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1. Valsartan for prevention of recurrent atrial fibrillation

Author

GISSI AF Investigators, Disertori M, Latini R, Barlera S, Franzosi MG, Staszewsky L, Maggioni AP, Lucci D, Di Pasquale G, Tognoni G, Delise P, Bertocchi F, Maiocchi G, Geraci E, Correale E, Lombardi F, Mugelli A, Urso R, Scardi S, Fabbri G, Bartolomei B, Barbato G, Carbonieri E, Ciricugno S, Cosmi F, Pratola C, Rossi MG, Sciarra L, Zeni P, Ceseri M, Atzori A, Bambi F, Baviera M, Bianchini F, Fenicia E, Gianfriddo M, Lonardo G, Luise A, Nota R, Orlando ME, Petrolo R, Pierattini C, Pierota V, Ragno A, Serio C, Tafi A, Tellaroli E, Masson S, Vago T, Gramenzi S, Orso F, Suliman I, Nicolis E, Casola C, Dall'Osso D, Gorini M, Bianchini E, Cabiddu S, Cangioli I, Carnaghi A, Cipressa ML, Cipressa L, Galbiati L, Lorimer A, Priami P, Moccetti T, Vaghi F, Capello AF, Rossetti G, Viada E, Morena L, Delucchi M, Reynaud SG, Allemano P, Massobrio N, Gavazzi A, Taddei F, Mor DA, Bortolini F, Lorini M, Inama G, Durin O, Pirelli S, Spotti A, Procopio R, Cuzzucrea D, Gentile G, Margonato A, Bassanelli G, Tavazzi L, Buzzi MP, Rordorf R, Gualco A, Opasich C, Gronda E, Genovese L, Mattioli R, Donatelli F, Uriarte JA, Rauhe W, Bertagnolli C, Canestrini S, Stefenelli C, Cioffi G, Giovanelli C, Rigatelli G, Boni S, Pasini A, Sitta N, Sacchetta A, Borgese L, Sciascia R, Targa L, Raviele A, Madalosso M, Bertaglia E, Zoppo FC, Capanna M, Fiorencis R, Baracca E, Rossi R, Rossi I, Trappolin R, Morgera T, Barducci E, Baldin MG, Gobbo G, Zardo F, Hrovatin E, Mos L, Vriz O, Sinagra G, Aleksova A, Mazzone C, Fresco C, Rubartelli P, Moroni LA, Camerieri A, Piana M, Mureddu R, Bertoli D, Petacchi R, Pancaldi LG, Gabrieli L, Urbinati S, Pedone C, Di Niro M, Brunelli A, Bosi S, Censi S, Moruzzi P, Pastori P, Modena MG, Malavasi V, Mezzetti M, Melandri F, Zuppiroli A, Fazi A, Testa R, Venturini E, Mazzinghi F, Cosmi D, Santoro GM, Minneci C, Galli M, Paperini L, Bovenzi FM, Cortigiani L, Cocchieri M, Severini D, Arcuri GM, Bagliani G, Bernardinangeli M, Proietti G, Bocconcelli P, Pierantozzi A, Monti F, Giamundo L, Tancredi P, Rossini E, Bianchi C, Bettiol F, Giovannini E, Fera MS, Santini M, Bianconi L, Boccanelli A, Morosetti P, Volpe M, Facciolo C, Vacri A, Romanazzi F, Napoletano C, Piccioni LL, Candelmo F, De Marco G, Arnese MR, Vetrano A, Prinzi D, De Rosa P, Capuano V, Torre S, D'Onofrio A, Ammendola E, Battista R, De Fusco A, Molero U, Iervoglini A, Stefanelli S, Fattore L, Bosco B, Liguori A, Padula G, De Luca I, Sorino M, Colonna P, D'Agostino C, Pierfelice O, Pettinati G, Muscella A, De Lorenzi E, Falco M, Giannattasio C, Baldi N, Clemente MA, D'Alessandro B, Truncellito L, Arabia F, Ciconte VA, Perticone F, Ruberto C, Buffon A, Tomaselli C, De Rosa F, Mazza S, Zampaglione G, Pirozzi AM, Butera A, Levato M, Musacchio D, Polimeni RM, Lacquaniti V, Pulitanò G, Ruggeri A, Provenzano A, Cuccurullo O, Musolino M, Marrari A, Anastasio L, Schiavello M, Comito MG, Gulizia MM, Francese GM, Vasquez L, Coppolino C, Casale A, D'Urso G, Oliva G, Giordano U, Andolina S, Sanfilippo N, Ingrillì F, Accardo S, Grasso S, Buffa L, Serra E., CHIARIELLO, MASSIMO, PERRONE FILARDI, PASQUALE, Delise, P., Bertocchi, F., Maiocchi, G., Geraci, E., Correale, E., Lombardi, F., Mugelli, A., Urso, R., Scardi, S., Fabbri, G., Bartolomei, B., Barbato, G., Carbonieri, E., Ciricugno, S., Cosmi, F., Pratola, C., Rossi, M. G., Sciarra, L., Zeni, P., Ceseri, M., Atzori, A., Bambi, F., Baviera, M., Bianchini, F., Fenicia, E., Gianfriddo, M., Lonardo, G., Luise, A., Nota, R., Orlando, M. E., Petrolo, R., Pierattini, C., Pierota, V., Ragno, A., Serio, C., Tafi, A., Tellaroli, E., Masson, S., Vago, T., Gramenzi, S., Orso, F., Suliman, I., Nicolis, E., Casola, C., Dall'Osso, D., Gorini, M., Bianchini, E., Cabiddu, S., Cangioli, I., Carnaghi, A., Cipressa, M. L., Cipressa, L., Galbiati, L., Lorimer, A., Priami, P., Moccetti, T., Vaghi, F., Capello, A. F., Rossetti, G., Viada, E., Morena, L., Delucchi, M., Reynaud, S. G., Allemano, P., Massobrio, N., Gavazzi, A., Taddei, F., Mor, D. A., Bortolini, F., Lorini, M., Inama, G., Durin, O., Pirelli, S., Spotti, A., Procopio, R., Cuzzucrea, D., Gentile, G., Margonato, A., Bassanelli, G., Tavazzi, L., Buzzi, M. P., Rordorf, R., Gualco, A., Opasich, C., Gronda, E., Genovese, L., Mattioli, R., Donatelli, F., Uriarte, J. A., Rauhe, W., Bertagnolli, C., Canestrini, S., Stefenelli, C., Cioffi, G., Giovanelli, C., Rigatelli, G., Boni, S., Pasini, A., Sitta, N., Sacchetta, A., Borgese, L., Sciascia, R., Targa, L., Raviele, A., Madalosso, M., Bertaglia, E., Zoppo, F. C., Capanna, M., Fiorencis, R., Baracca, E., Rossi, R., Rossi, I., Trappolin, R., Morgera, T., Barducci, E., Baldin, M. G., Gobbo, G., Zardo, F., Hrovatin, E., Mos, L., Vriz, O., Sinagra, G., Aleksova, A., Mazzone, C., Fresco, C., Rubartelli, P., Moroni, L. A., Camerieri, A., Piana, M., Mureddu, R., Bertoli, D., Petacchi, R., Pancaldi, L. G., Gabrieli, L., Urbinati, S., Pedone, C., Di Niro, M., Brunelli, A., Bosi, S., Censi, S., Moruzzi, P., Pastori, P., Modena, M. G., Malavasi, V., Mezzetti, M., Melandri, F., Zuppiroli, A., Fazi, A., Testa, R., Venturini, E., Mazzinghi, F., Cosmi, D., Santoro, G. M., Minneci, C., Galli, M., Paperini, L., Bovenzi, F. M., Cortigiani, L., Cocchieri, M., Severini, D., Arcuri, G. M., Bagliani, G., Bernardinangeli, M., Proietti, G., Bocconcelli, P., Pierantozzi, A., Monti, F., Giamundo, L., Tancredi, P., Rossini, E., Bianchi, C., Bettiol, F., Giovannini, E., Fera, M. S., Santini, M., Bianconi, L., Boccanelli, A., Morosetti, P., Volpe, M., Facciolo, C., Vacri, A., Romanazzi, F., Napoletano, C., Piccioni, L. L., Candelmo, F., De Marco, G., Arnese, M. R., Vetrano, A., Prinzi, D., De Rosa, P., Capuano, V., Torre, S., D'Onofrio, A., Ammendola, E., Chiariello, M., Filardi, Pp., Battista, R., De Fusco, A., Molero, U., Iervoglini, A., Stefanelli, S., Fattore, L., Bosco, B., Liguori, A., Padula, G., De Luca, I., Sorino, M., Colonna, P., D'Agostino, C., Pierfelice, O., Pettinati, G., Muscella, A., De Lorenzi, E., Falco, M., Giannattasio, C., Baldi, N., Clemente, M. A., D'Alessandro, B., Truncellito, L., Arabia, F., Ciconte, V. A., Perticone, F., Ruberto, C., Buffon, A., Tomaselli, C., De Rosa, F., Mazza, S., Zampaglione, G., Pirozzi, A. M., Butera, A., Levato, M., Musacchio, D., Polimeni, R. M., Lacquaniti, V., Pulitano, G., Ruggeri, A., Provenzano, A., Cuccurullo, O., Musolino, M., Marrari, A., Anastasio, L., Schiavello, M., Comito, M. G., Gulizia, M. M., Francese, G. M., Vasquez, L., Coppolino, C., Casale, A., D'Urso, G., Oliva, G., Giordano, U., Andolina, S., Sanfilippo, N., Ingrilli, F., Accardo, S., Grasso, S., Buffa, L., Serra, E., Disertori, Marcello, Latini, Roberto, Barlera, Simona, Franzosi, Maria Grazia, Staszewsky, Lidia, Maggioni, Aldo Pietro, Lucci, Donata, Di Pasquale, Giuseppe, Tognoni, Gianni, GISSI AF, Investigator, Disertori, M, Latini, R, Barlera, S, Franzosi, Mg, Staszewsky, L, Maggioni, Ap, Lucci, D, Di Pasquale, G, Tognoni, G, Delise, P, Bertocchi, F, Maiocchi, G, Geraci, E, Correale, E, Lombardi, F, Mugelli, A, Urso, R, Scardi, S, Fabbri, G, Bartolomei, B, Barbato, G, Carbonieri, E, Ciricugno, S, Cosmi, F, Pratola, C, Rossi, Mg, Sciarra, L, Zeni, P, Ceseri, M, Atzori, A, Bambi, F, Baviera, M, Bianchini, F, Fenicia, E, Gianfriddo, M, Lonardo, G, Luise, A, Nota, R, Orlando, Me, Petrolo, R, Pierattini, C, Pierota, V, Ragno, A, Serio, C, Tafi, A, Tellaroli, E, Masson, S, Vago, T, Gramenzi, S, Orso, F, Suliman, I, Nicolis, E, Casola, C, Dall'Osso, D, Gorini, M, Bianchini, E, Cabiddu, S, Cangioli, I, Carnaghi, A, Cipressa, Ml, Cipressa, L, Galbiati, L, Lorimer, A, Priami, P, Moccetti, T, Vaghi, F, Capello, Af, Rossetti, G, Viada, E, Morena, L, Delucchi, M, Reynaud, Sg, Allemano, P, Massobrio, N, Gavazzi, A, Taddei, F, Mor, Da, Bortolini, F, Lorini, M, Inama, G, Durin, O, Pirelli, S, Spotti, A, Procopio, R, Cuzzucrea, D, Gentile, G, Margonato, A, Bassanelli, G, Tavazzi, L, Buzzi, Mp, Rordorf, R, Gualco, A, Opasich, C, Gronda, E, Genovese, L, Mattioli, R, Donatelli, F, Uriarte, Ja, Rauhe, W, Bertagnolli, C, Canestrini, S, Stefenelli, C, Cioffi, G, Giovanelli, C, Rigatelli, G, Boni, S, Pasini, A, Sitta, N, Sacchetta, A, Borgese, L, Sciascia, R, Targa, L, Raviele, A, Madalosso, M, Bertaglia, E, Zoppo, Fc, Capanna, M, Fiorencis, R, Baracca, E, Rossi, R, Rossi, I, Trappolin, R, Morgera, T, Barducci, E, Baldin, Mg, Gobbo, G, Zardo, F, Hrovatin, E, Mos, L, Vriz, O, Sinagra, G, Aleksova, A, Mazzone, C, Fresco, C, Rubartelli, P, Moroni, La, Camerieri, A, Piana, M, Mureddu, R, Bertoli, D, Petacchi, R, Pancaldi, Lg, Gabrieli, L, Urbinati, S, Pedone, C, Di Niro, M, Brunelli, A, Bosi, S, Censi, S, Moruzzi, P, Pastori, P, Modena, Mg, Malavasi, V, Mezzetti, M, Melandri, F, Zuppiroli, A, Fazi, A, Testa, R, Venturini, E, Mazzinghi, F, Cosmi, D, Santoro, Gm, Minneci, C, Galli, M, Paperini, L, Bovenzi, Fm, Cortigiani, L, Cocchieri, M, Severini, D, Arcuri, Gm, Bagliani, G, Bernardinangeli, M, Proietti, G, Bocconcelli, P, Pierantozzi, A, Monti, F, Giamundo, L, Tancredi, P, Rossini, E, Bianchi, C, Bettiol, F, Giovannini, E, Fera, M, Santini, M, Bianconi, L, Boccanelli, A, Morosetti, P, Volpe, M, Facciolo, C, Vacri, A, Romanazzi, F, Napoletano, C, Piccioni, Ll, Candelmo, F, De Marco, G, Arnese, Mr, Vetrano, A, Prinzi, D, De Rosa, P, Capuano, V, Torre, S, D'Onofrio, A, Ammendola, E, Chiariello, Massimo, PERRONE FILARDI, Pasquale, Battista, R, De Fusco, A, Molero, U, Iervoglini, A, Stefanelli, S, Fattore, L, Bosco, B, Liguori, A, Padula, G, De Luca, I, Sorino, M, Colonna, P, D'Agostino, C, Pierfelice, O, Pettinati, G, Muscella, A, De Lorenzi, E, Falco, M, Giannattasio, C, Baldi, N, Clemente, Ma, D'Alessandro, B, Truncellito, L, Arabia, F, Ciconte, Va, Perticone, F, Ruberto, C, Buffon, A, Tomaselli, C, De Rosa, F, Mazza, S, Zampaglione, G, Pirozzi, Am, Butera, A, Levato, M, Musacchio, D, Polimeni, Rm, Lacquaniti, V, Pulitanò, G, Ruggeri, A, Provenzano, A, Cuccurullo, O, Musolino, M, Marrari, A, Anastasio, L, Schiavello, M, Comito, Mg, Gulizia, Mm, Francese, Gm, Vasquez, L, Coppolino, C, Casale, A, D'Urso, G, Oliva, G, Giordano, U, Andolina, S, Sanfilippo, N, Ingrillì, F, Accardo, S, Grasso, S, and Buffa, L

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Tetrazoles, Cardiomegaly, Comorbidity, Placebo, Cardioversion, Double-Blind Method, Recurrence, Multicenter trial, Internal medicine, Angiotensin II Type 1 Receptor Blocker, Cardiovascular Disease, Atrial Fibrillation, medicine, Left atrial enlargement, Diabetes Mellitus, Humans, Sinus rhythm, cardiovascular diseases, Prospective Studies, Tetrazole, Proportional Hazards Models, Aged, business.industry, Medicine (all), Hazard ratio, Atrial fibrillation, Diabetes Mellitu, Valine, General Medicine, Middle Aged, medicine.disease, valsartan, atrial fibrillation, Prospective Studie, Valsartan, Cardiovascular Diseases, cardiovascular system, Cardiology, Proportional Hazards Model, Female, business, Angiotensin II Type 1 Receptor Blockers, medicine.drug, Human
Abstract

BACKGROUND: Atrial fibrillation is the most common cardiac arrhythmia, and no current therapy is ideal for control of this condition. Experimental studies suggest that angiotensin II-receptor blockers (ARBs) can influence atrial remodeling, and some clinical studies suggest that they may prevent atrial fibrillation. METHODS: We conducted a large, randomized, prospective, placebo-controlled, multicenter trial to test whether the ARB valsartan could reduce the recurrence of atrial fibrillation. We enrolled patients who were in sinus rhythm but had had either two or more documented episodes of atrial fibrillation in the previous 6 months or successful cardioversion for atrial fibrillation in the previous 2 weeks. To be eligible, patients also had to have underlying cardiovascular disease, diabetes, or left atrial enlargement. Patients were randomly assigned to receive valsartan or placebo. The two primary end points were the time to a first recurrence of atrial fibrillation and the proportion of patients who had more than one recurrence of atrial fibrillation over the course of 1 year. RESULTS: A total of 1442 patients were enrolled in the study. Atrial fibrillation recurred in 371 of the 722 patients (51.4%) in the valsartan group, as compared with 375 of 720 (52.1%) in the placebo group (adjusted hazard ratio, 0.97; 96% confidence interval [CI], 0.83 to 1.14; P = 0.73). More than one episode of atrial fibrillation occurred in 194 of 722 patients (26.9%) in the valsartan group and in 201 of 720 (27.9%) in the placebo group (adjusted odds ratio, 0.89; 99% CI, 0.64 to 1.23; P = 0.34). The results were similar in all predefined subgroups of patients, including those who were not receiving angiotensin-converting-enzyme inhibitors. CONCLUSIONS: Treatment with valsartan was not associated with a reduction in the incidence of recurrent atrial fibrillation. (ClinicalTrials.gov number, NCT00376272.) Copyright © 2009 Massachusetts Medical Society.

Published
2009

2. Impact of mitral regurgitation on the outcome of patients treated with CRT-D: Data from the InSync ICD Italian registry

Author

Giuseppe, Boriani, M. D., H. D., P, Maurizio, Gasparini, † MAURIZIO LANDOLINA, ‡ MAURIZIO LUNATI, MAURO BIFFI, Massimo, Santini, LUIGI PADELETTI, Giulio, Molon, †† GIANLUCA BOTTO, ‡‡ TIZIANA DE SANTO, B. S., and SERGIO VALSECCHI, Gasparini, M., Galimberti, P., Regoli, F., Ceriotti, C., Istituto Clinico Humanitas, Rozzano-, Milano, Lunati, M., Cattafi, G., Magenta, G., Paolucci, M., Vecchi, R., Niguarda, Hospital, Milano, Santini, M., Ricci, R., San Filippo Neri, Roma, Gaita, F., Bocchiardo, M., Didonna, P., Caponi, D., Civile, Hospital, Asti, Tavazzi, L., Landolina, M., Rordorf, R., Petracci, B., Vicentini, A., Savastano, S., Matteo, Pol. S., Pavia, Padeletti, L., Pieragnoli, P., Careggi, Firenze, Vincenti, A., Deceglia, S., Cir ` o, A., Gerardo Dei Tintori, S., Monza(MI), Curnis, A., Mascioli, G., Spedali, Civili, Brescia, Puglisi, A., Bianchi, S., Peraldo, C., Fatebenefratelli, Roma, Sassara, M., Achilli, A., Turreni, F., Rossi, P., Belcolle, Hospital, Viterbo, Perego, Gb., Luca Auxologico, S., Ravazzi, P. A., Diotallevi, P., Antonio e Biagio, Ss., Alessandria, Tritto, M., Mater, Domini, Castellanza, (VA), Carboni, A., Ardissino, D., Gonzi, G., Serra, V., Civile, Parma, Vergara, G., Maria Del Carmine, S., Rovereto, (TN), Boriani, G., Biffi, M., Martignani, C., Diemberger, I., Orsola-Mailpighi, S., Bologna, Luzzi, G., Policlinico, Bari, Laurenzi, F., Camillo, S., Pistis, G., Mauriziano, Torino, Cesario, A., Grassi, G. B., Ostia, (RM), Zanotto, G., Civile, Verona, Orazi, S., Rieti, Ometto, R., Bonanno, C., Bortolo, S., Vicenza, Molon, G., Barbieri, E., Cuore, S., Negrar, (VR), Raviele, A., Gasparini, G., Umbertoi, Mestre, (VE), Botto, G., Luzi, M., Sagone, A., Anna, S., Como, Vado, A., Croce, S., Cuneo, Montenero, A., Multimedica, Giovanni (MI), Sestos., Inama, G., Maggiore, Crema, Sassone, B., Civile, Bentivoglio, (BO), Briedda, M., Zardo, F., Maria, S., Pordenone, E. Bertaglia, Mirano (VE), Proclemer, A., Udine, Zanon, F., Civile, Rovigo, Disertori, M., Gramegna, L., Delgreco, M., Dallafior, D., Chiara, S., Trento, Tomasi, C., Maresta, A., Piancastelli, M., Maria Croci, S., Ravenna, Bridda, A., Martino, S., Belluno, Mantovan, R., C`afoncello, Treviso, Fusco, A., Pederzoli, Peschiera, (VR), Baraldi, P., Agostino, S., Modena, G. Lonardi, Legnago (VR), Rahue, W., Maurizio, S., Bolzano, P. Delise, Conegliano (TV), Menozzi, C., Marianuova, S., Reggioemilia, Babudri, P., Borgoroma, Verona, Marconi, R., Mazzoni, Ascolipiceno, Alfano, G. DeFabrizio F., Moscati, G., Avellino, Barbato, G., Maggiore, Bologna, P. Gelmini, Desenzano (BS), Disabato, Leopoldo, S., Merate, (LC), Ricci, S., Ramazzini, Carpi, (MO), Aulerio, M. D., Biagio, S., Domodossola, (VB), Morgagni, G. L., Latini, R., Macerata, Bardelli, G., Fornaroli, Magenta, (MI), R. Paulichl, F. Tappeiner Merano (BZ), Bernasconi, M., Marzegalli, M., Carlo, S., Neri, G., Montebelluna, Treviso, E. Occhetta, Novara, Bocconcelli, P., Salvatore, S., Pesaro, A. Capucci, Piacenza, Campana, A., Giovanni, S., Salerno, N. Dibelardino, Velletri (RM), Vaglio, A., Giovanni, e Paolo, Venezi, A., Boriani G, Gasparini M, Landolina M, Lunati M, Biffi M, Santini M, Padeletti L, Molon G, Botto G, de Santo T, Valsecchi S, and InSync/InSync ICD Italian Registry Investigators.

Subjects
Male, Mitral Valve Insufficiency, Socio-culturale, heart failure, Comorbidity, CARDIAC RESYNCHRONIZATION THERAPY, mitral regurgitation, Risk Assessment, Survival Analysis, Survival Rate, Treatment Outcome, Italy, Risk Factors, Prevalence, Humans, Female, Registries, Aged
Abstract

We assessed the influence of clinically significant mitral regurgitation (MR) on clinical-echocardiographic response and outcome in heart failure (HF) patients treated with a biventricular defibrillator (cardiac resynchronization therapy defibrillator [CRT-D]). METHODS AND RESULTS: A total of 659 HF patients underwent successful implantation of CRT-D and were enrolled in a multicenter prospective registry (median follow-up of 15 months). Following baseline echocardiographic evaluation, patients were stratified into two groups according to the severity of MR: 232 patients with more than mild MR (Group MR+: grade 2, 3, and 4 MR) versus 427 patients with mild (grade 1) or no functional MR (Group MR-). On 6- and 12-month echocardiographic evaluation, MR was seen to have improved in the vast majority of MR+ patients, while it remained unchanged in most MR- patients. On 12-month follow-up evaluation, a comparable response to CRT was observed in the two groups, in terms of the extent of left ventricular reverse remodeling and combined clinical and echocardiographic response. During long-term follow-up, event-free survival did not differ between MR+ and MR- patients, even when subpopulations of patients with ischemic heart disease and with dilated cardiomyopathy were analyzed separately. On multivariate analysis, the only independent predictor of death from any cause was the lack of β-blocker use. CONCLUSIONS: This observational analysis supports the use of CRT-D in HF patients with clinically significant MR; MR had no major influence on patient outcome.

Published
2012

3. Effectiveness of cardiac resynchronization therapy in heart failure patients with valvular heart disease: comparison with patients affected by ischaemic heart disease or dilated cardiomyopathy. The InSync/InSync ICD Italian Registry

Author

Boriani, G, Gasparini, M, Landolina, M, Lunati, M, Biffi, M, Santini, M, Padeletti, L, Molon, G, Botto, G, De Santo, T, Valsecchi, S, Galimberti, P, Regoli, F, Ceriotti, C, Cattafi, G, Magenta, G, Paolucci, M, Vecchi, R, Ricci, R, Gaita, F, Bocchiardo, M, Didonna, P, Caponi, D, Tavazzi, L, Rordorf, R, Petracci, B, Vicentini, A, Savastano, S, Matteo, Ps, Pieragnoli, P, Vincenti, A, Deceglia, S, Ciró, A, Gerardo Dei Tintori, S, Curnis, A, Mascioli, G, Puglisi, A, Bianchi, S, Peraldo, C, Sassara, M, Achilli, A, Turreni, F, Rossi, P, Perego, Gb, Ravazzi, Pa, Diotallevi, P, Antonio, e Biagio SS, Tritto, M, Carboni, A, Ardissino, D, Gonzi, G, Serra, V, Vergara, G, Maria Del Carmine, S, Martignani, C, Frabetti, L, Orsola-Mailpighi, S, Luzzi, G, Laurenzi, F, Camillo, S, Pistis, G, Cesario, A, Grassi, Gb, Zanotto, G, Orazi, S, Ometto, R, Bonanno, C, Bortolo, S, Barbieri, E, Cuore, S, Raviele, A, Gasparini, G, Luzi, M, Sagone, A, Anna, S, Vado, A, Croce, S, Montenero, A, Giovanni, Ss, Inama, G, Sassone, B, Briedda, M, Zardo, F, Maria, S, Bertaglia, E, Proclemer, A, Zanon, F, Disertori, M, Gramegna, L, Delgreco, M, Dallafior, D, Chiara, S, Tomasi, C, Maresta, A, Piancastelli, M, Maria Croci, S, Bridda, A, Martino, S, Mantovan, R, Fusco, A, Baraldi, P, Agostino, S, Lonardi, G, Rahue, W, Maurizio, S, Delise, P, Menozzi, C, Marianuova, S, Babudri, P, Marconi, R, Defabrizio, G, Alfano, F, Moscati, G, Barbato, G, Gelmini, P, Disabato, Leopoldo, S, Ricci, S, Aulerio, Md, Biagio, S, Morgagni, Gl, Latini, R, Bardelli, G, Paulichl, R, Tappeiner Merano, F, Bernasconi, M, Marzegalli, M, Carlo, S, Neri, G, Occhetta, E, Bocconcelli, P, Salvatore, S, Capucci, A, Campana, A, Giovanni, S, Dibelardino, N, Vaglio, A, Boriani G, Gasparini M, Landolina M, Lunati M, Biffi M, Santini M, Padeletti L, Molon G, Botto G, De Santo T, and Valsecchi S

Subjects
Cardiomyopathy, Dilated, Male, medicine.medical_specialty, Pacemaker, Artificial, medicine.medical_treatment, Cardiac resynchronization therapy, Cardiomyopathy, Heart Valve Diseases, Myocardial Ischemia, Socio-culturale, Heart failure, Aged, Atrial Fibrillation, Defibrillators, Implantable, Female, Heart Failure, Humans, Middle Aged, Registries, Treatment Outcome, Ventricular Remodeling, Cardiac Pacing, Artificial, Clinical Research, Internal medicine, medicine, cardiovascular diseases, Remodelling, Valvular heart disease, Heart transplantation, Ejection fraction, business.industry, valvular heart disease, Atrial fibrillation, Dilated cardiomyopathy, medicine.disease, Cardiology, cardiovascular system, Cardiology and Cardiovascular Medicine, business
Abstract

Aims To analyse the effectiveness of cardiac resynchronization therapy (CRT) in patients with valvular heart disease (a subset not specifically investigated in randomized controlled trials) in comparison with ischaemic heart disease or dilated cardiomyopathy patients. Methods and results Patients enrolled in a national registry were evaluated during a median follow-up of 16 months after CRT implant. Patients with valvular heart disease treated with CRT ( n = 108) in comparison with ischaemic heart disease ( n = 737) and dilated cardiomyopathy ( n = 635) patients presented: (i) a higher prevalence of chronic atrial fibrillation, with atrioventricular node ablation performed in around half of the cases; (ii) a similar clinical and echocardiographic profile at baseline; (iii) a similar improvement of LVEF and a similar reduction in ventricular volumes at 6–12 months; (iv) a favourable clinical response at 12 months with an improvement of the clinical composite score similar to that occurring in patients with dilated cardiomyopathy and more pronounced than that observed in patients with ischaemic heart disease; (v) a long-term outcome, in term of freedom from death or heart transplantation, similar to patients affected by ischaemic heart disease and basically more severe than that of patients affected by dilated cardiomyopathy. Conclusion In ‘real world’ clinical practice, CRT appears to be effective also in patients with valvular heart disease. However, in this group of patients the outcome after CRT does not precisely overlap any of the two other groups of patients, for which much more data are currently available.

Published
2009

4. Heart rate variability monitored by the implanted device predicts response to CRT and long-term clinical outcome in patients with advanced heart failure

Author

Landolina, M, Gasparini, M, Lunati, M, Santini, M, Rodorf, R, Vincenti, A, Montenero AS, Diotallevi P., Bonanno, C, Desanto, T, Valsecchi, S, Padeletti, L, Galimberti, P, Regoli, F, Gronda, E, Cattafi, G, Magenta, G, Paolucci, M, Vecchi, R, Niguarda, Ricci, R, Gaita, F, Bocchiardo, M, Didonna, P, Caponi, D, Tavazzi, L, Rordorf, R, Petracci, B, Vicentini, A, Savastano, S, Pieragnoli, P, Deceglia, S, Cirò, A, Curnis, A, Mascioli, G, Puglisi, A, Bianchi, S, Peraldo, C, Sassara, M, Achilli, A, Turreni, F, Rossi, P, B Perego, G, A Ravazzi, P, Diotallevi, P, Carboni, A, Ardissino, D, Gonzi, G, Serra, V, Boriani, G, Biffi, M, Martignani, C, Frabetti, L, Luzzi, G, Laurenzi, F, Pistis, G, Cesario, A, Zanotto, G, Orazi, S, Ometto, R, Molon, G, Barbieri, E, Raviele, A, Gasparini, G, Botto, G, Luzi, M, Sagone, A, Vado, A, Montenero, A, Inama, G, Sassone, B, Briedda, M, Zardo, F, Bertaglia, E, Proclemer, A, Zanon, F, Disertori, M, Gramegna, L, Delgreco, M, Dallafior, D, Tomasi, C, Maresta, A, Piancastelli, M, Bridda, A, Mantovan, R, Fusco, A, Baraldi, P, Lonardi, G, Rahue, W, Delise, P, Menozzi, C, Babudri, P, Marconi, R, G De Fabrizio, Alfano, F, Barbato, G, Gelmini, P, Disabato, Ricci, S, D Aulerio, M, L Morgagni, G, Latini, R, Bardelli, G, Paulichl, R, Bernasconi, M, Marzegalli, M, Neri, G, Occhetta, E, Bocconcelli, P, Capucci, A, Campana, A, Dibelardino, N, Vaglio, A, Landolina M, Gasparini M, Lunati M, Santini M, Rordorf R, Vincenti A, Diotallevi P, Montenero AS, Bonanno C, De Santo T, Valsecchi S, Padeletti L, and InSync/InSync ICD Italian Registry Investigators [.., Boriani G,..]

Subjects
Male, medicine.medical_specialty, Time Factors, Cardiac pacing, medicine.medical_treatment, Socio-culturale, Heart Rate, Internal medicine, Heart rate variability, Medicine, Humans, In patient, Implanted device, Aged, Monitoring, Physiologic, Retrospective Studies, Heart transplantation, Heart Failure, Ventricular Remodeling, business.industry, Follow up studies, Cardiac Pacing, Artificial, Retrospective cohort study, Equipment Design, medicine.disease, Prognosis, Survival Rate, Heart failure, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Background: Few data exist on the long-term changes and the prognostic value of heart rate variability (HRV) assessed by implanted devices in heart failure (HF) patients treated with resynchronization therapy (CRT). Aims: To analyze the long-term changes in the standard deviation of 5-minute median atrial–atrial sensed intervals (SDANN), and assess its role in predicting CRT efficacy and major cardiovascular events. Methods and results: We included 509 consecutive patients implanted with CRT devices. At 12-month follow-up, 44 patients had died and 86 patients had at least one HF hospitalisation. A significant increase in SDANN occurred after 4 weeks of CRT (from 69±22 ms to 82±27 ms, p

Published
2008

5. Can short-term verapamil therapy reduce the recurrence of atrial fibrillation after successful low energy intracardiac cardioversion?

Author

Zardo F, Antonini-Canterin F, Brieda M, Hrovatin E, Pavan D, Burelli C, Cervesato E, and Gian Luigi Nicolosi

Subjects
Adult, Male, Electric Countershock, Atrial Function, Right, Middle Aged, Calcium Channel Blockers, Verapamil, Recurrence, Atrial Fibrillation, Humans, Female, Prospective Studies, Anti-Arrhythmia Agents, Aged
Abstract

Calcium-lowering drugs seem to be able to reduce the recurrences of atrial fibrillation (AF) after cardioversion by preventing electrical remodeling of atrial cells. The aim of our study was to prospectively evaluate the efficacy of short-term verapamil therapy associated with propafenone or amiodarone in reducing recurrences of AF after low energy intracardiac cardioversion.Eighty-two patients with chronic AF (mean duration 6.1 months, range 1-96 months) underwent low energy intracardiac cardioversion. Forty-one patients (Group A) were instructed to suspend antiarrhythmic therapy 48 hours before the procedure (only chronic amiodarone was allowed). The subsequent 41 patients (Group B), in addition to previous prescriptions, had to take verapamil (120 mg twice daily) for 3 days before low energy intracardiac cardioversion and for 7 days after cardioversion. A right atrium-coronary sinus or right atrium-left pulmonary artery electrode configuration was indifferently utilized. Propafenone (450-900 mg daily) or amiodarone (200 mg daily) was prescribed to all patients after cardioversion.Sinus rhythm was acutely restored in 80 patients (97.6%): the mean number of shocks delivered was 2.3 (range 1-5); the mean energy required was 10.5 J (range 7.2-19.8 J). No statistically significant differences were found between the right atrium-coronary sinus vs right atrium-left pulmonary artery electrode configuration regarding the energy required and the number of shocks delivered. Group A and Group B showed the same number of AF recurrences at the first month of follow-up.In our study, short-term verapamil treatment associated with propafenone or amiodarone seems to be useless for the prevention of recurrent AF after low energy intracardiac cardioversion.

Published
2001

6. Low energy intracardiac cardioversion of chronic atrial fibrillation by single femoral approach: safety and effectiveness of the procedure

Author

Zardo F, Antonini-Canterin F, Brieda M, Hrovatin E, Pavan D, Burelli C, Cervesato E, and Gian Luigi Nicolosi

Subjects
Adult, Male, Atrial Fibrillation, Chronic Disease, Electric Countershock, Humans, Female, Prospective Studies, Middle Aged, Aged
Abstract

Low energy intracardiac cardioversion has recently been introduced into clinical practice to treat both acute and chronic atrial fibrillation. It has also been suggested that low energy intracardiac cardioversion has a higher efficacy rate in restoring sinus rhythm than conventional external cardioversion.A prospective study was started in 41 patients (mean age 64.5 years) with chronic atrial fibrillation (mean duration 6.5 months), in order to obtain more data on low energy intracardiac cardioversion concerning: 1) time required to perform low energy intracardiac cardioversion by single venous femoral approach; 2) acute efficacy; 3) incidence of complications; 4) persistence of sinus rhythm after 1 month.Twenty patients had right atrium-coronary sinus (Group A) and 20 right atrium-left pulmonary artery (Group B) electrode configuration for defibrillation. In 1 patient the configuration was not available. In all patients (100%) sinus rhythm was acutely restored. No statistically significant differences were found between the two groups concerning mean energy and impedance required to obtain cardioversion. With mild sedation the discomfort induced by the electrical shock was minimal or mild. Only 44% of patients were in sinus rhythm 1 month after low energy intracardiac cardioversion, in spite of adequate pharmacological therapy.Low energy intracardiac cardioversion by single venous femoral approach may be considered a very effective and not time consuming procedure in acutely restoring sinus rhythm, with low complication rate; in addition the procedure was well accepted by all patients.

Published
2000

7. Simultaneous occurrence of larynx carcinoma and acute blastic transformation in a patient with essential thrombocythemia

Author

Ferrari, A., Mazzucconi, M. G., Chistolini, A., Diverio, D., Pasqualetti, D., Zardo, F., MAURIZI ENRICI, Riccardo, and Mandelli, Franco

Subjects
Male, complications, etiology, Carcinoma, Aged, Blast Crisis, etiology, Carcinoma, Squamous Cell, etiology, Humans, Laryngeal Neoplasms, etiology, Male, Neoplasms, Multiple Primary, Thrombocythemia, Essential, Multiple Primary, Neoplasms, Humans, Thrombocythemia, Blast Crisis, Laryngeal Neoplasms, Aged
Published
1990

8. [Idiopathic mitral valve prolapse syndrome (MPS). Apropos of a series of 80 cases]

Author

Bazzi A, Bitto S, Burelli C, Charmet A, Dall'Aglio V, Manfroni A, Martin G, Gian Luigi Nicolosi, Zanuttini D, and Zardo F

Subjects
Adult, Male, Mitral Valve Prolapse, Adolescent, Hemodynamics, Phonocardiography, Arrhythmias, Cardiac, Middle Aged, Angina Pectoris, Electrocardiography, Dyspnea, Asthenia, Vertigo, Humans, Female, Radiography, Thoracic, Child, Aged
Published
1980

9. [2-dimensional echocardiography in the evaluation of pericardial pathology: new prospects for its differential diagnosis]

Author

Lestuzzi C, Gian Luigi Nicolosi, Pavan D, Burelli C, Zardo F, and Zanuttini D

Subjects
Adult, Adolescent, Infant, Newborn, Pericarditis, Constrictive, Infant, Middle Aged, Pericardial Effusion, Diagnosis, Differential, Echocardiography, Child, Preschool, Humans, Child, Pericardium, Aged
Abstract

We examined retrospectively the M-mode and two-dimensional echocardiograms performed in our laboratory on 227 patients with pericardial diseases, in order to assess the capabilities and limits of echocardiography in this field. We observed 4 patients with congenital absence of the pericardium, 10 with of constrictive or infiltrative-adhesive pericarditis, 213 pericardial effusions, associated with left pleural effusion in 36 cases and with different kinds of intrapericardial masses in 33 cases. Through qualitative analysis of the echogenicity of such masses some aspects were singled out which may prove useful in identifying intrapericardial fat, as well as tumors. We also suggest new ways of using specific echocardiographic sections to differentiate left pleural effusions from pericardial effusions, and to identify very small pericardial effusions.

Published
1985

10. [Possibilities and difficulties of differential diagnosis by 2-dimensional echocardiography of mobile masses inside the right atrium. Apropos of a case]

Author

Dall'Aglio V, Gian Luigi Nicolosi, Burelli C, Zardo F, Pavan D, Lestuzzi C, Bontempi E, and Zanuttini D

Subjects
Diagnosis, Differential, Heart Neoplasms, Heart Diseases, Echocardiography, Humans, Female, Thrombosis, Heart Atria, Myxoma, Aged
Abstract

A peculiar case of mobile right atrial mass thrombotic in origin identified by two-dimensional echocardiography is reported. By the characteristics of the mass and the negative history for SBE and malignant neoplasm, the possibilities of tricuspid vegetations or infiltration by an extracardiac tumor could be reasonably ruled out. On the other hand, a myxomatous mass could not be excluded in this case. The thrombotic nature of the mass was recognized at autopsy. The possibility to identify by two-dimensional echocardiography right atrial masses together with the difficulties in certain particular cases to recognize their nature are discussed.

Published
1985

11. [Equilibrium angioscintigraphic evaluation of sequential changes in right ventricle function in patients with lower myocardial infarct and ischemic co-involvement of the right ventricle: long-term study]

Author

Cassin M, Spaziante R, Bruno A, Pa, Charmet, Gian Luigi Nicolosi, Zardo F, Burelli C, Martin G, Brieda M, and Zanuttini D

Subjects
Adult, Aged, 80 and over, Male, Heart Ventricles, Myocardial Infarction, Humans, Coronary Disease, Female, Heart, Middle Aged, Radionuclide Angiography, Aged, Follow-Up Studies
Abstract

The purpose of this study was to define the sequential changes in global and regional right ventricular function, using equilibrium gated radionuclide angiography, following transmural inferior myocardial infarction (IMI) and associated ischemic right ventricular involvement. 24 patients with IMI underwent radionuclide angiography within 72 hours of onset of chest pain; subsequent studies were done at 13 +/- 5 days and at 6 +/- 2 months. Scintigraphic evidence of ischemic right ventricular involvement was defined by depression of right ventricular ejection fraction (less than 40%) and regional wall motion abnormalities (hypo-a-dyskinesia of right ventricular free wall). Significant improvement of global right ventricular ejection fraction was observed in 15 patients at the second study, and in 21 patients at the third study. Right ventricular regional wall motion showed similar improvement from the initial to the final studies. Significant changes in right ventricular function occurred without concurrent changes in global and regional left ventricular ejection fraction. We concluded that patients with IMI and ischemic right ventricular involvement show frequently improvement of global and regional right ventricular function over time. This changes tend to occur early and without significant modifications in left ventricular function. The good prognosis observed in our patients, despite the high incidence of in hospital complications, might be related to the improvement of right ventricular function.

Published
1987

13. [Study of the intracardiac flow by real-time bidimensional color-coded Doppler echocardiography. Preliminary experience]

Author

Gian Luigi Nicolosi, Pavan D, Burelli C, Dall'Aglio V, Lestuzzi C, Zardo F, and Zanuttini D

Subjects
Adult, Heart Defects, Congenital, Adolescent, Cardiac Volume, Aortic Valve Insufficiency, Infant, Newborn, Infant, Mitral Valve Insufficiency, Middle Aged, Pulmonary Valve Insufficiency, Tricuspid Valve Insufficiency, Echocardiography, Evaluation Studies as Topic, Child, Preschool, Heart Valve Prosthesis, Humans, Mitral Valve Stenosis, Child, Aged
Abstract

The new technique of real-time two-dimensional color Doppler echocardiography has been recently developed to allow visualization of the blood flow inside the cardiac chambers. The blood flow informations are color coded and displayed in real-time into the two-dimensional echocardiographic images of the cardiac structures. The flow informations which are given are velocity, direction and variance, calculated from the Doppler signals obtained from all the sample points. Flow directed toward the transducer is coded in red; flow away from the transducer is coded in blue, while the echoes from the cardiac structures are imaged in gray scale. The magnitude of the velocity of flow is represented by the brightness of the color, with an 8-steps scale of brightness, beginning from the lowest grade, which is not colored on the screen. To represent the velocity spectrum variance, green is added to each color in proportion to the extent of turbulence. We report our preliminary experience with this technique in 91 subjects by using an Aloka SSD 880 commercial equipment (age range 18 days-82 years): 5 were normal, 15 had cardiomyopathy, 21 had congenital, 40 valvular, 6 ischemic and 4 other forms of heart disease. Color display of intracavitary flow allowed to identify normal and abnormal patterns. Valvular regurgitation and abnormal intracavitary shunts were easy to identify, suggesting the possibility of a semiquantitative assessment of the lesions. The possibility of a quantitative approach should be further investigated in the future.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1986

14. In vivo and in vitro evaluation of left ventricular thrombi by two-dimensional echocardiography. Comparison with cineventriculography

Author

Pavan D, Gian Luigi Nicolosi, Lestuzzi C, Marino P, Burelli C, Zardo F, Collazzo R, Pizzolitto S, Delendi N, and Zanuttini D

Subjects
Adult, Male, Adolescent, Cineradiography, Heart Ventricles, Infant, Coronary Disease, Middle Aged, Echocardiography, Evaluation Studies as Topic, Child, Preschool, Humans, Female, Child, Aged
Abstract

The purpose of this study was to assess the capability of two-dimensional echocardiography to identify left ventricular thrombi as compared to standard single plane cineventriculography in 284 patients, who underwent both procedures within 24 hours for diagnostic purposes. In order to obtain informations about the degree of thrombus organization and diagnostic accuracy of the echocardiographic technique, two-dimensional echocardiographic examinations were also performed in 31 thrombi from 16 autopsy specimens. In 249 cases the results were negative and in 14 cases positive by both techniques. Seven cases were positive by cineventriculography but negative by 2D-echocardiography. In seven cases the findings were equivocal by two-dimensional echocardiography; three of them were negative, two positive, and two equivocal by cineventriculography. In two cases the results were negative by two-dimensional echocardiography but equivocal by cineventriculography. Finally five cases were diagnosed to have a thrombus but two-dimensional echocardiography but not by cineventriculography. In two patients, positive by two-dimensional echocardiography, who were on anticoagulant therapy, follow-up studies showed the disappearance of left ventricular thrombi. In all of them the thrombi showed tissue characteristics similar to those of fresh thrombi examined in vitro. Two-dimensional echocardiography seems to be more reliable than cineventriculography for assessing the presence, extension, number, and morphology of left ventricular thrombi. In vitro studies suggest that two-dimensional echocardiography cannot visualize small thrombi, that fibrotic areas may simulate a thrombus and that in some cases under or overestimation is possible.

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