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1. An optimized multisource acquisition and registration workflow for imaging guided ventricular tachycardia ablation

Author

Parollo, M, primary, Torre, M, additional, Fiorentini, F, additional, Di Cori, A, additional, Segreti, L, additional, Grifoni, G, additional, Notarstefano, P, additional, De Sensi, F, additional, Rossi, A, additional, Lapira, F, additional, Cardelli, L, additional, Santoro, A, additional, Aquaro, G D, additional, Faggioni, L, additional, and Zucchelli, G, additional

Published
2024
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2. Implementation of an epicardial implantable MEMS sensor for continuous and real-time postoperative assessment of left ventricular activity in adult minipigs over a short- and long-term period

Author

Zinno, C., primary, Agnesi, F., additional, D'Alesio, G., additional, Dushpanova, A., additional, Brogi, L., additional, Camboni, D., additional, Bernini, F., additional, Terlizzi, D., additional, Casieri, V., additional, Gabisonia, K., additional, Alibrandi, L., additional, Grigoratos, C., additional, Magomajew, J., additional, Aquaro, G. D., additional, Schmitt, S., additional, Detemple, P., additional, Oddo, C. M., additional, Lionetti, V., additional, and Micera, S., additional

Published
2024
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3. AI Cardiac MRI Scar Analysis Aids Prediction of Major Arrhythmic Events in the Multicenter DERIVATE Registry

Author

Ghanbari, F, Joyce, T, Lorenzoni, V, Guaricci, A, Pavon, A, Fusini, L, Andreini, D, Rabbat, M, Aquaro, G, Abete, R, Bogaert, J, Camastra, G, Carigi, S, Carrabba, N, Casavecchia, G, Censi, S, Cicala, G, De Cecco, C, De Lazzari, M, Di Giovine, G, Di Roma, M, Focardi, M, Gaibazzi, N, Gismondi, A, Gravina, M, Lanzillo, C, Lombardi, M, Lozano-Torres, J, Masi, A, Moro, C, Muscogiuri, G, Nese, A, Pradella, S, Sbarbati, S, Schoepf, U, Valentini, A, Crelier, G, Masci, P, Pontone, G, Kozerke, S, Schwitter, J, Ghanbari F., Joyce T., Lorenzoni V., Guaricci A. I., Pavon A. -G., Fusini L., Andreini D., Rabbat M. G., Aquaro G. D., Abete R., Bogaert J., Camastra G., Carigi S., Carrabba N., Casavecchia G., Censi S., Cicala G., De Cecco C. N., De Lazzari M., Di Giovine G., Di Roma M., Focardi M., Gaibazzi N., Gismondi A., Gravina M., Lanzillo C., Lombardi M., Lozano-Torres J., Masi A., Moro C., Muscogiuri G., Nese A., Pradella S., Sbarbati S., Schoepf U. J., Valentini A., Crelier G., Masci P. G., Pontone G., Kozerke S., Schwitter J., Ghanbari, F, Joyce, T, Lorenzoni, V, Guaricci, A, Pavon, A, Fusini, L, Andreini, D, Rabbat, M, Aquaro, G, Abete, R, Bogaert, J, Camastra, G, Carigi, S, Carrabba, N, Casavecchia, G, Censi, S, Cicala, G, De Cecco, C, De Lazzari, M, Di Giovine, G, Di Roma, M, Focardi, M, Gaibazzi, N, Gismondi, A, Gravina, M, Lanzillo, C, Lombardi, M, Lozano-Torres, J, Masi, A, Moro, C, Muscogiuri, G, Nese, A, Pradella, S, Sbarbati, S, Schoepf, U, Valentini, A, Crelier, G, Masci, P, Pontone, G, Kozerke, S, Schwitter, J, Ghanbari F., Joyce T., Lorenzoni V., Guaricci A. I., Pavon A. -G., Fusini L., Andreini D., Rabbat M. G., Aquaro G. D., Abete R., Bogaert J., Camastra G., Carigi S., Carrabba N., Casavecchia G., Censi S., Cicala G., De Cecco C. N., De Lazzari M., Di Giovine G., Di Roma M., Focardi M., Gaibazzi N., Gismondi A., Gravina M., Lanzillo C., Lombardi M., Lozano-Torres J., Masi A., Moro C., Muscogiuri G., Nese A., Pradella S., Sbarbati S., Schoepf U. J., Valentini A., Crelier G., Masci P. G., Pontone G., Kozerke S., and Schwitter J.

Abstract

Background: Scar burden with late gadolinium enhancement (LGE) cardiac MRI (CMR) predicts arrhythmic events in patients with postinfarction in single-center studies. However, LGE analysis requires experienced human observers, is time consuming, and introduces variability. Purpose: To test whether postinfarct scar with LGE CMR can be quantified fully automatically by machines and to compare the ability of LGE CMR scar analyzed by humans and machines to predict arrhythmic events. Materials and Methods: This study is a retrospective analysis of the multicenter, multivendor CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy (DERIVATE) registry. Patients with chronic heart failure, echocardiographic left ventricular ejection fraction (LVEF) of less than 50%, and LGE CMR were recruited (from January 2015 through December 2020). In the current study, only patients with ischemic cardiomyopathy were included. Quantification of total, dense, and nondense scars was carried out by two experienced readers or a Ternaus network, trained and tested with LGE images of 515 and 246 patients, respectively. Univariable and multivariable Cox analyses were used to assess patient and cardiac characteristics associated with a major adverse cardiac event (MACE). Area under the receiver operating characteristic curve (AUC) was used to compare model performances. Results: In 761 patients (mean age, 65 years ± 11, 671 men), 83 MACEs occurred. With use of the testing group, univariable Cox-analysis found New York Heart Association class, left ventricle volume and/or function parameters (by echocardiography or CMR), guideline criterion (LVEF of ≤35% and New York Heart Association class II or III), and LGE scar analyzed by humans or the machine-learning algorithm as predictors of MACE. Machine-based dense or total scar conferred incremental value over the guideline criterion for the association with MACE (AUC: 0.68 vs 0.63, P = .02 and AUC: 0.67 vs 0.63

Published
2023

4. Cardiac Magnetic Resonance for Prophylactic Implantable-Cardioverter Defibrillator Therapy in Ischemic Cardiomyopathy: The DERIVATE–ICM International Registry

Author

Pontone, G, Guaricci, A, Fusini, L, Baggiano, A, Guglielmo, M, Muscogiuri, G, Volpe, A, Abete, R, Aquaro, G, Barison, A, Bogaert, J, Camastra, G, Carigi, S, Carrabba, N, Casavecchia, G, Censi, S, Cicala, G, De Cecco, C, De Lazzari, M, Di Giovine, G, Di Roma, M, Dobrovie, M, Focardi, M, Gaibazzi, N, Gismondi, A, Gravina, M, Lanzillo, C, Lombardi, M, Lorenzoni, V, Lozano-Torres, J, Martini, C, Marzo, F, Masi, A, Memeo, R, Moro, C, Nese, A, Palumbo, A, Pavon, A, Pedrotti, P, Marra, M, Pica, S, Pradella, S, Presicci, C, Rabbat, M, Raineri, C, Rodriguez-Palomares, J, Sbarbati, S, Schoepf, U, Squeri, A, Sverzellati, N, Symons, R, Tat, E, Timpani, M, Todiere, G, Valentini, A, Varga-Szemes, A, Masci, P, Schwitter, J, Pontone G., Guaricci A. I., Fusini L., Baggiano A., Guglielmo M., Muscogiuri G., Volpe A., Abete R., Aquaro G., Barison A., Bogaert J., Camastra G., Carigi S., Carrabba N., Casavecchia G., Censi S., Cicala G., De Cecco C. N., De Lazzari M., Di Giovine G., Di Roma M., Dobrovie M., Focardi M., Gaibazzi N., Gismondi A., Gravina M., Lanzillo C., Lombardi M., Lorenzoni V., Lozano-Torres J., Martini C., Marzo F., Masi A., Memeo R., Moro C., Nese A., Palumbo A., Pavon A. G., Pedrotti P., Marra M. P., Pica S., Pradella S., Presicci C., Rabbat M. G., Raineri C., Rodriguez-Palomares J. F., Sbarbati S., Schoepf U. J., Squeri A., Sverzellati N., Symons R., Tat E., Timpani M., Todiere G., Valentini A., Varga-Szemes A., Masci P. -G., Schwitter J., Pontone, G, Guaricci, A, Fusini, L, Baggiano, A, Guglielmo, M, Muscogiuri, G, Volpe, A, Abete, R, Aquaro, G, Barison, A, Bogaert, J, Camastra, G, Carigi, S, Carrabba, N, Casavecchia, G, Censi, S, Cicala, G, De Cecco, C, De Lazzari, M, Di Giovine, G, Di Roma, M, Dobrovie, M, Focardi, M, Gaibazzi, N, Gismondi, A, Gravina, M, Lanzillo, C, Lombardi, M, Lorenzoni, V, Lozano-Torres, J, Martini, C, Marzo, F, Masi, A, Memeo, R, Moro, C, Nese, A, Palumbo, A, Pavon, A, Pedrotti, P, Marra, M, Pica, S, Pradella, S, Presicci, C, Rabbat, M, Raineri, C, Rodriguez-Palomares, J, Sbarbati, S, Schoepf, U, Squeri, A, Sverzellati, N, Symons, R, Tat, E, Timpani, M, Todiere, G, Valentini, A, Varga-Szemes, A, Masci, P, Schwitter, J, Pontone G., Guaricci A. I., Fusini L., Baggiano A., Guglielmo M., Muscogiuri G., Volpe A., Abete R., Aquaro G., Barison A., Bogaert J., Camastra G., Carigi S., Carrabba N., Casavecchia G., Censi S., Cicala G., De Cecco C. N., De Lazzari M., Di Giovine G., Di Roma M., Dobrovie M., Focardi M., Gaibazzi N., Gismondi A., Gravina M., Lanzillo C., Lombardi M., Lorenzoni V., Lozano-Torres J., Martini C., Marzo F., Masi A., Memeo R., Moro C., Nese A., Palumbo A., Pavon A. G., Pedrotti P., Marra M. P., Pica S., Pradella S., Presicci C., Rabbat M. G., Raineri C., Rodriguez-Palomares J. F., Sbarbati S., Schoepf U. J., Squeri A., Sverzellati N., Symons R., Tat E., Timpani M., Todiere G., Valentini A., Varga-Szemes A., Masci P. -G., and Schwitter J.

Abstract

Background: Implantable cardioverter-defibrillator (ICD) therapy is the most effective prophylactic strategy against sudden cardiac death (SCD) in patients with ischemic cardiomyopathy (ICM) and left ventricle ejection fraction (LVEF) ≤35% as detected by transthoracic echocardiograpgy (TTE). This approach has been recently questioned because of the low rate of ICD interventions in patients who received implantation and the not-negligible percentage of patients who experienced SCD despite not fulfilling criteria for implantation. Objectives: The DERIVATE-ICM registry (CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy; NCT03352648) is an international, multicenter, and multivendor study to assess the net reclassification improvement (NRI) for the indication of ICD implantation by the use of cardiac magnetic resonance (CMR) as compared to TTE in patients with ICM. Methods: A total of 861 patients with ICM (mean age 65 ± 11 years, 86% male) with chronic heart failure and TTE-LVEF <50% participated. Major adverse arrhythmic cardiac events (MAACE) were the primary endpoints. Results: During a median follow-up of 1,054 days, MAACE occurred in 88 (10.2%). Left ventricular end-diastolic volume index (HR: 1.007 [95% CI: 1.000-1.011]; P = 0.05), CMR-LVEF (HR: 0.972 [95% CI: 0.945-0.999]; P = 0.045) and late gadolinium enhancement (LGE) mass (HR: 1.010 [95% CI: 1.002-1.018]; P = 0.015) were independent predictors of MAACE. A multiparametric CMR weighted predictive derived score identifies subjects at high risk for MAACE compared with TTE-LVEF cutoff of 35% with a NRI of 31.7% (P = 0.007). Conclusions: The DERIVATE-ICM registry is a large multicenter registry showing the additional value of CMR to stratify the risk for MAACE in a large cohort of patients with ICM compared with standard of care.

Published
2023

5. Cardiovascular Magnetic Resonance in Patients with Cardiac Electronic Devices: Evidence from a Multicenter Study

Author

Barison, A, Ricci, F, Pavon, A, Muscogiuri, G, Bisaccia, G, Camastra, G, De Lazzari, M, Lanzillo, C, Raguso, M, Monti, L, Vargiu, S, Pedrotti, P, Piacenti, M, Todiere, G, Pontone, G, Indolfi, C, Dellegrottaglie, S, Lombardi, M, Schwitter, J, Aquaro, G, Barison A., Ricci F., Pavon A. G., Muscogiuri G., Bisaccia G., Camastra G., De Lazzari M., Lanzillo C., Raguso M., Monti L., Vargiu S., Pedrotti P., Piacenti M., Todiere G., Pontone G., Indolfi C., Dellegrottaglie S., Lombardi M., Schwitter J., Aquaro G. D., Barison, A, Ricci, F, Pavon, A, Muscogiuri, G, Bisaccia, G, Camastra, G, De Lazzari, M, Lanzillo, C, Raguso, M, Monti, L, Vargiu, S, Pedrotti, P, Piacenti, M, Todiere, G, Pontone, G, Indolfi, C, Dellegrottaglie, S, Lombardi, M, Schwitter, J, Aquaro, G, Barison A., Ricci F., Pavon A. G., Muscogiuri G., Bisaccia G., Camastra G., De Lazzari M., Lanzillo C., Raguso M., Monti L., Vargiu S., Pedrotti P., Piacenti M., Todiere G., Pontone G., Indolfi C., Dellegrottaglie S., Lombardi M., Schwitter J., and Aquaro G. D.

Abstract

Background: Most recent cardiac implantable electronic devices (CIEDs) can safely undergo a cardiovascular magnetic resonance (CMR) scan under certain conditions, but metal artifacts may degrade image quality. The aim of this study was to assess the overall diagnostic yield of CMR and the extent of metal artifacts in a multicenter, multivendor study on CIED patients referred for CMR. Methods: We analyzed 309 CMR scans from 292 patients (age 57 ± 16 years, 219 male) with an MR-conditional pacemaker (n = 122), defibrillator (n = 149), or loop recorder (n = 38); CMR scans were performed in 10 centers from 2012 to 2020; MR-unsafe implants were excluded. Clinical and device parameters were recorded before and after the CMR scan. A visual analysis of metal artifacts was performed for each sequence on a segmental basis, based on a 5-point artifact score. Results: The vast majority of CMR scans (n = 255, 83%) were completely performed, while only 32 (10%) were interrupted soon after the first sequences and 22 (7%) were only partly acquired; CMR quality was non-diagnostic in 34 (11%) scans, poor (<1/3 sequences were diagnostic) in 25 (8%), or acceptable (1/3 to 2/3 sequences were diagnostic) in 40 (13%), while most scans (n = 201, 68%) were of overall good quality. No adverse event or device malfunctioning occurred, and only nonsignificant changes in device parameters were recorded. The most affected sequences were SSFP (median score 0.32 [interquartile range 0.07–0.91]), followed by GRE (0.18 [0.02–0.59]) and LGE (0.14 [0.02–0.55]). ICDs induced more artifacts (median score in SSFP images 0.87 [0.50–1.46]) than PMs (0.11 [0.03–0.28]) or ILRs (0.11 [0.00–0.56]). Moreover, most artifacts were located in the anterior, anteroseptal, anterolateral, and apical segments of the LV and in the outflow tract of the RV. Conclusions: CMR is a versatile imaging technique, with a high safety profile and overall good image quality even in patients with MR-conditional CIEDs. Several stra

Published
2023

9. Acute Myocarditis Associated With Desmosomal Gene Variants

Author

Ammirati, E, Raimondi, F, Piriou, N, Sardo Infirri, L, Mohiddin, S, Mazzanti, A, Shenoy, C, Cavallari, U, Imazio, M, Aquaro, G, Olivotto, I, Pedrotti, P, Sekhri, N, Van de Heyning, C, Broeckx, G, Peretto, G, Guttmann, O, Dellegrottaglie, S, Scatteia, A, Gentile, P, Merlo, M, Goldberg, R, Reyentovich, A, Sciamanna, C, Klaassen, S, Poller, W, Trankle, C, Abbate, A, Keren, A, Horowitz-Cederboim, S, Cadrin-Tourigny, J, Tadros, R, Annoni, G, Bonoldi, E, Toquet, C, Marteau, L, Probst, V, Trochu, J, Kissopoulou, A, Grosu, A, Kukavica, D, Trancuccio, A, Gil, C, Tini, G, Pedrazzini, M, Torchio, M, Sinagra, G, Gimeno, J, Bernasconi, D, Valsecchi, M, Klingel, K, Adler, E, Camici, P, Cooper, L, Ammirati E., Raimondi F., Piriou N., Sardo Infirri L., Mohiddin S. A., Mazzanti A., Shenoy C., Cavallari U. A., Imazio M., Aquaro G. D., Olivotto I., Pedrotti P., Sekhri N., Van de Heyning C. M., Broeckx G., Peretto G., Guttmann O., Dellegrottaglie S., Scatteia A., Gentile P., Merlo M., Goldberg R. I., Reyentovich A., Sciamanna C., Klaassen S., Poller W., Trankle C. R., Abbate A., Keren A., Horowitz-Cederboim S., Cadrin-Tourigny J., Tadros R., Annoni G. A., Bonoldi E., Toquet C., Marteau L., Probst V., Trochu J. N., Kissopoulou A., Grosu A., Kukavica D., Trancuccio A., Gil C., Tini G., Pedrazzini M., Torchio M., Sinagra G., Gimeno J. R., Bernasconi D., Valsecchi M. G., Klingel K., Adler E. D., Camici P. G., Cooper L. T., Ammirati, E, Raimondi, F, Piriou, N, Sardo Infirri, L, Mohiddin, S, Mazzanti, A, Shenoy, C, Cavallari, U, Imazio, M, Aquaro, G, Olivotto, I, Pedrotti, P, Sekhri, N, Van de Heyning, C, Broeckx, G, Peretto, G, Guttmann, O, Dellegrottaglie, S, Scatteia, A, Gentile, P, Merlo, M, Goldberg, R, Reyentovich, A, Sciamanna, C, Klaassen, S, Poller, W, Trankle, C, Abbate, A, Keren, A, Horowitz-Cederboim, S, Cadrin-Tourigny, J, Tadros, R, Annoni, G, Bonoldi, E, Toquet, C, Marteau, L, Probst, V, Trochu, J, Kissopoulou, A, Grosu, A, Kukavica, D, Trancuccio, A, Gil, C, Tini, G, Pedrazzini, M, Torchio, M, Sinagra, G, Gimeno, J, Bernasconi, D, Valsecchi, M, Klingel, K, Adler, E, Camici, P, Cooper, L, Ammirati E., Raimondi F., Piriou N., Sardo Infirri L., Mohiddin S. A., Mazzanti A., Shenoy C., Cavallari U. A., Imazio M., Aquaro G. D., Olivotto I., Pedrotti P., Sekhri N., Van de Heyning C. M., Broeckx G., Peretto G., Guttmann O., Dellegrottaglie S., Scatteia A., Gentile P., Merlo M., Goldberg R. I., Reyentovich A., Sciamanna C., Klaassen S., Poller W., Trankle C. R., Abbate A., Keren A., Horowitz-Cederboim S., Cadrin-Tourigny J., Tadros R., Annoni G. A., Bonoldi E., Toquet C., Marteau L., Probst V., Trochu J. N., Kissopoulou A., Grosu A., Kukavica D., Trancuccio A., Gil C., Tini G., Pedrazzini M., Torchio M., Sinagra G., Gimeno J. R., Bernasconi D., Valsecchi M. G., Klingel K., Adler E. D., Camici P. G., and Cooper L. T.

Abstract

Background: The risk of adverse cardiovascular events in patients with acute myocarditis (AM) and desmosomal gene variants (DGV) remains unknown. Objectives: The purpose of this study was to ascertain the risk of death, ventricular arrhythmias, recurrent myocarditis, and heart failure (main endpoint) in patients with AM and pathogenic or likely pathogenetic DGV. Methods: In a retrospective international study from 23 hospitals, 97 patients were included: 36 with AM and DGV (DGV[+]), 25 with AM and negative gene testing (DGV[−]), and 36 with AM without genetics testing. All patients had troponin elevation plus findings consistent with AM on histology or at cardiac magnetic resonance (CMR). In 86 patients, CMR changes in function and structure were re-assessed at follow-up. Results: In the DGV(+) AM group (88.9% DSP variants), median age was 24 years, 91.7% presented with chest pain, and median left ventricular ejection fraction (LVEF) was 56% on CMR (P = NS vs the other 2 groups). Kaplan-Meier curves demonstrated a higher risk of the main endpoint in DGV(+) AM compared with DGV(−) and without genetics testing patients (62.3% vs 17.5% vs 5.3% at 5 years, respectively; P < 0.0001), driven by myocarditis recurrence and ventricular arrhythmias. At follow-up CMR, a higher number of late gadolinium enhanced segments was found in DGV(+) AM. Conclusions: Patients with AM and evidence of DGV have a higher incidence of adverse cardiovascular events compared with patients with AM without DGV. Further prospective studies are needed to ascertain if genetic testing might improve risk stratification of patients with AM who are considered at low risk.

Published
2022

13. Myocardial Fibrosis at Cardiac MRI Helps Predict Adverse Clinical Outcome in Patients with Mitral Valve Prolapse

Author

Figliozzi, S, Georgiopoulos, G, Lopes, P, Bauer, K, Moura-Ferreira, S, Tondi, L, Mushtaq, S, Censi, S, Pavon, A, Bassi, I, Servato, M, Teske, A, Biondi, F, Filomena, D, Pica, S, Torlasco, C, Muraru, D, Monney, P, Quattrocchi, G, Maestrini, V, Agati, L, Monti, L, Pedrotti, P, Vandenberk, B, Squeri, A, Lombardi, M, Ferreira, A, Schwitter, J, Aquaro, G, Chiribiri, A, Rodríguez Palomares, J, Yilmaz, A, Andreini, D, Florian, A, Leiner, T, Abecasis, J, Badano, L, Bogaert, J, Masci, P, Figliozzi, Stefano, Georgiopoulos, Georgios, Lopes, Pedro M, Bauer, Klemens B, Moura-Ferreira, Sara, Tondi, Lara, Mushtaq, Saima, Censi, Stefano, Pavon, Anna Giulia, Bassi, Ilaria, Servato, Maria Luz, Teske, Arco J, Biondi, Federico, Filomena, Domenico, Pica, Silvia, Torlasco, Camilla, Muraru, Denisa, Monney, Pierre, Quattrocchi, Giuseppina, Maestrini, Viviana, Agati, Luciano, Monti, Lorenzo, Pedrotti, Patrizia, Vandenberk, Bert, Squeri, Angelo, Lombardi, Massimo, Ferreira, António M, Schwitter, Juerg, Aquaro, Giovanni Donato, Chiribiri, Amedeo, Rodríguez Palomares, José F, Yilmaz, Ali, Andreini, Daniele, Florian, Anca, Leiner, Tim, Abecasis, João, Badano, Luigi, Bogaert, Jan, Masci, Pier-Giorgio, Figliozzi, S, Georgiopoulos, G, Lopes, P, Bauer, K, Moura-Ferreira, S, Tondi, L, Mushtaq, S, Censi, S, Pavon, A, Bassi, I, Servato, M, Teske, A, Biondi, F, Filomena, D, Pica, S, Torlasco, C, Muraru, D, Monney, P, Quattrocchi, G, Maestrini, V, Agati, L, Monti, L, Pedrotti, P, Vandenberk, B, Squeri, A, Lombardi, M, Ferreira, A, Schwitter, J, Aquaro, G, Chiribiri, A, Rodríguez Palomares, J, Yilmaz, A, Andreini, D, Florian, A, Leiner, T, Abecasis, J, Badano, L, Bogaert, J, Masci, P, Figliozzi, Stefano, Georgiopoulos, Georgios, Lopes, Pedro M, Bauer, Klemens B, Moura-Ferreira, Sara, Tondi, Lara, Mushtaq, Saima, Censi, Stefano, Pavon, Anna Giulia, Bassi, Ilaria, Servato, Maria Luz, Teske, Arco J, Biondi, Federico, Filomena, Domenico, Pica, Silvia, Torlasco, Camilla, Muraru, Denisa, Monney, Pierre, Quattrocchi, Giuseppina, Maestrini, Viviana, Agati, Luciano, Monti, Lorenzo, Pedrotti, Patrizia, Vandenberk, Bert, Squeri, Angelo, Lombardi, Massimo, Ferreira, António M, Schwitter, Juerg, Aquaro, Giovanni Donato, Chiribiri, Amedeo, Rodríguez Palomares, José F, Yilmaz, Ali, Andreini, Daniele, Florian, Anca, Leiner, Tim, Abecasis, João, Badano, Luigi, Bogaert, Jan, and Masci, Pier-Giorgio

Abstract

Background: Patients with mitral valve prolapse (MVP) may develop adverse outcomes even in the absence of mitral regurgitation or left ventricular (LV) dysfunction. Purpose: To investigate the prognostic value of mitral annulus disjunction (MAD) and myocardial fibrosis at late gadolinium enhancement (LGE) cardiac MRI in patients with MVP without moderate-to-severe mitral regurgitation or LV dysfunction. Materials and Methods: In this longitudinal retrospective study, 118 144 cardiac MRI studies were evaluated between October 2007 and June 2020 at 15 European tertiary medical centers. Follow-up was from the date of cardiac MRI examination to June 2020; the minimum and maximum follow-up intervals were 6 months and 156 months, respectively. Patients were excluded if at least one of the following conditions was present: cardiomyopathy, LV ejection fraction less than 40%, ischemic heart disease, congenital heart disease, inflammatory heart disease, moderate or worse mitral regurgitation, participation in competitive sport, or electrocardiogram suggestive of channelopathies. In the remainder, cardiac MRI studies were reanalyzed, and patients were included if they were aged 18 years or older, MVP was diagnosed at cardiac MRI, and clinical information and electrocardiogram monitoring were available within 3 months from cardiac MRI examination. The end point was a composite of adverse outcomes: sustained ventricular tachycardia (VT), sudden cardiac death (SCD), or unexplained syncope. Multivariable Cox regression analysis was performed. Results: A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 women) were included. Over a median follow-up of 3.3 years, 18 patients (4%) reached the study end point. LGE presence (hazard ratio, 4.2 [95% CI: 1.5, 11.9]; P = .006) and extent (hazard ratio, 1.2 per 1% increase [95% CI: 1.1, 1.4]; P = .006), but not MAD presence (P = .89), were associated with clinical outcome. LGE presence had incremental prognostic value over MVP severi

Published
2023

14. Acute myocarditis associated with desmosomal gene variants

Author

Ammirati, E, primary, Raimondi, F, additional, Piriou, N, additional, Mohiddin, S A, additional, Imazio, M, additional, Aquaro, G, additional, Olivotto, I, additional, Van De Heyning, C M, additional, Peretto, G, additional, Merlo, M, additional, Klaassen, S, additional, Poller, W, additional, Adler, E D, additional, Camici, P G, additional, and Cooper, L T, additional

Published
2022
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15. Relationships between plasma cytokine balance and cardiac magnetic resonance imaging in long-term post-COVID follow-up: a cross-sectional preliminary study

Author

Simonini, L, primary, Sbrana, S, additional, Foffa, I, additional, Baroni, M, additional, Catapano, G, additional, Chiappino, D, additional, Grigoratos, C, additional, Marrone, C, additional, Losi, P, additional, Mannucci, F, additional, Salvadori, S, additional, Todiere, G, additional, Valenti, E, additional, Ait-Ali, L, additional, and Aquaro, G D, additional

Published
2022
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16. C63 PHENOTYPE – GENOTYPE RELATIONSHIP IN ARRHYTHMOGENIC CARDIOMYOPATHY

Author

Gueli, I, primary, Alderotti, B, additional, Todiere, G, additional, Grigoratos, C, additional, Modena, M, additional, Botto, N, additional, Vittorini, S, additional, Vergaro, G, additional, Giannoni, A, additional, Aimo, A, additional, Passino, C, additional, Aquaro, G, additional, Emdin, M, additional, and Barison, A, additional

Published
2022
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17. C65 POST–DISCHARGE ARRHYTHMIC RISK STRATIFICATION OF PATIENTS WITH ACUTE MYOCARDITIS AND LIFE–THREATENING VENTRICULAR TACHYARRHYTHMIAS

Author

Gentile, P, primary, Merlo, M, additional, Peretto, G, additional, Ammirati, E, additional, Sala, S, additional, Della Bella, P, additional, Aquaro, G, additional, Imazio, M, additional, Potena, L, additional, Campodonico, J, additional, Foà, A, additional, Raafs, A, additional, Hazebroek, M, additional, Brambatti, M, additional, Cercek, A, additional, Nucifora, G, additional, Shrivastava, S, additional, Huang, F, additional, Schmidt, M, additional, Muser, D, additional, Van De Heyning, C, additional, Van Craenenbroeck, E, additional, Aoki, T, additional, Sugimura, K, additional, Shimokawa, H, additional, Cannatà, A, additional, Artico, J, additional, Porcari, A, additional, Colopi, M, additional, Bussani, R, additional, Barbati, G, additional, Garascia, A, additional, Cipriani, M, additional, Agostoni, P, additional, Pereira, N, additional, Heymans, S, additional, Adler, E, additional, Camici, P, additional, Frigerio, M, additional, and Sinagra, G, additional

Published
2022
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19. Myocardial Fibrosis at Cardiac MRI Helps Predict Adverse Clinical Outcome in Patients with Mitral Valve Prolapse

Author

Stefano Figliozzi, Georgios Georgiopoulos, Pedro M. Lopes, Klemens B. Bauer, Sara Moura-Ferreira, Lara Tondi, Saima Mushtaq, Stefano Censi, Anna Giulia Pavon, Ilaria Bassi, Maria Luz Servato, Arco J. Teske, Federico Biondi, Domenico Filomena, Silvia Pica, Camilla Torlasco, Denisa Muraru, Pierre Monney, Giuseppina Quattrocchi, Viviana Maestrini, Luciano Agati, Lorenzo Monti, Patrizia Pedrotti, Bert Vandenberk, Angelo Squeri, Massimo Lombardi, António M. Ferreira, Juerg Schwitter, Giovanni Donato Aquaro, Amedeo Chiribiri, José F. Rodríguez Palomares, Ali Yilmaz, Daniele Andreini, Anca Florian, Tim Leiner, João Abecasis, Luigi Paolo Badano, Jan Bogaert, Pier-Giorgio Masci, Figliozzi, S, Georgiopoulos, G, Lopes, P, Bauer, K, Moura-Ferreira, S, Tondi, L, Mushtaq, S, Censi, S, Pavon, A, Bassi, I, Servato, M, Teske, A, Biondi, F, Filomena, D, Pica, S, Torlasco, C, Muraru, D, Monney, P, Quattrocchi, G, Maestrini, V, Agati, L, Monti, L, Pedrotti, P, Vandenberk, B, Squeri, A, Lombardi, M, Ferreira, A, Schwitter, J, Aquaro, G, Chiribiri, A, Rodríguez Palomares, J, Yilmaz, A, Andreini, D, Florian, A, Leiner, T, Abecasis, J, Badano, L, Bogaert, J, and Masci, P

Subjects
Radiology, Nuclear Medicine and imaging, myocardial fibrosis, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, mitral valve prolapse, cardiac magnetic resonance
Abstract

Background: Patients with mitral valve prolapse (MVP) may develop adverse outcomes even in the absence of mitral regurgitation or left ventricular (LV) dysfunction. Purpose: To investigate the prognostic value of mitral annulus disjunction (MAD) and myocardial fibrosis at late gadolinium enhancement (LGE) cardiac MRI in patients with MVP without moderate-to-severe mitral regurgitation or LV dysfunction. Materials and Methods: In this longitudinal retrospective study, 118 144 cardiac MRI studies were evaluated between October 2007 and June 2020 at 15 European tertiary medical centers. Follow-up was from the date of cardiac MRI examination to June 2020; the minimum and maximum follow-up intervals were 6 months and 156 months, respectively. Patients were excluded if at least one of the following conditions was present: cardiomyopathy, LV ejection fraction less than 40%, ischemic heart disease, congenital heart disease, inflammatory heart disease, moderate or worse mitral regurgitation, participation in competitive sport, or electrocardiogram suggestive of channelopathies. In the remainder, cardiac MRI studies were reanalyzed, and patients were included if they were aged 18 years or older, MVP was diagnosed at cardiac MRI, and clinical information and electrocardiogram monitoring were available within 3 months from cardiac MRI examination. The end point was a composite of adverse outcomes: sustained ventricular tachycardia (VT), sudden cardiac death (SCD), or unexplained syncope. Multivariable Cox regression analysis was performed. Results: A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 women) were included. Over a median follow-up of 3.3 years, 18 patients (4%) reached the study end point. LGE presence (hazard ratio, 4.2 [95% CI: 1.5, 11.9]; P = .006) and extent (hazard ratio, 1.2 per 1% increase [95% CI: 1.1, 1.4]; P = .006), but not MAD presence (P = .89), were associated with clinical outcome. LGE presence had incremental prognostic value over MVP severity and sustained VT and aborted SCD at baseline (area under the receiver operating characteristic curve, 0.70 vs 0.62; P = .03). Conclusion: In contrast to mitral annulus disjunction, myocardial fibrosis determined according to late gadolinium enhancement at cardiac MRI was associated with adverse outcome in patients with mitral valve prolapse without moderate-to-severe mitral regurgitation or left ventricular dysfunction.

Published
2022

20. Cardiac Magnetic Resonance for Prophylactic Implantable-Cardioverter Defibrillator Therapy in Ischemic Cardiomyopathy: The DERIVATE-ICM International Registry.

Author

Pontone G, Guaricci AI, Fusini L, Baggiano A, Guglielmo M, Muscogiuri G, Volpe A, Abete R, Aquaro G, Barison A, Bogaert J, Camastra G, Carigi S, Carrabba N, Casavecchia G, Censi S, Cicala G, De Cecco CN, De Lazzari M, Di Giovine G, Di Roma M, Dobrovie M, Focardi M, Gaibazzi N, Gismondi A, Gravina M, Lanzillo C, Lombardi M, Lorenzoni V, Lozano-Torres J, Martini C, Marzo F, Masi A, Memeo R, Moro C, Nese A, Palumbo A, Pavon AG, Pedrotti P, Marra MP, Pica S, Pradella S, Presicci C, Rabbat MG, Raineri C, Rodriguez-Palomares JF, Sbarbati S, Schoepf UJ, Squeri A, Sverzellati N, Symons R, Tat E, Timpani M, Todiere G, Valentini A, Varga-Szemes A, Masci PG, and Schwitter J

Subjects
Humans, Male, Middle Aged, Aged, Female, Contrast Media, Magnetic Resonance Imaging, Cine, Predictive Value of Tests, Gadolinium, Death, Sudden, Cardiac etiology, Death, Sudden, Cardiac prevention & control, Magnetic Resonance Spectroscopy adverse effects, Registries, Risk Factors, Defibrillators, Implantable adverse effects, Myocardial Ischemia complications, Myocardial Ischemia diagnostic imaging, Myocardial Ischemia therapy, Cardiomyopathies diagnostic imaging, Cardiomyopathies therapy, Cardiomyopathies complications
Abstract

Background: Implantable cardioverter-defibrillator (ICD) therapy is the most effective prophylactic strategy against sudden cardiac death (SCD) in patients with ischemic cardiomyopathy (ICM) and left ventricle ejection fraction (LVEF) ≤35% as detected by transthoracic echocardiograpgy (TTE). This approach has been recently questioned because of the low rate of ICD interventions in patients who received implantation and the not-negligible percentage of patients who experienced SCD despite not fulfilling criteria for implantation., Objectives: The DERIVATE-ICM registry (CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy; NCT03352648) is an international, multicenter, and multivendor study to assess the net reclassification improvement (NRI) for the indication of ICD implantation by the use of cardiac magnetic resonance (CMR) as compared to TTE in patients with ICM., Methods: A total of 861 patients with ICM (mean age 65 ± 11 years, 86% male) with chronic heart failure and TTE-LVEF <50% participated. Major adverse arrhythmic cardiac events (MAACE) were the primary endpoints., Results: During a median follow-up of 1,054 days, MAACE occurred in 88 (10.2%). Left ventricular end-diastolic volume index (HR: 1.007 [95% CI: 1.000-1.011]; P = 0.05), CMR-LVEF (HR: 0.972 [95% CI: 0.945-0.999]; P = 0.045) and late gadolinium enhancement (LGE) mass (HR: 1.010 [95% CI: 1.002-1.018]; P = 0.015) were independent predictors of MAACE. A multiparametric CMR weighted predictive derived score identifies subjects at high risk for MAACE compared with TTE-LVEF cutoff of 35% with a NRI of 31.7% (P = 0.007)., Conclusions: The DERIVATE-ICM registry is a large multicenter registry showing the additional value of CMR to stratify the risk for MAACE in a large cohort of patients with ICM compared with standard of care., Competing Interests: Funding Support and Author Disclosures The Italian Ministry of Health, Rome, Italy (RC 2017 R659/17-CCM698) has provided funding for this study. Dr De Cecco has received a grant from Siemens. Dr Pontone has received institutional fees from General Electric, Bracco, Heartflow, Medtronic, Bayer, and Bhoeringher. Dr Schwitter has received research support from Bayer Healthcare Switzerland. Dr Schoepf has received grants from Astellas, Bayer, General Electric, and Siemens Healthcare; personal fees from Guerbet; and speaking honoraria from Heartflow. Dr Varga-Szemes has received grants from Siemens Healthcare and personal fees from Elucid Bioimaging. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Published
2023
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21. Cardiac magnetic resonance for prophylactic implantable-cardioverter defibrillator therapy international study: prognostic value of cardiac magnetic resonance-derived right ventricular parameters substudy.

Author

Al'Aref SJ, Altibi AM, Malkawi A, Mansour M, Baskaran L, Masri A, Rahmouni H, Abete R, Andreini D, Aquaro G, Barison A, Bogaert J, Camastra G, Carigi S, Carrabba N, Casavecchia G, Censi S, Cicala G, Conte E, De Cecco CN, De Lazzari M, Di Giovine G, Di Roma M, Dobrovie M, Focardi M, Gaibazzi N, Gismondi A, Gravina M, Guglielmo M, Lanzillo C, Lombardi M, Lorenzoni V, Lozano-Torres J, Margonato D, Martini C, Marzo F, Masci P, Masi A, Memeo R, Moro C, Mushtaq S, Nese A, Palumbo A, Pavon AG, Pedrotti P, Pepi M, Perazzolo Marra M, Pica S, Pradella S, Presicci C, Rabbat MG, Raineri C, Rodriguez-Palomares JF, Sbarbati S, Schoepf UJ, Squeri A, Sverzellati N, Symons R, Tat E, Timpani M, Todiere G, Valentini A, Varga-Szemes A, Volpe A, Fusini L, Guaricci AI, Schwitter J, and Pontone G

Subjects
Humans, Female, Middle Aged, Aged, Male, Prognosis, Stroke Volume, Ventricular Function, Left, Risk Factors, Magnetic Resonance Imaging, Cine methods, Magnetic Resonance Spectroscopy adverse effects, Ventricular Function, Right, Heart Failure diagnostic imaging, Heart Failure therapy, Heart Failure complications, Defibrillators, Implantable adverse effects, Cardiomyopathies complications, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Dysfunction, Right therapy, Ventricular Dysfunction, Right etiology
Abstract

Aims: Right ventricular systolic dysfunction (RVSD) is an important determinant of outcomes in heart failure (HF) cohorts. While the quantitative assessment of RV function is challenging using 2D-echocardiography, cardiac magnetic resonance (CMR) is the gold standard with its high spatial resolution and precise anatomical definition. We sought to investigate the prognostic value of CMR-derived RV systolic function in a large cohort of HF with reduced ejection fraction (HFrEF)., Methods and Results: Study cohort comprised of patients enrolled in the CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DefibrillAtor ThErapy registry who had HFrEF and had simultaneous baseline CMR and echocardiography (n = 2449). RVSD was defined as RV ejection fraction (RVEF) <45%. Kaplan-Meier curves and cox regression were used to investigate the association between RVSD and all-cause mortality (ACM). Mean age was 59.8 ± 14.0 years, 42.0% were female, and mean left ventricular ejection fraction (LVEF) was 34.0 ± 10.8. Median follow-up was 959 days (interquartile range: 560-1590). RVSD was present in 936 (38.2%) and was an independent predictor of ACM (adjusted hazard ratio = 1.44; 95% CI [1.09-1.91]; P = 0.01). On subgroup analyses, the prognostic value of RVSD was more pronounced in NYHA I/II than in NYHA III/IV, in LVEF <35% than in LVEF ≥35%, and in patients with renal dysfunction when compared to those with normal renal function., Conclusion: RV systolic dysfunction is an independent predictor of ACM in HFrEF, with a more pronounced prognostic value in select subgroups, likely reflecting the importance of RVSD in the early stages of HF progression., Competing Interests: Conflict of interest: S.J.A. is supported by NIH 2R01 HL12766105 & 1R21 EB030654 and receives royalty fees from Elsevier. Carlo De Cecco received grant by Siemens. G.P. received institutional fees by General Electric, Bracco, Heartflow, Medtronic, Bayer, Bhoeringher. J.S. received research support by Bayer Healthcare Switzerland. U.J.S. received grant by Astellas, Bayer, General Electric, and Siemens Healthcare, personal fees by Guerbet, speaking honorarium by Heartflow. A.V.-S. received grant by Siemens Healthcare and personal fees by Elucid Bioimaging. The other authors have nothing to disclose., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2023
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22. [A rare case of myocarditis and pulmonary embolism after BNT162b2 mRNA vaccine].

Author

Mancini N, Cortigiani L, Aquaro G, and Bovenzi FM

Subjects
Adverse Drug Reaction Reporting Systems, BNT162 Vaccine, COVID-19 Vaccines adverse effects, Humans, Vaccines, Synthetic adverse effects, mRNA Vaccines, COVID-19, Myocarditis chemically induced, Pulmonary Embolism etiology
Abstract

In the clinical research arsenal, the COVID-19 vaccines are the strongest weapons against the most important worldwide sanitary crisis of the last centuries. Even if vaccine adverse events have mild clinical relevance, several thromboembolic events occurring after adenoviral recombinant vaccine administration have been reported. Cases of myocarditis and pericarditis after administration of mRNA vaccines have also recently been described. We report the case of a patient who suffered from two rare adverse events after BNT162b2 mRNA vaccine administration (Pfizer-BioNTech): acute myocarditis and pulmonary embolism. Although the temporal consequentiality does not demonstrate a causal link, the strong analogies emerging in the latest clinical reports suggest a possible relation. Further studies are needed to understand the potential mechanisms of myocardial damage and atypical thrombosis. Despite the favorable and self-limiting clinical course of post-vaccinal myocarditis, in these cases a tight follow-up is advisable and vaccine adverse event reporting remains mandatory, especially if not described during pivotal clinical trials.

Published
2022
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