship between pacing-induced realignment of HDFs and positive response to CRT. Methods and results: We retrospectively analyzed 38 patients from the CRT database of our institution fulfilling the inclusion criteria for HDFs-related echocardiographic assessment early pre and post CRT implantation, with available mid-term follow-up (≥ 6 months) evaluation. Standard echocardiographic and deformation parameters early pre and post CRT implantation were integrated with the measurement of HFDs through novel methods based on speckle-tracking analysis. At midterm follow-up 71% of patients were classified as responders (reduction of Left Ventricular Systolic Volume Indexed ≥ 15%). Patients did not display significant changes between close evaluations pre and post-implant in terms of ejection fraction and strain metrics. A significant reduction of the ratio between the amplitudes of transversal and longitudinal force components was found. The variation of this ratio strongly correlates (R2 =0.60) with Left Ventricular (LV) end-systolic volume variation at mid-term follow up. Conclusion: Pacing-induced realignment of HDFs is associated with CRT efficacy at follow up. These preliminary results claim for dedicated prospective clinical studies testing the potential impact of HDFs study for patient selection and pacing optimization in CRT.
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Affiliation(s)
- Matteo Dal Ferro
- Cardiovascular Department, Azienda Ospedaliera Universitaria Integrata of Trieste, Trieste, Italy
| | - Valerio De Paris
- Cardiovascular Department, Azienda Ospedaliera Universitaria Integrata of Trieste, Trieste, Italy
| | - Dario Collia
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Davide Stolfo
- Cardiovascular Department, Azienda Ospedaliera Universitaria Integrata of Trieste, Trieste, Italy
| | - Thomas Caiffa
- Cardiovascular Department, Azienda Ospedaliera Universitaria Integrata of Trieste, Trieste, Italy
| | - Giulia Barbati
- Biostatistics Unit, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Renata Korcova
- Cardiovascular Department, Azienda Ospedaliera Universitaria Integrata of Trieste, Trieste, Italy
| | - Bruno Pinamonti
- Cardiovascular Department, Azienda Ospedaliera Universitaria Integrata of Trieste, Trieste, Italy
| | - Luigino Zovatto
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Massimo Zecchin
- Cardiovascular Department, Azienda Ospedaliera Universitaria Integrata of Trieste, Trieste, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, Azienda Ospedaliera Universitaria Integrata of Trieste, Trieste, Italy
| | - Gianni Pedrizzetti
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
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Merlo M, Gentile P, Artico J, Cannatà A, Paldino A, De Angelis G, Barbati G, Alonge M, Gigli M, Pinamonti B, Ramani F, Zecchin M, Pirozzi F, Stolfo D, Sinagra G. Arrhythmic risk stratification in patients with dilated cardiomyopathy and intermediate left ventricular dysfunction. J Cardiovasc Med (Hagerstown) 2019; 20:343-350. [DOI: 10.2459/jcm.0000000000000792] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Affiliation(s)
- Bruno Pinamonti
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata of Trieste, Italy
| | - Antonio De Luca
- Division of Cardiology, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata of Trieste, Italy
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Porcari A, De Angelis G, Romani S, Paldino A, Artico J, Cannatà A, Gentile P, Pinamonti B, Merlo M, Sinagra G. Current diagnostic strategies for dilated cardiomyopathy: a comparison of imaging techniques. Expert Rev Cardiovasc Ther 2018; 17:53-63. [DOI: 10.1080/14779072.2019.1550719] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Aldostefano Porcari
- Cardiovascular Department, Università degli Studi di Trieste, Trieste, Italy
| | - Giulia De Angelis
- Cardiovascular Department, Università degli Studi di Trieste, Trieste, Italy
| | - Simona Romani
- Cardiovascular Department, Università degli Studi di Trieste, Trieste, Italy
| | - Alessia Paldino
- Cardiovascular Department, Università degli Studi di Trieste, Trieste, Italy
| | - Jessica Artico
- Cardiovascular Department, Università degli Studi di Trieste, Trieste, Italy
| | - Antonio Cannatà
- Cardiovascular Department, Università degli Studi di Trieste, Trieste, Italy
| | - Piero Gentile
- Cardiovascular Department, Università degli Studi di Trieste, Trieste, Italy
| | - Bruno Pinamonti
- Cardiovascular Department, Università degli Studi di Trieste, Trieste, Italy
| | - Marco Merlo
- Cardiovascular Department, Università degli Studi di Trieste, Trieste, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, Università degli Studi di Trieste, Trieste, Italy
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Negri F, De Luca A, Morea G, Dal Ferro M, Faganello G, Vitrella G, Chiatto M, Pinamonti B, Aquaro GD, Sinagra G. [Make a point on left ventricular noncompaction]. G Ital Cardiol (Rome) 2018; 19:371-378. [PMID: 29912226 DOI: 10.1714/2922.29370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hypertrabeculation is a feature of the left ventricle that, by itself, does not coincide with left ventricular non compaction (LVNC), which represents a specific cardiomyopathy. Nowadays, in the absence of gold standard diagnostic criteria, the clinician must integrate imaging aspects together with medical history. The family inheritance for LVNC, presence of neuromuscular disorders, symptoms or signs of heart failure, thromboembolic events, unexplained syncope, pathological findings at rest ECG, Holter ECG, stress test, systolic/diastolic dysfunction at rest echocardiogram, late gadolinium enhancement at cardiac magnetic resonance, and identification of specific mutations are all considered features useful for the diagnosis. Many aspects are not fully understood: multicenter studies, registers and observational studies are needed for a better comprehension of the pathology, adequate risk stratification and targeted follow-up.
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Affiliation(s)
- Francesco Negri
- S.C. Cardiologia, Dipartimento Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste - Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Università degli Studi, Trieste
| | - Antonio De Luca
- S.C. Cardiologia, Dipartimento Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste - Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Università degli Studi, Trieste
| | - Gaetano Morea
- S.C. Cardiologia, Dipartimento Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste
| | - Matteo Dal Ferro
- S.C. Cardiologia, Dipartimento Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste
| | - Giorgio Faganello
- Centro Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste
| | - Giancarlo Vitrella
- S.C. Cardiologia, Dipartimento Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste
| | | | - Bruno Pinamonti
- S.C. Cardiologia, Dipartimento Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste
| | | | - Gianfranco Sinagra
- S.C. Cardiologia, Dipartimento Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste - Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Università degli Studi, Trieste
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Merlo M, Gentile P, Gobbo M, Barbati G, Gigli M, Pinamonti B, Sinagra G. DILATED CARDIOMYOPATHY WITH MIDRANGE EJECTION FRACTION AT DIAGNOSIS: CHARACTERIZATION AND NATURAL HISTORY. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31244-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gentile P, Merlo M, Gobbo M, Pinamonti B, Ramani F, Barbati G, Gigli M, Stolfo D, Sinagra G. P711Dilated cardiomyopathy with Mid-range ejection fraction at diagnosis: characterization and natural history. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cappelletto C, Stolfo D, De Luca A, Pinamonti B, Barbati G, Pivetta A, Gobbo M, Brun F, Merlo M, Sinagra G. Lifelong arrhythmic risk stratification in arrhythmogenic right ventricular cardiomyopathy: distribution of events and impact of periodical reassessment. Europace 2017. [DOI: 10.1093/europace/eux093] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Chiara Cappelletto
- Department of Cardiology, University Hospital “Ospedali Riuniti”, SC Cardiologia, Polo Cardiologico, Ospedale di Cattinara, Via Valdoni 7, 34100 Trieste, Italy
| | - Davide Stolfo
- Department of Cardiology, University Hospital “Ospedali Riuniti”, SC Cardiologia, Polo Cardiologico, Ospedale di Cattinara, Via Valdoni 7, 34100 Trieste, Italy
| | - Antonio De Luca
- Department of Cardiology, University Hospital “Ospedali Riuniti”, SC Cardiologia, Polo Cardiologico, Ospedale di Cattinara, Via Valdoni 7, 34100 Trieste, Italy
| | - Bruno Pinamonti
- Department of Cardiology, University Hospital “Ospedali Riuniti”, SC Cardiologia, Polo Cardiologico, Ospedale di Cattinara, Via Valdoni 7, 34100 Trieste, Italy
| | - Giulia Barbati
- Department of Cardiology, University Hospital “Ospedali Riuniti”, SC Cardiologia, Polo Cardiologico, Ospedale di Cattinara, Via Valdoni 7, 34100 Trieste, Italy
- Cardiovascular Center, Azienda per i Servizi Sanitari n. 1 (A.S.S. 1) of Trieste, Italy
| | - Alberto Pivetta
- Department of Cardiology, University Hospital “Ospedali Riuniti”, SC Cardiologia, Polo Cardiologico, Ospedale di Cattinara, Via Valdoni 7, 34100 Trieste, Italy
| | - Marco Gobbo
- Department of Cardiology, University Hospital “Ospedali Riuniti”, SC Cardiologia, Polo Cardiologico, Ospedale di Cattinara, Via Valdoni 7, 34100 Trieste, Italy
| | - Francesca Brun
- Department of Cardiology, University Hospital “Ospedali Riuniti”, SC Cardiologia, Polo Cardiologico, Ospedale di Cattinara, Via Valdoni 7, 34100 Trieste, Italy
| | - Marco Merlo
- Department of Cardiology, University Hospital “Ospedali Riuniti”, SC Cardiologia, Polo Cardiologico, Ospedale di Cattinara, Via Valdoni 7, 34100 Trieste, Italy
| | - Gianfranco Sinagra
- Department of Cardiology, University Hospital “Ospedali Riuniti”, SC Cardiologia, Polo Cardiologico, Ospedale di Cattinara, Via Valdoni 7, 34100 Trieste, Italy
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Prati G, Gatti G, Belgrano M, Pinamonti B, Rauber E, Gripshi F, Pappalardo A, Sinagra G. Disseminated echinococcosis: follow your heart. J Cardiovasc Med (Hagerstown) 2017; 17 Suppl 2:e146-e148. [PMID: 28482352 DOI: 10.2459/jcm.0000000000000389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
: In this report, we present a rare case of cardiac echinococcosis presenting with cerebral haemorrhage due to rupture of a mycotic aneurysm in a peripheral branch of the media cerebral artery. Further investigations lead to discovery of multiple cysts in the heart and liver. The complementary use of transthoracic and transoesophageal echocardiography, MRI and computed tomography lead to the final diagnosis of disseminated echinococcosis and allowed precise evaluation of the anatomical and structural characteristics of the cardiac mass, its boundaries and its relationship with the surrounding anatomic structures.
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Affiliation(s)
- Giulio Prati
- aCardiovascular Department, University Hospital 'Ospedali Riuniti', Polo Cardiologico - via Valdoni n°7bPostgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy
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Zambon E, Iorio A, Di Nora C, Carriere C, Abate E, Merlo M, Barbati G, Di Lenarda A, Pinamonti B, Agostoni P, Sinagra G. Left ventricular function and exercise performance in idiopathic dilated cardiomyopathy. J Cardiovasc Med (Hagerstown) 2017; 18:230-236. [DOI: 10.2459/jcm.0000000000000411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Bobbo M, Pinamonti B, Merlo M, Stolfo D, Iorio A, Ramani F, Barbati G, Carriere C, Massa L, Poli S, Scapol S, Gigli M, Di Lenarda A, Sinagra G. Comparison of Patient Characteristics and Course of Hypertensive Hypokinetic Cardiomyopathy Versus Idiopathic Dilated Cardiomyopathy. Am J Cardiol 2017; 119:483-489. [PMID: 27988039 DOI: 10.1016/j.amjcard.2016.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/04/2016] [Accepted: 10/04/2016] [Indexed: 01/09/2023]
Abstract
Hypertensive hypokinetic cardiomyopathy (HHC) is defined by left ventricular (LV) systolic dysfunction with a history of systemic hypertension as the only possible cause. Although commonly encountered in clinical practice, its characterization and differences with true idiopathic dilated cardiomyopathy (IDC) are lacking. The aim of this study was to characterize the clinical instrumental features and the natural history of HHC. We analyzed the data of 4,191 patients referred to our center for newly diagnosed LV systolic dysfunction from 2005 to 2010. Of them, 310 presented idiopathic LV systolic dysfunction (LV ejection fraction <50%): 136 (44%) had a history of systemic hypertension and were defined HHC. The remaining 174 patients were considered IDC. Compared with patients with IDC, those with HHC were older (63 ± 11 vs 47 ± 14 years, p <0.001), with worse comorbidity profile, higher blood pressure, and increased LV mass. During follow-up, patients with HHC showed earlier and higher proportion of LV reverse remodeling (46% vs 21% at 6 months' follow-up). Moreover, they had a better long-term survival free from cardiovascular death/ventricular assist device/heart transplant/malignant ventricular arrhythmias (5.1 vs 12.6 in HHC and IDC, p = 0.03). Indeed, their mortality was mainly driven by noncardiovascular causes (at 10 years 9.6% vs 1.7% in HHC and IDC, p <0.001). In conclusion, HHC has a high prevalence among patients with "idiopathic" LV dysfunction. The natural history of patients with HHC is characterized by a rapid response to optimal therapy for heart failure, a favorable cardiovascular outcome, and a relevant incidence of noncardiovascular events.
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Picano E, Ciampi Q, Citro R, D’Andrea A, Scali MC, Cortigiani L, Olivotto I, Mori F, Galderisi M, Costantino MF, Pratali L, Di Salvo G, Bossone E, Ferrara F, Gargani L, Rigo F, Gaibazzi N, Limongelli G, Pacileo G, Andreassi MG, Pinamonti B, Massa L, Torres MAR, Miglioranza MH, Daros CB, de Castro e Silva Pretto JL, Beleslin B, Djordjevic-Dikic A, Varga A, Palinkas A, Agoston G, Gregori D, Trambaiolo P, Severino S, Arystan A, Paterni M, Carpeggiani C, Colonna P. Stress echo 2020: the international stress echo study in ischemic and non-ischemic heart disease. Cardiovasc Ultrasound 2017; 15:3. [PMID: 28100277 PMCID: PMC5242057 DOI: 10.1186/s12947-016-0092-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 12/12/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. METHODS In a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information. The study is endorsed by the Italian Society of Cardiovascular Echography and organized in 10 subprojects focusing on: contractile reserve for prediction of cardiac resynchronization or medical therapy response; stress B-lines in heart failure; hypertrophic cardiomyopathy; heart failure with preserved ejection fraction; mitral regurgitation after either transcatheter or surgical aortic valve replacement; outdoor SE in extreme physiology; right ventricular contractile reserve in repaired Tetralogy of Fallot; suspected or initial pulmonary arterial hypertension; coronary flow velocity, left ventricular elastance reserve and B-lines in known or suspected CAD; identification of subclinical familial disease in genotype-positive, phenotype- negative healthy relatives of inherited disease (such as hypertrophic cardiomyopathy). RESULTS We expect to recruit about 10,000 patients over a 5-year period (2016-2020), with sample sizes ranging from 5,000 for coronary flow velocity/ left ventricular elastance/ B-lines in CAD to around 250 for hypertrophic cardiomyopathy or repaired Tetralogy of Fallot. This data-base will allow to investigate technical questions such as feasibility and reproducibility of various SE parameters and to assess their prognostic value in different clinical scenarios. CONCLUSIONS The study will create the cultural, informatic and scientific infrastructure connecting high-volume, accredited SE labs, sharing common criteria of indication, execution, reporting and image storage of SE to obtain original safety, feasibility, and outcome data in evidence-poor diagnostic fields, also outside the established core application of SE in CAD based on regional wall motion abnormalities. The study will standardize procedures, validate emerging signs, and integrate the new information with established knowledge, helping to build a next-generation SE lab without inner walls.
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Affiliation(s)
- Eugenio Picano
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Quirino Ciampi
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Rodolfo Citro
- Heart Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
| | - Antonello D’Andrea
- Division of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy
| | - Maria Chiara Scali
- Cardiology Department, Pisa University and Nottola (Siena) Hospital, Pisa, Italy
| | | | | | - Fabio Mori
- Cardiology Department, Careggi Hospital, Florence, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | | | - Lorenza Pratali
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | | | - Eduardo Bossone
- Heart Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
| | - Francesco Ferrara
- Heart Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
| | - Luna Gargani
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Fausto Rigo
- Division of Cardiology, Ospedale dell’Angelo Mestre-Venice, Mestre, Italy
| | - Nicola Gaibazzi
- Cardiology Department, Parma University Hospital, Parma, Italy
| | | | - Giuseppe Pacileo
- Division of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy
| | | | - Bruno Pinamonti
- Cardiology Department, University Hospital “Ospedale Riuniti”, Trieste, Italy
| | - Laura Massa
- Cardiology Department, University Hospital “Ospedale Riuniti”, Trieste, Italy
| | - Marco A. R. Torres
- Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Branko Beleslin
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | - Ana Djordjevic-Dikic
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | - Albert Varga
- Institute of Family Medicine, University of Szeged, Szeged, Hungary
| | - Attila Palinkas
- Department of Internal Medicine, Elisabeth Hospital, Hodmezovasarhely, Hungary
| | - Gergely Agoston
- Institute of Family Medicine, University of Szeged, Szeged, Hungary
| | - Dario Gregori
- Department of Biostatistics, University of Padua, Padua, Italy
| | | | | | - Ayana Arystan
- RSE, Medical Centre Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
| | - Marco Paterni
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Clara Carpeggiani
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Paolo Colonna
- Cardiology Hospital, Policlinico of Bari, Bari, Italy
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Boileve V, Schueler R, Hinojar R, Bando M, Lo Iudice F, Andersen OS, Nielsen KM, Merlo M, Dreyfus J, Attias D, Codogno I, Brochet E, Vahanian A, Messika-Zeitoun D, Kaplan S, Oeztuerk C, Weber M, Sinning JM, Welt A, Werner N, Nickenig G, Hammerstingl C, Fernandez-Golfin C, Gonzalez-Gomez A, Garcia Martin A, Casas E, Del Val D, Pardo A, Mejias A, Moya JL, Barrios V, Jimenez Nacher JJ, Zamorano JL, Yamada H, Amano R, Tamai R, Torii Y, Nishio S, Seno Y, Kusunose K, Sata M, Santoro C, Buonauro A, Ferrone M, Esposito R, Trimarco B, Petitto M, Galderisi M, Gude E, Andreassen AK, Broch K, Skulstad H, Smiseth OA, Remme EW, Damgaard DW, Jensen JM, Kraglund KL, Kim WY, Stolfo D, Gobbo M, Gabassi G, Barbati G, De Luca A, Korcova R, Secoli G, Pinamonti B, Sinagra G. Moderated Posters: A little bit of everythingP1190What causes mitral annulus dilatation-A three dimensional studyP1191Impact of interventional edge-to-edge repair with the MitraClip system on mitral valve geometry: Long-term results from a prospective single centre studyP1192Real live applications of three-dimensional echocardiographic quantification of the left atrial volumes using an automated adaptive analytics algorithmP1193Quantitative ultrasound evaluation of the changes on tissue characteristics of carotid plaques by lipid lowering therapyP1194Effort heart rate increase is an independent predictor of longitudinal function reserve in the trained heart: a stress echocardiography studyP1195Incremental value of strain imaging in classification of heart failure with normal ejection fractionP1196Multimodality work-up of young stroke patients is beneficialP1197Prognostic significance of the hemodynamic non-invasive assessment in patients with dilated cardiomyopathy. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Berardini A, Biagini E, Saia F, Stolfo D, Previtali M, Grigioni F, Pinamonti B, Crimi G, Salvi A, Ferrario M, De Luca A, Gazzoli F, Bacchi Reggiani ML, Raineri C, Sinagra G, Rapezzi C. Percutaneous mitral valve repair: The last chance for symptoms improvement in advanced refractory chronic heart failure? Int J Cardiol 2016; 228:191-197. [PMID: 27875721 DOI: 10.1016/j.ijcard.2016.11.241] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/06/2016] [Accepted: 11/10/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND The role of percutaneous mitral valve repair (PMVR) in patients with end-stage heart failure (HF) and functional mitral regurgitation (FMR) is unclear. METHODS Seventy-five consecutive patients with FMR grade≥3+ and severe HF symptoms despite optimal medical therapy and resynchronization therapy underwent PMVR with the MitraClip system (Abbott, Abbott Park, IL, USA) at 3 centers. Clinical evaluation, echocardiography and pro-BNP measurement were performed at baseline and at 6-month. RESULTS Mean age was 67±11years, logistic EuroSCORE=23±18%, left ventricle ejection fraction (LVEF) 30±9%. In 6 patients (8%) PMVR was performed as a bridge to heart transplant; many patients were dependent from iv diuretics and/or inotropes. Rate of serious adverse in-hospital events was 1.3% (1 patient who died after conversion to cardiac surgery). Sixty-three patients (84%) were discharged with MR≤2+. At 6-month, 4 patients died (5%), 80% had MR≤2+ and 75% were in New York Heart Association class ≤II. Median pro-BNP decreased from 4395pg/ml to 2594pg/ml (p=0.04). There were no significant changes in LV end-diastolic volume (222±75ml vs. 217±79, p=0.19), end-systolic volume (LVESV, 154±66ml vs. 156±69, p=0.54) and LVEF (30±9% vs. 30±12%, p=0.86). Significant reverse remodeling (reduction of LVESV≥10%) was observed in 25%, without apparent association with baseline characteristics. The number of hospitalizations for HF in comparison with the 6months before PMVR were reduced from 1.1±0.8 to 0.3±0.6 (p<0.001). CONCLUSIONS In extreme risk HF patients with FMR, PMVR improved symptoms and reduced re-hospitalization and pro-BNP levels at 6months, despite the lack of LV reverse remodeling.
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Affiliation(s)
- Alessandra Berardini
- Cardiology Unit, Cardio-thoraco-vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Italy
| | - Elena Biagini
- Cardiology Unit, Cardio-thoraco-vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Italy
| | - Francesco Saia
- Cardiology Unit, Cardio-thoraco-vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Italy
| | - Davide Stolfo
- Cardiovascular Department, "Ospedali Riuniti" and University of Trieste, Trieste, Italy
| | - Mario Previtali
- Department of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesco Grigioni
- Cardiology Unit, Cardio-thoraco-vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Italy
| | - Bruno Pinamonti
- Cardiovascular Department, "Ospedali Riuniti" and University of Trieste, Trieste, Italy
| | - Gabriele Crimi
- Department of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessandro Salvi
- Cardiovascular Department, "Ospedali Riuniti" and University of Trieste, Trieste, Italy
| | - Maurizio Ferrario
- Department of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonio De Luca
- Cardiovascular Department, "Ospedali Riuniti" and University of Trieste, Trieste, Italy
| | - Fabrizio Gazzoli
- Department of Cardiac Surgery, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Maria Letizia Bacchi Reggiani
- Cardiology Unit, Cardio-thoraco-vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Italy
| | - Claudia Raineri
- Department of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, "Ospedali Riuniti" and University of Trieste, Trieste, Italy
| | - Claudio Rapezzi
- Cardiology Unit, Cardio-thoraco-vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Italy.
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Gigli M, Stolfo D, Merlo M, Barbati G, Ramani F, Brun F, Pinamonti B, Sinagra G. Insights into mildly dilated cardiomyopathy: temporal evolution and long-term prognosis. Eur J Heart Fail 2016; 19:531-539. [PMID: 27813212 DOI: 10.1002/ejhf.608] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/05/2016] [Accepted: 06/09/2016] [Indexed: 12/28/2022] Open
Abstract
AIMS Mildly dilated cardiomyopathy (MDCM) has been proposed as a subtype of dilated cardiomyopathy (DCM) characterized by systolic dysfunction in the absence of significant LV dilatation. Few data on the characteristics and outcomes of MDCM patients are available. We sought to assess the main features and the long-term natural history of MDCM. METHODS AND RESULTS From 1988 to 2010 we analysed all DCM patients consecutively evaluated at our Institution. MDCM was defined as LVEF <45% and LV end-diastolic volume index (LVEDVI) ≤70 mL/m2 in women and ≤89 mL/m2 in men. Among a total population of 638 patients, 226 (35%) fulfilled the criteria for MDCM. Compared with the other patients, they presented features of a less advanced disease and an overall long-term lower rate of all-cause mortality/heart transplantation (D/HTx; total events = 209; 144 deaths, 65 HTx): D/HTx at 10 years 15% in MDCM vs. 30% in DCM (P < 0.001). However, throughout the follow-up, 55 MDCM patients (24%) evolved to DCM by increasing LVEDVI, consistently worsening their long-term prognosis. Among persistent MDCM patients, a restrictive filling pattern [hazard ratio (HR) 5.30; 95% confidence interval (CI) 2.34-12.01, P < 0.001] and non-sustained ventricular tachycardia (HR 2.21; 95% CI 1.003-5.11, P = 0.047), but not LVEF, were independently associated with D/HTx at multivariate analysis [time-dependent receiver operating characteristic (ROC) curve: area under the curve (AUC) 0.80, 95% CI 0.65-0.94, P = 0.003]. CONCLUSIONS MDCM identifies a consistent subgroup of DCMs diagnosed in an earlier stage and presenting an apparent better evolution. However, some MDCMs evolve into DCM despite medical therapy, whereas persistent MDCMs with non-sustained ventricular arrhythmias and restrictive filling pattern are characterized by a very poor outcome.
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Affiliation(s)
- Marta Gigli
- Cardiovascular Department, 'Ospedali Riuniti' and University of Trieste, Trieste, Italy
| | - Davide Stolfo
- Cardiovascular Department, 'Ospedali Riuniti' and University of Trieste, Trieste, Italy
| | - Marco Merlo
- Cardiovascular Department, 'Ospedali Riuniti' and University of Trieste, Trieste, Italy
| | - Giulia Barbati
- Cardiovascular Department, 'Ospedali Riuniti' and University of Trieste, Trieste, Italy
| | - Federica Ramani
- Cardiovascular Department, 'Ospedali Riuniti' and University of Trieste, Trieste, Italy
| | - Francesca Brun
- Cardiovascular Department, 'Ospedali Riuniti' and University of Trieste, Trieste, Italy
| | - Bruno Pinamonti
- Cardiovascular Department, 'Ospedali Riuniti' and University of Trieste, Trieste, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, 'Ospedali Riuniti' and University of Trieste, Trieste, Italy
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Merlo M, Anzini M, Bussani R, Artico J, Barbati G, Stolfo D, Gigli M, Muça M, Naso P, Ramani F, Di Lenarda A, Pinamonti B, Sinagra G. Characterization and Long-Term Prognosis of Postmyocarditic Dilated Cardiomyopathy Compared With Idiopathic Dilated Cardiomyopathy. Am J Cardiol 2016; 118:895-900. [PMID: 27453513 DOI: 10.1016/j.amjcard.2016.05.063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 05/31/2016] [Accepted: 05/31/2016] [Indexed: 10/21/2022]
Abstract
Dilated cardiomyopathy (DC) is the final common pathway of different pathogenetic processes and presents a significant prognostic heterogeneity, possibly related to its etiologic variety. The characterization and long-term prognosis of postmyocarditic dilated cardiomyopathy (PM-DC) remain unknown. This study assesses the clinical-instrumental evolution and long-term prognosis of a large cohort of patients with PM-DC. We analyzed 175 patients affected with DC consecutively enrolled from 1993 to 2008 with endomyocardial biopsy (EMB) data available. PM-DC was defined in the presence of borderline myocarditis at EMB or persistent left ventricular dysfunction 1 year after diagnosis of active myocarditis at EMB. Other patients were defined as affected by idiopathic dilated cardiomyopathy (IDC). Analysis of follow-up evaluations was performed at 24, 60, and 120 months. We found 72 PM-DC of 175 enrolled patients (41%). Compared with IDC, patients with PM-DC were more frequently females and less frequently presented a familial history of DC. No other baseline significant differences were found. During the long-term follow-up (median 154, first to third interquartile range 78 to 220 months), patients with PM-DC showed a trend toward slower disease progression. Globally, 18 patients with PM-DC (25%) versus 49 with IDC (48%) experienced death/heart transplantation (p = 0.045). The prognostic advantage for patients with PM-DC became significant beyond 40 months of follow-up. At multivariable time-dependent Cox analysis, PM-DC was confirmed to have a global independent protective role (hazard ratio 0.53, 95% confidence interval 0.28 to 0.97, p = 0.04). In conclusion, PM-DC is characterized by better long-term prognosis compared with IDC. An exhaustive etiologic characterization appears relevant in the prognostic assessment of DC.
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Merlo M, Gobbo M, Stolfo D, Losurdo P, Ramani F, Barbati G, Pivetta A, Di Lenarda A, Anzini M, Gigli M, Pinamonti B, Sinagra G. The Prognostic Impact of the Evolution of RV Function in Idiopathic DCM. JACC Cardiovasc Imaging 2016; 9:1034-1042. [DOI: 10.1016/j.jcmg.2016.01.027] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 12/14/2015] [Accepted: 01/07/2016] [Indexed: 11/16/2022]
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Losurdo P, Stolfo D, Merlo M, Barbati G, Gobbo M, Gigli M, Ramani F, Pinamonti B, Zecchin M, Finocchiaro G, Mestroni L, Sinagra G. Early Arrhythmic Events in Idiopathic Dilated Cardiomyopathy. JACC Clin Electrophysiol 2016; 2:535-543. [PMID: 29759572 DOI: 10.1016/j.jacep.2016.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/20/2016] [Accepted: 05/12/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The study sought to provide an insight into the prevalence, characterization and possible reliable indicators of early sudden cardiac death/malignant ventricular arrhythmias (SCD/MVAs) in a large cohort of dilated cardiomyopathy (DCM). BACKGROUND DCM generally affects young individuals and is characterized by an unpredictable prognosis with a non-negligible risk of SCD/MVAs, particularly in early stages of disease. METHODS From 1988 to 2014, 952 patients with DCM were consecutively included in the Heart Muscle Disease Registry of Trieste. RESULTS Globally, 20 patients (2.1% of the overall population) experienced SCD/MVAs within the first 6 months after enrollment (primary endpoint). At baseline they showed a worse functional class (New York Heart Association functional class III to IV 42% vs. 22%, p = 0.038), a longer QRS complex duration (127 ± 41 ms vs. 108 ± 33 ms; p = 0.013) and a larger indexed left ventricular end-systolic volume (LVESVI) (82 ± 49 ml/m2 vs. 67 ± 34 ml/m2; p = 0.049), as compared to patients without early SCD/MVAs. Beta-blockers were less tolerated (59% vs. 83% in patients with no early SCD/MVAs; p = 0.008), mostly due to hemodynamic intolerance. At multivariate analysis, LVESVI (odds ratio [OR]: 1.012; 95% confidence interval [CI]: 1.000 to 1.024; p = 0.043) and QRS complex duration (OR: 1.017; 95% CI: 1.003 to 1.030; p = 0.015) were independently associated with the primary endpoint, whereas beta-blockers demonstrated a protective effect (OR: 0.169, CI: 0.048 to 0.593; p = 0.006). CONCLUSIONS Patients with DCM present a significant risk of major arrhythmic events in the first phase of the disease. Baseline LVESVI, QRS duration, and intolerance to beta-blocker therapy might be useful tools in the arrhythmic early risk assessment.
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Affiliation(s)
- Pasquale Losurdo
- Department of Cardiology, University Hospital "Ospedali Riuniti", Trieste, Italy.
| | - Davide Stolfo
- Department of Cardiology, University Hospital "Ospedali Riuniti", Trieste, Italy
| | - Marco Merlo
- Department of Cardiology, University Hospital "Ospedali Riuniti", Trieste, Italy
| | - Giulia Barbati
- Department of Cardiology, University Hospital "Ospedali Riuniti", Trieste, Italy
| | - Marco Gobbo
- Department of Cardiology, University Hospital "Ospedali Riuniti", Trieste, Italy
| | - Marta Gigli
- Department of Cardiology, University Hospital "Ospedali Riuniti", Trieste, Italy
| | - Federica Ramani
- Department of Cardiology, University Hospital "Ospedali Riuniti", Trieste, Italy
| | - Bruno Pinamonti
- Department of Cardiology, University Hospital "Ospedali Riuniti", Trieste, Italy
| | - Massimo Zecchin
- Department of Cardiology, University Hospital "Ospedali Riuniti", Trieste, Italy
| | - Gherardo Finocchiaro
- Cardiovascular Sciences Research Centre, St. George's, University of London, London, United Kingdom
| | - Luisa Mestroni
- Molecular Genetics, Cardiovascular Institute, University of Colorado Denver, Aurora, Colorado, USA
| | - Gianfranco Sinagra
- Department of Cardiology, University Hospital "Ospedali Riuniti", Trieste, Italy
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Pinamonti B, Habjan S, De Luca A, Proclemer A, Morea G, Abate E, Vitrella G, Sinagra G. [Work-up and management of constrictive pericarditis: a critical review]. G Ital Cardiol (Rome) 2016; 17:197-207. [PMID: 27029878 DOI: 10.1714/2190.23662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Constrictive pericarditis is a rare pericardial disorder that causes an impairment of cardiac filling and frequently heart failure. The clinical presentation is non-specific and the differential diagnosis includes myocardial diseases, particularly restrictive cardiomyopathy. Echocardiography has a central role in the initial diagnosis. Some peculiar signs, such as abnormal inspiratory shift of the interventricular septum, increased respiratory variations of transmitral, transtricuspid and hepatic vein flow velocities and the normality of early diastolic relaxation velocity (e') at tissue Doppler, increase the likelihood of the disease. These signs are an expression of increased ventricular interdependence and dissociation between intrathoracic and intracardiac pressures typical of pericardial constriction. For further diagnosis, computed tomography and magnetic resonance are used to identify the presence of pericardial thickening. Invasive cardiac catheterization is indicated in dubious cases and in the assessment of the severity of hemodynamic abnormalities, especially in cases with surgical indication. Pericardiectomy is indicated in symptomatic patients meeting the diagnostic criteria of constrictive pericarditis and is able to improve the prognosis.
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Affiliation(s)
- Bruno Pinamonti
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste
| | - Sara Habjan
- Dipartimento Cardiovascolare, Università di Lubjana, Lubjana, Slovenia
| | - Antonio De Luca
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste
| | - Alberto Proclemer
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste
| | - Gaetano Morea
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste
| | - Elena Abate
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste
| | - Giancarlo Vitrella
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste
| | - Gianfranco Sinagra
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste
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Merlo M, Gigli M, Poli S, Stolfo D, Brun F, Lardieri G, Pinamonti B, Zecchin M, Pivetta A, Vitrella G, Di Lenarda A, Sinagra G. [Dilated cardiomyopathy: a dynamic disease - clinical course, reverse remodeling and prognostic stratification]. G Ital Cardiol (Rome) 2016; 17:15-23. [PMID: 26901255 DOI: 10.1714/2140.23184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Dilated cardiomyopathy (DCM) is a relatively rare primary heart muscle disease with genetic or post-inflammatory etiology. In the last decade, the incidence and prevalence of the disease have significantly increased as a consequence of an earlier diagnosis supported by extensive familial screening programs and by the improvement in diagnostic techniques. Moreover, current therapeutic strategies have deeply modified the prognosis of DCM with a dramatic reduction in mortality. A significant number of patients with DCM present an impressive response to pharmacological and non-pharmacological therapy in terms of left ventricular reverse remodeling (reduction in ventricular size with improvement of systolic function), which confers a more favorable prognosis in the long term. However, the identification of patients with an increased likelihood of improvement after therapeutic optimization remains a challenging issue; in particular the assessment of arrhythmic risk carries important implications. Finally, the long-term follow-up of patients showing a significant left ventricular functional recovery under optimal treatment is still poorly known. Hence, the aim of the present review is to provide an insight into the clinical evolution/long-term follow-up of DCM, which should be actually considered a dynamic process rather than a static and chronic disease. Left ventricular reverse remodeling should be considered a key therapeutic goal, mostly associated with a long-standing recovery, but cannot be considered the expression of permanent "healing", confirming the need for a systematic and careful follow-up over time in this setting.
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Affiliation(s)
- Marco Merlo
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
| | - Marta Gigli
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
| | - Stefano Poli
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
| | - Davide Stolfo
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
| | - Francesca Brun
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
| | - Gerardina Lardieri
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
| | - Bruno Pinamonti
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
| | - Massimo Zecchin
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
| | - Alberto Pivetta
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
| | - Giancarlo Vitrella
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
| | - Andrea Di Lenarda
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
| | - Gianfranco Sinagra
- Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, A.O.U. "Ospedali Riuniti" e Università degli Studi, Trieste
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Gatti G, Dell'Angela L, Morosin M, Maschietto L, Pinamonti B, Benussi B, Forti G, Nicolosi GL, Sinagra G, Pappalardo A. Flexible band versus rigid ring annuloplasty for functional tricuspid regurgitation: two different patterns of right heart reverse remodelling. Interact Cardiovasc Thorac Surg 2016; 23:79-89. [PMID: 26993479 DOI: 10.1093/icvts/ivw047] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 12/18/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Annuloplasty bands and rings are widely used to treat functional tricuspid regurgitation (TR). However, the question as to which is the ideal annuloplasty device remains open. Early and late outcomes of tricuspid valve annuloplasty with flexible band (B-TVA) or rigid ring (R-TVA) are compared in the present study. METHODS Between 1999 and 2014, 462 consecutive patients (mean age, 69.2 ± 9.5 years) with grade ≥1+ functional TR (graded from 0 to 3+) underwent either B-TVA (n = 345; mean EuroSCORE II 9.2 ± 10.8%) or R-TVA (n = 117; mean EuroSCORE II 12 ± 13.4%) in addition to other cardiac procedures at the authors' institution. RESULTS One-to-one propensity score-matched analysis resulted in 98 pairs with similar baseline characteristics and operative risk. Hospital mortality was 7.5% after B-TVA and 12% after R-TVA (P = 0.14). R-TVA was associated with higher rates of low cardiac output (10.1 vs 17.9%, P = 0.025) and transient complete atrioventricular block (10.3 vs 17.2%, P = 0.046). Among the matched pairs, there were no significant differences in hospital mortality (5.1 vs 9.2%, P = 0.27) and perioperative complications. Both in overall series and matched pairs, between B-TVA and R-TVA patients, there were no significant differences in freedom from all-cause death (P = 0.29 and 0.91), cardiac and cerebrovascular deaths (P = 0.63 and 0.87) and grade ≥2+ TR (P = 0.68 and 0.77). Right atrial and tricuspid valve reverse remodelling combined with right ventricular reverse remodelling occurred after R-TVA but not after B-TVA. CONCLUSIONS B-TVA and R-TVA are equally effective in the treatment of functional TR. However, R-TVA causes over time a more complete right heart reverse remodelling.
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Affiliation(s)
- Giuseppe Gatti
- Division of Cardiac Surgery, Ospedali Riuniti and University of Trieste, Trieste, Italy
| | - Luca Dell'Angela
- Division of Cardiology, Ospedali Riuniti and University of Trieste, Trieste, Italy
| | - Marco Morosin
- Division of Cardiology, Ospedali Riuniti and University of Trieste, Trieste, Italy
| | - Luca Maschietto
- Division of Cardiac Surgery, Ospedali Riuniti and University of Trieste, Trieste, Italy
| | - Bruno Pinamonti
- Division of Cardiology, Ospedali Riuniti and University of Trieste, Trieste, Italy
| | - Bernardo Benussi
- Division of Cardiac Surgery, Ospedali Riuniti and University of Trieste, Trieste, Italy
| | - Gabriella Forti
- Division of Cardiac Surgery, Ospedali Riuniti and University of Trieste, Trieste, Italy
| | - Gian Luigi Nicolosi
- Department of Cardiology, Azienda Ospedaliera Santa Maria degli Angeli, Pordenone, Italy
| | - Gianfranco Sinagra
- Division of Cardiology, Ospedali Riuniti and University of Trieste, Trieste, Italy
| | - Aniello Pappalardo
- Division of Cardiac Surgery, Ospedali Riuniti and University of Trieste, Trieste, Italy
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Prati G, Vitrella G, Allocca G, Muser D, Buttignoni SC, Piccoli G, Morocutti G, Delise P, Pinamonti B, Proclemer A, Sinagra G, Nucifora G. Right Ventricular Strain and Dyssynchrony Assessment in Arrhythmogenic Right Ventricular Cardiomyopathy: Cardiac Magnetic Resonance Feature-Tracking Study. Circ Cardiovasc Imaging 2016; 8:e003647; discussion e003647. [PMID: 26534932 DOI: 10.1161/circimaging.115.003647] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Analysis of right ventricular (RV) regional dysfunction by cardiac magnetic resonance (CMR) imaging in arrhythmogenic RV cardiomyopathy (ARVC) may be inadequate because of the complex contraction pattern of the RV. Aim of this study was to determine the use of RV strain and dyssynchrony assessment in ARVC using feature-tracking CMR analysis. METHODS AND RESULTS Thirty-two consecutive patients with ARVC referred to CMR imaging were included. Thirty-two patients with idiopathic RV outflow tract arrhythmias and 32 control subjects, matched for age and sex to the ARVC group, were included for comparison purpose. CMR imaging was performed to assess biventricular function; feature-tracking analysis was applied to the cine CMR images to assess regional and global longitudinal, circumferential, and radial RV strains and RV dyssynchrony (defined as the SD of the time-to-peak strain of the RV segments). RV global longitudinal strain (-17±5% versus -26±6% versus -29±6%; P<0.001), global circumferential strain (-9±4% versus -12±4% versus -13±5%; P=0.001), and global radial strain (18 [12-26]% versus 22 [15-32]% versus 27 [20-39]%; P=0.015) were significantly lower and SD of the time-to-peak RV strain in all 3 directions were significantly higher among patients with ARVC compared with patients with RV outflow tract arrhythmias and controls. RV global longitudinal strain >-23.2%, SD of the time-to-peak RV longitudinal strain >113.1 ms, and SD of the time-to-peak RV circumferential strain >177.1 ms allowed correct identification of 88%, 75%, and 63% of ARVC patients with no or only minor CMR criteria for ARVC diagnosis. CONCLUSIONS Strain analysis by feature-tracking CMR helps to objectively quantify global and regional RV dysfunction and RV dyssynchrony in patients with ARVC and provides incremental value over conventional cine CMR imaging.
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Affiliation(s)
- Giulio Prati
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy
| | - Giancarlo Vitrella
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy
| | - Giuseppe Allocca
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy
| | - Daniele Muser
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy
| | - Sonja Cukon Buttignoni
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy
| | - Gianluca Piccoli
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy
| | - Giorgio Morocutti
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy
| | - Pietro Delise
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy
| | - Bruno Pinamonti
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy
| | - Alessandro Proclemer
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy
| | - Gianfranco Sinagra
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy
| | - Gaetano Nucifora
- From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
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Porto AG, Pinamonti B, Abate E, Korcova R, Iorio A, Stolfo D, Puggia I, Belgrano MG, Vitrella G, Sinagra G. An interesting case of left-to-right shunt: clues from noninvasive imaging. J Cardiovasc Med (Hagerstown) 2016; 17 Suppl 2:e122-e123. [PMID: 26735862 DOI: 10.2459/jcm.0000000000000296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Andrea Giuseppe Porto
- aCardiovascular Department bRadiology Department, 'Ospedali Riuniti and University of Trieste', Trieste, Italy
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Winter R, Fazlinezhad A, Martins Fernandes S, Pellegrino M, Iriart X, Moustafa S, Stolfo D, Bieseviciene M, Patel S, Vriz O, Sarvari SI, Santos M, Berezin A, Stoebe S, Benyounes Iglesias N, De Chiara B, Soliman A, Oni O, Ricci F, Tumasyan LR, Kim KH, Popa BA, Yiangou K, Olsen RH, Cacicedo A, Monti L, Holte E, Orlic D, Trifunovic D, Nucifora G, Casalta AC, Cavalcante JL, Keramida K, Calin A, Almeida Morais L, Bandera F, Galli E, Kamal HM, Leite L, Polte CL, Martinez Santos P, Jin CN, Generati G, Reali M, Kalcik M, Cacicedo A, Nascimento H, Ferreiro Quero C, Kazum S, Madeira S, Villagra JM, Muraru D, Gobbo M, Generati G, D'andrea A, Azevedo O, Nucifora G, Cruz I, Lozano Granero VC, Stampfli SF, Marketou M, Bento D, Mohty D, Hernandez Jimenez V, Gascuena R, Ingvarsson A, Cameli M, Werther Evaldsson A, Greiner S, Michelsen MM, El Eraky AZZA, Kamal HM, D'ascenzi F, Spinelli L, Stojanovic S, Mincu RI, Vindis D, Mantovani F, Yi JE, Styczynski G, Battah AHMED, O'driscoll J, Generati G, Velasco Del Castillo S, Voilliot D, Scali MC, Garcia Campos A, Opitz B, Herold IHF, Veiga CESAR, Santos Furtado M, Khan UM, Leite L, Leite L, Leite L, Keramida K, Molnar AA, Rio P, Huang MS, Papadopoulos C, Venneri L, Onut R, Casas Rojo E, Bayat F, Aggeli C, Ben Kahla S, Abid L, Choi JH, Barreiro Perez M, Lindqvist P, Sheehan F, Vojdanparast M, Nezafati P, Teixeira R, Generati G, Bandera F, Labate V, Alfonzetti E, Guazzi M, Dinet ML, Jalal Z, Cochet H, Thambo JB, Ho TH, Shah P, Murphy K, Nelluri BK, Lee H, Wilansky S, Mookadam F, Tonet E, Merlo M, Barbati G, Gigli M, Pinamonti B, Ramani F, Zecchin M, Sinagra G, Vaskelyte JJ, Mizariene V, Lesauskaite V, Verseckaite R, Karaliute R, Jonkaitiene R, Li L, Craft M, Danford D, Kutty S, Pellegrinet M, Zito C, Carerj S, Di Bello V, Cittadini A, Bossone E, Antonini-Canterin F, Rodriguez M, Sitges M, Sepulveda-Martinez A, Gratacos E, Bijnens B, Crispi F, Leite L, Martins R, Baptista R, Barbosa A, Ribeiro N, Oliveira A, Castro G, Pego M, Samura T, Kremzer A, Tarr A, Pfeiffer D, Hagendorff A, Van Der Vynckt C, Gout O, Devys JM, Cohen A, Musca F, D'angelo L, Cipriani MG, Parolini M, Rossi A, Santambrogio GM, Russo C, Giannattasio C, Moreo A, Moharram M, Gamal A, Reda A, Adebiyi A, Aje A, Aquilani R, Dipace G, Bucciarelli V, Bianco F, Miniero E, Scipioni G, De Caterina R, Gallina S, Adamyan KG, Chilingaryan AL, Tunyan LG, Cho JY, Yoon HJ, Ahn Y, Jeong MH, Cho JG, Park JC, Popa A, Cerin G, Azina CH, Yiangou A, Georgiou C, Zitti M, Ioannides M, Chimonides S, Pedersen LR, Snoer M, Christensen TE, Ghotbi AA, Hasbak P, Kjaer A, Haugaard SB, Prescott E, Velasco Del Castillo S, Gomez Sanchez V, Anton Ladislao A, Onaindia Gandarias J, Rodriguez Sanchez I, Jimenez Melo O, Garcia Cuenca E, Zugazabeitia Irazabal G, Romero Pereiro A, Nardi B, Di Giovine G, Malanchini G, Scardino C, Balzarini L, Presbitero P, Gasparini GL, Tesic M, Zamaklar-Trifunovic D, Vujisic-Tesic B, Borovic M, Milasinovic D, Zivkovic M, Kostic J, Belelsin B, Ostojic M, Krljanac G, Savic L, Asanin M, Aleksandric S, Petrovic M, Zlatic N, Lasica R, Mrdovic I, Muser D, Zanuttini D, Tioni C, Bernardi G, Spedicato L, Proclemer A, Galli E, Szymanski C, Salaun E, Lavoute C, Haentjens J, Tribouilloy C, Mancini J, Donal E, Habib G, Delgado-Montero A, Dahou A, Caballero L, Rijal S, Gorcsan J, Monin JL, Pibarot P, Lancellotti P, Kouris N, Kostopoulos V, Giannaris V, Trifou E, Markos L, Mihalopoulos A, Mprempos G, Olympios CD, Mateescu AD, Rosca M, Beladan CC, Enache R, Gurzun MM, Varga P, Calin C, Ginghina C, Popescu BA, Galrinho A, Branco L, Gomes V, Timoteo AT, Daniel P, Rodrigues I, Rosa S, Fragata J, Ferreira R, Generati G, Pellegrino M, Carbone F, Labate V, Alfonzetti E, Guazzi M, Leclercq C, Samset E, Donal E, Oraby MA, Eleraky AZ, Yossuef MA, Baptista R, Teixeira R, Ribeiro N, Oliveira AP, Barbosa A, Castro G, Martins R, Elvas L, Pego M, Gao SA, Lagerstrand KM, Johnsson ÅA, Bech-Hanssen O, Vilacosta I, Batlle Lopez E, Sanchez Sauce B, Jimenez Valtierra J, Espana Barrio E, Campuzano Ruiz R, De La Rosa Riestra A, Alonso Bello J, Perez Gonzalez F, Wan S, Sun JP, Lee AP, Bandera F, Pellegrino M, Carbone F, Labate V, Alfonzetti E, Guazzi M, Cimino S, Salatino T, Silvetti E, Mancone M, Pennacchi M, Giordano A, Sardella G, Agati L, Yesin M, Gunduz S, Gursoy MO, Astarcioglu MA, Karakoyun S, Bayam E, Cersit S, Ozkan M, Velasco Del Castillo S, Gomez Sanchez V, Anton Ladislao A, Onaindia Gandarias J, Rodriguez Sanchez I, Jimenez Melo O, Quintana Razcka O, Romero Pereiro A, Zugazabeitia Irazabal G, Braga M, Flores L, Ribeiro V, Melao F, Dias P, Maciel MJ, Bettencourt P, Mesa Rubio MD, Ruiz Ortiz M, Delgado Ortega M, Sanchez Fernandez J, Duran Jimenez E, Morenate Navio C, Romero M, Pan M, Suarez De Lezo J, Vaturi M, Weisenberg D, Monakier D, Valdman A, Vaknin- Assa H, Assali A, Kornowski R, Sagie A, Shapira Y, Ribeiras R, Abecasis J, Teles R, Castro M, Tralhao A, Horta E, Brito J, Andrade M, Mendes M, Avegliano G, Ronderos R, Matta MG, Camporrotondo M, Castro F, Albina G, Aranda A, Navia D, Siciliano M, Migliore F, Cavedon S, Folino F, Pedrizzetti G, Bertaglia M, Corrado D, Iliceto S, Badano LP, Merlo M, Stolfo D, Losurdo P, Ramani F, Barbati G, Pivetta A, Pinamonti B, Sinagra GF, Di Lenarda A, Bandera F, Pellegrino M, Labate V, Carbone F, Alfonzetti E, Guazzi M, Di Palma E, Baldini L, Verrengia M, Vastarella R, Limongelli G, Bossone E, Calabro' R, Russo MG, Pacileo G, Cruz I, Correia E, Bento D, Teles L, Lourenco C, Faria R, Domingues K, Picarra B, Marques N, Muser D, Gianfagna P, Morocutti G, Proclemer A, Gomes AC, Lopes LR, Stuart B, Caldeira D, Morgado G, Almeida AR, Canedo P, Bagulho C, Pereira H, Pardo Sanz A, Marco Del Castillo A, Monteagudo Ruiz JM, Rincon Diaz LM, Ruiz Rejon F, Casas E, Hinojar R, Fernandez-Golfin C, Zamorano Gomez JL, Erhart L, Staehli BE, Kaufmann BA, Tanner FC, Kontaraki J, Parthenakis F, Maragkoudakis S, Zacharis E, Patrianakos A, Vardas P, Domingues K, Correia E, Lopes L, Teles L, Picarra B, Magalhaes P, Faria R, Lourenco C, Azevedo O, Boulogne C, Magne J, Damy T, Martin S, Boncoeur MP, Aboyans V, Jaccard A, Saavedra Falero J, Alberca Vela MT, Molina Blazquez L, Mata Caballero R, Serrano Rosado JA, Elviro R, Di Gioia C, Fernandez Rozas I, Manzano MC, Martinez Sanchez JI, Molina M, Palma J, Werther Evaldsson A, Radegran G, Stagmo M, Waktare J, Roijer A, Meurling CJ, Righini FM, Sparla S, Di Tommaso C, Focardi M, D'ascenzi F, Tacchini D, Maccherini M, Henein M, Mondillo S, Ingvarsson A, Waktare J, Thilen U, Stagmo M, Roijer A, Radegran G, Meurling C, Jud A, Aurich M, Katus HA, Mereles D, Faber R, Pena A, Mygind ND, Suhrs HE, Zander M, Prescott E, Handoka NESRIN, Ghali MONA, Eldahshan NAHED, Ibrahim AHMED, Al-Eraky AZ, El Attar MA, Omar AS, Pelliccia A, Alvino F, Solari M, Cameli M, Focardi M, Bonifazi M, Mondillo S, Giudice CA, Assante Di Panzillo E, Castaldo D, Riccio E, Pisani A, Trimarco B, Deljanin Ilic M, Ilic S, Magda LS, Florescu M, Velcea A, Mihalcea D, Chiru A, Popescu BO, Tiu C, Vinereanu D, Hutyra M, Cechakova E, Littnerova S, Taborsky M, Lugli R, Bursi F, Fabbri M, Modena MG, Stefanelli G, Mussini C, Barbieri A, Youn HJ, O JH, Yoon HJ, Jung HO, Shin GJ, Rdzanek A, Pietrasik A, Kochman J, Huczek Z, Milewska A, Marczewska M, Szmigielski CA, Abd Eldayem SOHA, El Magd El Bohy ABO, Slee A, Peresso V, Nazir S, Sharma R, Bandera F, Pellegrino M, Labate V, Carbone F, Alfonzetti E, Guazzi M, Anton Ladislao A, Gomez Sanchez V, Cacidedo Fernandez Bobadilla A, Onaindia Gandarias JJ, Rodriguez Sanchez I, Romero Pereira A, Quintana Rackza O, Jimenez Melo O, Zugazabeitia Irazabal G, Huttin O, Venner C, Deballon R, Manenti V, Villemin T, Olivier A, Sadoul N, Juilliere Y, Selton-Suty C, Simioniuc A, Mandoli GE, Dini FL, Marzilli M, Picano E, Martin-Fernandez M, De La Hera Galarza JM, Corros-Vicente C, Leon-Aguero V, Velasco-Alonso E, Colunga-Blanco S, Fidalgo-Arguelles A, Rozado-Castano J, Moris De La Tassa C, Stelzmueller ME, Wisser W, Reichenfelser W, Mohl W, Saporito S, Mischi M, Bouwman RA, Van Assen HC, Van Den Bosch HCM, De Lepper A, Korsten HHM, Houthuizen P, Rodrigues A, Leal G, Silvestre O, Andrade J, Hjertaas JJ, Greve G, Matre K, Teixeira R, Baptista R, Barbosa A, Ribeiro N, Castro G, Martins R, Cardim N, Goncalves L, Pego M, Teixeira R, Baptista R, Barbosa A, Ribeiro N, Castro G, Martins R, Cardim N, Goncalves L, Pego M, Teixeira R, Baptista R, Barbosa A, Oliveira AP, Castro G, Martins R, Cardim N, Goncalves L, Pego M, Kouris N, Kostopoulos V, Markos L, Olympios CD, Kovacs A, Tarnoki AD, Tarnoki DL, Kolossvary M, Apor A, Maurovich-Horvat P, Jermendy G, Sengupta P, Merkely B, Viveiros Monteiro A, Galrinho A, Pereira-Da-Silva T, Moura Branco L, Timoteo A, Abreu J, Leal A, Varela F, Cruz Ferreira R, Yang LT, Tsai WC, Mpaltoumas K, Fotoglidis A, Triantafyllou K, Pagourelias E, Kassimatis E, Tzikas S, Kotsiouros G, Mantzogeorgou E, Vassilikos V, Calicchio F, Manivarmane R, Pareek N, Baksi J, Rosen S, Senior R, Lyon AR, Khattar RS, Marinescu C, Onciul S, Zamfir D, Tautu O, Dorobantu M, Carbonell San Roman A, Rincon Diez LM, Gonzalez Gomez A, Fernandez Santos S, Lazaro Rivera C, Moreno Vinues C, Sanmartin Fernandez M, Fernandez-Golfin C, Zamorano Gomez JL, Alirezaei T, Karimi AS, Kakiouzi V, Felekos I, Panagopoulou V, Latsios G, Karabela M, Petras D, Tousoulis D, Abid L, Abid D, Kammoun S, Ben Kahla S, Lee JW, Martin Fernandez M, Costilla Garcia SM, Diaz Pelaez E, Moris De La Tassa C. Poster session 3The imaging examinationP646Simulator-based testing of skill in transthoracic echoP647Clinical and echocardiographic characteristics of isolated left ventricular non-compactionP648Appropriate use criteria of transthoracic echocardiography and its clinical impact in an aged populationAnatomy and physiology of the heart and great vesselsP649Prevalence and determinants of exercise oscillatory ventilation in the EUROEX trial populationAssessment of diameters, volumes and massP650Left atrial remodeling after percutaneous left atrial appendage closureP651Global atrial performance with tyrosine kinase inhibitors in metastatic renal cell carcinomaP652Early right ventricular response to cardiac resynchronization therapy: impact on clinical outcomesP653Parameters of speckle-tracking echocardiography and biomechanical values of a dilative ascending aortaAssessments of haemodynamicsP654Right atrial hemodynamics in infants and children: observations from 3-dimensional echocardiography derived right atrial volumesAssessment of systolic functionP655One-point carotid wave intensity predicts cardiac mortality in patients with congestive heart failure and reduced ejection fractionP656Persistence of cardiac remodeling in adolescents with previous fetal growth restrictionP6572D speckle tracking-derived left ventricle global longitudinal strain and left ventricular dysfunction stages: a useful discriminator in moderate-to-severe aortic regurgitationP658Global longitudinal strain and strain rate in type two diabetes patients with chronic heart failure: relevance to circulating osteoprotegerinP659Analysis of left ventricular function in patients before and after surgical and interventional mitral valve therapyP660Left ventricular end-diastolic volume is complementary with global longitudinal strain for the prediction of left ventricular ejection fraction in echocardiographic daily practiceP661Left ventricular assist device, right ventricle function, and selection bias: the light side of the moonP662Assessment of right ventricular function in patients with anterior ST elevation myocardial infarction; a 2-d speckle tracking studyP663Right ventricular systolic function assessment in sickle cell anaemia using echocardiographyAssessment of diastolic functionP664Prognostic value of transthoracic cardiopulmonary ultrasound in cardiac surgery intensive care unitP665Comparative efficacy of renin-angiotensin system modulators on prognosis, right heart and left atrial parameters in patients with chronic heart failure and preserved left ventricular systolic functionP666Left atrial volume index is the most significant diastolic functional parameter of hemodynamic burden as measured by NT-proBNP in acute myocardial infarctionP667Preventive echocardiographic screening. preliminary dataP668Assessment of the atrial electromechanical delay and the mechanical functions of the left atrium in patients with diabetes mellitus type IIschemic heart diseaseP669Coronary flow velocity reserve by echocardiography as a measure of microvascular function: feasibility, reproducibility and agreement with PET in overweight patients with coronary artery diseaseP670Influence of cardiovascular risk in the occurrence of events in patients with negative stress echocardiographyP671Prevalence of transmural myocardial infarction and viable myocardium in chronic total occlusion (CTO) patientsP672The impact of the interleukin 6 receptor antagonist tocilizumab on mircovascular dysfunction after non st elevation myocardial infarction assessed by coronary flow reserve from a randomized studyP673Impact of manual thrombus aspiration on left ventricular remodeling: the echocardiographic substudy of the randomized Physiologic Assessment of Thrombus Aspirtion in patients with ST-segment ElevatioP674Acute heart failure in STEMI patients treated with primary percutaneous coronary intervention is related to transmural circumferential myocardial strainP675Long-term prognostic value of infarct size as assessed by cardiac magnetic resonance imaging after a first st-segment elevation myocardial infarctionHeart valve DiseasesP676Prognostic value of LV global longitudinal strain in aortic stenosis with preserved LV ejection fractionP677Importance of longitudinal dyssynchrony in low flow low gradient severe aortic stenosis patients undergoing dobutamine stress echocardiography. a multicenter study (on behalf of the HAVEC group)P678Predictive value of left ventricular longitudinal strain by 2D Speckle Tracking echocardiography, in asymptomatic patients with severe aortic stenosis and preserved ejection fractionP679Clinical and echocardiographic characteristics of the flow-gradient patterns in patients with severe aortic stenosis and preserved left ventricular ejection fractionP6802D and 3D speckle tracking assessment of left ventricular function in severe aortic stenosis, a step further from biplane ejection fractionP681Functional evaluation in aortic stenosis: determinant of exercise capacityP682Left ventricular mechanics: novel tools to evaluate left ventricular function in patients with primary mitral regurgitationP683Plasma B-type natriuretic peptide level in patients with isolated rheumatic mitral stenosisP684Quantitative assessment of severity in aortic regurgitation and the influence of elastic proprieties of thoracic aortaP685Characterization of chronic aortic and mitral regurgitation using cardiovascular magnetic resonanceP686Functional mitral regurgitation: a warning sign of underlying left ventricular systolic dysfunction in heart failure with preserved ejection fraction.P687Secondary mitral valve tenting in primary degenerative prolapse quantified by three-dimensional echocardiography predicts regurgitation recurrence after mitral valve repairP688Advanced heart failure with reduced ejection fraction and severe mitral insufficiency compensate with a higher oxygen peripheral extraction to a reduced cardiac output vs oxygen uptake response to maxP689Predictors of acute procedural success after percutaneous mitraclip implantation in patients with moderate-to-severe or severe mitral regurgitation and reduced ejection fractionP690The value of transvalvular gradients obtained by transthoracic echocardiography in estimation of severe paravalvular leakage in patients with mitral prosthetic valvesP691Characteristics of infective endocarditis in a non tertiary hospitalP692Infective endocarditis: predictors of severity in a 3-year retrospective analysisP693New echocardiographic predictors of early recurrent mitral functional regurgitation after mitraclip implantationP694Transesophageal echocardiography can be reliably used for the allocation of patients with severe aortic stenosis for tras-catheter aortic valve implantationP695Annular sizing for transcatheter aortic valve selection. A comparison between computed tomography and 3D echocardiographyP696Association between aortic dilatation, mitral valve prolapse and atrial septal aneurysm: first descriptive study.CardiomyopathiesP698Cardiac resynchronization therapy by multipoint pacing improves the acute response of left ventricular mechanics and fluid dynamics: a three-dimensional and particle image velocimetry echo studyP699Long-term natural history of right ventricular function in dilated cardiomyopathy: innocent bystander or leading actor?P700Right to left ventricular interdependence at rest and during exercise assessed by the ratio between pulmonary systolic to diastolic time in heart failure reduced ejection fractionP701Exercise strain imaging demonstrates impaired right ventricular contractile reserve in patients with hypertrophic cardiomyopathyP702Prevalence of overt left ventricular dysfunction (burn-out phase) in a portuguese population of hypertrophic cardiomyopathy, a multicentre studyP703Systolic and diastolic myocardial mechanics in hypertrophic cardiomyopathy and their link to the extent of hypertrophy, replacement fibrosis and interstitial fibrosisP704Multimodality imaging and genotype-phenotype associations in a cohort of patients with hypertrophic cardiomyopathy studied by next generation sequencing and cardiac magnetic resonanceP705Sudden cardiac death risk assessment in apical hypertrophic cardiomyopathy: do we need to add MRI to the equation?P706Prognostic value of left ventricular ejection fraction, proBNP, exercise capacity, and NYHA functional class in patients with left ventricular non-compaction cardiomyopathyP707The anti-hypertrophic microRNAs miR-1, miR-133a and miR-26b and their relationship to left ventricular hypertrophy in patients with essential hypertensionP708Prevalence of left ventricular systolic dysfunction in a portuguese population of left ventricular non-compaction cardiomyopathy, a multicentre studyP709Assessment of systolic and diastolic features in light chain amyloidosis: an echocardiographic and cardiac magnetic resonance studyP710Morbid obesity-associated hypertension identifies bariatric surgery best responders: Clinical and echocardiographic follow up studyP711Echocardiographic markera for overhydration in patients under haemodialysisP712Gender aspects of right ventricular size and function in clinically stable heart transplant patientsP713Evidence of cardiac stem cells from the left ventricular apical tip in patients undergone LVAD implant: a comparative strain-ultrastructural studySystemic diseases and other conditionsP714Speckle tracking assessment of right ventricular function is superior for differentiation of pressure versus volume overloaded right ventricleP715Prognostic value of pulmonary arterial pressure: analysis in a large dataset of timely matched non-invasive and invasive assessmentsP716Effect of the glucagon-like peptide-1 analogue liraglutide on left ventricular diastolic and systolic function in patients with type 2 diabetes: a randomised, single-blinded, crossover pilot studyP717Tissue doppler evaluation of left ventricular functions, left atrial mechanical functions and atrial electromechanical delay in juvenile idiopathic arthritisP718Echocardiographic detection of subclinical left ventricular dysfunction in patients with rheumatoid arthritisP719Left ventricular strain values are unaffected by intense training: a longitudinal, speckle-tracking studyP720Diastolic left ventricular function in autosomal dominant polycystic kidney disease: a matched-cohort, speckle-tracking echocardiographic studyP721Relationship between adiponectin level and left ventricular mass and functionP722Left atrial function is impaired in patients with multiple sclerosisMasses, tumors and sources of embolismP723Paradoxical embolization to the brain in patients with acute pulmonary embolism and confirmed patent foramen ovale with bidirectional shunt, results of prospective monitoringP724Following the European Society of Cardiology proposed echocardiographic algorithm in elective patients with clinical suspicion of infective endocarditis: diagnostic yield and prognostic implicationsP725Metastatic cardiac18F-FDG uptake in patients with malignancy: comparison with echocardiographic findingsDiseases of the aortaP726Echocardiographic measurements of aortic pulse wave velocity correlate well with invasive methodP727Assessment of increase in aortic and carotid intimal medial thickness in adolescent type 1 diabetic patientsStress echocardiographyP728Determinants and prognostic significance of heart rate variability in renal transplant candidates undergoing dobutamine stress echocardiographyP729Pattern of cardiac output vs O2 uptake ratio during maximal exercise in heart failure with reduced ejection fraction: pathophysiological insightsP730Prognostic value and predictive factors of cardiac events in patients with normal exercise echocardiographyP731Right ventricular mechanics during exercise echocardiography: normal values, feasibility and reproducibility of conventional and new right ventricular function parametersP732The added value of exercise-echo in heart failure patients: assessing dynamic changes in extravascular lung waterP733Applicability of appropriate use criteria of exercise stress echocardiography in real-life practice: what have we improved with new documents?Transesophageal echocardiographyP7343D-TEE guidance in percutaneous mitral valve interventions correcting mitral regurgitationContrast echocardiographyP735Pulmonary transit time by contrast enhanced ultrasound as parameter for cardiac performance: a comparison with magnetic resonance imaging and NT-ProBNPReal-time three-dimensional TEEP736Optimal parameter selection for anisotropic diffusion denoising filters applied to aortic valve 4d echocardiographsP737Left ventricle systolic function in non-alcoholic cirrhotic candidates for liver transplantation: a three-dimensional speckle-tracking echocardiography studyTissue Doppler and speckle trackingP738Optimizing speckle tracking echocardiography strain measurements in infants: an in-vitro phantom studyP739Usefulness of vascular mechanics in aortic degenerative valve disease to estimate prognosis: a two dimensional speckle tracking studyP740Vascular mechanics in aortic degenerative valve disease: a two dimensional speckle-tracking echocardiography studyP741Statins and vascular load in aortic valve disease patients, a speckle tracking echocardiography studyP742Is Left Bundle Branch Block only an electrocardiographic abnormality? Study of LV function by 2D speckle tracking in patients with normal ejection fractionP743Dominant inheritance of global longitudinal strain in a population of healthy and hypertensive twinsP744Mechanical differences of left atria in paroxysmal atrial fibrillation: A speckle-tracking study.P745Different distribution of myocardial deformation between hypertrophic cardiomyopathy and aortic stenosisP746Left atrial mechanics in patients with chronic renal failure. Incremental value for atrial fibrillation predictionP747Subclinical myocardial dysfunction in cancer patients: is there a direct effect of tumour growth?P748The abnormal global longitudinal strain predicts significant circumflex artery disease in low risk acute coronary syndromeP7493D-Speckle tracking echocardiography for assessing ventricular funcion and infarct size in young patients after acute coronary syndromeP750Evaluation of left ventricular dyssynchrony by echocardiograhy in patients with type 2 diabetes mellitus without clinically evident cardiac diseaseP751Differences in myocardial function between peritoneal dialysis and hemodialysis patients: insights from speckle tracking echoP752Appraisal of left atrium changes in hypertensive heart disease: insights from a speckle tracking studyP753Left ventricular rotational behavior in hypertensive patients: Two dimensional speckle tracking imaging studyComputed Tomography & Nuclear CardiologyP754Effectiveness of adaptive statistical iterative reconstruction of 64-slice dual-energy ct pulmonary angiography in the patients with reduced iodine load: comparison with standard ct pulmonary angiograP755Clinical prediction model to inconclusive result assessed by coronary computed tomography angiography. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Stolfo D, Tonet E, Merlo M, Barbati G, Gigli M, Pinamonti B, Ramani F, Zecchin M, Sinagra G. Early right ventricular response to cardiac resynchronization therapy: impact on clinical outcomes. Eur J Heart Fail 2015; 18:205-13. [DOI: 10.1002/ejhf.450] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/13/2015] [Accepted: 10/28/2015] [Indexed: 11/11/2022] Open
Affiliation(s)
- Davide Stolfo
- Cardiovascular Department; ‘Ospedali Riuniti’ and University of Trieste; Trieste Italy
| | - Elisabetta Tonet
- Cardiovascular Department; ‘Ospedali Riuniti’ and University of Trieste; Trieste Italy
| | - Marco Merlo
- Cardiovascular Department; ‘Ospedali Riuniti’ and University of Trieste; Trieste Italy
| | - Giulia Barbati
- Cardiovascular Department; ‘Ospedali Riuniti’ and University of Trieste; Trieste Italy
| | - Marta Gigli
- Cardiovascular Department; ‘Ospedali Riuniti’ and University of Trieste; Trieste Italy
| | - Bruno Pinamonti
- Cardiovascular Department; ‘Ospedali Riuniti’ and University of Trieste; Trieste Italy
| | - Federica Ramani
- Cardiovascular Department; ‘Ospedali Riuniti’ and University of Trieste; Trieste Italy
| | - Massimo Zecchin
- Cardiovascular Department; ‘Ospedali Riuniti’ and University of Trieste; Trieste Italy
| | - Gianfranco Sinagra
- Cardiovascular Department; ‘Ospedali Riuniti’ and University of Trieste; Trieste Italy
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Martins Fernandes S, Badano L, Garcia Campos A, Erdei T, Mehdipoor G, Hanboly N, Michalski BW, Vriz O, Mo VY, Le TT, Ribeiro JM, Ternacle J, Yurdakul SELEN, Shetye A, Stoebe S, Lisowska A, Chinali M, Orabona M, Contaldi C, De La Chica JA, Codolosa JN, Trzcinski P, Prado Diaz S, Morales Portano JD, Ha SJ, Valente F, Joseph G, Valente F, Scali MC, Cordeiro F, Duchateau N, Fabris E, Costantino MF, Cho IJ, Goublaire C, Lam W, Galli E, Kim KH, Mariani M, Malev E, Zuercher F, Tang Z, Cimino S, Mahia P, De La Chica JA, Petrovic J, Ciobotaru V, Remsey- Semmelweiss E, Kogoj P, Guerreiro S, Saxena A, Mozenska O, Pontone G, Macaya Ten F, Caballero L, Avegliano G, Halmai L, Reis L, Trifunovic D, Gospodinova M, Makavos G, D'ascenzi F, Dantas Tavares De Melo M, Bonapace S, Kulkarni A, Cameli M, Ingvarsson A, Driessen MMP, Tufekcioglu O, Radulescu D, Barac A, Cioffi G, Almeida Morais L, Ledakowicz-Polak A, Portugal G, Naksuk N, Parato VM, Kovalova S, Cherubini A, Corrado G, Malev E, Wierzbowska-Drabik K, Lesevic H, Laredj N, Pieles GE, Generati G, Van Zalen JJ, Aquila I, Cheng HL, Lanzoni L, Asmarats Serra L, Kadrabulatova S, Ranjbar S, Szczesniak-Stanczyk D, Sharka I, Di Salvo G, Ben Kahla S, Li L, Hadeed HA, Habeeb HA, Toscano A, Granata F, Djikic D, Wdowiak-Okrojek K, Girgis HYA, Sharma A, Soro C, Gallego Page JC, Corneli M, Teixeira R, Roussin I, Lynch M, Muraru D, Romeo G, Ermacora D, Marotta C, Aruta P, Cucchini U, Iliceto S, Martin-Fernandez M, De La Hera Galarza JM, Corros-Vicente C, Colunga Blanco S, Velasco-Alonso E, Leon-Aguero V, Rodriguez-Suarez ML, Moris De La Tassa C, Edwards J, Braim D, Price C, Fraser AG, Salmani F, Arjmand Shabestari A, Szymczyk E, Kupczynska K, Peczek L, Nawrot B, Lipiec P, Kasprzak JD, Driussi C, Ferrara F, Brosolo G, Antonini-Canterin F, Magne J, Aboyans V, Bossone E, Bellucci BM, Fisher JM, Balekian AA, Idapalapati S, Huang F, Wong JI, Tan RS, Teixeira R, Madeira M, Almeida I, Reis L, Siserman A, Dinis P, Dias L, Ramos AP, Goncalves L, Wan FW, Sawaki DS, Dubois-Rande JLDR, Adnot SA, Czibik GC, Derumeaux GD, Ercan G, Tekkesin ILKER, Sahin ST, Cengiz B, Celik G, Demircan S, Aytekin SAIDE, Razvi NA, Nazir SA, Price N, Khan JN, Kanagala P, Singh A, Squire I, Mccann GP, Langel M, Pfeiffer D, Hagendorff A, Ptaszynska-Kopczynska K, Marcinkiewicz-Siemion M, Knapp M, Witkowski M, Musial WJ, Kaminski K, Natali B, D' Anna C, Leonardi B, Secinaro A, Pongiglione G, Rinelli G, Renard S, Michel N, Mancini J, Haentjens J, Sitbon O, Habib G, Imbriaco M, Alcidi G, Santoro C, Buonauro A, Lo Iudice F, Lembo M, Cuocolo A, Trimarco B, Galderisi M, Mora Robles J, Roldan Jimenez MA, Mancisidor MA, De Mora MA, Alnabelsi T, Goykhman I, Koshkelashvili N, Romero-Corral A, Pressman GS, Michalski BW, Kupczynska K, Miskowiec D, Lipiec P, Kasprzak JD, Montoro Lopez N, Refoyo Salicio E, Valbuena Lopez SC, Gonzalez O, Alvarez C, Moreno Yanguela M, Bartha Rasero JL, De La Calle M, Guzman Martinez G, Suarez-Cuenca JA, Merino JA, Gomez Alvarez EB, Delgado LG, Woo YM, Bang WD, Sohn GH, Cheong SS, Yoo SY, Rodriguez Palomares JF, Gutierrez L, Maldonado G, Pineda V, Galian L, Teixido G, Gonzalez Allujas MT, Evangelista A, Garcia Dorado D, Zaremba T, Ekeloef S, Heiberg E, Engblom H, Jensen SE, Sogaard P, Rodriguez Palomares JF, Gutierrez L, Garcia G, Pineda V, Galian L, Teixido G, Gonzalez Allujas MT, Evangelista A, Garcia Dorado D, Dini FL, Galli F, Lattanzi F, Picano E, Marzilli M, Leao S, Moz M, Magalhaes P, Trigo J, Mateus PS, Ferreira A, Moreira JI, De Craene M, Legallois D, Labombarda F, Pellissier A, Sermesant M, Saloux E, Merlo M, Moretti M, Barbati G, Stolfo D, Gigli M, Pinamonti B, Sinagra G, Dores E, Matera A, Innelli P, Innelli P, Lopizzo A, Violini R, Fiorilli R, Cappabianca G, Picano E, Tarsia G, Seo J, Chang HJ, Heo R, Kim IC, Shim CY, Hong GR, Chung N, Melissopoulou MM, Nguyen V, Brochet E, Cimadevilla C, Codogno I, Vahanian A, Messika-Zeitoun D, Pontana F, Vassiliou V, Prasad S, Leclercq C, Samset E, Donal E, Lim DS, Bianchi G, Rossi F, Gianetti J, Marchi F, Cerone E, Nardelli A, Terrazzi M, Solinas M, Maffei S, Pshepiy A, Vasina L, Timofeev E, Reeva S, Zemtsovsky E, Brugger N, Jahren S, De Marchi SF, Seiler C, Jin CN, Tang H, Fan K, Kam K, Yan BP, Yu CM, Lee PW, Reali M, Silvetti E, Salatino T, Mancone M, Pennacchi M, Giordano A, Sardella G, Agati L, Tirado G, Nogales-Romo MT, Marcos-Alberca P, De Agustin A, Almeria C, Rodrigo JL, Garcia Fernandez MA, Macaya C, Perez De Isla L, Mancisidor M, Lara Garcia C, Vivancos R, De Mora M, Petrovic M, Vujisic-Tesic B, Trifunovic D, Boricic-Kostic M, Petrovic I, Draganic G, Petrovic O, Tomic-Dragovic M, Furlan T, Ambrozic J, Mohorko Pleskovic PN, Bunc M, Ribeiras R, Abecasis J, Andrade MJ, Mendes M, Ramakrishnan S, Gupta SK, Juneja R, Kothari SS, Zaleska M, Segiet A, Chwesiuk S, Kroc A, Kosior DA, Andreini D, Solbiati A, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Rota C, Guaricci AI, Pepi M, Pons Llinares J, Asmarats Serra L, Pericas Ramis P, Caldes Llull O, Grau Sepulveda A, Frontera G, Vaquer Segui A, Noris M, Bethencourt Gonzalez A, Climent Paya V, Martinez Moreno M, Saura D, Oliva MJ, Sanchez Quinones J, Garcia Honrubia A, Valdes M, De La Morena G, Terricabras M, Costabel JP, Ronderos R, Evangelista A, Venturini C, Galve E, Nemes A, Neubauer S, Rahman Haley S, Banner N, Teixeira R, Caetano F, Almeida I, Trigo J, Botelho A, Silva J, Nascimento J, Goncalves L, Tesic M, Jovanovic I, Petrovic O, Boricic-Kostic M, Dragovic M, Petrovic M, Stepanovic J, Banovic M, Vujisic-Tesic B, Guergelcheva V, Chamova T, Sarafov S, Tournev I, Denchev S, Ikonomidis I, Psarogiannakopoulos P, Tsirigotis P, Paraskevaidis I, Lekakis J, Pelliccia A, Natali BM, Cameli M, Focardi M, Bonifazi M, Mondillo S, Lima C, Assed L, Kalil Filho R, Mady C, Bochi EA, Salemi VMC, Targher G, Valbusa F, Rossi A, Lanzoni L, Lipari P, Zenari L, Molon G, Canali G, Barbieri E, Li L, Craft M, Nanda M, Lorenzo JM, Kutty S, Bombardini T, Sparla S, Di Tommaso C, Losito M, Incampo E, Maccherini M, Mondillo S, Werther Evaldsson A, Radegran G, Stagmo M, Waktare J, Roijer A, Meurling CJ, Hui W, Meijboom FJ, Bijnens B, Dragulescu A, Mertens L, Friedberg MK, Sensoy B, Suleymanoglu M, Akin Y, Sahan E, Sasmaz H, Pasca L, Buzdugan E, Chis B, Stoicescu L, Lynce FC, Smith KL, Mete M, Isaacs C, Viapiana O, Di Nora C, Ognibeni F, Fracassi E, Giollo A, Mazzone C, Faganello G, Di Lenarda A, Rossini M, Galrinho A, Branco L, Timoteo AT, Rodrigues I, Daniel P, Rosa S, Ferreira L, Ferreira R, Polak L, Krauza G, Stokfisz K, Zielinska M, Branco LM, Galrinho A, Mota Carmo M, Teresa Timoteo A, Aguiar Rosa S, Abreu J, Pinto Teixeira P, Viveiros Monteiro A, Cruz Ferreira R, Peeraphatdit T, Chaiteerakij R, Klarich KW, Masia S, Necas J, Nistri S, Negri F, Barbati G, Cioffi G, Russo G, Mazzone C, Faganello G, Pandullo C, Di Lenarda A, Durante A, Rovelli E, Genchi V, Trabattoni L, Zerboni SC, Cattaneo L, Butti E, Ferrari G, Luneva E, Mitrofanova L, Uspensky V, Zemtsovsky E, Kasprzak JD, Rosner S, Karl M, Ott I, Sonne C, Ali Lahmar HM, Hammou L, Forsey J, Gowing L, Miller F, Ramanujam P, Stuart AG, Williams CA, Bandera F, Pellegrino M, Carbone F, Labate V, Alfonzetti E, Guazzi M, Patel NR, Raju P, Beale L, Brickley G, Lloyd GW, Fernandez-Golfin C, Gonzalez A, Rincon LM, Hinojar R, Garcia A, Megias A, Jimenez-Nacher JJ, Moya JL, Zamorano JL, Molon G, Canali G, Bonapace S, Chiampan A, Albrigi L, Barbieri E, Noris Mora M, Rodriguez Fernandez A, Exposito Pineda C, Grande C, Gonzalez Colino R, Macaya Ten F, Fernandez Vazquez X, Fortuny Frau E, Bethencourt Gonzalez A, Karvandi M, Blaszczyk R, Zarczuk R, Brzozowski W, Janowski M, Wysokinski A, Stanczyk B, Myftiu S, Teferici D, Quka A, Dado E, Djamandi J, Kresto L, Duka A, Kristo A, Balla I, Issa Z, Moiduddin N, Siblini G, Bulbul Z, Abid L, Abid D, Kammoun S, Rush E, Craft M, Goodwin J, Kreikemeier R, Cantinotti M, Kutty S, Zolaly MA, Khoshhal SQ, El-Harbi K, Tarawah A, Al-Hawsawi Z, Al-Mozainy I, Bakhoum SWG, Nabil MN, Elebrashy IN, Chinali M, Albanese S, Carotti A, Iacobelli R, Esposito C, Secinaro A, Moscogiuri G, Pasquini L, Malvezzi Caracciolo M, Bianchi RM, Caso P, Arenga F, Riegler L, Scarafile R, D'andrea A, Russo MG, Calabro' P, Simic DS, Peric VP, Mujovic NM, Marinkovic MM, Jankovic NJ, Shim A, Wejner-Mik P, Kasprzak JD, Lipiec P, Jain N, Kharwar R, Saran RK, Narain VS, Dwivedi SK, Sethi R, Chandra S, Pradhan A, Safal S, Marchetti MF, Cacace C, Congia M, Nissardi V, Ruscazio M, Meloni L, Montisci R, Gallego Sanchez G, Calero S, Portero JJ, Tercero A, Garcia JC, Barambio M, Martinez Lazaro R, Meretta AH, Perea GO, Belcastro F, Aguirre E, De Luca I, Henquin R, Masoli O. Poster session 2THE IMAGING EXAMINATIONP536Appropriate use criteria of transthoracic echocardiography and its clinical impact: a continuous challengeP537Implementation of proprietary plug-ins in the DICOM-based computerized echo reporting system fuels the use of 3D echo and deformation imaging in the clinical routine of a multivendor laboratoryP538Exercise stress echocardiography appropriate use criteria: real-life cases classification ease and agreement among cardiologistsANATOMY AND PHYSIOLOGY OF THE HEART AND GREAT VESSELSP539Functional capacity in older people with normal ejection fraction correlates with left ventricular functional reserve and carotid-femoral pulse wave velocity but not with E/e and augmentation indexP540Survey of competency of practitioners for diagnosis of acute cardiopulmonary diseases manifest on chest x-rayASSESSMENT OF DIAMETERS, VOLUMES AND MASSP541Left atrium remodeling in dialysis patients with normal ejection fractionP542The prediction of postinfarction left ventricular remodeling and the role of of leptin and MCP-1 in regard to the presence of metabolic syndromeP543Ascending aorta and common carotid artery: diameters and stiffness in a group of 584 healthy subjectsAssessments of haemodynamicsP544Alternate echo parameters in patients without estimable RVSPAssessment of systolic functionP545Reduced contractile performance in heart failure with preserved ejection fraction: determination using novel preload-adjusted maximal left ventricular ejection forceP546Left ventricular dimensions and prognosis in acute coronary syndromesP547Time course of myocardial alterations in a murine model of high fat diet: A strain rate imaging studyP548Subclinical left ventricular systolic dysfunction in patients with premature ventricular contractionsP549Global myocardial strain by CMR-based feature tracking (FT) and tagging to predict development of severe left ventricular systolic dysfunction after acute st-elevation myocardial infarctionP550Echocardiographic analysis of left and right ventricular function in patients after mitral valve reconstructionP551The role of regional longitudinal strain assessment in predicting response to cardiac resynchronization therapy in patients with left ventricular systolic dysfunction and left bundle branch blockP552Speckle tracking automatic border detection improves echocardiographic evaluation of right ventricular systolic function in repaired tetralogy of fallot patients: comparison with MRI findingsP553Echocardiography: a reproducible and relevant tool in pah? intermediate results of the multicentric efort echogardiographic substudy (evaluation of prognostic factors and therapeutic targets in pah)Assessment of diastolic functionP554Relationship between left ventricular filling pressures and myocardial fibrosis in patients with uncomplicated arterial hypertensionP555Cardiac rehabilitation improves echocardiographic parameters of diastolic function in patients with ischemic heart diseaseP556Diastolic parameters in the calcified mitral annulusP557Biomarkers and echocardiography - combined weapon to diagnose and prognose heart failure with and without preserved ejection fractionP558Diastolic function changes of the maternal heart in twin and singleton pregnancyIschemic heart diseaseP559Syntax score as predictor for the correlation between epicardial adipose tissue and the severity of coronary lesions in patients with significant coronary diseaseP560Impact of strain analysis in ergonovine stress echocardiography for diagnosis vasospastic anginaP561Cardiac magnetic resonance tissue tracking: a novel method to predict infarct transmurality in acute myocardial infarctionP562Infarct size is correlated to global longitudinal strain but not left ventricular ejection fraction in the early stage of acute myocardial infarctionP563Magnetic resonance myocardial deformation assessment with tissue tracking and risk stratification in acute myocardial infarction patientsP564Increase in regional end-diastolic wall thickness by transthoracic echocardiography as a biomarker of successful reperfusion in anterior ST elevation acute myocardial infarctionP565Mitral regurgitation is associated with worse long-term prognosis in ST-segment elevation myocardial infarction treated with primary percutaneous coronary interventionP566Statistical significance of 3D motion and deformation indexes for the analysis of LAD infarctionHeart valve DiseasesP567Paradoxical low gradient aortic stenosis: echocardiographic progression from moderate to severe diseaseP568The beneficial effects of TAVI in mitral insufficiencyP569Impact of thoracic aortic calcification on the left ventricular hypertrophy and its regression after aortic valve replacement in patients with severe aortic stenosisP570Additional value of exercise-stress echocardiography in asymptomatic patients with aortic valve stenosisP571Valvulo-arterial impedance in severe aortic stenosis: a dual imaging modalities studyP572Left ventricular mechanics: novel tools to evaluate left ventricular performance in patients with aortic stenosisP573Comparison of long-term outcome after percutaneous mitral valvuloplasty versus mitral valve replacement in moderate to severe mitral stenosis with left ventricular dysfunctionP574Incidence of de novo left ventricular dysfunction in patient treated with aortic valve replacement for severe aortic regurgitationP575Transforming growth factor-beta dependant progression of the mitral valve prolapseP576Quantification of mitral regurgitation with multiple jets: in vitro validation of three-dimensional PISA techniqueP577Impaired pre-systolic contraction and saddle-shape deepening of mitral annulus contributes to atrial functional regurgitation: a three-dimensional echocardiographic studyP578Incidence and determinants of left ventricular (lv) reverse remodeling after MitraClip implantation in patients with moderate-to severe or severe mitral regurgitation and reduced lv ejection fractionP579Severe functional tricuspid regurgitation in rheumatic heart valve disease. New insights from 3D transthoracic echocardiographyP58015 years of evolution of the etiologic profile for prosthetic heart valve replacement through an echocardiography laboratoryP581The role of echocardiography in the differential diagnosis of prolonged fever of unknown originP582Predictive value for paravalvular regurgitation of 3-dimensional anatomic aortic annulus shape assessed by multidetector computed tomography post-transcatheter aortic valve replacementP583The significance and advantages of echo and CT imaging & measurement at transcatherter aortic valve implantation through the left common carotid accessP584Comparison of the self-expandable Medtronic CoreValve versus the balloon-expandable Edwards SAPIEN bioprostheses in high-risk patients undergoing transfemoral aortic valve implantationP585The impact of transcatheter aortic valve implantation on mitral regurgitation severityP586Echocardiographic follow up of children with valvular lesions secondary to rheumatic heart disease: Data from a prospective registryP587Valvular heart disease and different circadian blood pressure profilesCardiomyopathiesP588Comparison of transthoracic echocardiography versus cardiac magnetic for implantable cardioverter defibrillator therapy in primary prevention strategy dilated cardiomyopathy patientsP589Incidence and prognostic significance of left ventricle reverse remodeling in a cohort of patients with idiopathic dilated cardiomyopathyP590Early evaluation of diastolic function in fabry diseaseP591Echocardiographic predictors of atrial fibrillation development in hypertrophic cardiomyopathyP592Altered Torsion mechanics in patients with hypertrophic cardiomyopathy: LVOT-obstruction is the topdog?P593Prevention of sudden cardiac death in hypertrophic cardiomyopathy: what has changed in the guidelines?P594Coronary microcirculatory function as determinator of longitudinal systolic left ventricular function in hypertrophic cardiomyopathyP595Detection of subclinical myocardial dysfunction by tissue Doppler ehocardiography in patients with muscular dystrophiesP596Speckle tracking myocardial deformation analysis and three dimensional echocardiography for early detection of chemotherapy induced cardiac dysfunction in bone marrow transplantation patientsP597Left ventricular non compaction or hypertrabeculation: distinguishing between physiology and pathology in top-level athletesP598Role of multi modality imaging in familiar screening of Danon diseaseP599Early impairment of global longitudinal left ventricular systolic function independently predicts incident atrial fibrillation in type 2 diabetes mellitusP600Fetal cardiovascular programming in maternal diabetes mellitus and obesity: insights from deformation imagingP601Longitudinal strain stress echo evaluation of aged marginal donor hearts: feasibility in the Adonhers project.P602Echocardiographic evaluation of left ventricular size and function following heart transplantation - Gender mattersSystemic diseases and other conditionsP603The impact of septal kinetics on adverse ventricular-ventricular interactions in pulmonary stenosis and pulmonary arterial hypertensionP604Improvement in right ventricular mechanics after inhalation of iloprost in pulmonary hypertensionP605Does the treatment of patients with metabolic syndrome correct the right ventricular diastolic dysfunction?P606Predictors of altered cardiac function in breast cancer survivors who were treated with anthracycline-based therapyP607Prevalence and factors related to left ventricular systolic dysfunction in asymptomatic patients with rheumatoid arthritis: a prospective tissue-doppler echocardiography studyP608Diastolic and systolic left ventricle dysfunction presenting different prognostic implications in cardiac amyloidosisP609Diagnostic accuracy of Bedside Lung Ultrasonography in Emergency (BLUE) protocol for the diagnosis of pulmonary embolismP610Right ventricular systolic dysfunction and its incidence in breast cancer patients submitted to anthracycline therapyP611Right ventricular dysfunction is an independent predictor of survival among cirrhotic patients undergoing liver transplantCongenital heart diseaseP612Hypoplasia or absence of posterior leaflet: a rare congenital anomaly of the mitral valveP613ECHO screening for Barlow disease in proband's relativesDiseases of the aortaP614Aortic size distribution and prognosis in an unselected population of patients referred for standard transthoracic echocardiographyP615Abdominal aorta aneurysm ultrasonographic screening in a large cohort of asympromatic volounteers in an Italian urban settingP616Thoracic aortic aneurysm and left ventricular systolic functionStress echocardiographyP617Wall motion score index, systolic mitral annulus velocity and left ventricular mass predicted global longitudinal systolic strain in 238 patients examined by stress echocardiographyP618Prognostic parameters of exercise-induced severe mitral valve regurgitation and exercise-induced systolic pulmonary hypertensionP619Risk stratification after myocardial infarction: prognostic value of dobutamine stress echocardiographyP620relationship between LV and RV myocardial contractile reserve and metabolic parameters during incremental exercise and recovery in healthy children using 2-D strain analysisP621Increased peripheral extraction as a mechanism compensatory to reduced cardiac output in high risk heart failure patients with group 2 pulmonary hypertension and exercise oscillatory ventilationP622Can exercise induced changes in cardiac synchrony predict response to CRT?Transesophageal echocardiographyP623Fully-automated software for mitral valve assessment in chronic mitral regurgitation by three-dimensional transesophageal echocardiographyP624Real-time 3D transesophageal echocardiography provides more accurate orifice measurement in percutaneous transcatheter left atrial appendage closureP625Percutaneous closure of left atrial appendage: experience of 36 casesReal-time three-dimensional TEEP626Real-time three-dimensional transesophageal echocardiography during pulmonary vein cryoballoon ablation for atrial fibrilationP627Three dimensional ultrasound anatomy of intact mitral valve and in the case of type 2 disfunctionTissue Doppler and speckle trackingP629Left ventricle wall motion tracking from echocardiographic images by a non-rigid image registrationP630The first experience with the new prototype of a robotic system for remote echocardiographyP631Non-invasive PCWP influence on a loop diuretics regimen monitoring model in ADHF patients.P632Normal range of left ventricular strain, dimensions and ejection fraction using three-dimensional speckle-tracking echocardiography in neonatesP633Circumferential ascending aortic strain: new parameter in the assessment of arterial stiffness in systemic hypertensionP634Aortic vascular properties in pediatric osteogenesis imperfecta: a two-dimensional echocardiography derived aortic strain studyP635Assessment of cardiac functions in children with sickle cell anemia: doppler tissue imaging studyP636Assessment of left ventricular function in type 1 diabetes mellitus patients by two-dimensional speckle tracking echocardiography: relation to duration and control of diabetesP637A study of left ventricular torsion in l-loop ventricles using speckle-tracking echocardiographyP638Despite No-Reflow, global and regional longitudinal strains assessed by two-dimensional speckle tracking echocardiography are predictive indexes of left ventricular remodeling in patients with STEMIP639The function of reservoir of the left atrium in patients with medicaly treated arterial hypertensionP640The usefulness of speckle tracking analysis for predicting the recovery of regional systolic function after myocardial infarctionP641Two dimensional speckle tracking echocardiography in assessment of left ventricular systolic function in patients with rheumatic severe mitral regurgitation and normal ejection fractionP642The prediction of left-main and tripple vessel coronary artery disease by tissue doppler based longitudinal strain and strain rate imagingP643Role of speckle tracking in predicting arrhythmic risk and occurrence of appropriate implantable defibrillator Intervention in patients with ischemic and non-ischemic cardiomyopathyComputed Tomography & Nuclear CardiologyP644Cardiac adrenergic activity in patients with nonischemic dilated cardiomyopathy. Correlation with echocardiographyP645Different vascular territories and myocardial ischemia, there is a gradient of association? Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Iorio A, Di Nora C, Abate E, Pinamonti B, Rakar S, Vitrella G, Tursi V, Livi U, Salvi A, Sinagra G. MitraClip after heart transplantation: A case report. Int J Cardiol 2015; 196:143-4. [PMID: 26093525 DOI: 10.1016/j.ijcard.2014.10.099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 10/21/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Annamaria Iorio
- Cardiovascular Department "Ospedali Riuniti and University of Trieste", Trieste, Italy; Department of Cardiology, Santa Maria della Misericordia Hospital, Udine, Italy.
| | - Concetta Di Nora
- Cardiovascular Department "Ospedali Riuniti and University of Trieste", Trieste, Italy; Department of Cardiology, Santa Maria della Misericordia Hospital, Udine, Italy
| | - Elena Abate
- Cardiovascular Department "Ospedali Riuniti and University of Trieste", Trieste, Italy; Department of Cardiology, Santa Maria della Misericordia Hospital, Udine, Italy
| | - Bruno Pinamonti
- Cardiovascular Department "Ospedali Riuniti and University of Trieste", Trieste, Italy; Department of Cardiology, Santa Maria della Misericordia Hospital, Udine, Italy
| | - Serena Rakar
- Cardiovascular Department "Ospedali Riuniti and University of Trieste", Trieste, Italy; Department of Cardiology, Santa Maria della Misericordia Hospital, Udine, Italy
| | - Giancarlo Vitrella
- Cardiovascular Department "Ospedali Riuniti and University of Trieste", Trieste, Italy; Department of Cardiology, Santa Maria della Misericordia Hospital, Udine, Italy
| | - Vincenzo Tursi
- Cardiovascular Department "Ospedali Riuniti and University of Trieste", Trieste, Italy; Department of Cardiology, Santa Maria della Misericordia Hospital, Udine, Italy
| | - Ugolino Livi
- Cardiovascular Department "Ospedali Riuniti and University of Trieste", Trieste, Italy; Department of Cardiology, Santa Maria della Misericordia Hospital, Udine, Italy
| | - Alessandro Salvi
- Cardiovascular Department "Ospedali Riuniti and University of Trieste", Trieste, Italy; Department of Cardiology, Santa Maria della Misericordia Hospital, Udine, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department "Ospedali Riuniti and University of Trieste", Trieste, Italy; Department of Cardiology, Santa Maria della Misericordia Hospital, Udine, Italy
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Gerloni R, Merlo M, Vitrella G, Lardieri G, Pinamonti B, Pappalardo A, Cattin L, Sinagra G. Pulmonary artery aneurysm and sarcoidosis. J Cardiovasc Med (Hagerstown) 2015; 16 Suppl 2:S77-8. [PMID: 25635751 DOI: 10.2459/jcm.0b013e328365a04f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pulmonary artery aneurysm unassociated to congenital heart disease and pulmonary hypertension is exceedingly rare. Its pathogenesis and correct management remain unknown. Sarcoidosis is a systemic disease that can exceptionally involve large vessels, leading to stenosis and dilatation. Pulmonary artery aneurysm has never been described in association with sarcoidosis. Surgical approach should prevent aneurysm rupture, but it is not known when surgery should be preferred to strict medical follow-up. In this report we present a case of large pulmonary artery aneurysm associated to systemic sarcoidosis underlining problematic management of diseases 'forgotten' by evidence based medicine.
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Affiliation(s)
- Riccardo Gerloni
- aDepartment of Internal Medicine bDepartment of Cardiology cDepartment of Cardiac Surgery, 'Ospedali Riuniti' and University of Trieste, Trieste, Italy
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