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Gallone G, Bongiovanni F, Bruno F, Scudeler L, Landra F, Andreis A, Casoni R, Fava A, Pidello S, Raineri C, Usmiani T, Alunni G, Conrotto F, D‘ascenzo F, De Ferrari G. P316 TRANSTHYRETIN CARDIAC AMYLOIDOSIS IN PATIENTS WITH SEVERE AORTIC STENOSIS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT: A SINGLE CENTER EXPERIENCE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.303] [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
Background
Even if prevalent among patients with severe aortic stenosis (AS), the clinical suspicion for transthyretin cardiac amyloidosis (ATTR–CA) remains difficult in this subset.
Methods
Consecutive severe AS patients undergoing transcatheter aortic valve replacement (TAVR) evaluation at a single center were prospectively included. Those with suspected ATTR–CA based on clinical assessment underwent 99mTc–DPD cardiac scintigraphy. The RAISE score, a novel screening tool with high sensitivity for ATTR–CA in AS, was retrospectively calculated to rule–out ATTR–CA in the remaining patients. Patients were categorized as follow: “ATTR–CA +”: patients with confirmed ATTR–CA at 99mTc–DPD cardiac scintigraphy; “ATTR–CA –”: patients with negative 99mTc–DPD cardiac scintigraphy or a negative RAISE score; c) “ATTR–CA indeterminate”: patients not undergoing ATTR–CA assessment with a positive RAISE score. The characteristics and outcomes of ATTR–CA + and ATTR–CA – patients were compared.
Results
Of 107 included patients, ATTR–CA suspicion was posed in 13 patients and confirmed in 6. Patients were categorized as follow: 6 (5.6%) ATTR–CA +, 79 (73.8%) ATTR–CA –, 22 (20.6%) ATTR–CA indeterminate. Excluding ATTR–CA indeterminate patients, the prevalence of ATTR–CA was 7.1%. As compared to ATTR–CA – patients, ATTR–CA + patients were older, had higher procedural risk and more extensive myocardial and renal damage. They had higher left ventricle mass index and lower ECG voltages, translating into a lower voltage to mass ratio. Moreover, bifascicular block was more common. No difference in procedural outcomes and 1–year mortality was observed between groups.
Conclusions
Among severe AS patients, ATTR–CA is prevalent and presents with phenotypic features that may aid to differentiate it from lone AS. The procedural and mid–term outcomes following TAVR seems unaffected by ATTR–CA status.
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Affiliation(s)
- G Gallone
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - F Bongiovanni
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - F Bruno
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - L Scudeler
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - F Landra
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - A Andreis
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - R Casoni
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - A Fava
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - S Pidello
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - C Raineri
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - T Usmiani
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - G Alunni
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - F Conrotto
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - F D‘ascenzo
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
| | - G De Ferrari
- CITTÀ DELLA SALUTE E DELLA SCIENZA, TORINO, TORINO; UNIVERSITÀ DI SIENA, SIENA
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Caixeta IA, Silva NAM, Schultz EB, Raineri C. Management of Dairy Calves and Heifers and the Economic Impact on First Lactation. Bol Ind Anim 2022. [DOI: 10.17523/bia.2022.v79.e1508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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3
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Bocchino PP, Angelini F, Vairo A, Andreis A, Fortuni F, Franchin L, Frea S, Raineri C, Pidello S, Conrotto F, Montefusco A, Alunni G, De Ferrari GM. Clinical outcomes following isolated transcatheter tricuspid valve repair: a meta-analysis and meta-regression study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2222] [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
Significant tricuspid regurgitation (TR) is a common valvular heart disease worldwide.
Purpose
We aimed to assess the pooled clinical and echocardiographic outcomes of different isolated transcatheter tricuspid valve repair (ITTVR) strategies for significant (≥ moderate) TR.
Methods
We systematically searched the literature for studies evaluating the efficacy and safety of ITTVR for significant TR in adult. The primary outcomes were the improvement of New York Heart Association (NYHA) functional class and 6-minutes walking distance (6MWD) and the presence of severe or greater TR at the last available follow-up of each individual study. Random-effect meta-analysis was performed comparing outcomes before and after ITTVR.
Results
14 studies with 771 patients were included. Mean age was 77±8 years and mean EuroScore II was 6.8%±5.4%. At a weighted mean follow-up of 212 days, 209 (35%) patients had a NYHA III to IV functional class compared to 586 (84%) patients at baseline (risk ratio: 0.23, 95% CI 0.13 to 0.40, P-value<0.001). 6MWD significantly improved from 237±113 meters to 294±105 meters (mean difference: +50 meters, 95% CI +34 to +66 meters, P-value<0.001). 147 (24%) patients showed severe or greater TR after ITTVR compared to 616 (96%) at baseline (risk ratio: 0.29, 95% CI 0.20 to 0.42, P-value<0.001).
Conclusion
Patients undergoing ITTVR for significant TR experienced a significant improvement in NYHA functional status and 6MWD and a significant reduction in TR severity at mid-term follow-up.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P P Bocchino
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - F Angelini
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - A Vairo
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - A Andreis
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - F Fortuni
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - L Franchin
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - S Frea
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - C Raineri
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - S Pidello
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - F Conrotto
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - A Montefusco
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - G Alunni
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
| | - G M De Ferrari
- Hospital Citta Della Salute e della Scienza di Torino, Turin, Italy
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Dusi V, Masiello L, Vicentini A, Savastano S, Petracci B, Sanzo A, Baldi E, Greco A, Turco A, Raineri C, Scelsi L, Ghio S, Serio A, Arbustini E, Rordorf R. Long-term outcome of patients with cardiolaminopathy undergoing defibrillator implantation: single-center experience. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0628] [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
Mutations in the LMNA gene are associated with a high arrhythmic risk. The history of the disease in patients undergoing ICD implantation is poorly characterized.
Purpose
To evaluate the phenotype of patients with cardiolaminopathy at the time of first ICD implantation, the incidence, characteristics and timing of ventricular arrhythmias (VAs) during follow up and the predictive value of the European score (that assigns a point each to non-sustained VT (NSVT), left ventricular ejection fraction (LVEF)<45% at first contact, male sex and non-missense mutations) and of the Wahbi score (that also includes conduction disturbances) for both VAs and heart failure (HF) related outcomes.
Methods
Patients were identified retrospectively. Clinical and device data were collected at baseline and during follow-up.
Results
We identified 26 patients (54% male, 42±8 years, 31% with familial history of sudden cardiac death, 31% with non-missense mutation) undergoing ICD implantation, 96% in primary prevention, 47% with single chamber ICD, 38% with dual chamber ICD. At the time of implantation, 30% had skeletal muscle involvement, 15% history of syncope, 4% of cardiac arrest, 62% previous NSVT. Also, 38% had a history of supraventricular arrhythmias and 61% had AV conduction disturbances. LVEF was 41±11%, 35% were in NYHA class ≥2, the mean European and Wahbi scores were 2.1±0.8 and 18.2±8.9, respectively. During 8.3±5 years, 15% were transplanted, 8% died due to HF, 4% underwent LVAD implantation, despite 31% having received an upgrade to CRT-D. Appropriate device interventions occurred in 46% of patients with a median time to first event of 29 months (IQR 13–93), for a total of 137 ATP, 51% of which effective (median 3ATP/patient, IQR 1–8) and of 26 shocks, 96% of which effective (median 2 shocks/patient, IQR 1–3); 12% had an arrhythmic storm. The first treated arrhythmia was a polymorphic VT/VF in 17%, a monomorphic VT in the others (medium cycle length 293±37 msec). Survival free from appropriate ICD interventions at 1 and at 5 years was 75% and 19% respectively in case of a European score ≥3 vs 94% and 82% in case of a score <3 (Logrank test p<0.01), 72% and 46% in case of Wahbi score ≥30 vs 100% and 86% with score <30 (p<0.01), with no differences in terms of death/transplant (figure). At last follow-up, 92% of patients a were taking beta-blocker, 42% amiodarone, 8% sotalol, 4% flecainide, 8% mexiletine. Also, 4% had undergone invasive VT ablation, 8% bilateral cardiac sympathetic denervation.
Conclusions
Patients with cardiolaminopathy are at a high risk of both arrhythmic and heart failure progression over the first decade after implantation of the first ICD. A European score ≥3 identifies patients with 5-year shock/ATP free survival of less than 20% but does not predict death/transplantation. The first arrhythmic event in these patients is more frequently a rapid monomorphic VT with modest ATP efficacy.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- V Dusi
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - L.C Masiello
- University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Vicentini
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - S Savastano
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - B Petracci
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - A Sanzo
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
| | - E Baldi
- University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Greco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Turco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - C Raineri
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - L Scelsi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Serio
- Policlinic Foundation San Matteo IRCCS, Center for Cardiovascular Genetic Diseases, Pavia, Italy
| | - E Arbustini
- Policlinic Foundation San Matteo IRCCS, Center for Cardiovascular Genetic Diseases, Pavia, Italy
| | - R Rordorf
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Pavia, Italy
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5
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Fortuni F, Abete R, Raineri C, Ghio S, Angelini F, Scelsi L, Turco A, Crimi G, Leonardi S, Oltrona Visconti L, De Ferrari GM. P5554Follow the light - The prognostic value of late gadolinium enhancement in hypertrophic cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0498] [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 and aim
Hypertrophic cardiomyopathy (HCM) is a genetic based cardiomyopathy with heterogeneous phenotypic expression. Since it is one of the most common cause of sudden cardiac death (SCD) in the young different risk score have been proposed to properly identify the patients that would benefit from a primary prevention with an implantable cardioverter-defibrillator (ICD). ESC guidelines on HCM suggest to estimate the risk of SCD considering clinical and echocardiographic parameters and mention the use of cardiac magnetic resonance (CMR) only in the case of poor echo windows. The aim of the present study-level meta-analysis was to explore the prognostic value of late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) for adverse fatal events.
Methods
We searched PubMed and EMBASE for studies that investigated the prognostic value of LGE in patients with HCM. The outcomes of interest were SCD or aborted SCD, all-cause mortality and cardiovascular (CV) mortality. Random-effects Odds Ratios (ORs) were estimated using a DerSimonian-Laird method with a person-year approach. Moreover, an univariate meta-regression was performed to assess the moderator effect of mean age, LGE % of left ventricle (LV) and gender (expressed as male percentage).
Results
A total of 7 studies (n=3351) were included in the analysis. Mean follow-up was 3±0.63 years. Mean age was 47.7±14.6 years and 56.9% were male. LGE was detected in 1845 (55%) patients with a mean LGE percentage of LV of 7%. The presence of LGE was associated with an increased incidence of SCD or aborted SCD (OR 3.44; 95% CI 2.02–5.86; p<0.001- Figure), all-cause mortality (OR 1.92; 95% CI 1.31–2.81; p<0.001) and CV mortality (OR 3.16; 95% CI 1.77–5.64; p<0.001) compared with the absence of LGE at CMR. The LGE percentage of LV, mean age and gender did not have any moderator effect on the outcomes of interest. However, LGE % of LV was reported only in 4 studies and the absence of any moderator effect of this parameter could be due to a type II error.
Prognostic value of LGE for SCD
Conclusions
The presence of LGE at CMR in patients with HCM exhibited a substantial prognostic value in fatal events and, in particular, in the prediction of SCD. LGE assessment is an effective tool to stratify the arrhythmic risk in HCM. Therefore, it should be considered, especially in borderline cases, to improve the identification of HCM patients who could benefit from ICD implantation.
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Affiliation(s)
- F Fortuni
- University of Pavia, Division of Cardiology, Pavia, Italy
| | - R Abete
- University of Pavia, Division of Cardiology, Pavia, Italy
| | - C Raineri
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - F Angelini
- University of Turin, Division of Cardiology, Turin, Italy
| | - L Scelsi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Turco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - G Crimi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - S Leonardi
- Policlinic Foundation San Matteo IRCCS, a. Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - L Oltrona Visconti
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - G M De Ferrari
- Policlinic Foundation San Matteo IRCCS, a. Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
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6
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Turco A, Totaro P, Pellegrini C, Guida S, Cattadori B, Di Matteo A, Seminari E, Camporotondo R, Riccardi M, Ghio S, Raineri C, Scelsi L, D'Armini AM, Oltrona Visconti L, Pelenghi S. P5416A single-center, thirty-year experience of heart transplantation: analysis of the evolution of patients profile and long term outcomes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0374] [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
Heart Transplantation is still the gold standard therapy for patients suffering from end-stage cardiomyopathy and has been successfully performed in our center since 1985. Over this 30 years period there has been a significant evolution in patients characteristics and in candidate selection (either as a donor and as recipient) as shown by the recent benchmark from International Society of Heart and Lung Transplantation (ISHLT). Here we analyze the evolution of patients profile in our population and we correlated such evolution to the clinical outcomes and to the overall data from ISHLT.
Materials and methods
Overall 1122 patients underwent heart transplantation at our center from November 19th1985 to date. To analyze the evolution patients profile and donor criteria, patient population was divided in 4 groups according era of transplantation following ISHLT model (Group A from 1985 to 1991; Group B from 1992 to 2003; Group C from 2004 to 2008 and Group D from 2009 to date). Patients characteristics at time of transplantation, donor criteria ad clinical outcomes were analyzed and compared within 4 groups. An overall comparison of our results to the data from ISHLT was also performed.
Results
Overall Kaplan-Meier survival curve correlates favourably with ISHLT data showing a 20 years survival approaching 40%. Patients age at transplantation changed significantly among 4 groups from a median of 49 years (95% CI 47 to 51) in Group A to 54 years (95% CI 50 to 57) in Group D (p<0.001). Likewise donor age also changed significantly from a median of 24 years (95% CI 22 to 28) in Group A to 43 years (95% CI 39 to 47) in group D (p<0.001). Time on waiting list also changed significantly from a median of 115 days (95% CI 94 to 137) in Group A to 293 (95% CI 200 to 401) in Group D (p<0.001). As a marker of evolution of accepted donor criteria also ischemic time changed from 125±52 minutes of Group A to 153±61 minutes of Group D (p<0.001). As showed in Fig 1, Kaplan-Meier survival curves demonstrated a worse 1-year survival in Group D compared to others 3 Group.
Figure 1
Conclusions
The significant changing characteristics of both recipients and donors, over 30 years of activity, had a significant impact in early (1 year) postoperative survival following heart transplantation. Although medium/long term outcomes are still satisfactory in patients surviving at least 1 year, these data clearly suggest a more accurate patients selection and the need of alternative treatment before patients conditions deteriorate while on waiting list for heart transplantation
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Affiliation(s)
- A Turco
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - P Totaro
- Policlinic Foundation San Matteo IRCCS, Cardiac Surgical Department, Pavia, Italy
| | - C Pellegrini
- Policlinic Foundation San Matteo IRCCS, Cardiac Surgery-Clinical,Surgical,Diagnostic and Paediatric Sciences Department University of Pavia, Pavia, Italy
| | - S Guida
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - B Cattadori
- Policlinic Foundation San Matteo IRCCS, Cardiac Surgical Department, Pavia, Italy
| | - A Di Matteo
- Policlinic Foundation San Matteo IRCCS, Department of Infectious disease, Pavia, Italy
| | - E Seminari
- Policlinic Foundation San Matteo IRCCS, Department of Infectious disease, Pavia, Italy
| | - R Camporotondo
- Policlinic Foundation San Matteo IRCCS, Cardiac Intensive Care Unit, Pavia, Italy
| | - M Riccardi
- Policlinic Foundation San Matteo IRCCS, Cardiopulmonary anhestesiological, Pavia, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - C Raineri
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - L Scelsi
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - A M D'Armini
- Policlinic Foundation San Matteo IRCCS, Cardiac Surgery-Cardiopulmonary Surgery and Pulmonary Hypertension Unit, University of Pavia, Pavia, Italy
| | | | - S Pelenghi
- Policlinic Foundation San Matteo IRCCS, Cardiac Surgical Department, Pavia, Italy
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7
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Dusi V, Pugliese L, Passarelli I, Camporotondo R, Driussi M, Antonutti M, Miani D, Maurelli M, Facchin D, Savastano S, Raineri C, Rordorf R, Oltrona Visconti L, Proclemer A, De Ferrari GM. 5207Bilateral cardiac sympathetic denervation in structural heart disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0065] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Left cardiac sympathetic denervation (LCSD) is an established therapy for refractory ventricular arrhythmias (VAs) in channelopathies. A multicentric American and Indian case series suggested a greater efficacy of bilateral denervation (BCSD) in patients with structural heart disease (SHD).
Purpose
To describe our single-center experience with BCSD in SHD.
Methods
Nine patients (78% male, mean 55±18 yrs, mean LVEF 31±14%) with SHD and refractory VAs underwent BCSD. All had a Video-Assisted Thoracoscopic Surgery (VATS), in 2 cases associated with the robotic technique. The underlying cardiomyopathy (CMP) was non-ischemic (NICMP) in most cases (n=5, 55%), ischemic in 2 cases, arrhythmogenic right ventricular (ARVC) in one and related to lamin A/C deficiency in one. All patients had an ICD, 44% (n=4) a CRT-D. NYHA functional class I was present in 4 patients, the rest were in NYHA class II (n=3) or III (n=2). Three patients were candidates to heart transplant/LV assistance device. The arrhythmic burden pre BCSD included in 7 pts (78%) a history of electrical storm (ES); the median number of shocks/patient in the 12 months before BCSD was 5 (IQ range 3–18). Except for 2 patients with previous thyrotoxicosis, the remaining were either on amiodarone (n=6) or on sotalol (n=1) before BCSD. Main BCSD indications were represented by drug refractory fast VT in 7 pts (cycle <250 msec) and by recurrent monomorphic VT episodes (mean cycle 351 msec) after endocardial VT ablation in 2 patients.
Results
No major complication occurred. One patient (NICMP, NYHA II), has an uneventful follow up (FU) of less than 1 month and was excluded from the efficacy analysis. The median FU in the remaining 8 patients is 10 months (IQ range 6–19), during which the median number of shocks/patients was 0.5 (IQ range 0–3). Overall, 4 patients (50%) had ICD shock recurrences. Two cases (mean LVEF 17.5%, NYHA class III) had an ES during severe hemodynamic instability and subsequently died because of cardiogenic shock respectively 1 and 7 months after BCSD. One case had three, not consecutive ICD shocks 20 months after BCSD in the setting of severe amiodarone-induced thyrotoxicosis. Finally, one patient received a single intra-hospital ICD shock 5 days after BCSD before reintroduction of full-dose beta-blockers. The figure summarizes ICD shocks burden in the 6 months before and after BCSD. Among the 5 patients with NICMP/ARVC (4 in NYHA class I), only 1 had a single ICD shock recurrence.
ICD shocks pre versus post BCSD, n=8
Conclusions
Our case series, although numerically small, has a good follow-up and is the first reported in Europe. The results are in agreement with the suggested remarkable efficacy of BCSD in patients with good functional capacity and fast VAs. Therefore, cardiac sympathetic denervation should always be considered in patients with SHD and refractory ventricular tachyarrhythmias, especially in case VT ablation is either not indicated or fails.
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Affiliation(s)
- V Dusi
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - L Pugliese
- Dipartimento di Chirurgia - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - I Passarelli
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - R Camporotondo
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - M Driussi
- SOC Cardiologia, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - M Antonutti
- SOC Cardiologia, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - D Miani
- SOC Cardiologia, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - M Maurelli
- Dipartimento di Emergenza e Urgenza - Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - D Facchin
- SOC Cardiologia, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - S Savastano
- Dipartimento di Cardiologia - Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - C Raineri
- Dipartimento di Cardiologia - Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - R Rordorf
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - L Oltrona Visconti
- Dipartimento di Cardiologia - Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - A Proclemer
- SOC Cardiologia, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - G M De Ferrari
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
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8
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Montalto C, Crimi G, Mandurino-Mirizzi A, Frassica R, Gazzoli F, Covi R, Moschella M, Ghio S, Magrini G, Raineri C, Pelenghi S, Ferrario M, De Ferrari GM, Oltrona-Visconti L. P1856Percutaneous mitral edge-to-edge valvuloplasty in end-stage heart failure as a bridge to heart transplant: a case series from a single tertiary referral center. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0607] [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
Improved outcomes after percutaneous edge-to-edge mitral valvuloplasthy with MitraClip implantation were recently observed in patients with heart failure (HF) and functional severe mitral regurgitation (MR). Nonetheless, its efficacy in end-stage heart failure (HF) are lacking.
Purpose
Our aim was to investigate feasibility, preliminary efficacy on hemodynamics and follow-up of MitraClip implantation in a cohort of patients with very advanced HF.
Methods
Patients were retrospectively included in the present analysis if already in HT list, unsuitable for HT despite optimal medical and device therapy, or if implantation was a “bridge-to-candidacy”.
Results
Baseline and procedural characteristics are listed in Table 1; MR etiology was predominantly functional (n=7). No major complications were observed in the peri-operative period. At 6-month follow-up, invasive hemodynamics was available for 8 patients. A significant increase in cardiac index was observed (Least Square Mean Difference, LSMD = +0.47 L/min/m2; p=0.03; Figure 1), in conjunction with a numerical reduction in pulmonary vascular resistance (LSMD = −1.02 WU; p=0.3), a trend towards lower mean pulmonary arterial pressure (LSMD = −6.5 mmHg; p=0.053) and lower ejection fraction (LSMD = −6.5%; p=0.053). At a median follow-up of 772 days (IQR 156–1,578), all three patients unsuitable for HT at baseline could be eligible to HT list and one of them received LVAD. Moreover, two patients were transplanted, four experienced unplanned rehospitalization for HF, and one died of non-cardiac cause.
Table 1. Baseline clinical evaluation (n=10) Age (y) 53.67±8.43 HF Etiology – post ischemic 4 (40) Male sex 6 (60) HF Etiology – no CAD 4 (40) Body Surface Area (m2) 1.76±0.22 HF Etiology – other 2 (20) Chronic Resynchronization Therapy 5 (50) Euroscore II 6.00±2.74 Baseline MR grade (+) 4 (40) STS mortality 1.71±2.65 Residual MR grade (+) 1.71±0.49 Clips implanted (number) 1.78±0.67 Data are expressed as mean ± SD or count (valid %). MR scored on a scale from 0+ to 4+. STS, Society of Thoracic Surgeons.
Figure 1
Conclusions
Percutaneous edge-to-edge mitral valvuloplasty with MitraClip appears safe and effective in end-stage patients, impacts on clinical decision-making and therefore might be considered as a “bridge” towards a more definite strategy.
Acknowledgement/Funding
None
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Affiliation(s)
- C Montalto
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - G Crimi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Mandurino-Mirizzi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - R Frassica
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - F Gazzoli
- Policlinic Foundation San Matteo IRCCS, Division of Cardiac Surgery, Pavia, Italy
| | - R Covi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - M Moschella
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - G Magrini
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - C Raineri
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - S Pelenghi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiac Surgery, Pavia, Italy
| | - M Ferrario
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - G M De Ferrari
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit, Pavia, Italy
| | - L Oltrona-Visconti
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
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9
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Sormani P, Ammirati E, Moro C, Raineri C, Cipriani M, Veronese G, D" Elia S, Quattrocchi G, Milazzo A, Maestroni A, Giannattasio C, Frigerio M, Oliva F, Camici PG, Pedrotti P. P452Prognostic performance of clinical presentation and cardiac magnetic resonance ejection fraction and late enhancement pattern at basal examination in acute myocarditis. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez118.036] [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] [Indexed: 11/13/2022] Open
Affiliation(s)
- P Sormani
- Niguarda Ca" Granda Hospital, De Gasperis Cardio Center, Milan, Italy
| | - E Ammirati
- Niguarda Ca" Granda Hospital, De Gasperis Cardio Center, Milan, Italy
| | - C Moro
- Desio Hospital, Cardiology, Desio, Italy
| | - C Raineri
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - M Cipriani
- Niguarda Ca" Granda Hospital, De Gasperis Cardio Center, Milan, Italy
| | - G Veronese
- University of Milan-Bicocca, Milan, Italy
| | - S D" Elia
- Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - G Quattrocchi
- Niguarda Ca" Granda Hospital, De Gasperis Cardio Center, Milan, Italy
| | - A Milazzo
- Niguarda Ca" Granda Hospital, De Gasperis Cardio Center, Milan, Italy
| | - A Maestroni
- Busto Arsizio Hospital, Busto Arsizio, Italy
| | | | - M Frigerio
- Niguarda Ca" Granda Hospital, De Gasperis Cardio Center, Milan, Italy
| | - F Oliva
- Niguarda Ca" Granda Hospital, De Gasperis Cardio Center, Milan, Italy
| | - P G Camici
- Vita Salute University and San Raffaele Hospital, Milan, Italy
| | - P Pedrotti
- Niguarda Ca" Granda Hospital, De Gasperis Cardio Center, Milan, Italy
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10
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Dusi V, Pugliese L, Castelletti S, Dagradi F, Crotti L, Mori A, Camporotondo R, Raineri C, Scelsi L, Ghio S, Savastano S, Vicentini A, Rordorf R, Schwartz PJ, De Ferrari GM. P297Cardiac sympathetic denervation: evolving technique, expanding indications. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p297] [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] [Indexed: 11/12/2022] Open
Affiliation(s)
- V Dusi
- University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - L Pugliese
- Policlinic Foundation San Matteo IRCCS, Department of Surgery, Pavia, Italy
| | - S Castelletti
- Italian Institute for Auxology IRCCS, Center for Cardiac Arrhythmias of Genetic Origin, Milan, Italy
| | - F Dagradi
- Italian Institute for Auxology IRCCS, Center for Cardiac Arrhythmias of Genetic Origin, Milan, Italy
| | - L Crotti
- Italian Institute for Auxology IRCCS, Center for Cardiac Arrhythmias of Genetic Origin, Milan, Italy
| | - A Mori
- Policlinic Foundation San Matteo IRCCS, Department of Emergency and Urgency, Pavia, Italy
| | - R Camporotondo
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory for Clinical and Experimental Cardiology, Pavia, Italy
| | - C Raineri
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - L Scelsi
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - S Savastano
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - A Vicentini
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - R Rordorf
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - P J Schwartz
- Italian Institute for Auxology IRCCS, Center for Cardiac Arrhythmias of Genetic Origin, Milan, Italy
| | - G M De Ferrari
- University of Pavia, Department of Molecular Medicine, Pavia, Italy
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11
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Guida S, Ghio S, Fortuni F, Matrone B, Vullo E, Turco A, Scelsi L, Raineri C, Lombardi C, Badagliacca R, Oltrona Visconti L. P4535Right ventricular response to stress in pulmonary arterial hypertension. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4535] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Guida
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - S Ghio
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - F Fortuni
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - B Matrone
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - E Vullo
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - A Turco
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - L Scelsi
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - C Raineri
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - C Lombardi
- University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Brescia, Italy
| | - R Badagliacca
- Sapienza University of Rome, Pulmonary Hypertension Unit, Department of Cardiovascular and Respiratory Science, Rome, Italy
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12
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Raineri C, Pavesi C, Turco A, Ghio S, Scelsi L, Valentini A, Bassi EM, Dusi V, Petracci B, Savastano S, Sanzo A, Vicentini A, Rordorf R, Oltrona Visconti L, De Ferrari GM. P2867Late gadolinium enhancement at cardiac magnetic resonance accurately predicts arrhythmias in patients with non-ischemic cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2867] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Raineri
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - C Pavesi
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Turco
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Ghio
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - L Scelsi
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Valentini
- Institute of Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - E M Bassi
- Institute of Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - V Dusi
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - B Petracci
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Savastano
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Sanzo
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - A Vicentini
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - R Rordorf
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - L Oltrona Visconti
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G M De Ferrari
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
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13
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Ammirati E, Cipriani M, Sormani P, Varrenti M, Petrella D, Raineri C, Bonacina E, Garascia A, Gagliardone M, Pedrotti P, Moreo A, Russo C, Oliva F, Camici P, Frigerio M. P5142Survival and left ventricular function changes in fulminant versus non-fulminant acute myocarditis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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14
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Dusi V, Tavazzi G, Camporotondo R, Raineri C, Ghio S, Mori A, Vicentini A, Rordorf R, Pugliese L, De Ferrari G. 4988Bilateral cardiac sympathetic denervation for severe electrical storms in structural heart disease: first European experience. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx495.4988] [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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15
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De Nard F, Codullo V, Grosso V, Gallarati A, Ghio S, Scelsi L, Raineri C, Caporali R, Montecucco C. SAT0225 Screening for Pulmonary Arterial Hypertension in Systemic Sclerosis Patients: Single Center Real-Life Performance of The Detect Algorithm. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5236] [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: 11/04/2022]
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16
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Raineri C, Stivari TSS, Gameiro AH. Lamb Production Costs: Analyses of Composition and Elasticities Analysis of Lamb Production Costs. Asian-Australas J Anim Sci 2015; 28:1209-15. [PMID: 26104531 PMCID: PMC4478491 DOI: 10.5713/ajas.14.0585] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 09/26/2014] [Accepted: 09/30/2014] [Indexed: 11/27/2022]
Abstract
Since lamb is a commodity, producers cannot control the price of the product they sell. Therefore, managing production costs is a necessity. We explored the study of elasticities as a tool for basing decision-making in sheep production, and aimed at investigating the composition and elasticities of lamb production costs, and their influence on the performance of the activity. A representative sheep production farm, designed in a panel meeting, was the base for calculation of lamb production cost. We then performed studies of: i) costs composition, and ii) cost elasticities for prices of inputs and for zootechnical indicators. Variable costs represented 64.15% of total cost, while 21.66% were represented by operational fixed costs, and 14.19% by the income of the factors. As for elasticities to input prices, the opportunity cost of land was the item to which production cost was more sensitive: a 1% increase in its price would cause a 0.2666% increase in lamb cost. Meanwhile, the impact of increasing any technical indicator was significantly higher than the impact of rising input prices. A 1% increase in weight at slaughter, for example, would reduce total cost in 0.91%. The greatest obstacle to economic viability of sheep production under the observed conditions is low technical efficiency. Increased production costs are more related to deficient zootechnical indexes than to high expenses.
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Affiliation(s)
- C Raineri
- Department of Animal Nutrition and Animal Production, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Pirassununga, SP 13635-900, Brazil ; School of Veterinary Medicine, Federal University of Uberlandia, Uberlandia, MG 38400-902, Brazil
| | - T S S Stivari
- Department of Animal Nutrition and Animal Production, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Pirassununga, SP 13635-900, Brazil
| | - A H Gameiro
- Department of Animal Nutrition and Animal Production, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Pirassununga, SP 13635-900, Brazil
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17
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Ghio S, Morsolini M, Corsico A, Klersy C, Mattiucci G, Raineri C, Scelsi L, Vistarini N, Oltrona Visconti L, D'Armini AM. Pulmonary arterial compliance and exercise capacity after pulmonary endarterectomy. Eur Respir J 2014; 43:1403-9. [DOI: 10.1183/09031936.00195313] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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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18
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Jovanovic I, Giga V, Tesic M, Paunovic I, Kostic J, Dobric M, Dikic M, Stepanovic J, Belesiln B, Djordjevic-Dikic A, Lindqvist P, Henein M, Soderberg S, Gonzalez M, Tossavainen E, Djordjevic-Dikic A, Tesic M, Stepanovic J, Giga V, Kostic J, Trifunovic D, Jovanovic I, Paunovic I, Stanic S, Beleslin B, Koutsogiannis N, Moulias A, Xanthopoulou I, Mavronasiou E, Kakkavas A, Davlouros P, Alexopoulos D, Barbier P, Cefalu' C, Gripari P, Pontone G, Andreini D, Pepi M, Duncan AM, Snow T, Barker S, Davies S, Di Mario C, Moat N, Serra W, Chetta A, Marangio E, Reverberi C, Cattabiani MA, Ardissino D, Sahlen A, Hakansson F, Shahgaldi K, Manouras A, Norman M, Winter R, Johnson J, Fawzi S, Rafla SM, El Atroush H, Farouk K, Wilson C, Hilde J, Skjoerten I, Melsom M, Humerfelt S, Hansteen V, Hisdal J, Steine K, Rees P, Hutchings S, Magnino C, Omede' P, Avenatti E, Chiarlo M, Presutti D, Bucca C, Moretti C, Gaita F, Veglio F, Milan A, Kostic J, Tesic M, Stepanovic J, Giga V, Paunovic I, Marinkovic A, Jovanovic I, Beleslin B, Ostojic M, Djordjevic Dikic A, Najjar E, Winter R, Gunyeli E, Shahgaldi K, Manouras A, Rodriguez Munoz DA, Moya Mur J, Baguda JDJ, Lazaro Rivera C, Navas Tejedor P, Jimenez Nacher J, Castillo Orive M, Fernandez-Golfin C, Zamorano Gomez J, Satendra M, Sargento L, Sousa C, Lousada N, Palma Reis R, Said K, Shehata A, Ashour Z, El-Tobgi S, Li Kam Wa M, Pabari P, Perry S, Kyriacou A, Manisty C, Francis D, Kusmierczyk-Droszcz B, Kowalik E, Niewiadomska J, Lech A, Hoffman P, Patrianakos A, Kalogerakis A, Zacharaki A, Nyktari E, Psathakis E, Parthenakis F, Vardas P, Stefani L, Milicia M, Bartolini A, Gori N, Tempesti G, Toncelli L, Vono M, Di Tante V, Pedri S, Galanti G, Zhong L, Huang F, Le T, Chen Q, Gao F, Tan R, Anwar A, Nosir Y, Alasnig M, Llemit M, Alhagoly A, Chamsi-Pasha H, Trifunovic D, Ostojic M, Stankovic S, Vujisic-Tesic B, Petrovic M, Nedeljkovic I, Beleslin B, Djordjevic-Dikic A, Banovic M, Tesic M, Orii M, Hirata K, Tanimoto T, Ishibashi K, Yamano T, Ino Y, Yamaguchi T, Kubo T, Imanishi T, Akasaka T, Giesecke A, Ripsweden J, Shahgaldi K, Guyeli E, Winter R, Hristova K, Vasilev D, Pavlov P, Katova T, Simova I, Kostova V, Wada T, Hirata KH, Kubo T, Shiono Y, Ishibashi K, Tanimoto T, Ino Y, Yamaguchi T, Imanishi TI, Akasaka T, Martirosyan M, Adamyan K, Chilingaryan A, Negrea S, Alexandrescu C, Civaia F, Bourlon F, Dreyfus G, Malev E, Kim G, Omelchenko M, Mitrofanova L, Zemtsovsky E, Santoro A, Costantino F, Dores E, Tarsia G, Di Natale M, Innelli P, Schiano Lomoriello V, De Stefano F, Galderisi M, Lee SP, Ahn H, Hwang H, Kim H, Kim Y, Kim K, Kim K, Sohn D, Ahn H, Calin A, Popescu B, Rosca M, Beladan C, Enache R, Gurzun M, Calinescu C, Calin C, Ginghina C, Rafla S, Hamdy S, Lotfi M, Elneklawy M, Mordi I, Spratt J, Sonecki P, Stanton T, Mcculloch A, Goodfield N, Tzemos N, Ghulam Ali S, Fusini L, Tamborini G, Celeste F, Gripari P, Muratori M, Maffessanti F, Mirea O, Alamanni F, Pepi M, Demirkan B, Guray Y, Guray U, Ege M, Kisacik H, Sasmaz H, Korkmaz S, Petrovic-Nagorni S, Zdravkovic-Ciric S, Nagorni A, Stanojevic D, Jankovic-Tomasevic R, Atanaskovic V, Mitic V, Szymanski C, Magne J, Rusinaru D, Fournier A, Mezghani S, Peltier M, Touati G, Tribouilloy C, Huttin O, Khachab H, Voilliot D, Schwartz J, Zinzius P, Lemoine S, Carillo S, Popovic B, Juilliere Y, Selton-Suty C, Kimura K, Takenaka K, Ebihara A, Uno K, Morita H, Nakajima T, Motoyoshi Y, Komori T, Yatomi Y, Nagai R, Mihaila S, Mincu R, Rimbas R, Badiu C, Vinereanu D, Igual Munoz B, Maceira Gonzalez A, Domingo Valero D, Estornell Erill J, Giner Blasco J, Arnau Vives M, Molina Aguilar P, Navarro Manchon J, Zorio Grima E, Miglioranza M, Sant'anna R, Rover M, Mantovani A, Lessa J, Haertel J, Salgado Filho P, Kalil R, Leiria T, Risum N, Sogaard P, Fritz Hansen T, Bruun N, Kisslo J, Velazquez E, Jons C, Olsen N, Azevedo O, Lourenco M, Machado I, Pereira V, Medeiros R, Pereira A, Quelhas I, Lourenco A, Rangel I, Goncalves A, Sousa C, Correia A, Pinho T, Madureira A, Martins E, Silva-Cardoso J, Macedo F, Maciel M, Kinova E, Zlatareva N, Goudev A, Rogge B, Cramariuc D, Lonnebakken M, Rieck A, Gohlke-Baerwolf C, Chambers J, Boman K, Gerdts E, Florescu M, Mihalcea D, Enescu O, Suran B, Mincu R, Patrascu N, Magda L, Cinteza M, Vinereanu D, Bruno R, Cogo A, Bartesaghi M, Thapa K, Duo E, Basnyat B, Ghiadoni L, Picano E, Sicari R, Pratali L, Jensen-Urstad K, Nordin A, Bjornadal L, Svenungsson E, King GJ, Murphy R, Almuntaser I, Mc Loughlin B, Livingston A, Nevin S, Clarke J, De Sousa CC, Rangel I, Martins E, Correia A, Nadais G, Silveira F, Silva Cardoso J, Goncalves A, Macedo F, Maciel M, Lindqvist P, Henein M, Hornsten R, Rasmunsson J, Hedstrom M, Alm C, Filali T, Jedaida B, Lahidheb D, Gommidh M, Mahfoudhi H, Hajlaoui N, Dahmani R, Fehri W, Haouala H, Shin SH, Woo S, Kim D, Park K, Kwan J, Brambila CA, Gabrielli L, Bijnens B, Marin J, Sitges I, Grazioli G, Pare C, Mont L, Brugada J, Sitges M, Pica S, Ghio S, Raineri C, Camporotondo R, Rordorf R, Previtali M, Landolina M, Valentini A, Turco A, Visconti L, Stuart B, Santos A, Cruz I, Caldeira D, Cotrim C, Fazendas P, Joao I, Almeida A, Pereira H, Goncalves A, Pinho T, Sousa C, Rangel I, Correia A, Madureira A, Macedo F, Zamorano JL, Maciel M, Driessen M, Kort E, Leiner T, Cramer M, Sieswerda G, Chamuleau S, Kim D, Choi Y, Park H, Kim H, Shin J, Song J, Kang D, Song J, Parisi V, Galasso G, Festa G, Piccolo R, Rengo G, De Rosa R, Pagano G, Iacotucci P, Leosco D, Piscione F, Bellsham-Revell H, Nedjati-Gilani S, Yao C, Pushparajah K, Penney G, Simpson J, Lopez Melgar B, Sanchez Sanchez V, Rodriguez Garcia J, Coma Samartin R, Martin Asenjo R, Fernandez Casares S, Lopez-Guarch CJ, Diaz Anton B, Mayordomo Gomez S, Lombera Romero F, Yamada S, Okada K, Iwano H, Nishino H, Nakabachi M, Yokoyama S, Kaga S, Mikami T, Tsutsui H, Stoebe S, Tarr A, Pfeiffer D, Hagendorff A, Klitsie L, Roest A, Kuipers I, Van Der Hulst A, Hazekamp M, Blom N, Ten Harkel A, Hagendorff A, Stoebe S, Tarr A, Gelbrich G, Loeffler M, Pfeiffer D, Badran H, Elnoamany M, Soltan G, Ezat M, Elsedi M, Abdelfatah R, Yacoub M, Kydd A, Khan F, Mccormick L, Gopalan D, Virdee M, Dutka D, Ruiz Ortiz M, Mesa D, Delgado M, Romo E, Morenate M, Baeza F, Castillo F, Lopez Granados A, Del Prado JA, De Lezo JS, Kilickiran Avci B, Yurdakul S, Sahin S, Ermis E, Dilekci B, Aytekin S, Turhan S, Gerede D, Hural R, Ozcan O, Candemir B, Erol C, Saha SK, Kiotsekoglou A, Gopal A, Govind S, Lindqvist P, Soderberg S, Kawata T, Daimon M, Sekita G, Miyazaki S, Ichikawa R, Maruyama M, Suzuki H, Daida H, Persic V, Lovric D, Jurin H, Pehar Pejcinovic V, Baricevic Z, Pezo Nikolic B, Ivanac Vranesic I, Separovic Hanzevacki J, Ahn H, Cho G, Lee S, Kim H, Kim Y, Sohn D, Igual Munoz B, Estornell Erill J, Gonzalez AM, Bel Minguez A, Perez Guillen M, Donate Bertolin L, Monmeneu Menadas J, Lopez Lereu P, La Huerta AA, Argudo AM, Igual Munoz B, Gonzalez AM, Valero DD, La Huerta AA, Fernandez PA, Ferrer JM, Rueda Soriano J, Buendia Sanchez F, Estornell Erill J, Carrasco J, Carvalho MS, De Araujo Goncalves P, Sousa P, Dores H, Marques H, Pereira Machado F, Gaspar A, Aleixo A, Mota Carmo M, Roquette J, Vassiliadis IV, Despotopoulos E, Kaitozis O, Tekedis C, Al-Mallah M, Nour K, Tomaszewski A, Kutarski A, Brzozowski W, Tomaszewski M, Oleszczak K, Tong J, Bian Y, Yang F, Li P, Chen L, Shen X, Xu Y, Yan L, Kilickiran Avci B, Yurdakul S, Sahin S, Ermis E, Dilekci B, Aytekin S, Hristova K, Marinov R, Georgiev S, Kaneva A, Lasarov S, Mitev P, Katova T, Pilosoff V, Ikonomidis I, Tzortzis S, Triantafyllidi H, Paraskevaidis I, Trivilou P, Papadakis I, Papadopoulos C, Pavlidis G, Anastasiou-Nana M, Lekakis J. Poster session: Aortic stenosis. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes264] [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: 11/12/2022] Open
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Ghio S, Recusani F, Sebastiani R, Klersy C, Raineri C, Campana C, Lanzarini L, Gavazzi A, Tavazzi L. Doppler velocimetry in superior vena cava provides useful information on the right circulatory function in patients with congestive heart failure. Echocardiography 2001; 18:469-77. [PMID: 11567591 DOI: 10.1046/j.1540-8175.2001.00469.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although flow velocities curves recorded with pulsed-wave Doppler in systemic vein are known to provide functional data on the right circulatory function, little information is available on the relationship between right heart filling dynamics and right ventricular function. METHODS Consecutive patients with chronic heart failure due to severe systolic left ventricular dysfunction and in sinus rhythm underwent echocardiography and right heart catheterization. In the initial part of the study, the hemodynamic correlates of different flow velocity patterns recorded into the superior vena cava were evaluated in 120 patients. The accuracy of the prediction of different right heart hemodynamic profiles by means of the different venous flow patterns was then prospectively tested in a subsequent series of 86 patients. RESULTS The venous flow pattern was closely related to right heart hemodynamics. A normal Doppler pattern identified patients with normal right heart hemodynamics (sensitivity 86%, specificity 78%); a "predominant systolic wave" pattern identified patients with a reduced thermodilution-derived right ventricular ejection fraction (< 30%) and normal or slightly elevated right atrial pressure (< or = 8 mmHg) (sensitivity 69%, specificity 81%); a "predominant diastolic wave" pattern identified patients with a reduced right ventricular ejection fraction (< 3 0%) and elevated right atrial pressure (> 8 mmHg) (sensitivity 52%, specificity 95%). The observed and the predicted hemodynamic profiles turned out to be concordant in 80% of patients. CONCLUSIONS The analysis of the flow velocity pattern into the superior vena cava is a useful tool to estimate the extent of the right circulatory impairment in patients with congestive heart failure.
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Affiliation(s)
- S Ghio
- Dipartimento di Cardiologia, Policlinico S Matteo, 27100 Pavia, Italy.
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Lanzarini L, Raineri C, Bertoletti A. [Broad Chiari's network simulating a right cor triatriatum in a transthoracic echocardiogram correctly diagnosed with transesophageal echocardiography]. Ital Heart J Suppl 2000; 1:1208-9. [PMID: 11140294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- L Lanzarini
- Dipartimento di Cardiologia, IRCCS Policlinico San Matteo, Piazzale Golgi, 2 27100 Pavia.
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Bono G, Raineri C, Greco L, Mauri M, Clerici AM, Merlo P. Medium-term outcomes of Alzheimer patients in special care units. Funct Neurol 1997; 12:219-20. [PMID: 9218983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- G Bono
- Alzheimer Unit-Geriatric Institute, Molina, Varese, Italy
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Recusani F, Campana C, Scopelliti PA, Raineri C, Tronconi L. [Echocardiography versus catheterization in the selection of patients for heart transplantation]. Cardiologia 1995; 40:469-76. [PMID: 8998759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- F Recusani
- Cattedra di Cardiologia, Università degli Studi, Pavia
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