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1. Outcome and Morphofunctional Changes on Cardiac Magnetic Resonance in Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination

Author

Ammirati, E, Lupi, L, Palazzini, M, Ciabatti, M, Rossi, V, Gentile, P, Uribarri, A, Vecchio, C, Nassiacos, D, Cereda, A, Conca, C, Tumminello, G, Piriou, N, Lelarge, C, Pedrotti, P, Stucchi, M, Peretto, G, Galasso, M, Huang, F, Ianni, U, Procopio, A, Saponara, G, Cimaglia, P, Tomasoni, D, Moroni, F, Turco, A, Sala, S, Di Tano, G, Bollano, E, Moro, C, Abbate, A, Della Bona, R, Porto, I, Carugo, S, Campodonico, J, Pontone, G, Grosu, A, Bolognese, L, Salamanca, J, Diez-Villanueva, P, Ozieranski, K, Tyminska, A, Sardo Infirri, L, Bromage, D, Cannatà, A, Hong, K, Adamo, M, Quattrocchi, G, Foà, A, Potena, L, Garascia, A, Giannattasio, C, Adler, E, Sinagra, G, Ruschitzka, F, Camici, P, Metra, M, Pieroni, M, Ammirati, Enrico, Lupi, Laura, Palazzini, Matteo, Ciabatti, Michele, Rossi, Valentina A, Gentile, Piero, Uribarri, Aitor, Vecchio, Chiara R, Nassiacos, Daniele, Cereda, Alberto, Conca, Cristina, Tumminello, Gabriele, Piriou, Nicolas, Lelarge, Coline, Pedrotti, Patrizia, Stucchi, Miriam, Peretto, Giovanni, Galasso, Michele, Huang, Florent, Ianni, Umberto, Procopio, Antonio, Saponara, Gianluigi, Cimaglia, Paolo, Tomasoni, Daniela, Moroni, Francesco, Turco, Annalisa, Sala, Simone, Di Tano, Giuseppe, Bollano, Entela, Moro, Claudio, Abbate, Antonio, Della Bona, Roberta, Porto, Italo, Carugo, Stefano, Campodonico, Jeness, Pontone, Gianluca, Grosu, Aurelia, Bolognese, Leonardo, Salamanca, Jorge, Diez-Villanueva, Pablo, Ozieranski, Krzysztof, Tyminska, Agata, Sardo Infirri, Loren, Bromage, Daniel, Cannatà, Antonio, Hong, Kimberly N, Adamo, Marianna, Quattrocchi, Giuseppina, Foà, Alberto, Potena, Luciano, Garascia, Andrea, Giannattasio, Cristina, Adler, Eric D, Sinagra, Gianfranco, Ruschitzka, Frank, Camici, Paolo G, Metra, Marco, Pieroni, Maurizio, Ammirati, E, Lupi, L, Palazzini, M, Ciabatti, M, Rossi, V, Gentile, P, Uribarri, A, Vecchio, C, Nassiacos, D, Cereda, A, Conca, C, Tumminello, G, Piriou, N, Lelarge, C, Pedrotti, P, Stucchi, M, Peretto, G, Galasso, M, Huang, F, Ianni, U, Procopio, A, Saponara, G, Cimaglia, P, Tomasoni, D, Moroni, F, Turco, A, Sala, S, Di Tano, G, Bollano, E, Moro, C, Abbate, A, Della Bona, R, Porto, I, Carugo, S, Campodonico, J, Pontone, G, Grosu, A, Bolognese, L, Salamanca, J, Diez-Villanueva, P, Ozieranski, K, Tyminska, A, Sardo Infirri, L, Bromage, D, Cannatà, A, Hong, K, Adamo, M, Quattrocchi, G, Foà, A, Potena, L, Garascia, A, Giannattasio, C, Adler, E, Sinagra, G, Ruschitzka, F, Camici, P, Metra, M, Pieroni, M, Ammirati, Enrico, Lupi, Laura, Palazzini, Matteo, Ciabatti, Michele, Rossi, Valentina A, Gentile, Piero, Uribarri, Aitor, Vecchio, Chiara R, Nassiacos, Daniele, Cereda, Alberto, Conca, Cristina, Tumminello, Gabriele, Piriou, Nicolas, Lelarge, Coline, Pedrotti, Patrizia, Stucchi, Miriam, Peretto, Giovanni, Galasso, Michele, Huang, Florent, Ianni, Umberto, Procopio, Antonio, Saponara, Gianluigi, Cimaglia, Paolo, Tomasoni, Daniela, Moroni, Francesco, Turco, Annalisa, Sala, Simone, Di Tano, Giuseppe, Bollano, Entela, Moro, Claudio, Abbate, Antonio, Della Bona, Roberta, Porto, Italo, Carugo, Stefano, Campodonico, Jeness, Pontone, Gianluca, Grosu, Aurelia, Bolognese, Leonardo, Salamanca, Jorge, Diez-Villanueva, Pablo, Ozieranski, Krzysztof, Tyminska, Agata, Sardo Infirri, Loren, Bromage, Daniel, Cannatà, Antonio, Hong, Kimberly N, Adamo, Marianna, Quattrocchi, Giuseppina, Foà, Alberto, Potena, Luciano, Garascia, Andrea, Giannattasio, Cristina, Adler, Eric D, Sinagra, Gianfranco, Ruschitzka, Frank, Camici, Paolo G, Metra, Marco, and Pieroni, Maurizio

Published
2023

2. Outcome and Morphofunctional Changes on Cardiac Magnetic Resonance in Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination

Author

Enrico Ammirati, Laura Lupi, Matteo Palazzini, Michele Ciabatti, Valentina A. Rossi, Piero Gentile, Aitor Uribarri, Chiara R. Vecchio, Daniele Nassiacos, Alberto Cereda, Cristina Conca, Gabriele Tumminello, Nicolas Piriou, Coline Lelarge, Patrizia Pedrotti, Miriam Stucchi, Giovanni Peretto, Michele Galasso, Florent Huang, Umberto Ianni, Antonio Procopio, Gianluigi Saponara, Paolo Cimaglia, Daniela Tomasoni, Francesco Moroni, Annalisa Turco, Simone Sala, Giuseppe Di Tano, Entela Bollano, Claudio Moro, Antonio Abbate, Roberta Della Bona, Italo Porto, Stefano Carugo, Jeness Campodonico, Gianluca Pontone, Aurelia Grosu, Leonardo Bolognese, Jorge Salamanca, Pablo Diez-Villanueva, Krzysztof Ozieranski, Agata Tyminska, Loren Sardo Infirri, Daniel Bromage, Antonio Cannatà, Kimberly N. Hong, Marianna Adamo, Giuseppina Quattrocchi, Alberto Foà, Luciano Potena, Andrea Garascia, Cristina Giannattasio, Eric D. Adler, Gianfranco Sinagra, Frank Ruschitzka, Paolo G. Camici, Marco Metra, Maurizio Pieroni, Ammirati, E, Lupi, L, Palazzini, M, Ciabatti, M, Rossi, V, Gentile, P, Uribarri, A, Vecchio, C, Nassiacos, D, Cereda, A, Conca, C, Tumminello, G, Piriou, N, Lelarge, C, Pedrotti, P, Stucchi, M, Peretto, G, Galasso, M, Huang, F, Ianni, U, Procopio, A, Saponara, G, Cimaglia, P, Tomasoni, D, Moroni, F, Turco, A, Sala, S, Di Tano, G, Bollano, E, Moro, C, Abbate, A, Della Bona, R, Porto, I, Carugo, S, Campodonico, J, Pontone, G, Grosu, A, Bolognese, L, Salamanca, J, Diez-Villanueva, P, Ozieranski, K, Tyminska, A, Sardo Infirri, L, Bromage, D, Cannatà, A, Hong, K, Adamo, M, Quattrocchi, G, Foà, A, Potena, L, Garascia, A, Giannattasio, C, Adler, E, Sinagra, G, Ruschitzka, F, Camici, P, Metra, M, and Pieroni, M

Subjects
myocarditi, COVID-19, COVID-19 vaccines, magnetic resonance spectroscopy, myocarditis, vaccination, Cardiology and Cardiovascular Medicine, COVID-19 vaccine
Published
2023

3. Outcome and Morphofunctional Changes on Cardiac Magnetic Resonance in Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination.

Author

Ammirati E, Lupi L, Palazzini M, Ciabatti M, Rossi VA, Gentile P, Uribarri A, Vecchio CR, Nassiacos D, Cereda A, Conca C, Tumminello G, Piriou N, Lelarge C, Pedrotti P, Stucchi M, Peretto G, Galasso M, Huang F, Ianni U, Procopio A, Saponara G, Cimaglia P, Tomasoni D, Moroni F, Turco A, Sala S, Di Tano G, Bollano E, Moro C, Abbate A, Della Bona R, Porto I, Carugo S, Campodonico J, Pontone G, Grosu A, Bolognese L, Salamanca J, Diez-Villanueva P, Ozieranski K, Tyminska A, Sardo Infirri L, Bromage D, Cannatà A, Hong KN, Adamo M, Quattrocchi G, Foà A, Potena L, Garascia A, Giannattasio C, Adler ED, Sinagra G, Ruschitzka F, Camici PG, Metra M, and Pieroni M

Subjects
Humans, Magnetic Resonance Spectroscopy, COVID-19 prevention & control, COVID-19 Vaccines adverse effects, Heart Failure, Myocarditis diagnostic imaging, Myocarditis etiology
Abstract

Competing Interests: Disclosures Dr Ammirati received a grant from the Italian Ministry of Health (GR-2019-12368506; principal investigator of the investigator-driven MYTHS trial [Myocarditis Therapy With Steroids]) and a grant from the Italian Ministry of Health and NextGenerationEU (PNRR-MAD-2022-12376225) and is a consultant for Kiniksa and Cytokinetics. Dr Metra reports personal fees from Actelion, Amgen, AstraZeneca, Abbott, Bayer, Servier, Edwards Therapeutics, Livanova, Vifor pharma, and WindTree Therapeutics, as a member of Trials’ Committees or for speeches at sponsored meetings in the last 3 years. Dr Ruschitzka has not received personal payments by pharmaceutical companies or device manufacturers in the past 3 years (remuneration for the time spent in activities, such as participation as a steering committee member of clinical trials and a member of the Pfizer Research Award selection committee in Switzerland, were made directly to the University of Zurich). The Department of Cardiology (University Hospital of Zurich/University of Zurich) reports research, educational, and/or travel grants from Abbott, Abiomed, Alexion, Amgen, AstraZeneca, At the Limits Ltd, Bayer, Berlin Heart, B. Braun, Biosense Webster, Biosensors Europe AG, Biotronik, Boehringer Ingelheim, Boston Scientific, Bracco, Bristol Myers Squibb, Cardinal Health Switzerland, Concept Medical, Corteria, CSL, Daiichi Sankyo, Diatools AG, Edwards Lifesciences, Guidant Europe NV (BS), Hamilton Health Sciences, IHF, Innosuisse, Johnson/Johnson, Kaneka Corporation, Kantar, Kiniksa, Labormedizinisches Zentrum, MedAlliance, Medical Education Global Solutions, Medtronic, MicroPort, MSD, Mundipharma Medical Company, Novartis, Novo Nordisk, Orion, Pfizer, Quintiles Switzerland Sarl, RecorMedical, Roche Diagnostics, Roche Pharma, Sahajanand IN, Sanofi, Sarstedt AG, Servier, SIS Medical, Sorin CRM SAS, SSS International Clinical Research, Stromal, Terumo Deutschland, Trama Solutions, V-Wave, Vascular Medical, Vifor, Wissens Plus, and ZOLL. These grants do not impact on Dr Ruschitzka’s personal remuneration. The other authors report no conflicts.

Published
2023
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4. Clinical Presentation and Outcome in a Contemporary Cohort of Patients With Acute Myocarditis: Multicenter Lombardy Registry.

Author

Ammirati E, Cipriani M, Moro C, Raineri C, Pini D, Sormani P, Mantovani R, Varrenti M, Pedrotti P, Conca C, Mafrici A, Grosu A, Briguglia D, Guglielmetto S, Perego GB, Colombo S, Caico SI, Giannattasio C, Maestroni A, Carubelli V, Metra M, Lombardi C, Campodonico J, Agostoni P, Peretto G, Scelsi L, Turco A, Di Tano G, Campana C, Belloni A, Morandi F, Mortara A, Cirò A, Senni M, Gavazzi A, Frigerio M, Oliva F, and Camici PG

Subjects
Acute Disease, Adolescent, Adult, Aged, Biomarkers blood, Biopsy, Cardiovascular Agents therapeutic use, Female, Heart Transplantation, Hospital Mortality, Hospitalization, Humans, Italy, Magnetic Resonance Imaging, Male, Middle Aged, Registries, Retrospective Studies, Risk Factors, Stroke Volume, Time Factors, Treatment Outcome, Troponin blood, Ventricular Function, Left, Young Adult, Myocarditis diagnosis, Myocarditis mortality, Myocarditis physiopathology, Myocarditis therapy
Abstract

Background: There is controversy about the outcome of patients with acute myocarditis (AM), and data are lacking on how patients admitted with suspected AM are managed. We report characteristics, in-hospital management, and long-term outcome of patients with AM based on a retrospective multicenter registry from 19 Italian hospitals., Methods: A total of 684 patients with suspected AM and recent onset of symptoms (<30 days) were screened between May 2001 and February 2017. Patients >70 years of age and those >50 years of age without coronary angiography were excluded. The final study population comprised 443 patients (median age, 34 years; 19.4% female) with AM diagnosed by either endomyocardial biopsy or increased troponin plus edema and late gadolinium enhancement at cardiac magnetic resonance., Results: At presentation, 118 patients (26.6%) had left ventricular ejection fraction <50%, sustained ventricular arrhythmias, or a low cardiac output syndrome, whereas 325 (73.4%) had no such complications. Endomyocardial biopsy was performed in 56 of 443 (12.6%), and a baseline cardiac magnetic resonance was performed in 415 of 443 (93.7%). Cardiac mortality plus heart transplantation rates at 1 and 5 years were 3.0% and 4.1%. Cardiac mortality plus heart transplantation rates were 11.3% and 14.7% in patients with complicated presentation and 0% in uncomplicated cases (log-rank P<0.0001). Major AM-related cardiac events after the acute phase (postdischarge death and heart transplantation, sustained ventricular arrhythmias treated with electric shock or ablation, symptomatic heart failure needing device implantation) occurred in 2.8% at the 5-year follow-up, with a higher incidence in patients with complicated forms (10.8% versus 0% in uncomplicated AM; log-rank P<0.0001). β-Adrenoceptor blockers were the most frequently used medications both in complicated (61.9%) and in uncomplicated forms (53.8%; P=0.18). After a median time of 196 days, 200 patients had follow-up cardiac magnetic resonance, and 8 of 55 (14.5%) with complications at presentation had left ventricular ejection fraction <50% compared with 1 of 145 (0.7%) of those with uncomplicated presentation., Conclusions: In this contemporary study, overall serious adverse events after AM were lower than previously reported. However, patients with left ventricular ejection fraction <50%, ventricular arrhythmias, or low cardiac output syndrome at presentation were at higher risk compared with uncomplicated cases that had a benign prognosis and low risk of subsequent left ventricular systolic dysfunction.

Published
2018
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5. Tomographic left ventricular volumetric emptying analysis by real-time 3-dimensional echocardiography: influence of left ventricular dysfunction with and without electrical dyssynchrony.

Author

De Castro S, Faletra F, Di Angelantonio E, Conca C, Marcantonio A, Francone M, Cartoni D, Mirabelli F, Gaudio C, Caselli S, Carbone I, Auricchio A, and Pandian NG

Subjects
Adolescent, Adult, Aged, Bundle-Branch Block physiopathology, Case-Control Studies, Female, Heart Failure physiopathology, Humans, Hypertrophy, Left Ventricular diagnostic imaging, Hypertrophy, Left Ventricular physiopathology, Image Interpretation, Computer-Assisted, Italy, Male, Middle Aged, Observer Variation, Predictive Value of Tests, Reproducibility of Results, Switzerland, Time Factors, Ventricular Dysfunction, Left physiopathology, Young Adult, Bundle-Branch Block diagnostic imaging, Echocardiography, Three-Dimensional, Heart Failure diagnostic imaging, Myocardial Contraction, Sports, Stroke Volume, Ventricular Dysfunction, Left diagnostic imaging
Abstract

Background: The sequence of left ventricular (LV) systolic emptying is not completely understood. Using real-time 3-dimensional echocardiography, we investigated this sequence and LV synchronicity in physiological and pathological conditions., Methods and Results: The study population consisted of 116 healthy volunteers, 20 top-level athletes, 35 patients with LV dysfunction, and 84 patients with LV dysfunction and left bundle-branch block (LBBB). We subdivided the LV into 16 volumetric segments for regional analysis and into apical, middle, and basal regions to calculate the mean of end-systolic times and the time to minimum systolic volume of each region. In healthy volunteers and in top-level athletes, the emptying systolic times increased smoothly from apex to base. These differences determined an apex-to-base time gradient in the LV emptying sequence. In patients with LV dysfunction and without LBBB, this gradient was maintained with a relatively higher LV dyssynchrony. However, in patients with LV dysfunction and LBBB, there was no clear sequence in LV emptying volumes, and this group had the highest LV dyssynchrony., Conclusions: Real-time 3-dimensional echocardiography tomographic slicing of the LV enables accurate analysis of LV emptying in physiological conditions and in conditions of LV dysfunction with and without electrical dyssynchrony. Progressive dilation of LV produces deterioration in LV synchronicity. However, it is the presence of LV dysfunction in combination with LBBB that determines the loss of the apex-to-base time gradient in LV emptying.

Published
2008
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