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2. Rac1 modulates endothelial function and platelet aggregation in diabetes mellitus

Author

Schiattarella, G.G., Carrizzo, A., Ilardi, F., Damato, A., Ambrosio, M., Madonna, M., Trimarco, V., Marino, M., De Angelis, E., Settembrini, S., Perrino, C., Trimarco, B., Esposito, G., and Vecchione, C.

Subjects
Cardiovascular and Metabolic Diseases
Abstract

BACKGROUND: Vascular complications and abnormal platelet function contribute to morbidity and mortality in diabetes mellitus. We hypothesized that the Rho-related GTPase protein, Rac1, can influence both endothelial and platelet function and might represent a potential novel therapeutic target in diabetes mellitus. METHODS AND RESULTS: We used both in vitro and ex vivo approaches to test the effects of pharmacological inhibition of Rac1 during hyperglycemic condition. We evaluated the effect of NSC23766, a pharmacological inhibitor of Rac1, on vascular function in diabetic mice and platelet aggregation in diabetic subjects. We demonstrated that the administration of NSC23766 protects from hyperglycemia-induced endothelial dysfunction, restoring NO levels, and reduces oxidative stress generated by nicotinamide adenine dinucleotide phosphate oxidase. Mechanistically, we identified Rho-associated coiled-coil serine/threonine kinase-1 as a downstream target of Rac1. Moreover, we reported that during hyperglycemic conditions, human platelets showed hyperactivation of Rac1 and impaired NO release, which were both partially restored after NSC23766 treatment. Finally, we characterized the antiplatelet effect of NSC23766 during hyperglycemic conditions, demonstrating the additional role of Rac1 inhibition in reducing platelet aggregation in diabetic patients treated with common antiplatelet drugs. CONCLUSIONS: Our data suggest that the pharmacological inhibition of Rac1 could represent a novel therapeutic strategy to reduce endothelial dysfunction and platelet hyperaggregation in diabetes mellitus.

Published
2018

4. The importance of using strain derived criteria for detection of subclinical cardiotoxicity in breast cancer patients undergoing anthracycline and trastuzumab

Author

Santoro, C, Esposito, R, Schiano Lomoriello, V, Muscariello, R, Lembo, M, Ilardi, F, ARPINO, GRAZIA, DE PLACIDO, SABINO, DE SIMONE, GIOVANNI, GALDERISI, MAURIZIO, Santoro, C, Esposito, R, Schiano-Lomoriello, V, Muscariello, R, Lembo, M, Ilardi, F, Arpino, G, De Placido, S, de Simone, G, Galderisi, M, Schiano Lomoriello, V, Arpino, Grazia, DE PLACIDO, Sabino, DE SIMONE, Giovanni, and Galderisi, Maurizio

Published
2015

6. Quinacrine as a novel drug in the prevention of in-stent restenosis and thrombosis

Author

Gargiulo, G, Schiattarella, GG, Pironti, G, Di Serafino, L, Scudiero, L, Serino, F, Ilardi, F, Petrillo, G, PERRINO, CINZIA, CIRILLO, PLINIO, ESPOSITO, GIOVANNI, Gargiulo, G, Perrino, Cinzia, Schiattarella, Gg, Pironti, G, Di Serafino, L, Scudiero, L, Serino, F, Ilardi, F, Petrillo, G, Cirillo, Plinio, and Esposito, Giovanni

Published
2011

7. Endovascular treatment of carotid artery stenosis: evidences from randomized controlled trials and actual indications

Author

Ilardi, F., Magliulo, F., Gargiulo, G., Schiattarella, G.G., Carotenuto, G., Serino, F., Ferrone, M., Visco, E., Scudiero, F., Carbone, A., Perrino, C., Trimarco, B., and Esposito, G.

Subjects
Cardiovascular and Metabolic Diseases, cardiovascular diseases
Abstract

Atherosclerotic stenosis of common and internal carotid arteries is a well-recognized risk factor for ischemic stroke, and revascularization has been proven to be the main tool of prevention, particularly for patients with stenosis-related symptoms. While for many years surgical carotid endarterectomy (CEA) has been considered the gold-standard strategy to restore vascular patency, recently the endovascular treatment through percutaneous angioplasty and stent implantation (CAS) has become a valid alternative. In the last years, interesting data about the comparison of these strategies have emerged. CAS seems to cause more peri-procedural strokes, but may also avoid many adverse events related to surgery and general anaesthesia, including peri-procedural myocardial infarction. For these reasons, it was initially considered a second-choice strategy to be adopted in patients for whom surgery was contraindicated. However, more recent trials have shown that CAS might be considered an effective alternative to CEA. Moreover, the rapid evolution of CAS technique and materials suggests its potential to improve outcome and possible superiority compared to CEA in the next future. Purpose of this review is to discuss the most recent clinical evidences concerning the treatment of carotid artery stenosis, with a special focus on the endovascular treatment.

Published
2011

9. List of Contributors

Author

Abellás-Sequeiros, R.A., Alcidi, G., Alonso Salinas, G.L., Arpino, G., Ayach, B., Boni, R., Bours, V., Brown, J., Bucciarelli-Ducci, C., Cardinale, D., Coppola, C., Cosyns, B., Dulgheru, R., Edvardsen, T., Erba, P.A., Freres, P., Galderisi, M., González-Juanatey, J.R., Hinojar, R., Ilardi, F., Jerusalem, G., Kerkhove, D., Lancellotti, P., López Fernández, T., López López, A., López Sendón, J., Manrique, C.R., Maurea, N., Monagham, M.J., Moonen, M., Oury, C., Paciolla, I., Plana, J.C., Ramos, J., Rienzo, A., Rigo, F., Rodríguez Muñoz, D., Sánchez, V., Santoro, C., Scherrer-Crosbie, M., Sicari, R., Sollini, M., Sorrentino, R., Tiwari, N., and Zamorano Gómez, J.L.

Published
2017
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10. Acute myocarditis: prognostic role of speckle tracking echocardiography and comparison with cardiac magnetic resonance features

Author

Federica Ilardi, Giovanna Esposito, Vincenzo Russo, Antonello D'Andrea, Gianluca Pontone, Giovanni Esposito, Giuseppe Muscogiuri, Ercole Tagliamonte, Andrea D'Amato, Alfonso Desiderio, Simona Sperlongano, Sperlongano, S, D'Amato, A, Tagliamonte, E, Russo, V, Desiderio, A, Ilardi, F, Muscogiuri, G, Esposito, G, Pontone, G, D'Andrea, A, Sperlongano, S., D'Amato, A., Tagliamonte, E., Russo, V., Desiderio, A., Ilardi, F., Muscogiuri, G., Esposito, G., Pontone, G., and D'Andrea, A.

Subjects
Adult, Male, medicine.medical_specialty, Myocarditis, Magnetic Resonance Spectroscopy, Cardiac magnetic resonance, Prognosi, Contrast Media, Magnetic Resonance Imaging, Cine, Speckle tracking echocardiography, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Gadolinium, Predictive Value of Test, 030204 cardiovascular system & hematology, Ventricular Function, Left, 03 medical and health sciences, Cicatrix, Young Adult, 0302 clinical medicine, Ventricular arrhythmias, Predictive Value of Tests, Internal medicine, Acute myocarditi, medicine, Humans, In patient, cardiovascular diseases, 030212 general & internal medicine, Acute myocarditis, Prognosis, business.industry, Ultrasound, Stroke Volume, Vascular surgery, Middle Aged, medicine.disease, Cardiac surgery, Echocardiography, Cardiology, Ventricular arrhythmia, Female, Cardiology and Cardiovascular Medicine, business, Human
Abstract

To evaluate longitudinal systolic function in patients with myocarditis, its correlation with cardiac magnetic resonance (CMR) features, and its predictive value in functional recovery and arrhythmias onset during follow-up (FU) on optimized medical therapy (OMT). Patients with acute myocarditis, confirmed through CMR criteria, and age- and sex-matched healthy controls were enrolled. Two-dimensional (2D) transthoracic echocardiography, including speckle tracking analysis, was performed at admission and after 6months of FU. Patients of myocarditis group also underwent 24h ECG Holter monitoring during FU. 115 patients with myocarditis (mean age 41 ± 17, 70% males) and 70 healthy subjects were enrolled. Global longitudinal strain (GLS) and sub-epicardial strain were markedly lower in the myocarditis group than in controls (mean GLS%: −14.1 ± 5.1 vs −23.1 ± 3.6, p < 0.001). A strong positive correlation between total scar burden (TSB) on CMR and baseline LV GLS was found (r = 0.67, p < 0.0001). GLS improved after 6months of FU in myocarditis on OMT (mean GLS%: −14.1 ± 5.1 vs −16.5 ± 4.8, p < 0.01). By bivariate correlation analysis, baseline LVEF, GLS, and TSB were all associated with LVEF at 6months of FU. Moreover, by multivariable linear regression analysis, these parameters confirmed to be independent predictors of functional recovery at 6months (LVEF β 0.38, p < 0.01; GLS β −0.35, p < 0.01; total scar burden β −0.52, p < 0.0001). Segmental peak systolic strain was significantly different between segments with and without late gadolinium enhancement on CMR (−13.2 ± 3.1% vs −18.1 ± 3.5%, p < 0.001). A segmental strain of − 12% identified scar with a sensitivity of 79% and a specificity of 84% (AUC = 0.91; 95% CI 0.73–0.97; p < 0.001). In addition, baseline LV GLS in myocarditis resulted predictive of non-sustained ventricular tachycardias (cut-off value > −12%; sensitivity84%; specificity74.4%; AUC = 0.75). Parameters of myocardial longitudinal deformation are importantly associated with the presence of a scar on CMR and are predictors of functional outcome and ventricular arrhythmias in patients with acute myocarditis. Their assessment during ultrasound examination should be considered to get more information about the prognosis and risk stratification of this subset of patients.

Published
2022

11. Echocardiographic reference ranges for normal left ventricular layer-specific strain: results from the EACVI NORRE study

Author

Erwan Donal, Ralph Stephan von Bardeleben, Jose David Rodrigo Carbonero, Maurizio Galderisi, Simona Sperlongano, Monica Rosca, Caroline Piette, Roberta Manganaro, Daniele Barone, Adriana Postolache, Gonzalo de la Morena, Ciro Santoro, Federica Ilardi, Teresa López, George Kacharava, Bogdan A. Popescu, Monica Baroni, Elena Galli, Patrizio Lancellotti, Toshimitsu Tsugu, Julien Magne, Yun Yun Go, Dragos Vinereanu, Nuno Cardim, Marie Moonen, Julien Tridetti, Andreea Calin, José Luis Zamorano, Tolga Ozyigit, Krasimira Hristova, Martin Penicka, Mai-Linh Nguyen Trung, Bernard Cosyns, Raluca Elena Dulgheru, Alexandra Maria Chitroceanu, Tadafumi Sugimoto, George Athanassopoulos, Luigi P. Badano, Nico Van de Veire, Roberto M. Lang, Andreas Hagendorff, Tsugu, Toshimitsu, Postolache, Adriana, Dulgheru, Raluca, Sugimoto, Tadafumi, Tridetti, Julien, Nguyen Trung, Mai-Linh, Piette, Caroline, Moonen, Marie, Manganaro, Roberta, Ilardi, Federica, Chitroceanu, Alexandra Maria, Sperlongano, Simona, Go, Yun Yun, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andrea, Hristova, Krasimira, Lopez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan A, Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Drago, Zamorano, Jose Lui, Rosca, Monica, Calin, Andreea, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi P, Lang, Roberto M, Lancellotti, Patrizio, Tsugu, T., Postolache, A., Dulgheru, R., Sugimoto, T., Tridetti, J., Trung, M. -L. N., Piette, C., Moonen, M., Manganaro, R., Ilardi, F., Chitroceanu, A. M., Sperlongano, S., Go, Y. Y., Kacharava, G., Athanassopoulos, G. D., Barone, D., Baroni, M., Cardim, N., Hagendorff, A., Hristova, K., Lopez, T., de la Morena, G., Popescu, B. A., Penicka, M., Ozyigit, T., Carbonero, J. D. R., van de Veire, N., von Bardeleben, R. S., Vinereanu, D., Zamorano, J. L., Rosca, M., Calin, A., Magne, J., Cosyns, B., Galli, E., Donal, E., Santoro, C., Galderisi, M., Badano, L. P., Lang, R. M., Lancellotti, P., Clinical sciences, Cardio-vascular diseases, Cardiology, GIGA [Université Liège], Université de Liège, CHU Limoges, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), GE Healthcare and Philips Healthcare, Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Tsugu, T, Postolache, A, Dulgheru, R, Sugimoto, T, Tridetti, J, Nguyen Trung, M, Piette, C, Moonen, M, Manganaro, R, Ilardi, F, Chitroceanu, A, Sperlongano, S, Go, Y, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, de la Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, van de Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Rosca, M, Calin, A, Magne, J, Cosyns, B, Galli, E, Donal, E, Santoro, C, Galderisi, M, Badano, L, Lang, R, and Lancellotti, P

Subjects
Adult, Male, medicine.medical_specialty, adult echocardiography, deformation imaging, Heart Ventricles, 030204 cardiovascular system & hematology, Ventricular Function, Left, Reference values, 2D echocardiography, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, reference values, Healthy volunteers, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Endocardium, Normal range, Strain (chemistry), business.industry, Myocardium, Healthy subjects, reference value, Mean age, General Medicine, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Middle Aged, Apex (geometry), Echocardiography, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, business, Large group, Cardiology and Cardiovascular Medicine, Human
Abstract

Aims To obtain the normal range for 2D echocardiographic (2DE) measurements of left ventricular (LV) layer-specific strain from a large group of healthy volunteers of both genders over a wide range of ages. Methods and results A total of 287 (109 men, mean age: 46 ± 14 years) healthy subjects were enrolled at 22 collaborating institutions of the EACVI Normal Reference Ranges for Echocardiography (NORRE) study. Layer-specific strain was analysed from the apical two-, three-, and four-chamber views using 2DE software. The lowest values of layer-specific strain calculated as ±1.96 standard deviations from the mean were −15.0% in men and −15.6% in women for epicardial strain, −16.8% and −17.7% for mid-myocardial strain, and −18.7% and −19.9% for endocardial strain, respectively. Basal-epicardial and mid-myocardial strain decreased with age in women (epicardial; P = 0.008, mid-myocardial; P = 0.003) and correlated with age (epicardial; r = −0.20, P = 0.007, mid-myocardial; r = −0.21, P = 0.006, endocardial; r = −0.23, P = 0.002), whereas apical-epicardial, mid-myocardial strain increased with the age in women (epicardial; P = 0.006, mid-myocardial; P = 0.03) and correlated with age (epicardial; r = 0.16, P = 0.04). End/Epi ratio at the apex was higher than at the middle and basal levels of LV in men (apex; 1.6 ± 0.2, middle; 1.2 ± 0.1, base 1.1 ± 0.1) and women (apex; 1.6 ± 0.1, middle; 1.1 ± 0.1, base 1.2 ± 0.1). Conclusion The NORRE study provides useful 2DE reference ranges for novel indices of layer-specific strain.

Published
2020
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12. Echocardiographic reference ranges for normal non-invasive myocardial work indices: results from the EACVI NORRE study

Author

Stella Marchetta, Anne Bernard, Ralph Stephan von Bardeleben, Elena Galli, Tadafumi Sugimoto, Concetta Zito, Maurizio Galderisi, Sébastien Robinet, Daniele Barone, Sara Cimino, Monica Baroni, Tolga Ozyigit, Yun Yun Go, Bernard Cosyns, Roberta Manganaro, Marie Moonen, Ciro Santoro, George Athanassopoulos, Gonzalo de la Morena, Scipione Carerj, Andreas Hagendorff, Erwan Donal, José Luis Zamorano, Nico Van de Veire, Federica Ilardi, Patrizio Lancellotti, Dragos Vinereanu, Bogdan A. Popescu, Monica Rosca, Raluca Elena Dulgheru, Krasimira Hristova, Nuno Cardim, Jose David Rodrigo Carbonero, Roberto M. Lang, Teresa López-Fernández, Luigi P. Badano, Andreea Calin, Cécile Oury, Julien Magne, Martin Penicka, George Kacharava, Clinical sciences, Cardio-vascular diseases, Cardiology, Manganaro, R, Marchetta, S, Dulgheru, R, Ilardi, F, Sugimoto, T, Robinet, S, Cimino, S, Go, Y, Bernard, A, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, López-Fernández, T, de la Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, van de Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Rosca, M, Calin, A, Moonen, M, Magne, J, Cosyns, B, Galli, E, Donal, E, Carerj, S, Zito, C, Santoro, C, Galderisi, M, Badano, L, Lang, R, Oury, C, Lancellotti, P, Centre Hospitalier Universitaire de Liège (CHU-Liège), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Universität Leipzig [Leipzig], Universidad de Alcalá - University of Alcalá (UAH), Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), In vivo Cellular and Molecular Imaging Laboratory, Vrije Universiteit Brussel (VUB), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Messina, GE Healthcare, EACVI Research and Innovation Committee, Heart House, NORRE, Philips Healthcare, Manganaro, R., Marchetta, S., Dulgheru, R., Ilardi, F., Sugimoto, T., Robinet, S., Cimino, S., Go, Y. Y., Bernard, A., Kacharava, G., Athanassopoulos, G. D., Barone, D., Baroni, M., Cardim, N., Hagendorff, A., Hristova, K., Lopez-Fernandez, T., De La Morena, G., Popescu, B. A., Penicka, M., Ozyigit, T., Rodrigo Carbonero, J. D., Van De Veire, N., Von Bardeleben, R. S., Vinereanu, D., Zamorano, J. L., Rosca, M., Calin, A., Moonen, M., Magne, J., Cosyns, B., Galli, E., Donal, E., Carerj, S., Zito, C., Santoro, C., Galderisi, M., Badano, L. P., Lang, R. M., Oury, C., Lancellotti, P., Universität Leipzig, and Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, medicine.medical_specialty, adult echocardiography, Work efficiency, 030204 cardiovascular system & hematology, 2D echocardiography, 03 medical and health sciences, 0302 clinical medicine, Reference Values, Internal medicine, medicine.artery, Healthy volunteers, Medicine, Humans, Radiology, Nuclear Medicine and imaging, myocardial work, reference values, Prospective Studies, Brachial artery, adult echocardiography • 2D echocardiography • myocardial work • reference values, business.industry, Non invasive, Healthy subjects, reference value, Mean age, General Medicine, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Middle Aged, Europe, Blood pressure, Echocardiography, Heart Function Tests, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Large group, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing
Abstract

International audience; Aims - To obtain the normal ranges for 2D echocardiographic (2DE) indices of myocardial work (MW) from a large group of healthy volunteers over a wide range of ages and gender. Methods and results - A total of 226 (85 men, mean age: 45 ± 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from left ventricle (LV) pressure-strain loops. Peak LV systolic pressure was non-invasively derived from brachial artery cuff pressure. The lowest values of MW indices in men and women were 1270 mmHg% and 1310 mmHg% for GWI, 1650 mmHg% and 1544 mmHg% for GCW, and 90% and 91% for GWE, respectively. The highest value for GWW was 238 mmHg% in men and 239 mmHg% in women. Men had significant lower values of GWE and higher values of GWW. GWI and GCW significantly increased with age in women. Conclusion - The NORRE study provides useful 2DE reference ranges for novel indices of non-invasive MW.

Published
2019
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13. 3D echocardiographic reference ranges for normal left ventricular volumes and strain: results from the EACVI NORRE study

Author

Nico Van de Veire, Erwan Donal, Dragos Vinereanu, Federica Ilardi, Tolga Ozyigit, Christophe Martinez, Karima Addetia, Anne Bernard, José Luis Zamorano, Julien Magne, Andreas Hagendorff, Daniele Barone, Teresa López, Jose David Rodrigo Carbonero, Gonzalo de la Morena, Roberto M. Lang, George Athanassopoulos, Nuno Cardim, Monica Baroni, Luigi P. Badano, Ralph Stephan von Bardeleben, Bernard Cosyns, Natela Akhaladze, Martin Penicka, Patrizio Lancellotti, Tadafumi Sugimoto, Gilbert Habib, Raluca Elena Dulgheru, Krasimira Hristova, Bogdan A. Popescu, Luis Caballero, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA-Research), Université de Liège, Hospital Clínico Universitario Virgen de la Arrixaca = University Hospital Virgen de la Arrixaca [Murcia], CHU Limoges, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), University of Chicago, Cardio-vascular diseases, Clinical sciences, Bernard, A., Addetia, K., Dulgheru, R., Caballero, L., Sugimoto, T., Akhaladze, N., Athanassopoulos, G. D., Barone, D., Baroni, M., Cardim, N., Hagendorff, A., Hristova, K., Ilardi, F., Lopez, T., De La Morena, G., Popescu, B. A., Penicka, M., Ozyigit, T., Carbonero, J. D. R., Van De Veire, N., Von Bardeleben, R. S., Vinereanu, D., Zamorano, J. L., Martinez, C., Magne, J., Cosyns, B., Donal, E., Habib, G., Badano, L. P., Lang, R. M., Lancellotti, P., Bernard, A, Addetia, K, Dulgheru, R, Caballero, L, Sugimoto, T, Akhaladze, N, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Ilardi, F, Lopez, T, De La Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Carbonero, J, Van De Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Martinez, C, Magne, J, Cosyns, B, Donal, E, Habib, G, Badano, L, Lang, R, Lancellotti, P, Hospital Virgen de la Arrixaca, Murcia, Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Adult, Male, medicine.medical_specialty, Longitudinal strain, adult echocardiography, deformation imaging, Heart Ventricles, Cardiac Volume, Diastole, Echocardiography, Three-Dimensional, 030204 cardiovascular system & hematology, Ventricular Function, Left, Heart Ventricle, Reference values, 03 medical and health sciences, Young Adult, left ventricular function, 0302 clinical medicine, Internal medicine, Healthy volunteers, three-dimensional echocardiography, Medicine, Circumferential strain, Humans, Radiology, Nuclear Medicine and imaging, Reference Value, 030212 general & internal medicine, Systole, Aged, Ejection fraction, Strain (chemistry), business.industry, General Medicine, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Middle Aged, Healthy Volunteer, Healthy Volunteers, 3. Good health, Radiology Nuclear Medicine and imaging, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, business, Cardiology and Cardiovascular Medicine, Human
Abstract

International audience; Aim: To obtain the normal ranges for 3D echocardiography (3DE) measurement of left ventricular (LV) volumes, function, and strain from a large group of healthy volunteers. Methods and results: A total of 440 (mean age: 45 ± 13 years) out of the 734 healthy subjects enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study had good-quality 3DE data sets that have been analysed with a vendor-independent software package allowing homogeneous measurements regardless of the echocardiographic machine used to acquire the data sets. Upper limits of LV end-diastolic and end-systolic volumes were larger in men (97 and 42 mL/m2) than in women (82 and 35 mL/m2; P

Published
2017
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14. Arterial Hypertension in Aortic Valve Stenosis: A Critical Update

Author

Anna Franzone, Maria Lembo, Federica Ilardi, Maria Virginia Manzi, Costantino Mancusi, Ilaria Fucile, Christian Basile, Basile, C., Fucile, I., Lembo, M., Manzi, M. V., Ilardi, F., Franzone, A., and Mancusi, C.

Subjects
Aortic valve, medicine.medical_specialty, medicine.drug_class, Review, Afterload, Pharmacokinetics, Internal medicine, Medicine, echocardiography, Antihypertensive drug, left ventricular remodeling, business.industry, General Medicine, Stroke volume, medicine.disease, Stenosis, medicine.anatomical_structure, Aortic valve stenosis, Cardiology, antihypertensive drug, Sodium nitroprusside, business, medicine.drug, high blood pressure
Abstract

Aortic stenosis (AS) is a very common valve disease and is associated with high mortality once it becomes symptomatic. Arterial hypertension (HT) has a high prevalence among patients with AS leading to worse left ventricle remodeling and faster degeneration of the valve. HT also interferes with the assessment of the severity of AS, leading to an underestimation of the real degree of stenosis. Treatment of HT in AS has not historically been pursued due to the fear of excess reduction in afterload without a possibility of increasing stroke volume due to the fixed aortic valve, but most recent evidence shows that several drugs are safe and effective in reducing BP in patients with HT and AS. RAAS inhibitors and beta-blockers provide benefit in selected populations based on their profile of pharmacokinetics and pharmacodynamics. Different drugs, on the other hand, have proved to be unsafe, such as calcium channel blockers, or simply not easy enough to handle to be recommended in clinical practice, such as PDE5i, MRA or sodium nitroprusside. The present review highlights all available studies on HT and AS to guide antihypertensive treatment.

Published
2021

15. The Role of Multimodality Imaging in Athlete’s Heart Diagnosis: Current Status and Future Directions

Author

Giovanni Benfari, Simona Sperlongano, Stefano Palermi, Vincenzo Russo, Francesca Renon, Francesco Giallauria, Antonello D'Andrea, Eduardo Bossone, Giuseppe Limongelli, Federica Ilardi, Flavio D'Ascenzi, D'Andrea, A., Sperlongano, S., Russo, V., D'Ascenzi, F., Benfari, G., Renon, F., Palermi, S., Ilardi, F., Giallauria, F., Limongelli, G., and Bossone, E.

Subjects
cardiomyopathies, medicine.medical_specialty, Myocarditis, Cardiac computed tomography, Cardiac magnetic resonance, stress echocardiography, Speckle tracking echocardiography, Disease, Review, sudden cardiac death, Sudden cardiac death, Strain, multimodality imaging, Internal medicine, medicine, Stress Echocardiography, echocardiography, Athlete’s heart, Cardiomyopathies, Echocardiography, Multimodality imaging, Stress echocardiography, Cardiomyopathie, business.industry, General Medicine, medicine.disease, Review article, medicine.anatomical_structure, Cardiology, Medicine, Differential diagnosis, business, athlete’s heart, Artery
Abstract

“Athlete’s heart” is a spectrum of morphological and functional changes which occur in the heart of people who practice physical activity. When athlete’s heart occurs with its most marked expression, it may overlap with a differential diagnosis with certain structural cardiac diseases, including cardiomyopathies, valvular diseases, aortopathies, myocarditis, and coronary artery anomalies. Identifying the underlying cardiac is essential to reduce the potential for sudden cardiac death. For this purpose, a spectrum of imaging modalities, including rest and exercise stress echocardiography, speckle tracking echocardiography, cardiac magnetic resonance, computed tomography, and nuclear scintigraphy, can be undertaken. The objective of this review article is to provide to the clinician a practical step-by-step approach, aiming at distinguishing between extreme physiology and structural cardiac disease during the athlete’s cardiovascular evaluation.

Published
2021

16. Extent of Cardiac Damage and Mortality in Patients Undergoing Transcatheter Aortic Valve Implantation

Author

Roberta Esposito, Anna Franzone, Luigi Di Serafino, Cristina Iapicca, Giovanni Esposito, Domenico Simone Castiello, Andrea Mariani, Attilio Leone, Federica Ilardi, Ciro Santoro, Marisa Avvedimento, Plinio Cirillo, Maria Scalamogna, Domenico Angellotti, Raffaele Piccolo, Avvedimento, M., Franzone, A., Leone, A., Piccolo, R., Castiello, D. S., Ilardi, F., Mariani, A., Esposito, R., Iapicca, C., Angellotti, D., Scalamogna, M., Santoro, C., Di Serafino, L., Cirillo, P., and Esposito, G.

Subjects
medicine.medical_specialty, Tricuspid valve, business.industry, Mortality rate, Diastole, General Medicine, staging, medicine.disease, mortality, Article, Stenosis, medicine.anatomical_structure, Internal medicine, Mitral valve, medicine, Cardiology, Risk of mortality, cardiovascular system, Medicine, cardiac damage, Myocardial infarction, Stage (cooking), business, transcatheter aortic valve implantation
Abstract

(1) Aims: We sought to assess the impact of the extent of cardiac damage on survival among real-world patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). (2) Methods: A staging classification was applied to 262 patients from the EffecTAVI Registry at baseline and re-assessed within 30-days after TAVI. The primary endpoint of the study was all-cause mortality at 1-year. Secondary endpoints included cerebrovascular accident, myocardial infarction, permanent pacemaker implantation, endocarditis, and re-hospitalization for all causes. (3) Results: At baseline, 23 (8.7%) patients were in Stage 0/1 (no cardiac damage/left ventricular damage), 106 (40.4%) in Stage 2 (left atrial or mitral valve damage), 59 (22.5%) in Stage 3 (pulmonary vasculature or tricuspid valve damage) and 74 (28.3%) in Stage 4 (right ventricular damage). At 30-days after TAVI, a lower prevalence of advanced stages of cardiac damage than baseline, mainly driven by a significant improvement in left ventricular diastolic parameters and right ventricular function, was reported. At 1-year, a stepwise increase in mortality rates was observed according to staging at baseline: 4.3% in Stage 0/1, 6.6% in Stage 2, 18.6% in Stage 3 and 21.6% in Stage 4 (p = 0.08). No differences were found in secondary endpoints. (4) Conclusions: TAVI has an early beneficial impact on the left ventricular diastolic and right ventricular function. However, the extent of cardiac damage at baseline significantly affects the risk of mortality at 1-year after the procedure.

Published
2021

17. An Emergent Form of Cardiotoxicity: Acute Myocarditis Induced by Immune Checkpoint Inhibitors

Author

Federica Ilardi, Mario Enrico Canonico, Maria Prastaro, Giovanni Esposito, Vittoria Cuomo, Roberta Esposito, Silvia Orefice, Francesco De Stefano, L Fiorillo, Teresa Fedele, Ciro Santoro, Esposito, R., Fedele, T., Orefice, S., Cuomo, V., Prastaro, M., Canonico, M. E., Ilardi, F., De Stefano, F., Fiorillo, L., Santoro, C., and Esposito, G.

Subjects
medicine.medical_specialty, Myocarditis, cardio-oncology, Immune Checkpoint Inhibitor, Myocarditi, Review, 030204 cardiovascular system & hematology, Biochemistry, Pericardial effusion, Microbiology, immune checkpoint inhibitors, 03 medical and health sciences, Pericarditis, 0302 clinical medicine, Neoplasms, Immune-related adverse event, Medicine, Animals, Humans, cancer, Myocardial infarction, Intensive care medicine, Adverse effect, Molecular Biology, Cardiotoxicity, business.industry, Animal, Cancer, medicine.disease, QR1-502, Discontinuation, 030220 oncology & carcinogenesis, Acute Disease, Neoplasm, immune-related adverse events, myocarditis, business, Human
Abstract

Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that activate the immune system, aiming at enhancing antitumor immunity. ICIs have shown great promise in the treatment of several advanced malignancies. However, therapy with these immunomodulatory antibodies may lead to a wide spectrum of immune-related adverse events in any organ and any tissue. Cardiologic immune-related events include pericarditis, pericardial effusion, various types of arrhythmias including the occurrence of complete atrioventricular block, myocardial infarction, heart failure, and myocarditis. Although relatively rare, myocarditis is associated with a very high reported mortality in comparison to other adverse events. Myocarditis often presents significant diagnostic complexity and may be under-recognized. When confronted with an unexpected change in the clinical picture, the physician must differentiate between immune-related adverse events, cancer worsening, or other causes unrelated to the cancer or its therapy. However, this is not always easy. Therefore, with the increasing use of checkpoint inhibitors in cancer, all providers who care for patients with cancer should be made aware of this rare, but potentially fatal, cardiologic immune-related adverse event, and able to recognize when prompt consultation with a cardiologist specialist is indicated. In this review, we evaluate currently available scientific evidence and discuss clinical manifestations and new potential approaches to the diagnosis and therapy of acute myocarditis induced by ICIs. Temporary or permanent discontinuation of the ICIs and high-dose steroids have been administered to treat myocarditis, but symptoms may worsen in some patients despite therapy.

Published
2021

18. Myocardial work by echocardiography: Principles and applications in clinical practice

Author

Federica Ilardi, Antonello D’Andrea, Flavio D’Ascenzi, Francesco Bandera, Giovanni Benfari, Roberta Esposito, Alessandro Malagoli, Giulia Elena Mandoli, Ciro Santoro, Vincenzo Russo, Mario Crisci, Giovanni Esposito, Matteo Cameli, on behalf of the Working Group of Echocardiography of the Italian Society of Cardiology (SIC), Ilardi, F., D'Andrea, A., D'Ascenzi, F., Bandera, F., Benfari, G., Esposito, R., Malagoli, A., Mandoli, G. E., Santoro, C., Russo, V., Crisci, M., Esposito, G., and Cameli, M.

Subjects
medicine.medical_specialty, Pressure-strain loop, Ejection fraction, Longitudinal strain, business.industry, Myocardial function, Myocardial work, Pressure-strain loops, Speckle tracking, Strain, Work (physics), Objective method, Review, General Medicine, Systolic function, Clinical Practice, Internal medicine, pressure-strain loops, medicine, Cardiology, Medicine, business
Abstract

Left ventricular (LV) global longitudinal strain (GLS) has established itself in the last decade as a reliable, more objective method for the evaluation of LV systolic function, able to detect subtle abnormalities in LV contraction even in the presence of preserved ejection fraction (EF). However, recent studies have demonstrated that GLS, similar to LV EF, has important load dependency. Non-invasive myocardial work (MW) quantification has emerged in the last years as an alternative tool for myocardial function assessment. This new method, incorporating measurement of strain and LV pressure, has shown to overcome GLS and LV EF limitations and provide a loading-independent evaluation of myocardial performance. The presence of a commercially available echocardiographic software for the non-invasive MW calculation has allowed the application of this new method in different settings. This review sought to provide an overview on the current knowledge of non-invasive MW estimation, showing its potential applications and possible added value in clinical practice.

Published
2021

19. Left ventricular deformation and vortex analysis in heart failure: From ultrasound technique to current clinical application

Author

Roberta Bottino, Francesco Giallauria, Marco Di Maio, Federica Ilardi, Valeria Pergola, Eduardo Bossone, Vincenzo Russo, Paolo Golino, Donato Mele, Andreina Carbone, Antonello D'Andrea, Simona Sperlongano, Sperlongano, S., D'Andrea, A., Mele, D., Russo, V., Pergola, V., Carbone, A., Ilardi, F., Di Maio, M., Bottino, R., Giallauria, F., Bossone, E., and Golino, P.

Subjects
cardiac resynchronization therapy (CRT), medicine.medical_specialty, Medicine (General), medicine.medical_treatment, Clinical Biochemistry, Cardiac resynchronization therapy, Speckle tracking echocardiography, Context (language use), Review, 030204 cardiovascular system & hematology, Intracardiac injection, Color Doppler flow mapping (CDFM), 03 medical and health sciences, 0302 clinical medicine, R5-920, Internal medicine, medicine, Speckle tracking echocardiography (STE), 030212 general & internal medicine, Modalities, business.industry, Ultrasound, Heart failure with preserved ejection fraction (HFpEF), medicine.disease, Review article, Left ventricular vortex, Left ventricular strain, Heart failure (HF), Cardiac resyn-chronization therapy (CRT), Heart failure, Cardiology, color Doppler flow mapping (CDFM), heart failure (HF), heart failure with preserved ejection fraction (HFpEF), left ventricular strain, left ventricular vortex, speckle tracking echocardiography (STE), business
Abstract

Heart failure (HF) is a leading cause of cardiovascular morbidity and mortality. However, its symptoms and signs are not specific or can be absent. In this context, transthoracic echocardiography plays a key role in diagnosing the various forms of HF, guiding therapeutic decision making and monitoring response to therapy. Over the last few decades, new ultrasound modalities have been introduced in the field of echocardiography, aiming at better understanding the morpho-functional abnormalities occurring in cardiovascular diseases. However, they are still struggling to enter daily and routine use. In our review article, we turn the spotlight on some of the newest ultrasound technologies; in particular, analysis of myocardial deformation by speckle tracking echocardiography, and intracardiac flow dynamics by color Doppler flow mapping, highlighting their promising applications to HF diagnosis and management. We also focus on the importance of these imaging modalities in the selection of responses to cardiac resynchronization therapy.

Published
2021

20. Biventricular dysfunction and lung congestion in athletes on anabolic androgenic steroids: a speckle tracking and stress lung echocardiography analysis

Author

Andreina Carbone, Francesco Giallauria, Michele D'Alto, Eduardo Bossone, Antonello D'Andrea, Marco Di Maio, Eugenio Picano, Vincenzo Russo, Lucia Riegler, Simona Sperlongano, Juri Radmilovic, Federica Ilardi, D'Andrea, A., Radmilovic, J., Russo, V., Sperlongano, S., Carbone, A., Di Maio, M., Ilardi, F., Riegler, L., D'Alto, M., Giallauria, F., Bossone, E., Picano, E., D'Andrea, Antonello, Radmilovic, Juri, Russo, Vincenzo, Sperlongano, Simona, Carbone, Andreina, Di Maio, Marco, Ilardi, Federica, Riegler, Lucia, D'Alto, Michele, Giallauria, Francesco, Bossone, Eduardo, and Picano, Eugenio

Subjects
Male, medicine.medical_specialty, Epidemiology, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, Doppler echocardiography, Athlete’s heart, 030218 nuclear medicine & medical imaging, Strain, 03 medical and health sciences, 0302 clinical medicine, Athlete, Internal medicine, medicine.artery, medicine, Doping, Humans, Mass index, Athlete's heart, Lung, Steroid, Anabolic–androgenic steroids abuse, Ejection fraction, medicine.diagnostic_test, business.industry, Anabolic-androgenic steroids abuse, Blood pressure, medicine.anatomical_structure, Athletes, Echocardiography, Pulmonary artery, Cardiology, Right ventricle, Steroids, Exercise stress echocardiography, Cardiology and Cardiovascular Medicine, business, Sport training, Human, Echocardiography, Stress
Abstract

Aims The real effects of the chronic consumption of anabolic-androgenic steroids (AASs) on cardiovascular structures are subjects of intense debate. The aim of the study was to detect by speckle tracking echocardiography (STE) right ventricular (RV) and left ventricular (LV) dysfunction at rest and during exercise stress echocardiography (ESE) in athletes abusing AAS. Methods and results One hundred and fifteen top-level competitive bodybuilders were selected (70 males), including 65 athletes misusing AAS for at least 5 years (users), 50 anabolic-free bodybuilders (non-users), compared to 50 age- and sex-matched healthy sedentary controls. Standard Doppler echocardiography, STE analysis, and lung ultrasound at rest and at peak supine-bicycle ESE were performed. Athletes showed increased LV mass index, wall thickness, and RV diameters compared with controls, whereas LV ejection fraction was comparable within the groups. left atrial volume index, LV and RV strain, and LV E/Em were significantly higher in AAS users. Users showed more B-lines during stress (median 4.4 vs. 1.25 in controls and 1.3 in non-users, P Conclusions In athletes abusing steroids, STE analysis showed an impaired RV systolic deformation, closely associated with reduced functional capacity during physical effort, and—during exercise—more pulmonary congestion.

Published
2021

21. Impaired myocardial work efficiency in heart failure with preserved ejection fraction

Author

Matteo Cameli, Ciro Santoro, Giovanni Benfari, Francesco Bandera, Vincenzo Russo, Antonello D'Andrea, Michele D'Alto, Federica Ilardi, Alessandro Malagoli, Roberta Esposito, Giulia Elena Mandoli, Flavio D'Ascenzi, D'Andrea, A., Ilardi, F., D'Ascenzi, F., Bandera, F., Benfari, G., Esposito, R., Malagoli, A., Mandoli, G. E., Santoro, C., Russo, V., D'Alto, M., and Cameli, M.

Subjects
heart failure with preserved ejection fraction, medicine.medical_specialty, Longitudinal strain, contractile reserve, myocardial work, stress echocardiography, two-dimensional strain, Diastole, Female, Heart Ventricles, Humans, Stroke Volume, Ventricular Function, Left, Heart Failure, Ventricular Dysfunction, Left, Left, Work efficiency, Heart Ventricle, Internal medicine, Stress Echocardiography, Ventricular Dysfunction, Medicine, Ventricular Function, Radiology, Nuclear Medicine and imaging, Mass index, Subclinical infection, Ejection fraction, business.industry, General Medicine, Concomitant, Cardiology, Cardiology and Cardiovascular Medicine, business, Heart failure with preserved ejection fraction, Human
Abstract

Aims Heart failure with preserved ejection fraction (HFpEF) is a growing public health problem. Impairment in left ventricular (LV) diastolic function has been proposed as a key pathophysiologic determinant. However, the role of concomitant systolic dysfunction despite preserved LV ejection fraction (LVEF) has not been well characterized. To analyse LV myocardial deformation, diastolic function, and contractile reserve (CR) in patients with HFpEF at rest and while during exercise, as well as their correlation with functional capacity. Methods and results Standard echo, lung ultrasound, LV 2D speckle-tracking strain, and myocardial work efficiency (MWE) were performed at rest and during exercise in 230 patients with HFpEF (female sex 61.2%; 71.3 ± 5.3 years) in 150 age- and sex-comparable healthy controls. LV mass index and LAVI were significantly increased in HFpEF. Conversely, global longitudinal strain (GLS) and MWE were consequently reduced in HFpEF patients. During effort, HFpEF showed reduced exercise time, capacity, and VO2 peak. Increase in LVEF and LV GLS was significantly lower in HFpEF patients, while LV E/e′ ratio, pulmonary pressures, and B-lines by lung ultrasound rose. A multivariable analysis outlined that LV MWE at rest was closely related to maximal Watts reached (beta coefficient: 0.43; P Conclusions The lower resting values of LV GLS and MWE in HFpEF patients suggest an early subclinical myocardial damage, which seems to be closely associated with lower exercise capacity, greater pulmonary congestion, and blunted LV contractile reserve during effort.

Published
2021

22. Correlation between non-invasive myocardial work indices and main parameters of systolic and diastolic function

Author

Arnaud Ancion, Ciro Santoro, Roberto M. Lang, Krasimira Hristova, Dragos Vinereanu, Patrizio Lancellotti, Marie Moonen, Maurizio Galderisi, George Kacharava, José Luis Zamorano, Daniele Barone, Andreas Hagendorff, Julien Magne, Christophe Martinez, Bernard Cosyns, Nico Van de Veire, Monica Baroni, Tolga Ozyigit, Toshimitsu Tsugu, Nuno Cardim, Raluca Elena Dulgheru, Ralph Stephan von Bardeleben, Gonzalo de la Morena, Concetta Zito, Scipione Carerj, Luigi P. Badano, Elena Galli, Martin Penicka, George Athanassopoulos, Bogdan A. Popescu, Erwan Donal, Jose David Rodrigo Carbonero, Adriana Postolache, Federica Ilardi, Monica Rosca, Teresa López, Andreea Calin, Marianna Cicenia, Tadafumi Sugimoto, Roberta Manganaro, Stella Marchetta, Clinical sciences, Cardio-vascular diseases, Cardiology, Manganaro, Roberta, Marchetta, Stella, Dulgheru, Raluca, Sugimoto, Tadafumi, Tsugu, Toshimitsu, Ilardi, Federica, Cicenia, Marianna, Ancion, Arnaud, Postolache, Adriana, Martinez, Christophe, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andrea, Hristova, Krasimira, Lopez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan A, Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Drago, Zamorano, Jose Lui, Rosca, Monica, Calin, Andreea, Moonen, Marie, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Carerj, Scipione, Zito, Concetta, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi P, Lang, Roberto M, Lancellotti, Patrizio, Centre Hospitalier Universitaire de Liège (CHU-Liège), Service de cardiologie [Liège], CHU de Liège-Domaine Universitaire du Sart Tilman, Universität Leipzig [Leipzig], Hospital Univeristario Virgen de la Arrixaca, Johannes Gutenberg - Universität Mainz (JGU), University and Emergency Hospital, Universidad de Alcalá - University of Alcalá (UAH), Service de cardiologie [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Academisch Ziekenhuis Vrije Universiteit Brussel, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Messina, Università degli studi di Napoli Federico II, GE Healthcare and Philips Healthcare, Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de cardiologie et maladies vasculaires [CHU de Rennes], Manganaro, R, Marchetta, S, Dulgheru, R, Sugimoto, T, Tsugu, T, Ilardi, F, Cicenia, M, Ancion, A, Postolache, A, Martinez, C, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, de la Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, van de Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Rosca, M, Calin, A, Moonen, M, Magne, J, Cosyns, B, Galli, E, Donal, E, Carerj, S, Zito, C, Santoro, C, Galderisi, M, Badano, L, Lang, R, and Lancellotti, P

Subjects
Adult, Male, medicine.medical_specialty, Systole, adult echocardiography, Diastole, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, myocardial strain, myocardial work, speckle tracking echocardiography, Ventricular Function, Left, Correlation, Ventricular Dysfunction, Left, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Ejection fraction, business.industry, Work (physics), Stroke Volume, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, General Medicine, Middle Aged, medicine.anatomical_structure, Blood pressure, Echocardiography, Ventricle, Cardiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cardiology and Cardiovascular Medicine, business
Abstract

Aims The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and diastolic function by 2D echocardiography (2DE). Methods and results A total of 226 (85 men, mean age: 45 ± 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from LV pressure-strain loops using custom software. Peak LV pressure was estimated non-invasively from brachial artery cuff pressure. LV size, parameters of systolic and diastolic function and ventricular-arterial coupling were measured by echocardiography. As advanced indices of myocardial performance, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained. On multivariable analysis, GWI was significantly correlated with GLS (standardized beta-coefficient = −0.23, P Conclusion The non-invasive MW indices show a good correlation with traditional 2DE parameters of myocardial systolic function and myocardial strain.

Published
2020
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23. Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study

Author

Roberta Esposito, Andreea Motoc, Giuseppe Sammarco, Tomas Lapinskas, Sorina Mihaila Baldea, Tor Biering-Sørensen, Žanna Pičkure, Svetlin Netkov Tsonev, István Szabó, Anja Zupan Mežnar, Gergely Ágoston, Giovanna Di Giannuario, Katja Ažman Juvan, Giovanni Benfari, Guillem Casas, Artem Kalinin, Sergio Mondillo, Flemming Javier Olsen, Alessandro Salustri, Dragos Vinereanu, Savvas Loizos, Elena Galli, Augustine Coisne, Marcelo Haertel Miglioranza, Roberta Ancona, Jolanta Vaskelyte, Mihaela Maria Opris, Erwan Donal, Gerolamo Sibilio, Maria Concetta Pastore, Ciro Santoro, Galal Abushahba, Laura Galian-Gay, Salvatore Comenale Pinto, Vlatka Rešković Lukšić, Błażej Michalski, Maurizio Galderisi, Constantinos Hristou Papadopoulos, Riitta Paakkanen, Federica Ilardi, Dosen Dejan, Bernard Cosyns, R Dulgheru, Amandine Coppin, Martin Penicka, Doralisa Morrone, Dan Octavian Nistor, Krasimira Hristova, Asim Katbeh, Giulia Elena Mandoli, Fiorella Devito, Leonardo Griseli, Philippe Mortelmans, Thor Edvardsen, Caroline M. Van De Heyning, Bogdan A. Popescu, Karolina Kupczyńska, Matteo Cameli, Iacopo Fabiani, Julien Magne, Denisa Muraru, Cameli, Matteo, Miglioranza, Marcelo Haertel, Magne, Julien, Mandoli, Giulia Elena, Benfari, Giovanni, Ancona, Roberta, Sibilio, Gerolamo, Reskovic Luksic, Vlatka, Dejan, Dosen, Griseli, Leonardo, Van De Heyning, Caroline M., Mortelmans, Philippe, Michalski, Blazej, Kupczynska, Karolina, Di Giannuario, Giovanna, Devito, Fiorella, Dulgheru, Raluca, Ilardi, Federica, Salustri, Alessandro, Abushahba, Galal, Morrone, Doralisa, Fabiani, Iacopo, Penicka, Martin, Katbeh, Asim, Sammarco, Giuseppe, Esposito, Roberta, Santoro, Ciro, Pastore, Maria Concetta, Comenale Pinto, Salvatore, Kalinin, Artem, Pičkure, Žanna, Ažman Juvan, Katja, Zupan Mežnar, Anja, Coisne, Augustine, Coppin, Amandine, Opris, Mihaela Maria, Nistor, Dan Octavian, Paakkanen, Riitta, Biering-Sørensen, Tor, Olsen, Flemming Javier, Lapinskas, Toma, Vaškelyté, Jolanta Justina, Galian-Gay, Laura, Casas, Guillem, Motoc, Andreea Iulia, Papadopoulos, Constantinos Hristou, Loizos, Savva, Ágoston, Gergely, Szabó, Istvan, Hristova, Krasimira, Tsonev, Svetlin Netkov, Galli, Elena, Vinereanu, Drago, Mihaila Baldea, Sorina, Muraru, Denisa, Mondillo, Sergio, Donal, Erwan, Galderisi, Maurizio, Cosyns, Bernard, Edvardsen, Thor, Popescu, Bogdan A., University of Helsinki, HUS Heart and Lung Center, Helsinki University Hospital Area, Università degli Studi di Siena = University of Siena (UNISI), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire Brugmann [Bruxelles] (CHU), University of Oslo (UiO), University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Cameli, M, Miglioranza, M, Magne, J, Mandoli, G, Benfari, G, Ancona, R, Sibilio, G, Reskovic Luksic, V, Dejan, D, Griseli, L, Van De Heyning, C, Mortelmans, P, Michalski, B, Kupczynska, K, Di Giannuario, G, Devito, F, Dulgheru, R, Ilardi, F, Salustri, A, Abushahba, G, Morrone, D, Fabiani, I, Penicka, M, Katbeh, A, Sammarco, G, Esposito, R, Santoro, C, Pastore, M, Comenale Pinto, S, Kalinin, A, Pičkure, Ž, Ažman Juvan, K, Zupan Mežnar, A, Coisne, A, Coppin, A, Opris, M, Nistor, D, Paakkanen, R, Biering-Sørensen, T, Olsen, F, Lapinskas, T, Vaškelyté, J, Galian-Gay, L, Casas, G, Motoc, A, Papadopoulos, C, Loizos, S, Ágoston, G, Szabó, I, Hristova, K, Tsonev, S, Galli, E, Vinereanu, D, Mihaila Baldea, S, Muraru, D, Mondillo, S, Donal, E, Galderisi, M, Cosyns, B, Edvardsen, T, Popescu, B, CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical sciences, Faculty of Medicine and Pharmacy, Cardiology, and Cardio-vascular diseases

Subjects
medicine.medical_specialty, Clinical Biochemistry, CONSENSUS DOCUMENT, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, GUIDELINES, RECOMMENDATIONS, Article, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, QRS complex, 0302 clinical medicine, Interquartile range, DEFORMATION, Internal medicine, Medicine, speckle tracking echocardiography, AMERICAN SOCIETY, reference point, EACVI/ASE/INDUSTRY TASK-FORCE, EUROPEAN ASSOCIATION, standardization, left atrial strain, multi-centric study, Reproducibility, Mitral regurgitation, lcsh:R5-920, business.industry, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, medicine.disease, DYSFUNCTION, Stenosis, Heart failure, 3121 General medicine, internal medicine and other clinical medicine, Cardiology, Population study, HEART-FAILURE, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Human medicine, Left atrial strain, Multi-centric study, Reference point, Standardization, Cardiology and Cardiovascular Medicine, business, lcsh:Medicine (General)
Abstract

International audience; Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume–pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference.

Published
2020
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24. Outcomes of Patients With Asymptomatic Aortic Stenosis Followed Up in Heart Valve Clinics

Author

Shizhen Liu, Andrea Rossi, Elena Galli, Erwan Donal, Gilbert Habib, Stefano Nistri, Thomas Modine, Augustin Coisne, Julien Magne, Raluca Elena Dulgheru, Jeroen J. Bax, Raphael Rosenhek, Madalina Garbi, Marie-Annick Clavel, Linda D. Gillam, John C. Chambers, Victoria Delgado, David Montaigne, Philippe Pibarot, Khalil Fattouch, E. Mara Vollema, Mani A. Vannan, Stella Marchetta, Romain Capoulade, Federica Ilardi, Laurent Davin, Bernard Cosyns, Olivier Gach, Guy Lloyd, Anne Bernard, Stephane Lafitte, Lionel Tastet, Luc Pierard, Patrizio Lancellotti, Cécile Oury, Marc Radermecker, Robert Zilberszac, Clinical sciences, Cardio-vascular diseases, Cardiology, Lancellotti, P., Magne, J., Dulgheru, R., Clavel, M. -A., Donal, E., Vannan, M. A., Chambers, J., Rosenhek, R., Habib, G., Lloyd, G., Nistri, S., Garbi, M., Marchetta, S., Fattouch, K., Coisne, A., Montaigne, D., Modine, T., Davin, L., Gach, O., Radermecker, M., Liu, S., Gillam, L., Rossi, A., Galli, E., Ilardi, F., Tastet, L., Capoulade, R., Zilberszac, R., Vollema, E. M., Delgado, V., Cosyns, B., Lafitte, S., Bernard, A., Pierard, L. A., Bax, J. J., Pibarot, P., Oury, C., Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA-Research), Université de Liège, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Quebec Heart and Lung Institute, Université Laval [Québec] (ULaval), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Guy's and St Thomas' Hospitals, Medizinische Universität Wien = Medical University of Vienna, Aix Marseille Université (AMU), Assistance Publique - Hôpitaux de Marseille (APHM), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), King's Health Partners, Università degli studi di Palermo - University of Palermo, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Leiden University Medical Center (LUMC), Universiteit Leiden, CHU Bordeaux [Bordeaux], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and INSB-INSB-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, Registrie, United State, Canada, medicine.medical_specialty, 030204 cardiovascular system & hematology, Asymptomatic, Sudden death, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, Retrospective Studie, Internal medicine, medicine, Humans, Prospective Studies, Registries, 030212 general & internal medicine, Heart valve, Watchful Waiting, Prospective cohort study, Retrospective Studies, Aged, Aged, 80 and over, Asymptomatic Disease, Ejection fraction, business.industry, Disease Management, Aortic Valve Stenosis, Middle Aged, medicine.disease, Aortic Valve Stenosi, United States, 3. Good health, Europe, Prospective Studie, Stenosis, Death, Sudden, Cardiac, medicine.anatomical_structure, Aortic valve stenosis, Asymptomatic Diseases, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, medicine.symptom, business, Cardiology and Cardiovascular Medicine, Human
Abstract

International audience; Importance - The natural history and the management of patients with asymptomatic aortic stenosis (AS) have not been fully examined in the current era. Objective - To determine the clinical outcomes of patients with asymptomatic AS using data from the Heart Valve Clinic International Database. Design, setting, and participants - This registry was assembled by merging data from prospectively gathered institutional databases from 10 heart valve clinics in Europe, Canada, and the United States. Asymptomatic patients with an aortic valve area of 1.5 cm2 or less and preserved left ventricular ejection fraction (LVEF) greater than 50% at entry were considered for the present analysis. Data were collected from January 2001 to December 2014, and data were analyzed from January 2017 to July 2018. Main outcomes and measures - Natural history, need for aortic valve replacement (AVR), and survival of asymptomatic patients with moderate or severe AS at entry followed up in a heart valve clinic. Indications for AVR were based on current guideline recommendations. Results - Of the 1375 patients included in this analysis, 834 (60.7%) were male, and the mean (SD) age was 71 (13) years. A total of 861 patients (62.6%) had severe AS (aortic valve area less than 1.0 cm2). The mean (SD) overall survival during medical management (mean [SD] follow up, 27 [24] months) was 93% (1%), 86% (2%), and 75% (4%) at 2, 4, and 8 years, respectively. A total of 104 patients (7.6%) died under observation, including 57 patients (54.8%) from cardiovascular causes. The crude rate of sudden death was 0.65% over the duration of the study. A total of 542 patients (39.4%) underwent AVR, including 388 patients (71.6%) with severe AS at study entry and 154 (28.4%) with moderate AS at entry who progressed to severe AS. Those with severe AS at entry who underwent AVR did so at a mean (SD) of 14.4 (16.6) months and a median of 8.7 months. The mean (SD) 2-year and 4-year AVR-free survival rates for asymptomatic patients with severe AS at baseline were 54% (2%) and 32% (3%), respectively. In those undergoing AVR, the 30-day postprocedural mortality was 0.9%. In patients with severe AS at entry, peak aortic jet velocity (greater than 5 m/s) and LVEF (less than 60%) were associated with all-cause and cardiovascular mortality without AVR; these factors were also associated with postprocedural mortality in those patients with severe AS at baseline who underwent AVR (surgical AVR in 310 patients; transcatheter AVR in 78 patients). Conclusions and relevance - In patients with asymptomatic AS followed up in heart valve centers, the risk of sudden death is low, and rates of overall survival are similar to those reported from previous series. Patients with severe AS at baseline and peak aortic jet velocity of 5.0 m/s or greater or LVEF less than 60% have increased risks of all-cause and cardiovascular mortality even after AVR. The potential benefit of early intervention should be considered in these high-risk patients.

Published
2018
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25. Echocardiographic reference ranges for normal left atrial function parameters results from the EACVI NORRE study

Author

Tadafumi, Sugimoto, Sébastien, Robinet, Raluca, Dulgheru, Anne, Bernard, Federica, Ilardi, Laura, Contu, Karima, Addetia, Luis, Caballero, George, Kacharava, George D, Athanassopoulos, Daniele, Barone, Monica, Baroni, Nuno, Cardim, Andreas, Hagendorff, Krasimira, Hristova, Teresa, Lopez, Gonzalo, de la Morena, Bogdan A, Popescu, Martin, Penicka, Tolga, Ozyigit, Jose David, Rodrigo Carbonero, Nico, van de Veire, Ralph Stephan, Von Bardeleben, Dragos, Vinereanu, Jose Luis, Zamorano, Yun Yun, Go, Stella, Marchetta, Alain, Nchimi, Monica, Rosca, Andreea, Calin, Marie, Moonen, Sara, Cimino, Julien, Magne, Bernard, Cosyns, Elena, Galli, Erwan, Donal, Gilbert, Habib, Roberta, Esposito, Maurizio, Galderisi, Luigi P, Badano, Roberto M, Lang, Patrizio, Lancellotti, Centre Hospitalier Universitaire de Liège (CHU-Liège), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hospital Univeristario Virgen de la Arrixaca, Onassis Cardiac Surgery Center [Athens] (OCSC), Universität Leipzig [Leipzig], Universidad de Alcalá - University of Alcalá (UAH), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Timone [CHU - APHM] (TIMONE), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Hospital Clínico Universitario Virgen de la Arrixaca = University Hospital Virgen de la Arrixaca [Murcia], Universität Leipzig, CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical sciences, Cardio-vascular diseases, Cardiology, Sugimoto, T, Robinet, S, Dulgheru, R, Bernard, A, Ilardi, F, Contu, L, Addetia, K, Caballero, L, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, De La Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, Van De Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Go, Y, Marchetta, S, Nchimi, A, Rosca, M, Calin, A, Moonen, M, Cimino, S, Magne, J, Cosyns, B, Galli, E, Donal, E, Habib, G, Esposito, R, Galderisi, M, Badano, L, Lang, R, Lancellotti, P, Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Sugimoto, Tadafumi, Robinet, Sébastien, Dulgheru, Raluca, Bernard, Anne, Ilardi, Federica, Contu, Laura, Addetia, Karima, Caballero, Lui, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andrea, Hristova, Krasimira, Lopez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan A, Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Drago, Zamorano, Jose Lui, Go, Yun Yun, Marchetta, Stella, Nchimi, Alain, Rosca, Monica, Calin, Andreea, Moonen, Marie, Cimino, Sara, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Habib, Gilbert, Esposito, Roberta, Galderisi, Maurizio, Badano, Luigi P, Lang, Roberto M, and Lancellotti, Patrizio

Subjects
Male, deformation imaging, Pump function, Echocardiography, Three-Dimensional, Sex Factor, 030204 cardiovascular system & hematology, Cohort Studies, 0302 clinical medicine, Left atrial, Reference Values, Healthy volunteers, Image Processing, Computer-Assisted, Age Factor, adult echocardiography, left atrial function, reference values, 030212 general & internal medicine, Multivariate Analysi, Observer Variation, Healthy subjects, Age Factors, General Medicine, Middle Aged, Reference Standards, Healthy Volunteer, Healthy Volunteers, Homogeneous, Radiology Nuclear Medicine and imaging, Echocardiography, Cardiology, Linear Model, Atrial Function, Left, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, Human, Adult, medicine.medical_specialty, Statistics, Nonparametric, 03 medical and health sciences, Sex Factors, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Heart Atria, Left atrial function, business.industry, reference value, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Reference values, Multivariate Analysis, Linear Models, Reference Standard, Parameter, Cohort Studie, Large group, business
Abstract

International audience; Aims - To obtain the normal ranges for echocardiographic measurements of left atrial (LA) function from a large group of healthy volunteers accounting for age and gender. Methods and results - A total of 371 (median age 45 years) healthy subjects were enrolled at 22 collaborating institutions collaborating in the Normal Reference Ranges for Echocardiography (NORRE) study of the European Association of Cardiovascular Imaging (EACVI). Left atrial data sets were analysed with a vendor-independent software (VIS) package allowing homogeneous measurements irrespective of the echocardiographic equipment used to acquire data sets. The lowest expected values of LA function were 26.1%, 48.7%, and 41.4% for left atrial strain (LAS), 2D left atrial emptying fraction (LAEF), and 3D LAEF (reservoir function); 7.7%, 24.2%, and -0.53/s for LAS-active, LAEF-active, and LA strain rate during LA contraction (SRa) (pump function) and 12.0% and 21.6% for LAS-passive and LAEF-passive (conduit function). Left atrial reservoir and conduit function were decreased with age while pump function was increased. All indices of reservoir function and all LA strains had no difference in both gender and vendor. However, inter-vendor differences were observed in LA SRa despite the use of VIS. Conclusion - The NORRE study provides contemporary, applicable echocardiographic reference ranges for LA function. Our data highlight the importance of age-specific reference values for LA functions.

Published
2018
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26. Echocardiographic reference ranges for normal left ventricular 2D strain: results from the EACVI NORRE study

Author

Ralph Stephan von Bardeleben, José Luis Zamorano, Jose David Rodrigo Carbonero, Maurizio Galderisi, Daniele Barone, Monica Baroni, Erwan Donal, Gonzalo de la Morena, Krasimira Hristova, Federica Ilardi, Tolga Ozyigit, Laura Contu, Anne Bernard, Natela Akhaladze, Martin Penicka, Yun Yun Go, Nico Van de Veire, Karima Addetia, Stella Marchetta, Bernard Cosyns, Nuno Cardim, Luis Caballero, Julien Magne, Roberto M. Lang, Dragos Vinereanu, Raluca Elena Dulgheru, Luigi P. Badano, Patrizio Lancellotti, Andreas Hagendorff, Andrea Calin, Tadafumi Sugimoto, Monica Rosca, Gilbert Habib, George Athanassopoulos, Bogdan A. Popescu, Marie Moonen, Teresa López, Cardio-vascular diseases, Clinical sciences, Faculty of Medicine and Pharmacy, Centre Hospitalier Universitaire de Liège (CHU-Liège), Universität Leipzig [Leipzig], Johannes Gutenberg - Universität Mainz (JGU), Universidad de Alcalá - University of Alcalá (UAH), CHU Dupuytren, Academisch Ziekenhuis Vrije Universiteit Brussel, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Universita degli Studi di Padova, University of Chicago, GE Healthcare, Philips Healthcare, Universität Leipzig, Johannes Gutenberg - Universität Mainz = Johannes Gutenberg University (JGU), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Università degli Studi di Padova = University of Padua (Unipd), Sugimoto, T, Dulgheru, R, Bernard, A, Ilardi, F, Contu, L, Addetia, K, Caballero, L, Akhaladze, N, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, De La Morena, G, Popescu, B, Moonen, M, Penicka, M, Ozyigit, T, Carbonero, J, Van De Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Go, Y, Rosca, M, Calin, A, Magne, J, Cosyns, B, Marchetta, S, Donal, E, Habib, G, Galderisi, M, Badano, L, Lang, R, Lancellotti, P, Sugimoto, Tadafumi, Dulgheru, Raluca, Bernard, Anne, Ilardi, Federica, Contu, Laura, Addetia, Karima, Caballero, Lui, Akhaladze, Natela, Athanassopoulos, George D., Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andrea, Hristova, Krasimira, Lopez, Teresa, De La Morena, Gonzalo, Popescu, Bogdan A., Moonen, Marie, Penicka, Martin, Ozyigit, Tolga, Carbonero, Jose David Rodrigo, Van De Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Drago, Zamorano, Jose Lui, Go, Yun Yun, Rosca, Monica, Calin, Andrea, Magne, Julien, Cosyns, Bernard, Marchetta, Stella, Donal, Erwan, Habib, Gilbert, Galderisi, Maurizio, Badano, Luigi P., Lang, Roberto M., and Lancellotti, Patrizio

Subjects
Male, Longitudinal strain, deformation imaging, [SDV]Life Sciences [q-bio], Sex Factor, 030204 cardiovascular system & hematology, Standard deviation, Ventricular Function, Left, Heart Ventricle, 2D echocardiography, 0302 clinical medicine, Reference Values, Nuclear Medicine and Imaging, Image Processing, Computer-Assisted, Medicine, Circumferential strain, Age Factor, Reference Value, 030212 general & internal medicine, Multivariate Analysi, Adult echocardiography, Deformation imaging, Reference values, Radiology, Nuclear Medicine and Imaging, Cardiology and Cardiovascular Medicine, Observer Variation, Strain (chemistry), Age Factors, General Medicine, Middle Aged, Healthy Volunteer, Healthy Volunteers, Europe, Homogeneous, Echocardiography, Radiology Nuclear Medicine and imaging, Cardiology, Linear Model, Female, Radiology, Radial stress, Human, Adult, medicine.medical_specialty, adult echocardiography, Heart Ventricles, 03 medical and health sciences, Sex Factors, Internal medicine, Humans, Radiology, Nuclear Medicine and imaging, 2d strain, business.industry, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Multivariate Analysis, Linear Models, business
Abstract

International audience; Aims - To obtain the normal ranges for 2D echocardiographic (2DE) measurements of left ventricular (LV) strain from a large group of healthy volunteers accounting for age and gender. Methods and results - A total of 549 (mean age: 45.6 ± 13.3 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. 2DE data sets have been analysed with a vendor-independent software package allowing homogeneous measurements irrespective of the echocardiographic equipment used to acquire the data sets. The lowest expected values of LV strains and twist calculated as ± 1.96 standard deviations from the mean were -16.7% in men and -17.8% in women for longitudinal strain, -22.3% and -23.6% for circumferential strain, 20.6% and 21.5% for radial strain, and 2.2 degrees and 1.9 degrees for twist, respectively. In multivariable analysis, longitudinal strain decreased with age whereas the opposite occurred with circumferential and radial strain. Male gender was associated with lower strain for longitudinal, circumferential, and radial strain. Inter-vendor differences were observed for circumferential and radial strain despite the use of vendor-independent software. Importantly, no intervendor differences were noted in longitudinal strain. Conclusion - The NORRE study provides contemporary, applicable 2D echocardiographic reference ranges for LV longitudinal, radial, and circumferential strain. Our data highlight the importance of age- and gender-specific reference values for LV strain.

Published
2017
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27. What Does 3D Echocardiography Add to 2D Echocardiography in the Assessment of Mitral Regurgitation?

Author

Stella Marchetta, Raluca Elena Dulgheru, Federica Ilardi, Laura Contu, Tadafumi Sugimoto, Yun Yun Go, Patrizio Lancellotti, Sugimoto, T., Dulgheru, R., Marchetta, S., Ilardi, F., Contu, L., Go, Y. Y., and Lancellotti, P.

Subjects
medicine.medical_specialty, Echocardiography, Three-Dimensional, 030204 cardiovascular system & hematology, Assessment, Effective Regurgitant Orifice Area, 03 medical and health sciences, 0302 clinical medicine, 2d echocardiography, Mitral valve, Internal medicine, medicine, Humans, 030212 general & internal medicine, Heart valve, Mitral regurgitation, 3D echocardiography, Transoesophageal echocardiography, business.industry, Mitral Valve Insufficiency, Patient management, Echocardiography, Doppler, Color, Clinical Practice, medicine.anatomical_structure, Cardiology, Transcatheter procedure, Mitral Valve, Cardiology and Cardiovascular Medicine, business, 3d echocardiography, Human
Abstract

Purpose of Review: The purpose of this review was to elucidate the additional value of 3D echocardiography for the assessment of mitral regurgitation (MR) compared to standard 2D echocardiography. Recent Findings: 3D echocardiography provides key information, aetiology, degenerative mitral valve disease vs. secondary MR, causes and mechanism, severity by measurements of effective regurgitant orifice area and regurgitant volume; likelihood of reparability and assessment of pre- and intra-mitral valve transcatheter procedures. Summary: 3D echocardiography as a promising method for assessment of MR is useful and crucial for research, clinical practice and patient management in all heart valve team members.

Published
2017

28. Effects of antihypertensive therapy on glucose, insulin metabolism, left ventricular diastolic dysfunction and renin system in overweight and obese hypertensives

Author

Francesca Musella, Maria Leonarda De Rosa, Fabio Maresca, Federica Ilardi, Rossella Luciano, Carmen D'Amore, De Rosa, M. L., Musella, F., Ilardi, F., D'Amore, C., Luciano, R., Maresca, F., DE ROSA, MARIA LEONARDA, Francesca, Musella, Federica, Ilardi, Carmen, D'Amore, Rossella, Luciano, and Fabio, Maresca

Subjects
Amide, Blood Glucose, Male, medicine.medical_specialty, Medicine (General), Diastole, Overweight, Ventricular Function, Left, Renin-Angiotensin System, chemistry.chemical_compound, Endocrinology, R5-920, Fumarates, Internal medicine, Renin–angiotensin system, Renin, Internal Medicine, medicine, Humans, Insulin, Cardiac structure, Obesity, Antihypertensive Agents, Aged, Ultrasonography, business.industry, Fumarate, Biomarker, Aliskiren, Middle Aged, Amides, Antihypertensive Agent, chemistry, Hypertension, Cardiology, Left ventricular diastolic dysfunction, Female, Intravenous Glucose Tolerance Test, medicine.symptom, business, Biomarkers, Insulin metabolism, Human
Abstract

Background: We attempted to test the hypothesis that the direct renin inhibitor aliskiren can improve diastolic dysfunction, glucose, and insulin metabolism (GIM) in overweight and obese hypertensive patients. Methods and results: Seventy-eight hypertensive patients were divided into two groups: 38 treated with aliskiren for six months, and 40 treated without aliskiren but with only traditional anti-hypertensive therapy, as controls. Doppler mitral flow velocity patterns were assessed before and after aliskiren during a six-month period. GIM (three-hour intravenous glucose tolerance test) was measured after four to six weeks of washout and six months of treatment. The mitral E/A ratio increased from 0.65 ± 0.11 to 0.75 ± 0.19. None of the indexes changed in the control group. In the control group, GIM parameters, fasting glucose levels (5.3 ± 0.9 to 6.0 ± 1.5 mmol/l; p = 0.003), fasting insulin levels (121 ± 121 to 189 ± 228 pmol/l; p = 0.03), and most other relevant metabolic measures (p < 0.05 for all) significantly worsened. Aliskiren did not affect GIM. In the control group LVM/height was not affected (119 ± 12 to 120 ± 17 g/m; p = 0.8), whereas aliskiren significantly reduced LVM/height (120 ± 13 to 111 ± 19 g/m; p = 0.04). Conclusions: Optimal target BP was achieved in the group as a whole and in both obese patient groups, while benefits to cardiac structure were of a smaller magnitude. In high-risk, overweight/obese patients with hypertension, traditional therapy provides significantly greater BP- versus aliskiren-lowering throughout the 24-hour dosing interval. Therefore in obese, hypertensive individuals, adequate and similar blood pressure control was achieved with aliskiren; however, the aliskiren group and not the control group was associated with a more favorable GIM profile and led to a significant regression of LVM; overall aliskiren-based treatment offers sustained control of PRA. © 2014 The Author(s).

Published
2014

29. Total occlusion of the abdominal aorta in a patient with renal failure and refractory hypertension: a case report

Author

Fabio Magliulo, Laura Scudiero, Federica Ilardi, Gabriele G. Schiattarella, Giovanni Esposito, Maria Piera Petretta, Mario De Laurentis, Cinzia Perrino, Giuseppe Carotenuto, Perrino, Cinzia, Scudiero, L., Petretta, Mp, Schiattarella, Gg, De laurentis, M., Ilardi, F., Magliulo, F., Carotenuto, G., and Esposito, Giovanni

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Aortography, lcsh:Medicine, Arterial Occlusive Diseases, Inferior mesenteric artery, abdominal aorta, Iliac Artery, medicine.artery, Internal medicine, Occlusion, medicine, Humans, Right Renal Artery, Aorta, Abdominal, Renal Insufficiency, Aorta, medicine.diagnostic_test, business.industry, Abdominal aorta, lcsh:R, Middle Aged, Atherosclerosis, Bypass surgery, Cardiovascular and Metabolic Diseases, Angiography, Hypertension, Cardiology, Radiology, Cardiology and Cardiovascular Medicine, business
Abstract

Total occlusion of the abdominal aorta is unusual, and potentially catastrophic. It occurs in patients with advanced atherosclerotic occlusive disease, and can cause severe ischemic manifestations, depending on the site of obstruction. Prompt and appropriate diagnostic and therapeutic approaches are important whenever this condition is suspected, in order to avoid a fatal outcome. The development of a complex network of collaterals may prevent the manifestation of acute ischemic phenomena, and cause a delay in diagnosis and treatment. Here we report the clinical case of a 59-year-old man who was referred to our Department for evaluation of renal failure and refractory hypertension. Ultrasonography and 99mTc-DTPA scintigraphy showed a shrunken, non-functioning left kidney, while CT angiography and aortography showed the complete occlusion of the aorta from below the right renal artery down to the bifurcation of both common iliac arteries, with a critical stenosis of the origin of the right renal artery, an occlusion of the left renal artery as well as of the origin of the inferior mesenteric artery. The patient was referred to the surgery department for aorto-bifemoral bypass surgery and re-implantation of the right renal artery.

Published
2011

30. Changes and prognostic impact of noninvasive myocardial work indices in patients undergoing transcatheter aortic valve implantation.

Author

Ilardi F, Franzone A, Iapicca C, Manzo R, Angellotti D, Nappa D, Castiello DS, Mariani A, Santoro C, Avvedimento M, Leone A, D'Andrea A, Cirillo P, Spaccarotella C, Piccolo R, and Esposito G

Subjects
Humans, Male, Female, Aged, Retrospective Studies, Aged, 80 and over, Echocardiography, Registries, Prognosis, Treatment Outcome, Ventricular Function, Left, Severity of Illness Index, Aortic Valve surgery, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement mortality, Aortic Valve Stenosis surgery, Aortic Valve Stenosis physiopathology, Aortic Valve Stenosis mortality, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis complications
Abstract

Purpose: The prognostic significance of noninvasive myocardial work (MW) indices in patients undergoing transcatheter aortic valve implantation (TAVI) has not been adequately examined., Methods: We retrospectively selected 88 consecutive patients (mean age 79.9 ± 6.4 years, 40% males) with severe aortic stenosis scheduled for TAVI enrolled in the EffecTAVI registry. Exclusion criteria were prior valve surgery, atrial fibrillation, and left bundle branch block (LBBB) at baseline. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were measured by echocardiography at baseline and at 30 days. Accuracy of the noninvasive measures was assessed by invasive evaluation of MW., Results: In the overall population, a significant reduction in GWI (2406 ± 567 vs. 2063 ± 515 mmHg% before and after TAVI respectively, P  < 0.001), GCW (2783 ± 616 vs. 2380 ± 495 mmHg%, P  < 0.001) and GWW (238 ± 203 vs. 186 ± 135 mmHg%, P  = 0.015) was observed at 30 days after TAVI. GWE improved only in patients who did not develop left ventricular dyssynchrony due to new-onset LBBB or pacemaker implantation following TAVI. In a multivariable Cox-regression analysis, GWE after TAVI (hazard ratio 0.892, 95% confidence interval 0.81-0.97; P  = 0.011) was the strongest predictor of adverse events (a composite of all-cause death, worsening of dyspnea, or rehospitalization for cardiovascular events) at 1-year follow-up., Conclusions: TAVI results in significant changes in MW indices, including an early decrease in GWI, GCW and GWW, and an improvement in GWE in patients without left ventricle dyssynchrony. A GWE equal or less than 92% at 30 days is indicative of poor clinical outcomes at 1 year., (Copyright © 2024 Italian Federation of Cardiology - I.F.C. All rights reserved.)

Published
2024
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31. Echocardiographic and clinical features of patients developing prosthesis-patient mismatch after transcatheter aortic valve replacement: Insights from the Recovery-TAVR registry.

Author

Bruno F, Rampone JM, Islas F, Gorla R, Gallone G, Melillo F, Leone PP, Cimaglia P, Pastore MC, Franzone A, Landra F, Scudeler L, Jimenez-Quevedo P, Viva T, Piroli F, Bragato R, Trichilo M, Degiovanni A, Salizzoni S, Ilardi F, Andreis A, Nombela-Franco L, Tusa M, Toselli M, Conrotto F, Montorfano M, Manzo R, Cameli M, Patti G, Stefanini G, Testa L, La Torre M, Giannini F, Agricola E, Escaned J, De Filippo O, De Ferrari GM, and D'Ascenzo F

Subjects
Humans, Male, Female, Aged, 80 and over, Aged, Postoperative Complications epidemiology, Postoperative Complications etiology, Prosthesis Design, Aortic Valve surgery, Aortic Valve diagnostic imaging, Prosthesis Fitting, Transcatheter Aortic Valve Replacement adverse effects, Registries, Heart Valve Prosthesis adverse effects, Echocardiography methods, Aortic Valve Stenosis surgery
Abstract

Background: The impact of prosthesis-patient mismatch (PPM) on major endpoints after transcatheter aortic valve replacement (TAVR) is controversial and the effects on progression of heart damage are poorly investigated. Therefore, our study aims to evaluate the prevalence and predictors of PPM in a "real world" cohort of patients at intermediate and low surgical risk, its impact on mortality and the clinical-echocardiographic progression of heart damage., Methods: 963 patients who underwent TAVR procedure between 2017 and 2021, from the RECOVERY-TAVR international multicenter observational registry, were included in this analysis. Multiparametric echocardiographic data of these patients were analyzed at 1-year follow-up (FU). Clinical and echocardiographic features were stratified by presence of PPM and PPM severity, as per the most current international recommendations, using VARC-3 criteria., Results: 18% of patients developed post-TAVR. PPM, and 7.7% of the whole cohort had severe PPM. At baseline, 50.3% of patients with PPM were male (vs 46.2% in the cohort without PPM, P = .33), aged 82 (IQR 79-85y) years vs 82 (IQR 78-86 P = .46), and 55.6% had Balloon-Expandable valves implanted (vs 46.8% of patients without PPM, P = .04); they had smaller left ventricular outflow tract (LVOT) diameter (20 mm, IQR 19-21 vs 20 mm, IQR 20-22, P = .02), reduced SVi (34.2 vs 38 mL/m 2 , P < .01) and transaortic flow rate (190.6 vs 211 mL/s, P < .01). At predischarge FU patients with PPM had more paravalvular aortic regurgitation (moderate-severe AR 15.8% vs 9.2%, P < .01). At 1-year FU, maladaptive alterations of left ventricular parameters were found in patients with PPM, with a significant increase in end-systolic diameter (33 mm vs 28 mm, P = .03) and a significant increase in left ventricle end systolic indexed volume in those with moderate and severe PPM (52 IQR 42-64 and 52, IQR 41-64 vs 44 IQR 35-59 in those without, P = .02)). No evidence of a significant impact of PPM on overall (P = .71) and CV (P = .70) mortality was observed. Patients with moderate/severe PPM had worse NYHA functional class at 1 year (NYHA III-IV 13% vs 7.8%, P = .03). Prosthesis size≤23 mm (OR 11.6, 1.68-80.1) was an independent predictor of PPM, while SVi (OR 0.87, 0.83-0.91, P < .001) and LVOT diameter (OR 0.79, 0.65-0.95, P = .01) had protective effect., Conclusions: PPM was observed in 18% of patients undergoing TAVR. Echocardiographic evaluations demonstrated a PPM-related pattern of early ventricular maladaptive alterations, possibly precursor to a reduction in cardiac function, associated with a significant deterioration in NYHA class at 1 year. These findings emphasize the importance of prevention of PPM of any grade in patients undergoing TAVR procedure, especially in populations at risk., Competing Interests: Declaration of competing interest The authors have no conflict of interest to report related to this study., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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32. Stress echocardiography in heart failure patients: additive value and caveats.

Author

Pastore MC, Campora A, Mandoli GE, Lisi M, Benfari G, Ilardi F, Malagoli A, Sperlongano S, Henein MY, Cameli M, and D'Andrea A

Subjects
Humans, Prognosis, Stroke Volume physiology, Echocardiography, Stress methods, Heart Failure physiopathology, Heart Failure diagnostic imaging, Heart Failure diagnosis
Abstract

Heart failure (HF) is a clinical syndrome characterized by well-defined signs and symptoms due to structural and/or myocardial functional impairment, resulting in raised intracardiac pressures and/or inadequate cardiac stroke volume at rest or during exercise. This could derive from direct ischemic myocardial injury or other chronic pathological conditions, including valvular heart disease (VHD) and primary myocardial disease. Early identification of HF etiology is essential for accurate diagnosis and initiation of early and appropriate treatment. Thus, the presence of accurate means for early diagnosis of HF symptoms or subclinical phases is fundamental, among which echocardiography being the first line diagnostic investigation. Echocardiography could be performed at rest, to identify overt structural and functional abnormalities or during physical or pharmacological stress, in order to elicit subclinical myocardial function impairment e.g. wall motion abnormalities and raised ventricular filling pressures. Beyond diagnosis of ischemic heart disease, stress echocardiography (SE) has recently shown its unique value for the evaluation of diastolic heart failure, VHD, non-ischemic cardiomyopathies and pulmonary hypertension, with recommendations from international societies in several clinical settings. All these features make SE an important additional tool, not only for diagnostic assessment, but also for prognostic stratification and therapeutic management of patients with HF. In this review, the unique value of SE in the evaluation of HF patients will be described, with the objective to provide an overview of the validated methods for each setting, particularly for HF management., (© 2024. The Author(s).)

Published
2024
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33. New perspectives in the echocardiographic hemodynamics multiparametric assessment of patients with heart failure.

Author

Lisi M, Luisi GA, Pastore MC, Mandoli GE, Benfari G, Ilardi F, Malagoli A, Sperlongano S, Henein MY, Cameli M, and D'Andrea A

Subjects
Humans, Prognosis, Heart Ventricles physiopathology, Heart Ventricles diagnostic imaging, Ventricular Dysfunction, Left physiopathology, Ventricular Dysfunction, Left diagnostic imaging, Heart Failure physiopathology, Heart Failure diagnostic imaging, Stroke Volume physiology, Hemodynamics physiology, Ventricular Function, Left physiology, Echocardiography methods
Abstract

International Guidelines consider left ventricular ejection fraction (LVEF) as an important parameter to categorize patients with heart failure (HF) and to define recommended treatments in clinical practice. However, LVEF has some technical and clinical limitations, being derived from geometric assumptions and is unable to evaluate intrinsic myocardial function and LV filling pressure (LVFP). Moreover, it has been shown to fail to predict clinical outcome in patients with end-stage HF. The analysis of LV antegrade flow derived from pulsed-wave Doppler (stroke volume index, stroke distance, cardiac output, and cardiac index) and non-invasive evaluation of LVFP have demonstrated some advantages and prognostic implications in HF patients. Speckle tracking echocardiography (STE) is able to unmask intrinsic myocardial systolic dysfunction in HF patients, particularly in those with LV preserved EF, hence allowing analysis of LV, right ventricular and left atrial (LA) intrinsic myocardial function (global peak atrial LS, (PALS)). Global PALS has been proven a reliable index of LVFP which could fill the gaps "gray zone" in the previous Guidelines algorithm for the assessment of LV diastolic dysfunction and LVFP, being added to the latest European Association of Cardiovascular Imaging Consensus document for the use of multimodality imaging in evaluating HFpEF. The aim of this review is to highlight the importance of the hemodynamics multiparametric approach of assessing myocardial function (from LVFP to stroke volume) in patients with HF, thus overcoming the limitations of LVEF., (© 2024. The Author(s).)

Published
2024
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34. Role of speckle tracking echocardiography beyond current guidelines in cardiac resynchronization therapy.

Author

Sperlongano S, Benfari G, Ilardi F, Lisi M, Malagoli A, Mandoli GE, Pastore MC, Mele D, Cameli M, and D'Andrea A

Subjects
Humans, Treatment Outcome, Echocardiography, Ventricular Function, Left physiology, Stroke Volume, Cardiac Resynchronization Therapy, Heart Failure diagnostic imaging, Heart Failure therapy
Abstract

Cardiac resynchronization therapy (CRT) is a device-based treatment applied to patients with a specific profile of heart failure. According to current guidelines, indication for CRT is given on the basis of QRS morphology and duration, and traditional transthoracic echocardiography is mainly used to estimate left ventricular (LV) ejection fraction. However, the identification of patients who may benefit from CRT remains challenging, since the application of the above-mentioned guidelines is still associated with a high rate of non-responders. The assessment of various aspects of LV mechanics (including contractile synchrony, coordination and propagation, and myocardial work) performed by conventional and novel ultrasound technologies, first of all speckle tracking echocardiography (STE), may provide additional, useful information for CRT patients' selection, in particular among non-LBBB patients, who generally respond less to CRT. A multiparametric approach, based on the combination of ECG criteria and echocardiographic indices of LV dyssynchrony/discoordination would be desirable to improve the prediction of CRT response., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Published
2024
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35. Arrhythmic mitral valve prolapse: a practical approach for asymptomatic patients.

Author

Malagoli A, Albini A, Benfari G, Ilardi F, Lisi M, Mandoli GE, Pastore MC, Sperlongano S, Cameli M, and D'Andrea A

Subjects
Humans, Algorithms, Consensus, Death, Sudden, Cardiac etiology, Death, Sudden, Cardiac prevention & control, Papillary Muscles, Mitral Valve Prolapse complications, Mitral Valve Prolapse diagnostic imaging
Abstract

Mitral valve prolapse (MVP) is usually regarded as a benign condition though the proportion of patients with a life-threatening arrhythmic MVP form remains undefined. Recently, an experts' consensus statement on arrhythmic MVP has proposed approaches for risk stratification across the spectrum of clinical manifestation. However, sudden cardiac death may be the first presentation, making clinicians focused to early unmasking this subset of asymptomatic patients. Growing evidence on the role of cardiac imaging in the in-deep stratification pathway has emerged in the last decade. Pathology findings have suggested the fibrosis of papillary muscles and inferobasal left ventricular wall as the malignant hallmark. Cardiac magnetic resonance, while of limited availability, allows the identification of this arrhythmogenic substrate. Therefore, speckle-tracking echocardiography may be a gateway to prompt referring patients to further advanced imaging investigation. Our review aims to summarize the phenotypic features linked to the arrhythmic risk and to propose an image-based algorithm intended to help stratifying asymptomatic MVP patients., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2024
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36. Exercise Stress Echocardiography in Athletes: Applications, Methodology, and Challenges.

Author

Palermi S, Sperlongano S, Mandoli GE, Pastore MC, Lisi M, Benfari G, Ilardi F, Malagoli A, Russo V, Ciampi Q, Cameli M, and D'Andrea A

Abstract

This comprehensive review explores the role of exercise stress echocardiography (ESE) in assessing cardiovascular health in athletes. Athletes often exhibit cardiovascular adaptations because of rigorous physical training, making the differentiation between physiological changes and potential pathological conditions challenging. ESE is a crucial diagnostic tool, offering detailed insights into an athlete's cardiac function, reserve, and possible arrhythmias. This review highlights the methodology of ESE, emphasizing its significance in detecting exercise-induced anomalies and its application in distinguishing between athlete's heart and other cardiovascular diseases. Recent advancements, such as LV global longitudinal strain (GLS) and myocardial work (MW), are introduced as innovative tools for the early detection of latent cardiac dysfunctions. However, the use of ESE also subsumes limitations and possible pitfalls, particularly in interpretation and potential false results, as explained in this article.

Published
2023
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37. Acute advanced aortic stenosis.

Author

Avvedimento M, Angellotti D, Ilardi F, Leone A, Scalamogna M, Castiello DS, Manzo R, Mariani A, Immobile Molaro M, Simonetti F, Spaccarotella CAM, Piccolo R, Esposito G, and Franzone A

Subjects
Humans, Quality of Life, Aortic Valve surgery, Treatment Outcome, Balloon Valvuloplasty, Aortic Valve Stenosis surgery, Aortic Valve Stenosis diagnosis, Heart Valve Prosthesis, Heart Failure therapy, Heart Failure complications
Abstract

Acute decompensation often represents the onset of symptoms associated with severe degenerative aortic stenosis (AS) and usually complicates the clinical course of the disease with a dismal impact on survival and quality of life. Several factors may derange the faint balance between left ventricular preload and afterload and precipitate the occurrence of symptoms and signs of acute heart failure (HF). A standardized approach for the management of this condition is currently lacking. Medical therapy finds very limited application in this setting, as drugs usually indicated for the control of acute HF might worsen hemodynamics in the presence of AS. Urgent aortic valve replacement is usually performed by transcatheter than surgical approach whereas, over the last decades, percutaneous balloon valvuloplasty gained renewed space as bridge to definitive therapy. This review focuses on the pathophysiological aspects of acute advanced AS and summarizes current evidence on its management., (© 2023. The Author(s).)

Published
2023
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39. Inter-center reproducibility of standard and advanced echocardiographic parameters in the EACVI-AFib echo registry.

Author

Santoro C, Donal E, Magne J, Sade LE, Penicka M, Katbeh A, Cosyns B, Cameli M, Hanzevacki JS, Luksic VR, Agricola E, Citro R, Hagendorff A, Lancellotti P, Habib G, Moreo A, Cardim N, Parato VM, Neskovic A, Rosca M, Galli E, Motoc A, Mandoli G, Ingallina G, Prota C, Stoebe S, Piette C, Mouhat B, Carbone A, Chiara B, Ilardi F, Stankovic I, Zamorano JL, Popescu BA, Edvardsen T, and Galderisi M

Subjects
Humans, Reproducibility of Results, Echocardiography methods, Heart Atria diagnostic imaging, Registries, Atrial Fibrillation
Abstract

Aim: we sought to test the inter-center reproducibility of 16 echo laboratories involved in the EACVI-Afib Echo Europe., Methods: This was done on a dedicated setting of 10 patients with sinus rhythm (SR) and 10 with persistent atrial fibrillation (AF), collected by the Principal Investigator. Images and loops of echo-exams were stored and made available for labs. The tested measurements included main echo-Doppler parameters, global longitudinal strain (GLS) and peak atrial longitudinal strain (PALS)., Results: Single measures interclass correlation coefficients (ICCs) of left ventricular mass and ejection fraction were suboptimal in both patients with SR and AF. Among diastolic parameters, ICCs of deceleration time were poor, in particular in AF (=.50). ICCs of left atrial size and function, besides optimal in AF, showed an acceptable despite moderate concordance in SR. ICC of GLS was .81 and .78 in SR and AF respectively. ICCs of PALS were suitable but lower in 4-chamber than in 2-chamber view. By depicting the boxplot of the 16 laboratories, GLS distribution was completely homogeneous in SR, whereas GLS of AF and PALS of both SR and AF presented a limited number of outliers. GLS mean ± SE of the 16 labs was 19.7 ± .36 (95% CI: 18.8-20.4) in SR and 16.5 ± .29 (95% CI: 15.9-17.1) in AF, whereas PALS mean ± SE was 43.8 ± .70 (95% CI: 42.3-45.3) and 10.2 ± .32 (95% CI: 9.5-10.9) respectively., Conclusion: While the utilization of some standard-echo variables should be discouraged in registries, the application of GLS and PALS could be largely promoted because their superior reproducibility, even in AF., (© 2023 The Authors. Echocardiography published by Wiley Periodicals LLC.)

Published
2023
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40. Echocardiographic Evaluation of Aortic Stenosis: A Comprehensive Review.

Author

Manzo R, Ilardi F, Nappa D, Mariani A, Angellotti D, Immobile Molaro M, Sgherzi G, Castiello DS, Simonetti F, Santoro C, Canonico ME, Avvedimento M, Piccolo R, Franzone A, and Esposito G

Abstract

Echocardiography represents the most important diagnostic tool in the evaluation of aortic stenosis. The echocardiographic assessment of its severity should always be performed through a standardized and stepwise approach in order to achieve a comprehensive evaluation. The latest technical innovations in the field of echocardiography have improved diagnostic accuracy, guaranteeing a better and more detailed evaluation of aortic valve anatomy. An early diagnosis is of utmost importance since it shortens treatment delays and improves patient outcomes. Echocardiography plays a key role also in the evaluation of all the structural changes related to aortic stenosis. Detailed evaluation of subtle and subclinical changes in left ventricle function has a prognostic significance: scientific efforts have been addressed to identify the most accurate global longitudinal strain cut-off value able to predict adverse outcomes. Moreover, in recent years the role of artificial intelligence is increasingly emerging as a promising tool able to assist cardiologists in aortic stenosis screening and diagnosis, especially by reducing the rate of aortic stenosis misdiagnosis.

Published
2023
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41. Stroke volume index and transvalvular flow rate trajectories in severe aortic stenosis treated with TAVR.

Author

Gallone G, Islas F, Gorla R, Melillo F, Leone PP, Cimaglia P, Pastore MC, Franzone A, Landra F, Bruno F, Scudeler L, Jimenez-Quevedo P, Viva T, Piroli F, Bragato R, Trichilo M, Degiovanni A, Ilardi F, Andreis A, Nombela-Franco L, Maurizio T, Toselli M, Conrotto F, Montorfano M, Manzo R, Cameli M, Patti G, Stefanini G, Testa L, Giannini F, Agricola E, Escaned J, D'Ascenzo F, and De Ferrari GM

Subjects
Humans, Stroke Volume, Treatment Outcome, Risk Factors, Retrospective Studies, Aortic Valve diagnostic imaging, Aortic Valve surgery, Severity of Illness Index, Transcatheter Aortic Valve Replacement methods, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery
Abstract

Aims: The prognostic impact of flow trajectories according to stroke volume index (SVi) and transvalvular flow rate (FR) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) remains poorly assessed. We evaluated and compared SVi and FR prior and after TAVR for severe AS., Methods and Results: Patients were categorized according to SVi (<35 mL/m2) and FR (<200 mL/s). The association of pre- and post-TAVR SVi and FR with all-cause mortality up to 3 years was assessed with multivariable Cox regression models. Among 980 patients with pre-TAVR flow assessment, SVi was reduced in 41.3% and FR in 48.1%. Baseline flow status was not an independent mortality predictor [SVi: hazard ratio (HR) 1.22, 95% confidence interval (CI) 0.85-1.82, FR: HR 0.78, 95% CI 0.48-1.27]. Among 731 patients undergoing early (5 days, interquartile range 2-29) post-TAVR flow assessment, SVi recovered in 40.1% and FR in 49.0% patients with baseline low flow. Reduced FR following TAVR was an independent predictor of mortality (HR 1.67, 95% CI 1.02-2.74), whereas SVi was not (HR 0.97, 95% CI 0.53-1.78). Three-year estimated mortality in patients with recovered FR was lower than that in patients with reduced FR (13.3 vs. 37.7% vs, P = 0.003) and similar to that in patients with normal baseline FR (P = 0.317)., Conclusion: Baseline flow status was not an independent predictor of mid-term mortality among all-comers with severe AS undergoing TAVR. Flow recovery early after TAVR was frequent. Post-TAVR FR, but not SVi, was independently associated with mid-term all-cause mortality. By impacting flow status, AV replacement modifies the association of flow status with outcomes., Competing Interests: Conflict of interest: M.M. received consultant fees from Abbott, Boston Scientific, Kardia, and Medtronic. The other authors have no conflicts of interest to declare., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2023
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42. Stress Echocardiography in Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.

Author

Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D'Angelo M, Da Ros S, D'Andrea F, D'Andrea A, D'Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Del Giudice C, Dell'Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Bella G, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi RM, Inserra CA, Iori E, Izzo A, La Rosa G, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Picano E, and Carerj S

Abstract

Background: The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand the volumes of activity, modalities and stressors used during stress echocardiography (SE) in Italy., Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved through an electronic survey based on a structured questionnaire, uploaded on the SIECVI website., Results: Data were obtained from 228 echocardiographic laboratories, and SE examinations were performed in 179 centers (80.6%): 87 centers (47.5%) were in the northern regions of Italy, 33 centers (18.4%) were in the central regions, and 61 (34.1%) in the southern regions. We annotated a total of 4057 SE. We divided the SE centers into three groups, according to the numbers of SE performed: <10 SE (low-volume activity, 40 centers), between 10 and 39 SE (moderate volume activity, 102 centers) and ≥40 SE (high volume activity, 37 centers). Dipyridamole was used in 139 centers (77.6%); exercise in 120 centers (67.0%); dobutamine in 153 centers (85.4%); pacing in 37 centers (21.1%); and adenosine in 7 centers (4.0%). We found a significant difference between the stressors used and volume of activity of the centers, with a progressive increase in the prevalence of number of stressors from low to high volume activity ( P = 0.033). The traditional evaluation of regional wall motion of the left ventricle was performed in all centers, with combined assessment of coronary flow velocity reserve (CFVR) in 90 centers (50.3%): there was a significant difference in the centers with different volume of SE activity: the incidence of analysis of CFVR was significantly higher in high volume centers compared to low - moderate - volume (32.5%, 41.0% and 73.0%, respectively, P < 0.001). The lung ultrasound (LUS) was assessed in 67 centers (37.4%). Furthermore for LUS, we found a significant difference in the centers with different volume of SE activity: significantly higher in high volume centers compared to low - moderate - volume (25.0%, 35.3% and 56.8%, respectively, P < 0.001)., Conclusions: This nationwide survey demonstrated that SE was significantly widespread and practiced throughout Italy. In addition to the traditional indication to coronary artery disease based on regional wall motion analysis, other indications are emerging with an increase in the use of LUS and CFVR, especially in high-volume centers., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cardiovascular Echography.)

Published
2023
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43. Beyond Aortic Stenosis: Addressing the Challenges of Multivalvular Disease Assessment.

Author

Bombace S, Meucci MC, Fortuni F, Ilardi F, Manzo R, Canciello G, Esposito G, Grayburn PA, Losi MA, and Sannino A

Abstract

Aortic stenosis (AS) can often coexist with other valvular diseases or be combined with aortic regurgitation (AR), leading to unique pathophysiological conditions. The combination of affected valves can vary widely, resulting in a lack of standardized diagnostic or therapeutic approaches. Echocardiography is crucial in assessing patients with valvular heart disease (VHD), but careful consideration of the hemodynamic interactions between combined valvular defects is necessary. This is important as it may affect the reliability of commonly used echocardiographic parameters, making the diagnosis challenging. Therefore, a multimodality imaging approach, including computed tomography or cardiac magnetic resonance, is often not just beneficial but crucial. It represents the future of diagnostics in this intricate field due to its unprecedented capacity to quantify and comprehend valvular pathology. The absence of definitive data and guidelines for the therapeutic management of AS in the context of multiple valve lesions makes this condition particularly challenging. As a result, an individualized, case-by-case approach is necessary, guided primarily by the recommendations for the predominant valve lesion. This review aims to summarize the pathophysiology of AS in the context of multiple and mixed valve disease, with a focus on the hemodynamic implications, diagnostic challenges, and therapeutic options.

Published
2023
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44. The efficacy of PCSK9 inhibitors on major cardiovascular events and lipid profile in patients with diabetes: a systematic review and meta-analysis of randomized controlled trials.

Author

Imbalzano E, Ilardi F, Orlando L, Pintaudi B, Savarese G, and Rosano G

Subjects
Humans, PCSK9 Inhibitors, Antibodies, Monoclonal therapeutic use, Randomized Controlled Trials as Topic, Cholesterol, LDL, Proprotein Convertase 9, Diabetes Mellitus diagnosis, Diabetes Mellitus drug therapy, Diabetes Mellitus epidemiology, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases prevention & control
Abstract

Objective: To evaluate the specific effects of PCSK9 inhibitors (i.e. alirocumab and evolocumab) on major cardiovascular events (MACE) and lipid profile in patients with diabetes., Methods and Results: We conducted a systematic review of literature according to the PRISMA statement. A total of eight randomized control trials (RCTs) enrolling 20 651 patients with diabetes were included. The mean follow-up was 51 weeks. We included RCTs that had compared the subtilisin-kexin type 9 inhibitors (PCSK9i) alirocumab and evolocumab with placebo in subjects with hypercholesterolaemia and diabetes mellitus.MACE occurred in 8.7% of patients with diabetes randomized to PCSK9i vs. 11.0% of those randomized to placebo. Thus, the use of alirocumab or evolocumab reduced MACE by 18% [odds ratio (OR): 0.82; 95% confidence interval (CI): 0.74-0.90]. Compared with control group, the use of PCSK9 inhibitors was associated with a significant percentage change from baseline in low-density lipoprotein cholesterol [mean difference (MD) -58.48%; 95% CI: -63.73 to -53.22%, P < 0.0001], high-density lipoprotein cholesterol (HDL-C) (MD 5.21%; 95% CI: 3.26-7.17%), triglycerides (MD -14.59%; 95% CI: -19.42 to -9.76%), non-HDL-C (MD -48.84%; 95% CI: -54.54 to -43.14%), and total cholesterol (MD -33.76%; 95% CI: -38.71 to -28.8%). Moreover, a significant reduction of lipoprotein(a) (MD -32.90%; 95% CI: -38.55 to -27.24%) and apolipoprotein B (MD -46.83%; 95% CI: -52.71 to --40.94%) were observed in PCSK9i group compared with placebo., Conclusion: PCSK9i appear to be effective in reducing the risk of MACE and in improving lipid profiles of subjects with diabetes and dyslipidaemia., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2023
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45. Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism.

Author

Ilardi F, Crisci M, Calabrese C, Scognamiglio A, Arenga F, Manzo R, Mariniello DF, Allocca V, Annunziata A, D'Andrea A, Merenda R, Monda V, Esposito G, and Fiorentino G

Abstract

The aim of this study was to investigate the presence of subclinical cardiac dysfunction in recovered coronavirus disease 2019 (COVID-19) patients, who were stratified according to a previous diagnosis of pulmonary embolism (PE) as a complication of COVID-19 pneumonia. Out of 68 patients with SARS-CoV-2 pneumonia followed up for one year, 44 patients (mean age 58.4 ± 13.3, 70% males) without known cardiopulmonary disease were divided in two groups (PE+ and PE-, each comprising 22 patients) and underwent clinical and transthoracic echocardiographic examination, including right-ventricle global longitudinal strain (RV-GLS), and RV free wall longitudinal strain (RV-FWLS). While no significant differences were found in the left- or right-heart chambers' dimensions between the two study groups, the PE+ patients showed a significant reduction in RV-GLS (-16.4 ± 2.9 vs. -21.6 ± 4.3%, p < 0.001) and RV-FWLS (-18.9 ± 4 vs. -24.6 ± 5.12%, p < 0.001) values compared to the PE- patients. According to the ROC-curve analysis, RV-FWLS < 21% was the best cut-off with which to predict PE diagnosis in patients after SARS-CoV-2 pneumonia (sensitivity 74%, specificity 89%, area under the curve = 0.819, p < 0.001). According to the multivariate logistic regression model, RV-FWLS < 21% was independently associated with PE (HR 34.96, 95% CI:3.24-377.09, p = 0.003) and obesity (HR 10.34, 95% CI:1.05-101.68, p = 0.045). In conclusion, in recovered COVID-19 patients with a history of PE+, there is a persistence of subclinical RV dysfunction one year after the acute phase of the disease, detectable by a significant impairment in RV-GLS and RV-FWLS. A reduction in RV-FWLS of lower than 21% is independently associated with COVID-related PE.

Published
2023
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46. Hemodynamic Performance of Transcatheter Aortic Valves: A Comprehensive Review.

Author

Angellotti D, Manzo R, Castiello DS, Immobile Molaro M, Mariani A, Iapicca C, Nappa D, Simonetti F, Avvedimento M, Leone A, Canonico ME, Spaccarotella CAM, Franzone A, Ilardi F, Esposito G, and Piccolo R

Abstract

Transcatheter aortic valve implantation (TAVI) is a widely adopted treatment option for patients with severe aortic stenosis. Its popularity has grown significantly in recent years due to advancements in technology and imaging. As TAVI use is increasingly expanded to younger patients, the need for long-term assessment and durability becomes paramount. This review aims to provide an overview of the diagnostic tools to evaluate the hemodynamic performance of aortic prosthesis, with a special focus on the comparison between transcatheter and surgical aortic valves and between self-expandable and balloon-expandable valves. Moreover, the discussion will encompass how cardiovascular imaging can effectively detect long-term structural valve deterioration.

Published
2023
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47. Is There Still a Role for Invasive Assessment of Aortic Gradient?

Author

Angellotti D, Immobile Molaro M, Simonetti F, Ilardi F, Castiello DS, Mariani A, Manzo R, Avvedimento M, Leone A, Nappa D, Piccolo R, Losi MA, Franzone A, and Esposito G

Abstract

Advances in technology and imaging have expanded the range of tools for diagnosing aortic stenosis (AS). The accurate assessment of aortic valve area and mean pressure gradient is crucial to determine which patients are appropriate candidates for aortic valve replacement. Nowadays, these values can be obtained noninvasively or invasively, with similar results. Contrariwise, in the past, cardiac catheterization played a major role in the evaluation of AS severity. In this review, we will discuss the historical role of the invasive assessment of AS. Moreover, we will specifically focus on tips and tricks for properly performing cardiac catheterization in patients with AS. We will also elucidate the role of invasive methods in current clinical practice and their additional value to the information provided through non-invasive techniques.

Published
2023
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48. Multimodality imaging in decompensated heart failure.

Author

D'Andrea A, Ilardi F, Palermi S, Riegler L, Miele T, Giallauria F, D'Alto M, Russo V, and Cice G

Abstract

Heart failure (HF) is usually suspected by clinical history, symptoms, physical examination, electrocardiogram findings, and natriuretic peptides' values. However, echocardiography and other imaging techniques play an essential role in supporting HF diagnosis. Thanks to its non-invasiveness and safety, transthoracic echocardiography is the first-level technique of choice to assess myocardial structure and function, trying to establish the diagnosis of HF with reduced, mildly reduced, and preserved ejection fraction. The role of echocardiography is not limited to diagnosis but it represents a crucial tool in guiding therapeutic decision-making and monitoring response to therapy. Over the last decades, several technological advancements were made in the imaging field, aiming at better understanding the morphofunctional abnormalities occurring in cardiovascular diseases. The purpose of this review article is to summarize the incremental role of imaging techniques (in particular cardiac magnetic resonance and myocardial scintigraphy) in HF, highlighting their essential applications to HF diagnosis and management., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2023
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49. Echocardiographic Evaluation after Transcatheter Aortic Valve Implantation: A Comprehensive Review.

Author

Angellotti D, Manzo R, Castiello DS, Immobile Molaro M, Mariani A, Iapicca C, Nappa D, Simonetti F, Avvedimento M, Leone A, Canonico ME, Spaccarotella CAM, Franzone A, Ilardi F, Esposito G, and Piccolo R

Abstract

Transcatheter aortic valve implantation (TAVI) is an increasingly popular treatment option for patients with severe aortic stenosis. Recent advancements in technology and imaging tools have significantly contributed to the success of TAVI procedures. Echocardiography plays a pivotal role in the evaluation of TAVI patients, both before and after the procedure. This review aims to provide an overview of the most recent technical advancements in echocardiography and their use in the follow-up of TAVI patients. In particular, the focus will be on the examination of the influence of TAVI on left and right ventricular function, which is frequently accompanied by other structural and functional alterations. Echocardiography has proven to be key also in detecting valve deterioration during extended follow-up. This review will provide valuable insights into the technical advancements in echocardiography and their role in the follow-up of TAVI patients.

Published
2023
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50. Organization and Activity of Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.

Author

Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D'Angelo M, Ros SD, D'Andrea F, D'Andrea A, D'Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Giudice CD, Dell'Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi R, Inserra CA, Iori E, Izzo A, Rosa G, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Di Bella G, and Carerj S

Abstract

Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy., Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website., Results: Data were obtained from 228 echocardiographic laboratories: 112 centers (49%) in the northern, 43 centers (19%) in the central, and 73 (32%) in the southern regions. During the month of observation, we collected 101,050 transthoracic echocardiography (TTE) examinations performed in all centers. As concern other modalities there were performed 5497 transesophageal echocardiography (TEE) examinations in 161/228 centers (71%); 4057 stress echocardiography (SE) examinations in 179/228 centers (79%); and examinations with ultrasound contrast agents (UCAs) in 151/228 centers (66%). We did not find significant regional variations between the different modalities. The usage of picture archiving and communication system (PACS) was significantly higher in the northern (84%) versus central (49%) and southern (45%) centers ( P < 0.001). Lung ultrasound (LUS) was performed in 154 centers (66%), without difference between cardiology and noncardiology centers. The evaluation of left ventricular (LV) ejection fraction was evaluated mainly using the qualitative method in 223 centers (94%), occasionally with the Simpson method in 193 centers (85%), and with selective use of the three-dimensional (3D) method in only 23 centers (10%). 3D TTE was present in 137 centers (70%), and 3D TEE in all centers where TEE was done (71%). The assessment of LV diastolic function was done routinely in 80% of the centers. Right ventricular function was evaluated using tricuspid annular plane systolic excursion in all centers, using tricuspid valve annular systolic velocity by tissue Doppler imaging in 53% of the centers, and using fractional area change in 33% of the centers. When we divided into cardiology (179, 78%) and noncardiology (49, 22%) centers, we found significant differences in the SE (93% vs. 26%, P < 0.001), TEE (85% vs. 18%), UCA (67% vs. 43%, P < 0001), and STE (87% vs. 20%, P < 0.001). The incidence of LUS evaluation was similar between the cardiology and noncardiology centers (69% vs. 61%, P = NS)., Conclusions: This nationwide survey demonstrated that digital infrastructures and advanced echocardiography modalities, such as 3D and STE, are widely available in Italy with a notable diffuse uptake of LUS in the core TTE examination, a suboptimal diffusion of PACS recording, and conservative use of UCA, 3D, and strain. There are significant differences between northern and central-southern regions and echocardiographic laboratories that pertain to the cardiac unit. This inhomogeneous distribution of technology represents one of the main issues that must be solved to standardize the practice of echocardiography., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cardiovascular Echography.)

Published
2023
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