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Bigazzi F, Dal Pino B, Pavanello C, Sbrana F, Aquaro GD, Napoli V, Palmieri C, Barison A, Calabresi L, Sampietro T. Familial LCAT deficiency and cardiovascular disease: the game is not over. A case of dramatic multivessel atherosclerosis. Minerva Med 2023; 114:535-537. [PMID: 32486613 DOI: 10.23736/s0026-4806.20.06633-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Federico Bigazzi
- Lipoapheresis Unit, Reference Center for the Diagnosis and Treatment of Inherited Dyslipidemias, Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
| | - Beatrice Dal Pino
- Lipoapheresis Unit, Reference Center for the Diagnosis and Treatment of Inherited Dyslipidemias, Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
| | - Chiara Pavanello
- E. Grossi Paoletti Center, Department of Pharmacology and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Francesco Sbrana
- Lipoapheresis Unit, Reference Center for the Diagnosis and Treatment of Inherited Dyslipidemias, Fondazione Toscana "Gabriele Monasterio", Pisa, Italy -
| | - Giovanni D Aquaro
- MRI Lab, Department of Cardiology, Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
| | - Vinicio Napoli
- Department of Translational Research and New Technologies in Medicine and Surgery, Pisa University, Pisa, Italy
| | - Cataldo Palmieri
- Division of Interventional Cardiology, Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
| | - Andrea Barison
- MRI Lab, Department of Cardiology, Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
| | - Laura Calabresi
- E. Grossi Paoletti Center, Department of Pharmacology and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Tiziana Sampietro
- Lipoapheresis Unit, Reference Center for the Diagnosis and Treatment of Inherited Dyslipidemias, Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
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Simonini L, Sbrana S, Foffa I, Baroni M, Catapano G, Chiappino D, Grigoratos C, Marrone C, Losi P, Mannucci F, Salvadori S, Todiere G, Valenti E, Ait-Ali L, Aquaro GD. Relationships between plasma cytokine balance and cardiac magnetic resonance imaging in long-term post-COVID follow-up: a cross-sectional preliminary study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.245] [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
COVID-19 infection can lead to a constellation of long-lasting post-infectious sequelae, including myocardial dysfunction, whose outcome is strongly affected by a fine-tuned balance between pro- and anti-inflammatory systemic immune responses. Plasma cytokines are key mediators of this immunological balance. In this preliminary study we evaluated the cross-sectional association between the circulating levels of the main pro- and anti-inflammatory cytokines and cardiac magnetic resonance (CMR) abnormalities.
Methods
71 subjects (59% female, mean age 52±14) with previous diagnosis of COVID-19 infection were enrolled at our institution for MULTICOVID protocol, comprehensive of CMR and biomarkers assessment performed >3 months and <1 year following the first negative swab test. CMR protocols consisted of conventional sequences (cine, T2-weighted imaging, and late gadolinium enhancement [LGE]) and quantitative mapping sequences (T1, T2, and extracellular volume [ECV] mapping). Plasma levels of cytokines TNF-α, IL-1β, IL-1α, IFN-α2, IL-6, IL-8, IL-13, IL-10, IL-17A, IL-18, IP-10, MIG and MCP-1 were quantified by Multiplex Immunoassays on the Luminex technology platform. Soluble cardiologic and biochemical biomarkers were measured by routine laboratory analysis.
Results
After a median of 9 (IQR 6–11) months following negative swab, CMR was normal in 48 subjects, while in 23 (32%) it revealed tissue characterization abnormalities (myocardial late enhancement and/or edema). By multivariate regression analysis (adjusted for age, sex, vaccination, severity degrees of the initial COVID disease, presence of comorbidities, smoke, time interval between COVID diagnosis and CMR assessment) the cytokine ratio TNF-α/(IL-10+IL-13) was independently associated (OR=2.89, 95% CI 1.19–7.04, p=0.02) with CMR abnormalities. Interestingly, the cumulative pro-/anti-inflammatory cytokine ratio (IL-1β+TNF-α+IFN-α2+IL-6+IL-17A+IL-8)/(IL-10+IL-13) showed a positive (OR=1.70, 95% CI: 1.04–2.75) and significant (p=0.03) association with CMR imaging aspects. Also, the ratio IFN-α2/(IL-10+IL-13), although without achieving a complete statistical significance (p=0.09), was associated positively with CMR findings.
Conclusions
The preliminary results of this cross-sectional study suggest that the systemic inflammatory environment, long-lasting unbalanced towards a prevalent cytokine-driven pro-inflammatory condition following COVID infection, could affect the development of CMR-detectable myocardial edema and fibrosis in long-term post-COVID subjects.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Tuscany Region
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Affiliation(s)
- L Simonini
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - S Sbrana
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - I Foffa
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - M Baroni
- Fondazione Toscana Gabriele Monasterio , Massa , Italy
| | - G Catapano
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
| | - D Chiappino
- Fondazione Toscana Gabriele Monasterio , Massa , Italy
| | - C Grigoratos
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
| | - C Marrone
- Fondazione Toscana Gabriele Monasterio , Massa , Italy
| | - P Losi
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - F Mannucci
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
| | - S Salvadori
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - G Todiere
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
| | - E Valenti
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - L Ait-Ali
- Institute of Clinical Physiology (IFC) , Pisa , Italy
| | - G D Aquaro
- Fondazione Toscana Gabriele Monasterio , Pisa , Italy
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Ait-Ali L, Martins DS, Khraiche D, Festa P, Barison A, Martini N, Benadjaoud Y, Anjos R, Boddaert N, Bonnet D, Aquaro GD, Raimondi F. Cardiac MRI prediction of recovery in children with acute myocarditis. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.007] [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: 11/29/2022]
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4
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Guaricci AI, Masci PG, Muscogiuri G, Guglielmo M, Baggiano A, Fusini L, Lorenzoni V, Martini C, Andreini D, Pavon AG, Aquaro GD, Barison A, Todiere G, Rabbat MG, Tat E, Raineri C, Valentini A, Varga-Szemes A, Schoepf UJ, De Cecco CN, Bogaert J, Dobrovie M, Symons R, Focardi M, Gismondi A, Lozano-Torres J, Rodriguez-Palomares JF, Lanzillo C, Di Roma M, Moro C, Di Giovine G, Margonato D, De Lazzari M, Perazzolo Marra M, Nese A, Casavecchia G, Gravina M, Marzo F, Carigi S, Pica S, Lombardi M, Censi S, Squeri A, Palumbo A, Gaibazzi N, Camastra G, Sbarbati S, Pedrotti P, Masi A, Carrabba N, Pradella S, Timpani M, Cicala G, Presicci C, Puglisi S, Sverzellati N, Santobuono VE, Pepi M, Schwitter J, Pontone G. CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Ischaemic dilated CardioMyopathy: an international Registry. Europace 2021; 23:1072-1083. [PMID: 33792661 DOI: 10.1093/europace/euaa401] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 12/06/2020] [Indexed: 02/06/2023] Open
Abstract
AIMS The aim of this registry was to evaluate the additional prognostic value of a composite cardiac magnetic resonance (CMR)-based risk score over standard-of-care (SOC) evaluation in a large cohort of consecutive unselected non-ischaemic cardiomyopathy (NICM) patients. METHODS AND RESULTS In the DERIVATE registry (www.clinicaltrials.gov/registration: RCT#NCT03352648), 1000 (derivation cohort) and 508 (validation cohort) NICM patients with chronic heart failure (HF) and left ventricular ejection fraction <50% were included. All-cause mortality and major adverse arrhythmic cardiac events (MAACE) were the primary and secondary endpoints, respectively. During a median follow-up of 959 days, all-cause mortality and MAACE occurred in 72 (7%) and 93 (9%) patients, respectively. Age and >3 segments with midwall fibrosis on late gadolinium enhancement (LGE) were the only independent predictors of all-cause mortality (HR: 1.036, 95% CI: 1.0117-1.056, P < 0.001 and HR: 2.077, 95% CI: 1.211-3.562, P = 0.008, respectively). For MAACE, the independent predictors were male gender, left ventricular end-diastolic volume index by CMR (CMR-LVEDVi), and >3 segments with midwall fibrosis on LGE (HR: 2.131, 95% CI: 1.231-3.690, P = 0.007; HR: 3.161, 95% CI: 1.750-5.709, P < 0.001; and HR: 1.693, 95% CI: 1.084-2.644, P = 0.021, respectively). A composite clinical and CMR-based risk score provided a net reclassification improvement of 63.7% (P < 0.001) for MAACE occurrence when added to the model based on SOC evaluation. These findings were confirmed in the validation cohort. CONCLUSION In a large multicentre, multivendor cohort registry reflecting daily clinical practice in NICM work-up, a composite clinical and CMR-based risk score provides incremental prognostic value beyond SOC evaluation, which may have impact on the indication of implantable cardioverter-defibrillator implantation.
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Affiliation(s)
| | | | - Giuseppe Muscogiuri
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Marco Guglielmo
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Andrea Baggiano
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Laura Fusini
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | | | - Chiara Martini
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Daniele Andreini
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Anna Giulia Pavon
- Cardiovascular Department, CMR Center, University Hospital Lausanne, CHUV, Switzerland
| | - Giovanni D Aquaro
- U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana Pisa, Pisa, Italy
| | - Andrea Barison
- U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana Pisa, Pisa, Italy
| | - Giancarlo Todiere
- U.O.C. Risonanza Magnetica per Immagini, Fondazione G. Monasterio CNR-Regione Toscana Pisa, Pisa, Italy
| | | | - Emily Tat
- Loyola University of Chicago, Chicago, IL, USA
| | - Claudia Raineri
- Department of Cardiology, Città della salute e della Scienza - Ospedale Molinette -Turin, Pavia, Italy
| | - Adele Valentini
- Department of Radiology, Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - U Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Carlo N De Cecco
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.,Division of Cardiothoracic Imaging, Emory University, Atlanta, GA, USA
| | - Jan Bogaert
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Monica Dobrovie
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Rolf Symons
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
| | - Marta Focardi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Annalaura Gismondi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Jordi Lozano-Torres
- Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josè F Rodriguez-Palomares
- Department of Cardiology, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigaciín Biomédica en Red-CV, CIBER CV. Spain
| | | | - Mauro Di Roma
- Cardiology Department, Policlinico Casilino, Rome, Italy
| | - Claudio Moro
- Department of Cardiology, ASST Monza, P.O. Desio, Italy
| | | | | | | | | | - Alberto Nese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health University of Padua Medical School, Padova, Italy
| | - Grazia Casavecchia
- Cardiology Department, Ca' Foncello Hospital Azienda N 2 Marca Trevigiana, Treviso, Italy
| | - Matteo Gravina
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Samuela Carigi
- Department of Cardiology, Infermi Hospital, Rimini, Italy
| | - Silvia Pica
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Massimo Lombardi
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Stefano Censi
- Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA), Italy
| | - Angelo Squeri
- Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA), Italy
| | - Alessandro Palumbo
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Nicola Gaibazzi
- Department of Cardiology, Azienda Ospedaliero-Universitaria, Parma, Italy
| | | | | | - Patrizia Pedrotti
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Ambra Masi
- 'De Gasperis' Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Nazario Carrabba
- Cardiovascular and Thoracic Department of Careggi Hospital, Florence, Italy
| | | | - Mauro Timpani
- Department of Neuroscience, Imaging and Clinical Sciences, SS Annunziata Hospital, Chieti, Italy
| | - Gloria Cicala
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Cristina Presicci
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Sara Puglisi
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Nicola Sverzellati
- Scienze Radiologiche, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Mauro Pepi
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Juerg Schwitter
- Cardiovascular Department, CMR Center, University Hospital Lausanne, CHUV, Switzerland.,Lausanne University, Faculty of Biology and Medicine, Lausanne, Switzerland
| | - Gianluca Pontone
- Department of Cardiovascular, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
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5
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Casas G, Limeres J, Oristrell G, Gutierrez-Garcia L, Andreini D, Borregan M, Larrañaga-Moreira JM, Lopez-Sainz A, Codina-Solà M, Teixido-Tura G, Sorolla-Romero JA, Fernández-Álvarez P, González-Carrillo J, Guala A, La Mura L, Soler-Fernández R, Sao Avilés A, Santos-Mateo JJ, Marsal JR, Ribera A, de la Pompa JL, Villacorta E, Jiménez-Jáimez J, Ripoll-Vera T, Bayes-Genis A, Garcia-Pinilla JM, Palomino-Doza J, Tiron C, Pontone G, Bogaert J, Aquaro GD, Gimeno-Blanes JR, Zorio E, Garcia-Pavia P, Barriales-Villa R, Evangelista A, Masci PG, Ferreira-González I, Rodríguez-Palomares JF. Clinical Risk Prediction in Patients With Left Ventricular Myocardial Noncompaction. J Am Coll Cardiol 2021; 78:643-662. [PMID: 34384546 DOI: 10.1016/j.jacc.2021.06.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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] [Received: 03/14/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Left ventricular noncompaction (LVNC) is a heterogeneous entity with uncertain prognosis. OBJECTIVES This study sought to develop and validate a prediction model of major adverse cardiovascular events (MACE) and to identify LVNC cases without events during long-term follow-up. METHODS This is a retrospective longitudinal multicenter cohort study of consecutive patients fulfilling LVNC criteria by echocardiography or cardiovascular magnetic resonance. MACE were defined as heart failure (HF), ventricular arrhythmias (VAs), systemic embolisms, or all-cause mortality. RESULTS A total of 585 patients were included (45 ± 20 years of age, 57% male). LV ejection fraction (LVEF) was 48% ± 17%, and 18% presented late gadolinium enhancement (LGE). After a median follow-up of 5.1 years, MACE occurred in 223 (38%) patients: HF in 110 (19%), VAs in 87 (15%), systemic embolisms in 18 (3%), and 34 (6%) died. LVEF was the main variable independently associated with MACE (P < 0.05). LGE was associated with HF and VAs in patients with LVEF >35% (P < 0.05). A prediction model of MACE was developed using Cox regression, composed by age, sex, electrocardiography, cardiovascular risk factors, LVEF, and family aggregation. C-index was 0.72 (95% confidence interval: 0.67-0.75) in the derivation cohort and 0.72 (95% confidence interval: 0.71-0.73) in an external validation cohort. Patients with no electrocardiogram abnormalities, LVEF ≥50%, no LGE, and negative family screening presented no MACE at follow-up. CONCLUSIONS LVNC is associated with an increased risk of heart failure and ventricular arrhythmias. LVEF is the variable most strongly associated with MACE; however, LGE confers additional risk in patients without severe systolic dysfunction. A risk prediction model is developed and validated to guide management.
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Affiliation(s)
- Guillem Casas
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain
| | - Javier Limeres
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Gerard Oristrell
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain
| | - Laura Gutierrez-Garcia
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Mar Borregan
- Genetics and Molecular Medicine Department and Pediatric Institute of Rare Diseases, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jose M Larrañaga-Moreira
- Inherited Cardiovascular Diseases Unit, Cardiology Department, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde, Universidade da Coruña, A Coruña, Spain
| | - Angela Lopez-Sainz
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Heart Failure and Inherited Cardiac Diseases Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARD-Heart), Madrid, Spain
| | - Marta Codina-Solà
- Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Gisela Teixido-Tura
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Paula Fernández-Álvarez
- Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Andrea Guala
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Lucia La Mura
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Rafaela Soler-Fernández
- Radiology Department, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde, Universidade da Coruña, A Coruña, Spain
| | - Augusto Sao Avilés
- Cardiology Department, Vall d'Hebron Hospital, Barcelona, Spain; Neurology/Neuroimmunology Department, Vall d'Hebron Hospital, Barcelona, Spain; Statistics and Bioinformatics Unit (UEB-VHIR), Vall d'Hebron Hospital, Barcelona, Spain
| | | | - Josep Ramon Marsal
- Epidemiology Unit of the Cardiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid, Spain
| | - Aida Ribera
- Epidemiology Unit of the Cardiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid, Spain
| | - José Luis de la Pompa
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Intercellular Signalling in Cardiovascular Development and Disease Laboratory, Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | - Eduardo Villacorta
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Cardiology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Juan Jiménez-Jáimez
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Cardiology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Tomás Ripoll-Vera
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Cardiology Department, Hospital Universitario Son Llatzer and Institut d'Investigaciò Sanitària Illes Balears, Mallorca, Spain
| | - Antoni Bayes-Genis
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Cardiology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Manuel Garcia-Pinilla
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Heart Failure and Familial Cardiomyopathies Unit, Cardiology Department, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| | - Julián Palomino-Doza
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Cardiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Coloma Tiron
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitari Dr Josep Trueta, Girona, Spain; Medical Science Department, School of Medicine, University of Girona, Girona, Spain
| | | | - Jan Bogaert
- Gasthuisberg University Hospital, Leuven, Belgium
| | | | - Juan Ramon Gimeno-Blanes
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Cardiology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Esther Zorio
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Heart Diseases Unit, Cardiology Department, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, Spain; CAFAMUSME Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Pablo Garcia-Pavia
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Heart Failure and Inherited Cardiac Diseases Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN-GUARD-Heart), Madrid, Spain; Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain
| | - Roberto Barriales-Villa
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Diseases Unit, Cardiology Department, Instituto de Investigación Biomédica de A Coruña, Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde, Universidade da Coruña, A Coruña, Spain
| | - Artur Evangelista
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Pier Giorgio Masci
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Ignacio Ferreira-González
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Epidemiology Unit of the Cardiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid, Spain.
| | - José F Rodríguez-Palomares
- Cardiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain; Inherited Cardiovascular Disease Unit and Cardiovascular Genetics. Hospital Universitari Vall d'Hebron, Barcelona, Spain.
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6
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Leali M, Aimo A, Ricci G, Vergaro G, Todiere G, Grigoratos C, Aquaro GD, Siciliano G, Emdin M, Passino C, Barison A. Cardiac magnetic resonance findings in patients with type 1 myotonic dystrophy. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Heart disease is a major determinant of prognosis in type 1 myotonic dystrophy (DM1), second only to respiratory complications. Cardiac imaging, possibly including cardiac magnetic resonance (CMR), is recommended in patients with DM1. However, limited information is available on CMR findings and their prognostic significance in DM1.
Methods
We identified all patients with DM1 evaluated from 2009 to 2020 in a CMR laboratory with an established collaboration with a Neuromuscular Disorder Unit.
Results
Thirty-four patients were retrieved (21 males, aged 45 ± 12). At the time of CMR examination, 97% had neuromuscular symptoms (mean duration 16 ± 13 years), 12 (35%) presented with atrioventricular block (n = 11 1st degree, n = 1 2nd degree type 1), 15 (44%) with intraventricular conduction disturbances (n = 5 left bundle branch block, n = 5 right bundle branch block, n = 3 left anterior fascicular block, n = 2 other non-specific intraventricular conduction delay), 4 (12%) with atrial fibrillation or flutter. No patient had a device. At CMR, 5 (15%) patients had left ventricular (LV) systolic dysfunction (LV ejection fraction [LVEF] <50%) and 5 (15%) a depressed right ventricular (RV) function (RVEF <50%). Compared to age- and sex-specific reference values for our laboratory, 12 (35%) patients showed a decreased LV end-diastolic volume index (LVEDVi), 7 (21%) a decreased LV mass index (LVMi), and 29 (83%) a decreased LVMi/LVEDVi ratio. Nine (26%) patients had mid-wall late gadolinium enhancement (LGE, mean extent 4.5 ± 2.0% of LVM; n = 8 septal, n = 4 inferolateral, n = 2 inferior, n = 1 anterolateral), and 14 (40%) some areas of fatty infiltration (n = 9 involving the LV, n = 13 the RV). Native T1 in the interventricular septum (1,041 ± 53 ms) approached the upper reference limit (1,089 ms), and the extracellular volume was slightly increased (33 ± 2%, reference values <30%). Over a median follow-up of 3.3 years (interquartile interval 1.6-4.7), 2 (6%) patients died, one for infectious and respiratory complications and the other for unknown causes, 5 (15%) patients underwent pacemaker implantation for conduction disturbances, and 4 (12%) had a documentation of high-risk (Lown class ≥4) ventricular ectopic beats (VEBs). Among all CMR variables collected, higher values of LVMi/LVEDVi ratio emerged as univariate predictor of all-cause death (p = 0.044). At logistic regression analysis, anteroseptal wall thickness was associated with the need for pacemaker implantation (p = 0.028), while LGE mass was associated with high-risk VEBs (p = 0.026).
Conclusions
Patients with DM1 display several structural and functional cardiac abnormalities, with variable degrees of cardiac muscle hypotrophy, fibrosis and fatty infiltration. The possibility to predict the need for pacemaker implantation, ventricular arrhythmias and all-cause or cardiovascular mortality should be verified in larger cohorts.
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Affiliation(s)
- M Leali
- Sant"Anna School of Advanced Studies, Pisa, Italy
| | - A Aimo
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - G Ricci
- University of Pisa, Department of Clinical and Experimental Medicine, Pisa, Italy
| | - G Vergaro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - G Todiere
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - C Grigoratos
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - GD Aquaro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - G Siciliano
- University of Pisa, Department of Clinical and Experimental Medicine, Pisa, Italy
| | - M Emdin
- Sant"Anna School of Advanced Studies, Pisa, Italy
| | - C Passino
- Sant"Anna School of Advanced Studies, Pisa, Italy
| | - A Barison
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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7
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Figliozzi S, Georgiopoulos G, Aquaro GD, Bauer K, Monti L, Filomena D, Pica S, Censi S, Lopez P, Quattrocchi G, Servato ML, Schwitter J, Andreini D, Bogaert J, Masci PG. Late gadolinium enhancement predicts adverse clinical outcome in patients with mitral valve prolapse/mitral annulus disjunction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.048] [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: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Mitral vAlve prolapse and disjunction by cardiac maGnetIC resonance (MA-GIC) registry
Backgroung
Mitral valve prolapse (MVP) is 2-3% prevalent in the general population with good prognosis. However, some patients develop complex ventricular arrhythmias (CVAs), sudden cardiac death (SCD), or severe mitral regurgitation (MR). Previous studies suggested that bi-leaflet involvement, mitral annulus disjunction (MAD), and myocardial fibrosis (MF) are associated with adverse outcome. Notwithstanding, these findings were limited to autopsic series or single-centre studies involving highly selected patients. Moreover, MF has been scantly investigated as predictor of clinical outcome.
Purpose
To investigate the prognostic significance of MF in an international multicentre study of MVP patients studied by cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE).
Methods
From October 2007 to June 2020 patients undergoing LGE-CMR were screened in 14 European centres. Inclusion criteria were: i) age > 18 years; ii) full clinical history and cardiac rhythm monitoring at baseline; iii) MVP (leaflet displacement ≥ 2 mm beyond the annulus). Exclusion criteria were: i) ischemic heart disease; ii) primary cardiomyopathy; iii) inflammatory heart disease; iv) congenital heart diseases; v) moderate-to-severe valvular heart disease. CVAs at the study outset was defined as one of the following: i) ventricular ectopic beats >10000/24h; ii) ≥ 1 episode of non-sustained ventricular tachycardia (VT); iii) sustained VT; iv) aborted SCD. Primary end-point was a composite of SCD, unexplained syncope, and mitral valve repair/replacement. Secondary end-point was a composite of SCD and unexplained syncope.
Results
Four-hundred-fifty-eight MVP patients were eventually included (46 ± 16 years old, 51% males) of whom 68% had MAD. LGE was detected in 103 (22%) of subjects with mid-wall pattern (46%) in left ventricular (LV) lateral wall (66%) as the most prevalent feature. At baseline, 37% of LGE-positive patients vs. 18% of LGE-negative individuals had CVAs (P < 0.001). SVT and/or aborted SCD were more prevalent in LGE-positive than in LGE-negative patients (9% vs 2%, P < 0.001). By multivariable Cox-regression analysis, LGE presence or extent were strong independent predictors of the primary (HR = 4.02, P = 0.003 and HR = 4.76 per 10% increase, P = 0.032, respectively) and secondary (HR = 5.39, P = 0.008 and HR = 8.78 per 10% increase, P = 0.012, respectively) endpoints after correction for major confounders including LV volumes, left atrial size and MAD presence.
Conlusion
Myocardial fibrosis by LGE is the strongest independent predictor of clinical outcome in MVP. In contrast, MAD per se does not harbinger worse prognosis.
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Affiliation(s)
- S Figliozzi
- IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences; San Luca Hospital, Milan, Italy
| | - G Georgiopoulos
- King"s College London, School of Biomedical Engineering and Imaging Sciences - St Thomas" Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - GD Aquaro
- Fondazione Toscana Gabriele Monasterio, Magnetic Resonance Unit, Pisa, Italy
| | - K Bauer
- University Hospital Muenster, Department of Cardiology, Muenster, Germany
| | - L Monti
- IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - D Filomena
- Sapienza University of Rome, Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Rome, Italy
| | - S Pica
- IRCCS Policlinico San Donato, Multimodality Cardiac Imaging Section, San Donato Milanese, Italy
| | - S Censi
- Maria Cecilia Hospital, GVM Care&Research, Cotignola, Italy
| | - P Lopez
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Cardiology Department, Lisboa, Portugal
| | - G Quattrocchi
- Niguarda Hospital, CardioThoraxVascular Department "De Gasperis", Milan, Italy
| | - ML Servato
- Universit Autònoma de Barcelona (UAB), Vall Hebron Hospital Institut de Recerca (VIHR) y CIBER-CV, Cardiovascular Imaging Unit, Cardiology Department at Vall Hebron Hospital, Barcelona, Spain
| | - J Schwitter
- Lausanne University Hospital, Cardiac MRI Centre, Lausanne, Switzerland
| | - D Andreini
- Centro Cardiologico Monzino, IRCCS, University of Milan, Milan, Italy
| | - J Bogaert
- Gasthuisberg University Hospital, Imaging & Pathology Department, Leuven, Belgium
| | - PG Masci
- King"s College London, School of Biomedical Engineering and Imaging Sciences - St Thomas" Hospital, London, United Kingdom of Great Britain & Northern Ireland
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8
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Martins DS, Ait-Ali L, Khraiche D, Festa P, Barison A, Martini N, Benadjaoud Y, Anjos R, Boddaert N, Bonnet D, Aquaro GD, Raimondi F. Evolution of acute myocarditis in a pediatric population: An MRI based study. Int J Cardiol 2020; 329:226-233. [PMID: 33359333 DOI: 10.1016/j.ijcard.2020.12.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/26/2020] [Accepted: 12/09/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiac Magnetic Resonance (CMR) data regarding myocarditis presentation and disease course is still lacking in pediatric patients. We evaluate baseline CMR and evolution of functional and tissue abnormalities in children with acute myocarditis. METHODS CMR was performed in 125 patients with clinical diagnosis of acute myocarditis. Clinical follow-up was performed for a median of 498 (214-923) days. RESULTS LVEF was depressed (<55%) in 56 cases (45%) upon baseline CMR. LGE was found in 93 patients (77%) of cases. LGE was exclusively subepicardial in 29 patients (23%), while other LGE patterns (midwall/mixed) were present in 64 (51%). CMR was repeated in 92 (74%) patients. 67% presented recover of function at a median of 170 (70-746) days after onset of symptoms. Midwall/mixed LGE pattern had a statistically significant correlation with absent recover of function (OR 0.20 p 0.036). Thirteen patients (16%) had recovery from LV dysfunction but with persistence of LGE. Sub-epicardial pattern of LGE (OR 3.33, 95% CI 1.08-10.2, p = 0.036) and the presence of fever at admission (OR 4.67, 95% CI 1.16-18.7, p = 0.03) were associated with a significantly higher likelihood of complete normalization while midwall/mixed LGE pattern was associated with non-recovery. CONCLUSIONS In pediatric myocarditis, midwall/mixed LGE pattern is associated with absent recover of function. Patients with recover of function may still have persistence of LGE, while a complete recovery from functional and tissue abnormalities is found only in a third of patients. Midwall/mixed pattern of LGE at first MRI was associated to worse outcome.
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Affiliation(s)
- Duarte S Martins
- Unité médico-chirurgicale de cardiologie congénitale et pédiatrique, centre de référence des maladies cardiaques congénitales complexes - M3C, Hôpital universitaire Necker-Enfants Malades, Université de Paris, France and Pediatric Cardiology Department, Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
| | - Lamia Ait-Ali
- Institute of Clinical Physiology CNR, UO Massa and Fondazione G. Monasterio, CNR-Regione Toscana, Italy
| | - Diala Khraiche
- Unité médico-chirurgicale de cardiologie congénitale et pédiatrique, centre de référence des maladies cardiaques congénitales complexes - M3C, Hôpital universitaire Necker-Enfants Malades, Université de Paris, France
| | | | | | | | - Yasmine Benadjaoud
- Laboratory of Embriology and Genetic Malformation, INSERM UMR 1163, Imagine Institute, Université de Paris, F-75015 Paris, France
| | - Rui Anjos
- Pediatric Cardiology Department, Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Nathalie Boddaert
- Pediatric Radiology Unit, Hôpital universitaire Necker-Enfants Malades, Université de Paris, France
| | - Damien Bonnet
- Unité médico-chirurgicale de cardiologie congénitale et pédiatrique, centre de référence des maladies cardiaques congénitales complexes - M3C, Hôpital universitaire Necker-Enfants Malades, Université de Paris, France
| | | | - Francesca Raimondi
- Unité médico-chirurgicale de cardiologie congénitale et pédiatrique, centre de référence des maladies cardiaques congénitales complexes - M3C, Hôpital universitaire Necker-Enfants Malades, Université de Paris, France and Laboratory of Embriology and Genetic Malformation, INSERM UMR 1163, Imagine Institute, F-75015 Paris, France
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9
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Ait-Ali L, Martins DS, Khraiche D, Festa P, Barison A, Martini N, Benadjaoud Y, Anjos R, Boddaert N, Bonnet D, Aquaro GD, Raimondi F. Cardiac MRI Prediction of Recovery in Children With Acute Myocarditis. JACC Cardiovasc Imaging 2020; 14:693-695. [PMID: 33248957 DOI: 10.1016/j.jcmg.2020.08.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 12/28/2022]
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10
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Furini G, Pizzino F, Casieri V, Mariani M, Solinas M, Maffei S, Chiappino D, Aquaro GD, Lionetti V. High plasma levels of exosomal miR21 and miR133a are associated with LV reverse remodelling after surgical mitral valve repair. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.05199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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11
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Albani S, Pinamonti B, Giovinazzo T, de Scordilli M, Fabris E, Stolfo D, Perkan A, Gregorio C, Barbati G, Geri P, Confalonieri M, Lo Giudice F, Aquaro GD, Pasquero P, Porta M, Sinagra G, Mesin L. Accuracy of right atrial pressure estimation using a multi-parameter approach derived from inferior vena cava semi-automated edge-tracking echocardiography: a pilot study in patients with cardiovascular disorders. Int J Cardiovasc Imaging 2020; 36:1213-1225. [PMID: 32193772 DOI: 10.1007/s10554-020-01814-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 03/07/2020] [Indexed: 01/05/2023]
Abstract
The echocardiographic estimation of right atrial pressure (RAP) is based on the size and inspiratory collapse of the inferior vena cava (IVC). However, this method has proven to have limits of reliability. The aim of this study is to assess feasibility and accuracy of a new semi-automated approach to estimate RAP. Standard acquired echocardiographic images were processed with a semi-automated technique. Indexes related to the collapsibility of the vessel during inspiration (Caval Index, CI) and new indexes of pulsatility, obtained considering only the stimulation due to either respiration (Respiratory Caval Index, RCI) or heartbeats (Cardiac Caval Index, CCI) were derived. Binary Tree Models (BTM) were then developed to estimate either 3 or 5 RAP classes (BTM3 and BTM5) using indexes estimated by the semi-automated technique. These BTMs were compared with two standard estimation (SE) echocardiographic methods, indicated as A and B, distinguishing among 3 and 5 RAP classes, respectively. Direct RAP measurements obtained during a right heart catheterization (RHC) were used as reference. 62 consecutive 'all-comers' patients that had a RHC were enrolled; 13 patients were excluded for technical reasons. Therefore 49 patients were included in this study (mean age 62.2 ± 15.2 years, 75.5% pulmonary hypertension, 34.7% severe left ventricular dysfunction and 51% right ventricular dysfunction). The SE methods showed poor accuracy for RAP estimation (method A: misclassification error, ME = 51%, R2 = 0.22; method B: ME = 69%, R2 = 0.26). Instead, the new semi-automated methods BTM3 and BTM5 have higher accuracy (ME = 14%, R2 = 0.47 and ME = 22%, R2 = 0.61, respectively). In conclusion, a multi-parametric approach using IVC indexes extracted by the semi-automated approach is a promising tool for a more accurate estimation of RAP.
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Affiliation(s)
- Stefano Albani
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy.
| | - Bruno Pinamonti
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Tatiana Giovinazzo
- Mathematical Biology and Physiology, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Marco de Scordilli
- Department of Medical Science, Surgery and Health (DCSMCS), University of Trieste, Trieste, Italy
| | - Enrico Fabris
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Davide Stolfo
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Andrea Perkan
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Caterina Gregorio
- Department of Medical Sciences, Biostatistics Unit, University of Trieste, Trieste, Italy
- Department of Statistical Sciences, University of Padova, Padua, Italy
| | - Giulia Barbati
- Department of Medical Sciences, Biostatistics Unit, University of Trieste, Trieste, Italy
| | - Pietro Geri
- Cardiothoracic Department, Division of Pneumology and Respiratory Intermediate Care Unit, ASUITS, Trieste, Italy
| | - Marco Confalonieri
- Cardiothoracic Department, Division of Pneumology and Respiratory Intermediate Care Unit, ASUITS, Trieste, Italy
| | - Francesco Lo Giudice
- Pulmonary Hypertension National Service, Hammersmith Hospital Imperial College NHS Trust, London, UK
| | | | - Paolo Pasquero
- Department of Internal Medicine, Internal Medicine 1, University of Turin, Turin, Italy
| | - Massimo Porta
- Department of Internal Medicine, Internal Medicine 1, University of Turin, Turin, Italy
| | - Gianfranco Sinagra
- Cardiothoracic Department, Division of Cardiology and Postgraduate School in Cardiovascular Sciences, University of Trieste, Trieste, Italy
| | - Luca Mesin
- Mathematical Biology and Physiology, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
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12
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Aimo A, Barison A, Mirizzi G, Castiglione V, Ripoli A, Panchetti L, Rossi A, Startari U, Emdin M, Aquaro GD, Piacenti M. P995The extent of late gadolinium enhancement predicts defibrillator shocks in patients with non-ischaemic heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0588] [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
Implantable cardioverter defibrillator (ICD) is recommended for patients with non-ischaemic heart failure (HF) and left ventricular ejection fraction (LVEF) ≤35%, although most patients will not experience any appropriate ICD intervention. We assessed if cardiovascular magnetic resonance (CMR) findings may predict benefit from ICD implantation.
Methods and results
We retrieved the data of all patients (n=183) with non-ischaemic HF receiving an ICD for primary prevention at our Institution, and undergoing CMR within 1 month before implantation. 183 patients were evaluated (men 73%, median age 66 years, LVEF 24%, N-terminal fraction of pro-B-type natriuretic peptide 1217 ng/L, atrial fibrillation, flutter or atrial ectopic rhythm 21%). They received single-chamber (n=21, 12%), dual-chamber (n=34, 19%), or cardiac resynchronization therapy devices (n=127, 69%); 1 patient (1%) received a subcutaneous defibrillator. Twenty patients (11%) experienced a shock for ventricular tachycardia or fibrillation (VT/VF) over 2.5 years (0.8–5.4), and 13 (7%) had an inappropriate shock over 2.7 years (0.9–5.4). Late gadolinium enhancement (LGE) was present in 146 patients (80%), but on average accounted for limited percentage of LV mass (4% [2–11%]). LGE mass independently predicted shocks for VT/VF (HR 2.13, 95% CI 1.02–4.47; p=0.045). LGE mass ≥14% (the best cut-off at receiver operating characteristics analysis) independently predicted shocks for VT/VF (HR 3.82, 95% CI 1.51–9.68; p=0.005). LGE mass <4% was the only univariate predictor of inappropriate shocks (HR 4.82, 95% CI 1.07–21.76; p=0.041).
Conclusions
Patients with non-ischaemic HF and LGE mass ≥14% benefit most from ICD, while those with LGE mass <4% display mainly inappropriate shocks.
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Affiliation(s)
- A Aimo
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - A Barison
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - G Mirizzi
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - V Castiglione
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - A Ripoli
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - L Panchetti
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - A Rossi
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - U Startari
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - M Emdin
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - G D Aquaro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - M Piacenti
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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13
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Aimo A, Barison A, Valleggi A, Salerni S, De Caterina R, Emdin M, Aquaro GD. P597Clinical and prognostic correlates of volume/time curve at cardiac magnetic resonance in patients with non-ischemic heart failure and left bundle branch block. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In patients with non-ischaemic systolic heart failure (HF) and left bundle branch block (LBBB), the systolic phase of the left ventricular (LV) volume/time (V/t) curve at cardiac magnetic resonance (CMR) can display a wide or a narrow pattern (WP/NP). The clinical and prognostic significance of these patterns are currently unknown.
Methods
Consecutive patients with systolic non-ischaemic HF (LV ejection fraction <50%) and LBBB were enrolled. They underwent a baseline evaluation including CMR, and were periodically re-evaluated during follow-up. The endpoint was a composite of cardiovascular death, heart failure (HF)-related event, and ventricular arrhythmias requiring defibrillator shock.
Results
Out of 101 patients (mean age 64±11 years, males 50%), NP was found in 29 and WP in 72, with no difference in QRS duration. Patients with WP had worse clinical presentation and greater LV volumes, but similar LGE prevalence, extent or distribution. The WP subgroup displayed a greater maximal dyssynchrony time, expressed both as absolute duration (192±80 vs. 143±65 ms, P<0.001), and as percentage of the RR interval (25±11% vs. 8±4%, p<0.001). Even the systolic dyssynchrony index was higher in patients with WP (13±4 vs. 7±3%, p<0.001). The contractility index was lower in patients with the WP (2.6±1.2 vs 3.2±1.7, p<0.05). Over a median follow-up duration of 44 months (interquartile interval 23–59), only WP (p=0.029) and NT-proBNP (p=0.004) demonstrated an independent prognostic value for cardiac events.
Conclusions
In patients with non-ischaemic systolic HF and LBBB, the WP of V/t curves identifies a subgroup of patients with greater LV dyssynchrony, worse clinical conditions and prognosis.
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Affiliation(s)
- A Aimo
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - A Barison
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - A Valleggi
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - S Salerni
- G. d Annunzio University, Chieti, Italy
| | - R De Caterina
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - M Emdin
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - G D Aquaro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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14
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Morini S, Aquaro GD, Taborchi G, Martone R, Gabriele M, Bartolini S, Vignini E, Vergaro G, Barison A, Emdin M, Olivotto I, Perfetto F, Di Mario C, Cappelli F. P2728Prognostic impact of left atrial function in patients with cardiac amyloidosis: a cardiac magnetic resonance study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1045] [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
Left atrial function (AEF) is a parameter of paramount importance that has a prognostic value in a number of heart conditions. Cardiac involvement in both light-chain and transthyretin amyloidosis is the main driver of prognosis and influences treatment strategies. Cardiac magnetic resonance (CMR) provides high quality images of the left and right atria using high temporal resolution steady state free precession (SSFP) cine sequences.
Purpose
The aim of our study was to assess by CMR left atrial function and his correlation with prognosis in patients with cardiac amyloidosis.
Method
We enrolled 80 consecutive patients with diagnosis of cardiac amyloidosis: 38 patients (47%) with light-chain and 42 patients (53%) with transthyretin one. CMR was performed using a 1.5-T scanner. In all subjects, the study of atria was obtained by acquiring cine steady-state free precession (SSFP). Left Atrial function was evaluated by the ratio between the maximum and the minimum LA volume. A median follow up of 937 days was performed and 36 patients (44%) died of cardiac causes. We evaluated cardiac death as endpoint. We split out all the patient in 4 different quartiles depending on left atrial function: in the first quartile patients with AEF≤14% that reflects severe atrial dysfunction, in the second quartile patients with AEF between 14 and 19%, in the third quartile patients with AEF between 19 and 36% and in the last one patients with AEF≥36% that represent patients with normal value of left atrial function.
Results
We found that CMR assessed left atrial function allowed to individuate and stratify the prognosis in patients with cardiac amyloidosis. The most effective parameter to evaluate cardiac death was left atrial function with a cut off ≤14% that could predict cardiac related mortality with the same accuracy in both light-chain and transthyretin amyloidosis patients. Kaplan Meier analysis showed that patients with AEF≤14% had a worse prognosis as compared to patient with AEF≥14% (log rank p. 0001). Furthermore patients with AEF≤14% have a cardiac death risk of 32% at 1 year and 61% at 3 years.
Kaplan Meier analysis
Conclusion
Cardiac magnetic resonance is an imaging modality that allows to individuate with great accuracy left atrial function in patients with various heart conditions and especially cardiac amyloidosis. CMR left atrial function assessment clearly identifies a subgroup of cardiac amyloid patients with an increased risk of death.
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Affiliation(s)
- S Morini
- Careggi University Hospital (AOUC), Florence, Italy
| | - G D Aquaro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - G Taborchi
- Careggi University Hospital (AOUC), Florence, Italy
| | - R Martone
- Careggi University Hospital (AOUC), Florence, Italy
| | - M Gabriele
- Careggi University Hospital (AOUC), Florence, Italy
| | - S Bartolini
- Careggi University Hospital (AOUC), Florence, Italy
| | - E Vignini
- Careggi University Hospital (AOUC), Florence, Italy
| | - G Vergaro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - A Barison
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - M Emdin
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - I Olivotto
- Careggi University Hospital (AOUC), Florence, Italy
| | - F Perfetto
- Careggi University Hospital (AOUC), Florence, Italy
| | - C Di Mario
- Careggi University Hospital (AOUC), Florence, Italy
| | - F Cappelli
- Careggi University Hospital (AOUC), Florence, Italy
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Barison A, Aimo A, Castiglione V, Arzilli C, Mirizzi G, Todiere G, Grigoratos C, Piacenti M, Aquaro GD, Emdin M. 322Late gadolinium enhancement predicts appropriate defibrillator interventions in nonischaemic dilated cardiomyopathy. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez102.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- A Barison
- Fondazione "G. Monasterio" CNR - Regione Toscana, Pisa, Italy
| | - A Aimo
- Azienda Ospedaliero - Universitaria Pisana, Pisa, Italy
| | - V Castiglione
- Fondazione "G. Monasterio" CNR - Regione Toscana, Pisa, Italy
| | - C Arzilli
- Azienda Ospedaliero - Universitaria Pisana, Pisa, Italy
| | - G Mirizzi
- Fondazione "G. Monasterio" CNR - Regione Toscana, Pisa, Italy
| | - G Todiere
- Fondazione "G. Monasterio" CNR - Regione Toscana, Pisa, Italy
| | - C Grigoratos
- Fondazione "G. Monasterio" CNR - Regione Toscana, Pisa, Italy
| | - M Piacenti
- Fondazione "G. Monasterio" CNR - Regione Toscana, Pisa, Italy
| | - G D Aquaro
- Fondazione "G. Monasterio" CNR - Regione Toscana, Pisa, Italy
| | - M Emdin
- Scuola Superiore Sant"Anna, Pisa, Italy
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Pavon AG, Pontone G, Symons R, Francone M, Zalewski J, Barison A, Aquaro GD, Muscogiuri G, Muller O, Baggiano A, Andreini D, Camici PG, Schwitter J, Bogaert J, Masci PG. 46Optimal timing for cardiovascular magnetic resonance after ST-segment elevation myocardial infarction for effective risk stratification. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez112.001] [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)
- A G Pavon
- University Hospital Centre Vaudois (CHUV), Centre of Cardiac Magnetic Resonance, Lausanne, Switzerland
| | - G Pontone
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - R Symons
- Gasthuisberg University Hospital, Leuven, Belgium
| | - M Francone
- Sapienza University of Rome, Rome, Italy
| | | | - A Barison
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - G D Aquaro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | | | - O Muller
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - A Baggiano
- Gasthuisberg University Hospital, Leuven, Belgium
| | - D Andreini
- Cardiology Center Monzino IRCCS, Milan, Italy
| | - P G Camici
- San Raffaele Hospital, Department of Cardiology, Milan, Italy
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Centre of Cardiac Magnetic Resonance, Lausanne, Switzerland
| | - J Bogaert
- Gasthuisberg University Hospital, Leuven, Belgium
| | - P G Masci
- University Hospital Centre Vaudois (CHUV), Centre of Cardiac Magnetic Resonance, Lausanne, Switzerland
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Todiere G, Barison A, Nugara C, Negri F, Gentile G, Bianco F, Faletta C, Novo G, De Caterina R, Zachara E, Re F, Clemenza F, Sinagra G, Emdin M, Aquaro GD. 324Prognostic role of late gadolinium enhancement in patients with low or intermediate HCM SCD risk score: a multicenter study. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez102.004] [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)
- G Todiere
- Gabriele Monasterio Foundation-CNR Region Toscana, MRI Laboratory, Institute of Clinical Physiology, Pisa, Italy
| | - A Barison
- Gabriele Monasterio Foundation-CNR Region Toscana, MRI Laboratory, Institute of Clinical Physiology, Pisa, Italy
| | - C Nugara
- Mediterranean Institute for Transplantation and High Specialization Therapies (IsMeTT), Palermo, Italy
| | - F Negri
- University of Trieste, Trieste, Italy
| | - G Gentile
- Mediterranean Institute for Transplantation and High Specialization Therapies (IsMeTT), Palermo, Italy
| | - F Bianco
- University of Chieti-Pescara, Chieti, Italy
| | - C Faletta
- Mediterranean Institute for Transplantation and High Specialization Therapies (IsMeTT), Palermo, Italy
| | - G Novo
- University of Palermo, Palermo, Italy
| | | | - E Zachara
- San Camillo Forlanini Hospital, Rome, Italy
| | - F Re
- San Camillo Forlanini Hospital, Rome, Italy
| | - F Clemenza
- Mediterranean Institute for Transplantation and High Specialization Therapies (IsMeTT), Palermo, Italy
| | - G Sinagra
- University of Trieste, Trieste, Italy
| | - M Emdin
- Sant"Anna School of Advanced Studies, Pisa, Italy
| | - G D Aquaro
- Gabriele Monasterio Foundation-CNR Region Toscana, MRI Laboratory, Institute of Clinical Physiology, Pisa, Italy
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Ait Ali L, Aquaro GD, Peritore G, Ricci F, De Marchi D, Emdin M, Passino C, Festa P. Cardiac Magnetic Resonance Evaluation of Pulmonary Transit Time and Blood Volume in Adult Congenital Heart disease. J Magn Reson Imaging 2019; 50:779-786. [DOI: 10.1002/jmri.26684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/31/2019] [Accepted: 01/31/2019] [Indexed: 11/06/2022] Open
Affiliation(s)
- Lamia Ait Ali
- Institute of Clinical Physiology CNR; Massa Italy
- MRI Lab, Fondazione G. Monasterio CNR-Regione Toscana; Pisa Italy
| | | | | | - Fabrizio Ricci
- Institute for Advanced Biomedical Technologies, Department of Neuroscience, Imaging and Clinical Sciences; "G. d'Annunzio" University; Chieti Italy
| | | | - Michele Emdin
- Division of Cardiology and Cardiovascular Medicine; Fondazione G. Monasterio CNR-Regione Toscana; Pisa Italy
| | - Claudio Passino
- Division of Cardiology and Cardiovascular Medicine; Fondazione G. Monasterio CNR-Regione Toscana; Pisa Italy
| | - Pierluigi Festa
- MRI Lab, Fondazione G. Monasterio CNR-Regione Toscana; Pisa Italy
- Pediatric Cardiology and GUCH Unit; Fondazione G. Monasterio CNR-Regione Toscana; Massa Italy
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Todiere G, Barison A, Grigoratos C, Cosentino F, Negri F, Angeramo F, Novo G, Falletta C, Gentile G, Nugara C, Emdin M, Re F, Zachara E, Clemenza F, Aquaro GD. 401Prognostic role of late gadolinium enhancement in patients with low-intermediate 5 year HCM SCD risk score: a multicenter study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.401] [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)
- G Todiere
- Gabriele Monasterio Foundation-CNR Region Toscana, MRI Laboratory, Institute of Clinical Physiology, Pisa, Italy
| | - A Barison
- Gabriele Monasterio Foundation-CNR Region Toscana, MRI Laboratory, Institute of Clinical Physiology, Pisa, Italy
| | - C Grigoratos
- Sant'Anna School of Advanced Studies, Pisa, Italy
| | - F Cosentino
- University of Palermo, Cardiology, Palermo, Italy
| | - F Negri
- University of Trieste, Cardiology, Trieste, Italy
| | - F Angeramo
- G. d'Annunzio University, Cardiology, Chieti, Italy
| | - G Novo
- University of Palermo, Cardiology, Palermo, Italy
| | - C Falletta
- Mediterranean Institute for Transplantation and High Specialization Therapies (IsMeTT), Palermo, Italy
| | - G Gentile
- Mediterranean Institute for Transplantation and High Specialization Therapies (IsMeTT), Palermo, Italy
| | - C Nugara
- University of Palermo, Cardiology, Palermo, Italy
| | - M Emdin
- Gabriele Monasterio Foundation-CNR Region Toscana, MRI Laboratory, Institute of Clinical Physiology, Pisa, Italy
| | - F Re
- San Camillo Forlanini Hospital, Rome, Italy
| | - E Zachara
- San Camillo Forlanini Hospital, Rome, Italy
| | - F Clemenza
- Mediterranean Institute for Transplantation and High Specialization Therapies (IsMeTT), Palermo, Italy
| | - G D Aquaro
- Gabriele Monasterio Foundation-CNR Region Toscana, MRI Laboratory, Institute of Clinical Physiology, Pisa, Italy
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20
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Ricci F, Aung N, Boubertakh R, Camaioni C, Doimo S, Fung K, Khanji M, Malcomson J, Mantini C, Paiva J, Gallina S, Fedorowski A, Mohiddin S, Aquaro GD, Petersen SE. 3004Pulmonary blood volume index as a quantitative biomarker of diastolic function in hypertrophic cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3004] [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)
- F Ricci
- G. D'Annunzio University, Institute of Cardiology and Center of Excellence on Aging, Chieti, Italy
| | - N Aung
- Queen Mary University of London, London, United Kingdom
| | | | - C Camaioni
- Barts Health NHS Trust, London, United Kingdom
| | - S Doimo
- University of Trieste, Trieste, Italy
| | - K Fung
- Queen Mary University of London, London, United Kingdom
| | - M Khanji
- Queen Mary University of London, London, United Kingdom
| | - J Malcomson
- Queen Mary University of London, London, United Kingdom
| | - C Mantini
- G. d'Annunzio University, Chieti, Italy
| | - J Paiva
- Queen Mary University of London, London, United Kingdom
| | - S Gallina
- G. d'Annunzio University, Chieti, Italy
| | | | - S Mohiddin
- Barts Health NHS Trust, London, United Kingdom
| | - G D Aquaro
- Gabriele Monasterio Foundation, Pisa, Italy
| | - S E Petersen
- Queen Mary University of London, London, United Kingdom
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21
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Barison A, Aimo A, Ortalda A, Todiere G, Grigoratos C, Passino C, Camici PG, Aquaro GD, Emdin M. Late gadolinium enhancement as a predictor of functional recovery, need for defibrillator implantation and prognosis in non-ischemic dilated cardiomyopathy. Int J Cardiol 2018; 250:195-200. [DOI: 10.1016/j.ijcard.2017.10.043] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 10/02/2017] [Accepted: 10/13/2017] [Indexed: 02/05/2023]
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Di Bella G, Camastra G, Monti L, Dellegrottaglie S, Piaggi P, Moro C, Pepe A, Lanzillo C, Pontone G, Perazzolo Marra M, Di Roma M, Scatteia A, Aquaro GD. Left and right ventricular morphology, function and late gadolinium enhancement extent and localization change with different clinical presentation of acute myocarditis Data from the ITAlian multicenter study on MYocarditis (ITAMY). J Cardiovasc Med (Hagerstown) 2017; 18:881-887. [DOI: 10.2459/jcm.0000000000000574] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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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23
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Ricci F, Barison A, Todiere G, Mantini C, Cotroneo AR, Emdin M, De Caterina R, Galllina S, Aquaro GD. Prognostic value of pulmonary blood volume by first-pass contrast-enhanced CMR in heart failure outpatients: the PROVE-HF study. Eur Heart J Cardiovasc Imaging 2017; 19:896-904. [DOI: 10.1093/ehjci/jex214] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 04/24/2017] [Accepted: 08/16/2017] [Indexed: 12/24/2022] Open
Affiliation(s)
- F Ricci
- Institute for Advanced Biomedical Technologies, “G. d'Annunzio” University, Via Luigi Polacchi, 11 - 66100 Chieti, Italy
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Via dei Vestini. 31 - 66100 Chieti, Italy
- Institute of Cardiology, Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Via dei Vestini, 31 - 66100 Chieti, Italy
| | - A Barison
- G. Monasterio Foundation, MRI-laboratory, Via Giuseppe Moruzzi, 1 - 56124 Pisa, Italy
| | - G Todiere
- G. Monasterio Foundation, MRI-laboratory, Via Giuseppe Moruzzi, 1 - 56124 Pisa, Italy
| | - C Mantini
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Via dei Vestini. 31 - 66100 Chieti, Italy
| | - A R Cotroneo
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Via dei Vestini. 31 - 66100 Chieti, Italy
| | - M Emdin
- G. Monasterio Foundation, MRI-laboratory, Via Giuseppe Moruzzi, 1 - 56124 Pisa, Italy
| | - R De Caterina
- Institute of Cardiology, Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Via dei Vestini, 31 - 66100 Chieti, Italy
| | - S Galllina
- Institute of Cardiology, Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University, Via dei Vestini, 31 - 66100 Chieti, Italy
| | - G D Aquaro
- G. Monasterio Foundation, MRI-laboratory, Via Giuseppe Moruzzi, 1 - 56124 Pisa, Italy
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Pontone G, Di Bella G, Castelletti S, Maestrini V, Festa P, Ait-Ali L, Masci PG, Monti L, di Giovine G, De Lazzari M, Cipriani A, Guaricci AI, Dellegrottaglie S, Pepe A, Marra MP, Aquaro GD. Clinical recommendations of cardiac magnetic resonance, Part II. J Cardiovasc Med (Hagerstown) 2017; 18:209-222. [DOI: 10.2459/jcm.0000000000000499] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Treibel TA, Duca F, Schwitter J, Ide S, Sandrini C, Fridman Y, Fridman Y, Hackman B, Kadakkal A, Sayeed A, Maanja M, Daya HA, Moon JC, Wong TC, Schelbert EB, Kammerlander AA, Zotter-Tufaro C, Aschauer S, Bonderman D, Mascherbauer J, Beigelman-Aubry C, Peguret N, Stuber M, Delacoste J, Belmondo B, Lovis A, Simons J, Long O, Grant K, Berchier G, Rohner C, Bonanno G, Coppo S, Ozsahin EM, Qanadli S, Meuli R, Bourhis J, Riesenkampff E, Chiasson D, Dipchand AI, Kantor PF, Chaturvedi RR, Yoo SJ, Grosse-Wortmann L, Aquaro GD, De Marchi D, Ait Ali L, Khraiche D, Boddaert N, Bonnet D, Raimondi F, Hackman BE, Kadakkal A, Daya HA, Wong TC, Schelbert EB. BEST ORAL ABSTRACTS1575Extracellular volume associates with outcomes more strongly than native or post-contrast myocardial T11507Cardiac Magnetic Resonance measured Extracellular Volume Independently Predicts Adverse Outcome in Heart Failure with Preserved Ejection Fraction1457Cardiac MRI Under Percussive Ventilation: A New Promising Technique1644Histological Validation of Cardiac Magnetic Resonance for the Evaluation of Myocardial Fibrosis after Heart Transplantation in Children1493First Pass Perfusion Reserve Index in Paediatric Patients with Arterial Switch for Transposition of Great Arteries1652Myocardial Fibrosis is Prevalent in Obstructive Sleep Apnea and Associated with Hospitalization for Heart Failure or Death. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Di Bella G, Minutoli F, Madaffari A, Mazzeo A, Russo M, Donato R, Zito C, Aquaro GD, Piccione MC, Pedri S, Vita G, Pingitore A, Carerj S. Left atrial function in cardiac amyloidosis. J Cardiovasc Med (Hagerstown) 2016; 17:113-21. [DOI: 10.2459/jcm.0000000000000188] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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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Aquaro GD, Barison A, Todiere G, Cagnolo A, Emdin M, lombardi M. Cardiac magnetic resonance in pericardial disease. J Cardiovasc Magn Reson 2015. [PMCID: PMC4328927 DOI: 10.1186/1532-429x-17-s1-p377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Barison A, Aquaro GD, Pugliese NR, Cappelli F, Chiappino S, Vergaro G, Mirizzi G, Todiere G, Passino C, Masci PG, Perfetto F, Emdin M. Measurement of myocardial amyloid deposition in systemic amyloidosis: insights from cardiovascular magnetic resonance imaging. J Intern Med 2015; 277:605-14. [PMID: 25346163 DOI: 10.1111/joim.12324] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Cardiac involvement in systemic amyloidosis is caused by the extracellular deposition of misfolded proteins, mainly immunoglobulin light chains (AL) or transthyretin (ATTR), and may be detected by cardiovascular magnetic resonance (CMR). The aim of this study was to measure myocardial extracellular volume (ECV) in amyloid patients with a novel T1 mapping CMR technique and to determine the correlation between ECV and disease severity. METHODS Thirty-six patients with biopsy-proven systemic amyloidosis (mean age 70 ± 9 years, 31 men, 30 with AL and six with ATTR amyloidosis) and seven patients with possible amyloidosis (mean age 64 ± 10 years, six men) underwent comprehensive clinical and CMR assessment, with ECV estimation from pre- and postcontrast T1 mapping. Thirty healthy subjects (mean age 39 ± 17 years, 21 men) served as the control group. RESULTS Amyloid patients presented with left ventricular (LV) concentric hypertrophy with impaired biventricular systolic function. Cardiac ECV was higher in amyloid patients (definite amyloidosis, 0.43 ± 0.12; possible amyloidosis, 0.34 ± 0.11) than in control subjects (0.26 ± 0.04, P < 0.05); even in amyloid patients without late gadolinium enhancement (0.35 ± 0.10), ECV was significantly higher than in the control group (P < 0.01). A cut-off value of myocardial ECV >0.316, corresponding to the 95th percentile in normal subjects, showed a sensitivity of 79% and specificity of 97% for discriminating amyloid patients from control subjects (area under the curve of 0.884). Myocardial ECV was significantly correlated with LV ejection fraction (R(2) = 0.16), LV mean wall thickness (R(2) = 0.41), LV diastolic function (R(2) = 0.21), right ventricular ejection fraction (R(2) = 0.13), N-terminal fragment of the pro-brain natriuretic peptides (R(2) = 0.23) and cardiac troponin (R(2) = 0.33). CONCLUSION Myocardial ECV was increased in amyloid patients and correlated with disease severity. Thus, measurement of myocardial ECV represents a potential noninvasive index of amyloid burden for use in early diagnosis and disease monitoring.
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Affiliation(s)
- A Barison
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Scuola Superiore Sant'Anna, Pisa, Italy
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Nucifora G, Aquaro GD, Lombardi M. Cardiac magnetic resonance for early detection and risk stratification of patients with non-compaction cardiomyopathy: reply. Eur J Heart Fail 2014. [DOI: 10.1093/eurjhf/hfr113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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)
- Gaetano Nucifora
- Fondazione CNR/Regione Toscana ‘Gabriele Monasterio’; Pisa Italy
- Division of Cardiology, Cardiothoracic Department; Azienda Ospedaliero-Universitaria ‘Santa Maria della Misericordia’ P.le Santa Maria della Misericordia; 33100 Udine Italy
| | | | - Massimo Lombardi
- Fondazione CNR/Regione Toscana ‘Gabriele Monasterio’; Pisa Italy
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Nucifora G, Aquaro GD, Masci PG, Pingitore A, Lombardi M. Magnetic resonance assessment of prevalence and correlates of right ventricular abnormalities in isolated left ventricular noncompaction. Am J Cardiol 2014; 113:142-6. [PMID: 24176065 DOI: 10.1016/j.amjcard.2013.08.049] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 08/26/2013] [Accepted: 08/26/2013] [Indexed: 02/06/2023]
Abstract
The aim of the present study was to evaluate the prevalence and correlates of right ventricular (RV) noncompaction (RVNC), RV systolic dysfunction, and RV myocardial fibrosis in patients with isolated left ventricular (LV) noncompaction (LVNC). For this purpose, cine and contrast-enhanced cardiac magnetic resonance imaging (MRI) was used. A total of 56 consecutive patients with isolated LVNC were included in the study. The diagnosis of isolated LVNC was based on the presence of standard cardiac MRI and clinical criteria. For each patient, cine and contrast-enhanced cardiac MR images were analyzed to evaluate the prevalence and correlates of RVNC, RV dysfunction, and late gadolinium enhancement (a surrogate of myocardial fibrosis) involving the RV. Mean age of the patient population was 45 ± 19 years; 35 patients (63%) were men. RVNC was observed in 5 patients (9%). Impaired RV systolic function was observed in 9 patients (16%). Late gadolinium enhancement was not observed in any RV segment. No association was found between wall motion abnormalities and noncompaction at RV segmental level (φ coefficient 0.041, p = 0.26). At multivariate analysis, LV ejection fraction was the only variable independently related to RV ejection fraction (β = 0.62, p <0.001). In conclusion, RV systolic dysfunction is present in a non-negligible proportion of patients with isolated LVNC; LV systolic function is the only variable independently related to RV systolic function.
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De Carlo M, Aquaro GD, Palmieri C, Guerra E, Misuraca L, Giannini C, Lombardi M, Berti S, Petronio AS. A prospective randomized trial of thrombectomy versus no thrombectomy in patients with ST-segment elevation myocardial infarction and thrombus-rich lesions: MUSTELA (MUltidevice Thrombectomy in Acute ST-Segment ELevation Acute Myocardial Infarction) trial. JACC Cardiovasc Interv 2013; 5:1223-30. [PMID: 23257370 DOI: 10.1016/j.jcin.2012.08.013] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [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] [Received: 07/30/2012] [Accepted: 08/31/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate whether thrombectomy during primary percutaneous coronary intervention (pPCI) in patients with high thrombus burden improves myocardial reperfusion and reduces infarct size. BACKGROUND Thrombectomy aims at reducing distal thrombotic embolization during pPCI, improving myocardial reperfusion and clinical outcome. METHODS We randomized 208 patients with high thrombus burden in a 1:1 ratio to either pPCI with thrombectomy (Group T) or standard pPCI (Group S). Thrombectomy was performed with either rheolytic or manual aspiration catheters. Three-month magnetic resonance imaging was performed to assess infarct size and transmurality and microvascular obstruction (MVO). The primary endpoints were ST-segment elevation resolution (STR) >70% at 60 min and 3-month infarct size. RESULTS The baseline profile was similar between groups, except for a higher rate of initial Thrombolysis In Myocardial Infarction flow grade 3 in Group S (p = 0.002). Group T showed a significantly higher rate of STR (57.4% vs. 37.3%; p = 0.004) and of final myocardial blush 3 (68.3% vs. 52.9%; p = 0.03). Group T and Group S did not differ with regard to infarct size (20.4 ± 10.5% vs. 19.3 ± 10.6%; p = 0.54) and transmurality (11.9 ± 12.0% vs. 11.6 ± 12.7%; p = 0.92), but Group T showed significantly less MVO (11.4% vs. 26.7%; p = 0.02) and a higher prevalence of inhomogeneous scar (p < 0.0001). One-year freedom from major adverse cardiac events was similar between groups. CONCLUSIONS Thrombectomy as an adjunct to pPCI in patients with high thrombus load yielded better post-procedural STR and reduced MVO at 3 months but was not associated with a reduction in infarct size and transmurality. Thromboaspiration in Patients With High Thrombotic Burden Undergoing Primary Percutaneous (Coronary Intervention; NCT01472718).
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Affiliation(s)
- Marco De Carlo
- Cardiac Catheterization Laboratory, Cardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
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Barison A, De Marchi D, Masci P, Milanesi M, Aquaro GD, Keilberg P, Positano V, Lombardi M. 1027T1-mapping measurement with a multi-breathhold delayed
enhancement sequence and a single-breathhold cine inversion-recovery spoiled
gradient echo sequence: comparison between two techniques. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet070bj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Emdin M, Aquaro GD, Pugliese NR, Del Franco A, Todiere G, Perfetto F, Barison A, Lombardi M, Monasterio FTG. MYOCARDIAL GADOLINIUM KINETICS EVALUATION AT MRI FOR THE DIAGNOSIS OF CARDIAC AMYLOIDOSIS. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)61237-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Caselli C, Lionetti V, Cabiati M, Prescimone T, Aquaro GD, Ottaviano V, Bernini F, Mattii L, Del Ry S, Giannessi D. Regional evidence of modulation of cardiac adiponectin level in dilated cardiomyopathy: pilot study in a porcine animal model. Cardiovasc Diabetol 2012; 11:143. [PMID: 23164042 PMCID: PMC3537584 DOI: 10.1186/1475-2840-11-143] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 11/07/2012] [Indexed: 12/30/2022] Open
Abstract
Background The role of systemic and myocardial adiponectin (ADN) in dilated cardiomyopathy is still debated. We tested the regulation of both systemic and myocardial ADN and the relationship with AMP-activated protein kinase (AMPK) activity in a swine model of non-ischemic dilated cardiomyopathy. Methods and results Cardiac tissue was collected from seven instrumented adult male minipigs by pacing the left ventricular (LV) free wall (180 beats/min, 3 weeks), both from pacing (PS) and opposite sites (OS), and from five controls. Circulating ADN levels were inversely related to global and regional cardiac function. Myocardial ADN in PS was down-regulated compared to control (p < 0.05), yet ADN receptor 1 was significantly up-regulated (p < 0.05). No modifications of AMPK were observed in either region of the failing heart. Similarly, myocardial mRNA levels of PPARγ, PPARα, TNFα, iNOS were unchanged compared to controls. Conclusions Paradoxically, circulating ADN did not show any cardioprotective effect, confirming its role as negative prognostic biomarker of heart failure. Myocardial ADN was reduced in PS compared to control in an AMPK-independent fashion, suggesting the occurrence of novel mechanisms by which reduced cardiac ADN levels may regionally mediate the decline of cardiac function.
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Affiliation(s)
- Chiara Caselli
- Consiglio Nazionale delle Ricerche (CNR), Institute of Clinical Physiology, Laboratory of Cardiovascular Biochemistry, Pisa, Italy
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Del Ry S, Cabiati M, Lionetti V, Aquaro GD, Martino A, Mattii L, Morales MA. Pacing-induced regional differences in adenosine receptors mRNA expression in a swine model of dilated cardiomyopathy. PLoS One 2012; 7:e47011. [PMID: 23071699 PMCID: PMC3470544 DOI: 10.1371/journal.pone.0047011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 09/11/2012] [Indexed: 01/09/2023] Open
Abstract
The adenosinergic system is essential in the mediation of intrinsic protection and myocardial resistance to insult; it may be considered a cardioprotective molecule and adenosine receptors (ARs) represent potential therapeutic targets in the setting of heart failure (HF). The aim of the study was to test whether differences exist between mRNA expression of ARs in the anterior left ventricle (LV) wall (pacing site: PS) compared to the infero septal wall (opposite region: OS) in an experimental model of dilated cardiomyopathy. Cardiac tissue was collected from LV PS and OS of adult male minipigs with pacing-induced HF (n = 10) and from a control group (C, n = 4). ARs and TNF–α mRNA expression was measured by Real Time-PCR and the results were normalized with the three most stably expressed genes (GAPDH, HPRT1, TBP). Immunohistochemistry analysis was also performed. After 3 weeks of pacing higher levels of expression for each analyzed AR were observed in PS except for A1R (A1R: C = 0.6±0.2, PS = 0.1±0.04, OS = 0.04±0.01, p<0.0001 C vs. PS and OS respectively; A2AR: C = 1.04±0.59, PS = 2.62±0.79, OS = 2.99±0.79; A2BR: C = 1.2±0.1, PS = 5.59±2.3, OS = 1.59±0.46; A3R: C = 0.76±0.18, PS = 8.40±3.38, OS = 4.40±0.83). Significant contractile impairment and myocardial hypoperfusion were observed at PS after three weeks of pacing as compared to OS. TNF-α mRNA expression resulted similar in PS (6.3±2.4) and in OS (5.9±2.7) although higher than in control group (3.4±1.5). ARs expression was mainly detected in cardiomyocytes. This study provided new information on ARs local changes in the setting of LV dysfunction and on the role of these receptors in relation to pacing-induced abnormalities of myocardial perfusion and contraction. These results suggest a possible therapeutic role of adenosine in patients with HF and dyssynchronous LV contraction.
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MESH Headings
- Animals
- Cardiac Pacing, Artificial
- Cardiomyopathy, Dilated/genetics
- Cardiomyopathy, Dilated/physiopathology
- Cardiomyopathy, Dilated/therapy
- Disease Models, Animal
- Gene Expression Regulation
- Heart Failure/genetics
- Heart Failure/physiopathology
- Heart Rate/genetics
- Heart Ventricles/physiopathology
- Magnetic Resonance Imaging
- Male
- RNA, Messenger
- Receptors, Purinergic P1/genetics
- Receptors, Purinergic P1/metabolism
- Swine
- Swine, Miniature
- Tumor Necrosis Factor-alpha/genetics
- Ventricular Dysfunction, Left/physiopathology
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Barison A, Masci PG, Fontana M, Milanesi M, Poletti R, Positano V, Passino C, Aquaro GD, Todiere G, Emdin M, Lombardi M. Myocardial fibrosis as a early cardiac marker of disease in patients with lamin A/C mutations. J Cardiovasc Magn Reson 2011. [PMCID: PMC3106518 DOI: 10.1186/1532-429x-13-s1-o76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Simioniuc A, Campan M, Lionetti V, Marinelli M, Aquaro GD, Cavallini C, Valente S, Di Silvestre D, Cantoni S, Bernini F, Simi C, Pardini S, Mauri P, Neglia D, Ventura C, Pasquinelli G, Recchia FA. Placental stem cells pre-treated with a hyaluronan mixed ester of butyric and retinoic acid to cure infarcted pig hearts: a multimodal study. Cardiovasc Res 2011; 90:546-556. [DOI: 10.1093/cvr/cvr018] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
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Campan M, Lionetti V, Aquaro GD, Forini F, Matteucci M, Vannucci L, Chiuppesi F, Di Cristofano C, Faggioni M, Maioli M, Barile L, Messina E, Lombardi M, Pucci A, Pistello M, Recchia FA. Ferritin as a reporter gene for in vivo tracking of stem cells by 1.5-T cardiac MRI in a rat model of myocardial infarction. Am J Physiol Heart Circ Physiol 2011; 300:H2238-50. [DOI: 10.1152/ajpheart.00935.2010] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [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: 11/22/2022]
Abstract
The methods currently utilized to track stem cells by cardiac MRI are affected by important limitations, and new solutions are needed. We tested human ferritin heavy chain (hFTH) as a reporter gene for in vivo tracking of stem cells by cardiac MRI. Swine cardiac stem/progenitor cells were transduced with a lentiviral vector to overexpress hFTH and cultured to obtain cardiospheres (Cs). Myocardial infarction was induced in rats, and, after 45 min, the animals were subjected to intramyocardial injection of ∼200 hFTH-Cs or nontransduced Cs or saline solution in the border zone. By employing clinical standard 1.5-Tesla MRI scanner and a multiecho T2* gradient echo sequence, we localized iron-accumulating tissue only in hearts treated with hFTH-Cs. This signal was detectable at 1 wk after infarction, and its size did not change significantly after 4 wk (6.33 ± 3.05 vs. 4.41 ± 4.38 mm2). Cs transduction did not affect their cardioreparative potential, as indicated by the significantly better preserved left ventricular global and regional function and the 36% reduction in infarct size in both groups that received Cs compared with control infarcts. Prussian blue staining confirmed the presence of differentiated, iron-accumulating cells containing mitochondria of porcine origin. Cs-derived cells displayed CD31, α-smooth muscle, and α-sarcomeric actin antigens, indicating that the differentiation into endothelial, smooth muscle and cardiac muscle lineage was not affected by ferritin overexpression. In conclusion, hFTH can be used as a MRI reporter gene to track dividing/differentiating stem cells in the beating heart, while simultaneously monitoring cardiac morpho-functional changes.
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Affiliation(s)
| | - Vincenzo Lionetti
- Sector of Medicine, Scuola Superiore Sant′Anna
- Fondazione CNR-Regione Toscana “G. Monasterio”
| | | | | | | | - Laura Vannucci
- Retrovirus Centre and Virology Section, Department of Experimental Pathology, University of Pisa, Pisa
| | - Flavia Chiuppesi
- Retrovirus Centre and Virology Section, Department of Experimental Pathology, University of Pisa, Pisa
| | - Claudio Di Cristofano
- Department of Experimental Medicine, La Sapienza University, Polo Pontino, I.C.O.T, Latina
| | | | - Margherita Maioli
- Department of Biomedical Sciences and National Institute of Biostructures and Biosystems, University of Sassari, Sassari
| | - Lucio Barile
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan
| | - Elisa Messina
- Department of Experimental Medicine, La Sapienza University of Rome, Rome
| | | | - Angela Pucci
- Division of Surgical, Molecular and Ultrastructural Pathology, Pisa University Hospital, Pisa, Italy; and
| | - Mauro Pistello
- Retrovirus Centre and Virology Section, Department of Experimental Pathology, University of Pisa, Pisa
| | - Fabio A. Recchia
- Sector of Medicine, Scuola Superiore Sant′Anna
- Department of Physiology, New York Medical College, Valhalla, New York
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Di Bella G, Minutoli F, Pingitore A, Zito C, Mazzeo A, Aquaro GD, Di Leo R, Recupero A, Stancanelli C, Baldari S, Vita G, Carerj S. Endocardial and epicardial deformations in cardiac amyloidosis and hypertrophic cardiomyopathy. Circ J 2011; 75:1200-8. [PMID: 21427499 DOI: 10.1253/circj.cj-10-0844] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [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: 11/09/2022]
Abstract
BACKGROUND The aim of the present study was to analyze epicardial (EPI) and endocardial (ENDO) strain (S) in patients with transthyretin-related cardiac amyloidosis (TTR-CA) and hypertrophic cardiomyopathy (HCM) using echocardiography (TTE) with 2-dimensional feature tracking imaging (FTI). METHODS AND RESULTS Thirty-three subjects (11 with HCM, 11 with TTR-CA, and 11 healthy subjects as controls) with a New York Heart Association functional class ≤ II underwent conventional TTE and FTI. TTE was used for the evaluation of left ventricle (LV) wall thickness, mass, systolic and diastolic function. FTI was used for the evaluation of EPI and ENDO longitudinal, and circumferential, and radial S. LV wall thickness and mass were higher in both TTR-CA and HCM in comparison with controls (P < 0.001), but ejection fraction (EF) was similar among patients with TTR-CA, HCM and controls (63 ± 6%, 64 ± 6%, 61 ± 5%, respectively). ENDO and EPI longitudinal and circumferential S and radial S were significantly lower in HCM and TTR-CA when compared with controls (P < 0.01). No differences in EPI and ENDO longitudinal S, ENDO circumferential S and radial S were found between TTR-CA and HCM groups, while EPI circumferential S was significantly lower in the TTRCA group (6 ± 3.3%) than in the HCM group (8.1 ± 4.3%; P < 0.0001). CONCLUSIONS Longitudinal, circumferential and radial LV deformations are impaired in patients with TTR-CA and HCM with a preserved EF. Impairment of EPI circumferential strain is greater in TTR-CA than in HCM.
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Affiliation(s)
- Gianluca Di Bella
- Clinical and Experimental Department of Medicine and Pharmacology, University of Messina, Italy.
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Prescimone T, Lionetti V, Caselli C, Aquaro GD, Cabiati M, Ottaviano V, Del Ry S, Giannessi D. Severity of regional myocardial dysfunction is not affected by cardiomyocyte apoptosis in non-ischemic heart failure. Pharmacol Res 2011; 63:207-15. [DOI: 10.1016/j.phrs.2010.09.006] [Citation(s) in RCA: 10] [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: 06/30/2010] [Revised: 09/28/2010] [Accepted: 09/28/2010] [Indexed: 11/30/2022]
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Meloni A, Dell'Amico MC, Favilli B, Aquaro GD, Festa P, Chiodi E, Renne S, Galati MC, Sardella L, Keilberg P, Positano V, Lombardi M, Pepe A. Left Ventricular Volumes, Mass and Function normalized to the body surface area, age and gender from CMR in a large cohort of well-treated Thalassemia Major patients without myocardial iron overload. J Cardiovasc Magn Reson 2011. [PMCID: PMC3106521 DOI: 10.1186/1532-429x-13-s1-p305] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Meloni A, Dell'Amico MC, Favilli B, Aquaro GD, Lamia AA, Chiodi E, Ascioti C, Renne S, Bitti PP, Gerardi C, Positano V, Lombardi M, Pepe A. Right Ventricular Volumes and Function normalized to body surface area, age and sex in a large cohort of well-treated Thalassemia Major without myocardial iron overload. J Cardiovasc Magn Reson 2011. [PMCID: PMC3106469 DOI: 10.1186/1532-429x-13-s1-p299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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43
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Nucifora G, Aquaro GD, Pingitore A, Masci PG, Lombardi M. Myocardial fibrosis in isolated left ventricular non-compaction and its relation to disease severity. Eur J Heart Fail 2011; 13:170-6. [PMID: 21208941 DOI: 10.1093/eurjhf/hfq222] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.8] [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: 01/23/2023] Open
Abstract
AIMS The aim of the present study was to evaluate the prevalence and extent of myocardial fibrosis in patients with isolated left ventricular non-compaction (LVNC) and to determine its relation to clinical status and LV systolic function. METHODS AND RESULTS The cardiac magnetic resonance imaging (MRI) database of our institution was searched for all patients with a first diagnosis of isolated LVNC. The diagnosis of isolated LVNC was based on the presence of standard cardiac MRI and clinical criteria. For each patient, cine and contrast-enhanced cardiac MR images were analysed to evaluate LV systolic function and the prevalence and extent of late gadolinium enhancement (LGE), a surrogate of myocardial fibrosis. A total of 42 patients (mean age 46 ± 20 years, 62% male) were identified. Late gadolinium enhancement was observed in 23 (55%) patients with isolated LVNC, occupying 4.8 ± 6.7% of the LV mass. Both the presence and extent of LGE were significantly related to the number of abnormal clinical features (i.e. symptomatic status, resting electrocardiogram abnormalities, and 24 h Holter monitoring abnormalities; P < 0.001 and P= 0.001, respectively). Similarly, LGE was more prevalent and extensive in patients with LV ejection fraction (EF) < 50% compared with patients with LVEF ≥ 50% (90 vs. 23%; P< 0.001 and 8.9 ± 7.6 vs. 1.1 ± 2.4%; P< 0.001, respectively). At multivariate analysis, both the presence and extent of LV LGE were independently related to LVEF (β = -0.63; P < 0.001 and β = -0.62; P< 0.001, respectively). CONCLUSION Myocardial fibrosis is related to clinical disease severity and LV systolic dysfunction in isolated LVNC.
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Affiliation(s)
- Gaetano Nucifora
- Division of Cardiovascular Magnetic Resonance, Fondazione CNR/Regione Toscana Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy.
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Nucifora G, Aquaro GD, Masci PG, Barison A, Todiere G, Pingitore A, Lombardi M. Lipomatous metaplasia in ischemic cardiomyopathy: Current knowledge and clinical perspective. Int J Cardiol 2011; 146:120-2. [DOI: 10.1016/j.ijcard.2010.09.090] [Citation(s) in RCA: 11] [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: 07/15/2010] [Accepted: 09/26/2010] [Indexed: 11/24/2022]
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Barison A, Aquaro GD, Todiere G, Nucifora G, Corciu AI, Pasanisi E, Neglia D, Coceani M. Intramural myocardial hemorrhagic rupture in a patient with metastatic cancer and myocardial infarction. J Cardiovasc Med (Hagerstown) 2010; 12:277-9. [PMID: 20625306 DOI: 10.2459/jcm.0b013e32833cdd9b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 77-year-old man with anterior ST-elevated myocardial infarction and lateral myocardial rupture underwent successful percutaneous revascularization. Cardiac magnetic resonance imaging (MRI) and positron emission tomography (PET) unveiled a disseminated metastatic cancer, likely responsible not only for a prothrombotic paraneoplastic syndrome but also for ventricular metastasis and myocardial rupture. The patient unfortunately died because of noncardiovascular complications of cancer.
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Affiliation(s)
- Andrea Barison
- Scuola Superiore SantO'Anna, Italy bFondazione Gabriele Monasterio CNR - Regione Toscana, Pisa, Italy.
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Lionetti V, Cantoni S, Cavallini C, Bianchi F, Valente S, Frascari I, Olivi E, Aquaro GD, Bonavita F, Scarlata I, Maioli M, Vaccari V, Tassinari R, Bartoli A, Recchia FA, Pasquinelli G, Ventura C. Hyaluronan mixed esters of butyric and retinoic acid affording myocardial survival and repair without stem cell transplantation. J Biol Chem 2010; 285:9949-9961. [PMID: 20097747 PMCID: PMC2843241 DOI: 10.1074/jbc.m109.087254] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Possible cardiac repair by adult stem cell transplantation is currently hampered by poor cell viability and delivery efficiency, uncertain differentiating fate in vivo, the needs of ex vivo cell expansion, and consequent delay in transplantation after the onset of heart attack. By the aid of magnetic resonance imaging, positron emission tomography, and immunohistochemistry, we show that injection of a hyaluronan mixed ester of butyric and retinoic acid (HBR) into infarcted rat hearts afforded substantial cardiovascular repair and recovery of myocardial performance. HBR restored cardiac [18F]fluorodeoxyglucose uptake and increased capillary density and led to the recruitment of endogenous Stro-1-positive stem cells. A terminal deoxynucleotidyltransferase-mediated dUTP nick end labeling assay demonstrated that HBR-treated hearts exhibited a decrease in the number of apoptotic cardiomyocytes. In isolated rat cardiomyocytes and Stro-1 stem cells, HBR enhanced the transcription of vascular endothelial growth factor, hepatocyte growth factor, kdr, akt, and pim-1. HBR also increased the secretion of vascular endothelial growth factor and hepatocyte growth factor, suggesting that the mixed ester may have recruited both myocardial and Stro-1 cells also. An increase in capillarogenesis was induced in vitro with medium obtained from HBR-exposed cells. In the infarcted myocardium, HBR injection increased histone H4 acetylation significantly. Acetyl-H4 immunoreactivity increased in rat cardiomyocytes and Stro-1 cells exposed to HBR, compared with untreated cells. In conclusion, efficient cardiac regenerative therapy can be afforded by HBR without the need of stem cell transplantation or vector-mediated gene delivery.
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Affiliation(s)
- Vincenzo Lionetti
- Sector of Medicine, Scuola Superiore S. Anna, I-56124 Pisa, Italy; Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche Fondazione G. Monasterio, I-56124 Pisa, Italy
| | - Silvia Cantoni
- Laboratory of Molecular Biology and Stem Cell Engineering, Cardiovascular Department-National Institute of Biostructures and Biosystems, S. Orsola-Malpighi Hospital, University of Bologna, I-40138 Bologna, Italy; Bioscience Institute, RSM-47891 Falciano, Republic of San Marino
| | - Claudia Cavallini
- Laboratory of Molecular Biology and Stem Cell Engineering, Cardiovascular Department-National Institute of Biostructures and Biosystems, S. Orsola-Malpighi Hospital, University of Bologna, I-40138 Bologna, Italy; Bioscience Institute, RSM-47891 Falciano, Republic of San Marino
| | - Francesca Bianchi
- Laboratory of Molecular Biology and Stem Cell Engineering, Cardiovascular Department-National Institute of Biostructures and Biosystems, S. Orsola-Malpighi Hospital, University of Bologna, I-40138 Bologna, Italy; Bioscience Institute, RSM-47891 Falciano, Republic of San Marino
| | - Sabrina Valente
- Department of Hematology, Oncology, and Clinical Pathology, University of Bologna, I-40138 Bologna, Italy
| | - Irene Frascari
- Laboratory of Molecular Biology and Stem Cell Engineering, Cardiovascular Department-National Institute of Biostructures and Biosystems, S. Orsola-Malpighi Hospital, University of Bologna, I-40138 Bologna, Italy; Bioscience Institute, RSM-47891 Falciano, Republic of San Marino
| | - Elena Olivi
- Laboratory of Molecular Biology and Stem Cell Engineering, Cardiovascular Department-National Institute of Biostructures and Biosystems, S. Orsola-Malpighi Hospital, University of Bologna, I-40138 Bologna, Italy; Bioscience Institute, RSM-47891 Falciano, Republic of San Marino
| | - Giovanni D Aquaro
- Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche Fondazione G. Monasterio, I-56124 Pisa, Italy
| | - Francesca Bonavita
- Laboratory of Molecular Biology and Stem Cell Engineering, Cardiovascular Department-National Institute of Biostructures and Biosystems, S. Orsola-Malpighi Hospital, University of Bologna, I-40138 Bologna, Italy; Bioscience Institute, RSM-47891 Falciano, Republic of San Marino
| | - Ignazio Scarlata
- Laboratory of Molecular Biology and Stem Cell Engineering, Cardiovascular Department-National Institute of Biostructures and Biosystems, S. Orsola-Malpighi Hospital, University of Bologna, I-40138 Bologna, Italy; Bioscience Institute, RSM-47891 Falciano, Republic of San Marino
| | - Margherita Maioli
- Department of Biomedical Sciences, University of Sassari, I-07100 Sassari, Italy
| | - Valentina Vaccari
- Laboratory of Molecular Biology and Stem Cell Engineering, Cardiovascular Department-National Institute of Biostructures and Biosystems, S. Orsola-Malpighi Hospital, University of Bologna, I-40138 Bologna, Italy; Bioscience Institute, RSM-47891 Falciano, Republic of San Marino
| | - Riccardo Tassinari
- Laboratory of Molecular Biology and Stem Cell Engineering, Cardiovascular Department-National Institute of Biostructures and Biosystems, S. Orsola-Malpighi Hospital, University of Bologna, I-40138 Bologna, Italy; Bioscience Institute, RSM-47891 Falciano, Republic of San Marino
| | | | - Fabio A Recchia
- Sector of Medicine, Scuola Superiore S. Anna, I-56124 Pisa, Italy; Department of Physiology, New York Medical College, Valhalla, New York 10595
| | - Gianandrea Pasquinelli
- Department of Hematology, Oncology, and Clinical Pathology, University of Bologna, I-40138 Bologna, Italy
| | - Carlo Ventura
- Laboratory of Molecular Biology and Stem Cell Engineering, Cardiovascular Department-National Institute of Biostructures and Biosystems, S. Orsola-Malpighi Hospital, University of Bologna, I-40138 Bologna, Italy; Bioscience Institute, RSM-47891 Falciano, Republic of San Marino.
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Aquaro GD, Di Bella G, Strata E, Pingitore A, Lombardi M. Three-year follow-up with cardiac magnetic resonance in a patient with biventricular non-compaction cardiomyopathy. Int J Cardiol 2008; 129:e74-6. [PMID: 17854927 DOI: 10.1016/j.ijcard.2007.06.121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Accepted: 06/23/2007] [Indexed: 11/27/2022]
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Rovai D, Di Bella G, Rossi G, Lombardi M, Aquaro GD, L'Abbate A, Pingitore A. Q-wave prediction of myocardial infarct location, size and transmural extent at magnetic resonance imaging. Coron Artery Dis 2007; 18:381-9. [PMID: 17627188 DOI: 10.1097/mca.0b013e32820588c2] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We investigated how pathologic Q waves or equivalents predict location, size and transmural extent of myocardial infarction (MI). METHODS MI characteristics, detected by contrast-enhanced magnetic resonance imaging, were compared with 12-lead electrocardiogram in 79 patients with previous first MI. RESULTS Q waves involved only the anterior leads (V1-V4) in 13 patients: in all patients MI involved the anterior and anteroseptal walls and apex; 81% of scar tissue was within these regions. Q waves involved only the inferior leads (II, III, aVF) in 13 patients: in 12 of these patients MI involved the inferior and inferoseptal walls; however, only 59% of scar occupied these regions. Q waves involved only lateral leads (V5, V6, I, aVL) in 11 patients: in nine of these patients MI involved the lateral wall but only 27% of scar tissue was within this wall. Q waves involved two electrocardiogram locations in 42 patients. In the 79 patients as a whole, the number of anterior Q waves was related to anterior MI size (r=0.70); however, the number of inferior and lateral Q waves was only weakly related to MI size in corresponding territories (r=0.35 and 0.33). A tall and broad R wave in V1-V2 was a more powerful predictor of lateral MI size than Q waves. Finally, the number of Q waves accurately reflected the transmural extent of the infarction (r=0.70) only in anterior infarctions. CONCLUSION Q waves reliably predict MI location, size and transmural extent only in patients with anterior infarction. A tall and broad R wave in V1-V2 reflects a lateral MI.
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Pingitore A, Di Bella G, Lombardi M, Iervasi G, Strata E, Aquaro GD, Positano V, De Marchi D, Rossi G, L'Abbate A, Rovai D. The obesity paradox and myocardial infarct size. J Cardiovasc Med (Hagerstown) 2007; 8:713-7. [PMID: 17700401 DOI: 10.2459/jcm.0b013e328011c984] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [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: 11/05/2022]
Abstract
OBJECTIVE Obese subjects have a risk of death from cardiovascular disease higher than those with normal body weight. Obese patients, however, have a better outcome when undergoing coronary revascularisation, and when suffering from heart failure or chronic kidney disease. The term 'obesity paradox' underlines the divergence between increased risk and better outcome in sick obese patients. We tested the hypothesis that the obesity paradox could also occur in myocardial infarction. METHODS A group of 89 patients (mean age 62 +/- 11 years) with previous myocardial infarction (Q-wave in 72 patients) underwent contrast-enhanced MRI. RESULTS Areas of delayed contrast enhancement (which reflects myocardial necrosis) were present in 15 +/- 9% of left ventricular myocardium. Infarct size was not influenced by patient age, gender, history of arterial hypertension, hypercholesterolaemia, hypertriglyceridaemia nor tobacco smoking. Infarct size, however, was larger in insulin-dependent diabetic patients (P = 0.06) and in those with a family history of premature coronary artery disease (P = 0.06). Surprisingly, infarct size was smaller in obese patients (11 +/- 4% of left ventricular myocardium) than in those with normal body weight (16 +/- 9% of left ventricular myocardium, P = 0.03). Insulin-dependent diabetes mellitus, obesity and family history of coronary artery disease were the only independent predictors of infarct size at multiple linear regression analysis. CONCLUSIONS Owing to its limitations (small sample size and exclusion of extremely obese patients), this study generates a working hypothesis, which should be tested in larger prospective studies, that the obesity paradox could also occur in myocardial infarction.
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Lionetti V, Guiducci L, Simioniuc A, Aquaro GD, Simi C, De Marchi D, Burchielli S, Pratali L, Piacenti M, Lombardi M, Salvadori P, Pingitore A, Neglia D, Recchia FA. Mismatch between uniform increase in cardiac glucose uptake and regional contractile dysfunction in pacing-induced heart failure. Am J Physiol Heart Circ Physiol 2007; 293:H2747-56. [PMID: 17704291 DOI: 10.1152/ajpheart.00592.2007] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Increased glucose utilization and regional differences in contractile function are well-known alterations of the failing heart and play an important pathophysiological role. We tested whether, similar to functional derangement, changes in glucose uptake develop following a regional pattern. Heart failure was induced in 13 chronically instrumented minipigs by pacing the left ventricular (LV) free wall at 180 beats/min for 3 wk. Regional changes in contractile function and stress were assessed by magnetic resonance imaging, whereas regional flow and glucose uptake were measured by positron emission tomography utilizing, respectively, the radiotracers [(13)N]ammonia and (18)F-deoxyglucose. In heart failure, LV end-diastolic pressure was 20 +/- 4 mmHg, and ejection fraction was 35 +/- 4% (all P < 0.05 vs. control). Sustained pacing-induced dyssynchronous LV activation caused a more pronounced decrease in LV systolic thickening (7.45 +/- 3.42 vs. 30.62 +/- 8.73%, P < 0.05) and circumferential shortening (-4.62 +/- 1.0 vs. -7.33 +/- 1.2%, P < 0.05) in the anterior/anterior-lateral region (pacing site) compared with the inferoseptal region (opposite site). Conversely, flow was reduced significantly by approximately 32% compared with control and was lower in the opposite site region. Despite these nonhomogeneous alterations, regional end-systolic wall stress was uniformly increased by 60% in the failing LV. Similar to wall stress, glucose uptake markedly increased vs. control (0.24 +/- 0.004 vs. 0.07 +/- 0.01 micromol x min(-1) x g(-1), P < 0.05), with no significant regional differences. In conclusion, high-frequency pacing of the LV free wall causes a dyssynchronous pattern of contraction that leads to progressive cardiac failure with a marked mismatch between increased glucose uptake and regional contractile dysfunction.
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Affiliation(s)
- Vincenzo Lionetti
- Sector of Medicine, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 56122 Pisa, Italy
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