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51. Antithrombotic therapy in ventricular assist device (VAD) management: From ancient beliefs to updated evidence. A narrative review

Author

Morici, N, Varrenti, M, Brunelli, D, Perna, E, Cipriani, M, Ammirati, E, Frigerio, M, Cattaneo, M, Oliva, F, Morici N., Varrenti M., Brunelli D., Perna E., Cipriani M., Ammirati E., Frigerio M., Cattaneo M., Oliva F., Morici, N, Varrenti, M, Brunelli, D, Perna, E, Cipriani, M, Ammirati, E, Frigerio, M, Cattaneo, M, Oliva, F, Morici N., Varrenti M., Brunelli D., Perna E., Cipriani M., Ammirati E., Frigerio M., Cattaneo M., and Oliva F.

Abstract

Platelets play a key role in the pathogenesis of ventricular assist device (VAD) thrombosis; therefore, antiplatelet drugs are essential, both in the acute phase and in the long-term follow-up in VAD management. Aspirin is the most used agent and still remains the first-choice drug for lifelong administration after VAD implantation. Anticoagulant drugs are usually recommended, but with a wide range of efficacy targets. Dual antiplatelet therapy, targeting more than one pathway of platelet activation, has been used for patients developing a thrombotic event, despite an increased risk of bleeding complications. Although different strategies have been attempted, bleeding and thrombotic events remain frequent and there are no uniform strategies adopted for pharmacological management in the short and mid- or long-term follow up. The aim of this article is to provide an overview of the evidence from randomized clinical trials and observational studies with a focus on the pathophysiologic mechanisms underlying bleeding and thrombosis in VAD patients and the best antithrombotic regimens available.

Published
2018

52. Single-center outbreak of Pneumocystis jirovecii pneumonia in heart transplant recipients

Author

Veronese, G, Ammirati, E, Moioli, M, Baldan, R, Orcese, C, De Rezende, G, Veronese, S, Masciocco, G, Perna, E, Travi, G, Puoti, M, Cipriani, M, Tiberi, S, Cirillo, D, Frigerio, M, Veronese G., Ammirati E., Moioli M. C., Baldan R., Orcese C. A., De Rezende G., Veronese S., Masciocco G., Perna E., Travi G., Puoti M., Cipriani M., Tiberi S., Cirillo D., Frigerio M., Veronese, G, Ammirati, E, Moioli, M, Baldan, R, Orcese, C, De Rezende, G, Veronese, S, Masciocco, G, Perna, E, Travi, G, Puoti, M, Cipriani, M, Tiberi, S, Cirillo, D, Frigerio, M, Veronese G., Ammirati E., Moioli M. C., Baldan R., Orcese C. A., De Rezende G., Veronese S., Masciocco G., Perna E., Travi G., Puoti M., Cipriani M., Tiberi S., Cirillo D., and Frigerio M.

Abstract

Background: Pneumocystis jirovecii pneumonia (PJP) outbreaks are described in solid organ transplant recipients. Few reports suggest interhuman transmission with important infection control implications. We described a large PJP outbreak in heart transplant (HTx) recipients. Methods: Six cases of PJP occurred in HTx recipients within 10 months in our hospital. Demographics, clinical characteristics, treatment and outcomes were described. To identify contacts among individuals a review of all dates of out-patient visits and patient hospitalizations was performed. Cross exposure was also investigated using genotyping on PJ isolates. Results: At the time of PJP-related hospitalization, patients' mean age was 49 ± standard deviation 4 years, median time from HTx was 8 (25%-75% interquartile range [Q1-Q3] 5-12) months and none of the cases were on prophylaxis. At PJP-related admission, 5 patients had CMV reactivation, of whom 4 were on antiviral preemptive treatment. Median in-hospital stay was 30 (Q1-Q3, 28-48) days; and 2 cases required intensive care unit admission. All patients survived beyond 2 years. Transmission map analysis suggested interhuman transmission in all cases (presumed incubation period, median 90 [Q1-Q3, 64-91] days). Genotyping was performed in 4 cases, demonstrating the same PJ strain in 3 cases. Conclusions: We described a large PJP cluster among HTx recipients, supporting the nosocomial acquisition of PJP through interhuman transmission. Based on this experience, extended prophylaxis for more than 6 months after HTx could be considered in specific settings. Further work is required to understand its optimal duration and timing based on individual risk factor profiles and to define standardized countermeasures to prevent and limit PJP outbreaks.

Published
2018

53. Carotid artery plaque uptake of 11C-PK11195 inversely correlates with circulating monocytes and classical CD14++CD16− monocytes expressing HLA-DR

Author

Ammirati, E, Moroni, F, Magnoni, M, Busnardo, E, Di Terlizzi, S, Villa, C, Sizzano, F, Scotti, I, Palini, A, Presotto, L, Bettinardi, V, Spagnolo, P, Besana, F, Gianolli, L, Rimoldi, O, Camici, P, Ammirati E., Moroni F., Magnoni M., Busnardo E., Di Terlizzi S., Villa C., Sizzano F., Scotti I., Palini A., Presotto L., Bettinardi V., Spagnolo P., Besana F., Gianolli L., Rimoldi O. E., Camici P. G., Ammirati, E, Moroni, F, Magnoni, M, Busnardo, E, Di Terlizzi, S, Villa, C, Sizzano, F, Scotti, I, Palini, A, Presotto, L, Bettinardi, V, Spagnolo, P, Besana, F, Gianolli, L, Rimoldi, O, Camici, P, Ammirati E., Moroni F., Magnoni M., Busnardo E., Di Terlizzi S., Villa C., Sizzano F., Scotti I., Palini A., Presotto L., Bettinardi V., Spagnolo P., Besana F., Gianolli L., Rimoldi O. E., and Camici P. G.

Abstract

Background: We explored the relation between blood concentrations of monocyte/lymphocyte subsets and carotid artery plaque macrophage content, measured by positron emission tomography (PET) with 11C-PK11195. Methods and results: In 9 patients with carotid plaques we performed 11C-PK11195-PET/computed tomography angiography imaging and measurement of absolute concentrations and frequencies of circulating monocytes and T-cell subsets. Plaque standardized uptake value (SUV) for 11C-PK11195 was negatively correlated with concentrations of total monocytes (r = −0.58, p = 0.05) and CD14++CD16−HLA-DR+ classical subset (r = −0.82, p = 0.005). These correlations hold true also in relation to plaque target to background ratio. No correlation was observed between plaque SUV and CD3+T lymphocytes, CD4+T lymphocytes nor with activated CD3+CD4+T cells expressing HLA-DR. Conclusions: We first demonstrated a reduction in the absolute concentration of monocytes and particularly in classical monocytes expressing HLA-DR in the presence of an increased uptake of 11C-PK11195 in carotid plaques. The present work, despite being a pilot study comprising only a small number of subjects provides new insights in the search for specific cellular biomarkers with potential diagnostic and prognostic value in patients with a known carotid plaque.

Published
2018

55. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study

Author

Roth, GA, Mensah, GA, Johnson, CO, Addolorato, G, Ammirati, E, Baddour, LM, Barengo, NC, Beaton, A, Benjamin, EJ, Benziger, CP, Bonny, A, Brauer, M, Brodmann, M, Cahill, TJ, Carapetis, JR, Catapano, AL, Chugh, S, Cooper, LT, Coresh, J, Criqui, MH, DeCleene, NK, Eagle, KA, Emmons-Bell, S, Feigin, VL, Fernández-Sola, J, Fowkes, FGR, Gakidou, E, Grundy, SM, He, FJ, Howard, G, Hu, F, Inker, L, Karthikeyan, G, Kassebaum, NJ, Koroshetz, WJ, Lavie, C, Lloyd-Jones, D, Lu, HS, Mirijello, A, Misganaw, AT, Mokdad, AH, Moran, AE, Muntner, P, Narula, J, Neal, B, Ntsekhe, M, Oliveira, GMM, Otto, CM, Owolabi, MO, Pratt, M, Rajagopalan, S, Reitsma, MB, Ribeiro, ALP, Rigotti, NA, Rodgers, A, Sable, CA, Shakil, SS, Sliwa, K, Stark, BA, Sundström, J, Timpel, P, Tleyjeh, II, Valgimigli, M, Vos, T, Whelton, PK, Yacoub, M, Zuhlke, LJ, Abbasi-Kangevari, M, Abdi, A, Abedi, A, Aboyans, V, Abrha, WA, Abu-Gharbieh, E, Abushouk, AI, Acharya, D, Adair, T, Adebayo, OM, Ademi, Z, Advani, SM, Afshari, K, Afshin, A, Agarwal, G, Agasthi, P, Ahmad, S, Ahmadi, S, Ahmed, MB, Aji, B, Akalu, Y, Akande-Sholabi, W, Aklilu, A, Akunna, CJ, Alahdab, F, Al-Eyadhy, A, Alhabib, KF, Alif, SM, Alipour, V, Aljunid, SM, Alla, F, Almasi-Hashiani, A, Almustanyir, S, Roth, GA, Mensah, GA, Johnson, CO, Addolorato, G, Ammirati, E, Baddour, LM, Barengo, NC, Beaton, A, Benjamin, EJ, Benziger, CP, Bonny, A, Brauer, M, Brodmann, M, Cahill, TJ, Carapetis, JR, Catapano, AL, Chugh, S, Cooper, LT, Coresh, J, Criqui, MH, DeCleene, NK, Eagle, KA, Emmons-Bell, S, Feigin, VL, Fernández-Sola, J, Fowkes, FGR, Gakidou, E, Grundy, SM, He, FJ, Howard, G, Hu, F, Inker, L, Karthikeyan, G, Kassebaum, NJ, Koroshetz, WJ, Lavie, C, Lloyd-Jones, D, Lu, HS, Mirijello, A, Misganaw, AT, Mokdad, AH, Moran, AE, Muntner, P, Narula, J, Neal, B, Ntsekhe, M, Oliveira, GMM, Otto, CM, Owolabi, MO, Pratt, M, Rajagopalan, S, Reitsma, MB, Ribeiro, ALP, Rigotti, NA, Rodgers, A, Sable, CA, Shakil, SS, Sliwa, K, Stark, BA, Sundström, J, Timpel, P, Tleyjeh, II, Valgimigli, M, Vos, T, Whelton, PK, Yacoub, M, Zuhlke, LJ, Abbasi-Kangevari, M, Abdi, A, Abedi, A, Aboyans, V, Abrha, WA, Abu-Gharbieh, E, Abushouk, AI, Acharya, D, Adair, T, Adebayo, OM, Ademi, Z, Advani, SM, Afshari, K, Afshin, A, Agarwal, G, Agasthi, P, Ahmad, S, Ahmadi, S, Ahmed, MB, Aji, B, Akalu, Y, Akande-Sholabi, W, Aklilu, A, Akunna, CJ, Alahdab, F, Al-Eyadhy, A, Alhabib, KF, Alif, SM, Alipour, V, Aljunid, SM, Alla, F, Almasi-Hashiani, A, and Almustanyir, S

Abstract

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside

Published
2020

57. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019

Author

Roth, GA, Mensah, GA, Johnson, CO, Addolorato, G, Ammirati, E, Baddour, LM, Barengo, NC, Beaton, AZ, Benjamin, EJ, Benziger, CP, Bonny, A, Brauer, M, Brodmann, M, Cahill, TJ, Carapetis, J, Catapano, AL, Chugh, SS, Cooper, LT, Coresh, J, Criqui, M, DeCleene, N, Eagle, KA, Emmons-Bell, S, Feigin, VL, Fernández-Solà, J, Fowkes, G, Gakidou, E, Grundy, SM, He, FJ, Howard, G, Hu, F, Inker, L, Karthikeyan, G, Kassebaum, N, Koroshetz, W, Lavie, C, Lloyd-Jones, D, Lu, HS, Mirijello, A, Temesgen, AM, Mokdad, A, Moran, AE, Muntner, P, Narula, J, Neal, B, Ntsekhe, M, Moraes de Oliveira, G, Otto, C, Owolabi, M, Pratt, M, Rajagopalan, S, Reitsma, M, Ribeiro, ALP, Rigotti, N, Rodgers, A, Sable, C, Shakil, S, Sliwa-Hahnle, K, Stark, B, Sundström, J, Timpel, P, Tleyjeh, IM, Valgimigli, M, Vos, T, Whelton, PK, Yacoub, M, Zuhlke, L, Murray, C, Fuster, V, Beaton, A, Carapetis, JR, Chugh, S, Criqui, MH, DeCleene, NK, Fernández-Sola, J, Fowkes, FGR, Kassebaum, NJ, Koroshetz, WJ, Misganaw, AT, Mokdad, AH, Oliveira, GMM, Otto, CM, Owolabi, MO, Reitsma, MB, Rigotti, NA, Sable, CA, Shakil, SS, Sliwa, K, Stark, BA, Tleyjeh, II, Zuhlke, LJ, Abbasi-Kangevari, M, Abdi, A, Abedi, A, Aboyans, V, Abrha, WA, Abu-Gharbieh, E, Abushouk, AI, Acharya, D, Adair, T, Adebayo, OM, Ademi, Z, Advani, SM, Afshari, K, Afshin, A, Agarwal, G, Agasthi, P, Ahmad, S, Ahmadi, S, Ahmed, MB, Aji, B, Akalu, Y, Akande-Sholabi, W, Aklilu, A, Akunna, CJ, Alahdab, F, Al-Eyadhy, A, Alhabib, KF, Alif, SM, Alipour, V, Aljunid, SM, Alla, F, Almasi-Hashiani, A, Almustanyir, S, Al-Raddadi, RM, Amegah, AK, Amini, S, Aminorroaya, A, Amu, H, Amugsi, DA, Ancuceanu, R, Anderlini, D, Andrei, T, Andrei, CL, Ansari-Moghaddam, A, Anteneh, ZA, Antonazzo, IC, Antony, B, Anwer, R, Appiah, LT, Arabloo, J, Ärnlöv, J, Artanti, KD, Ataro, Z, Ausloos, M, Avila-Burgos, L, Awan, AT, Awoke, MA, Ayele, HT, Ayza, MA, Azari, S, B, DB, Baheiraei, N, Baig, AA, Bakhtiari, A, Banach, M, Banik, PC, Baptista, EA, Barboza, MA, Barua, L, Basu, S, Bedi, N, Béjot, Y, Bennett, DA, Bensenor, IM, Berman, AE, Bezabih, YM, Bhagavathula, AS, Bhaskar, S, Bhattacharyya, K, Bijani, A, Bikbov, B, Birhanu, MM, Boloor, A, Brant, LC, Brenner, H, Briko, NI, Butt, ZA, Caetano dos Santos, FL, Cahill, LE, Cahuana-Hurtado, L, Cámera, LA, Campos-Nonato, IR, Cantu-Brito, C, Car, J, Carrero, JJ, Carvalho, F, Castañeda-Orjuela, CA, Catalá-López, F, Cerin, E, Charan, J, Chattu, VK, Chen, S, Chin, KL, Choi, J-YJ, Chu, D-T, Chung, S-C, Cirillo, M, Coffey, S, Conti, S, Costa, VM, Cundiff, DK, Dadras, O, Dagnew, B, Dai, X, Damasceno, AAM, Dandona, L, Dandona, R, Davletov, K, De la Cruz-Góngora, V, De la Hoz, FP, De Neve, J-W, Denova-Gutiérrez, E, Derbew Molla, M, Derseh, BT, Desai, R, Deuschl, G, Dharmaratne, SD, Dhimal, M, Dhungana, RR, Dianatinasab, M, Diaz, D, Djalalinia, S, Dokova, K, Douiri, A, Duncan, BB, Duraes, AR, Eagan, AW, Ebtehaj, S, Eftekhari, A, Eftekharzadeh, S, Ekholuenetale, M, El Nahas, N, Elgendy, IY, Elhadi, M, El-Jaafary, SI, Esteghamati, S, Etisso, AE, Eyawo, O, Fadhil, I, Faraon, EJA, Faris, PS, Farwati, M, Farzadfar, F, Fernandes, E, Fernandez Prendes, C, Ferrara, P, Filip, I, Fischer, F, Flood, D, Fukumoto, T, Gad, MM, Gaidhane, S, Ganji, M, Garg, J, Gebre, AK, Gebregiorgis, BG, Gebregzabiher, KZ, Gebremeskel, GG, Getacher, L, Obsa, AG, Ghajar, A, Ghashghaee, A, Ghith, N, Giampaoli, S, Gilani, SA, Gill, PS, Gillum, RF, Glushkova, EV, Gnedovskaya, EV, Golechha, M, Gonfa, KB, Goudarzian, AH, Goulart, AC, Guadamuz, JS, Guha, A, Guo, Y, Gupta, R, Hachinski, V, Hafezi-Nejad, N, Haile, TG, Hamadeh, RR, Hamidi, S, Hankey, GJ, Hargono, A, Hartono, RK, Hashemian, M, Hashi, A, Hassan, S, Hassen, HY, Havmoeller, RJ, Hay, SI, Hayat, K, Heidari, G, Herteliu, C, Holla, R, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Huang, J, Humayun, A, Iavicoli, I, Ibeneme, CU, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Iqbal, U, Irvani, SSN, Shariful Islam, Sheikh, Islam, RM, Iso, H, Iwagami, M, Jain, V, Javaheri, T, Jayapal, SK, Jayaram, S, Jayawardena, R, Jeemon, P, Jha, RP, Jonas, JB, Jonnagaddala, J, Joukar, F, Jozwiak, JJ, Jürisson, M, Kabir, A, Kahlon, T, Kalani, R, Kalhor, R, Kamath, A, Kamel, I, Kandel, H, Kandel, A, Karch, A, Kasa, AS, Katoto, PDMC, Kayode, GA, Khader, YS, Khammarnia, M, Khan, MS, Khan, MN, Khan, M, Khan, EA, Khatab, K, Kibria, GMA, Kim, YJ, Kim, GR, Kimokoti, RW, Kisa, S, Kisa, A, Kivimäki, M, Kolte, D, Koolivand, A, Korshunov, VA, Koulmane Laxminarayana, SL, Koyanagi, A, Krishan, K, Krishnamoorthy, V, Kuate Defo, B, Kucuk Bicer, B, Kulkarni, V, Kumar, GA, Kumar, N, Kurmi, OP, Kusuma, D, Kwan, GF, La Vecchia, C, Lacey, B, Lallukka, T, Lan, Q, Lasrado, S, Lassi, ZS, Lauriola, P, Lawrence, WR, Laxmaiah, A, LeGrand, KE, Li, M-C, Li, B, Li, S, Lim, SS, Lim, L-L, Lin, H, Lin, Z, Lin, R-T, Liu, X, Lopez, AD, Lorkowski, S, Lotufo, PA, Lugo, A, M, NK, Madotto, F, Mahmoudi, M, Majeed, A, Malekzadeh, R, Malik, AA, Mamun, AA, Manafi, N, Mansournia, MA, Mantovani, LG, Martini, S, Mathur, MR, Mazzaglia, G, Mehata, S, Mehndiratta, MM, Meier, T, Menezes, RG, Meretoja, A, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, IM, Miller, TR, Mirrakhimov, EM, Mirzaei, H, Moazen, B, Moghadaszadeh, M, Mohammad, Y, Mohammad, DK, Mohammed, S, Mohammed, MA, Mokhayeri, Y, Molokhia, M, Montasir, AA, Moradi, G, Moradzadeh, R, Moraga, P, Morawska, L, Moreno Velásquez, I, Morze, J, Mubarik, S, Muruet, W, Musa, KI, Nagarajan, AJ, Nalini, M, Nangia, V, Naqvi, AA, Narasimha Swamy, S, Nascimento, BR, Nayak, VC, Nazari, J, Nazarzadeh, M, Negoi, RI, Neupane Kandel, S, Nguyen, HLT, Nixon, MR, Norrving, B, Noubiap, JJ, Nouthe, BE, Nowak, C, Odukoya, OO, Ogbo, FA, Olagunju, AT, Orru, H, Ortiz, A, Ostroff, SM, Padubidri, JR, Palladino, R, Pana, A, Panda-Jonas, S, Parekh, U, Park, E-C, Parvizi, M, Pashazadeh Kan, F, Patel, UK, Pathak, M, Paudel, R, Pepito, VCF, Perianayagam, A, Perico, N, Pham, HQ, Pilgrim, T, Piradov, MA, Pishgar, F, Podder, V, Polibin, RV, Pourshams, A, Pribadi, DRA, Rabiee, N, Rabiee, M, Radfar, A, Rafiei, A, Rahim, F, Rahimi-Movaghar, V, Ur Rahman, MH, Rahman, Muhammad, Rahmani, AM, Rakovac, I, Ram, P, Ramalingam, S, Rana, J, Ranasinghe, P, Rao, SJ, Rathi, P, Rawal, L, Rawasia, WF, Rawassizadeh, R, Remuzzi, G, Renzaho, AMN, Rezapour, A, Riahi, SM, Roberts-Thomson, RL, Roever, L, Rohloff, P, Romoli, M, Roshandel, G, Rwegerera, GM, Saadatagah, S, Saber-Ayad, MM, Sabour, S, Sacco, S, Sadeghi, M, Saeedi Moghaddam, S, Safari, S, Sahebkar, A, Salehi, S, Salimzadeh, H, Samaei, M, Samy, AM, Santos, IS, Santric-Milicevic, MM, Sarrafzadegan, N, Sarveazad, A, Sathish, T, Sawhney, M, Saylan, M, Schmidt, MI, Schutte, AE, Senthilkumaran, S, Sepanlou, SG, Sha, F, Shahabi, S, Shahid, I, Shaikh, MA, Shamali, M, Shamsizadeh, M, Shawon, MSR, Sheikh, A, Shigematsu, M, Shin, M-J, Shin, JI, Shiri, R, Shiue, I, Shuval, K, Siabani, S, Siddiqi, TJ, Silva, DAS, Singh, JA, Mtech, AS, Skryabin, VY, Skryabina, AA, Soheili, A, Spurlock, EE, Stockfelt, L, Stortecky, S, Stranges, S, Suliankatchi Abdulkader, R, Tadbiri, H, Tadesse, EG, Tadesse, DB, Tajdini, M, Tariqujjaman, M, Teklehaimanot, BF, Temsah, M-H, Tesema, AK, Thakur, B, Thankappan, KR, Thapar, R, Thrift, AG, Timalsina, B, Tonelli, M, Touvier, M, Tovani-Palone, MR, Tripathi, A, Tripathy, JP, Truelsen, TC, Tsegay, GM, Tsegaye, GW, Tsilimparis, N, Tusa, BS, Tyrovolas, S, Umapathi, KK, Unim, B, Unnikrishnan, B, Usman, MS, Vaduganathan, M, Valdez, PR, Vasankari, TJ, Velazquez, DZ, Venketasubramanian, N, Vu, GT, Vujcic, IS, Waheed, Y, Wang, Y, Wang, F, Wei, J, Weintraub, RG, Weldemariam, AH, Westerman, R, Winkler, AS, Wiysonge, CS, Wolfe, CDA, Wubishet, BL, Xu, G, Yadollahpour, A, Yamagishi, K, Yan, LL, Yandrapalli, S, Yano, Y, Yatsuya, H, Yeheyis, TY, Yeshaw, Y, Yilgwan, CS, Yonemoto, N, Yu, C, Yusefzadeh, H, Zachariah, G, Zaman, SB, Zaman, MS, Zamanian, M, Zand, R, Zandifar, A, Zarghi, A, Zastrozhin, MS, Zastrozhina, A, Zhang, Z-J, Zhang, Y, Zhang, W, Zhong, C, Zou, Z, Zuniga, YMH, Murray, CJL, Roth, GA, Mensah, GA, Johnson, CO, Addolorato, G, Ammirati, E, Baddour, LM, Barengo, NC, Beaton, AZ, Benjamin, EJ, Benziger, CP, Bonny, A, Brauer, M, Brodmann, M, Cahill, TJ, Carapetis, J, Catapano, AL, Chugh, SS, Cooper, LT, Coresh, J, Criqui, M, DeCleene, N, Eagle, KA, Emmons-Bell, S, Feigin, VL, Fernández-Solà, J, Fowkes, G, Gakidou, E, Grundy, SM, He, FJ, Howard, G, Hu, F, Inker, L, Karthikeyan, G, Kassebaum, N, Koroshetz, W, Lavie, C, Lloyd-Jones, D, Lu, HS, Mirijello, A, Temesgen, AM, Mokdad, A, Moran, AE, Muntner, P, Narula, J, Neal, B, Ntsekhe, M, Moraes de Oliveira, G, Otto, C, Owolabi, M, Pratt, M, Rajagopalan, S, Reitsma, M, Ribeiro, ALP, Rigotti, N, Rodgers, A, Sable, C, Shakil, S, Sliwa-Hahnle, K, Stark, B, Sundström, J, Timpel, P, Tleyjeh, IM, Valgimigli, M, Vos, T, Whelton, PK, Yacoub, M, Zuhlke, L, Murray, C, Fuster, V, Beaton, A, Carapetis, JR, Chugh, S, Criqui, MH, DeCleene, NK, Fernández-Sola, J, Fowkes, FGR, Kassebaum, NJ, Koroshetz, WJ, Misganaw, AT, Mokdad, AH, Oliveira, GMM, Otto, CM, Owolabi, MO, Reitsma, MB, Rigotti, NA, Sable, CA, Shakil, SS, Sliwa, K, Stark, BA, Tleyjeh, II, Zuhlke, LJ, Abbasi-Kangevari, M, Abdi, A, Abedi, A, Aboyans, V, Abrha, WA, Abu-Gharbieh, E, Abushouk, AI, Acharya, D, Adair, T, Adebayo, OM, Ademi, Z, Advani, SM, Afshari, K, Afshin, A, Agarwal, G, Agasthi, P, Ahmad, S, Ahmadi, S, Ahmed, MB, Aji, B, Akalu, Y, Akande-Sholabi, W, Aklilu, A, Akunna, CJ, Alahdab, F, Al-Eyadhy, A, Alhabib, KF, Alif, SM, Alipour, V, Aljunid, SM, Alla, F, Almasi-Hashiani, A, Almustanyir, S, Al-Raddadi, RM, Amegah, AK, Amini, S, Aminorroaya, A, Amu, H, Amugsi, DA, Ancuceanu, R, Anderlini, D, Andrei, T, Andrei, CL, Ansari-Moghaddam, A, Anteneh, ZA, Antonazzo, IC, Antony, B, Anwer, R, Appiah, LT, Arabloo, J, Ärnlöv, J, Artanti, KD, Ataro, Z, Ausloos, M, Avila-Burgos, L, Awan, AT, Awoke, MA, Ayele, HT, Ayza, MA, Azari, S, B, DB, Baheiraei, N, Baig, AA, Bakhtiari, A, Banach, M, Banik, PC, Baptista, EA, Barboza, MA, Barua, L, Basu, S, Bedi, N, Béjot, Y, Bennett, DA, Bensenor, IM, Berman, AE, Bezabih, YM, Bhagavathula, AS, Bhaskar, S, Bhattacharyya, K, Bijani, A, Bikbov, B, Birhanu, MM, Boloor, A, Brant, LC, Brenner, H, Briko, NI, Butt, ZA, Caetano dos Santos, FL, Cahill, LE, Cahuana-Hurtado, L, Cámera, LA, Campos-Nonato, IR, Cantu-Brito, C, Car, J, Carrero, JJ, Carvalho, F, Castañeda-Orjuela, CA, Catalá-López, F, Cerin, E, Charan, J, Chattu, VK, Chen, S, Chin, KL, Choi, J-YJ, Chu, D-T, Chung, S-C, Cirillo, M, Coffey, S, Conti, S, Costa, VM, Cundiff, DK, Dadras, O, Dagnew, B, Dai, X, Damasceno, AAM, Dandona, L, Dandona, R, Davletov, K, De la Cruz-Góngora, V, De la Hoz, FP, De Neve, J-W, Denova-Gutiérrez, E, Derbew Molla, M, Derseh, BT, Desai, R, Deuschl, G, Dharmaratne, SD, Dhimal, M, Dhungana, RR, Dianatinasab, M, Diaz, D, Djalalinia, S, Dokova, K, Douiri, A, Duncan, BB, Duraes, AR, Eagan, AW, Ebtehaj, S, Eftekhari, A, Eftekharzadeh, S, Ekholuenetale, M, El Nahas, N, Elgendy, IY, Elhadi, M, El-Jaafary, SI, Esteghamati, S, Etisso, AE, Eyawo, O, Fadhil, I, Faraon, EJA, Faris, PS, Farwati, M, Farzadfar, F, Fernandes, E, Fernandez Prendes, C, Ferrara, P, Filip, I, Fischer, F, Flood, D, Fukumoto, T, Gad, MM, Gaidhane, S, Ganji, M, Garg, J, Gebre, AK, Gebregiorgis, BG, Gebregzabiher, KZ, Gebremeskel, GG, Getacher, L, Obsa, AG, Ghajar, A, Ghashghaee, A, Ghith, N, Giampaoli, S, Gilani, SA, Gill, PS, Gillum, RF, Glushkova, EV, Gnedovskaya, EV, Golechha, M, Gonfa, KB, Goudarzian, AH, Goulart, AC, Guadamuz, JS, Guha, A, Guo, Y, Gupta, R, Hachinski, V, Hafezi-Nejad, N, Haile, TG, Hamadeh, RR, Hamidi, S, Hankey, GJ, Hargono, A, Hartono, RK, Hashemian, M, Hashi, A, Hassan, S, Hassen, HY, Havmoeller, RJ, Hay, SI, Hayat, K, Heidari, G, Herteliu, C, Holla, R, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Househ, M, Huang, J, Humayun, A, Iavicoli, I, Ibeneme, CU, Ibitoye, SE, Ilesanmi, OS, Ilic, IM, Ilic, MD, Iqbal, U, Irvani, SSN, Shariful Islam, Sheikh, Islam, RM, Iso, H, Iwagami, M, Jain, V, Javaheri, T, Jayapal, SK, Jayaram, S, Jayawardena, R, Jeemon, P, Jha, RP, Jonas, JB, Jonnagaddala, J, Joukar, F, Jozwiak, JJ, Jürisson, M, Kabir, A, Kahlon, T, Kalani, R, Kalhor, R, Kamath, A, Kamel, I, Kandel, H, Kandel, A, Karch, A, Kasa, AS, Katoto, PDMC, Kayode, GA, Khader, YS, Khammarnia, M, Khan, MS, Khan, MN, Khan, M, Khan, EA, Khatab, K, Kibria, GMA, Kim, YJ, Kim, GR, Kimokoti, RW, Kisa, S, Kisa, A, Kivimäki, M, Kolte, D, Koolivand, A, Korshunov, VA, Koulmane Laxminarayana, SL, Koyanagi, A, Krishan, K, Krishnamoorthy, V, Kuate Defo, B, Kucuk Bicer, B, Kulkarni, V, Kumar, GA, Kumar, N, Kurmi, OP, Kusuma, D, Kwan, GF, La Vecchia, C, Lacey, B, Lallukka, T, Lan, Q, Lasrado, S, Lassi, ZS, Lauriola, P, Lawrence, WR, Laxmaiah, A, LeGrand, KE, Li, M-C, Li, B, Li, S, Lim, SS, Lim, L-L, Lin, H, Lin, Z, Lin, R-T, Liu, X, Lopez, AD, Lorkowski, S, Lotufo, PA, Lugo, A, M, NK, Madotto, F, Mahmoudi, M, Majeed, A, Malekzadeh, R, Malik, AA, Mamun, AA, Manafi, N, Mansournia, MA, Mantovani, LG, Martini, S, Mathur, MR, Mazzaglia, G, Mehata, S, Mehndiratta, MM, Meier, T, Menezes, RG, Meretoja, A, Mestrovic, T, Miazgowski, B, Miazgowski, T, Michalek, IM, Miller, TR, Mirrakhimov, EM, Mirzaei, H, Moazen, B, Moghadaszadeh, M, Mohammad, Y, Mohammad, DK, Mohammed, S, Mohammed, MA, Mokhayeri, Y, Molokhia, M, Montasir, AA, Moradi, G, Moradzadeh, R, Moraga, P, Morawska, L, Moreno Velásquez, I, Morze, J, Mubarik, S, Muruet, W, Musa, KI, Nagarajan, AJ, Nalini, M, Nangia, V, Naqvi, AA, Narasimha Swamy, S, Nascimento, BR, Nayak, VC, Nazari, J, Nazarzadeh, M, Negoi, RI, Neupane Kandel, S, Nguyen, HLT, Nixon, MR, Norrving, B, Noubiap, JJ, Nouthe, BE, Nowak, C, Odukoya, OO, Ogbo, FA, Olagunju, AT, Orru, H, Ortiz, A, Ostroff, SM, Padubidri, JR, Palladino, R, Pana, A, Panda-Jonas, S, Parekh, U, Park, E-C, Parvizi, M, Pashazadeh Kan, F, Patel, UK, Pathak, M, Paudel, R, Pepito, VCF, Perianayagam, A, Perico, N, Pham, HQ, Pilgrim, T, Piradov, MA, Pishgar, F, Podder, V, Polibin, RV, Pourshams, A, Pribadi, DRA, Rabiee, N, Rabiee, M, Radfar, A, Rafiei, A, Rahim, F, Rahimi-Movaghar, V, Ur Rahman, MH, Rahman, Muhammad, Rahmani, AM, Rakovac, I, Ram, P, Ramalingam, S, Rana, J, Ranasinghe, P, Rao, SJ, Rathi, P, Rawal, L, Rawasia, WF, Rawassizadeh, R, Remuzzi, G, Renzaho, AMN, Rezapour, A, Riahi, SM, Roberts-Thomson, RL, Roever, L, Rohloff, P, Romoli, M, Roshandel, G, Rwegerera, GM, Saadatagah, S, Saber-Ayad, MM, Sabour, S, Sacco, S, Sadeghi, M, Saeedi Moghaddam, S, Safari, S, Sahebkar, A, Salehi, S, Salimzadeh, H, Samaei, M, Samy, AM, Santos, IS, Santric-Milicevic, MM, Sarrafzadegan, N, Sarveazad, A, Sathish, T, Sawhney, M, Saylan, M, Schmidt, MI, Schutte, AE, Senthilkumaran, S, Sepanlou, SG, Sha, F, Shahabi, S, Shahid, I, Shaikh, MA, Shamali, M, Shamsizadeh, M, Shawon, MSR, Sheikh, A, Shigematsu, M, Shin, M-J, Shin, JI, Shiri, R, Shiue, I, Shuval, K, Siabani, S, Siddiqi, TJ, Silva, DAS, Singh, JA, Mtech, AS, Skryabin, VY, Skryabina, AA, Soheili, A, Spurlock, EE, Stockfelt, L, Stortecky, S, Stranges, S, Suliankatchi Abdulkader, R, Tadbiri, H, Tadesse, EG, Tadesse, DB, Tajdini, M, Tariqujjaman, M, Teklehaimanot, BF, Temsah, M-H, Tesema, AK, Thakur, B, Thankappan, KR, Thapar, R, Thrift, AG, Timalsina, B, Tonelli, M, Touvier, M, Tovani-Palone, MR, Tripathi, A, Tripathy, JP, Truelsen, TC, Tsegay, GM, Tsegaye, GW, Tsilimparis, N, Tusa, BS, Tyrovolas, S, Umapathi, KK, Unim, B, Unnikrishnan, B, Usman, MS, Vaduganathan, M, Valdez, PR, Vasankari, TJ, Velazquez, DZ, Venketasubramanian, N, Vu, GT, Vujcic, IS, Waheed, Y, Wang, Y, Wang, F, Wei, J, Weintraub, RG, Weldemariam, AH, Westerman, R, Winkler, AS, Wiysonge, CS, Wolfe, CDA, Wubishet, BL, Xu, G, Yadollahpour, A, Yamagishi, K, Yan, LL, Yandrapalli, S, Yano, Y, Yatsuya, H, Yeheyis, TY, Yeshaw, Y, Yilgwan, CS, Yonemoto, N, Yu, C, Yusefzadeh, H, Zachariah, G, Zaman, SB, Zaman, MS, Zamanian, M, Zand, R, Zandifar, A, Zarghi, A, Zastrozhin, MS, Zastrozhina, A, Zhang, Z-J, Zhang, Y, Zhang, W, Zhong, C, Zou, Z, Zuniga, YMH, and Murray, CJL

Abstract

Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019.Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019.Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside hi

Published
2020

60. Survival and Left Ventricular Function Changes in Fulminant Versus Nonfulminant Acute Myocarditis

Author

Ammirati, E, Cipriani, M, Lilliu, M, Sormani, P, Varrenti, M, Raineri, C, Petrella, D, Garascia, A, Pedrotti, P, Roghi, A, Bonacina, E, Moreo, A, Bottiroli, M, Gagliardone, M, Mondino, M, Ghio, S, Totaro, R, Turazza, F, Russo, C, Oliva, F, Camici, P, Frigerio, M, Ammirati E., Cipriani M., Lilliu M., Sormani P., Varrenti M., Raineri C., Petrella D., Garascia A., Pedrotti P., Roghi A., Bonacina E., Moreo A., Bottiroli M., Gagliardone M. P., Mondino M., Ghio S., Totaro R., Turazza F. M., Russo C. F., Oliva F., Camici P. G., Frigerio M., Ammirati, E, Cipriani, M, Lilliu, M, Sormani, P, Varrenti, M, Raineri, C, Petrella, D, Garascia, A, Pedrotti, P, Roghi, A, Bonacina, E, Moreo, A, Bottiroli, M, Gagliardone, M, Mondino, M, Ghio, S, Totaro, R, Turazza, F, Russo, C, Oliva, F, Camici, P, Frigerio, M, Ammirati E., Cipriani M., Lilliu M., Sormani P., Varrenti M., Raineri C., Petrella D., Garascia A., Pedrotti P., Roghi A., Bonacina E., Moreo A., Bottiroli M., Gagliardone M. P., Mondino M., Ghio S., Totaro R., Turazza F. M., Russo C. F., Oliva F., Camici P. G., and Frigerio M.

Abstract

Background: Previous reports have suggested that despite their dramatic presentation, patients with fulminant myocarditis (FM) might have better outcome than those with acute nonfulminant myocarditis (NFM). In this retrospective study, we report outcome and changes in left ventricular ejection fraction (LVEF) in a large cohort of patients with FM compared with patients with NFM. Methods: The study population consists of 187 consecutive patients admitted between May 2001 and November 2016 with a diagnosis of acute myocarditis (onset of symptoms <1 month) of whom 55 required inotropes and/or mechanical circulatory support (FM) and the remaining 132 were hemodynamically stable (NFM). We also performed a subanalysis in 130 adult patients with acute viral myocarditis and viral prodrome within 2 weeks from the onset, which includes 34 with FM and 96 with NFM. Patients with giant-cell myocarditis, eosinophilic myocarditis, or cardiac sarcoidosis and those <15 years of age were excluded from the subanalysis. Results: In the whole population (n=187), the rate of in-hospital death or heart transplantation was 25.5% versus 0% in FM versus NFM, respectively (P<0.0001). Long-term heart transplantation-free survival at 9 years was lower in FM than NFM (64.5% versus 100%, log-rank P<0.0001). Despite greater improvement in LVEF during hospitalization in FM versus NFM forms (median, 32% [interquartile range, 20%-40%] versus 3% [0%-10%], respectively; P<0.0001), the proportion of patients with LVEF <55% at last follow-up was higher in FM versus NFM (29% versus 9%; relative risk, 3.32; 95% confidence interval, 1.45-7.64, P=0.003). Similar results for survival and changes in LVEF in FM versus NFM were observed in the subgroup (n=130) with viral myocarditis. None of the patients with NFM and LVEF ≥55% at discharge had a significant decrease in LVEF at follow-up. Conclusions: Patients with FM have an increased mortality and need for heart transplantation compared with t

Published
2017

61. 2422Outcome of histologically-proven fulminant versus acute non-fulminant myocarditis with left ventricular systolic dysfunction. Evidence from the International Registry on Acute Myocarditis

Author

Ammirati, E, primary, Veronese, G, additional, Brambatti, M, additional, Merlo, M, additional, Potena, L, additional, Okumura, T, additional, Pinney, S, additional, Braun, O, additional, Van De Heyning, C M, additional, Montero, S, additional, Shimokawa, H, additional, Sinagra, G, additional, Adler, E, additional, Frigerio, M, additional, and Camici, P G, additional

Published
2019
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63. P452Prognostic performance of clinical presentation and cardiac magnetic resonance ejection fraction and late enhancement pattern at basal examination in acute myocarditis

Author

Sormani, P, primary, Ammirati, E, additional, Moro, C, additional, Raineri, C, additional, Cipriani, M, additional, Veronese, G, additional, D" Elia, S, additional, Quattrocchi, G, additional, Milazzo, A, additional, Maestroni, A, additional, Giannattasio, C, additional, Frigerio, M, additional, Oliva, F, additional, Camici, P G, additional, and Pedrotti, P, additional

Published
2019
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64. 1-Year Coronary IVUS in Heart Transplant Recipient Fails to Predict 10-Year Cardiovascular Mortality

Author

Verde, A., primary, Bossi, I., additional, Iconelli, A., additional, Masciocco, G., additional, D'Angelo, L., additional, Varrenti, M., additional, Santolamazza, C., additional, Giglio, A., additional, Perna, E., additional, Foti, G., additional, Garascia, A., additional, Cipriani, M., additional, Ammirati, E., additional, and Frigerio, M., additional

Published
2019
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65. Efficacy and safety of artificial urinary sphincter (AUS): Results of a large multi-institutional cohort of patients with mid-term follow-up

Author

Tutolo, M., Cornu, J.N., Bauer, R.M.M.J., Ahyai, S., Bozzini, G., Heesakkers, J.P., Drake, M.J., Tikkinen, K.A., Launonen, E., Larre, S., Thiruchelvam, N., Lee, R. van der, Li, P., Favro, M., Zaffuto, E., Bachmann, A., Martinez-Salamanca, J.I., Pichon, T., Nunzio, C. De, Ammirati, E., Haab, F., Aa, F. Van der, Tutolo, M., Cornu, J.N., Bauer, R.M.M.J., Ahyai, S., Bozzini, G., Heesakkers, J.P., Drake, M.J., Tikkinen, K.A., Launonen, E., Larre, S., Thiruchelvam, N., Lee, R. van der, Li, P., Favro, M., Zaffuto, E., Bachmann, A., Martinez-Salamanca, J.I., Pichon, T., Nunzio, C. De, Ammirati, E., Haab, F., and Aa, F. Van der

Abstract

Item does not contain fulltext, AIMS: To assess efficacy and safety as well as predictive factors of dry rate and freedom from surgical revision in patients underwent AUS placement. The artificial urinary sphincter (AUS) is still considered the standard for the treatment of moderate to severe post-prostatectomy stress urinary incontinence (SUI). However, data reporting efficacy and safety from large series are lacking. METHODS: A multicenter, retrospective study was conducted in 16 centers in Europe and USA. Only primary cases of AUS implantation in non-neurogenic SUI after prostate surgery, with a follow-up of at least 1 year were included. Efficacy data (continence rate, based on pad usage) and safety data (revision rate in case of infection and erosion, as well as atrophy or mechanical failure) were collected. Multivariable analyses were performed in order to investigate possible predictors of the aforementioned outcomes. RESULTS: Eight hundred ninety-two men had primary AUS implantation. At 32 months mean follow-up overall dry rate and surgical revision were 58% and 30.7%, respectively. Logistic regression analysis showed that patients without previous incontinence surgery had a higher probability to be dry after AUS implantation (OR: 0.51, P = 0.03). Moreover institutional case-load was positively associated with dry rate (OR: 1.18; P = 0.005) and freedom from revision (OR: 1.51; P = 0.00). CONCLUSIONS: The results of this study showed that AUS is an effective option for the treatment of SUI after prostate surgery. Moreover previous incontinence surgery and low institutional case-load are negatively associated to efficacy and safety outcomes.

Published
2019

66. A prospective comparison of mid-term outcomes in patients treated with heart transplantation with advanced age donors versus left ventricular assist device implantation

Author

Ammirati, E, Cipriani, M, Varrenti, M, Colombo, T, Garascia, A, Cannata, A, Pedrazzini, G, Benazzi, E, Milazzo, F, Oliva, F, Gagliardone, M, Russo, C, Frigerio, M, Ammirati E., Cipriani M. G., Varrenti M., Colombo T., Garascia A., Cannata A., Pedrazzini G., Benazzi E., Milazzo F., Oliva F., Gagliardone M. P., Russo C. F., Frigerio M., Ammirati, E, Cipriani, M, Varrenti, M, Colombo, T, Garascia, A, Cannata, A, Pedrazzini, G, Benazzi, E, Milazzo, F, Oliva, F, Gagliardone, M, Russo, C, Frigerio, M, Ammirati E., Cipriani M. G., Varrenti M., Colombo T., Garascia A., Cannata A., Pedrazzini G., Benazzi E., Milazzo F., Oliva F., Gagliardone M. P., Russo C. F., and Frigerio M.

Abstract

OBJECTIVES In Europe, the age of heart donors is constantly increasing. Ageing of heart donors limits the probability of success of heart transplantation (HTx). The aim of this study is to compare the outcome of patients with advanced heart failure (HF) treated with a continuous-flow left ventricular assist device (CF-LVAD) with indication as bridge to transplantation (BTT) or bridge to candidacy (BTC) versus recipients of HTx with the donor's age above 55 years (HTx with donors >55 years). METHODS we prospectively evaluated 301 consecutive patients with advanced HF treated with a CF-LVAD (n = 83) or HTx without prior bridging (n = 218) in our hospital from January 2006 to January 2015. We compared the outcome of CF-LVAD-BTT (n = 37) versus HTx with donors >55 years (n = 45) and the outcome of CF-LVAD-BTT plus BTC (n = 62) versus HTx with donors >55 years at the 1- and 2-year follow-up. Survival was evaluated according to the first operation. RESULTS The perioperative (30-day) mortality rate was 0% in the LVAD-BTT group vs 20% (n = 9) in the HTx group with donors >55 years (P = 0.003). Perioperative mortality occurred in 5% of the LVAD-BTT/BTC patients (n = 3) and in 20% of the HTx with donors >55 year group (P = 0.026). Kaplan-Meier curves estimated a 2-year survival rate of 94.6% in CF-LVAD-BTT vs 68.9% in HTx with donors >55 years [age- and sex-adjusted hazard ratio (HR) 0.25; 95% confidence interval (CI) 0.08-0.81; P = 0.02 in favour of CF-LVAD]. Considering the post-HTx outcome, a trend in favour of CF-LVAD-BTT was also observed (age- and sex-adjusted HR 0.45; 95% CI 0.17-1.16; P = 0.09 in favour of CF-LVAD), whereas CF-LVAD-BTT/BTC showed a similar survival at 2 years compared with HTx with donors >55 years, both censoring the follow-up at the time of HTx and considering the post-HTx outcome. CONCLUSIONS Early and mid-term outcomes of patients treated with a CF-LVAD with BTT indication seem better than HTx with old donors. It must be emphasized that up to 19%

Published
2016

67. Heart rate and outcome in patients with acute and chronic heart failure [La frequenza cardiaca e la prognosi nello scompenso cardiaco acuto e cronico]

Author

Oliva, F, Ammirati, E, Campana, C, Carubelli, V, Cirò, A, Di Tano, G, Mortara, A, Senni, M, Morandi, F, Metra, M, Oliva F, Ammirati E, Campana C, Carubelli V, Cirò A, Di Tano G, Mortara A, Senni M, Morandi F, Metra M, Oliva, F, Ammirati, E, Campana, C, Carubelli, V, Cirò, A, Di Tano, G, Mortara, A, Senni, M, Morandi, F, Metra, M, Oliva F, Ammirati E, Campana C, Carubelli V, Cirò A, Di Tano G, Mortara A, Senni M, Morandi F, and Metra M

Abstract

Heart rate (HR) is not only a physical sign but also a biomarker. High HR in several cardiac disorders is associated with increased mortality. In heart failure (HF), HR represents an important therapeutic target, both in the acute and chronic phase. Beta-blockers are a milestone of recommended treatments in HF patients with reduced ejection fraction. However, hemodynamic profile or intolerance may limit the use or the optimization of beta-blocker treatment, both during hospitalization and outpatient follow-up. More recently, ivabradine has become available, a drug that lowers HR by blocking the I(f) current in the pacemaker cells at the sinoatrial node level. In the SHIFT trial, ivabradine was shown to improve the outcome of patients with chronic HF, in sinus rhythm, with HR >70 b/min while on beta-blockers. Preliminary data have shown that this drug has a good safety profile and lowers effectively HR even during hospitalization due to worsening HF. However, further studies are warranted to understand if an earlier administration of ivabradine can lead to a better prognosis beyond symptom control and improved hemodynamics. In patients with atrial fibrillation and HF, the target is the restoration of sinus rhythm, alternatively rate control should be pursued with beta-blockers, amiodarone or digitalis, even if there is no clear evidence of an association between ventricular rate response in patients with atrial fibrillation at discharge after an HF hospitalization and major cardiovascular events. In this review, the studies that point to a role of HR both as a biomarker and a therapeutic target in patients with acute and chronic HF are described. In addition, the proportions of patients who do not reach target HR values at discharge after an acute decompensated HF episode or in the chronic phase are evaluated based on the Italian registries.

Published
2016

70. Heart rate and outcome in patients with acute and chronic heart failure [La frequenza cardiaca e la prognosi nello scompenso cardiaco acuto e cronico]

Author

Oliva F, Ammirati E, Campana C, Carubelli V, Cirò A, Di Tano G, Mortara A, Senni M, Morandi F, Metra M, Oliva, F, Ammirati, E, Campana, C, Carubelli, V, Cirò, A, Di Tano, G, Mortara, A, Senni, M, Morandi, F, and Metra, M

Subjects
Heart Failure, Treatment Outcome, Heart Rate, Atrial Fibrillation, Chronic Disease, cute Disease, Adrenergic beta-Antagonist, Human
Abstract

Heart rate (HR) is not only a physical sign but also a biomarker. High HR in several cardiac disorders is associated with increased mortality. In heart failure (HF), HR represents an important therapeutic target, both in the acute and chronic phase. Beta-blockers are a milestone of recommended treatments in HF patients with reduced ejection fraction. However, hemodynamic profile or intolerance may limit the use or the optimization of beta-blocker treatment, both during hospitalization and outpatient follow-up. More recently, ivabradine has become available, a drug that lowers HR by blocking the I(f) current in the pacemaker cells at the sinoatrial node level. In the SHIFT trial, ivabradine was shown to improve the outcome of patients with chronic HF, in sinus rhythm, with HR >70 b/min while on beta-blockers. Preliminary data have shown that this drug has a good safety profile and lowers effectively HR even during hospitalization due to worsening HF. However, further studies are warranted to understand if an earlier administration of ivabradine can lead to a better prognosis beyond symptom control and improved hemodynamics. In patients with atrial fibrillation and HF, the target is the restoration of sinus rhythm, alternatively rate control should be pursued with beta-blockers, amiodarone or digitalis, even if there is no clear evidence of an association between ventricular rate response in patients with atrial fibrillation at discharge after an HF hospitalization and major cardiovascular events. In this review, the studies that point to a role of HR both as a biomarker and a therapeutic target in patients with acute and chronic HF are described. In addition, the proportions of patients who do not reach target HR values at discharge after an acute decompensated HF episode or in the chronic phase are evaluated based on the Italian registries.

Published
2016

74. Implantation Strategies and Outcomes of Patients Treated with Left Ventricular Assist Devices Awaiting for Heart Transplant in Europe and United States: Data from the TransAtlantic Registry on VAD and Transplant (TRAVIATA)

Author

Brambatti, M., primary, Braun, O.O., additional, Ammirati, E., additional, Shah, P., additional, Klein, L., additional, Perna, E., additional, Van De Heyning, C., additional, Cikes, M., additional, Gjesdal, G., additional, Gernhofer, Y.K., additional, Minto, J., additional, Jakus, N., additional, Russo, C.F., additional, Kassemos, M., additional, Partida, C., additional, Quan, B., additional, Milicic, D., additional, Cipriani, M., additional, Bogar, L.J., additional, De Bock, D., additional, Pretorius, V., additional, Nilsson, J., additional, Frigerio, M., additional, and Adler, E., additional

Published
2018
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77. Safety of Centrifugal Left Ventricular Assist Device Implantation in Patients With Severe Left Ventricular Dysfunction and Secondary Mitral Valve Regurgitation Treated With Mitral Clips

Author

Ammirati, E., primary, Musca, F., additional, Van de Heyning, C.M., additional, Perna, E., additional, Cipriani, M., additional, Cannata, A., additional, D'Angelo, L., additional, Milazzo, F., additional, Moreo, A., additional, De Bock, D., additional, Russo, C.F., additional, and Frigerio, M., additional

Published
2018
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78. Which "Roadmap" in Patients With Advanced or Refractory Heart Failure, Eligible for LVAD and Heart Transplantation?

Author

Bertoldi, L.F., primary, Perna, E., additional, Giglio, A.F., additional, Ammirati, E., additional, Cipriani, M.G., additional, Garascia, A., additional, Macera, F., additional, D'Angelo, L., additional, Varrenti, M., additional, Costetti, A., additional, Nonini, S., additional, Gagliardone, M.P., additional, Russo, C., additional, Camici, P.G., additional, and Frigerio, M., additional

Published
2018
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79. Not every fulminant lymphocytic myocarditis fully recovers

Author

Veronese, G, Cipriani, M, Petrella, D, Pedrotti, P, Giannattasio, C, Garascia, A, Oliva, F, Klingel, K, Frigerio, M, Ammirati, E, VERONESE, GIACOMO, Cipriani, Manlio, Petrella, Duccio, PEDROTTI, PATRIZIA, Giannattasio, Cristina, Garascia, Andrea, Oliva, Fabrizio, Klingel, Karin, Frigerio, Maria, Ammirati, Enrico, Veronese, G, Cipriani, M, Petrella, D, Pedrotti, P, Giannattasio, C, Garascia, A, Oliva, F, Klingel, K, Frigerio, M, Ammirati, E, VERONESE, GIACOMO, Cipriani, Manlio, Petrella, Duccio, PEDROTTI, PATRIZIA, Giannattasio, Cristina, Garascia, Andrea, Oliva, Fabrizio, Klingel, Karin, Frigerio, Maria, and Ammirati, Enrico

Abstract

Fulminant myocarditis is a distinct entity within the acute forms of myocarditis characterized by a rapidly progressive clinical course. Lymphocytic forms have been historically reported to generally resolve spontaneously with early appropriate aggressive supportive care alone. We describe the case of a 28-year-old man with lymphocytic fulminant myocarditis presenting with out-of-hospital cardiac arrest, treated with veno-arterial extracorporeal membrane oxygenation, progressed to end stage cardiac failure requiring heart transplantation. In line with recent evidence, we highlight the need for prolonged supportive treatment and the eventual persistent long-term ventricular dysfunction in patients with fulminant myocarditis

Published
2018

86. Disease trends over time and CD4 + CCR5 + T-cells expansion predict carotid atherosclerosis development in patients with systemic lupus erythematosus

Author

Baragetti, A., primary, Ramirez, G.A., additional, Magnoni, M., additional, Garlaschelli, K., additional, Grigore, L., additional, Berteotti, M., additional, Scotti, I., additional, Bozzolo, E., additional, Berti, A., additional, Camici, P.G., additional, Catapano, A.L., additional, Manfredi, A.A., additional, Ammirati, E., additional, and Norata, G.D., additional

Published
2018
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88. Cardiac surgery for patients with heart failure due to structural heart disease in Uganda: access to surgery and outcomes

Author

Grimaldi A, Ammirati E, Karam N, Vermi AC, De Concilio A, Trucco G, Aloi F, Arioli F, Figini F, Ferrarello S, Sacco FM, Grottola R, D'Arbela PG, Marijon E, Freers J, Mirabel M., ALFIERI , OTTAVIO, Grimaldi, A, Ammirati, E, Karam, N, Vermi, Ac, De Concilio, A, Trucco, G, Aloi, F, Arioli, F, Figini, F, Ferrarello, S, Sacco, Fm, Grottola, R, D'Arbela, Pg, Alfieri, Ottavio, Marijon, E, Freers, J, and Mirabel, M.

Abstract

Objective: Few data are available on heart failure (HF) in sub-Saharan Africa. We aimed to provide a current picture of HF aetiologies in urban Uganda, access to heart surgery, and outcomes. Methods: We prospectively collected clinical and echocardiographic data from 272 consecutive patients referred for suspected heart disease to a tertiary hospital in Kampala during seven non-governmental organisation (NGO) missions from 2009 to 2013. We focused the analysis on 140 patients who fulfilled standardised criteria of HF by echocardiography. Results: Rheumatic heart disease (RHD) was the leading cause of HF in 44 (31%) patients. Among the 50 children included (age

Published
2014

89. Noninvasive imaging of vascular inflammation

Author

Ammirati E, Moroni F, Pedrotti P, Scotti I, Magnoni M, Bozzolo EP, Rimoldi OE, CAMICI , PAOLO, Ammirati, E, Moroni, F, Pedrotti, P, Scotti, I, Magnoni, M, Bozzolo, Ep, Rimoldi, Oe, and Camici, Paolo

Published
2014

90. Pharmacological treatment of hypertrophic cardiomyopathy: current practice and novel perspectives

Author

Ammirati, E., Contri, R., Coppini, R., Cecchi, F., Frigerio, M., and Olivotto, I.

Subjects
Amiodarone, Beta-blockers, Hypertrophic cardiomyopathy, Left ventricular outflow tract obstruction, Pharmacological treatment, Ranolazine, Sudden cardiac death, Adrenergic beta-Antagonists, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Anti-Arrhythmia Agents, Anticoagulants, Calcium Channel Blockers, Cardiomyopathy, Hypertrophic, Diuretics, Humans, Mineralocorticoid Receptor Antagonists, Ventricular Outflow Obstruction, cardiovascular system, macromolecular substances, cardiovascular diseases
Published
2016

91. P5196Extent and characteristics of atherosclerotic plaques and their relation to brain white matter hyperintensities in asymptomatic patients with non-obstructive carotid lesions

Author

Moroni, F., primary, Ammirati, E., additional, Magnoni, M., additional, Rocca, M.A., additional, Messina, R., additional, Anzalone, N., additional, De Filippis, C., additional, Scotti, I., additional, Besana, F., additional, Spagnolo, P., additional, Rimoldi, O.E., additional, Chiesa, R., additional, Falini, A., additional, Filippi, M., additional, and Camici, P.G., additional

Published
2017
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92. P5142Survival and left ventricular function changes in fulminant versus non-fulminant acute myocarditis

Author

Ammirati, E., primary, Cipriani, M., additional, Sormani, P., additional, Varrenti, M., additional, Petrella, D., additional, Raineri, C., additional, Bonacina, E., additional, Garascia, A., additional, Gagliardone, M.P., additional, Pedrotti, P., additional, Moreo, A., additional, Russo, C.F., additional, Oliva, F., additional, Camici, P.G., additional, and Frigerio, M., additional

Published
2017
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94. First Outbreak of Pneumocystis jirovecii Pneumonia in Heart Transplantation Recipients

Author

Ammirati, E., primary, Veronese, G., additional, Moioli, M.C., additional, Baldan, R., additional, Orcese, C., additional, De Rezende, G., additional, Veronese, S., additional, Perna, E., additional, Masciocco, G., additional, Travi, G., additional, Puoti, M., additional, Mondino, M.G., additional, Cipriani, M., additional, Cirillo, D.M., additional, and Frigerio, M., additional

Published
2017
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95. Comparison Between Italian and Unites States Centers on Outcome and Likelihood of Heart Transplantation in Patients Treated with Left Ventricular Assist Device as Bridge to Transplantation

Author

Ammirati, E., primary, Brambatti, M., additional, Cipriani, M., additional, Perna, E., additional, Mizeracki, A., additional, Silva Enciso, J., additional, Tran, H., additional, Calini, A.R., additional, Pretorius, G.V., additional, Russo, C.F., additional, Frigerio, M., additional, and Adler, E., additional

Published
2017
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96. Predictors of Clinical Outcome and Subsequent Target Lesion Revascularization After Percutaneous Coronary Procedures with Drug Eluting Stents and Everolimus Eluting Bioresorbable Scaffolds for Cardiac Allograft Vasculopathy

Author

Turazza, F.M., primary, Vaccaro, V., additional, Bossi, I.M., additional, D'Anna, M., additional, Piccalò, G., additional, Pedrazzini, G.L., additional, Masciocco, G., additional, Foti, G., additional, Colombo, P., additional, Perna, E., additional, Ammirati, E., additional, and Frigerio, M., additional

Published
2017
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97. Five-Year Outcome in Patients Treated with Heart Transplantation with Advanced Age Donors versus Patients on Waiting List for Heart Transplantation Implanted with Left Ventricular Assist Device

Author

Ammirati, E., primary, Cipriani, M., additional, Perna, E., additional, Varrenti, M., additional, Colombo, T., additional, Garascia, A., additional, Cannata, A., additional, Pedrazzini, G., additional, Milazzo, F., additional, Oliva, F., additional, Gagliardone, M.P., additional, Russo, C.F., additional, and Frigerio, M., additional

Published
2017
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98. Previous incontinence surgery and surgical volume predict social continence and surgical revision: Results of a large multi-institutional study

Author

Tutolo, M., primary, Castagna, G., additional, Ammirati, E., additional, Drake, M., additional, Thiruchelvam, N., additional, Tikkinen, K., additional, Bachmann, A., additional, Martinez-Salamanca, J., additional, Bozzini, G., additional, Bauer, R., additional, Heesakkers, J., additional, Favro, M., additional, Lee, R., additional, Larré, S., additional, De Nunzio, C., additional, Haab, F., additional, Ahyai, S., additional, Pichon, T., additional, Cornu, J.-N., additional, and Van Der Aa, F., additional

Published
2017
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99. Quantitative changes in late gadolinium enhancement at cardiac magnetic resonance in the early phase of acute myocarditis

Author

Ammirati, E, Moroni, F, Sormani, P, Peritore, A, Milazzo, A, Quattrocchi, G, Cipriani, M, Oliva, F, Giannattasio, C, Frigerio, M, Roghi, A, Camici, P, Pedrotti, P, SORMANI, PAOLA, PERITORE, ANGELICA, GIANNATTASIO, CRISTINA, PEDROTTI, PATRIZIA, Ammirati, E, Moroni, F, Sormani, P, Peritore, A, Milazzo, A, Quattrocchi, G, Cipriani, M, Oliva, F, Giannattasio, C, Frigerio, M, Roghi, A, Camici, P, Pedrotti, P, SORMANI, PAOLA, PERITORE, ANGELICA, GIANNATTASIO, CRISTINA, and PEDROTTI, PATRIZIA

Abstract

Background The presence of late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) has diagnostic and prognostic value in patients with acute myocarditis (AM). Aim of our study was to quantify the changes in LGE extension (LGE%) early after AM and evaluate its relations with biventricular function and morphology. Methods We investigated 76 consecutive patients with AM (acute onset of chest pain/heart failure/ventricular arrhythmias not explained by other causes, and raised troponin) that met CMR criteria based on myocardial oedema at T2-weighted images and LGE on post-contrast images at median time of 6 days from onset of symptoms. We quantified LGE% at baseline and after 148 days in 49 patients. Results Median left ventricular (LV)-ejection fraction (EF) was 64% (interquartile range [Q1–Q3]: 56–67%), and LGE% 9.4% (Q1–Q3: 7.5–13.2%). LGE% was correlated with LV end-systolic volume index (LV-ESVi; r = + 0.34; p = 0.003). LGE% was inversely correlated with LV-EF (r = − 0.31; p = 0.009) and time to CMR scan (r = − 0.25; p = 0.028). In the 49 patients with a second CMR scan, despite no significant variations in LV-EF, a significant decrease of LGE% was observed (p < 0.0001) with a relative reduction of 42% compared with baseline. Patients showing increased LV-ESVi at follow up had a lower decrease of LGE% (p = 0.038). Conclusions In the acute phase of AM the LGE extension is a dynamic process that reflects impairment of LV function and is time dependent. LGE% appears one of the CMR parameters with the largest relative variations in the first months after AM

Published
2017

100. Disease trends over time and CD4+CCR5+ T-cells expansion predict carotid atherosclerosis development in patients with systemic lupus erythematosus

Author

Baragetti, A., Ramirez, G., Magnoni, M., Garlaschelli, K., Grigore, L., Berteotti, M., Scotti, I., Bozzolo, E., Berti, A., Camici, P., Catapano, A., Manfredi, A., Ammirati, E., Norata, Giuseppe, Baragetti, A., Ramirez, G., Magnoni, M., Garlaschelli, K., Grigore, L., Berteotti, M., Scotti, I., Bozzolo, E., Berti, A., Camici, P., Catapano, A., Manfredi, A., Ammirati, E., and Norata, Giuseppe

Abstract

Background and Aim: Patients with Systemic Lupus Erythematosus (SLE) present increased cardiovascular mortality compared to the general population. Few studies have assessed the long-term development and progression of carotid atherosclerotic plaque in SLE patients. Our aim was to investigate the association of clinical and laboratory markers of disease activity and classical cardiovascular risk factors (CVRF) with carotid atherosclerosis development in SLE patients in a prospective 5-year study. Methods and results: Clinical history and information on principal CVRFs were collected at baseline and after 5 years in 40 SLE patients (36 women, mean age 42 ± 9 years; 14.4 ± 7 years of mean disease duration) and 50 age-matched controls. Carotid Doppler ultrasonography was employed to quantify the atherosclerotic burden at baseline and at follow up. Clinimetrics were applied to assess SLE activity over time (SLEDAI). The association between basal circulating T cell subsets (including CD4 + CCR5 + ; CD4 + CXCR3 + ; CD4 + HLADR + ; CD4 + CD45RA + RO - , CD4 + CD45RO + RA - and their subsets) and atherosclerosis development was evaluated. During the 5-year follow up, 32% of SLE patients, developed carotid atherosclerosis compared to 4% of controls. Furthermore, considering SLEDAI changes over time, patients within the highest tertile were those with increased incidence of carotid atherosclerosis independently of CVRF. In addition, increased levels of CD4 + CCR5 + T cells were independently associated with the development of carotid atherosclerosis in SLE patients. Conclusion: Serial clinical evaluations over time, rather than a single point estimation of disease activity or CVRF burden, are required to define the risk of carotid atherosclerosis development in SLE patients. Specific T cell subsets are associated with long-term atherosclerotic progression and may further be of help in predicting vascular disease progression.

Published
2017

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