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Pieroni M, Ciabatti M, Zocchi C, Tavanti V, Camporeale A, Saletti E, Fumagalli C, Venezia D, Lombardi M, Olivotto I, Bolognese L. Optimal timing of follow-up cardiac magnetic resonance in patients with uncomplicated acute myocarditis. Int J Cardiol 2024; 397:131603. [PMID: 37979787 DOI: 10.1016/j.ijcard.2023.131603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/28/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Cardiac magnetic resonance (CMR) is central in the diagnosis and prognostic stratification of acute myocarditis (AM) but the timing of repeated CMR scans to assess edema resolution and late gadolinium enhancement (LGE) stabilization remain unclear. We assessed edema and LGE evolution over 12 months to identify the optimal timing of repeat CMR evaluation in AM. METHODS AND RESULTS Thirty-three consecutive patients with AM underwent CMR at clinical presentation (CMR-1), after 3 months (CMR-2) and after 12-months (CMR-3). CMR included assessment of edema and LGE, left ventricular ejection fraction (LVEF) and left ventricular mass index (LVMi). After CMR-3 patients were followed-up every three-months by clinical evaluation, Holter-monitoring, and echocardiography. All patients had edema and LGE at CMR-1. At CMR-2 edema-positive segments (0.42 ± 0.34 vs. 3.18 ± 2.33, p < 0.005), LGE (4.98 ± 4.56 vs. 9.60 ± 8.58 g, and 4.22 ± 3.97% vs 7.50 ± 5.61%) and LVMi (69.82 ± 11.83 vs 76.06 ± 13.13 g/m2) (all p < 0.0001) significantly reduced, while LVEF (63.12 ± 5.47% vs.61.15 ± 6.87% p < 0.05) significantly improved, compared to CMR-1. At CMR-2 edema persisted in 7 patients (21%) but resolved at CMR-3 with no further changes of LVMi, LVEF and LGE. During follow-up (85 ± 15 months), 5 (15%) patients showed persistent ventricular arrhythmias. Univariate predictors of arrhythmic persistence were LGE extension at CMR-2 and CMR-3 (both p < 0.05), but not at CMR-1 (p = 0.07). CONCLUSIONS Most patients with uncomplicated AM show edema resolution with LGE stabilization after 3 months. Further CMR evaluations should be limited to patients with persisting edema at this time. LGE extent measured after edema resolution is associated with persistent ventricular arrhythmias.
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Affiliation(s)
| | | | - Chiara Zocchi
- Cardiovascular Department, San Donato Hospital, Arezzo, Italy
| | | | - Antonia Camporeale
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
| | - Elisa Saletti
- Cardiovascular Department, San Donato Hospital, Arezzo, Italy
| | - Carlo Fumagalli
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Duccio Venezia
- Radiology Department, San Donato Hospital, Arezzo, Italy
| | - Massimo Lombardi
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
| | - Iacopo Olivotto
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Pediatric Cardiology, Meyer Children's Hospital IRCCS, Florence, Italy
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Fumagalli C, Zocchi C, Ciabatti M, Milazzo A, Cappelli F, Fumagalli S, Pieroni M, Olivotto I. From Atrial Fibrillation Management to Atrial Myopathy Assessment: The Evolving Concept of Left Atrium Disease in Hypertrophic Cardiomyopathy. Can J Cardiol 2024:S0828-282X(24)00074-6. [PMID: 38286174 DOI: 10.1016/j.cjca.2024.01.026] [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] [Received: 12/10/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 01/31/2024] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is the most prevalent genetically inherited cardiovascular disorder in adults and a significant cause of heart failure and sudden cardiac death. Historically, atrial fibrillation (AF) has been considered as a critical aspect in HCM patients as it is considered to be a marker of disease progression, escalates the frequency of heart failure hospitalisations, increases the risk of thromboembolic events, and worsens quality of life and outcome. Increasing evidence suggests that AF is the result of a subtle long-standing process that starts early in the history of HCM. The process of left atrial dilation accompanied by morphologic and functional remodelling is the quintessential prerequisite for the onset of AF. This review aims to describe the current understanding of AF pathophysiology in HCM, emphasising the role of left atrial myopathy in its development. In addition, we discuss risk factors and management strategies specific to AF in the context of HCM, providing insights into the complexities and challenges of treating this specific patient population.
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Affiliation(s)
- Carlo Fumagalli
- Cardiomyopathy Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy.
| | - Chiara Zocchi
- Cardiomyopathy Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Cardiovascular Department, San Donato Hospital, Arezzo, Italy
| | | | - Alessandra Milazzo
- Cardiomyopathy Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesco Cappelli
- Cardiomyopathy Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Stefano Fumagalli
- Geriatric Intensive Care Unit and Geriatric Arrhythmia Unit, Department of Experimental and Clinical Medicine, University of Florence and AOU Careggi, Florence, Italy
| | | | - Iacopo Olivotto
- Cardiomyopathy Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Meyer Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Florence, Italy
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3
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Bertero E, Chiti C, Schiavo MA, Tini G, Costa P, Todiere G, Mabritto B, Dei LL, Giannattasio A, Mariani D, Lofiego C, Santolamazza C, Monda E, Quarta G, Barbisan D, Mandoli GE, Mapelli M, Sguazzotti M, Negri F, De Vecchi S, Ciabatti M, Tomasoni D, Mazzanti A, Marzo F, de Gregorio C, Raineri C, Vianello PF, Marchi A, Biagioni G, Insinna E, Parisi V, Ditaranto R, Barison A, Giammarresi A, De Ferrari GM, Priori S, Metra M, Pieroni M, Patti G, Imazio M, Perugini E, Agostoni P, Cameli M, Merlo M, Sinagra G, Senni M, Limongelli G, Ammirati E, Vagnarelli F, Crotti L, Badano L, Calore C, Gabrielli D, Re F, Musumeci G, Emdin M, Barbato E, Musumeci B, Autore C, Biagini E, Porto I, Olivotto I, Canepa M. Real-world candidacy to mavacamten in a contemporary hypertrophic obstructive cardiomyopathy population. Eur J Heart Fail 2024; 26:59-64. [PMID: 38131253 DOI: 10.1002/ejhf.3120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/20/2023] [Revised: 12/01/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
AIMS In the EXPLORER-HCM trial, mavacamten reduced left ventricular outflow tract obstruction (LVOTO) and improved functional capacity of symptomatic hypertrophic obstructive cardiomyopathy (HOCM) patients. We sought to define the potential use of mavacamten by comparing real-world HOCM patients with those enrolled in EXPLORER-HCM and assessing their eligibility to treatment. METHODS AND RESULTS We collected information on HOCM patients followed up at 25 Italian HCM outpatient clinics and with significant LVOTO (i.e. gradient ≥30 mmHg at rest or ≥50 mmHg after Valsalva manoeuvre or exercise) despite pharmacological or non-pharmacological therapy. Pharmacological or non-pharmacological therapy resolved LVOTO in 1044 (61.2%) of the 1706 HOCM patients under active follow-up, whereas 662 patients (38.8%) had persistent LVOTO. Compared to the EXPLORER-HCM trial population, these real-world HOCM patients were older (62.1 ± 14.3 vs. 58.5 ± 12.2 years, p = 0.02), had a lower body mass index (26.8 ± 5.3 vs. 29.7 ± 4.9 kg/m2 , p < 0.0001) and a more frequent history of atrial fibrillation (21.5% vs. 9.8%, p = 0.027). At echocardiography, they had lower left ventricular ejection fraction (LVEF, 66 ± 7% vs. 74 ± 6%, p < 0.0001), higher left ventricular outflow tract gradients at rest (60 ± 27 vs. 52 ± 29 mmHg, p = 0.003), and larger left atrial volume index (49 ± 16 vs. 40 ± 12 ml/m2 , p < 0.0001). Overall, 324 (48.9%) would have been eligible for enrolment in the EXPLORER-HCM trial and 339 (51.2%) for treatment with mavacamten according to European guidelines. CONCLUSIONS Real-world HOCM patients differ from the EXPLORER-HCM population for their older age, lower LVEF and larger atrial volume, potentially reflecting a more advanced stage of the disease. About half of real-world HOCM patients were found eligible to mavacamten.
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Affiliation(s)
- Edoardo Bertero
- Cardiovascular Unit, Department of Internal Medicine, University of Genova, Genova, Italy
| | - Chiara Chiti
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Maria Alessandra Schiavo
- Cardiology Unit, Cardio-Thoraco-Vascular Department, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- European Reference Network for Rare, Low Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart)
| | - Giacomo Tini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Paolo Costa
- Cardiovascular Unit, Department of Internal Medicine, University of Genova, Genova, Italy
| | - Giancarlo Todiere
- Cardiothoracic Department, Fondazione Toscana Gabriele Monasterio Pisa, Pisa, Italy
| | - Barbara Mabritto
- Division of Cardiology, Azienda Sanitaria Ospedaliera Ordine Mauriziano, Torino, Italy
| | - Lorenzo-Lupo Dei
- Cardiology Division, Cardiomyopathies Unit, St. Camillo Hospital, Rome, Italy
- Cardiology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alessia Giannattasio
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Davide Mariani
- IRCCS, Istituto Auxologico Italiano, Department of Cardiology, San Luca Hospital, Cardiomyopathy Unit, Milan, Italy
| | - Carla Lofiego
- Department of Cardiology, Lancisi Cardiovascular Center, Marche University Hospital, Ancona, Italy
| | - Caterina Santolamazza
- De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Emanuele Monda
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli', Monaldi Hospital, Naples, Italy
| | - Giovanni Quarta
- SC Cardiology 1, Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Davide Barbisan
- European Reference Network for Rare, Low Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart)
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University of Trieste, Trieste, Italy
| | - Giulia Elena Mandoli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Massimo Mapelli
- Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | | | - Francesco Negri
- Cardiology Department, University Hospital 'Santa Maria della Misericordia', Azienda Sanitaria Universitaria Integrata Friuli Centrale (ASUFC), Udine, Italy
| | - Simona De Vecchi
- Division of Cardiology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | | | - Daniela Tomasoni
- Cardiology and Cardiac Catheterization Laboratory, Cardio-Thoracic Department, Civil Hospitals; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Andrea Mazzanti
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Molecular Cardiology, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | | | - Cesare de Gregorio
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Claudia Raineri
- Division of Cardiology, Cardiovascular and Thoracic Department, 'Città della Salute e della Scienza, Hospital, Turin, Italy
| | | | - Alberto Marchi
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Giulia Biagioni
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Eleonora Insinna
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Vanda Parisi
- Cardiology Unit, Cardio-Thoraco-Vascular Department, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- European Reference Network for Rare, Low Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart)
| | - Raffaello Ditaranto
- Cardiology Unit, Cardio-Thoraco-Vascular Department, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- European Reference Network for Rare, Low Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart)
| | - Andrea Barison
- Cardiothoracic Department, Fondazione Toscana Gabriele Monasterio Pisa, Pisa, Italy
| | - Andrea Giammarresi
- SC Cardiology 1, Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Cardiovascular and Thoracic Department, 'Città della Salute e della Scienza, Hospital, Turin, Italy
| | - Silvia Priori
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Molecular Cardiology, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | - Marco Metra
- Cardiology and Cardiac Catheterization Laboratory, Cardio-Thoracic Department, Civil Hospitals; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | | | - Giuseppe Patti
- Division of Cardiology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Massimo Imazio
- Cardiology Department, University Hospital 'Santa Maria della Misericordia', Azienda Sanitaria Universitaria Integrata Friuli Centrale (ASUFC), Udine, Italy
| | | | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Matteo Cameli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Marco Merlo
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University of Trieste, Trieste, Italy
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University of Trieste, Trieste, Italy
| | - Michele Senni
- SC Cardiology 1, Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Giuseppe Limongelli
- Inherited and Rare Cardiovascular Diseases, Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli', Monaldi Hospital, Naples, Italy
| | - Enrico Ammirati
- De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Fabio Vagnarelli
- Department of Cardiology, Lancisi Cardiovascular Center, Marche University Hospital, Ancona, Italy
| | - Lia Crotti
- IRCCS, Istituto Auxologico Italiano, Department of Cardiology, San Luca Hospital, Cardiomyopathy Unit, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Luigi Badano
- IRCCS, Istituto Auxologico Italiano, Department of Cardiology, San Luca Hospital, Cardiomyopathy Unit, Milan, Italy
| | - Chiara Calore
- Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Domenico Gabrielli
- Cardiology Division, Cardiomyopathies Unit, St. Camillo Hospital, Rome, Italy
| | - Federica Re
- Cardiology Division, Cardiomyopathies Unit, St. Camillo Hospital, Rome, Italy
| | - Giuseppe Musumeci
- Division of Cardiology, Azienda Sanitaria Ospedaliera Ordine Mauriziano, Torino, Italy
| | - Michele Emdin
- Cardiothoracic Department, Fondazione Toscana Gabriele Monasterio Pisa, Pisa, Italy
| | - Emanuele Barbato
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Beatrice Musumeci
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Camillo Autore
- Department of Cardiology and Respiratory Sciences, San Raffaele Cassino, Cassino, Italy
| | - Elena Biagini
- Cardiology Unit, Cardio-Thoraco-Vascular Department, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Italo Porto
- Cardiovascular Unit, Department of Internal Medicine, University of Genova, Genova, Italy
- Cardiovascular Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Iacopo Olivotto
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Marco Canepa
- Cardiovascular Unit, Department of Internal Medicine, University of Genova, Genova, Italy
- Cardiovascular Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Calò L, Crescenzi C, Martino A, Casella M, Romeo F, Cappelletto C, Bressi E, Panattoni G, Stolfo D, Targetti M, Toso E, Musumeci MB, Tini G, Ciabatti M, Stefanini M, Silvetti E, Stazi A, Danza ML, Rebecchi M, Canestrelli S, Fedele E, Lanzillo C, Fusco A, Sangiuolo FC, Oliviero G, Radesich C, Perotto M, Pieroni M, Golia P, Mango R, Gasperetti A, Autore C, Merlo M, de Ruvo E, Russo AD, Olivotto I, Sinagra G, Gaita F. The Diagnostic Value of the 12-Lead ECG in Arrhythmogenic Left Ventricular Cardiomyopathy: Novel ECG Signs. JACC Clin Electrophysiol 2023; 9:2615-2627. [PMID: 37768253 DOI: 10.1016/j.jacep.2023.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Electrocardiographic (ECG) findings in arrhythmogenic left ventricular cardiomyopathy (ALVC) are limited to small case series. OBJECTIVES This study aimed to analyze the ECG characteristics of ALVC patients and to correlate ECG with cardiac magnetic resonance and genotype data. METHODS We reviewed data of 54 consecutive ALVC patients (32 men, age 39 ± 15 years) and compared them with 84 healthy controls with normal cardiac magnetic resonance. RESULTS T-wave inversion was often noted (57.4%), particularly in the inferior and lateral leads. Low QRS voltages in limb leads were observed in 22.2% of patients. The following novel ECG findings were identified: left posterior fascicular block (LPFB) (20.4%), pathological Q waves (33.3%), and a prominent R-wave in V1 with a R/S ratio ≥0.5 (24.1%). The QRS voltages were lower in ALVC compared with controls, particularly in lead I and II. At receiver-operating characteristic analysis, the sum of the R-wave in I to II ≤8 mm (AUC: 0.909; P < 0.0001) and S-wave in V1 plus R-wave in V6 ≤12 mm (AUC: 0.784; P < 0.0001) effectively discriminated ALVC patients from controls. It is noteworthy that 4 of the 8 patients with an apparently normal ECG were recognized by these new signs. Transmural late gadolinium enhancement was associated to LPFB, a R/S ratio ≥0.5 in V1, and inferolateral T-wave inversion, and a ringlike pattern correlated to fragmented QRS, SV1+RV6 ≤12 mm, low QRS voltage, and desmoplakin alterations. CONCLUSIONS Pathological Q waves, LPFB, and a prominent R-wave in V1 were common ECG signs in ALVC. An R-wave sum in I to II ≤8 mm and SV1+RV6 ≤12 mm were specific findings for ALVC phenotypes compared with controls.
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Affiliation(s)
- Leonardo Calò
- Division of Cardiology, Policlinico Casilino, Rome, Italy.
| | | | | | - Michela Casella
- Cardiology and Arrhythmology Clinic, University Cardiology Hospital Ospedali Riuniti, Ancona, Italy
| | - Fabiana Romeo
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Chiara Cappelletto
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Edoardo Bressi
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | | | - Davide Stolfo
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Mattia Targetti
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Elisabetta Toso
- Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Maria Beatrice Musumeci
- Cardiology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Giacomo Tini
- Cardiology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | | | | | - Elisa Silvetti
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | | | | | - Marco Rebecchi
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | | | - Elisa Fedele
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | | | - Armando Fusco
- Division of Radiology, Policlinico Casilino, Rome, Italy
| | | | - Giada Oliviero
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Cinzia Radesich
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Maria Perotto
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | | | - Paolo Golia
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Ruggiero Mango
- Cardiology Unit, Department of Emergency and Critical Care, Policlinico Tor Vergata, Rome, Italy
| | | | - Camillo Autore
- Cardiology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Marco Merlo
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | | | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, University Cardiology Hospital Ospedali Riuniti, Ancona, Italy
| | - Iacopo Olivotto
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy; Cardiology Unit, Meyer University Children Hospital IRCCS, University of Florence, Florence, Italy
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - Fiorenzo Gaita
- Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
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5
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Ciabatti M, Zocchi C, Olivotto I, Bolognese L, Pieroni M. Myocarditis and COVID-19 related issues. Glob Cardiol Sci Pract 2023; 2023:e202328. [PMID: 38404624 PMCID: PMC10886760 DOI: 10.21542/gcsp.2023.28] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/12/2023] [Indexed: 02/27/2024] Open
Abstract
The recent COVID-19 (Coronavirus Disease 2019) pandemic by SARS-CoV2 infection has caused millions of deaths and hospitalizations across the globe. In the early pandemic phases, the infection had been initially considered a primary pulmonary disease. However, increasing evidence has demonstrated a wide range of possible cardiac involvement. Most of systemic and cardiac damage is likely sustained by a complex interplay between inflammatory, immune-related and thrombotic mechanisms. Biventricular failure and myocardial damage with elevation of cardiac biomarkers have been reported in COVID-19 patients, although histological demonstration of acute myocarditis has been rarely documented. Indeed while cardiac magnetic resonance findings include different patterns of myocardial involvement in terms of late gadolinium enhancement, histological data from necropsy and endomyocardial biopsy showed peculiar inflammatory patterns, mostly composed by macrophages. On the other hand COVID-19 vaccines based on mRN technology have been also associated with increased risk of myocarditis. COVID-19 and mRNA vaccine-related myocarditis present different clinical and imaging presentations and recent data suggest the presence of distinctive immunological mechanisms involved.
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Affiliation(s)
| | - Chiara Zocchi
- Cardiovascular Department, San Donato Hospital, Arezzo, Italy
| | - Iacopo Olivotto
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Meyer Children Hospital, Florence, Italy
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6
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Ammirati E, Lupi L, Palazzini M, Ciabatti M, Rossi VA, Gentile P, Uribarri A, Vecchio CR, Nassiacos D, Cereda A, Conca C, Tumminello G, Piriou N, Lelarge C, Pedrotti P, Stucchi M, Peretto G, Galasso M, Huang F, Ianni U, Procopio A, Saponara G, Cimaglia P, Tomasoni D, Moroni F, Turco A, Sala S, Di Tano G, Bollano E, Moro C, Abbate A, Della Bona R, Porto I, Carugo S, Campodonico J, Pontone G, Grosu A, Bolognese L, Salamanca J, Diez-Villanueva P, Ozieranski K, Tyminska A, Sardo Infirri L, Bromage D, Cannatà A, Hong KN, Adamo M, Quattrocchi G, Foà A, Potena L, Garascia A, Giannattasio C, Adler ED, Sinagra G, Ruschitzka F, Camici PG, Metra M, Pieroni M. Outcome and Morphofunctional Changes on Cardiac Magnetic Resonance in Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination. Circ Heart Fail 2023; 16:e010315. [PMID: 37183708 DOI: 10.1161/circheartfailure.122.010315] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Enrico Ammirati
- Department of De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy (E.A., M. Palazzini, P.G., P.P., G.Q., A. Garascia, C.G.)
| | - Laura Lupi
- Institute of Cardiology, Azienda Socio-Sanitaria Territoriale Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy (L.L., D.T., M.A., M.M.)
| | - Matteo Palazzini
- Department of De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy (E.A., M. Palazzini, P.G., P.P., G.Q., A. Garascia, C.G.)
- Department of Medicine and Surgery, Bicocca University, Milano, Italy (M. Palazzini, M.G., C.G.)
| | - Michele Ciabatti
- Cardiovascular Department, San Donato Hospital, Arezzo, Italy (M.C., L.B., M. Pieroni)
| | - Valentina A Rossi
- Department of Cardiology, University Heart Center, University Hospital Zurich and University of Zurich, Switzerland (V.A.R., F.R.)
| | - Piero Gentile
- Department of De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy (E.A., M. Palazzini, P.G., P.P., G.Q., A. Garascia, C.G.)
| | - Aitor Uribarri
- Cardiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain (A.U.)
- Vall d'Hebron Institute de Recerca, Barcelona, Spain (A.U.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain (A.U.)
| | - Chiara R Vecchio
- Department of Cardiology, Presidio Ospedaliero di Saronno, Azienda Socio-Sanitaria Territoriale Valle Olona, Saronno, Varese, Italy (C.R.V., D.N.)
| | - Daniele Nassiacos
- Department of Cardiology, Presidio Ospedaliero di Saronno, Azienda Socio-Sanitaria Territoriale Valle Olona, Saronno, Varese, Italy (C.R.V., D.N.)
| | - Alberto Cereda
- Cardiovascular Department, Association Socio Sanitary Territorial Santi Paolo e Carlo, Milano, Italy (A. Cereda, C.C.)
| | - Cristina Conca
- Cardiovascular Department, Association Socio Sanitary Territorial Santi Paolo e Carlo, Milano, Italy (A. Cereda, C.C.)
| | - Gabriele Tumminello
- Division of Cardiology, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Cà Granda Ospedale Maggiore Policlinico, University of Milan, Italy (G.T., S.C.)
| | - Nicolas Piriou
- Nantes Université, CHU Nantes, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, l'Institut du Thorax, France (N.P., C.L.)
| | - Coline Lelarge
- Nantes Université, CHU Nantes, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, l'Institut du Thorax, France (N.P., C.L.)
| | - Patrizia Pedrotti
- Department of De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy (E.A., M. Palazzini, P.G., P.P., G.Q., A. Garascia, C.G.)
| | - Miriam Stucchi
- Cardiology Unit, Azienda Socio-Sanitaria Territoriale della Brianza (MB), Vimercate Hospital, Italy (M.S.)
| | - Giovanni Peretto
- San Raffaele Hospital and Vita Salute University, Milano, Italy (G. Peretto, S.S., P.G.C.)
| | - Michele Galasso
- Department of Medicine and Surgery, Bicocca University, Milano, Italy (M. Palazzini, M.G., C.G.)
| | - Florent Huang
- Service de Cardiologie, Hôpital Foch, Suresnes, France (F.H.)
| | - Umberto Ianni
- Cardiology Unit, Madonna del Soccorso Hospital, Azienda Sanitaria Unica Regionale Marche 5, San Benedetto del Tronto, Italy (U.I.)
| | - Antonio Procopio
- Intensive Cardiac Care Unit, "F. Renzetti" Hospital, Lanciano, Chieti, Italy (A.P.)
| | - Gianluigi Saponara
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy (G.S.)
| | - Paolo Cimaglia
- Maria Cecilia Hospital, GVM Care and Research, Cotignola, Ravenna, Italy (P.C)
| | - Daniela Tomasoni
- Institute of Cardiology, Azienda Socio-Sanitaria Territoriale Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy (L.L., D.T., M.A., M.M.)
| | - Francesco Moroni
- Pauley Heart Center, Virginia Commonwealth University, Richmond (F.M., A.A.)
| | - Annalisa Turco
- Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (A. Turco)
| | - Simone Sala
- San Raffaele Hospital and Vita Salute University, Milano, Italy (G. Peretto, S.S., P.G.C.)
| | - Giuseppe Di Tano
- Unità Operativa Cardiologia, Azienda Socio-Sanitaria Territoriale di Cremona, Ospedale OglioPo, Casalmaggiore, Cremona, Italy (G.D.T.)
| | - Entela Bollano
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (E.B.)
| | - Claudio Moro
- Department of Cardiology, Azienda Socio-Sanitaria Territoriale Monza, Desio, Italy (C.M.)
| | - Antonio Abbate
- Pauley Heart Center, Virginia Commonwealth University, Richmond (F.M., A.A.)
| | - Roberta Della Bona
- Cardiology Unit, Cardiothoracic and Vascular Department, IRCCS San Martino Hospital, Genoa, Italy (R.D.B., I.P.)
| | - Italo Porto
- Cardiology Unit, Cardiothoracic and Vascular Department, IRCCS San Martino Hospital, Genoa, Italy (R.D.B., I.P.)
- Department of Internal Medicine and Medical Specialties, University of Genoa, Italy (I.P.)
| | - Stefano Carugo
- Division of Cardiology, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Cà Granda Ospedale Maggiore Policlinico, University of Milan, Italy (G.T., S.C.)
- Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Italy (S.C., J.C.)
| | - Jeness Campodonico
- Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Italy (S.C., J.C.)
- Centro Cardiologico Monzino IRCCS, University of Milan, Italy (J.C., G. Pontone)
| | - Gianluca Pontone
- Centro Cardiologico Monzino IRCCS, University of Milan, Italy (J.C., G. Pontone)
| | - Aurelia Grosu
- Cardiovascular Department, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy (A. Grosu)
| | - Leonardo Bolognese
- Cardiovascular Department, San Donato Hospital, Arezzo, Italy (M.C., L.B., M. Pieroni)
| | - Jorge Salamanca
- Cardiology Department, Hospital Universitario De La Princesa, Madrid, Spain (J.S., P.D.-V.)
| | - Pablo Diez-Villanueva
- Cardiology Department, Hospital Universitario De La Princesa, Madrid, Spain (J.S., P.D.-V.)
| | - Krzysztof Ozieranski
- First Department of Cardiology, Medical University of Warsaw, Poland (K.O., A. Tyminska)
| | - Agata Tyminska
- First Department of Cardiology, Medical University of Warsaw, Poland (K.O., A. Tyminska)
| | - Loren Sardo Infirri
- Ospedale di Circolo e fondazione Macchi, Azienda Socio-Sanitaria Territoriale Sette Laghi, Varese, Italy (L.S.I.)
| | - Daniel Bromage
- School of Cardiovascular Medicine and Metabolic Medicine and Sciences, King's College London British Heart Foundation Centre of Excellence, King's College London, United Kingdom (D.B., A. Cannatà)
- Department of Cardiology, King's College Hospital London, United Kingdom (D.B., A. Cannatà)
| | - Antonio Cannatà
- School of Cardiovascular Medicine and Metabolic Medicine and Sciences, King's College London British Heart Foundation Centre of Excellence, King's College London, United Kingdom (D.B., A. Cannatà)
- Department of Cardiology, King's College Hospital London, United Kingdom (D.B., A. Cannatà)
| | - Kimberly N Hong
- Division of Cardiology, Department of Medicine, University of California San Diego (K.N.H., E.D.A.)
| | - Marianna Adamo
- Institute of Cardiology, Azienda Socio-Sanitaria Territoriale Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy (L.L., D.T., M.A., M.M.)
| | - Giuseppina Quattrocchi
- Department of De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy (E.A., M. Palazzini, P.G., P.P., G.Q., A. Garascia, C.G.)
| | - Alberto Foà
- Academic Hospital S. Orsola-Malpighi, Bologna, Italy (A.F., L.P.)
| | - Luciano Potena
- Academic Hospital S. Orsola-Malpighi, Bologna, Italy (A.F., L.P.)
| | - Andrea Garascia
- Department of De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy (E.A., M. Palazzini, P.G., P.P., G.Q., A. Garascia, C.G.)
| | - Cristina Giannattasio
- Department of De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy (E.A., M. Palazzini, P.G., P.P., G.Q., A. Garascia, C.G.)
- Department of Medicine and Surgery, Bicocca University, Milano, Italy (M. Palazzini, M.G., C.G.)
| | - Eric D Adler
- Division of Cardiology, Department of Medicine, University of California San Diego (K.N.H., E.D.A.)
| | - Gianfranco Sinagra
- Cardiovascular Department, Center for Diagnosis and Treatment of Cardiomyopathies, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Italy (G.S.)
| | - Frank Ruschitzka
- Department of Cardiology, University Heart Center, University Hospital Zurich and University of Zurich, Switzerland (V.A.R., F.R.)
- Center for Translational and Experimental Cardiology, Department of Cardiology, University Hospital Zurich, University of Zurich, Schlieren, Switzerland (F.R.)
| | - Paolo G Camici
- San Raffaele Hospital and Vita Salute University, Milano, Italy (G. Peretto, S.S., P.G.C.)
| | - Marco Metra
- Institute of Cardiology, Azienda Socio-Sanitaria Territoriale Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy (L.L., D.T., M.A., M.M.)
| | - Maurizio Pieroni
- Cardiovascular Department, San Donato Hospital, Arezzo, Italy (M.C., L.B., M. Pieroni)
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Pieroni M, Ciabatti M, Bolognese L. Stroke in hypertrophic cardiomyopathy. Never mind the rhythm. Int J Cardiol 2023:S0167-5273(23)00736-2. [PMID: 37244383 DOI: 10.1016/j.ijcard.2023.05.043] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
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Pieroni M, Zocchi C, Ciabatti M. Fabry disease in patients with pacemaker: A needle in a haystack? Int J Cardiol 2023; 377:89-90. [PMID: 36640960 DOI: 10.1016/j.ijcard.2023.01.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 01/08/2023] [Indexed: 01/13/2023]
Affiliation(s)
- Maurizio Pieroni
- From the Cardiovascular Department, San Donato Hospital, Arezzo, Italy.
| | - Chiara Zocchi
- From the Cardiovascular Department, San Donato Hospital, Arezzo, Italy
| | - Michele Ciabatti
- From the Cardiovascular Department, San Donato Hospital, Arezzo, Italy
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Russo V, Ciabatti M, Brunacci M, Dendramis G, Santobuono V, Tola G, Picciolo G, Teresa LM, D'Andrea A, Nesti M. Opportunities and drawbacks of the subcutaneous defibrillator across different clinical settings. Expert Rev Cardiovasc Ther 2023; 21:151-164. [PMID: 36847583 DOI: 10.1080/14779072.2023.2184350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/01/2023]
Abstract
INTRODUCTION The subcutaneous implantable cardioverter-defibrillator (S-ICD) is an established therapy for the prevention of sudden cardiac death (SCD) and an alternative to a transvenous implantable cardioverter-defibrillator system in selected patients. Beyond randomized clinical trials, many observational studies have described the clinical performance of S-ICD across different subgroups of patients. AREAS COVERED Our review aimed to describe the opportunities and drawbacks of the S-ICD, focusing on their use in special populations and across different clinical settings. EXPERT OPINION The choice to implant S-ICD should be based on the patient's tailored approach, which takes into account the adequate S-ICD screening at rest or during stress, the infective risk, the ventricular arrhythmia susceptibility, the progressive nature of the underlying disease, the work or sports activity, and the risk of lead-related complications.
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Affiliation(s)
- Vincenzo Russo
- Cardiology Unit, University of Campania 'Luigi Vanvitelli' - Monaldi Hospital, Naples, Italy
| | | | | | | | | | | | | | | | | | - Martina Nesti
- Cardiology Unit, San Donato Hospital, Arezzo (FI), Italy
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10
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Palazzini M, Ammirati E, Lupi L, Garascia A, Gentile P, Pedrotti P, Giannattasio C, Ciabatti M, Rossi V, Ruschitzka F, Uribarri A, Vecchio C, Nassiacos D, Cereda A, Tumminiello G, Piriou N, Stucchi M, Peretto G, Galasso M, Sala S, Camici P, Huang F, Ianni U, Procopio A, Saponara G, Cimaglia P, Tomasoni D, Moroni F, Turco A, Di Tano G, Bollano E, Moro C, Abbate A, Bona RD, Porto I, Carugo S, Campodonico J, Pontone G, Grosu A, Adamo M, Salamanca J, Ozieransky K, Infirri LS, Cannatà A, Adler E, Sinagra G, Metra M, Pieroni M. 138 OUTCOME AND MORPHO-FUNCTIONAL CHANGES ON CARDIAC MAGNETIC RESONANCE IN PATIENT WITH ACUTE MYOCARDITIS FOLLOWING MRNA COVID 19 VACCINATION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.394] [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: 12/23/2022]
Abstract
Abstract
Background
MessengerRNA (mRNA) COVID-19 vaccination has been associated with a higher-than-expected occurrence of acute myocarditis. Scarce information is available on mid-term prognosis and changes in cardiac function, volumes, and tissue characterization on cardiac magnetic resonance (CMR).
Methods
Retrospective, multicenter study including patients with a definite diagnosis of acute myocarditis within 30 days from mRNA COVID-19 vaccination, with a confirmed myocarditis diagnosis based on endomyocardial biopsy (EMB) or autopsy or by the coexistence of positive biomarkers (troponin >99th upper reference limit or elevated creatine kinase myocardial band [CK-MB]) and cardiac MRI findings consistent with AM according to the 2018 updated Lake Louise Criteria.
Results
77 patients (median age 25 years [IQR 20-35], 15% female) were included and followed-up for 147 days [IQR 74-215]. Follow-up CMR was available in n=49 patients and showed no changes in biventricular ejection fraction (EF) as compared to CMR at diagnosis (left ventricular EF: 59%[55-65]vs. 60%[57-64], p=0.507, right ventricular EF: 56%[52-62]vs. 57%[52-61], p=0.563, respectively). Late gadolinium enhancement was present in all patients at diagnosis and persisted in only n=39 (79.6%) at follow-up (p=0.001), generally sparing the anterior wall and the septum. N=10 (20.4%) had a persistent edema based on T2-weighted short tau inversion recovery (STIR) sequences, with predominant involvement of inferior or inferior-lateral walls. The proportion of patients with increased T1 and T2 mapping signals significantly decreased at follow-up (n=13 (68%) vs. n=4 (13%),p<0.001, and n=21 (84%) vs. n=3 (10%),p<0.001, respectively), as well as the presence of pericardial effusion (n=16 (33%) vs. n=3 (6%),p=0.004).
No differences in morpho-functional CMR parameters based on the type of vaccine administered were found (BNT162b2 Pfizer/BioNTech®, n=36, 73.5%, m-RNA-1273 Moderna®, n=13, 26.5%).
Among patients with available follow-up (N=75, 97.4%), no major adverse cardiovascular events nor myocarditis recurrence or death were reported.
Conclusions
At mid-term follow-up, patients who experienced an acute myocarditis after a mRNA COVID-19 vaccine had preserved biventricular EF. The rate and localization of residual scar or edema on CMR is in line with classic viral myocarditis with a good prognosis. This new piece of information should further reassure patients who experience acute myocarditis after mRNA COVID-19 vaccination.
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Affiliation(s)
| | - Enrico Ammirati
- De Gasperis Cardio Center, Niguarda Hospital , Milano , Italy
| | - Laura Lupi
- Institute Of Cardiology, Department Of Medical And Surgical Specialties, Radiological Sciences And Public Healt, University Of Brescia , Brescia , Italy
| | - Andrea Garascia
- De Gasperis Cardio Center, Niguarda Hospital , Milano , Italy
| | - Piero Gentile
- De Gasperis Cardio Center, Niguarda Hospital , Milano , Italy
| | | | | | | | - Valentina Rossi
- Universitatsspital Zurich , Klinik Fur Kardiologie, Zurich , Switzerland
| | - Frank Ruschitzka
- Universitatsspital Zurich , Klinik Fur Kardiologie, Zurich , Switzerland
| | - Aitor Uribarri
- Departamento De Cardiologia, Hospital Clinico Universitario , Valladolid , Spain
| | - Chiara Vecchio
- Department Of Cardiology , Presidio Ospedaliero Di Saronno, Asst Valle Olona, Saronno (Va) Italy
| | - Daniele Nassiacos
- Department Of Cardiology , Presidio Ospedaliero Di Saronno, Asst Valle Olona, Saronno (Va) Italy
| | - Alberto Cereda
- Cardiovascular Department , Asst Santi Paolo E Carlo, Milano , Italy
| | - Gabriele Tumminiello
- Fondazione Istituto Di Ricovero E Cura A Carattere Scientifico Ca Granda Ospedale Maggiore Policlinico, Division Of Cardiology , Milan , Italy
| | - Nicolas Piriou
- Universite Nantes, Chu Nantes, Centre National De La Recherche Scientifique, Institute National De La Sant Et De La Recherche Medicale , Nantes , France
| | - Miriam Stucchi
- Unita Operativa Complessa Di Cardiologia, Azienda Socio Sanitaria Territoriale Della Brianza (Mb) Vimercate Hospital , Italy
| | - Giovanni Peretto
- San Raffaele Hospital And Vita Salute University , Milano , Italy
| | - Michele Galasso
- San Raffaele Hospital And Vita Salute University , Milano , Italy
| | - Simone Sala
- San Raffaele Hospital And Vita Salute University , Milano , Italy
| | - Paolo Camici
- San Raffaele Hospital And Vita Salute University , Milano , Italy
| | - Florent Huang
- Service De Cardiologie , Hopital Foch, Suresnes , France
| | - Umberto Ianni
- Institute Of Cardiology And Center Of Excellence On Aging- G. D’annunzio University , Chieti , Italy
| | - Antonio Procopio
- Institute Of Cardiology And Center Of Excellence On Aging- G. D’annunzio University , Chieti , Italy
| | - Gianluigi Saponara
- Department Of Cardiovascular And Thoracic Science, Fondazione Policlinico Universitario A. Gemelli , Istituto Di Ricovero E Cura A Carattere Scientifico, Roma , Italy
| | | | - Daniela Tomasoni
- Institute Of Cardiology, Department Of Medical And Surgical Specialties, Radiological Sciences And Public Healt, University Of Brescia , Brescia , Italy
| | - Francesco Moroni
- Cardiovascular Unit, Pauley Heart Center, Virginia Commonwealth University , Richmond, Va , Usa
| | - Annalisa Turco
- Cardiologia, Fondazione Irccs Policlinico S Matteo , Pavia
| | - Giuseppe Di Tano
- Azienda Socio Sanitaria Territoriale Di Cremona, Cremona Hospital , Italy
| | - Entela Bollano
- Department Of Cardiology, Sahlgrenska University Hospital , 41390, Gothenburg , Sweden
| | - Claudio Moro
- Department Of Cardiology , Azienda Socio Sanitaria Territoriale Monza, P.O Desio , Italy
| | - Antonio Abbate
- Cardiovascular Unit, Pauley Heart Center, Virginia Commonwealth University , Richmond, Va , Usa
| | - Roberta Dalla Bona
- Cardiology Unit, Cardiothoracic And Vascular Department, Istituto Di Ricovero E Cura A Carattere Scientifico S. Martino , Genoa , Italy , , Genoa , Italy
- Department Of Internal Medicine And Medical Specialties, University Of Genoa , Genoa , Italy , , Genoa , Italy
| | - Italo Porto
- Cardiology Unit, Cardiothoracic And Vascular Department, Istituto Di Ricovero E Cura A Carattere Scientifico S. Martino , Genoa , Italy , , Genoa , Italy
- Department Of Internal Medicine And Medical Specialties, University Of Genoa , Genoa , Italy , , Genoa , Italy
| | - Stefano Carugo
- Fondazione Istituto Di Ricovero E Cura A Carattere Scientifico Ca Granda Ospedale Maggiore Policlinico, Division Of Cardiology , Milan , Italy
| | - Jeness Campodonico
- Centro Cardiologico Monzino , Istituto Di Ricovero E Cura A Carattere Scientifico, Milano , Italy
| | - Gianluca Pontone
- Centro Cardiologico Monzino , Istituto Di Ricovero E Cura A Carattere Scientifico, Milano , Italy
| | - Aurelia Grosu
- Cardiovascular Department , Azienda Socio Sanitaria Territoriale, Papa Giovanni Xxiii, Bergamo , Italy
| | - Marianna Adamo
- Institute Of Cardiology, Department Of Medical And Surgical Specialties, Radiological Sciences And Public Healt, University Of Brescia , Brescia , Italy
| | - Jorge Salamanca
- Cardiology Department,Hospital Universitario De La Princesa , Madrid , Spain
| | | | - Loren Sardo Infirri
- Ospedale Di Circolo E Fondazione Macchi , Azienda Socio Sanitaria Territoriale Sette Laghi, Varese , Italy
| | - Antonio Cannatà
- School Of Cardiovascular Medicine And Science, King’s College London British Heart Foundation, Centre Of Excellence, James Black Center , London , UK
| | - Eric Adler
- Division Of Cardiology, Department Of Medicine, University Of California S Diego , Ca , Usa
| | - Gianfranco Sinagra
- Center For Diagnosis And Treatment Of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (Asugi) And University Of Trieste , 34149, Trieste , Italy
| | - Marco Metra
- Institute Of Cardiology, Department Of Medical And Surgical Specialties, Radiological Sciences And Public Healt, University Of Brescia , Brescia , Italy
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Cacioli G, Polizzi V, Ciabatti M, Cristiano E, Pergolini A, Distefano G, Della Monica PL, Comisso M, Piazza V, Sbaraglia F, Musumeci F. 677 PREDICTION OF RIGHT VENTRICULAR FAILURE AFTER LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION: ROLE OF VASODILATOR CHALLENGE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.436] [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: 12/23/2022]
Abstract
Abstract
Pulmonary artery pulsatility index (PAPi) is an indicator of right ventricular (RV) function and an independent predictor of right ventricular failure (RVF) following left ventricular assist device (LVAD) implantation. Administration of vasodilator challenge during right heart catheterization (RHC) could reduce RV workload allowing a better assessment of its functional reserve.
Patients undergoing LVAD implantation at our Institution between May 2013 and August 2021 were enrolled. Only patients who had undergone RHC and vasodilator challenge with sodium nitroprusside were analyzed. We collected all available clinical, instrumental, and haemodynamic parameters, at baseline and after nitroprusside infusion and evaluated potential associations with post-LVAD RVF. Of the 54 patients analyzed, 19 (35%) developed RVF after LVAD implantation. Fractional area change (FAC) (OR: 0.647, CI: 0.481–0.871; P = 0.004), pulmonary artery systolic pressure (PASP)(OR: 0.856, CI: 0.761–0.964; P=0.010), and post-sodium nitroprusside (NTP) PAPi (OR: 0.218, CI: 0.073–0.653; P = 0.006) were independent predictors of post-LVAD RVF. The model combining FAC, PASP, and post-NTP PAPi demonstrated a predictive accuracy of 90.7%. Addition of post-NTP PAPi significantly increased the predictive accuracy of the European Registry for Patients with Mechanical Circulatory Support right-sided heart failure risk score [79.4 vs. 70.4%; area under the curve (AUC): 0.841 vs. 0.724, P = 0.022] and the CRITT score (79.6% vs. 74%; AUC: 0.861 vs. 0.767 P = 0.033).
Post-NTP PAPi has observed to be an independent predictor of RVF following LVAD implantation. Dynamic assessment of PAPi using a vasodilator challenge may represent a method of testing RV functional reserve in candidates for LVAD implantation. Larger and prospective studies are needed to confirm this hypothesis.
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Affiliation(s)
- Giulio Cacioli
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Vincenzo Polizzi
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | | | - Ernesto Cristiano
- Division Of Cardiology, Department Of Clinical And Molecular Medicine, Sapienza University , Rome
| | - Amedeo Pergolini
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Giada Distefano
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | | | - Marina Comisso
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Vito Piazza
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Fabio Sbaraglia
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Francesco Musumeci
- Cardiac Surgery And Heart Transplant Unit , Azienda Ospedaliera San Camillo Forlanini, Roma
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12
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Felici M, Ciabatti M, Bolognese L. [Lambda-waves: in electrocardiography, the wave width counts more]. G Ital Cardiol (Rome) 2022; 23:911. [PMID: 36504208 DOI: 10.1714/3913.38957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Massimo Felici
- U.O.C. Cardiologia-UTIC, Ospedale San Donato, Arezzo Dipartimento Malattie Cardiovascolari, Toraciche e Neurologiche, USL Toscana Sudest, Arezzo
| | - Michele Ciabatti
- U.O.C. Cardiologia-UTIC, Ospedale San Donato, Arezzo Dipartimento Malattie Cardiovascolari, Toraciche e Neurologiche, USL Toscana Sudest, Arezzo
| | - Leonardo Bolognese
- U.O.C. Cardiologia-UTIC, Ospedale San Donato, Arezzo Dipartimento Malattie Cardiovascolari, Toraciche e Neurologiche, USL Toscana Sudest, Arezzo
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Cacioli G, Polizzi V, Ciabatti M, Cristiano E, Pergolini A, Distefano G, Lilla Della Monica P, Comisso M, Piazza V, Sbaraglia F, Musumeci F. Prediction of right ventricular failure after left ventricular assist device implantation: role of vasodilator challenge. Eur Heart J Acute Cardiovasc Care 2022; 11:629-639. [PMID: 35866303 DOI: 10.1093/ehjacc/zuac085] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 01/01/2023]
Abstract
AIMS Pulmonary artery pulsatility index (PAPi) is an indicator of right ventricular (RV) function and an independent predictor of right ventricular failure (RVF) following left ventricular assist device (LVAD) implantation. Administration of vasodilator challenge during right heart catheterization (RHC) could reduce RV workload allowing a better assessment of its functional reserve. METHODS AND RESULTS Patients undergoing LVAD implantation at our Institution between May 2013 and August 2021 were enrolled. Only patients who had undergone RHC and vasodilator challenge with sodium nitroprusside were analyzed. We collected all available clinical, instrumental, and haemodynamic parameters, at baseline and after nitroprusside infusion and evaluated potential associations with post-LVAD RVF. Of the 54 patients analyzed, 19 (35%) developed RVF after LVAD implantation. Fractional area change (FAC) (OR: 0.647, CI: 0.481-0.871; P = 0.004), pulmonary artery systolic pressure (PASP) (OR: 0.856, CI: 0.761-0.964; P = 0.010), and post-sodium nitroprusside (NTP) PAPi (OR: 0.218, CI: 0.073-0.653; P = 0.006) were independent predictors of post-LVAD RVF. The model combining FAC, PASP, and post-NTP PAPi demonstrated a predictive accuracy of 90.7%. Addition of post-NTP PAPi significantly increased the predictive accuracy of the European Registry for Patients with Mechanical Circulatory Support right-sided heart failure risk score [79.4 vs. 70.4%; area under the curve (AUC): 0.841 vs. 0.724, P = 0.022] and the CRITT score (79.6% vs. 74%; AUC: 0.861 vs. 0.767 P = 0.033). CONCLUSION Post-NTP PAPi has observed to be an independent predictor of RVF following LVAD implantation. Dynamic assessment of PAPi using a vasodilator challenge may represent a method of testing RV functional reserve in candidates for LVAD implantation. Larger and prospective studies are needed to confirm this hypothesis.
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Affiliation(s)
- Giulio Cacioli
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Vincenzo Polizzi
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | | | - Ernesto Cristiano
- Division of Cardiology, Department of Clinical and Molecular Medicine; School of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Amedeo Pergolini
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Giada Distefano
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | | | - Marina Comisso
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Vito Piazza
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Fabio Sbaraglia
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Francesco Musumeci
- Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Roma
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Lillo R, Pieroni M, Camporeale A, Ciabatti M, Lombardo A, Massetti M, Graziani F. Echocardiography in Anderson-Fabry Disease. Rev Cardiovasc Med 2022. [DOI: 10.31083/j.rcm2306201] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Pieroni M, Ciabatti M, Graziani F, Camporeale A, Saletti E, Lillo R, Figliozzi S, Bolognese L. The Heart in Fabry Disease: Mechanisms Beyond Storage and Forthcoming Therapies. Rev Cardiovasc Med 2022. [DOI: 10.31083/j.rcm2306196] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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16
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Camporeale A, Diano A, Tondi L, Pica S, Pasqualin G, Ciabatti M, Graziani F, Pieroni M, Lombardi M. Cardiac Magnetic Resonance Features of Fabry Disease: From Early Diagnosis to Prognostic Stratification. Rev Cardiovasc Med 2022. [DOI: 10.31083/j.rcm2305177] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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17
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Ammirati E, Buono A, Moroni F, Gigli L, Power JR, Ciabatti M, Garascia A, Adler ED, Pieroni M. State-of-the-Art of Endomyocardial Biopsy on Acute Myocarditis and Chronic Inflammatory Cardiomyopathy. Curr Cardiol Rep 2022; 24:597-609. [PMID: 35201561 PMCID: PMC8866555 DOI: 10.1007/s11886-022-01680-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [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] [Accepted: 02/10/2022] [Indexed: 12/11/2022]
Abstract
Purpose of Review Histologic evidence of myocardial inflammatory infiltrate not secondary to an ischemic injury is required by current diagnostic criteria to reach a definite diagnosis of myocarditis. Endomyocardial biopsy (EMB) is therefore often indicated for the diagnosis of myocarditis, although it may lack sufficient sensitivity considering the limited possibility of myocardial sampling. Improving the diagnostic yield and utility of EMB is of high priority in the fields of heart failure cardiology and myocarditis in particular. The aim of the present review is to highlight indications, strengths, and shortcomings of current EMB techniques, and discuss innovations currently being tested in ongoing clinical studies, especially in the setting of acute myocarditis and chronic inflammatory cardiomyopathy. Recent Findings EMB provides unique diagnostic elements and prognostic information which can effectively guide the treatment of myocarditis. Issues affecting the diagnostic performance in the setting of acute myocarditis and chronic inflammatory cardiomyopathies will be discussed in this review in the light of recent expert consensus documents on the management of these conditions and on indication to EMB. Recent innovations using electroanatomic mapping (EAM)-guided EMB and fluoroscopic-guided EMB during temporary mechanical circulatory support have improved the utility of the procedure. Summary EMB remains an important diagnostic test whose results need to be interpreted in the context of (1) clinical pre-test probability, (2) timing of sampling, (3) quality of sampling (4) site of sampling, (5) histologic type of myocarditis, and (6) analytic methods that are applied. Herein we will review these caveats as well as perspectives and innovations related to the use of this diagnostic tool.
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Affiliation(s)
- Enrico Ammirati
- De Gasperis" Cardio Center and Transplant Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy.
| | - Andrea Buono
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza, Brescia, Italy
| | | | - Lorenzo Gigli
- De Gasperis" Cardio Center and Transplant Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy
| | - John R Power
- Division of Cardiology, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Michele Ciabatti
- Cardiovascular Department, ASL8 Arezzo San Donato Hospital, Arezzo, Italy
| | - Andrea Garascia
- De Gasperis" Cardio Center and Transplant Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy
| | - Eric D Adler
- Division of Cardiology, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Maurizio Pieroni
- Cardiovascular Department, ASL8 Arezzo San Donato Hospital, Arezzo, Italy
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Ciabatti M, Pieroni M, Felici M, Bolognese L. Multimodality Imaging Assessment and Follow-Up in a Case of Rickettsial Myocarditis: Echocardiographic and Cardiac Magnetic Resonance Features. Circ Cardiovasc Imaging 2021; 14:1151-1154. [PMID: 34875869 DOI: 10.1161/circimaging.121.013481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michele Ciabatti
- Cardiovascular, Neurological and Respiratory Department, San Donato Hospital, Arezzo, Italy
| | - Maurizio Pieroni
- Cardiovascular, Neurological and Respiratory Department, San Donato Hospital, Arezzo, Italy
| | - Massimo Felici
- Cardiovascular, Neurological and Respiratory Department, San Donato Hospital, Arezzo, Italy
| | - Leonardo Bolognese
- Cardiovascular, Neurological and Respiratory Department, San Donato Hospital, Arezzo, Italy
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Ciabatti M, Nesti M, Reccia M, Saletti E, Notarstefano P, Pieroni M, Bolognese L. Mechanical dispersion identifies patients with extensive electroanatomic abnormalities in Brugada syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0269] [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
Background
Brugada syndrome (BrS) was initially described as a pure electrical disorder caused by ion channel abnormalities in the absence of structural heart disease. However, imaging, autopsy and endomyocardial biopsy studies have increasingly demonstrated in patients with BrS the presence of myocardial structural alterations of the right ventricle (RV), particularly in the outflow tract. Indeed, electroanatomic mapping studies identified electroanatomic abnormalities of the RV outflow tract in both unipolar and bipolar maps with a significant correlation between the extension of low-voltage areas and the inducibility of arrhythmias at electrophysiological study or the incidence of malignant arrhythmias during the follow up. New echocardiographic parameters have been proposed to identify subtle myocardial alterations associated with arrhythmic events. Mechanical dispersion (MD) of the left ventricle (LV) has been identified as a prognostic marker in the arrhythmic risk stratification in various cardiac diseases including some cardiomyopathies.
Purpose
In this study we evaluated MD and global longitudinal strain (GLS) of RV and LV in patients with BrS to identify echocardiographic correlates of the abnormalities detected by electroanatomic mapping.
Methods
We performed 2D-Echocardiography with speckle tracking analysis of RV and LV in patients with BrS previously submitted to RV electroanatomic mapping. All studies were performed by investigators blind to clinical features and electrophysiological findings. Echocardiographic data were compared with electroanatomic mapping and electrophysiological study findings and with clinical data.
Results
We enrolled 18 patients (52±11 years, male 44%). Patients with a LV MD value ≥40 ms showed a pathological unipolar area with voltage <5.5 mV significantly more extended than patients with a LV MD value <40 ms (28.49±21.06 vs 10.47±8.22; p=0.03). Patients with LV MD ≥40 ms also showed a trend to greater extension of the unipolar area with voltage <4 mV (13.94±13.11 vs 4.94±3.12; p=0.07), a greater extension of the bipolar area with voltage <1.5 mV (6.24±5.22 vs 2.24±3.15; p=0.07) and higher inducibility at programmed ventricular stimulation (70% vs 37.5%, p=0.34). No correlation was observed between RV MD or GLS values and the extent of the low-voltage areas or with the presence of genetic mutations associated with BrS.
Conclusions
In patients with BrS a LV MD ≥40 ms is associated with a greater extension of low-voltage areas at unipolar mapping. Echocardiographic evaluation with MD analysis may represent a valuable non-invasive tool to identify electroanatomic alterations prompting further invasive studies including electronatomic mapping and electrophysiological study. Prospective studies on larger series may further clarify the potential role of MD and electroanatomic mapping in the prognostic stratification of patients with BrS.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- M Ciabatti
- San Donato Hospital of Arezzo, Arezzo, Italy
| | - M Nesti
- San Donato Hospital of Arezzo, Arezzo, Italy
| | - M Reccia
- San Donato Hospital of Arezzo, Arezzo, Italy
| | - E Saletti
- San Donato Hospital of Arezzo, Arezzo, Italy
| | | | - M Pieroni
- San Donato Hospital of Arezzo, Arezzo, Italy
| | - L Bolognese
- San Donato Hospital of Arezzo, Arezzo, Italy
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20
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Ciabatti M, Martinese L, Quacquarelli A, Pieroni M, Feri M, Bolognese L. Cytosorb treatment in severe COVID-19 cardiac and pulmonary disease. Eur Heart J Case Rep 2021; 5:ytab123. [PMID: 33870079 PMCID: PMC8039116 DOI: 10.1093/ehjcr/ytab123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/29/2021] [Accepted: 03/15/2021] [Indexed: 12/05/2022]
Affiliation(s)
- Michele Ciabatti
- Cardiovascular, Respiratory and Neurological Department, Via Pietro Nenni 22, San Donato Hospital, Arezzo 52100, Italy
| | - Lucia Martinese
- Cardiovascular, Respiratory and Neurological Department, Via Pietro Nenni 22, San Donato Hospital, Arezzo 52100, Italy
| | - Antonio Quacquarelli
- Intensive Care, Perioperative Medicine and Antalgic Therapy Department, Via Pietro Nenni 22, San Donato Hospital, Arezzo 52100, Italy
| | - Maurizio Pieroni
- Cardiovascular, Respiratory and Neurological Department, Via Pietro Nenni 22, San Donato Hospital, Arezzo 52100, Italy
| | - Marco Feri
- Intensive Care, Perioperative Medicine and Antalgic Therapy Department, Via Pietro Nenni 22, San Donato Hospital, Arezzo 52100, Italy
| | - Leonardo Bolognese
- Cardiovascular, Respiratory and Neurological Department, Via Pietro Nenni 22, San Donato Hospital, Arezzo 52100, Italy
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Pieroni M, Pieruzzi F, Mignani R, Graziani F, Olivotto I, Riccio E, Ciabatti M, Limongelli G, Manna R, Bolognese L, Pisani A. Potential resistance to SARS-CoV-2 infection in lysosomal storage disorders. Clin Kidney J 2021; 14:1488-1490. [PMID: 34221376 PMCID: PMC7929028 DOI: 10.1093/ckj/sfab045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/11/2021] [Indexed: 12/11/2022] Open
Affiliation(s)
| | - Federico Pieruzzi
- Clinical Nephrology, School of Medicine, University of Milano Bicocca, Milan, Italy.,Nephrology and Dialysis Unit, ASST-Monza San Gerardo Hospital, Monza, Italy
| | - Renzo Mignani
- Department of Nephrology, Infermi Hospital, Rimini, Italy
| | - Francesca Graziani
- Cardiovascular Department, Policlinico Gemelli, Catholic University, Rome, Italy
| | - Iacopo Olivotto
- Cardiomyopathy Unit, Careggi Hospital, Florence, University Florence, Italy
| | - Eleonora Riccio
- Department of Public Health, Nephrology Unit, University of Naples 'Federico II', Naples, Italy
| | | | - Giuseppe Limongelli
- Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Raffaele Manna
- Department of Internal Medicine, Policlinico Gemelli, Catholic University, Rome, Italy
| | | | - Antonio Pisani
- Department of Public Health, Nephrology Unit, University of Naples 'Federico II', Naples, Italy
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Ciabatti M, Fumagalli C, Beltrami M, Vignini E, Martinese L, Tomberli A, Zampieri M, Bertini A, Carrassa G, Marchi A, Berteotti M, Cappelli F, Bolognese L, Pieroni M, Olivotto I. Prevalence, causes and predictors of cardiovascular hospitalization in patients with hypertrophic cardiomyopathy. Int J Cardiol 2020; 318:94-100. [DOI: 10.1016/j.ijcard.2020.07.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/24/2020] [Accepted: 07/23/2020] [Indexed: 12/16/2022]
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Pieroni M, Notarstefano P, Ciabatti M, Nesti M, Martinese L, Liistro F, Bolognese L. Electroanatomic mapping‐guided endomyocardial biopsy in patients with apparently idiopathic ventricular arrhythmias. Pacing Clin Electrophysiol 2020; 43:1028-1038. [DOI: 10.1111/pace.14014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/18/2020] [Accepted: 07/12/2020] [Indexed: 12/11/2022]
Affiliation(s)
| | | | | | - Martina Nesti
- Cardiovascular Department San Donato Hospital Arezzo Italy
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Vergara R, Vignini E, Ciabatti M, Migliorini A, Valenti R, Antoniucci D. Long-Term Mortality Comparison of Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock and Treated With Culprit-Only or Multivessel Percutaneous Coronary Intervention. Cardiovasc Revasc Med 2020; 22:10-15. [PMID: 32605903 DOI: 10.1016/j.carrev.2020.06.021] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/24/2020] [Accepted: 06/08/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES We sought to determine whether, in a real word context of patients with Acute Myocardial Infarction (AMI), multivessel disease (MVD) and cardiogenic shock (CS), the successful treatment with primary percutaneous coronary intervention (p-PCI) of only culprit lesions (OC-PCI) is associated with better long-term mortality rates than multivessel PCI (MV-PCI) of all significant lesions. METHODS From our registry of all consecutive patients admitted for AMI between January 1995 and December 2016 we selected those presenting with CS and MVD successfully treated with p-PCI, and compared those who underwent OC-PCI against MV-PCI, either during the p-PCI (MV-pPCI) or by staged revascularization (Staged-PCI) during hospitalization. The primary endpoint was 2-year all-cause death. RESULTS Among 4210 patients with AMI, 406 (9.6%) presented CS (Killip class IV). A total of 292 patients had MVD. Of them, 252 (86.3%) were successfully treated with p-PCI, 159 patients with OC-PCI and 93 with MV-PCI, either in the same (n = 29) or staged procedure (n = 64). At 2-year follow-up the overall mortality was 47.6%, lower in MV-PCI group (37.6% vs 53.5% in OC-PCI, p = 0.019). Diabetes (HR = 1.50, 1.01-2.22), three vessel disease (HR = 1.49, 1.02-2.17) and basal left ventricular ejection fraction <15% (HR = 3.39, 2.41-6.27) were independent predictors of mortality, while MV-PCI was the only variable associated with improved survival (HR = 0.54, 0.36-0.81). CONCLUSIONS In this real world registry of AMI patients with MVD presenting CS, MV-PCI was associated with better long-term survival.
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Affiliation(s)
- Ruben Vergara
- Division of Cardiology, Careggi-Hospital, Florence, Italy.
| | - Elisa Vignini
- Division of Cardiology, Careggi-Hospital, Florence, Italy
| | | | | | - Renato Valenti
- Division of Cardiology, Careggi-Hospital, Florence, Italy
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Ciabatti M, Vignini E, Mattesini A, Di Mario C, Valente S. Why can flu be so deadly? An unusual case of cardiogenic shock. Intern Emerg Med 2020; 15:679-684. [PMID: 31104304 DOI: 10.1007/s11739-019-02094-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/11/2019] [Accepted: 04/27/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Michele Ciabatti
- Structural Interventional Cardiology, Cardiologic Intensive Care Unit, Careggi University Hospital, Largo Brambilla 3, 50100, Florence, Italy
| | - Elisa Vignini
- Structural Interventional Cardiology, Cardiologic Intensive Care Unit, Careggi University Hospital, Largo Brambilla 3, 50100, Florence, Italy
| | - Alessio Mattesini
- Structural Interventional Cardiology, Cardiologic Intensive Care Unit, Careggi University Hospital, Largo Brambilla 3, 50100, Florence, Italy.
| | - Carlo Di Mario
- Structural Interventional Cardiology, Cardiologic Intensive Care Unit, Careggi University Hospital, Largo Brambilla 3, 50100, Florence, Italy
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Vergara R, Valenti R, Migliorini A, Ciabatti M, Grazia De Gregorio M, Taborchi G, Morini S, Rondine R, Martone R, Antoniucci D. Clinical and Angiographic Outcomes Comparison of Patients With Left Main Vs Non-Left Main Bifurcation Lesions Treated With Percutaneous Coronary Intervention With Second-Generation Drug-Eluting Stents. J Invasive Cardiol 2018; 30:443-446. [PMID: 30504512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION It is not clear if differences exist about treating left main bifurcation (LMB) and non-left main bifurcation (non-LMB) lesions by means of percutaneous coronary intervention (PCI). METHODS We prospectively analyzed all consecutive patients treated at our center for bifurcation lesions from January 1, 2011 to December 31, 2015, including acute myocardial infarction (MI) and cardiogenic shock, and compared the angiographic and clinical outcomes of patients with LMB and non-LMB lesions treated with PCI and second-generation drug-eluting stent (2G-DES) implantation. The primary endpoint was the major adverse cardiac event (MACE) composite, including MI, clinically indicated target-vessel revascularization (TVR), and cardiac death (CD) at 2-year follow-up. We also compared the angiographic patency of the vessel, which was a composite of the restenosis-reocclusion (RR) rate. RESULTS Out of 1081 patients (1368 bifurcations), a total of 320 patients had LMB (29%). Overall, procedural success was 98.4%. Clinical follow-up rate was 100%. Angiographic follow-up rate was 83.7%. No differences were seen regarding the primary endpoint of all MACE (17.8% in LMB vs 18.0% in non-LMB; P>.99), MI rate (4.3% in LMB vs 2.9% in non-LMB; P=.20), and CD (8.7% in LMB vs 5.8% in non-LMB; P=.08). The overall RR rate was 11.8%, with 5% RR rate in the LMB group (16/320 lesions) and 9.7% RR rate in the non-LMB group (102/1048 lesions); P<.01. The LMB group had a better TVR rate (5.0% vs 9.4% in the non-LMB group; P=.01). CONCLUSION PCI with 2G-DES for LMB has better target-vessel patency and TVR rates when compared with non-LMB lesions, without clinical differences in terms of 2-year clinical outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - David Antoniucci
- Division of Cardiology, Careggi Hospital, Viale Pieraccini 17, I-50134, Florence, Italy. ruben.arg@ gmail.com
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Vergara R, Vignini E, Ciabatti M, Migliorini A, Valenti R. TCT-51 Long-term Mortality Comparison of Patients With Acute Myocardial Infarction and Cardiogenic Shock Treated With Culprit-Only or Multivessel Percutaneous Coronary Intervention. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1137] [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: 10/28/2022]
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