144 results on '"SCRUTINIO, DOMENICO"'
Search Results
102. Physical activity for coronary heart disease: cardioprotective mechanisms and effects on prognosis
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Scrutinio, Domenico, primary, Bellotto, Fabio, additional, Lagioia, Rocco, additional, and Passantino, Andrea, additional
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- 2005
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103. APO(a) Variants and Lipoprotein(a) in Men with or without Myocardial Infarction
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Chimienti, Guglielmina, primary, Lamanuzzi, Biagia L., additional, Nardulli, Marina, additional, Colacicco, Anna M., additional, Capurso, Antonio, additional, La Gioia, Rocco, additional, Scrutinio, Domenico, additional, and Pepe, Gabriella, additional
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- 2002
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104. Ticlopidine versus aspirin after myocardial infarction (stami) trial
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Scrutinio, Domenico, primary, Cimminiello, Claudio, additional, Marubini, Ettore, additional, Vittoria Pitzalis, Maria, additional, Di Biase, Matteo, additional, and Rizzon, Paolo, additional
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- 2001
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105. Mutational Spectrum of CYP24A1Gene in a Cohort of Italian Patients with Idiopathic Infantile Hypercalcemia
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Gigante, Maddalena, Santangelo, Luisa, Diella, Sterpeta, Caridi, Gianluca, Argentiero, Lucia, D''Alessandro, Maria Michela, Martino, Marida, Stea, Emma Diletta, Ardissino, Gianluigi, Carbone, Vincenza, Pepe, Silvana, Scrutinio, Domenico, Maringhini, Silvio, Ghiggeri, Gian Marco, Grandaliano, Giuseppe, Giordano, Mario, and Gesualdo, Loreto
- Abstract
Background/Aims:Loss-of-function mutations in the CYP24A1gene, which encodes the vitamin D-24 hydroxylase, have been recognized as a cause of elevated 1,25-dihydroxyvitamin D concentrations, hypercalcemia, hypercalciuria, nephrocalcinosis and nephrolithiasis in infants and adults. As only a case report describing 2 adult patients has been reported in Italian population, we report here the mutation analysis of CYP24A1gene in an Italian cohort of 12 pediatric and adult patients with idiopathic infantile hypercalcemia (IIH). Methods:We performed mutational screening of CYP24A1 gene in a cohort of 12 Italian patients: 8 children with nephrocalcinosis, hypercalcemia and PTH levels <10 pg/ml and 4 adult patients with nephrolithiasis, mild hypercalcemia and PTH levels <10 pg/ml from 11 unrelated Italian families. Clinical and biochemical data were collected. Genomic DNA was extracted from peripheral blood leucocytes using standard methods, and whole coding sequence of CYP24A1 gene was analysed in all patients and family members by polymerase chain reaction and direct sequencing. The potential pathogenicity of the newly identified missense mutations was evaluated by 3 different in silico approaches (Sorting Intolerant from Tolerant, Polyphen and Mutation Taster) and by comparative analysis in 14 different species using ClustalW software. Results:CYP24A1 bi-allelic mutations were found in 8 individuals from 7 Italian families (7/11; 64%). Overall, 6 different CYP24A1 mutations, including one small deletion (p.Glu143del), 4 missense mutations (p.Leu148Pro; p.Arg396Trp; p.Pro503Leu; p.Glu383Gln) and one nonsense mutation (p.Tyr220*) were identified. Two out of 6 mutations (p.Tyr220* and p.Pro503Leu) were not previously described. Moreover, a new CYP24A1variant was identified by genetic screening of asymptomatic controls. Conclusion:To the best of our knowledge, this is the first report of a CYP24A1molecular analysis performed in an Italian cohort of adult and pediatric Italian patients. This study (1) confirms that CYP24A1 plays a causal role in some but not all cases of IIH (64%); (2) expands the spectrum of known CYP24A1pathogenic mutations; (3) describes 2 hotspots detected in 50% of all Italian cases; and (4) emphasizes the importance of recognition and genetic diagnosis of CYP24A1defects in infantile as well as adult hypercalcemia.
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- 2016
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106. Ivabradine, coronary artery disease, and heart failure: beyond rhythm control.
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Scicchitano, Pietro, Cortese, Francesca, Ricci, Gabriella, Carbonara, Santa, Moncelli, Michele, Iacoviello, Massimo, Cecere, Annagrazia, Gesualdo, Michele, Zito, Annapaola, Caldarola, Pasquale, Scrutinio, Domenico, Lagioia, Rocco, Riccioni, Graziano, and Ciccone, Marco Matteo
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- 2014
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107. Comparison of a fixed combination of nifedipine slow release and atenolol (Bay-R-1999) and nifedipine slow release alone in patients with stable angina pectoris: A multicenter, randomized, double-blind, parallel-group study
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Lagioia, Rocco, primary, Scrutinio, Domenico, additional, Ricci, Antonio, additional, Ochan, Michael, additional, and Rizzon, Paolo, additional
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- 1995
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108. Effects of l-carnitine administration on left ventricular remodeling after acute anterior myocardial infarction: the l-Carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) trial
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Iliceto, Sabino, primary, Scrutinio, Domenico, additional, Bruzzi, Paolo, additional, D'Ambrosio, Gaetano, additional, Boni, Luca, additional, Di Biase, Matteo, additional, Biasco, Giuseppina, additional, Hugenholtz, Paul G., additional, and Rizzon, Paolo, additional
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- 1995
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109. Transient myocardial ischemia in patients with chronic angina: relation to heart rate changes and variability in exercise threshold
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Scrutinio, Domenico, primary, Lagioia, Rocco, additional, Di Biase, Matteo, additional, and Rizzon, Paolo, additional
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- 1995
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110. 923-2 Effects of L-Carnitine on Left Ventricular Function After Acute Myocardial Infarction. Results of the CEDIM (Carnitina Ecocardiografia Digitale Infarto Miocardico) Trial
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Iliceto, Sabino, primary, Marangelli, Vito, additional, Santoro, Giuseppe, additional, Bani, Luca, additional, D’Ambrosio, Gaetano, additional, Scrutinio, Domenico, additional, Bruzzi, Paolo, additional, Hugenholtz, Paul G., additional, and Rizzon, Paolo, additional
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- 1995
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111. Association Between Conformity With Performance Measures and 1-Year Postdischarge Survival in Patients With Acute Decompensated Heart Failure.
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Scrutinio, Domenico, Passantino, Andrea, Ricci, Vito Antonio, and Catanzaro, Raffaella
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Recognition of the treatment gap in patients with heart failure (HF) led to the development of a set of process-of-care measures to improve the quality of care. To assess the association of established and emerging process-of-care measures with 1-year postdischarge survival, 496 patients with acute decompensated HF were studied. After adjustment for established prognostic factors, the relative risk (RR) for mortality in patients eligible for treatment was as follows: 0.49 (P < .001) for discharge prescription of renin-angiotensin system inhibitors (RAS-Is), 0.59 (P = .015) for β-blockers, 0.44 (P < .001) for combination therapy (ie, a β-blocker and a RAS-I), 0.87 (P nonsignificant) for aldosterone antagonists, and 0.49 (P nonsignificant) for planned cardioverter-defibrillator implantation. After adjustment for propensity scores, the RR was 0.49 (P < .001) for RAS-Is, 0.67 (P = .04) for β-blockers, and 0.57 (P < .001) for combination therapy. The data suggest that performance measures for RAS-Is, β-blockers, and combination therapy are strongly associated with improved 1-year survival. [ABSTRACT FROM PUBLISHER]
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- 2013
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112. A Digital Network for Long-distance Echocardiographic Image and Data Transmission in Clinical Trials: The CEDIM Study Experience
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Iliceto, Sabino, primary, D'Ambrosio, Gaetano, additional, Scrutinio, Domenico, additional, Marangelli, Vito, additional, Boni, Luca, additional, and Rizzon, Paolo, additional
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- 1993
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113. Recombinant tissue type plasminogen activator and heparin in acute angina at rest
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Scrutinio, Domenico, primary, Biasco, Maria Giuseppa, additional, and Rizzon, Paolo, additional
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- 1993
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114. Propionil-L-carnitine: a new compound in the metabolic approach to the treatment of effort angina
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Lagioia, Rocco, primary, Scrutinio, Domenico, additional, Giulio Mangini, Stefano, additional, Ricci, Antonio, additional, Mastropasqua, Filippo, additional, Valentini, Giovanni, additional, Ramunni, Giovanni, additional, Totaro Fila, Giuseppe, additional, and Rizzon, Paolo, additional
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- 1992
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115. Comorbidity in patients undergoing coronary artery bypass graft surgery: impact on outcome and implications for cardiac rehabilitation
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Scrutinio, Domenico and Giannuzzi, Pantaleo
- Abstract
The increasing comorbid disease burden among patients undergoing coronary artery bypass graft surgery (CABG) and the improved operative survival are expanding the number of post-CABG patients living with prognostically significant comorbidities. In a large contemporary database, 29.9% of the patients receiving isolated CABG had diabetes mellitus, 16% peripheral vascular disease, 18.6% chronic obstructive pulmonary disease, and 27.5% renal dysfunction. Patients with comorbidity are more likely to be old and often female, may have special care-requirements early after discharge, and are at increased risk for adverse outcomes. Contemporary available evidence indicates that older individuals, women, and patients with comorbidities are significantly less likely to receive cardiac rehabilitation. In addition, compliance with proven atherosclerosis risk reduction strategies for CABG patients is suboptimal. In this article we will review the impact of comorbidity on short-term and long-term outcome after CABG and their implications for cardiac rehabilitation.
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- 2008
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116. Rehabilitation medicine and appropriateness criteria: between chronicity, multi-morbidity and complexity
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Scrutinio, Domenico and Mauro Carone
117. Percent achieved of predicted peak exercise oxygen uptake and kinetics of recovery of oxygen uptake after exercise for risk stratification in chronic heart failure
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Scrutinio, Domenico, Passantino, Andrea, Lagioia, Rocco, Francesco Napoli, Ricci, Antonio, and Rizzon, Paolo
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- 1998
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118. Revisiting a Prognosticating Algorithm from Cardiopulmonary Exercise Testing in Chronic Heart Failure (from the MECKI Score Population)
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Ugo Corrà, Massimo Francesco Piepoli, Andrea Giordano, Francesco Doni, Alessandra Magini, Alice Bonomi, Elisabetta Salvioni, Rocco Lagioia, Giuseppe Limongelli, Stefania Paolillo, Damiano Magrì, Pasquale Perrone Filardi, Gianfranco Sinagra, Angela B. Scardovi, Marco Metra, Michele Senni, Domenico Scrutinio, Rosa Raimondo, Michele Emdin, Gaia Cattadori, Gianfranco Parati, Federica Re, Mariantonietta Cicoira, Chiara Minà, Michele Correale, Maria Frigerio, Enrico Perna, Maurizio Bussotti, Elisa Battaia, Marco Guazzi, Francesco Bandera, Roberto Badagliacca, Andrea Di Lenarda, Aldo Maggioni, Claudio Passino, Susanna Sciomer, Giuseppe Pacileo, Massimo Mapelli, Carlo Vignati, Francesco Clemenza, Carlo Lombardi, Piergiuseppe Agostoni, Corrà, Ugo, Piepoli, Massimo Francesco, Giordano, Andrea, Doni, Francesco, Magini, Alessandra, Bonomi, Alice, Salvioni, Elisabetta, Lagioia, Rocco, Limongelli, Giuseppe, Paolillo, Stefania, Magrì, Damiano, Filardi, Pasquale Perrone, Sinagra, Gianfranco, Scardovi, Angela B, Metra, Marco, Senni, Michele, Scrutinio, Domenico, Raimondo, Rosa, Emdin, Michele, Cattadori, Gaia, Parati, Gianfranco, Re, Federica, Cicoira, Mariantonietta, Minà, Chiara, Correale, Michele, Frigerio, Maria, Perna, Enrico, Bussotti, Maurizio, Battaia, Elisa, Guazzi, Marco, Bandera, Francesco, Badagliacca, Roberto, Lenarda, Andrea Di, Maggioni, Aldo, Passino, Claudio, Sciomer, Susanna, Pacileo, Giuseppe, Mapelli, Massimo, Vignati, Carlo, Clemenza, Francesco, Lombardi, Carlo, and Agostoni, Piergiuseppe
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Heart Failure ,Oxygen Consumption ,Adrenergic beta-Antagonists ,Exercise Test ,Humans ,Stroke Volume ,HFrEF ,Prognosis ,Cardiology and Cardiovascular Medicine ,Algorithms ,Ventricular Function, Left - Abstract
Cardiopulmonary exercise testing is a prognostic tool in heart failure with reduced left ventricular ejection fraction (HFrEF). Prognosticating algorithms have been proposed, but none has been validated. In 2017, a predictive algorithm, based on peak oxygen consumption (VO2), ventilatory response to exercise (ventilation [VE] carbon dioxide production [VCO2], the VE/VCO2 slope), exertional oscillatory ventilation (EOV), and peak respiratory exchange ratio, was recommended, according treatment with β blockers: patients with HFrEF registered in the metabolic exercise test data combined with cardiac and kidney indexes (MECKIs) database were used to validated this algorithm. According to the inclusion/exclusion criteria, 4,683 MECKI patients with HFrEF were enrolled. At 3years follow-up, the end point was cardiovascular death and urgent heart transplantation (cardiovascular events [CV]). CV events occurred in 25% in patients without β blockers, whereas those with β-blockers had 11% (p 10
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- 2022
119. Dose-dependent efficacy of β-blocker in patients with chronic heart failure and atrial fibrillation
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Michele Correale, Domenico Scrutinio, Stefania Paolillo, Gaia Cattadori, Marco Metra, Gianfranco Sinagra, Jeness Campodonico, Giuseppe Pacileo, Simone Binno, Massimo Mapelli, Angela Beatrice Scardovi, Marco Guazzi, Carlo Vignati, Susanna Sciomer, Massimo F Piepoli, Michele Emdin, Claudio Passino, Elisa Battaia, Pasquale Perrone Filardi, Andrea Di Lenarda, Piergiuseppe Agostoni, Carlo Lombardi, Fabrizio Veglia, Aldo P. Maggioni, Damiano Magrì, Giuseppe Limongelli, Chiara Minà, Federica Re, Elisabetta Salvioni, Maurizio Bussotti, Ugo Corrà, Francesco Clemenza, Michele Senni, Roberto Badagliacca, Rosa Raimondo, Rocco Lagioia, Alice Bonomi, Mariantonietta Cicoira, Maria Frigerio, Enrico Perna, Gianfranco Parati, Campodonico, Jene, Piepoli, Massimo, Clemenza, Francesco, Bonomi, Alice, Paolillo, Stefania, Salvioni, Elisabetta, Corrà, Ugo, Binno, Simone, Veglia, Fabrizio, Lagioia, Rocco, Sinagra, Gianfranco, Cattadori, Gaia, Scardovi, Angela B., Metra, Marco, Senni, Michele, Scrutinio, Domenico, Raimondo, Rosa, Emdin, Michele, Magrì, Damiano, Parati, Gianfranco, Re, Federica, Cicoira, Mariantonietta, Minà, Chiara, Limongelli, Giuseppe, Correale, Michele, Frigerio, Maria, Bussotti, Maurizio, Perna, Enrico, Battaia, Elisa, Guazzi, Marco, Badagliacca, Roberto, Di Lenarda, Andrea, Maggioni, Aldo, Passino, Claudio, Sciomer, Susanna, Pacileo, Giuseppe, Mapelli, Massimo, Vignati, Carlo, Lombardi, Carlo, Filardi, Pasquale Perrone, Agostoni, Piergiuseppe, Campodonico, J., Piepoli, M., Clemenza, F., Bonomi, A., Paolillo, S., Salvioni, E., Corra, U., Binno, S., Veglia, F., Lagioia, R., Sinagra, G., Cattadori, G., Scardovi, A. B., Metra, M., Senni, M., Scrutinio, D., Raimondo, R., Emdin, M., Magri, D., Parati, G., Re, F., Cicoira, M., Mina, C., Limongelli, G., Correale, M., Frigerio, M., Bussotti, M., Perna, E., Battaia, E., Guazzi, M., Badagliacca, R., Di Lenarda, A., Maggioni, A., Passino, C., Sciomer, S., Pacileo, G., Mapelli, M., Vignati, C., Lombardi, C., Filardi, P. P., Agostoni, P., Campodonico, J, Piepoli, M, Clemenza, F, Bonomi, A, Paolillo, S, Salvioni, E, Corrà, U, Binno, S, Veglia, F, Lagioia, R, Sinagra, G, Cattadori, G, Scardovi, A, Metra, M, Senni, M, Scrutinio, D, Raimondo, R, Emdin, M, Magrì, D, Parati, G, Re, F, Cicoira, M, Minà, C, Limongelli, G, Correale, M, Frigerio, M, Bussotti, M, Perna, E, Battaia, E, Guazzi, M, Badagliacca, R, Di Lenarda, A, Maggioni, A, Passino, C, Sciomer, S, Pacileo, G, Mapelli, M, Vignati, C, Lombardi, C, Filardi, P, and Agostoni, P
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Male ,medicine.medical_specialty ,Prognosi ,medicine.medical_treatment ,Cardiopulmonary exercise test ,Prognosis ,β-Blockers, Atrial fibrillation ,Cardiology and Cardiovascular Medicine ,Adrenergic beta-Antagonists ,Dose dependence ,heart failure, atrial fibrillation, prognosis, beta-blocker, cardiopulmonary exercise test ,030204 cardiovascular system & hematology ,Follow-Up Studie ,03 medical and health sciences ,0302 clinical medicine ,Retrospective Studie ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Survival analysis ,Aged ,Retrospective Studies ,Heart Failure ,Entire population ,Dose-Response Relationship, Drug ,business.industry ,Confounding ,Adrenergic beta-Antagonist ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Death ,Treatment Outcome ,Ventricular assist device ,Heart failure ,beta-blocker ,Cardiology ,β-Blockers ,Female ,business ,Human ,Follow-Up Studies - Abstract
The usefulness of β-blockers in heart failure (HF) patients with permanent atrial fibrillation (AF) has been questioned. Background: The usefulness of β-blockers in heart failure (HF) patients with permanent atrial fibrillation (AF) has been questioned. Methods and results: We analyzed data from HF patients (958 patients (801 males, 84%, age 67 ± 11 years)) with AF enrolled in the MECKI score database. We evaluated prognosis (composite of cardiovascular death, urgent heart transplant, or left ventricular assist device) of patients receiving β-blockers (n = 777, 81%) vs. those not treated with β-blockers (n = 181, 19%). We also analyzed the role β1-selectivity and the role of daily β-blocker dose. To account for different HF severity, Kaplan-Meier survival curves were normalized for relevant confounding factors and for treatment strategies. Dose was available in 629 patients. Median follow-up was 1312 (577–2304) days in the entire population, 1203 (614–2420) and 1325 (569–2300) days in patients not receiving and receiving β-blockers. 224 (23%, 54/1000 events/year), 163 (21%, 79/1000 events/year), and 61 (34%, 49/1000 events/year) events were recorded, respectively. At 10-year patients treated with β-blockers had a better outcome (HR 0.447, p < 0.01) with no effects as regards β1selective drugs (53%) vs. β1-β2 blockers (47%). Survival improved in parallel with β-blocker dose increase (HR 0.296, 0.496, 0.490 for the high, medium, and low dose vs. no β-blockers, p < 0.0001). Conclusion: HF patients with AF taking a β-blocker have a better outcome (with a survival improvement in parallel with daily dose but no differences as regards β1 selectivity) but this does not mean that β-blockers improve outcomes in these patients as we cannot control for all the potential confounders associated with β-blocker use.
- Published
- 2018
120. Machine learning to predict mortality after rehabilitation among patients with severe stroke
- Author
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Petronilla Battista, Ernesto Losavio, Domenico Scrutinio, Pietro Guida, Carlo Ricciardi, Gaetano Pagano, Giovanni D'Addio, Mario Cesarelli, Leandro Donisi, Scrutinio, Domenico, Ricciardi, Carlo, Donisi, Leandro, Losavio, Ernesto, Battista, Petronilla, Guida, Pietro, Cesarelli, Mario, Pagano, Gaetano, D'Addio, Giovanni, Scrutinio, D., Ricciardi, C., Donisi, L., Losavio, E., Battista, P., Guida, P., Cesarelli, M., Pagano, G., and D'Addio, G.
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United State ,Male ,Logistic Model ,medicine.medical_treatment ,Clinical Decision-Making ,lcsh:Medicine ,Severe stroke ,030204 cardiovascular system & hematology ,Medicare ,Logistic regression ,Machine learning ,computer.software_genre ,Article ,Machine Learning ,03 medical and health sciences ,Engineering ,0302 clinical medicine ,Humans ,Medicine ,Risk threshold ,Mortality ,lcsh:Science ,Severe disability ,Stroke ,Aged ,Multidisciplinary ,Rehabilitation ,Receiver operating characteristic ,business.industry ,lcsh:R ,Stroke Rehabilitation ,Middle Aged ,medicine.disease ,United States ,Random forest ,Algorithm ,Logistic Models ,Neurology ,ROC Curve ,lcsh:Q ,Female ,Artificial intelligence ,business ,computer ,Algorithms ,030217 neurology & neurosurgery ,Human - Abstract
Stroke is among the leading causes of death and disability worldwide. Approximately 20–25% of stroke survivors present severe disability, which is associated with increased mortality risk. Prognostication is inherent in the process of clinical decision-making. Machine learning (ML) methods have gained increasing popularity in the setting of biomedical research. The aim of this study was twofold: assessing the performance of ML tree-based algorithms for predicting three-year mortality model in 1207 stroke patients with severe disability who completed rehabilitation and comparing the performance of ML algorithms to that of a standard logistic regression. The logistic regression model achieved an area under the Receiver Operating Characteristics curve (AUC) of 0.745 and was well calibrated. At the optimal risk threshold, the model had an accuracy of 75.7%, a positive predictive value (PPV) of 33.9%, and a negative predictive value (NPV) of 91.0%. The ML algorithm outperformed the logistic regression model through the implementation of synthetic minority oversampling technique and the Random Forests, achieving an AUC of 0.928 and an accuracy of 86.3%. The PPV was 84.6% and the NPV 87.5%. This study introduced a step forward in the creation of standardisable tools for predicting health outcomes in individuals affected by stroke.
- Published
- 2020
121. Heart failure prognosis over time: how the prognostic role of oxygen consumption and ventilatory efficiency during exercise has changed in the last 20 years
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Paolillo, S., Veglia, F., Salvioni, E., Corra, U., Piepoli, M., Lagioia, R., Limongelli, G., Sinagra, G., Cattadori, G., Scardovi, A. B., Metra, M., Senni, M., Bonomi, A., Scrutinio, D., Raimondo, R., Emdin, M., Magri, D., Parati, G., Re, F., Cicoira, M., Mina, C., Correale, M., Frigerio, M., Bussotti, M., Battaia, E., Guazzi, M., Badagliacca, R., Di Lenarda, A., Maggioni, A., Passino, C., Sciomer, S., Pacileo, G., Mapelli, M., Vignati, C., Clemenza, F., Binno, S., Lombardi, C., Filardi, P. P., Agostoni, P., Apostolo, A., Palermo, P., Contini, M., Farina, S., Mantegazza, V., Spadafora, E., Lattarulo, M. S., Giordano, A., Mezzani, A., Ricci, R., Ferraironi, A., Carubelli, V., Pietrucci, F., Malfatto, G., Caravita, Sergio, Vigano, E., Valente, F., Vastarella, R., Gravino, R., Roselli, T., Buono, A., De Maria, R., Passantino, A., Santoro, D., Campanale, S., Caputo, D., Bertipaglia, D., Confalonieri, M., Gentile, P., Zambon, E., Morosin, M., Carriere, C., Ferraretti, A., Marchese, G., Iorio, A., Pastormerlo, L., Gargiulo, P., Villani, G. Q., Oliva, F., Perna, E., Paolillo, Stefania, Veglia, Fabrizio, Salvioni, Elisabetta, Corrà, Ugo, Piepoli, Massimo, Lagioia, Rocco, Limongelli, Giuseppe, Sinagra, Gianfranco, Cattadori, Gaia, Scardovi, Angela B., Metra, Marco, Senni, Michele, Bonomi, Alice, Scrutinio, Domenico, Raimondo, Rosa, Emdin, Michele, Magrì, Damiano, Parati, Gianfranco, Re, Federica, Cicoira, Mariantonietta, Minà, Chiara, Correale, Michele, Frigerio, Maria, Bussotti, Maurizio, Battaia, Elisa, Guazzi, Marco, Badagliacca, Roberto, Di Lenarda, Andrea, Maggioni, Aldo, Passino, Claudio, Sciomer, Susanna, Pacileo, Giuseppe, Mapelli, Massimo, Vignati, Carlo, Clemenza, Francesco, Binno, Simone, Lombardi, Carlo, Filardi, Pasquale Perrone, Agostoni, Piergiuseppe, Apostolo, Anna, Palermo, Pietro, Contini, Mauro, Farina, Stefania, Mantegazza, Valentina, Spadafora, Emanuele, Lattarulo, Maria Silvia, Giordano, Andrea, Mezzani, Alessandro, Ricci, Roberto, Ferraironi, Alessandro, Carubelli, Valentina, Pietrucci, Francesca, Malfatto, Gabriella, Caravita, Sergio, Viganò, Elena, Valente, Fabio, Vastarella, Rossella, Gravino, Rita, Roselli, Teo, Buono, Andrea, De Maria, Renata, Passantino, Andrea, Santoro, Daniela, Campanale, Saba, Caputo, Domenica, Bertipaglia, Donatella, Confalonieri, Marco, Gentile, Piero, Zambon, Elena, Morosin, Marco, Carriere, Cosimo, Ferraretti, Armando, Marchese, Giovanni, Iorio, Annamaria, Pastormerlo, Luigi, Gargiulo, Paola, Villani, Giovanni Quinto, Oliva, Fabrizio, Perna, Enrico, Paolillo, S, Veglia, F, Salvioni, E, Corrà, U, Piepoli, M, Lagioia, R, Limongelli, G, Sinagra, G, Cattadori, G, Scardovi, A, Metra, M, Senni, M, Bonomi, A, Scrutinio, D, Raimondo, R, Emdin, M, Magrì, D, Parati, G, Re, F, Cicoira, M, Minà, C, Correale, M, Frigerio, M, Bussotti, M, Battaia, E, Guazzi, M, Badagliacca, R, Di Lenarda, A, Maggioni, A, Passino, C, Sciomer, S, Pacileo, G, Mapelli, M, Vignati, C, Clemenza, F, Binno, S, Lombardi, C, Perrone Filardi, P, Agostoni, P, Apostolo, A, Palermo, P, Contini, M, Farina, S, Mantegazza, V, Spadafora, E, Lattarulo, M, Giordano, A, Mezzani, A, Ricci, R, Ferraironi, A, Carubelli, V, Pietrucci, F, Malfatto, G, Caravita, S, Vigano', E, Valente, F, Vastarella, R, Gravino, R, Roselli, T, Buono, A, De Maria, R, Passantino, A, Santoro, D, Campanale, S, Caputo, D, Bertipaglia, D, Confalonieri, M, Gentile, P, Zambon, E, Morosin, M, Carriere, C, Ferraretti, A, Marchese, G, Iorio, A, Pastormerlo, L, Gargiulo, P, Villani, G, Oliva, F, Perna, E, Paolillo, S., Veglia, F., Salvioni, E., Corra, U., Piepoli, M., Lagioia, R., Limongelli, G., Sinagra, G., Cattadori, G., Scardovi, A. B., Metra, M., Senni, M., Bonomi, A., Scrutinio, D., Raimondo, R., Emdin, M., Magri, D., Parati, G., Re, F., Cicoira, M., Mina, C., Correale, M., Frigerio, M., Bussotti, M., Battaia, E., Guazzi, M., Badagliacca, R., Di Lenarda, A., Maggioni, A., Passino, C., Sciomer, S., Pacileo, G., Mapelli, M., Vignati, C., Clemenza, F., Binno, S., Lombardi, C., Filardi, P. P., Agostoni, P., Apostolo, A., Palermo, P., Contini, M., Farina, S., Mantegazza, V., Spadafora, E., Lattarulo, M. S., Giordano, A., Mezzani, A., Ricci, R., Ferraironi, A., Carubelli, V., Pietrucci, F., Malfatto, G., Caravita, S., Vigano, E., Valente, F., Vastarella, R., Gravino, R., Roselli, T., Buono, A., De Maria, R., Passantino, A., Santoro, D., Campanale, S., Caputo, D., Bertipaglia, D., Confalonieri, M., Gentile, P., Zambon, E., Morosin, M., Carriere, C., Ferraretti, A., Marchese, G., Iorio, A., Pastormerlo, L., Gargiulo, P., Villani, G. Q., Oliva, F., and Perna, E.
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Male ,Prognosi ,Cardiopulmonary exercise test ,Heart failure ,Peak oxygen uptake ,Prognosis ,VE/VCO2 slope ,cardiopulmonary exercise test ,heart failure ,peak oxygen uptake ,prognosis ,ve/vco ,2 ,slope ,disease progression ,exercise test ,female ,follow-up studies ,humans ,male ,middle aged ,oxygen consumption ,pulmonary ventilation ,roc curve ,respiratory function tests ,retrospective studies ,forecasting ,Settore MED/11 - Malattie dell'Apparato Cardiovascolare ,Follow-Up Studie ,VE/VCO ,Oxygen Consumption ,Cardiology and Cardiovascular Medicine ,Retrospective Studie ,Humans ,Respiratory Function Test ,Retrospective Studies ,VE/VCO 2 slope ,Middle Aged ,Respiratory Function Tests ,ROC Curve ,Disease Progression ,Exercise Test ,Female ,Pulmonary Ventilation ,Human ,Follow-Up Studies ,Forecasting - Abstract
Aims: Exercise-derived parameters, specifically peak exercise oxygen uptake (peak VO 2 ) and minute ventilation/carbon dioxide relationship slope (VE/VCO 2 slope), have a pivotal prognostic value in heart failure (HF). It is unknown how the prognostic threshold of peak VO 2 and VE/VCO 2 slope has changed over the last 20 years in parallel with HF prognosis improvement. Methods and results: Data from 6083 HF patients (81% male, age 61 ± 13 years), enrolled in the MECKI score database between 1993 and 2015, were retrospectively analysed. By enrolment year, four groups were generated: group 1 1993–2000 (n = 440), group 2 2001–2005 (n = 1288), group 3 2006–2010 (n = 2368), and group 4 2011–2015 (n = 1987). We compared the 10-year survival of groups and analysed how the overall risk (cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation) changed over time according to peak VO 2 and VE/VCO 2 slope and to major clinical and therapeutic variables. At 10 years, a progressively higher survival from group 1 to group 3 was observed, with no further improvement afterwards. A 20% risk for peak VO 2 15 mL/min/kg (95% confidence interval 16–13), 9 (11–8), 4 (4–2) and 5 (7–4) was observed in group 1, 2, 3, and 4, respectively, while the VE/VCO 2 slope value for a 20% risk was 32 (37–29), 47 (51–43), 59 (64–55), and 57 (63–52), respectively. Conclusions: Heart failure prognosis improved over time up to 2010 in a HF population followed by experienced centres. The peak VO 2 and VE/VCO 2 slope cut-offs identifying a definite risk progressively decreased and increased over time, respectively. The prognostic threshold of peak VO 2 and VE/VCO 2 slope must be updated whenever HF prognosis improves.
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- 2019
122. Digital exercise echocardiography: Comparison of peak upright bicycle versus post-treadmill echo imaging for detecting coronary artery disease
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Caiati, Carlo, Carretta, Domenico, Carrata, Francesco, Ricci, Antonio, Lagioia, Rocco, Scrutinio, Domenico, Iliceto, Sabino, and Rizzon, Paolo
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- 1995
- Full Text
- View/download PDF
123. A modified transgastric echocardiografic approach allows color Doppler guided continuous wave Doppler assessment of valvular and subvalvular aortic stenosis
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Caiati, Carlo, Carretta, Domenico, Carrata, Francesco, Ricci, Antonio, Scrutinio, Domenico, Iliceto, Sabino, and Rizzon, Paolo
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- 1995
- Full Text
- View/download PDF
124. Heart failure and anemia: Effects on prognostic variables
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Giovanni Marchese, Simone Binno, Fabrizio Oliva, Pantaleo Giannuzzi, Stefania Farina, Alessandro Mezzani, Michele Emdin, Elisa Battaia, Michele Correale, Chiara Minà, Roberto Badagliacca, Claudio Passino, Piergiuseppe Agostoni, Gianfranco Sinagra, Giuseppe Pacileo, Alice Bonomi, Elisabetta Salvioni, Mauro Contini, Marco Metra, Alessandro Ferraironi, Davide Girola, Anna Maria Iorio, Rocco La Gioia, Susanna Sciomer, Mariantonietta Cicoira, Ugo Corrà, Sergio Caravita, Angela Beatrice Scardovi, Domenico Scrutinio, Marco Guazzi, Stefania Paolillo, Maria Frigerio, Damiano Magrì, Pasquale Perrone Filardi, Fabrizio Veglia, Gaia Cattadori, Francesco Clemenza, Rosa Raimondo, Massimo Mapelli, Romualdo Belardinelli, Pietro Palermo, Andrea Di Lenarda, Anna Apostolo, Massimo F Piepoli, Maurizio Bussotti, Giuseppe Limongelli, Federica Re, Gianfranco Parati, Carlo Lombardi, Paola Gargiulo, Cattadori, G, Agostoni, P, Corrà, U, Sinagra, G, Veglia, F, Salvioni, E, Bonomi, A, La Gioia, R, Scardovi, Ab, Ferraironi, A, Emdin, M, Metra, M, Di Lenarda, A, Limongelli, G, Raimondo, R, Re, F, Guazzi, M, Belardinelli, R, Parati, G, Caravita, S, Magrì, D, Lombardi, C, Frigerio, M, Oliva, F, Girola, D, Mezzani, A, Farina, S, Mapelli, M, Scrutinio, D, Pacileo, G, Apostolo, A, Iorio, A, Paolillo, S, Filardi, Pp, Gargiulo, P, Bussotti, M, Marchese, G, Correale, M, Badagliacca, R, Sciomer, S, Palermo, P, Contini, M, Giannuzzi, P, Battaia, E, Cicoira, M, Clemenza, F, Minà, C, Binno, S, Passino, C, Piepoli, M, Cattadori, Gaia, Agostoni, Piergiuseppe, Corrã , Ugo, Sinagra, Gianfranco, Veglia, Fabrizio, Salvioni, Elisabetta, Bonomi, Alice, La Gioia, Rocco, Scardovi, Angela B., Ferraironi, Alessandro, Emdin, Michele, Metra, Marco, Di Lenarda, Andrea, Limongelli, Giuseppe, Raimondo, Rosa, Re, Federica, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Caravita, Sergio, Magrã¬, Damiano, Lombardi, Carlo, Frigerio, Maria, Oliva, Fabrizio, Girola, Davide, Mezzani, Alessandro, Farina, Stefania, Mapelli, Massimo, Scrutinio, Domenico, Pacileo, Giuseppe, Apostolo, Anna, Iorio, Annamaria, Paolillo, Stefania, Filardi, Pasquale Perrone, Gargiulo, Paola, Bussotti, Maurizio, Marchese, Giovanni, Correale, Michele, Badagliacca, Roberto, Sciomer, Susanna, Palermo, Pietro, Contini, Mauro, Giannuzzi, Pantaleo, Battaia, Elisa, Cicoira, Mariantonietta, Clemenza, Francesco, Minã , Chiara, Binno, Simone, Passino, Claudio, Piepoli, Massimo F., Corrà, Ugo, DI LENARDA, Andrea, Magrì, Damiano, Minà, Chiara, Scardovi, A, and Filardi, P
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Male ,Prognostic variable ,medicine.medical_specialty ,Anemia ,Prognosi ,Renal function ,Heart failure ,Settore MED/11 - Malattie dell'Apparato Cardiovascolare ,Comorbidity ,030204 cardiovascular system & hematology ,Cohort Studies ,Prognosis ,Hemoglobins ,03 medical and health sciences ,Oxygen Consumption ,0302 clinical medicine ,Internal medicine ,medicine ,Internal Medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Aged ,Proportional Hazards Models ,Entire population ,Ejection fraction ,business.industry ,Sodium ,Hazard ratio ,Stroke Volume ,Carbon Dioxide ,Middle Aged ,medicine.disease ,Italy ,Multivariate Analysis ,Exercise Test ,Cardiology ,Female ,Hemoglobin ,Pulmonary Ventilation ,business - Abstract
Background: Anemia is frequent in heart failure (HF), and it is associated with higher mortality. The predictive power of established HF prognostic parameters in anemic HF patients is unknown. Methods: Clinical, laboratory, echocardiographic and cardiopulmonary-exercise-test (CPET) data were analyzed in 3913 HF patients grouped according to hemoglobin (Hb) values. 248 (6%), 857 (22%), 2160 (55%) and 648 (17%) patients had very low (b11 g/dL), low (11–12 for females, 11–13 for males), normal (12–15 for females, 13–15 for males) and high (N15) Hb, respectively. Results: Median follow-up was 1363 days (606–1883). CPETs were always performed safely. Hb was related to prognosis (Hazard ratio (HR) = 0.864). No prognostic difference was observed between normal and high Hb groups. Peak oxygen consumption (VO2), ventilatory efficiency (VE/VCO2 slope), plasma sodium concentration, ejection fraction (LVEF), kidney function and Hb were independently related to prognosis in the entire popula- tion. Considering Hb groups separately, peakVO2 (very low Hb HR = 0.549, low Hb HR = 0.613, normal Hb HR = 0.618, high Hb HR = 0.542) and LVEF (very low Hb HR = 0.49, low Hb HR = 0.692, normal Hb HR = 0.697, high Hb HR = 0.694) maintained their prognostic roles. High VE/VCO2 slope was associated with poor prognosis only in patients with low and normal Hb. Conclusions: Anemic HF patients have a worse prognosis, but CPET can be safely performed. PeakVO2 and LVEF, but not VE/VCO2 slope, maintain their prognostic power also in HF patients with Hb b 11 g/dL, suggesting CPET use and a multiparametric approach in HF patients with low Hb. However, the prognostic effect of an anemia-oriented follow-up is unknown.
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- 2017
125. Mediterranean diet impact on cardiovascular diseases: a narrative review
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Domenico Scrutinio, Marco Triggiani, Pier Sergio Saba, Anna Vittoria Mattioli, Lucia Cugusi, Giuseppina Novo, Simona Di Francesco, Federica Moscucci, Alberto Farinetti, Pasquale Palmiero, Pietro Palermo, Annapaola Zito, Maria Maiello, Roberto F E Pedretti, Savina Nodari, Pietro Scicchitano, Olivia Manfrini, Giuseppe Mercuro, Gianfranco Parati, Alessandra Dei Cas, Paolo Emilio Puddu, Susanna Sciomer, Salvatore Novo, Vincenzo Sucato, R. Tenaglia, Marco Matteo Ciccone, Roberto Pedrinelli, Mattioli, A, Palmiero, P, Manfrini, O, Puddu, P, Nodari, S, Dei Cas, A, Mercuro, G, Scrutinio, D, Palermo, P, Sciomer, S, Di Francesco, S, Novo, G, Novo, S, Pedretti, R, Zito, A, Parati, G, Pedrinelli, R, Farinetti, A, Maiello, M, Moscucci, F, Tenaglia, R, Sucato, V, Triggiani, M, Cugusi, L, Scicchitano, P, Saba, P, Ciccone, M, Mattioli, A., Pasquale, P., Olivia, M., Puddu, P., Savina, N., Alessandra Dei Cas, Giuseppe, M., Domenico, S., Pietro, P., Susanna, S., Simona Di Francesco, Giuseppina, N., Salvatore, N., Pedretti, R., Annapaola, Z., Gianfranco, P., Roberto, P., Alberto, F., Maria, M., Federica, M., Tenaglia, R., Vincenzo, S., Marco, T., Lucia, C., Pietro, S., Saba, P., Ciccone, M., Mattioli, Anna V., Palmiero, Pasquale, Manfrini, Olivia, Puddu, Paolo E., Nodari, Savina, Dei Cas, Alessandra, Mercuro, Giuseppe, Scrutinio, Domenico, Palermo, Pietro, Sciomer, Susanna, Di Francesco, Simona, Novo, Giuseppina, Novo, Salvatore, Pedretti, Roberto F. E., Zito, Annapaola, Parati, Gianfranco, Pedrinelli, Roberto, Farinetti, Alberto, Maiello, Maria, Moscucci, Federica, Tenaglia, Raffaele L., Sucato, Vincenzo, Triggiani, Marco, Cugusi, Lucia, Scicchitano, Pietro, Saba, Pier S., and Ciccone, Marco M.
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lifestyle ,Mediterranean diet ,inactive lifestyle ,Disease ,030204 cardiovascular system & hematology ,Diet, Mediterranean ,Sudden cardiac death ,Coronary artery disease ,03 medical and health sciences ,cardiovascular diseases, lifestyle, Mediterranean diet, preventive cardiology, vascular diseases ,Vascular Stiffness ,0302 clinical medicine ,cardiovascular disease ,Environmental health ,medicine ,Humans ,Healthy Lifestyle ,030212 general & internal medicine ,Mediterranean diet impact on cardiovascular diseases ,Randomized Controlled Trials as Topic ,alimentation ,Traditional medicine ,business.industry ,cardiovascular disease (CVD) ,preventive cardiology ,food and beverages ,vascular disease ,mediterranean diet ,General Medicine ,medicine.disease ,Natural history ,cardiovascular diseases ,vascular diseases ,Cardiology and Cardiovascular Medicine ,Cardiovascular Diseases ,mediterranean diet, cardiovascular disease ,Heart failure ,Arterial stiffness ,Narrative review ,business - Abstract
Cardiovascular disease (CVD) accounts for more than 17 million deaths per year worldwide. It has been estimated that the influence of lifestyle on CVD mortality amounts to 13.7% for smoking, 13.2% for poor diet, and 12% for inactive lifestyle. These results deeply impact both the healthy status of individuals and their skills in working. The impact of CVD on productivity loss accounts for the 24% in total costs for CVD management. Mediterranean diet (MedD) can positively impact on natural history of CVD. It is characterized by a relatively high consumption of inexpensive and genuine food such as cereals, vegetables, legumes, nuts, fish, fresh fruits, and olive oil as the principal source of fat, low meat consumption and low-to-moderate consumption of milk, dairy products, and wine. Its effects on cardiovascular health are related to the significant improvements in arterial stiffness. Peripheral artery disease, coronary artery disease, and chronic heart failure are all positively influenced by the MedD. Furthermore, MedD lowers the risk of sudden cardiac death due to arrhythmias. The present narrative review aims to analyze the effects of MedD on CVD.
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- 2017
126. Metabolic exercise data combined with cardiac and kidney indexes: MECKI score. Predictive role in cardiopulmonary exercise testing with low respiratory exchange ratio in heart failure
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Corrà, U, Agostoni, P, Piepoli, Mf, Giordano, A, Mezzani, A, Giannuzzi, P, Cattadori, G, Fiorentini, C, Salvioni, E, Giovannardi, M, Veglia, F, Apostolo, A, Palermo, P, Contini, M, Vignati, C, Farina, S, Bovis, F, Cicoira, M, Vassanelli, C, La Gioia, R, Scrutinio, D, Passantino, A, Santoro, D, Campanale, S, Caputo, D, Scardovi, Ab, Ricci, R, Emdin, Michele, Metra, M, Dei Cas, L, Sinagra, G, Berton, E, Limongelli, G, Iorio, Am, Roselli, T, Buono, A, Calabrò, R, Raimondo, R, Vaninetti, R, Bertipaglia, D, Re, F, Guazzi, M, Belardinelli, R, Pietrucci, F, Parati, G, Magrì, D, Di Lenarda, A, Paolillo, S, Perrone Filardi, P, Passino, Claudio, Pastormerlo, Luigi Emilio, Malfatto, G, Caravita, S., Corrà, Ugo, Agostoni, Piergiuseppe, Piepoli, Massimo F., Giordano, Andrea, Mezzani, Alessandro, Giannuzzi, Pantaleo, Cattadori, Gaia, Fiorentini, Cesare, Salvioni, Elisabetta, Giovannardi, Marta, Veglia, Fabrizio, Apostolo, Anna, Palermo, Pietro, Contini, Mauro, Vignati, Carlo, Farina, Stefania, Bovis, Francesca, Cicoira, Mariantonietta, Vassanelli, Corrado, La Gioia, Rocco, Scrutinio, Domenico, Passantino, Andrea, Santoro, Daniela, Campanale, Saba, Caputo, Domenica, Scardovi, Angela B., Ricci, Roberto, Emdin, Michele, Metra, Marco, Dei Cas, Livio, Sinagra, Gianfranco, Berton, Emanuela, Limongelli, Giuseppe, Iorio, Anna Maria, Roselli, Teo, Buono, Andrea, Calabro', Raffaele, Raimondo, Rosa, Vaninetti, Raffaella, Bertipaglia, Donatella, Re, Federica, Guazzi, Marco, Belardinelli, Milano Romualdo, Pietrucci, Francesca, Parati, Gianfranco, Magrì, Damiano, Di Lenarda, Andrea, Paolillo, Stefania, Perrone Filardi, Pasquale, Passino, Claudio, Pastormerlo, Luigi E., Malfatto, Gabriella, Corrà, U, Agostoni, P, Piepoli, M, Giordano, A, Mezzani, A, Giannuzzi, P, Cattadori, G, Fiorentini, C, Salvioni, E, Giovannardi, M, Veglia, F, Apostolo, A, Palermo, P, Contini, M, Vignati, C, Farina, S, Bovis, F, Cicoira, M, Vassanelli, C, La Gioia, R, Scrutinio, D, Passantino, A, Santoro, D, Campanale, S, Caputo, D, Scardovi, A, Ricci, R, Emdin, M, Metra, M, Dei Cas, L, Sinagra, G, Berton, E, Limongelli, G, Iorio, A, Roselli, T, Buono, A, Calabrò, R, Raimondo, R, Vaninetti, R, Bertipaglia, D, Re, F, Guazzi, M, Belardinelli, M, Pietrucci, F, Parati, G, Magrì, D, Di Lenarda, A, Paolillo, S, Perrone Filardi, P, Passino, C, Pastormerlo, L, Malfatto, G, Calabrò, Raffaele, and DI LENARDA, Andrea
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Male ,medicine.medical_specialty ,Cardiopulmonary exercise ,Heart failure ,Oxygen consumption ,Prognosis ,Respiratory quotient ,Prognosi ,Renal function ,Respiratory physiology ,Kidney Function Tests ,Severity of Illness Index ,Predictive Value of Tests ,Internal medicine ,Severity of illness ,medicine ,Humans ,Respiratory exchange ratio ,Aged ,Kidney ,business.industry ,Medicine (all) ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Predictive value of tests ,Exercise Test ,Respiratory Mechanics ,Cardiology ,Female ,Energy Metabolism ,Cardiology and Cardiovascular Medicine ,business ,cardiopulmonary exercise ,heart failure ,oxygen consumption ,prognosis ,respiratory quotient ,aged ,energy metabolism ,exercise test ,female ,humans ,kidney function tests ,male ,middle aged ,predictive value of tests ,respiratory mechanics ,severity of illness index ,cardiology and cardiovascular medicine - Abstract
n/a
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- 2015
127. Sex Profile and Risk Assessment With Cardiopulmonary Exercise Testing in Heart Failure: Propensity Score Matching for Sex Selection Bias
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Domenico Scrutinio, Stefania Paolillo, Marco Metra, Cesare Fiorentini, Mariantonietta Cicoira, Michele Emdin, Corrado Vassanelli, Massimo F Piepoli, Angela Beatrice Scardovi, Alessandro Mezzani, Anna Maria Iorio, Marco Guazzi, Elisa Battaia, Rosa Raimondo, Andrea Di Lenarda, Pietro Palermo, Rocco La Gioia, Giuseppe Limongelli, Gianfranco Sinagra, Damiano Magrì, Federica Re, Piergiuseppe Agostoni, Andrea Giordano, Pantaleo Giannuzzi, Claudio Passino, Anna Apostolo, Elisabetta Salvioni, Gianfranco Parati, Fabrizio Veglia, Gaia Cattadori, Marta Giovannardi, Roberto Ricci, Mauro Contini, Ugo Corrà, Romualdo Belardinelli, Corrà, Ugo, Agostoni, Piergiuseppe, Giordano, Andrea, Cattadori, Gaia, Battaia, Elisa, La Gioia, Rocco, Scardovi, Angela B., Emdin, Michele, Metra, Marco, Sinagra, Gianfranco, Limongelli, Giuseppe, Raimondo, Rosa, Re, Federica, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Magrì, Damiano, Fiorentini, Cesare, Cicoira, Mariantonietta, Salvioni, Elisabetta, Giovannardi, Marta, Veglia, Fabrizio, Mezzani, Alessandro, Scrutinio, Domenico, DI LENARDA, Andrea, Ricci, Roberto, Apostolo, Anna, Iorio, Anna Maria, Paolillo, Stefania, Palermo, Pietro, Contini, Mauro, Vassanelli, Corrado, Passino, Claudio, Giannuzzi, Pantaleo, Piepoli, Massimo F., Corrà, U, Agostoni, P, Giordano, A, Cattadori, G, Battaia, E, La Gioia, R, Scardovi, A, Emdin, M, Metra, M, Sinagra, G, Limongelli, G, Raimondo, R, Re, F, Guazzi, M, Belardinelli, R, Parati, G, Magrì, D, Fiorentini, C, Cicoira, M, Salvioni, E, Giovannardi, M, Veglia, F, Mezzani, A, Scrutinio, D, Di Lenarda, A, Ricci, R, Apostolo, A, Iorio, A, Paolillo, S, Palermo, P, Contini, M, Vassanelli, C, Passino, C, Giannuzzi, P, Piepoli, M, Corra, U., Agostoni, P., Giordano, A., Cattadori, G., Battaia, E., La Gioia, R., Scardovi, A. B., Emdin, M., Metra, M., Sinagra, G., Limongelli, G., Raimondo, R., Re, F., Guazzi, M., Belardinelli, R., Parati, G., Magri, D., Fiorentini, C., Cicoira, M., Salvioni, E., Giovannardi, M., Veglia, F., Mezzani, A., Scrutinio, D., Di Lenarda, A., Ricci, R., Apostolo, A., Iorio, A. M., Paolillo, S., Palermo, P., Contini, M., Vassanelli, C., Passino, C., Giannuzzi, P., and Piepoli, M. F.
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Male ,medicine.medical_specialty ,Multivariate analysis ,Databases, Factual ,media_common.quotation_subject ,Heart Failure, Cardiopulmonary exercise testing ,Selection Bia ,030204 cardiovascular system & hematology ,Risk Assessment ,Ventricular Function, Left ,Body Mass Index ,Follow-Up Studie ,03 medical and health sciences ,0302 clinical medicine ,Oxygen Consumption ,Risk Factors ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,cardiology and cardiovascular medicine ,cardiopulmonary exercise test ,sex selection ,Propensity Score ,Selection Bias ,media_common ,Aged ,Selection bias ,Heart Failure ,Univariate analysis ,business.industry ,Risk Factor ,Middle Aged ,medicine.disease ,Cardiopulmonary exercise testing ,Italy ,Heart failure ,Propensity score matching ,Cardiology ,Physical therapy ,Exercise Test ,Population study ,Female ,business ,Risk assessment ,Cardiology and Cardiovascular Medicine ,Body mass index ,Follow-Up Studies ,Human - Abstract
Background In heart failure (HF), women show better survival despite a comparatively low peak oxygen consumption ( V ˙ o 2 ): this raises doubt about the accuracy of risk assessment by cardiopulmonary exercise testing (CPET) in women. Accordingly, we aimed to check (1) whether the predictive role of well-known CPET risk indexes, ie, peak V ˙ o 2 and ventilatory response ( V ˙ e/ V ˙ co 2 slope), is sex independent and (2) if sex-related characteristics that impact outcome in HF should be considered as associations that may confound the effect of sex on survival. Methods The study population consisted of 2985 patients with HF, 498 (17%) of whom were women, from the multicentre Metabolic Exercise Test Data Combined with Cardiac and Kidney Indexes (MECKI): the end point was cardiovascular death within a 3-year period. Results During the follow-up, 305 (12%) men and 39 (8%) women ( P = 0.005) died, and female sex was linked to better survival on univariate analysis ( P = 0.008) and independent of peak V ˙ o 2 and V ˙ e/ V ˙ co 2 slope on multivariate analysis. According to propensity score matching for female sex to exclude a sex selection bias and sample discrepancy, 498 men were selected: the standardized percentage bias ranged from 20.8 ( P P = 0.667). After clinical profile harmonizing, female sex was predictive of HF at univariate analysis. Conclusions The low peak V ˙ o 2 and female association with better outcome in HF might be counterfeit: the female prognostic advantage is lost when sex-specific differences are correctly taken into account with propensity score matching, suggesting that for an effective and efficient HF model, adjustment must be made for sex-related characteristics.
- Published
- 2016
128. Prognostic role of atrial fibrillation in patients affected by chronic heart failure. Data from the MECKI score research group
- Author
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Marco Metra, Angela Beatrice Scardovi, Francesco Clemenza, Marco Guazzi, Giuseppe Limongelli, Federica Re, Claudio Passino, Piergiuseppe Agostoni, Rosa Raimondo, Massimo F Piepoli, Maria Frigerio, Romualdo Belardinelli, Domenico Scrutinio, Stefania Paolillo, Andrea Di Lenarda, Daniele Masarone, Rocco La Gioia, Davide Girola, Marta Giovannardi, Gianfranco Parati, Gaia Cattadori, Michele Correale, Pasquale Perrone-Filardi, Giuseppe Pacileo, Michele Emdin, Mariantonietta Cicoira, Gianfranco Sinagra, Paola Gargiulo, Carlo Lombardi, Annamaria Iorio, Elisabetta Salvioni, Ugo Corrà, Paolillo, S, Agostoni, P, Masarone, D, Corrà, U, Passino, C, Scrutinio, D, Correale, M, Cattadori, G, Metra, M, Girola, D, Piepoli, M, Salvioni, E, Giovannardi, M, Iorio, A, Emdin, M, Raimondo, R, Re, F, Cicoira, M, Belardinelli, R, Guazzi, M, Clemenza, F, Parati, G, Scardovi, A, Di Lenarda, A, La Gioia, R, Frigerio, M, Lombardi, C, Gargiulo, P, Sinagra, G, Pacileo, G, Perrone Filardi, P, Limongelli, G, Piepoli, Mf, Iorio, Annamaria, Scardovi, Ab, DI LENARDA, Andrea, Sinagra, Gianfranco, Limongelli, G., Paolillo, Stefania, Agostoni, Piergiuseppe, Masarone, Daniele, Corrà, Ugo, Passino, Claudio, Scrutinio, Domenico, Correale, Michele, Cattadori, Gaia, Metra, Marco, Girola, Davide, Piepoli, Massimo F, Salvioni, Elisabetta, Giovannardi, Marta, Emdin, Michele, Raimondo, Rosa, Re, Federica, Cicoira, Mariantonietta, Belardinelli, Romualdo, Guazzi, Marco, Clemenza, Francesco, Parati, Gianfranco, Scardovi, Angela B, Di Lenarda, Andrea, La Gioia, Rocco, Frigerio, Maria, Lombardi, Carlo, Gargiulo, Paola, Pacileo, Giuseppe, PERRONE FILARDI, Pasquale, Limongelli, Giuseppe, Piepoli, Massimo F., Scardovi, Angela B., and Perrone Filardi, Pasquale
- Subjects
Male ,medicine.medical_specialty ,Digoxin ,Prognosi ,Left ,Renal function ,Heart failure ,Matching analysi ,Kaplan-Meier Estimate ,Severity of Illness Index ,Regression Analysi ,Ventricular Function, Left ,Atrial fibrillation ,MECKI score ,Matching analysis ,Prognosis ,Aged ,Atrial Fibrillation ,Biomarkers ,Chronic Disease ,Female ,Heart Failure ,Hospitalization ,Humans ,Middle Aged ,Multivariate Analysis ,Regression Analysis ,Internal medicine ,medicine ,Clinical endpoint ,Internal Medicine ,Ventricular Function ,Sinus rhythm ,Multivariate Analysi ,Ejection fraction ,business.industry ,Biomarker ,medicine.disease ,medicine.anatomical_structure ,Ventricle ,Cardiology ,business ,medicine.drug ,Human - Abstract
Background Atrial fibrillation (AF) is common in heart failure (HF). It is unclear whether AF has an independent prognostic role in HF. The aim of the present study was to assess the prognostic role of AF in HF patients with reduced ejection fraction (EF). Methods HF patients were followed in 17 centers for 3.15 years (1.51–5.24). Study endpoints were the composite of cardiovascular (CV) death and heart transplant (HTX) and all-cause death. Data analysis was performed considering the entire population and a 1 to 1 match between sinus rhythm (SR) and AF patients. Match process was done for age ± 5, gender, left ventricle EF ± 5, peakVO 2 ± 3 (ml/min/kg) and recruiting center. Results A total of 3447 patients (SR = 2882, AF = 565) were included in the study. Considering the entire population, CV death and HTX occurred in 114 (20%) AF vs. 471 (16%) SR (p = 0.026) and all-cause death in 130 (23%) AF vs. 554 (19.2%) SR patients (p = 0.039). At univariable Cox analysis, AF was significantly related to prognosis. Applying a multivariable model based on all variables significant at univariable analysis (EF, peakVO 2 , ventilation/carbon dioxide relationship slope, sodium, kidney function, hemoglobin, beta-blockers and digoxin) AF was no longer associated with adverse outcomes. Matching procedure resulted in 338 couples. CV death and HTX occurred in 63 (18.6%) AF vs. 74 (21.9%) SR (p = 0.293) and all-cause death in 71 (21%) AF vs. 80 (23.6%) SR (p = 0.406), with no survival differences between groups. Conclusion In systolic HF AF is a marker of disease severity but not an independent prognostic indicator.
- Published
- 2015
129. Deceptive meaning of oxygen uptake measured at the anaerobic threshold in patients with systolic heart failure and atrial fibrillation
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Damiano, Magrì, Piergiuseppe, Agostoni, Ugo, Corrà, Claudio, Passino, Domenico, Scrutinio, Pasquale, Perrone-Filardi, Michele, Correale, Gaia, Cattadori, Marco, Metra, Davide, Girola, Massimo F, Piepoli, AnnaMaria, Iorio, Michele, Emdin, Rosa, Raimondo, Federica, Re, Mariantonietta, Cicoira, Romualdo, Belardinelli, Marco, Guazzi, Giuseppe, Limongelli, Francesco, Clemenza, Gianfranco, Parati, Maria, Frigerio, Matteo, Casenghi, Angela B, Scardovi, Alessandro, Ferraironi, Andrea, Di Lenarda, Maurizio, Bussotti, Anna, Apostolo, Stefania, Paolillo, Rocco, La Gioia, Paola, Gargiulo, Pietro, Palermo, Chiara, Minà, Stefania, Farina, Elisa, Battaia, Antonello, Maruotti, Giuseppe, Pacileo, Mauro, Contini, Fabrizio, Oliva, Roberto, Ricci, Gianfranco, Sinagra, Corrado, Vassanelli, Magrì, D, Agostoni, P, Corrà, U, Passino, C, Scrutinio, D, Perrone Filardi, P, Correale, M, Cattadori, G, Metra, M, Girola, D, Piepoli, M, Iorio, A, Emdin, M, Raimondo, R, Re, F, Cicoira, M, Belardinelli, R, Guazzi, M, Limongelli, G, Clemenza, F, Parati, G, Frigerio, M, Casenghi, M, Scardovi, A, Ferraironi, A, Di Lenarda, A, Bussotti, M, Apostolo, A, Paolillo, S, La Gioia, R, Gargiulo, P, Palermo, P, Minà, C, Farina, S, Battaia, E, Maruotti, A, Pacileo, G, Contini, M, Oliva, F, Ricci, R, Sinagra, G, Magrì, Damiano, Agostoni, Piergiuseppe, Corrà, Ugo, Passino, Claudio, Scrutinio, Domenico, Perrone Filardi, Pasquale, Correale, Michele, Cattadori, Gaia, Metra, Marco, Girola, Davide, Piepoli, Massimo F., Iorio, Annamaria, Emdin, Michele, Raimondo, Rosa, Re, Federica, Cicoira, Mariantonietta, Belardinelli, Romualdo, Guazzi, Marco, Limongelli, Giuseppe, Clemenza, Francesco, Parati, Gianfranco, Frigerio, Maria, Casenghi, Matteo, Scardovi, Angela B., Ferraironi, Alessandro, DI LENARDA, Andrea, Bussotti, Maurizio, Apostolo, Anna, Paolillo, Stefania, La Gioia, Rocco, Gargiulo, Paola, Palermo, Pietro, Minà, Chiara, Farina, Stefania, Battaia, Elisa, Maruotti, Antonello, Pacileo, Giuseppe, Contini, Mauro, Oliva, Fabrizio, Ricci, Roberto, Sinagra, Gianfranco, PERRONE FILARDI, Pasquale, Piepoli, Massimo F, Scardovi, Angela B, Di Lenarda, Andrea, Magri', D, Corra', U, PERRONE FILARDI, P, Correal, M, Piepoli, Mf, Iorio, Am, Raimonod, R, Cicoria, M, Scardovi, Ab, DI LENARDA, A, LA GIOIA, R, Mina', C, and Sinagra, G.
- Subjects
Male ,Time Factors ,Digoxin ,Anaerobic Threshold ,Epidemiology ,medicine.medical_treatment ,Heart failure ,anaerobic threshold ,atrial fibrillation ,exercise ,prognosis ,Predictive Value of Test ,Kaplan-Meier Estimate ,Risk Factors ,Atrial Fibrillation ,Sinus rhythm ,Prospective Studies ,Multivariate Analysi ,Heart transplantation ,Ejection fraction ,Cardiology and Cardiovascular Medicine ,Atrial fibrillation ,Middle Aged ,Prognosis ,Italy ,Area Under Curve ,Cardiology ,Female ,Anaerobic exercise ,prognosi ,medicine.drug ,Human ,medicine.medical_specialty ,Time Factor ,Prognosi ,Reproducibility of Result ,Oxygen Consumption ,Predictive Value of Tests ,Internal medicine ,Aged ,Heart Failure, Systolic ,Heart Transplantation ,Humans ,Multivariate Analysis ,Proportional Hazards Models ,ROC Curve ,Reproducibility of Results ,Exercise Test ,medicine ,business.industry ,Risk Factor ,medicine.disease ,Transplantation ,Prospective Studie ,Proportional Hazards Model ,business ,Systolic - Abstract
Background: Oxygen uptake at the anaerobic threshold (VO 2 AT), a submaximal exercise-derived variable, independent of patients' motivation, is a marker of outcome in heart failure (HF). However, previous evidence of VO 2 AT values paradoxically higher in HF patients with permanent atrial fibrillation (AF) than in those with sinus rhythm (SR) raised uncertainties. Design: We tested the prognostic role of VO 2 AT in a large cohort of systolic HF patients, focusing on possible differences between SR and AF. Methods: Altogether 2976 HF patients (2578 with SR and 398 with AF) were prospectively followed. Besides a clinical examination, each patient underwent a maximal cardiopulmonary exercise test (CPET). Results: The follow-up was analysed for up to 1500 days. Cardiovascular death or urgent cardiac transplantation occurred in 303 patients (250 (9.6%) patients with SR and 53 (13.3%) patients with AF, p=0.023). In the entire population, multivariate analysis including peak oxygen uptake (VO 2 ) showed a prognostic capacity (C-index) similar to that obtained including VO 2 AT (0.76 vs 0.72). Also, left ventricular ejection fraction, ventilation vs carbon dioxide production slope, β-blocker and digoxin therapy proved to be significant prognostic indexes. The receiver-operating characteristic (ROC) curves analysis showed that the best predictive VO 2 AT cut-off for the SR group was 11.7 ml/kg/min, while it was 12.8 ml/kg/min for the AF group. Conclusions: VO 2 AT, a submaximal CPET-derived parameter, is reliable for long-term cardiovascular mortality prognostication in stable systolic HF. However, different VO 2 AT cut-off values between SR and AF HF patients should be adopted.
- Published
- 2015
130. Cardiac rehabilitation for old-old patients with heart failure and severe functional impairment.
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Scrutinio D, Guida P, Carbonara R, and Passantino A
- Abstract
Background: The effects of cardiac rehabilitation (CR) in old patients with heart failure (HF) and severe functional impairment (SFI) are not well established., Methods: We studied 1397 patients with HF and severe functional impairment, defined as a six-minute walking distance (6MWD) <300 m, admitted to inpatient CR. The patients were divided into three groups: Group A (young, ≤65 years), Group B (old-young, 66 to 75 years), and Group C (old-old, >75 years). The primary outcome was an increase in 6MWD to 300 m or more after CR. We used multivariable Cox modeling to determine the association of the primary outcome with three-year mortality after discharge from CR., Results: At admission to CR, 38.5 % of the patients in group A, 40.0 % in group B, and 46.3 % in group C (p = .029) were unable to walk unassisted. Of these patients, 29.5 %, 32.6 %, and 30.2 % (p = .835), respectively, regained the ability to walk independently. Overall, 370 (26.5 %) patients achieved the primary outcome, 49.1 % in group A, 32.2 % in group B, and 15.7 % in group C (p < .001). The adjusted HR of 3-year mortality for the patients who achieved the primary outcome was 0.53 (95 %CI 0.34-0.83; p = .005) in group A, 0.49 (95 %CI 0.33-0.74; p = .001) in group B, and 0.68 (95 %CI 0.47-0.98; p = .037) in group C., Conclusions: Our findings suggest that old-old patients with HF and severe functional impairment may benefit from CR and that functional improvement may predict improved survival., Competing Interests: Declaration of competing interest None declared., (Copyright © 2024. Published by Elsevier B.V.)
- Published
- 2024
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131. Functional limitation predicts mortality in heart failure with preserved ejection fraction.
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Scrutinio D, Guida P, and Passantino A
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Background: While the prognostic value of six-minute walking test (6MWT) in patients with heart failure (HF) and reduced ejection fraction has been firmly established, there are few or no data correlating the distance walked during 6MWT (6MWD) with mortality in patients with HF with preserved ejection fraction (HFpEF) METHODS: We studied 482 patients with HFpEF who had been admitted to inpatients cardiac rehabilitation. The primary outcome was 3-year all-cause mortality. The association between 6MWD and the primary outcome was assessed using multivariable models. Established risk markers were incorporated into the models., Results: 174 patients died during the 3-year follow-up. Taking the highest tertile of 6MWD (≥360 m) as reference, the adjusted hazard ratio (HR) of the primary outcome was 2.23 (95 % CI 1.31-3.78; p = .003) for the patients in the intermediate tertile (241-359 m) and 4.94 (95 % CI 2.90-8.39; p < .001) for those in the lowest tertile (≤240 m). The annual mortality rate was 25.0 % in the lowest tertile, 10.9 % in the intermediate tertile, and 5.3 % in the highest tertile. When the distance walked was normalized for age, sex, and body mass index and expressed as percent-of-predicted walking distance, the adjusted HR was 1.30 (95 % CI 0.76-2.22; p = .331) for the patients in the intermediate tertile (58.2 % to 77.6 %) and 3.52 (95 % CI 2.12-5.85; p < .001) for those in the lowest tertile (≤58.1 %)., Conclusions: Our findings suggest that measuring functional capacity by evaluating the distance that a patient can walk over a period of 6 min provides important prognostic information in HFpEF., Competing Interests: Declarations of competing interest The authors declare they have no conflict of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2024. Published by Elsevier B.V.)
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- 2024
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132. Diffuse idiopathic skeletal hyperostosis in subjects with congestive heart failure undergoing cardiac rehabilitation: A decision tree analysis.
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Ambrosino P, Scrutinio D, De Campi M, Miniero E, Formisano R, Spedicato GA, Iannuzzi GL, and Pappone N
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- Aged, Cohort Studies, Cross-Sectional Studies, Decision Trees, Female, Heart Failure pathology, Humans, Male, Risk Factors, Cardiac Rehabilitation methods, Heart Failure complications, Hyperostosis, Diffuse Idiopathic Skeletal etiology
- Abstract
Objective: To assess the prevalence of diffuse idiopathic skeletal hyperostosis and its relationship with vascular risk factors among patients with congestive heart failure., Design: Population-based cross-sectional study., Participants: A total of 584 consecutive patients admitted to a Rehabilitative Cardiology Unit., Methods: Chi-square Automatic Interaction Detector (CHAID) decision tree analysis was used to build a predictive model., Results: The mean age (standard deviation) of the study population was 68.1 years (standard deviation 12.3), and 77.7% of the subjects were men. The overall prevalence of diffuse idiopathic skeletal hyperostosis in the cohort was 49.8%. Logistic regression analysis showed that age was a predictor of diffuse idiopathic skeletal hyperostosis (odds ratio: 1.034; 95% confidence interval 1.021-1.047, p < 0.001), with increasing odds ratios for increasing age tertiles. The CHAID prediction model identified 2 age "buckets": < 69 and ≥ 69 years. Patients ≥ 69 years had a diffuse idiopathic skeletal hyperostosis prevalence of 60.1%, compared with 39.2% among those < 69 years. Notably, body mass index was a predictor of diffuse idiopathic skeletal hyperostosis in this younger subset of patients (p = 0.028), with 2 body mass index "buckets", ≤ 23.3 and > 23.3 kg/m2, the latter showing more than twice the prevalence of diffuse idiopathic skeletal hyperostosis (43.2% vs 20%)., Conclusion: Diffuse idiopathic skeletal hyperostosis is extremely frequent among patients with congestive heart failure, with age and body mass index being the strongest predictors.
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- 2020
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133. Gender and age normalization and ventilation efficiency during exercise in heart failure with reduced ejection fraction.
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Salvioni E, Corrà U, Piepoli M, Rovai S, Correale M, Paolillo S, Pasquali M, Magrì D, Vitale G, Fusini L, Mapelli M, Vignati C, Lagioia R, Raimondo R, Sinagra G, Boggio F, Cangiano L, Gallo G, Magini A, Contini M, Palermo P, Apostolo A, Pezzuto B, Bonomi A, Scardovi AB, Filardi PP, Limongelli G, Metra M, Scrutinio D, Emdin M, Piccioli L, Lombardi C, Cattadori G, Parati G, Caravita S, Re F, Cicoira M, Frigerio M, Clemenza F, Bussotti M, Battaia E, Guazzi M, Bandera F, Badagliacca R, Di Lenarda A, Pacileo G, Passino C, Sciomer S, Ambrosio G, and Agostoni P
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- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Exercise Test, Female, Follow-Up Studies, Heart Failure diagnosis, Heart Failure physiopathology, Humans, Italy epidemiology, Male, Middle Aged, Morbidity trends, Prognosis, Retrospective Studies, Sex Factors, Young Adult, Exercise physiology, Forecasting, Heart Failure epidemiology, Lung physiopathology, Oxygen Consumption physiology, Stroke Volume physiology, Ventricular Function, Left physiology
- Abstract
Aims: Ventilation vs. carbon dioxide production (VE/VCO
2 ) is among the strongest cardiopulmonary exercise testing prognostic parameters in heart failure (HF). It is usually reported as an absolute value. The current definition of normal VE/VCO2 slope values is inadequate, since it was built from small groups of subjects with a particularly limited number of women and elderly. We aimed to define VE/VCO2 slope prediction formulas in a sizable population and to test whether the prognostic power of VE/VCO2 slope in HF was different if expressed as a percentage of the predicted value or as an absolute value., Methods and Results: We calculated the linear regressions between age and VE/VCO2 slope in 1136 healthy subjects (68% male, age 44.9 ± 14.5, range 13-83 years). We then applied age-adjusted and sex-adjusted formulas to predict VE/VCO2 slope to HF patients included in the metabolic exercise test data combined with cardiac and kidney indexes score database, which counts 6112 patients (82% male, age 61.4 ± 12.8, left ventricular ejection fraction 33.2 ± 10.5%, peakVO2 14.8 ± 4.9, mL/min/kg, VE/VCO2 slope 32.7 ± 7.7) from 24 HF centres. Finally, we evaluated whether the use of absolute values vs. percentages of predicted VE/VCO2 affected HF prognosis prediction (composite of cardiovascular mortality + urgent transplant or left ventricular assist device). We did so in the entire cardiac and kidney indexes score population and separately in HF patients with severe (peakVO2 < 14 mL/min/kg, n = 2919, 61.1 events/1000 pts/year) or moderate (peakVO2 ≥ 14 mL/min/kg, n = 3183, 19.9 events/1000 pts/year) HF. In the healthy population, we obtained the following equations: female, VE/VCO2 = 0.052 × Age + 23.808 (r = 0.192); male, VE/VCO2 = 0.095 × Age + 20.227 (r = 0.371) (P = 0.007). We applied these formulas to calculate the percentages of predicted VE/VCO2 values. The 2-year survival prognostic power of VE/VCO2 slope was strong, and it was similar if expressed as absolute value or as a percentage of predicted value (AUCs 0.686 and 0.690, respectively). In contrast, in severe HF patients, AUCs significantly differed between absolute values (0.637) and percentages of predicted values (0.650, P = 0.0026). Moreover, VE/VCO2 slope expressed as a percentage of predicted value allowed to reclassify 6.6% of peakVO2 < 14 mL/min/kg patients (net reclassification improvement = 0.066, P = 0.0015)., Conclusions: The percentage of predicted VE/VCO2 slope value strengthens the prognostic power of VE/VCO2 in severe HF patients, and it should be preferred over the absolute value for HF prognostication. Furthermore, the widespread use of VE/VCO2 slope expressed as percentage of predicted value can improve our ability to identify HF patients at high risk, which is a goal of utmost clinical relevance., (© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)- Published
- 2020
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134. [Rehabilitation medicine and appropriateness criteria: between chronicity, multi-morbidity and complexity].
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Scrutinio D and Carone M
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- Aging, Health Services Needs and Demand trends, Humans, Italy, Rehabilitation trends, Disabled Persons, Health Services Accessibility, Rehabilitation organization & administration
- Abstract
Summary: In the last two decades, population aging has led to a substantial increase in the number of people living with moderate-to-severe disability and, consequently, an increased demand for rehabilitation care. It is estimated that, currently, 2.8 million people live with severe disability in Italy. Although greater access to rehabilitation care is required to meet the needs of disabled patients, the capacity to provide rehabilitation has not changed over the last years and fails to meet current rehabilitation needs. Efforts should be devoted for aligning the capacity to provide rehabilitation care to the increased demand for rehabilitation care., Competing Interests: The authors of this article have no conflict of interests to disclose., (Copyright© by Aracne Editrice, Roma, Italy.)
- Published
- 2019
135. [Palliative care in the cardiac setting: a consensus document of the Italian Society of Cardiology/Italian Society of Palliative Care (SIC/SICP)].
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Antonione R, Sinagra G, Moroni M, Correale M, Redaelli D, Scrutinio D, Malinverni E, Nodari S, Calabrò R, Penco I, and Mercuro G
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- Advance Care Planning, Communication, Decision Making, Heart Failure physiopathology, Humans, Terminal Care methods, Heart Failure therapy, Palliative Care methods, Quality of Life
- Abstract
Palliative care is recognized as an approach that improves quality of life of patients and families facing life-threatening illnesses. This is achieved through prevention, early identification, assessment and treatment of symptoms and other psycho-social, spiritual and economic issues. Palliative care is not dependent on prognosis and can be delivered as "simultaneous care", together with disease-modifying treatments and adequate symptom relief. Palliative care relies on coordination across settings of care and offers open communication to patients and caregivers. Recently, there is increasing interest in the potential role of palliative care in refractory, advanced heart failure treated with optimal, maximized therapy.Heart failure is a chronic progressive syndrome characterized by periods of stability interrupted by acute exacerbations, usually leading to reduced functional status. It accounts for approximately one-third of deaths in industrialized countries and is a common cause of hospitalization. Fifty percent of patients with advanced heart failure die within 1 year of diagnosis and 50% of the remainder within 5 years. The trajectory of heart failure is often unpredictable and approximately 30% to 50% of patients die suddenly. Patients with heart failure suffer from numerous symptoms, often resistant to conventional treatments, frequently under-recognized and under-treated. Symptom assessment and control improve quality of life in patients with advanced heart failure; this can be managed at best by collaboration between specialistic teams.Although heart failure is a life-shortening condition, therapeutic and technological advances (such as left ventricular assist devices, coronary revascularization, percutaneous valve implantation, and implantable cardioverter defibrillators) can help healthcare professionals in the management of patients with advanced heart failure, improving global condition and reducing the risk of sudden death. On the other hand, it has to be acknowledged that management of cardiovascular implanted electronic devices towards end of life requires awareness of legal, ethical, religious principles regarding potential withdrawal of life-sustaining therapies.Adequate communication with patients regarding adverse events, end of life, benefits vs burdens of therapies and interventions, treatment preferences, and decision-making should be an issue in early stages of disease. The process of advanced care planning should be clearly documented and regularly reviewed.Barriers to the provision of palliative care in heart failure include clinical issues (disease trajectory), prognostic uncertainty, failure in identification of patients who need palliative care and timing of referral to specialist services, but also misconceptions of patients, families and sanitary staff regarding the role of palliative care, organization problems, and finally educational and time issues.This document focuses on the need of further, coordinated research and work-out on: (i) identification of heart failure patients eligible for palliative care, in terms of clinical and social-psychological issues, (ii) identification of trigger events and timing of referral; (iii) identification of adequate performance indicators/scales for measurement, assessment and follow-up of symptoms and quality of life in end-stage heart failure, including patient-reported outcome measures; (iv) treatment, care and organization strategies and models for advanced/end-stage heart failure ("care management"); and (v) implementation of knowledge and education of healthcare professionals in the fields of communication, ethics, and advanced care planning in heart failure.
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- 2019
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136. Multiparametric prognostic scores in chronic heart failure with reduced ejection fraction: a long-term comparison.
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Agostoni P, Paolillo S, Mapelli M, Gentile P, Salvioni E, Veglia F, Bonomi A, Corrà U, Lagioia R, Limongelli G, Sinagra G, Cattadori G, Scardovi AB, Metra M, Carubelli V, Scrutinio D, Raimondo R, Emdin M, Piepoli M, Magrì D, Parati G, Caravita S, Re F, Cicoira M, Minà C, Correale M, Frigerio M, Bussotti M, Oliva F, Battaia E, Belardinelli R, Mezzani A, Pastormerlo L, Guazzi M, Badagliacca R, Di Lenarda A, Passino C, Sciomer S, Zambon E, Pacileo G, Ricci R, Apostolo A, Palermo P, Contini M, Clemenza F, Marchese G, Gargiulo P, Binno S, Lombardi C, Passantino A, and Filardi PP
- Subjects
- Cause of Death trends, Exercise Test, Female, Follow-Up Studies, Heart Failure physiopathology, Heart Failure surgery, Heart Transplantation, Heart-Assist Devices, Humans, Italy epidemiology, Male, Middle Aged, Morbidity trends, Oxygen Consumption, Prognosis, Prospective Studies, Reproducibility of Results, Survival Rate trends, Time Factors, Disease Management, Heart Failure epidemiology, Risk Assessment, Stroke Volume physiology
- Abstract
Aims: Risk stratification in heart failure (HF) is crucial for clinical and therapeutic management. A multiparametric approach is the best method to stratify prognosis. In 2012, the Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score was proposed to assess the risk of cardiovascular mortality and urgent heart transplantation. The aim of the present study was to compare the prognostic accuracy of MECKI score to that of HF Survival Score (HFSS) and Seattle HF Model (SHFM) in a large, multicentre cohort of HF patients with reduced ejection fraction., Methods and Results: We collected data on 6112 HF patients and compared the prognostic accuracy of MECKI score, HFSS, and SHFM at 2- and 4-year follow-up for the combined endpoint of cardiovascular death, urgent cardiac transplantation, or ventricular assist device implantation. Patients were followed up for a median of 3.67 years, and 931 cardiovascular deaths, 160 urgent heart transplantations, and 12 ventricular assist device implantations were recorded. At 2-year follow-up, the prognostic accuracy of MECKI score was significantly superior [area under the curve (AUC) 0.781] to that of SHFM (AUC 0.739) and HFSS (AUC 0.723), and this relationship was also confirmed at 4 years (AUC 0.764, 0.725, and 0.720, respectively)., Conclusion: In this cohort, the prognostic accuracy of the MECKI score was superior to that of HFSS and SHFM at 2- and 4-year follow-up in HF patients in stable clinical condition. The MECKI score may be useful to improve resource allocation and patient outcome, but prospective evaluation is needed., (© 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.)
- Published
- 2018
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137. [The SOCRATES-REDUCED study].
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Scrutinio D, Di Lenarda A, and Cherubini A
- Published
- 2017
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138. Predicting mortality in patients with acute heart failure: Role of risk scores.
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Passantino A, Monitillo F, Iacoviello M, and Scrutinio D
- Abstract
Acute heart failure is a leading cause of hospitalization and death, and it is an increasing burden on health care systems. The correct risk stratification of patients could improve clinical outcome and resources allocation, avoiding the overtreatment of low-risk subjects or the early, inappropriate discharge of high-risk patients. Many clinical scores have been derived and validated for in-hospital and post-discharge survival; predictive models include demographic, clinical, hemodynamic and laboratory variables. Data sets are derived from public registries, clinical trials, and retrospective data. Most models show a good capacity to discriminate patients who reach major clinical end-points, with C-indices generally higher than 0.70, but their applicability in real-world populations has been seldom evaluated. No study has evaluated if the use of risk score-based stratification might improve patient outcome. Some variables (age, blood pressure, sodium concentration, renal function) recur in most scores and should always be considered when evaluating the risk of an individual patient hospitalized for acute heart failure. Future studies will evaluate the emerging role of plasma biomarkers.
- Published
- 2015
- Full Text
- View/download PDF
139. Renal function and peak exercise oxygen consumption in chronic heart failure with reduced left ventricular ejection fraction.
- Author
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Scrutinio D, Agostoni P, Gesualdo L, Corrà U, Mezzani A, Piepoli M, Di Lenarda A, Iorio A, Passino C, Magrì D, Masarone D, Battaia E, Girola D, Re F, Cattadori G, Parati G, Sinagra G, Villani GQ, Limongelli G, Pacileo G, Guazzi M, Metra M, Frigerio M, Cicoira M, Minà C, Malfatto G, Caravita S, Bussotti M, Salvioni E, Veglia F, Correale M, Scardovi AB, Emdin M, Giannuzzi P, Gargiulo P, Giovannardi M, Perrone-Filardi P, Raimondo R, Ricci R, Paolillo S, Farina S, Belardinelli R, Passantino A, and La Gioia R
- Subjects
- Adult, Aged, Chronic Disease, Female, Follow-Up Studies, Humans, Kidney Function Tests, Male, Middle Aged, Exercise, Heart Failure complications, Heart Failure metabolism, Heart Failure physiopathology, Kidney Diseases etiology, Kidney Diseases mortality, Kidney Diseases physiopathology, Oxygen Consumption, Stroke Volume
- Abstract
Background: Chronic kidney disease is associated with sympathetic activation and muscle abnormalities, which may contribute to decreased exercise capacity. We investigated the correlation of renal function with peak exercise oxygen consumption (V̇O2) in heart failure (HF) patients. METHODS AND RESULTS: We recruited 2,938 systolic HF patients who underwent clinical, laboratory, echocardiographic and cardiopulmonary exercise testing. The patients were stratified according to estimated glomerular filtration rate (eGFR). Mean follow-up was 3.7 years. The primary outcome was a composite of cardiovascular death and urgent heart transplantation at 3 years. On multivariable regression, eGFR was predictor of peakV̇O2(P<0.0001). Other predictors were age, sex, body mass index, HF etiology, NYHA class, atrial fibrillation, resting heart rate, B-type natriuretic peptide, hemoglobin, and treatment. After adjusting for significant covariates, the hazard ratio for primary outcome associated with peakV̇O2<12 ml·kg(-1)·min(-1)was 1.75 (95% confidence interval (CI): 1.06-2.91; P=0.0292) in patients with eGFR ≥60, 1.77 (0.87-3.61; P=0.1141) in those with eGFR of 45-59, and 2.72 (1.01-7.37; P=0.0489) in those with eGFR <45 ml·min(-1)·1.73 m(-2). The area under the receiver-operating characteristic curve for peakV̇O2<12 ml·kg(-1)·min(-1)was 0.63 (95% CI: 0.54-0.71), 0.67 (0.56-0.78), and 0.57 (0.47-0.69), respectively. Testing for interaction was not significant., Conclusions: Renal dysfunction is correlated with peakV̇O2. A peakV̇O2cutoff of 12 ml·kg(-1)·min(-1)offers limited prognostic information in HF patients with more severely impaired renal function.
- Published
- 2015
- Full Text
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140. Exercise Performance Is a Prognostic Indicator in Elderly Patients With Chronic Heart Failure--Application of Metabolic Exercise Cardiac Kidney Indexes Score.
- Author
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Carubelli V, Metra M, Corrà U, Magrì D, Passino C, Lombardi C, Scrutinio D, Correale M, Cattadori G, Piepoli MF, Salvioni E, Giovannardi M, Raimondo R, Cicoira M, Belardinelli R, Guazzi M, Limongelli G, Clemenza F, Parati G, Scardovi AB, Di Lenarda A, Bussotti M, La Gioia R, and Agostoni P
- Subjects
- Adrenergic beta-Antagonists administration & dosage, Adult, Age Factors, Aged, Chronic Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Oxygen blood, Sodium blood, Databases, Factual, Exercise Therapy, Heart Failure, Systolic blood, Heart Failure, Systolic physiopathology, Heart Failure, Systolic therapy, Kidney metabolism, Kidney physiopathology, Organ Dysfunction Scores, Stroke Volume
- Abstract
Background: In patients with chronic heart failure (HF) the Metabolic Exercise Cardiac Kidney Indexes (MECKI) score, is a predictor of cardiovascular death and urgent heart transplantation. We investigated the relationship between age, exercise tolerance and the prognostic value of the MECKI score., Methods and results: We analyzed data from 3,794 patients with chronic systolic HF. The primary endpoint was a composite of cardiovascular death and urgent heart transplantation. Older patients had higher prevalence of comorbidities and lower exercise performance compared with younger subjects (peak V̇O2, 925 vs. 1,351 L/min; P<0.0001; V̇E/V̇CO2slope, 33.2 vs. 28.3; P>0.0001). The rate of the primary endpoint was 19% in the highest age quartile and 14% in the lowest quartile. At multivariable analysis, the independent predictors of the primary endpoint were left ventricular ejection fraction (LVEF), eGFR, peak V̇O2, serum Na(+)and the use of β-blockers in patients aged ≥70 years, and LVEF, eGFR and peak V̇O2in younger subjects. The MECKI risk score increased across age subgroups, but on receiver operating characteristic curve analysis its prognostic power was similar in both patients aged ≥70 and <70 years., Conclusions: Older patients with HF are a high-risk population with lower exercise performance. The MECKI score increased according to age and maintained its prognostic value also in older patients.
- Published
- 2015
- Full Text
- View/download PDF
141. The ADHF/NT-proBNP risk score to predict 1-year mortality in hospitalized patients with advanced decompensated heart failure.
- Author
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Scrutinio D, Ammirati E, Guida P, Passantino A, Raimondo R, Guida V, Sarzi Braga S, Canova P, Mastropasqua F, Frigerio M, Lagioia R, and Oliva F
- Subjects
- Aged, Cardiotonic Agents administration & dosage, Disease Progression, Diuretics administration & dosage, Female, Follow-Up Studies, Heart Failure therapy, Heart Transplantation, Heart-Assist Devices, Humans, Infusions, Intravenous, Italy, Male, Middle Aged, Predictive Value of Tests, Proportional Hazards Models, Survival Analysis, Ventricular Dysfunction, Left diagnosis, Ventricular Dysfunction, Left mortality, Ventricular Dysfunction, Left therapy, Heart Failure blood, Heart Failure mortality, Hospitalization, Natriuretic Peptide, Brain blood, Peptide Fragments blood
- Abstract
Background: The acute decompensated heart failure/N-terminal pro-B-type natriuretic peptide (ADHF/NT-proBNP) score is a validated risk scoring system that predicts mortality in hospitalized heart failure patients with a wide range of left ventricular ejection fractions (LVEFs). We sought to assess discrimination and calibration of the score when applied to patients with advanced decompensated heart failure (AHF)., Methods: We studied 445 patients hospitalized for AHF, defined by the presence of severe symptoms of worsening HF at admission, severely depressed LVEF, and the need for intravenous diuretic and/or inotropic drugs. The primary outcome was cumulative (in-hospital and post-discharge) mortality and post-discharge 1-year mortality. Separate analyses were performed for patients aged ≤ 70 years. A Seattle Heart Failure Score (SHFS) was calculated for each patient discharged alive., Results: During follow-up, 144 patients (32.4%) died, and 69 (15.5%) underwent heart transplantation (HT) or ventricular assist device (VAD) implantation. After accounting for the competing events (VAD/HT), the ADHF/NT-proBNP score's C-statistic for cumulative mortality was 0.738 in the overall cohort and 0.771 in patients aged ≤ 70 years. The C-statistic for post-discharge mortality was 0.741 and 0.751, respectively. Adding prior (≤6 months) hospitalizations for HF to the score increased the C-statistic for post-discharge mortality to 0.759 in the overall cohort and to 0.774 in patients aged ≤ 70 years. Predicted and observed mortality rates by quartiles of score were highly correlated. The SHFS demonstrated adequate discrimination but underestimated the risk. The ADHF/NT-proBNP risk calculator is available at http://www.fsm.it/fsm/file/NTproBNPscore.zip., Conclusions: Our data suggest that the ADHF/NT-proBNP score may efficiently predict mortality in patients hospitalized with AHF., (Copyright © 2014 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
142. [Italian guidelines on cardiac rehabilitation and secondary prevention of cardiovascular disease: executive summary].
- Author
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Griffo R, Urbinati S, Giannuzzi P, Jesi AP, Sommaruga M, Sagliocca L, Bianco E, Tassoni G, Iannucci M, Sanges D, Baldi C, Rociola R, Carbonelli MG, Familiari MG, Cristinziani GR, Amari C, Richichi I, Alessandrini F, Mordenti F, Mauro B, Mozzetta S, Miglioretti M, Buchberger R, Cammarano R, Sampaolo L, Pellegrini L, Rusticali B, Mele A, Ceci V, Chieffo C, Bolognese L, Schweiger C, Michielin P, Baglio G, Nobile A, Scrutinio D, and Vigorito C
- Subjects
- Adult, Aged, Exercise, Female, Follow-Up Studies, Heart Diseases psychology, Heart Diseases therapy, Humans, Italy, Life Style, Male, Meta-Analysis as Topic, Myocardial Infarction rehabilitation, Patient Satisfaction, Primary Health Care, Psychotherapy, Quality of Life, Randomized Controlled Trials as Topic, Risk Factors, Surveys and Questionnaires, World Health Organization, Cardiovascular Diseases prevention & control, Heart Diseases rehabilitation, Practice Guidelines as Topic
- Published
- 2008
143. [Role of professional nurses in the management of patients with chronic heart failure in cardiac rehabilitation].
- Author
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Cirrottola F and Scrutinio D
- Subjects
- Disease Management, Humans, Patient Education as Topic, Heart Failure nursing, Heart Failure rehabilitation
- Abstract
On the basis of the results of pathophysiological and controlled clinical studies, cardiac rehabilitation is now recognized as an effective therapeutic intervention in patients with chronic heart failure (CHF). Achieving clinical stability, optimizing medical therapy, education and counseling regarding lifestyle changes, implementing an exercise training programme, and ensuring an adequate follow-up are the core components of cardiac rehabilitation in CHF. Cardiologists, nurses, physiotherapists, psychologists, and dietitians, all aim at the achievement of such objectives. Education and counseling of patients with CHF are essential aspects of patient care as they can improve the clinical and functional outcome of such patients. In this setting, specially trained nurses may play a pivotal role. An organized plan of patient education and counseling should include explanation of the disease and dietary and exercise regimen recommendations; in addition, the patients should be taught the name of each drug and its purpose, dosage, frequency, and significant side effects.
- Published
- 2003
144. The role of dobutamine stress echocardiography in idiopathic dilated cardiomyopathy.
- Author
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Scrutinio D, Napoli VF, Ricci A, and Rizzon P
- Subjects
- Cardiomyopathy, Dilated physiopathology, Humans, Prognosis, Cardiomyopathy, Dilated diagnostic imaging, Echocardiography, Stress, Myocardial Contraction physiology, Ventricular Function, Left physiology
- Abstract
In patients with chronic heart failure, myocardial contractile responsiveness to dobutamine is diminished as a result of beta-receptor desensitization due to chronic adrenergic activation. Changes in beta-receptor effector mechanisms are more marked in idiopathic dilated cardiomyopathy (IDCM) than in ischemic dilated cardiomyopathy. As the magnitude of the dobutamine effect is proportional to the severity of left ventricular systolic dysfunction, the heterogeneous cardiotonic effects of dobutamine in IDCM may represent different evolutive stages of a progressive disease process. On the basis of this pathophysiologic background, some studies were undertaken to investigate the prognostic and functional implications of dobutamine stress echocardiography (DSE) in IDCM. Prognostic studies consistently suggest that myocardial response to dobutamine is related to the clinical outcome. However, the limited number of patients and events in the individual studies are important limitations. Moreover, the impact of beta-blockers on the potential ability of DSE to predict the prognosis needs to be assessed. A few studies also suggest that changes in left ventricular systolic function parameters following dobutamine infusion are related to exercise tolerance, as assessed by peak exercise oxygen consumption and functional recovery of the failing myocardium. The data suggest that DSE is a promising method, which may improve the risk stratification process in patients with IDCM and provide further insights into the pathophysiologic mechanisms underlying progressive systolic pump dysfunction and exercise intolerance. Further studies are however needed to define the role of DSE in IDCM.
- Published
- 2002
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