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1,288 results on '"Camici, Paolo G."'

102. Role of risk stratification by SPECT, PET, and hybrid imaging in guiding management of stable patients with ischaemic heart disease: expert panel of the EANM cardiovascular committee and EACVI

Author

Acampa, Wanda, Gaemperli, Oliver, Gimelli, Alessia, Knaapen, Paul, Schindler, Thomas H., Verberne, Hein J., Zellweger, Michael J., Kaufmann, Philipp A., Rosenhek, Raphael, Haugaa, Kristina H., Cardim, Nuno, Delgado, Victoria, Camici, Paolo G., Donal, Erwan, Galderisi, Maurizio, Edvardsen, Thor, and Hacker, Markus

Published
2015
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107. Insights to advance our management of myocardial ischemia: From obstructive epicardial disease to functional coronary alterations

Author

Merz, C. Noel Bairey, primary, Beltrame, John F., additional, Berry, Colin, additional, Boden, William E., additional, Camici, Paolo G., additional, Crea, Filippo, additional, Hochman, Judith S., additional, Kaski, Juan Carlos, additional, O'Gara, Patrick T., additional, Ong, Peter, additional, Pepine, Carl J., additional, Shimokawa, Hiroaki, additional, Sechtem, Udo, additional, and Stone, Gregg W., additional

Published
2021
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117. Prevalence and outcome of patients with acute myocarditis and positive viral search on nasopharyngeal swab

Author

Ammirati, Enrico, primary, Varrenti, Marisa, additional, Veronese, Giacomo, additional, Fanti, Diana, additional, Nava, Alice, additional, Cipriani, Manlio, additional, Pedrotti, Patrizia, additional, Garascia, Andrea, additional, Bottiroli, Maurizio, additional, Oliva, Fabrizio, additional, Bramerio, Manuela, additional, Veronese, Silvio, additional, Giannattasio, Cristina, additional, Bonoldi, Emanuela, additional, Perno, Carlo F., additional, Camici, Paolo G., additional, and Frigerio, Maria, additional

Published
2021
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118. Temporal relation between second dose BNT162b2 mRNA Covid-19 vaccine and cardiac involvement in a patient with previous SARS-COV-2 infection

Author

Ammirati, Enrico, primary, Cavalotti, Cristina, additional, Milazzo, Angela, additional, Pedrotti, Patrizia, additional, Soriano, Francesco, additional, Schroeder, Jan W., additional, Morici, Nuccia, additional, Giannattasio, Cristina, additional, Frigerio, Maria, additional, Metra, Marco, additional, Camici, Paolo G., additional, and Oliva, Fabrizio, additional

Published
2021
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120. An EAPCI expert consensus document on ischaemia with non-obstructive coronary arteries in collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation endorsed by Coronary Vasomotor Disorders International Study Group

Author

Kunadian, Vijay, Chieffo, Alaide, Camici, Paolo G., Berry, Colin, Escaned, Javier, Maas, Angela H E M, Prescott, Eva, Karam, Nicole, Appelman, Yolande, Fraccaro, Chiara, Buchanan, Gill Louise, Manzo-Silberman, Stephane, Al-Lamee, Rasha, Regar, Evelyn, Lansky, Alexandra, Abbott, J. Dawn, Badimon, Lina, Duncker, Dirk J., Mehran, Roxana, Capodanno, Davide, Baumbach, Andreas, Kunadian, Vijay, Chieffo, Alaide, Camici, Paolo G., Berry, Colin, Escaned, Javier, Maas, Angela H E M, Prescott, Eva, Karam, Nicole, Appelman, Yolande, Fraccaro, Chiara, Buchanan, Gill Louise, Manzo-Silberman, Stephane, Al-Lamee, Rasha, Regar, Evelyn, Lansky, Alexandra, Abbott, J. Dawn, Badimon, Lina, Duncker, Dirk J., Mehran, Roxana, Capodanno, Davide, and Baumbach, Andreas

Abstract

This consensus document, a summary of the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI), appraises the importance of ischaemia with non-obstructive coronary arteries (INOCA). Angina pectoris affects approximately 112 million people globally. Up to 70% of patients undergoing invasive angiography do not have obstructive coronary artery disease, more common in women than in men, and a large proportion have INOCA as a cause of their symptoms. INOCA patients present with a wide spectrum of symptoms and signs that are often misdiagnosed as non-cardiac leading to under-diagnosis/investigation and under-treatment. INOCA can result from heterogeneous mechanism including coronary vasospasm and microvascular dysfunction and is not a benign condition. Compared to asymptomatic individuals, INOCA is associated with increased incidence of cardiovascular events, repeated hospital admissions, as well as impaired quality of life and associated increased health care costs. This consensus document provides a definition of INOCA and guidance to the community on the diagnostic approach and management of INOCA based on existing evidence from research and best available clinical practice; noting gaps in knowledge and potential areas for further investigation.

Published
2021

121. Prevalence and Outcome of Patients with Acute Myocarditis and Positive Viral Search on Nasopharyngeal Swab

Author

Ammirati, E, Varrenti, M, Veronese, G, Fanti, D, Nava, A, Cipriani, M, Pedrotti, P, Garascia, A, Bottiroli, M, Oliva, F, Bramerio, M, Veronese, S, Giannattasio, C, Bonoldi, E, Perno, C, Camici, P, Frigerio, M, Ammirati, Enrico, Varrenti, Marisa, Veronese, Giacomo, Fanti, Diana, Nava, Alice, Cipriani, Manlio, Pedrotti, Patrizia, Garascia, Andrea, Bottiroli, Maurizio, Oliva, Fabrizio, Bramerio, Manuela, Veronese, Silvio, Giannattasio, Cristina, Bonoldi, Emanuela, Perno, Carlo F, Camici, Paolo G, Frigerio, Maria, Ammirati, E, Varrenti, M, Veronese, G, Fanti, D, Nava, A, Cipriani, M, Pedrotti, P, Garascia, A, Bottiroli, M, Oliva, F, Bramerio, M, Veronese, S, Giannattasio, C, Bonoldi, E, Perno, C, Camici, P, Frigerio, M, Ammirati, Enrico, Varrenti, Marisa, Veronese, Giacomo, Fanti, Diana, Nava, Alice, Cipriani, Manlio, Pedrotti, Patrizia, Garascia, Andrea, Bottiroli, Maurizio, Oliva, Fabrizio, Bramerio, Manuela, Veronese, Silvio, Giannattasio, Cristina, Bonoldi, Emanuela, Perno, Carlo F, Camici, Paolo G, and Frigerio, Maria

Published
2021

122. Temporal Relation Between Second Dose BNT162b2 mRNA Covid-19 Vaccine and Cardiac involvement in a Patient with Previous SARS-COV-2 Infection

Author

Ammirati, E, Cavalotti, C, Milazzo, A, Pedrotti, P, Soriano, F, Schroeder, J, Morici, N, Giannattasio, C, Frigerio, M, Metra, M, Camici, P, Oliva, F, Ammirati, Enrico, Cavalotti, Cristina, Milazzo, Angela, Pedrotti, Patrizia, Soriano, Francesco, Schroeder, Jan W, Morici, Nuccia, Giannattasio, Cristina, Frigerio, Maria, Metra, Marco, Camici, Paolo G, Oliva, Fabrizio, Ammirati, E, Cavalotti, C, Milazzo, A, Pedrotti, P, Soriano, F, Schroeder, J, Morici, N, Giannattasio, C, Frigerio, M, Metra, M, Camici, P, Oliva, F, Ammirati, Enrico, Cavalotti, Cristina, Milazzo, Angela, Pedrotti, Patrizia, Soriano, Francesco, Schroeder, Jan W, Morici, Nuccia, Giannattasio, Cristina, Frigerio, Maria, Metra, Marco, Camici, Paolo G, and Oliva, Fabrizio

Published
2021

123. WITHDRAWN: Temporal relation between second dose BNT162b2 mRNA Covid-19 vaccine and cardiac involvement in a patient with previous SARS-COV-2 infection

Author

Ammirati, E, Cavalotti, C, Milazzo, A, Pedrotti, P, Soriano, F, Schroeder, J, Morici, N, Giannattasio, C, Frigerio, M, Metra, M, Camici, P, Oliva, F, Ammirati, Enrico, Cavalotti, Cristina, Milazzo, Angela, Pedrotti, Patrizia, Soriano, Francesco, Schroeder, Jan W, Morici, Nuccia, Giannattasio, Cristina, Frigerio, Maria, Metra, Marco, Camici, Paolo G, Oliva, Fabrizio, Ammirati, E, Cavalotti, C, Milazzo, A, Pedrotti, P, Soriano, F, Schroeder, J, Morici, N, Giannattasio, C, Frigerio, M, Metra, M, Camici, P, Oliva, F, Ammirati, Enrico, Cavalotti, Cristina, Milazzo, Angela, Pedrotti, Patrizia, Soriano, Francesco, Schroeder, Jan W, Morici, Nuccia, Giannattasio, Cristina, Frigerio, Maria, Metra, Marco, Camici, Paolo G, and Oliva, Fabrizio

Abstract

The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.ijcha.2021.100774. The duplicate article has therefore been withdrawn.

Published
2021

131. Optimized Treatment of ST-Elevation Myocardial Infarction

Author

Niccoli, Giampaolo, Montone, Rocco A., Ibanez, Borja, Thiele, Holger, Crea, Filippo, Heusch, Gerd, Bulluck, Heerajnarain, Hausenloy, Derek J., Berry, Colin, Stiermaier, Thomas, Camici, Paolo G., Eitel, Ingo, Niccoli, Giampaolo, Montone, Rocco A, Ibanez, Borja, Thiele, Holger, Crea, Filippo, Heusch, Gerd, Bulluck, Heerajnarain, Hausenloy, Derek J, Berry, Colin, Stiermaier, Thoma, Camici, Paolo G, and Eitel, Ingo

Subjects
Myocardial reperfusion, Myocardial infarction, Myocardium, Ventricular remodeling, Medizin, cardiovascular system, cardiovascular diseases, Percutaneous coronary intervention
Abstract

Primary percutaneous coronary intervention is nowadays the preferred reperfusion strategy for patients with acute ST-segment-elevation myocardial infarction, aiming at restoring epicardial infarct-related artery patency and achieving microvascular reperfusion as early as possible, thus limiting the extent of irreversibly injured myocardium. Yet, in a sizeable proportion of patients, primary percutaneous coronary intervention does not achieve effective myocardial reperfusion due to the occurrence of coronary microvascular obstruction (MVO). The amount of infarcted myocardium, the so-called infarct size, has long been known to be an independent predictor for major adverse cardiovascular events and adverse left ventricular remodeling after myocardial infarction. Previous cardioprotection studies were mainly aimed at protecting cardiomyocytes and reducing infarct size. However, several clinical and preclinical studies have reported that the presence and extent of MVO represent another important independent predictor of adverse left ventricular remodeling, and recent evidences support the notion that MVO may be more predictive of major adverse cardiovascular events than infarct size itself. Although timely and complete reperfusion is the most effective way of limiting myocardial injury and subsequent ventricular remodeling, the translation of effective therapeutic strategies into improved clinical outcomes has been largely disappointing. Of importance, despite the presence of a large number of studies focused on infarct size, only few cardioprotection studies addressed MVO as a therapeutic target. In this review, we provide a detailed summary of MVO including underlying causes, diagnostic techniques, and current therapeutic approaches. Furthermore, we discuss the hypothesis that simultaneously addressing infarct size and MVO may help to translate cardioprotective strategies into improved clinical outcome following ST-segment-elevation myocardial infarction. Sí

Published
2019

132. Clinical Presentation and Outcome in a Contemporary Cohort of Patients With Acute Myocarditis

Author

Ammirati, Enrico, Cipriani, Manlio, Moro, Claudio, Raineri, Claudia, Pini, Daniela, Sormani, Paola, Mantovani, Riccardo, Varrenti, Marisa, Pedrotti, Patrizia, Conca, Cristina, Mafrici, Antonio, Grosu, Aurelia, Briguglia, Daniele, Guglielmetto, Silvia, Perego, Giovanni B, Colombo, Stefania, Caico, Salvatore I, Giannattasio, Cristina, Maestroni, Alberto, Carubelli, Valentina, Metra, Marco, Lombardi, Carlo, Campodonico, Jeness, Agostoni, Piergiuseppe, Peretto, Giovanni, Scelsi, Laura, Turco, Annalisa, Di Tano, Giuseppe, Campana, Carlo, Belloni, Armando, Morandi, Fabrizio, Mortara, Andrea, Cirò, Antonio, Senni, Michele, Gavazzi, Antonello, Frigerio, Maria, Oliva, Fabrizio, Camici, Paolo G, Ammirati, Enrico, Cipriani, Manlio, Moro, Claudio, Raineri, Claudia, Pini, Daniela, Sormani, Paola, Mantovani, Riccardo, Varrenti, Marisa, Pedrotti, Patrizia, Conca, Cristina, Mafrici, Antonio, Grosu, Aurelia, Briguglia, Daniele, Guglielmetto, Silvia, Perego, Giovanni B, Colombo, Stefania, Caico, Salvatore I, Giannattasio, Cristina, Maestroni, Alberto, Carubelli, Valentina, Metra, Marco, Lombardi, Carlo, Campodonico, Jene, Agostoni, Piergiuseppe, Peretto, Giovanni, Scelsi, Laura, Turco, Annalisa, Di Tano, Giuseppe, Campana, Carlo, Belloni, Armando, Morandi, Fabrizio, Mortara, Andrea, Cirò, Antonio, Senni, Michele, Gavazzi, Antonello, Frigerio, Maria, Oliva, Fabrizio, and Camici, Paolo G

Subjects
myocarditi, treatment outcome, magnetic resonance imaging, biopsy, heart transplantation
Abstract

There is controversy about the outcome of patients with acute myocarditis (AM), and data are lacking on how patients admitted with suspected AM are managed. We report characteristics, in-hospital management, and long-term outcome of patients with AM based on a retrospective multicenter registry from 19 Italian hospitals.

Published
2019

133. Predictors of Long-Term Mortality in Patients with Myocardial Infarction and Nonobstructed Coronary Arteries: A Systematic Review and Meta-Regression Study

Author

Pelliccia, Francesco, Pasceri, Vincenzo, Niccoli, Giampaolo, Tanzilli, Gaetano, Speciale, Giulio, Gaudio, Carlo, Crea, Filippo, Camici, Paolo G, Pelliccia, Francesco, Pasceri, Vincenzo, Niccoli, Giampaolo, Tanzilli, Gaetano, Speciale, Giulio, Gaudio, Carlo, Crea, Filippo, and Camici, Paolo G

Subjects
MINOCA, myocardial infarction, prognosis, Coronary artery disease
Abstract

The long-term mortality of patients with myocardial infarction and non-obstructed coronary arteries (MINOCA) remains poorly defined. This study aimed to determine long-term mortality of patients with MINOCA and identify potential prognostic determinants of long-term outcome.

Published
2019

134. Clinical characteristics and long-term prognosis of contemporary patients with vasospastic angina: Ethnic differences detected in an international comparative study

Author

Sato, Koichi, Takahashi, Jun, Odaka, Yuji, Suda, Akira, Sueda, Shozo, Teragawa, Hiroki, Ishii, Katsuhisa, Kiyooka, Takahiko, Hirayama, Atsushi, Sumiyoshi, Tetsuya, Tanabe, Yasuhiko, Kimura, Kazuo, Kaikita, Koichi, Ong, Peter, Sechtem, Udo, Camici, Paolo G., Kaski, Juan Carlos, Crea, Filippo, Beltrame, John F., Shimokawa, Hiroaki, Sato, Koichi, Takahashi, Jun, Odaka, Yuji, Suda, Akira, Sueda, Shozo, Teragawa, Hiroki, Ishii, Katsuhisa, Kiyooka, Takahiko, Hirayama, Atsushi, Sumiyoshi, Tetsuya, Tanabe, Yasuhiko, Kimura, Kazuo, Kaikita, Koichi, Ong, Peter, Sechtem, Udo, Camici, Paolo G., Kaski, Juan Carlo, Crea, Filippo, Beltrame, John F., and Shimokawa, Hiroaki

Subjects
Coronary spasm, International cohort study, Clinical characteristic, Ethnic difference, Cardiology and Cardiovascular Medicine, Vasospastic angina
Abstract

Background: Possible ethnic differences in clinical characteristics and long-term prognosis of contemporary patients with vasospastic angina (VSA) remain to be elucidated. Methods and results: The Japanese Coronary Spasm Association (JCSA) conducted an international, prospective, and multicenter registry study for VSA patients. A total of 1457 VSA patients (Japanese/Caucasians, 1339/118) were enrolled based on the same diagnostic criteria. Compared with Caucasian patients, Japanese patients were characterized by higher proportions of males (68 vs. 51%) and smoking history (60 vs. 49%). Japanese patients more often had angina especially during the night and early morning hours, compared with Caucasians. Ninety-five percent of Japanese and 84% of Caucasian patients underwent pharmacological provocation test. Importantly, no significant differences in the patterns of coronary spasm were apparent, with diffuse spasm most frequently noted in both ethnicities. The prescription rate of calcium-channel blockers was higher in Japanese (96 vs. 86%), whereas the uses of nitrates (46 vs. 59%), statins (43 vs. 65%), renin-angiotensin-system inhibitors (27 vs. 51%), and β-blockers (10 vs. 24%) were more common in Caucasian patients. Survival rate free from major adverse cardiac events (MACE) was slightly but significantly higher in Japanese than in Caucasians (86.7 vs. 76.6% at 5 years, P < 0.001). Notably, multivariable analysis revealed that the JCSA risk score correlated with MACE rates not only in Japanese but also in Caucasian patients. Conclusion: These results indicate that there are ethnic differences in clinical profiles and long-term prognosis of contemporary VSA patients.

Published
2019

136. Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group

Author

Shimokawa, Hiroaki, primary, Suda, Akira, additional, Takahashi, Jun, additional, Berry, Colin, additional, Camici, Paolo G, additional, Crea, Filippo, additional, Escaned, Javier, additional, Ford, Tom, additional, Yii, Eric, additional, Kaski, Juan Carlos, additional, Kiyooka, Takahiko, additional, Mehta, Puja K, additional, Ong, Peter, additional, Ozaki, Yukio, additional, Pepine, Carl, additional, Rimoldi, Ornella, additional, Safdar, Basmah, additional, Sechtem, Udo, additional, Tsujita, Kenichi, additional, Yasuda, Satoshi, additional, Beltrame, John F, additional, and Merz, C Noel Bairey, additional

Published
2021
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137. WITHDRAWN: Temporal relation between second dose BNT162b2 mRNA Covid-19 vaccine and cardiac involvement in a patient with previous SARS-COV-2 infection

Author

Ammirati, Enrico, primary, Cavalotti, Cristina, additional, Milazzo, Angela, additional, Pedrotti, Patrizia, additional, Soriano, Francesco, additional, Schroeder, Jan W., additional, Morici, Nuccia, additional, Giannattasio, Cristina, additional, Frigerio, Maria, additional, Metra, Marco, additional, Camici, Paolo G., additional, and Oliva, Fabrizio, additional

Published
2021
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139. Determinants of coronary microvascular dysfunction in symptomatic hypertrophic cardiomyopathy

Author

Knaapen, Paul, Germans, Tjeerd, Camici, Paolo G., Rimoldi, Ornella E., ten Cate, Folkert J., ten Berg, Jurrien M., Dijkmans, Pieter A., Boellaard, Ronald, van Dockum, Willem G., Gotte, Marco J.W., Twisk, Jos W.R., van Rossum, Albert C., Lammertsma, Adriaan A., and Visser, Frans C.

Subjects
Microcirculation disorders -- Research, Cardiomyopathy, Hypertrophic -- Research, Cardiovascular research, Biological sciences
Abstract

Impaired hyperemic myocardial blood flow (MBF) in hypertrophic cardiomyopathy (HCM), despite normal epicardial coronary arteries, results in microvascular dysfunction. The aim of the present study was to determine the relative contribution of extravascular compressive forces to microvascular dysfunction in HCM. Eighteen patients with symptomatic HCM and normal coronary arteries and 10 age-matched healthy volunteers were studied with PET to quantify resting and hyperemic MBF at a subendocardial and subepicardial level. In HCM patients, MRI was performed to determine left ventricular (LV) mass index (LVMI) and volumes, echocardiography to assess diastolic perfusion time, heart catheterization to measure LV outflow tract gradient (LVOTG) and LV pressures, and serum NH2terminal pro-brain natriuretic peptide (NT-proBNP) as a biochemical marker of LV wall stress. Hyperemic MBF was blunted in HCM vs. controls (2.26 [+ or -] 0.97 vs. 2.93 [+ or -] 0.64 ml*[min.sup.-1]*[g.sup.-1], P < 0.05). In contrast to controls (1.38 [+ or -] 0.15 to 1.25 [+ or -] 0.19, P = not significant), the endocardial-to-epicardial MBF ratio decreased significantly in HCM during hyperemia (1.20 [+ or -] 0.11 to 0.88 [+ or -] 0.18, P < 0.01). This pattern was similar for hypertrophied septum and lateral wall. Hyperemic MBF was inversely correlated with LVOTG, NT-proBNP, left atrial volume index, and LVMI (all P < 0.01). Multivariate regression analysis, however, revealed that only LVMI and NT-proBNP were independently related to hyperemic MBF, with greater impact at the subendocardial myocardial layer. Hyperemic MBF is more severely impaired at the subendocardial level in HCM patients. The level of impairment is related to markers of increased hemodynamic LV loading conditions and LV mass. These observations suggest that, in addition to reduced capillary density caused by hypertrophy, extravascular compressive forces contribute to microvascular dysfunction in HCM patients. hypertrophic cardiomyopathy; outflow tract obstruction; coronary microcirculation; imaging

Published
2008

145. Systemic nitric oxide synthase inhibition improves coronary flow reserve to adenosine in patients with significant stenoses

Author

Kaufmann, Philipp A., Rimoldi, Ornella E., Gnecchi-Ruscone, Tomaso, Luscher, Thomas F., and Camici, Paolo G.

Subjects
Nitric oxide -- Physiological aspects, Blood flow -- Physiological aspects, Blood flow -- Research, Vasopressin -- Physiological aspects, Vasopressin -- Research, PET imaging -- Usage, Coronary heart disease -- Development and progression, Coronary heart disease -- Research, Biological sciences
Abstract

We studied the impact of systemic infusion of the nitric oxide synthase (NOS) inhibitor [N.sup.G]-monomethyl-L-arginine (L-NMMA) on coronary flow reserve (CFR) in patients with coronary artery disease (CAD). We have previously demonstrated that CFR to adenosine was significantly increased after systemic infusion of L-NMMA in normal volunteers but not in recently transplanted denervated hearts. At baseline, myocardial blood flow (MBF; ml x [min.sup-1] x [g.sup.-1]) was measured at rest and during intravenous administration of adenosine (140 [micro]g x [kg.sup.-1] x [min.sup.-1]) in 10 controls (47 [+ or -] 5 yr) and 10 CAD patients (58 [+ or -] 8 yr; P < 0.01 vs. controls) using positron emission tomography and [sup.15]O-labeled water. Both MBF measurements were repeated during intravenous infusion of 10 mg/kg L-NMMA. CFR was calculated as the ratio of MBF during adenosine to MBF at rest. CFR was significantly higher in healthy volunteers than in CAD patients and increased significantly after L-NMMA in controls (4.00 [+ or -] 1.10 to 6.15 [+ or -] 1.35; P < 0.0001) and in patients, both in territories subtended by stenotic coronary arteries (>70% luminal diameter; 2.06 [+ or -] 1.13 to 3.21 [+ or -] 1.07; P < 0.01) and in remote segments (3.20 [+ or -] 1.23 to 3.92 [+ or -] 1.62; P < 0.05). In conclusion, CFR can be significantly increased in CAD by a systemic infusion of L-NMMA. Similarly to our previous findings in normal volunteers, this suggests that adenosine-induced hyperemia in CAD patients is constrained by a mechanism that can be relieved by systemic NOS inhibition with L-NMMA. coronary circulation; autonomic nervous system; ischemic heart disease; cardiac imaging; positron emission tomography

Published
2007

146. Coronary microvascular dysfunction

Author

Camici, Paolo G. and Crea, Filippo

Subjects
Coronary heart disease -- Diagnosis, Coronary heart disease -- Care and treatment, Coronary heart disease -- Prognosis, Coronary heart disease -- Risk factors, Angiography -- Usage
Abstract

Coronary angiography reveals the relationship between the severity and extent of coronary artery disease (CAD) and survival, but some studies suggest that abnormalities in the function and structure of the coronary microcirculation occur in many clinical conditions. These abnormalities represent epiphenomena in some instances, whereas in others they represent important markers of risk or contribute to the pathogenesis of myocardial ischemia, and so become therapeutic targets.

Published
2007

147. An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group

Author

Kunadian, Vijay, Chieffo, Alaide, Camici, Paolo G., Berry, Colin, Escaned, Javier, Maas, Angela H.E.M., Prescott, Eva, Karam, Nicole, Appelman, Yolande, Fraccaro, Chiara, Louise Buchanan, Gill, Manzo-Silberman, Stephane, Al-Lamee, Rasha, Regar, Evelyn, Lansky, Alexandra, Abbott, J. Dawn, Badimon, Lina, Duncker, Dirk J., Mehran, Roxana, Capodanno, Davide, Baumbach, Andreas, Kunadian, Vijay, Chieffo, Alaide, Camici, Paolo G., Berry, Colin, Escaned, Javier, Maas, Angela H.E.M., Prescott, Eva, Karam, Nicole, Appelman, Yolande, Fraccaro, Chiara, Louise Buchanan, Gill, Manzo-Silberman, Stephane, Al-Lamee, Rasha, Regar, Evelyn, Lansky, Alexandra, Abbott, J. Dawn, Badimon, Lina, Duncker, Dirk J., Mehran, Roxana, Capodanno, Davide, and Baumbach, Andreas

Abstract

This consensus document, a summary of the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI), appraises the importance of ischaemia with non-obstructive coronary arteries (INOCA). Angina pectoris affects approximately 112 million people globally. Up to 70% of patients undergoing invasive angiography do not have obstructive coronary artery disease, more common in women than in men, and a large proportion have INOCA as a cause of their symptoms. INOCA patients present with a wide spectrum of symptoms and signs that are often misdiagnosed as non-cardiac leading to under-diagnosis/investigation and under-Treatment. INOCA can result from heterogeneous mechanism including coronary vasospasm and microvascular dysfunction and is not a benign condition. Compared to asymptomatic individuals, INOCA is associated with increased incidence of cardiovascular events, repeated hospital admissions, as well as impaired quality of life and associated increased health care costs. This consensus document provides a definition of INOCA and guidance to the community on the diagnostic approach and management of INOCA based on existing evidence from research and best available clinical practice; noting gaps in knowledge and potential areas for further investigation.

Published
2020

148. Early or deferred cardiovascular magnetic resonance after ST-segment-elevation myocardial infarction for effective risk stratification

Author

Masci, P, Pavon, A, Pontone, G, Symons, R, Lorenzoni, V, Francone, M, Zalewski, J, Barison, A, Guglielmo, M, Aquaro, G, Galea, N, Muscogiuri, G, Muller, O, Carbone, I, Baggiano, A, Iglesias, J, Nessler, J, Andreini, D, Camici, P, Claus, P, Luca, L, Agati, L, Janssens, S, Schwitter, J, Bogaert, J, Masci, Pier Giorgio, Pavon, Anna Giulia, Pontone, Gianluca, Symons, Rolf, Lorenzoni, Valentina, Francone, Marco, Zalewski, Jaroslaw, Barison, Andrea, Guglielmo, Marco, Aquaro, Giovanni Donato, Galea, Nicola, Muscogiuri, Giuseppe, Muller, Olivier, Carbone, Iacopo, Baggiano, Andrea, Iglesias, Juan F, Nessler, Jadwiga, Andreini, Daniele, Camici, Paolo G, Claus, Piet, Luca, Laura de, Agati, Luciano, Janssens, Stefan, Schwitter, Jurg, Bogaert, Jan, Masci, P, Pavon, A, Pontone, G, Symons, R, Lorenzoni, V, Francone, M, Zalewski, J, Barison, A, Guglielmo, M, Aquaro, G, Galea, N, Muscogiuri, G, Muller, O, Carbone, I, Baggiano, A, Iglesias, J, Nessler, J, Andreini, D, Camici, P, Claus, P, Luca, L, Agati, L, Janssens, S, Schwitter, J, Bogaert, J, Masci, Pier Giorgio, Pavon, Anna Giulia, Pontone, Gianluca, Symons, Rolf, Lorenzoni, Valentina, Francone, Marco, Zalewski, Jaroslaw, Barison, Andrea, Guglielmo, Marco, Aquaro, Giovanni Donato, Galea, Nicola, Muscogiuri, Giuseppe, Muller, Olivier, Carbone, Iacopo, Baggiano, Andrea, Iglesias, Juan F, Nessler, Jadwiga, Andreini, Daniele, Camici, Paolo G, Claus, Piet, Luca, Laura de, Agati, Luciano, Janssens, Stefan, Schwitter, Jurg, and Bogaert, Jan

Abstract

Aims: In ST-segment-elevation myocardial infarction (STEMI), cardiovascular magnetic resonance (CMR) holds the potentiality to improve risk stratification in addition to Thrombolysis in Myocardial Infarction (TIMI) risk score. Nevertheless, the optimal timing for CMR after STEMI remains poorly defined. We aim at comparing the prognostic performance of three stratification strategies according to the timing of CMR after STEMI. Methods and results: The population of this prospective registry-based study included 492 reperfused STEMI patients. All patients underwent post-reperfusion (median: 4 days post-STEMI) and follow-up (median: 4.8 months post-STEMI) CMR. Left ventricular (LV) volumes, function, infarct size, and microvascular obstruction extent were quantified. Primary endpoint was a composite of all-death and heart failure (HF) hospitalization. Baseline-to-follow-up percentage increase of LV end-diastolic (EDV; DLV-EDV) =20% or end-systolic volumes (ESV; DLV-ESV) =15% were tested against outcome. Three multivariate models were developed including TIMI risk score plus early post-STEMI (early-CMR) or follow-up CMR (deferred-CMR) or both CMRs parameters along with adverse LV remodelling (paired-CMRs). During a median follow-up of 8.3 years, the primary endpoint occurred in 84 patients (47 deaths; 37 HF hospitalizations). Early-CMR, deferred-CMR, and paired-CMR demonstrated similar predictive value for the primary endpoint (C-statistic: 0.726, 0.728, and 0.738, respectively; P = 0.663). DLV-EDV =20% or DLV-ESV =15% were unadjusted outcome predictors (hazard ratio: 2.020 and 2.032, respectively; P = 0.002 for both) but lost their predictive value when corrected for other covariates in paired-CMR model. Conclusion: In STEMI patients, early-, deferred-, or paired-CMR were equivalent stratification strategies for outcome prediction. Adverse LV remodelling parameters were not independent prognosticators.

Published
2020

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