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1. Differences between familial and sporadic dilated cardiomyopathy: ESC EORP Cardiomyopathy & Myocarditis registry

Author

Asselbergs F. W., Sammani A., Elliott P., Gimeno J. R., Tavazzi L., Tendera M., Kaski J. P., Maggioni A. P., Rubis P. P., Jurcut R., Helio T., Calo L., Sinagra G., Zdravkovic M., Olivotto I., Kavoliuniene A., Laroche C., Caforio A. L. P., Charron P., Komissarova S., Chakova N., Niyazova S., Linhart A., Kuchynka P., Palecek T., Podzimkova J., Fikrle M., Nemecek E., Bundgaard H., Tfelt-Hansen J., Theilade J., Thune J. J., Axelsson A., Mogensen J., Henriksen F., Hey T., Nielsen S. K., Videbaek L., Andreasen S., Arnsted H., Saad A., Ali M., Lommi J., Nieminennew M. S., Dubourg O., Mansencal N., Arslan M., Siam Tsieu V., Damy T., Guellich A., Guendouz S., Tissot C. M., Lamine A., Rappeneau S., Hagege A., Desnos M., Bachet A., Hamzaoui M., Isnard R., Legrand L., Maupain C., Gandjbakhch E., Kerneis M., Pruny J. -F., Bauer A., Pfeiffer B., Felix S. B., Dorr M., Kaczmarek S., Lehnert K., Pedersen A. -L., Beug D., Bruder M., Bohm M., Kindermann I., Linicus Y., Werner C., Neurath B., Schild-Ungerbuehler M., Seggewiss H., Neugebauer A., McKeown P., Muir A., McOsker J., Jardine T., Divine G., Lorenzini M., Watkinson O., Wicks E., Iqbal H., Mohiddin S., O'Mahony C., Sekri N., Carr-White G., Bueser T., Rajani R., Clack L., Damm J., Jones S., Sanchez-Vidal R., Smith M., Walters T., Wilson K., Rosmini S., Anastasakis A., Ritsatos K., Vlagkouli V., Forster T., Sepp R., Borbas J., Nagy V., Tringer A., Kakonyi K., Szabo L. A., Maleki M., Noohi Bezanjani F., Amin A., Naderi N., Parsaee M., Taghavi S., Ghadrdoost B., Jafari S., Khoshavi M., Rapezzi C., Biagini E., Corsini A., Gagliardi C., Graziosi M., Longhi S., Milandri A., Ragni L., Palmieri S., Arretini A., Castelli G., Cecchi F., Fornaro A., Tomberli B., Spirito P., Devoto E., Della Bella P., Maccabelli G., Sala S., Guarracini F., Peretto G., Russo M. G., Calabro R., Pacileo G., Limongelli G., Masarone D., Pazzanese V., Rea A., Rubino M., Tramonte S., Valente F., Caiazza M., Cirillo A., Del Giorno G., Esposito A., Gravino R., Marrazzo T., Trimarco B., Losi M. -A., Di Nardo C., Giamundo A., Musella F., Pacelli F., Scatteia A., Canciello G., Caforio A., Iliceto S., Calore C., Leoni L., Perazzolo Marra M., Rigato I., Tarantini G., Schiavo A., Testolina M., Arbustini E., Di Toro A., Giuliani L. P., Serio A., Fedele F., Frustaci A., Alfarano M., Chimenti C., Drago F., Baban A., Lanzillo C., Martino A., Uguccioni M., Zachara E., Halasz G., Re F., Carriere C., Merlo M., Ramani F., Krivickiene A., Tamuleviciute-Prasciene E., Viezelis M., Celutkiene J., Balkeviciene L., Laukyte M., Paleviciute E., Pinto Y., Wilde A., Van Der Heijden J., Van Laake L., De Jonge N., Hassink R., Kirkels J. H., Ajuluchukwu J., Olusegun-Joseph A., Ekure E., Mizia-Stec K., Czekaj A., Sikora-Puz A., Skoczynska A., Wybraniec M., Rubis P., Dziewiecka E., Wisniowska-Smialek S., Bilinska Z., Chmielewski P., Foss-Nieradko B., Michalak E., Stepien-Wojno M., Mazek B., Rocha Lopes L., Almeida A. R., Cruz I., Gomes A. C., Pereira A. R., Brito D., Madeira H., Francisco A. R., Menezes M., Moldovan O., Oliveira Guimaraes T., Silva D., Ginghina C., Mursa A., Popescu B. A., Apetrei E., Militaru S., Mircea Coman I., Frigy A., Fogarasi Z., Kocsis I., Szabo I. A., Fehervari L., Nikitin I., Resnik E., Komissarova M., Lazarev V., Shebzukhova M., Ustyuzhanin D., Blagova O., Alieva I., Kulikova V., Lutokhina Y., Pavlenko E., Varionchik N., Ristic A. D., Seferovic P. M., Veljic I., Zivkovic I., Milinkovic I., Pavlovic A., Radovanovic G., Simeunovic D., Aleksic M., Djokic J., Hinic S., Klasnja S., Mircetic K., Monserrat L., Fernandez X., Garcia-Giustiniani D., Larranaga J. M., Ortiz-Genga M., Barriales-Villa R., Martinez-Veira C., Veira E., Cequier A., Salazar-Mendiguchia J., Manito N., Gonzalez J., Fernandez-Aviles F., Medrano C., Yotti R., Cuenca S., Espinosa M. A., Mendez I., Zatarain E., Alvarez R., Garcia-Pavia P., Briceno A., Cobo-Marcos M., Dominguez F., De Teresa Galvan E., Garcia Pinilla J. M., Abdeselam-Mohamed N., Lopez-Garrido M. A., Morcillo Hidalgo L., Ortega-Jimenez M. V., Robles Mezcua A., Guijarro-Contreras A., Gomez-Garcia D., Robles-Mezcua M., Gimeno Blanes J. R., Castro F. J., Munoz Esparza C., Sabater Molina M., Sorli Garcia M., Lopez Cuenca D., Ripoll-Vera T., Alvarez J., Nunez J., Gomez Y., Sanchez Fernandez P. L., Villacorta E., Avila C., Bravo L., Diaz-Pelaez E., Gallego-Delgado M., Garcia-Cuenllas L., Plata B., Lopez-Haldon J. E., Pena Pena M. L., Cantero Perez E. M., Zorio E., Arnau M. A., Sanz J., Marques-Sulex E., University Medical Center [Utrecht], University College of London [London] (UCL), Hospital Univeristario Virgen de la Arrixaca, University Hospital of Ferrara and Maria Cecilia Hospital, Medical University of Silesia, Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Chair of Medical Biochemistry, Jagiellonian University - Medical College, Chair of Medical Biochemistry, Emergency Hospital Floreasca Bucharest, Emergency Hospital Floreasca Bucharest, 8 Calea Floresca, Sector 1, 014461 Bucharest, Romania, University of Helsinki, Policlinico Casilino (Ospedale Policlinico Casilino), University of Trieste, University of Belgrade [Belgrade], Careggi University Hospital, Lithuanian University of health Sciences [Kaunas], Universita degli Studi di Padova, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hospital Clínico Universitario Virgen de la Arrixaca = University Hospital Virgen de la Arrixaca [Murcia], Medical University of Silesia (SUM), Université Nice Sophia Antipolis (1965 - 2019) (UNS), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Università degli studi di Trieste = University of Trieste, Università degli Studi di Padova = University of Padua (Unipd), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), HAL-SU, Gestionnaire, Asselbergs, F. W., Sammani, A., Elliott, P., Gimeno, J. R., Tavazzi, L., Tendera, M., Kaski, J. P., Maggioni, A. P., Rubis, P. P., Jurcut, R., Helio, T., Calo, L., Sinagra, G., Zdravkovic, M., Olivotto, I., Kavoliuniene, A., Laroche, C., Caforio, A. L. P., Charron, P., Komissarova, S., Chakova, N., Niyazova, S., Linhart, A., Kuchynka, P., Palecek, T., Podzimkova, J., Fikrle, M., Nemecek, E., Bundgaard, H., Tfelt-Hansen, J., Theilade, J., Thune, J. J., Axelsson, A., Mogensen, J., Henriksen, F., Hey, T., Nielsen, S. K., Videbaek, L., Andreasen, S., Arnsted, H., Saad, A., Ali, M., Lommi, J., Nieminennew, M. S., Dubourg, O., Mansencal, N., Arslan, M., Siam Tsieu, V., Damy, T., Guellich, A., Guendouz, S., Tissot, C. M., Lamine, A., Rappeneau, S., Hagege, A., Desnos, M., Bachet, A., Hamzaoui, M., Isnard, R., Legrand, L., Maupain, C., Gandjbakhch, E., Kerneis, M., Pruny, J. -F., Bauer, A., Pfeiffer, B., Felix, S. B., Dorr, M., Kaczmarek, S., Lehnert, K., Pedersen, A. -L., Beug, D., Bruder, M., Bohm, M., Kindermann, I., Linicus, Y., Werner, C., Neurath, B., Schild-Ungerbuehler, M., Seggewiss, H., Neugebauer, A., Mckeown, P., Muir, A., Mcosker, J., Jardine, T., Divine, G., Lorenzini, M., Watkinson, O., Wicks, E., Iqbal, H., Mohiddin, S., O'Mahony, C., Sekri, N., Carr-White, G., Bueser, T., Rajani, R., Clack, L., Damm, J., Jones, S., Sanchez-Vidal, R., Smith, M., Walters, T., Wilson, K., Rosmini, S., Anastasakis, A., Ritsatos, K., Vlagkouli, V., Forster, T., Sepp, R., Borbas, J., Nagy, V., Tringer, A., Kakonyi, K., Szabo, L. A., Maleki, M., Noohi Bezanjani, F., Amin, A., Naderi, N., Parsaee, M., Taghavi, S., Ghadrdoost, B., Jafari, S., Khoshavi, M., Rapezzi, C., Biagini, E., Corsini, A., Gagliardi, C., Graziosi, M., Longhi, S., Milandri, A., Ragni, L., Palmieri, S., Arretini, A., Castelli, G., Cecchi, F., Fornaro, A., Tomberli, B., Spirito, P., Devoto, E., Della Bella, P., Maccabelli, G., Sala, S., Guarracini, F., Peretto, G., Russo, M. G., Calabro, R., Pacileo, G., Limongelli, G., Masarone, D., Pazzanese, V., Rea, A., Rubino, M., Tramonte, S., Valente, F., Caiazza, M., Cirillo, A., Del Giorno, G., Esposito, A., Gravino, R., Marrazzo, T., Trimarco, B., Losi, M. -A., Di Nardo, C., Giamundo, A., Musella, F., Pacelli, F., Scatteia, A., Canciello, G., Caforio, A., Iliceto, S., Calore, C., Leoni, L., Perazzolo Marra, M., Rigato, I., Tarantini, G., Schiavo, A., Testolina, M., Arbustini, E., Di Toro, A., Giuliani, L. P., Serio, A., Fedele, F., Frustaci, A., Alfarano, M., Chimenti, C., Drago, F., Baban, A., Lanzillo, C., Martino, A., Uguccioni, M., Zachara, E., Halasz, G., Re, F., Carriere, C., Merlo, M., Ramani, F., Krivickiene, A., Tamuleviciute-Prasciene, E., Viezelis, M., Celutkiene, J., Balkeviciene, L., Laukyte, M., Paleviciute, E., Pinto, Y., Wilde, A., Van Der Heijden, J., Van Laake, L., De Jonge, N., Hassink, R., Kirkels, J. H., Ajuluchukwu, J., Olusegun-Joseph, A., Ekure, E., Mizia-Stec, K., Czekaj, A., Sikora-Puz, A., Skoczynska, A., Wybraniec, M., Rubis, P., Dziewiecka, E., Wisniowska-Smialek, S., Bilinska, Z., Chmielewski, P., Foss-Nieradko, B., Michalak, E., Stepien-Wojno, M., Mazek, B., Rocha Lopes, L., Almeida, A. R., Cruz, I., Gomes, A. C., Pereira, A. R., Brito, D., Madeira, H., Francisco, A. R., Menezes, M., Moldovan, O., Oliveira Guimaraes, T., Silva, D., Ginghina, C., Mursa, A., Popescu, B. A., Apetrei, E., Militaru, S., Mircea Coman, I., Frigy, A., Fogarasi, Z., Kocsis, I., Szabo, I. A., Fehervari, L., Nikitin, I., Resnik, E., Komissarova, M., Lazarev, V., Shebzukhova, M., Ustyuzhanin, D., Blagova, O., Alieva, I., Kulikova, V., Lutokhina, Y., Pavlenko, E., Varionchik, N., Ristic, A. D., Seferovic, P. M., Veljic, I., Zivkovic, I., Milinkovic, I., Pavlovic, A., Radovanovic, G., Simeunovic, D., Aleksic, M., Djokic, J., Hinic, S., Klasnja, S., Mircetic, K., Monserrat, L., Fernandez, X., Garcia-Giustiniani, D., Larranaga, J. M., Ortiz-Genga, M., Barriales-Villa, R., Martinez-Veira, C., Veira, E., Cequier, A., Salazar-Mendiguchia, J., Manito, N., Gonzalez, J., Fernandez-Aviles, F., Medrano, C., Yotti, R., Cuenca, S., Espinosa, M. A., Mendez, I., Zatarain, E., Alvarez, R., Garcia-Pavia, P., Briceno, A., Cobo-Marcos, M., Dominguez, F., De Teresa Galvan, E., Garcia Pinilla, J. M., Abdeselam-Mohamed, N., Lopez-Garrido, M. A., Morcillo Hidalgo, L., Ortega-Jimenez, M. V., Robles Mezcua, A., Guijarro-Contreras, A., Gomez-Garcia, D., Robles-Mezcua, M., Gimeno Blanes, J. R., Castro, F. J., Munoz Esparza, C., Sabater Molina, M., Sorli Garcia, M., Lopez Cuenca, D., Ripoll-Vera, T., Alvarez, J., Nunez, J., Gomez, Y., Sanchez Fernandez, P. L., Villacorta, E., Avila, C., Bravo, L., Diaz-Pelaez, E., Gallego-Delgado, M., Garcia-Cuenllas, L., Plata, B., Lopez-Haldon, J. E., Pena Pena, M. L., Cantero Perez, E. M., Zorio, E., Arnau, M. A., Sanz, J., Marques-Sulex, E., Cardiology, ACS - Heart failure & arrhythmias, HUS Heart and Lung Center, Clinicum, Department of Medicine, Kardiologian yksikkö, Helsinki University Hospital Area, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)

Subjects
Registrie, lcsh:Diseases of the circulatory (Cardiovascular) system, EUROBSERVATIONAL RESEARCH-PROGRAM, Dilated cardiomyopathy, Europe, Familial, Genetic, Prognosis, Sporadic, Adult, Humans, Prospective Studies, Registries, Cardiomyopathies, Cardiomyopathy, Dilated, Myocarditis, Cardiomyopathy, 030204 cardiovascular system & hematology, 0302 clinical medicine, Original Research Articles, Dilated, PILOT, Original Research Article, 030212 general & internal medicine, Prospective cohort study, Ejection fraction, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, medicine.diagnostic_test, Guideline adherence, 3. Good health, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Prognosi, FREQUENCY, 03 medical and health sciences, Internal medicine, medicine, Cardiomyopathie, Genetic testing, business.industry, medicine.disease, Prospective Studie, lcsh:RC666-701, 3121 General medicine, internal medicine and other clinical medicine, Heart failure, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; AimsDilated cardiomyopathy (DCM) is a complex disease where genetics interplay with extrinsic factors. This study aims to compare the phenotype, management, and outcome of familial DCM (FDCM) and non‐familial (sporadic) DCM (SDCM) across Europe.Methods and resultsPatients with DCM that were enrolled in the prospective ESC EORP Cardiomyopathy & Myocarditis Registry were included. Baseline characteristics, genetic testing, genetic yield, and outcome were analysed comparing FDCM and SDCM; 1260 adult patients were studied (238 FDCM, 707 SDCM, and 315 not disclosed). Patients with FDCM were younger (P < 0.01), had less severe disease phenotype at presentation (P < 0.02), more favourable baseline cardiovascular risk profiles (P ≤ 0.007), and less medication use (P ≤ 0.042). Outcome at 1 year was similar and predicted by NYHA class (HR 0.45; 95% CI [0.25–0.81]) and LVEF per % decrease (HR 1.05; 95% CI [1.02–1.08]. Throughout Europe, patients with FDCM received more genetic testing (47% vs. 8%, P < 0.01) and had higher genetic yield (55% vs. 22%, P < 0.01).ConclusionsWe observed that FDCM and SDCM have significant differences at baseline but similar short‐term prognosis. Whether modification of associated cardiovascular risk factors provide opportunities for treatment remains to be investigated. Our results also show a prevalent role of genetics in FDCM and a non‐marginal yield in SDCM although genetic testing is largely neglected in SDCM. Limited genetic testing and heterogeneity in panels provides a scaffold for improvement of guideline adherence.

Published
2021

2. Prevalence and clinical significance of red flags in patients with hypertrophic cardiomyopathy

Author

Giuseppe Limongelli, Emanuele Monda, Paolo Calabrò, Giuseppe Pacileo, Stefania Tramonte, Rita Gravino, Mariagiovanna Russo, Augusto Esposito, Perry M. Elliott, Ernesto Ammendola, Giulia Frisso, Daniele Masarone, Gemma Salerno, Marta Rubino, Felice Gragnano, Martina Caiazza, Limongelli, G., Monda, E., Tramonte, S., Gragnano, F., Masarone, D., Frisso, G., Esposito, A., Gravino, R., Ammendola, E., Salerno, G., Rubino, M., Caiazza, M., Russo, M., Calabro, P., Elliott, P. M., and Pacileo, G.

Subjects
Adult, Male, Systemic disease, medicine.medical_specialty, Adolescent, Population, 030204 cardiovascular system & hematology, hypertrophic cardiomyopathy, red flags, genetic background, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Prevalence, medicine, Humans, Clinical significance, 030212 general & internal medicine, Family history, Child, education, Aged, education.field_of_study, medicine.diagnostic_test, business.industry, Infant, Newborn, Hypertrophic cardiomyopathy, Infant, Cardiomyopathy, Hypertrophic, Middle Aged, medicine.disease, Cross-Sectional Studies, Child, Preschool, Cohort, Etiology, Female, Cardiology and Cardiovascular Medicine, business, Electrocardiography
Abstract

Introduction: We sought to determine prevalence and predictive accuracy of clinical markers (red flags, RF), known to be associated with specific systemic disease in a consecutive cohort of patients with hypertrophic cardiomyopathy (HCM). Methods: We studied 129 consecutive patients (23.7 ± 20.9 years, range 0–74 years; male/female 68%/32%). Pre-specified RF were categorized into five domains: family history; signs/symptoms; electrocardiography; imaging; and laboratory. Sensitivity (Se), specificity (Sp), negative predictive value (NPV), positive predictive value (PPV), and predictive accuracy of RF were analyzed in the genotyped population. Results: In the overall cohort of 129 patients, 169 RF were identified in 62 patients (48%). Prevalence of RF was higher in infants (78%) and in adults >55 years old (58%). Following targeted genetic and clinical evaluation, 94 patients (74%) had a definite diagnosis (sarcomeric HCM or specific causes of HCM). We observed 14 RF in 13 patients (21%) with sarcomeric gene disease, 129 RF in 34 patients (97%) with other specific causes of HCM, and 26 RF in 15 patients (45%) with idiopathic HCM (p < 0.0001). Non-sarcomeric causes of HCM were the most prevalent in ages 55yo. Se, Sp, PPV, NPV and PA of RF were 97%, 70%, 55%, 98% and 77%, respectively. Single and clinical combination of RF (clusters) had an high specificity, NPV and predictive accuracy for the specific etiologies (syndromes/metabolic/infiltrative disorders associated with HCM). Conclusions: An extensive diagnostic work up, focused on analysis of specific diagnostic RF in patients with unexplained LVH facilitates a clinical diagnosis in 74% of patients with HCM.

Published
2020

3. Corrigendum to 'Long-term prognostic role of diabetes mellitus and glycemic control in heart failure patients with reduced ejection fraction: Insights from the MECKI Score database' [Int J Cardiol. 2020 Oct 15; 317: 103–110. PMID: 32360652] (International Journal of Cardiology (2020) 317 (103–110), (S0167527320312663), (10.1016/j.ijcard.2020.04.079))

Author

Rosa Raimondo, P. Perrone Filardi, Enrico Perna, Rocco Lagioia, Piero Gentile, Alessandra Scoccia, Alice Bonomi, Elisabetta Salvioni, Paola Gugliandolo, Andrea Passantino, Piergiuseppe Agostoni, Chiara Minà, Ugo Corrà, Massimo F Piepoli, C. Cavaliere, Luca Arcari, Angela Beatrice Scardovi, Giuseppe Limongelli, Maria Frigerio, Maurizio Bussotti, Federica Re, Stefania Paolillo, Damiano Magrì, Roberto Badagliacca, Massimo Mapelli, Gaia Cattadori, Michele Correale, Gianfranco Sinagra, Nicola Cosentino, Carlo Vignati, Sergio Caravita, Rita Gravino, Paola Gargiulo, Gianfranco Parati, Francesco Clemenza, Paolillo, S., Salvioni, E., Perrone Filardi, P., Bonomi, A., Sinagra, G., Gentile, P., Gargiulo, P., Scoccia, A., Cosentino, N., Gugliandolo, P., Badagliacca, R., Lagioia, R., Correale, M., Frigerio, M., Perna, E., Piepoli, M., Re, F., Raimondo, R., Mina, C., Clemenza, F., Bussotti, M., Limongelli, G., Gravino, R., Passantino, A., Magri, D., Parati, G., Caravita, S., Scardovi, A. B., Arcari, L., Vignati, C., Mapelli, M., Cattadori, G., Cavaliere, C., Corra, U., and Agostoni, P.

Subjects
MECKI score database, medicine.medical_specialty, Ejection fraction, business.industry, MEDLINE, heart failure, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, medicine.disease, prognostic, diabetes mellitus, reduced ejection fraction, Term (time), Heart failure, Diabetes mellitus, Internal medicine, Cardiology, medicine, Cardiology and Cardiovascular Medicine, business, Glycemic
Abstract

The authors regret that the Author Dr. Bussotti Maurizio appears with the following affiliation: Unità Operativa Cardiologia Riabilitativa, Multimedica IRCCS, Milano, Italy. But that was a mistake, the right affiliation of Dr. Bussotti Maurizio is instead: Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy. The authors kindly ask you to correct this affiliation also with all abstracting partners as PubMed. The authors would like to apologise for any inconvenience caused. DOI of original article: .

Published
2021

4. Berlin Heart EXCOR® pediatric ventricular assist device in a patient with Sotos syndrome: a case report

Author

Maria Giovanna Russo, Marina Verrengia, Danilo De Paulis, Giuseppe Limongelli, Daniele Masarone, Andrea Petraio, Ciro Maiello, Rita Gravino, Giuseppe Pacileo, Gravino, R., Limongelli, G., Petraio, A., Masarone, D., Russo, M. G., Maiello, C., Verrengia, M., De Paulis, D., and Pacileo, G.

Subjects
medicine.medical_specialty, medicine.medical_treatment, Biventricular assist device, lcsh:Medicine, Case Report, Disease, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, In patient, Craniofacial, Child, Contraindication, NSD1 gene, Sotos Syndrome, Berlin Heart EXCOR® pediatric ventricular assist device, business.industry, Sotos syndrome, lcsh:R, General Medicine, medicine.disease, 030220 oncology & carcinogenesis, Ventricular assist device, Circulatory system, Cardiology, Heart Transplantation, Female, Heart-Assist Devices, business, Human
Abstract

Introduction Berlin Heart EXCOR® pediatric ventricular assist device is a mechanical circulatory support device currently used in pediatric patients. Sotos syndrome is a well-described multiple anomaly syndrome characterized by overgrowth, distinctive craniofacial appearance, cardiac abnormalities, and variable learning disabilities. Case presentation We describe a 7-year-old female Caucasian child with classic Sotos syndrome features subjected to implantation of Berlin Heart EXCOR® pediatric biventricular assist device mechanical support. A heart transplant was carried out after a support time of 459 days. After 5 years of follow-up, our patient is clinically stable and the performance of the transplanted heart is excellent. Conclusion This case confirms that Berlin Heart EXCOR® pediatric ventricular assist device can provide satisfactory and safe circulatory support for children with end-stage heart diseases, even in those with Sotos syndrome. The syndrome is not a contraindication to implantation, since the complications are the same as those observed in patients without the syndrome and the prognosis is not affected by the disease.

Published
2018

5. Right Ventricular Ejection Fraction and Left Ventricular Dyssynchrony by 3D Echo Correlate With Functional Impairment in Patients With Dilated Cardiomyopathy

Author

Luca Del Viscovo, Maria Giovanna Russo, Gemma Salerno, Giuseppe Pacileo, Sergio Cuomo, Antonello D'Andrea, Raffaele Calabrò, Raffaella Scarafile, Maria Luisa De Rimini, Pietro Muto, Massimo Romano, Eduardo Bossone, Rita Gravino, Giuseppe Limongelli, Ilaria Ferrara, Lucia Riegler, D'Andrea, A, Gravino, R, Riegler, L, Salerno, G, Scarafile, R, Romano, M, Cuomo, S, Del Viscovo, L, Ferrara, I, De Rimini, Ml, Muto, P, Limongelli, G, Pacileo, G, Bossone, E, Russo, Mg, Calabro, R, DEL VISCOVO, Luca, DE RIMINI, Ml, Limongelli, Giuseppe, Russo, Maria Giovanna, and Calabro', Raffaele

Subjects
Cardiomyopathy, Dilated, Male, medicine.medical_specialty, Cardiac Volume, Echocardiography, Three-Dimensional, Cardiomyopathy, Ventricular Dysfunction, Left, Oxygen Consumption, Internal medicine, medicine, Humans, Aerobic exercise, Ventricular dyssynchrony, Heart Failure, Ejection fraction, business.industry, Stroke Volume, Dilated cardiomyopathy, Stroke volume, medicine.disease, Magnetic Resonance Imaging, Heart failure, Circulatory system, Exercise Test, Ventricular Function, Right, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

BACKGROUND: The aim of the study was to detect if right ventricular (RV) ejection fraction assessed by real-time 3-dimensional echocardiography (RT3DE) could predict patients with dilated cardiomyopathy (DCM) with greater functional impairment in response to cardiopulmonary exercise. METHODS AND RESULTS: Seventy chronic heart failure patients with DCM (55.5 ± 9.1 years; 48 males; 30 ischemic; New York Heart Association Class III: 48) underwent both left ventricular (LV) and RV analysis by RT3DE. Postprocessing software provided data of RT3DE systolic dyssynchrony index of 16 LV segments (systolic dyssynchrony index [SDI]) and of both LV and RV ejection fraction. Cardiac magnetic resonance was performed in a subgroup of 40 DCM patients to confirm RT3DE measurements. All the patients underwent also bicycle cardiopulmonary exercise test with evaluation of oxygen consumption (VO2) peak% (percentage of the predicted value), VE/VCO2 slope, and circulatory power (CP). Mean LV ejection fraction was 29.8 ± 4.6%. RT3DE LV SDI index was 8.4.4 ± 4.2, and RV ejection fraction was 51.3 ± 4.6%. By cardiopulmonary test, mean VO2 peak was 15.2 ± 4.4 mL·kg·min, and mean CP was 2.1 ± 0.8. By univariable analyses, significant correlations were detectable between SDI index and VO2 peak% (r = -0.56; P < .0001) and peak CP (r = -0.48; P < .0005). Also RV ejection fraction directly correlated with VO2 peak% (r = 0.58; P < .0001) and inversely with VE/VCO2 slope (r = -0.44; P < .001). By multivariable analysis, SDI index (β coefficient = -0.46; P < .001) and 3D RV ejection fraction (β coefficient = 0.42; P < .001) emerged as the only independent determinants of VO2 peak% during cardiopulmonary test. CONCLUSIONS: Increased LV electromechanical dyssynchrony and impaired RV function in DCM patients are independently associated with worse ability to perform aerobic exercise.

Published
2011

6. Left Ventricular Myocardial Velocities and Deformation Indexes in Top-Level Athletes

Author

Eduardo Bossone, Enrica Pezzullo, Giuseppe Pacileo, Sergio Cuomo, Gemma Salerno, Rosangela Cocchia, Pio Caso, Lucia Riegler, Enrica Golia, Rita Gravino, Antonello D'Andrea, Giuseppe Limongelli, Raffaele Calabrò, Rodolfo Citro, Raffaella Scarafile, Maria Giovanna Russo, D'Andrea, A, Cocchia, R, Riegler, L, Scarafile, R, Salerno, G, Gravino, R, Golia, E, Pezzullo, E, Citro, R, Limongelli, Giuseppe, Pacileo, G, Cuomo, S, Caso, P, Russo, Maria Giovanna, Bossone, E, Calabro', Raffaele, Limongelli, G, Russo, Mg, and Calabro, R

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Systole, Population, Diastole, Blood Pressure, Left ventricular hypertrophy, Ventricular Function, Left, Young Adult, Tissue Doppler echocardiography, Heart Rate, Reference Values, Internal medicine, Heart Septum, Image Processing, Computer-Assisted, medicine, Humans, Radiology, Nuclear Medicine and imaging, Interventricular septum, education, Exercise, Echocardiography, Doppler, Pulsed, education.field_of_study, Ejection fraction, biology, Athletes, business.industry, Resistance Training, Stroke Volume, biology.organism_classification, medicine.disease, Myocardial Contraction, Biomechanical Phenomena, Blood pressure, medicine.anatomical_structure, Echocardiography, Physical Fitness, Multivariate Analysis, Physical Endurance, Cardiology, Hypertrophy, Left Ventricular, Cardiology and Cardiovascular Medicine, business, Software
Abstract

BACKGROUND: The aim of this study was to define the range of left ventricular (LV) velocities and deformation indexes in highly trained athletes, analyzing potential differences induced by different long-term training protocols. METHODS: Standard echocardiography, pulsed-wave tissue Doppler echocardiography, and two-dimensional strain echocardiography of the interventricular septum and lateral wall were performed in 370 endurance athletes and 280 power athletes. Using pulsed-wave tissue Doppler, the following parameters of myocardial function were assessed: systolic peak velocities (S(m)), early (E(m)) and late (A(m)) diastolic velocities, and the E(m)/A(m) ratio. By two-dimensional strain echocardiography, peaks of regional systolic strain and LV global longitudinal strain were calculated. RESULTS: LV mass index and ejection fraction did not significantly differ between the two groups. However, power athletes showed an increased sum of wall thicknesses (P < .01) and relative wall thickness, while LV stroke volume and LV end-diastolic diameter (P < .001) were greater in endurance athletes. By pulsed-wave tissue Doppler analysis, E(m) and E(m)/A(m) at both the septal and lateral wall levels were higher in endurance athletes. By two-dimensional strain echocardiography, myocardial deformation indexes were comparable between the two groups. E(m)/A(m) ratios ≥ 1 were found in the overall population, while 90 % of athletes had an E(m) ≥ 16 cm/sec, S(m) ≥ 10 cm/sec, and global longitudinal strain ≤ -16%. Multivariate analyses evidenced independent positive association between Em peak velocity and LV end-diastolic volume (P < .001) and an independent correlation of global longitudinal strain with the sum of LV wall thicknesses (P < .005). CONCLUSIONS: This study describes the full spectrum of systolic and diastolic myocardial velocities and deformation indexes in a large population of competitive athletes.

Published
2010

7. Natriuretic peptides: molecular biology, pathophysiology and clinical implications for the cardiologist

Author

Eduardo Bossone, Giuseppe Pacileo, Alessandra Rea, Enrica Golia, Rita Gravino, Lucio Santangelo, Raffaele Calabrò, Andrea Buono, Daniele Masarone, Giuseppe Limongelli, Raffaella D’Alessandro, Giuseppe Del Giorno, Ernesto Ammendola, Gemma Salerno, Maria Giovanna Russo, D'Alessandro, R, Masarone, D, Buono, A, Gravino, R, Rea, A, Salerno, G, Golia, E, Ammendola, E, Del Giorno, G, Santangelo, L, Russo, Maria Giovanna, Calabro', Raffaele, Bossone, E, Pacileo, G, Limongelli, Giuseppe, Russo, Mg, Calabrò, R, and Limongelli, G.

Subjects
medicine.medical_specialty, Sympathetic nervous system, medicine.drug_class, Volume overload, Cardiology, Adrenergic, Diuresis, Bioinformatics, Natriuresis, Internal medicine, Natriuretic peptide, Medicine, Humans, Natriuretic Peptides, Heart Failure, business.industry, medicine.disease, Prognosis, Pathophysiology, Endocrinology, medicine.anatomical_structure, Heart failure, Disease Progression, Molecular Medicine, Cardiology and Cardiovascular Medicine, business, Biomarkers
Abstract

Natriuretic peptides (NPs) counter the effects of volume overload or adrenergic activation of the cardiovascular system. They are able to induce arterial vasodilatations, natriuresis and diuresis, and they reduce the activities of the renin–angiotensin–aldosterone system and the sympathetic nervous system. However, in addition to wall stress, other factors have been associated with elevated natriuretic peptide levels. Since 2000, because of their characteristics, NPs have become quantitative plasma biomarkers of heart failure. Nowadays, NPs play an important role not only in the diagnosis of heart failure, but also for a prognostic purpose and a guide to medical therapy. Finally, a new drug that modulates the NP system or recombinant analogs of NPs are now available in patients with heart failure.

Published
2013

8. Right heart morphology and function in heart transplantation recipients

Author

Luigi Nunziata, Lucia Riegler, Giuseppe Pacileo, Raffaele Calabrò, Raffaella Scarafile, Giovanni Di Salvo, Eduardo Bossone, Maria Giovanna Russo, Antonello D'Andrea, Giuseppe Limongelli, Rita Gravino, Gemma Salerno, Cristiano Amarelli, Ciro Maiello, Pio Caso, D'Andrea, A, Riegler, L, Nunziata, L, Scarafile, R, Gravino, R, Salerno, G, Amarelli, C, Maiello, C, Limongelli, G, Di Salvo, G, Caso, P, Bossone, E, Calabro, R, Pacileo, G, Russo, Mg, Limongelli, Giuseppe, DI SALVO, Giovanni, Calabro', Raffaele, and Russo, Maria Giovanna

Subjects
Male, medicine.medical_treatment, Heart Valve Diseases, Blood Pressure, right ventricle, right atrium, Doppler imaging, Imaging, Diastole, Heart Septum, Ventricular Function, Heart transplantation, Exercise Tolerance, Ejection fraction, Doppler, Age Factors, General Medicine, Middle Aged, Magnetic Resonance Imaging, Echocardiography, Doppler, Right, medicine.anatomical_structure, Cine, Echocardiography, cardiovascular system, Cardiology, Female, cardiac transplant, Cardiology and Cardiovascular Medicine, cardiopulmonary test, medicine.medical_specialty, Systole, Heart Ventricles, Magnetic Resonance Imaging, Cine, Regurgitation (circulation), Imaging, Three-Dimensional, Oxygen Consumption, medicine.artery, Internal medicine, three-dimensional echocardiography, medicine, Humans, Heart Atria, pulmonary pressure, Heart Failure, business.industry, Stroke Volume, Doppler echocardiography, Transplantation, heart failure, Case-Control Studies, Exercise Test, Ventricular Function, Right, Heart Transplantation, Ventricle, Three-Dimensional, Pulmonary artery, business
Abstract

BACKGROUND: The right heart is a major determinant of prognosis in cardiac transplant recipient patients. AIM: To investigate right ventricular morphology and function and their relationship with exercise capacity in cardiac transplant recipient patients using standard tranthoracic echocardiography and a new three-dimensional echocardiographic software adapted for right ventricular analysis. METHODS: One hundred fifteen relatively stable cardiac transplant recipient patients (71 men; 58.3 ± 5.8 years; 7.8 ± 4.5 years after transplantation) and 80 healthy age-comparable and sex-comparable controls underwent standard echocardiography, tissue Doppler imaging (TDI), and three-dimensional echocardiography, focused on the right ventricular analysis. Along with left heart parameters, right ventricular measurements included end-diastolic diameters at basal and mid-cavity level; base-to-apex length; tricuspid annulus plane systolic excursion (TAPSE); TDI right ventricular systolic peak velocity (Sm); and three-dimensional ejection fraction. Using the peak systolic tricuspid regurgitation velocity (TRV) and the end-diastolic pulmonary regurgitation velocity, the modified Bernoulli equation was used to calculate the pulmonary artery systolic (PASP) and diastolic pressures. Pulmonary artery vascular conductance (PAVC) was estimated by left ventricular stroke volume/4 × (TRV - pulmonary regurgitation velocity). RESULTS: Left ventricular diameters and ejection fraction did not significantly differ between the two groups, whereas mass index was increased in cardiac transplant recipient patients (P

Published
2013

9. Effect of cardiac resynchronization therapy on cardiotrophin-1 circulating levels in patients with heart failure

Author

Maria Giovanna Russo, Antonello D'Andrea, Daniele Masarone, Lucia Riegler, Rita Gravino, Raffaella Scarafile, Giovanni Di Salvo, Lucio Santangelo, T. Miele, T. Roselli, Giuseppe Limongelli, Massimo Romano, Raffaele Calabrò, Paolo Calabrò, Valeria Maddaloni, Gemma Salerno, Giuseppe Pacileo, Limongelli, Giuseppe, Roselli, T, Pacileo, G, Calabro', Paolo, Maddaloni, V, Masarone, D, Riegler, L, Gravino, R, Scarafile, R, Salerno, G, Miele, T, D'Andrea, A, Santangelo, L, Romano, M, DI SALVO, Giovanni, Russo, Maria Giovanna, and Calabró, R.

Subjects
Adult, Male, medicine.medical_specialty, Cardiotrophin 1, medicine.medical_treatment, Cardiomyopathy, Cardiac resynchronization therapy, Doppler echocardiography, Cardiac Resynchronization Therapy, Internal medicine, Internal Medicine, Medicine, Humans, cardiovascular diseases, Ventricular remodeling, Aged, Heart Failure, medicine.diagnostic_test, Ventricular Remodeling, business.industry, Heart failure, Cytokines, Echocardiography, Doppler, Exercise Test, Female, Middle Aged, Doppler, medicine.disease, medicine.anatomical_structure, Ventricle, Echocardiography, cardiovascular system, Emergency Medicine, Cardiology, Sample collection, business, circulatory and respiratory physiology
Abstract

Cardiotrophin-1 (CT-1) is a member of the interleukin (IL-6) family of cytokines. Plasma CT-1 levels correlate with the left ventricle mass index in patients with dilatated cardiomyopathy and congestive heart failure (CHF). The aim of this paper was to evaluate CT-1 plasma levels, before and after cardiac resynchronization therapy CRT, and to characterizeits prognostic role in patients with CHF. Fifty-two consecutive patients (M/F = 39/13; 56 ± 11 years old) underwent clinical and echocardiographic evaluation, and blood sample collection at baseline. The same evaluation was repeated 6.4 ± 0.79 months after CRT. Patients with a decreased LV end-systolic volume by at least 15% (reverse remodeling) were considered echo responders to CRT. Twenty-nine patients (56%) were responders to CRT. After CRT, only 15 patients (29%) showed increased CT-1 after CRT. They were all non responders to CRT. A multivariate, logistic model showed CT-1 as an independent predictor of CRT echo response (p = 0.005; OR 0.97). During follow-up (18 ± 7 months), 21 cardiac events in 18 patients occurred. A Cox multivariable model showed plasma BNP pre-CRT (p = 0.02; CI 1.2-5.6; OR 3.1) and CT1 post-CRT (p = 0.01; CI 1.4-4.3; OR 2.7) as independent predictors of cardiac events. Analysis of CT-1 plasma levels deserves future consideration for larger, longitudinal studies in patients with CHF.

Published
2011

10. Association between right ventricular two-dimensional strain and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy

Author

Gemma Salerno, Maria Giovanna Russo, Giovanni Di Salvo, Massimo Romano, Sergio Cuomo, Rita Gravino, Raffaella Scarafile, Antonello D'Andrea, Lucia Riegler, Raffaele Calabrò, Enrica Pezzullo, Giuseppe Limongelli, Eduardo Bossone, Giuseppe Pacileo, Pio Caso, Salerno, G, D'Andrea, A, Bossone, E, Scarafile, R, Riegler, L, Di Salvo, G, Gravino, R, Pezzullo, E, Limongelli, G, Romano, M, Cuomo, S, Pacileo, G, Caso, P, Russo, Mg, Calabro, R, DI SALVO, Giovanni, Limongelli, Giuseppe, Russo, Maria Giovanna, and Calabro', Raffaele

Subjects
Male, Ventricular Dysfunction, Right, Left, Myocardial Ischemia, heart failure, right ventricle, Ventricular Function, Left, Dilated, Ventricular Dysfunction, Ventricular Function, Observer Variation, Exercise Tolerance, resynchronization therapy, Doppler, Dilated cardiomyopathy, General Medicine, two-dimensional strain imaging, Exercise capacity, Middle Aged, Echocardiography, Doppler, Right, medicine.anatomical_structure, Italy, Echocardiography, Circulatory system, Cardiology, cardiovascular system, Female, cardiopulmonary exercise test, dilated cardiomyopathy, right ventricular function, Adult, Cardiomyopathy, Dilated, Humans, Linear Models, Positron-Emission Tomography, Predictive Value of Tests, Proportional Hazards Models, Pulmonary Ventilation, Reproducibility of Results, Exercise Test, Ventricular Function, Right, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Cardiomyopathy, Work rate, Internal medicine, medicine, Aerobic exercise, In patient, cardiovascular diseases, business.industry, medicine.disease, Ventricle, Two dimensional strain, business
Abstract

OBJECTIVES: To detect right ventricular myocardial function in dilated cardiomyopathy (DCM) using two-dimensional strain echocardiography (2DSE) and to evaluate the relationship between right ventricular dysfunction and response to cardiopulmonary exercise test (CPET). METHODS: Seventy-five DCM patients (44 idiopathic and 31 ischemic) without clinical signs of right ventricular failure underwent standard echo, 2DSE analysis of right ventricle and bicycle CPET. RESULTS: The two groups were comparable for clinical and standard two-dimensional echocardiographic and Doppler variables, except for right ventricular diameters that were mildly increased in patients with idiopathic DCM. Right ventricular global longitudinal strain (RV GLS) and regional peak myocardial right ventricular strain were significantly impaired in patients with idiopathic DCM compared with ischemic DCM (both P

Published
2011

11. Right ventricular myocardial involvement in either physiological or pathological left ventricular hypertrophy: an ultrasound speckle-tracking two-dimensional strain analysis

Author

Rosangela Cocchia, Maria Giovanna Russo, Giuseppe Pacileo, Lucia Riegler, Sergio Cuomo, Rita Gravino, Antonello D'Andrea, Enrica Golia, Giuseppe Limongelli, Raffaella Scarafile, Francesca Castaldo, Giuseppe De Corato, Eduardo Bossone, Gemma Salerno, Pio Caso, Giovanni Di Salvo, Raffaele Calabrò, D'Andrea, A, Caso, P, Bossone, E, Scarafile, R, Riegler, L, Di Salvo, G, Gravino, R, Cocchia, R, Castaldo, F, Salerno, G, Golia, E, Limongelli, G, De Corato, G, Cuomo, S, Pacileo, G, Russo, Mg, Calabro, R, DI SALVO, Giovanni, Limongelli, Giuseppe, DE CORATO, G, Russo, Maria Giovanna, and Calabro', Raffaele

Subjects
Adult, Male, medicine.medical_specialty, Heart Ventricles, Population, Statistics as Topic, Diastole, Left ventricular hypertrophy, Muscle hypertrophy, Internal medicine, Heart Septum, Medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Systole, education, education.field_of_study, business.industry, Myocardium, Hypertrophic cardiomyopathy, Stroke Volume, General Medicine, Stroke volume, Cardiomyopathy, Hypertrophic, medicine.disease, Echocardiography, Doppler, Preload, Multivariate Analysis, cardiovascular system, Cardiology, Linear Models, Hypertrophy, Left Ventricular, Cardiology and Cardiovascular Medicine, business, Echocardiography, Stress
Abstract

AIMS: To analyse right ventricular (RV) myocardial deformation in patients with left ventricular (LV) hypertrophy secondary to either hypertrophic cardiomyopathy (HCM) or athlete's competitive endurance training. METHODS AND RESULTS: Standard Doppler echo, exercise stress echo, and 2D speckle-tracking strain echocardiography (2DSE) of RV longitudinal deformation in RV septal and lateral walls were performed in 50 top-level endurance athletes and in 35 patients with HCM, all men, having evidence of LV hypertrophy. Right ventricular global longitudinal strain (GLS) was calculated by averaging local strains along the entire right ventricle. The two groups were comparable for age and blood pressure, whereas athletes showed lower heart rate and increased body surface area than HCM. Interventricular septal thickness was higher in HCM, whereas both LV and RV end-diastolic diameters (LVEDD and RVEDD) and LV stroke volume were increased in athletes. Right ventricular tricuspid annulus systolic excursion was comparable between the two groups. Conversely, RV GLS and regional peaks of RV myocardial strain were significantly impaired in patients with HCM (all P < 0.001). Multiple linear regression models detected an independent association between RV GLS and LVEDD (beta-coefficient = -0.68, P < 0.0001) in athletes, as well as an independent correlation of the same RV GLS with septal thickness (beta = 0.63, P < 0.0001) in HCM. An RV GLS cut-off value of -0.16% differentiated athletes and HCM with an 86% sensitivity and a 92% specificity. Furthermore, in the overall population, RV GLS (beta = 0.51, P < 0.0001) was a powerful independent predictor of maximal workload during exercise stress echo. CONCLUSION: Right ventricular myocardial systolic deformation is positively influenced by preload increase in athletes and negatively associated with increased septal thickness in HCM. Therefore, 2DSE may represent a useful tool in the differential diagnosis between athlete's heart and HCM, underlining the different involvement of RV myocardial function in either physiological or pathological LV hypertrophy.

Published
2010

12. Aortic Root Dimensions in Elite Athletes

Author

Antonello D'Andrea, Maria Giovanna Russo, Sergio Cuomo, Giovanni Di Salvo, Olga Vriz, Pio Caso, Rosangela Cocchia, Rodolfo Citro, Raffaele Calabrò, Giuseppe Limongelli, Raffaella Scarafile, Gemma Salerno, Lucia Riegler, Rita Gravino, Eduardo Bossone, D'Andrea, A, Cocchia, R, Riegler, L, Scarafile, R, Salerno, G, Gravino, R, Vriz, O, Citro, R, Limongelli, G, Di Salvo, G, Cuomo, S, Caso, P, Russo, Mg, Calabro, R, Bossone, E, Limongelli, Giuseppe, DI SALVO, Giovanni, Russo, Maria Giovanna, Calabro', Raffaele, and Bossone, E.

Subjects
Adolescent, Adult, Aorta, Aortic Valve, Aortic Valve Insufficiency, Diastole, Female, Humans, Male, Predictive Value of Tests, Sensitivity and Specificity, Sinus of Valsalva, Athletes, Echocardiography, medicine.medical_specialty, medicine.artery, Internal medicine, Ascending aorta, Medicine, Cardiac skeleton, Body surface area, Ejection fraction, business.industry, Sinotubular Junction, Anatomy, Stroke volume, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Although cardiac adaptation to different sports has been extensively described, the potential effect of top-level training on the aortic root dimension remains not investigated fully. To explore the full range of aortic root diameters in athletes, 615 elite athletes (370 endurance-trained athletes and 245 strength-trained athletes; 410 men; mean age 28.4 +/- 10.2 years, range 18 to 40) underwent transthoracic echocardiography. The end-diastolic aortic diameters were measured at 4 locations: (1) the aortic annulus, (2) the sinuses of Valsalva, (3) the sinotubular junction, and (4) the maximum diameter of the proximal ascending aorta. Ascending aorta dilation at the sinuses of Valsalva was defined as a diameter greater than the upper limit of the 95% confidence interval of the overall distribution. The left ventricular (LV) mass index and ejection fraction did not significantly differ between the 2 groups. However, the strength-trained athletes had an increased body surface area, sum of wall thickness (septum plus LV posterior wall), LV circumferential end-systolic stress, and relative wall thickness. In contrast, the left atrial volume index, LV stroke volume, and LV end-diastolic diameter were greater in the endurance-trained athletes. The aortic root diameter at all levels was significantly greater in the strength-trained athletes (p

Published
2010

13. Clinical outcome in patients with intermediate stenosis of left anterior descending coronary artery after deferral of revascularization on the basis of noninvasive coronary flow reserve measurement

Author

Rodolfo Citro, Rosangela Cocchia, Lucia Riegler, F.E.S.C. Sergio Severino M.D., Raffaella Scarafile, Gemma Salerno, Francesca Castaldo, Claudia Mita, Raffaele Calabrò, F.E.S.C. Pio Caso M.D., Sergio Pirone, F.E.S.C. Paolo Calabrò M.D., F.E.S.C. Sergio Cuomo M.D., Maurizio Cappelli Bigazzi, F.E.S.C. Antonello D'Andrea M.D., Rita Gravino, D' ANDREA, A, Severino, S, Mit, C, Riegler, L, Cocchia, R, Gravino, R, Castaldo, F, Scarafile, R, Salerno, G, Pirone, S, Calabro', Paolo, Bigazzi, Mc, Citro, R, Cuomo, S, Caso, P, and Calabro', Raffaele

Subjects
Male, medicine.medical_specialty, Coronary Revascularization Procedure, Coronary Artery Disease, Fractional flow reserve, Anterior Descending Coronary Artery, Coronary artery disease, Internal medicine, Myocardial Revascularization, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Myocardial infarction, Ultrasonography, business.industry, Unstable angina, Incidence, Coronary flow reserve, Middle Aged, Prognosis, medicine.disease, Fractional Flow Reserve, Myocardial, Stenosis, Treatment Outcome, Italy, cardiovascular system, Cardiology, Female, Radiology, Cardiology and Cardiovascular Medicine, business
Abstract

Several reports suggest that noninvasive measurements of coronary flow reserve (CFR) by use of echocardiography may support decision making in intermediate stenosis of the left anterior descending coronary artery (LAD). The aim of the present study was therefore to analyze the clinical outcome in patients with intermediate stenosis of LAD after deferral of coronary revascularization on the basis of noninvasive CFR measurement.the study population included 280 patients with intermediate LAD stenosis (50-70% by angiography) (62.2 +/- 9.6 years). All the patients underwent transthoracic CFR assessment of LAD (after dipyridamole infusion) within 2 weeks from coronary angiography. If CFR of LAD wasor = 2, PTCA was recommended; if CFR was2, medical treatment was chosen. Primary end points were cardiac death, myocardial infarction, coronary revascularization procedure, and unstable angina.mean follow-up was 43 +/- 11 months (range 12-52 months). In 150 patients (53.6%) (CFRor = 2), coronary artery revascularization was performed (PTCA group); the remaining 130 patients (46.4%) (CFR2) were medically treated (medical group). Survival from cardiac death was 94% in the PTCA group and 92.4% in the medical group (P = 0.56). As for all cardiac events, the Kaplan-Meier percentage survival from cardiac events was 88.3% in the PTCA group and 86.4% in the medical group (P = 0.36).even if CFR as a "stand-alone" diagnostic criterion suffers from several structural limitations, a combined strategy including also other clinical and instrumental measurements before undergoing interventional procedures could improve the cost-benefit practice, in particular, for the management of patients with intermediate LAD stenosis.

Published
2009

14. Effects of global longitudinal strain and total scar burden on response to cardiac resynchronization therapy in patients with ischaemic dilated cardiomyopathy

Author

Giuseppe Limongelli, Luigi Ascione, Rosangela Cocchia, Raffaella Scarafile, Sergio Cuomo, Gemma Salerno, Raffaele Calabrò, Giovanni Di Salvo, Luca Del Viscovo, Antonello D'Andrea, Raffaele Iengo, Francesca Castaldo, Lucia Riegler, Pio Caso, Rita Gravino, Lucio Santangelo, D' ANDREA, A, Caso, P, Scarafile, R, Riegler, L, Salerno, G, Castaldo, F, Gravino, R, Cocchia, R, DEL VISCOVO, Luca, Limongelli, Giuseppe, DI SALVO, Giovanni, Ascione, L, Iengo, R, Cuomo, S, Santangelo, Lucio, and Calabro', Raffaele

Subjects
Male, Cardiac magnetic resonance, Longitudinal strain, medicine.medical_treatment, Left, Cardiomyopathy, Ventricular Dysfunction, Left, Ischaemic dilated cardiomyopathy, Dilated, Ventricular Dysfunction, Ejection fraction, medicine.diagnostic_test, Cardiac Pacing, Artificial, Doppler, Dilated cardiomyopathy, Middle Aged, Global strain, Heart failure, Myocardial scar, Resynchronization therapy, Two-dimensional strain imaging, Aged, Algorithms, Cardiomyopathy, Dilated, Cicatrix, Echocardiography, Doppler, Female, Humans, Magnetic Resonance Imaging, Myocardium, Prognosis, ROC Curve, Sensitivity and Specificity, Echocardiography, Artificial, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Cardiac resynchronization therapy, Internal medicine, medicine, In patient, cardiovascular diseases, business.industry, Magnetic resonance imaging, medicine.disease, Cardiac Pacing, business
Abstract

Aims To evaluate whether quantification of the extent of scarred left ventricular (LV) tissue by speckle-tracking strain echo (2DSE) can predict response to cardiac resynchronization therapy (CRT) in patients with ischaemic dilated cardiomyopathy (DCM). Methods and results Forty-five patients (58.3 ± 8.3 years; 24 males) with ischaemic DCM scheduled for CRT, and 25 controls were studied. A week before implantation all the patients underwent standard Doppler echo, 2DSE, and contrast-enhanced magnetic resonance (MR). Clinical and echocardiographic evaluation was repeated 6 months after CRT. The patients were considered as responders to CRT if LV end-systolic volume decreased by 15%. In DCM patients, LV ejection fraction was 29.2 ± 5.1%. By evaluating the 765 segments with MR, subendocardial infarct was identified in 17.0% and transmural infarct in 18.3%. With 2DSE, the average global longitudinal strain (GLS) was −23.1 ± 3.6% in controls and −15.1 ± 5.1% in DCM (P = 0.001). GLS showed a close correlation with total scar burden using MR (r = 0.64, P < 0.001). At follow-up, patients were subdivided into responders (n = 30; 66.7%) and non-responders (n = 15; 33.3%) to CRT. GLS was significantly different in non-responders than in responders (GLS: −10.4 ± 5.1 in non-responders vs. −18.4 ± 14% in responders, P < 0.001). In a multivariable analysis, GLS (P < 0.0001) and radial intraventricular dyssynchrony (P < 0.001) were powerful independent determinants of response to CRT. Conclusion GLS is strongly associated with total scar burden assessed by MR, and is an excellent independent predictor of response to CRT.

Published
2009

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