Search

Your search keyword '"AMARELLI C"' showing total 260 results
Start Over Author "AMARELLI C"
260 results on '"AMARELLI C"'

1. SGLT2 Inhibitors in Patients with Advanced Heart Failure Awaiting Heart Transplant: Preliminary Results from The SGLT2i-HT Study

Author

Gallone, G., primary, Pidello, S., additional, Bertarelli, E., additional, Tedeschi, A., additional, Maione, D., additional, Cacioli, G., additional, Pradegan, N., additional, Tessari, C., additional, Di Nora, C., additional, Verde, A., additional, Perna, E., additional, Raineri, C., additional, Marro, M., additional, Simonato, E., additional, Breviario, F., additional, Cavallier, F., additional, Amarelli, C., additional, Turco, A., additional, Vendramin, I., additional, Gerosa, G., additional, Scelsi, L., additional, Lilla Della Monica, P., additional, Sinagra, G., additional, Garascia, A., additional, Merlo, M., additional, Rinaldi, M., additional, De Ferrari, G.M., additional, and Boffini, M., additional

Published
2024
Full Text
View/download PDF

6. Progressive right ventricular dysfunction and exercise impairment in patients with heart failure and diabetes mellitus: insights from the T.O.S.CA. Registry

Author

Salzano, A, D'Assante, R, Iacoviello, M, Triggiani, V, Rengo, G, Cacciatore, F, Maiello, C, Limongelli, G, Masarone, D, Sciacqua, A, Perrone Filardi, P, Mancini, A, Volterrani, M, Vriz, O, Castello, R, Passantino, A, Campo, M, Modesti, Pa, De Giorgi, A, Arcopinto, M, Gargiulo, P, Perticone, M, Colao, A, Milano, S, Garavaglia, A, Napoli, R, Suzuki, T, Bossone, E, Marra, Am, Cittadini, A, Saccà, L, Monti, Mg, Matarazzo, M, Stagnaro, Fm, Piccioli, L, Lombardi, A, Panicara, V, Flora, M, Golia, L, Faga, V, Ruocco, A, Della Polla, D, Franco, R, Schiavo, A, Gigante, A, Spina, E, Sicuranza, M, Monaco, F, Apicella, M, Miele, C, Campanino, Ag, Mazza, L, Abete, R, Farro, A, Luciano, F, Polizzi, R, Ferrillo, G, De Luca, M, Crisci, G, Giardino, F, Barbato, M, Ranieri, B, Ferrara, F, Russo, V, Malinconico, M, Citro, R, Guastalamacchia, E, Leone, M, Giagulli, Va, Amarelli, C, Mattucci, I, Calabrò, P, Calabrò, R, D'Andrea, A, Maddaloni, V, Pacileo, G, Scarafile, R, Belfiore, A, Cimellaro, A, Casaretti, L, Paolillo, S, Favuzzi, Amr, Di Segni, C, Bruno, C, Vergani, E, Massaro, R, Grimaldi, F, Frigo, A, Sorrentino, Mr, Malandrino, D, Manfredini, R, Fabbian, F, Puzzo, A, Ragusa, L, Caliendo, L, Carbone, L, Frigiola, A, Generali, T, Giacomazzi, F, De Vincentiis, C, Ballotta, A, Garofalo, P, Malizia, G, Misiano, G, Israr, Mz, Bernieh, D, Cassambai, S, Yazaki, Y, Heaney, Lm, Eagle, Ka, Ventura, Ho, Bruzzese, D, Salzano, Andrea, D'Assante, Roberta, Iacoviello, Massimo, Triggiani, Vincenzo, Rengo, Giuseppe, Cacciatore, Francesco, Maiello, Ciro, Limongelli, Giuseppe, Masarone, Daniele, Sciacqua, Angela, Filardi, Pasquale Perrone, Mancini, Antonio, Volterrani, Maurizio, Vriz, Olga, Castello, Roberto, Passantino, Andrea, Campo, Michela, Modesti, Pietro A, De Giorgi, Alfredo, Arcopinto, Michele, Gargiulo, Paola, Perticone, Maria, Colao, Annamaria, Milano, Salvatore, Garavaglia, Agnese, Napoli, Raffaele, Suzuki, Toru, Bossone, Eduardo, Marra, Alberto M, Cittadini, Antonio, and Misiano, Gabriella

Subjects
Registrie, Heart Failure, Endocrinology, Diabetes and Metabolism, Ventricular Dysfunction, Right, Diabetes, Insulins, Socio-culturale, Stroke Volume, Insulin resistance, Diabete, Cardiopulmonary exercise test, Chronic heart failure, Diabetes, Insulin resistance, Right ventricle, TOSCA Registry, Chronic heart failure, Diabetes Mellitus, Type 2, TOSCA Registry, Exercise Test, Ventricular Function, Right, Humans, Insulin, Right ventricle, Registries, Cardiology and Cardiovascular Medicine, Cardiopulmonary exercise test, TOSCA, Human, LS4_7
Abstract

Background Findings from the T.O.S.CA. Registry recently reported that patients with concomitant chronic heart failure (CHF) and impairment of insulin axis (either insulin resistance—IR or diabetes mellitus—T2D) display increased morbidity and mortality. However, little information is available on the relative impact of IR and T2D on cardiac structure and function, cardiopulmonary performance, and their longitudinal changes in CHF. Methods Patients enrolled in the T.O.S.CA. Registry performed echocardiography and cardiopulmonary exercise test at baseline and at a patient-average follow-up of 36 months. Patients were divided into three groups based on the degree of insulin impairment: euglycemic without IR (EU), euglycemic with IR (IR), and T2D. Results Compared with EU and IR, T2D was associated with increased filling pressures (E/e′ratio: 15.9 ± 8.9, 12.0 ± 6.5, and 14.5 ± 8.1 respectively, p 2) in TD2 vs EU and IR patients was recorded (respectively, 15.8 ± 3.8 ml/Kg/min, 18.4 ± 4.3 ml/Kg/min and 16.5 ± 4.3 ml/Kg/min, p 2 in the T2D group (+ 13% increase in RV dimension, − 21% decline in TAPSE/PAPS ratio and − 20% decrease in peak VO2). Conclusion The higher risk of death and CV hospitalizations exhibited by HF-T2D patients in the T.O.S.CA. Registry is associated with progressive RV ventricular dysfunction and exercise impairment when compared to euglycemic CHF patients, supporting the pivotal importance of hyperglycaemia and right chambers in HF prognosis. Trial registration ClinicalTrials.gov identifier: NCT023358017

Published
2022

8. (1110) - SGLT2 Inhibitors in Patients with Advanced Heart Failure Awaiting Heart Transplant: Preliminary Results from The SGLT2i-HT Study

Author

Pidello, S., Bertarelli, E., Tedeschi, A., Maione, D., Cacioli, G., Pradegan, N., Tessari, C., Di Nora, C., Verde, A., Perna, E., Raineri, C., Marro, M., Simonato, E., Breviario, F., Cavallier, F., Amarelli, C., Turco, A., Vendramin, I., Gerosa, G., Scelsi, L., Lilla Della Monica, P., Sinagra, G., Garascia, A., Merlo, M., Rinaldi, M., De Ferrari, G.M., and Boffini, M.

Published
2024
Full Text
View/download PDF

9. Multiple hormonal and metabolic deficiency syndrome predicts outcome in heart failure: the T.O.S.CA. Registry

Author

Cittadini A., Salzano A., Iacoviello M., Triggiani V., Rengo G., Cacciatore F., Maiello C., Limongelli G., Masarone D., Perticone F., Cimellaro A., Filardi P. P., Paolillo S., Mancini A., Volterrani M., Vriz O., Castello R., Passantino A., Campo M., Modesti P. A., de Giorgi A., Monte I. P., Puzzo A., Ballotta A., D'Assante R., Arcopinto M., Gargiulo P., Sciacqua A., Bruzzese D., Colao A., Napoli R., Suzuki T., Eagle K. A., Ventura H. O., Marra A. M., Bossone E., Sacca L., Monti M. G., Matarazzo M., Stagnaro F. M., Piccioli L., Lombardi A., Panicara V., Flora M., Golia L., Faga V., Ruocco A., della Polla D., Franco R., Schiavo A., Gigante A., Spina E., Sicuranza M., Monaco F., Apicella M., Miele C., Campanino A. G., Mazza L., Abete R., Farro A., Luciano F., Polizzi R., Ferrillo G., de Luca M., Crisci G., Giardino F., Barbato M., Ranieri B., Ferrara F., Russo V., Malinconico M., Citro R., Guastalamacchia E., Leone M., Giagulli V. A., Amarelli C., Mattucci I., Calabro P., Calabro R., D'Andrea A., Maddaloni V., Pacileo G., Scarafile R., Belfiore A., Casaretti L., Favuzzi A. M. R., Di Segni C., Bruno C., Vergani E., Massaro R., Grimaldi F., Frigo A., Campo M. R., Sorrentino M. R., Malandrino D., Manfredini R., Fabbian F., Ragusa L., Caliendo L., Carbone L., Frigiola A., Generali T., Giacomazzi F., de Vincentiis C., Garofalo P., Malizia G., Milano S., Misiano G., Israr M. Z., Bernieh D., Cassambai S., Yazaki Y., Heaney L. M., Cittadini, Antonio, Salzano, Andrea, Iacoviello, Massimo, Triggiani, Vincenzo, Rengo, Giuseppe, Cacciatore, Francesco, Maiello, Ciro, Limongelli, Giuseppe, Masarone, Daniele, Perticone, Francesco, Cimellaro, Antonio, Perrone Filardi, Pasquale, Paolillo, Stefania, Mancini, Antonio, Volterrani, Maurizio, Vriz, Olga, Castello, Roberto, Passantino, Andrea, Campo, Michela, Modesti, Pietro A, De Giorgi, Alfredo, Monte, Ines P, Puzzo, Alfonso, Ballotta, Andrea, D'Assante, Roberta, Arcopinto, Michele, Gargiulo, Paola, Sciacqua, Angela, Bruzzese, Dario, Colao, Annamaria, Napoli, Raffaele, Suzuki, Toru, Eagle, Kim A, Ventura, Hector O, Marra, Alberto M, Bossone, Eduardo, Cittadini, A., Salzano, A., Iacoviello, M., Triggiani, V., Rengo, G., Cacciatore, F., Maiello, C., Limongelli, G., Masarone, D., Perticone, F., Cimellaro, A., Filardi, P. P., Paolillo, S., Mancini, A., Volterrani, M., Vriz, O., Castello, R., Passantino, A., Campo, M., Modesti, P. A., de Giorgi, A., Monte, I. P., Puzzo, A., Ballotta, A., D'Assante, R., Arcopinto, M., Gargiulo, P., Sciacqua, A., Bruzzese, D., Colao, A., Napoli, R., Suzuki, T., Eagle, K. A., Ventura, H. O., Marra, A. M., Bossone, E., Sacca, L., Monti, M. G., Matarazzo, M., Stagnaro, F. M., Piccioli, L., Lombardi, A., Panicara, V., Flora, M., Golia, L., Faga, V., Ruocco, A., della Polla, D., Franco, R., Schiavo, A., Gigante, A., Spina, E., Sicuranza, M., Monaco, F., Apicella, M., Miele, C., Campanino, A. G., Mazza, L., Abete, R., Farro, A., Luciano, F., Polizzi, R., Ferrillo, G., de Luca, M., Crisci, G., Giardino, F., Barbato, M., Ranieri, B., Ferrara, F., Russo, V., Malinconico, M., Citro, R., Guastalamacchia, E., Leone, M., Giagulli, V. A., Amarelli, C., Mattucci, I., Calabro, P., Calabro, R., D'Andrea, A., Maddaloni, V., Pacileo, G., Scarafile, R., Belfiore, A., Casaretti, L., Favuzzi, A. M. R., Di Segni, C., Bruno, C., Vergani, E., Massaro, R., Grimaldi, F., Frigo, A., Campo, M. R., Sorrentino, M. R., Malandrino, D., Manfredini, R., Fabbian, F., Ragusa, L., Caliendo, L., Carbone, L., Frigiola, A., Generali, T., Giacomazzi, F., de Vincentiis, C., Garofalo, P., Malizia, G., Milano, S., Misiano, G., Israr, M. Z., Bernieh, D., Cassambai, S., Yazaki, Y., and Heaney, L. M.

Subjects
medicine.medical_specialty, Multiple hormonal and metabolic deficiency syndrome, Epidemiology, Prognosi, Anabolic deficiency, Socio-culturale, Heart failure, 030204 cardiovascular system & hematology, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, Insulin resistance, Diabetes mellitus, Internal medicine, Multiple hormonal, medicine, Clinical endpoint, Humans, 030212 general & internal medicine, Prospective Studies, Registries, TOSCA, LS4_7, Ejection fraction, business.industry, Hazard ratio, Metabolic deficiency syndrome, Heart failure • Anabolic deficiency • Multiple hormonal and metabolic deficiency syndrome • Hormones • Prognosis • TOSCA, Stroke Volume, medicine.disease, Prognosis, Hormone, Confidence interval, Heart failure, Anabolic deficiency, Multiple hormonal and metabolic deficiency syndrome, Hormones, Prognosis, TOSCA, Hormones, Hospitalization, Observational study, Cardiology and Cardiovascular Medicine, business
Abstract

Aims Recent evidence supports the occurrence of multiple hormonal and metabolic deficiency syndrome (MHDS) in chronic heart failure (CHF). However, no large observational study has unequivocally demonstrated its impact on CHF progression and outcome. The T.O.S.CA. (Trattamento Ormonale nello Scompenso CArdiaco; Hormone Treatment in Heart Failure) Registry has been specifically designed to test the hypothesis that MHDS affects morbidity and mortality in CHF patients. Methods and Results The T.O.S.CA. Registry is a prospective, multicentre, observational study involving 19 Italian centres. Thyroid hormones, insulin-like growth factor-1, total testosterone, dehydropianoandrosterone sulfate, insulin resistance, and the presence of diabetes were evaluated. A MHDS was defined as the presence of ≥2 hormone deficiencies (HDs). Primary endpoint was a composite of all-cause mortality and cardiovascular hospitalizations. Four hundred and eighty heart failure patients with ejection fraction ≤45% were enrolled. MHDS or diabetes was diagnosed in 372 patients (77.5%). A total of 271 events (97 deaths and 174 cardiovascular hospitalizations) were recorded, 41% in NO-MHDS and 62% in MHDS (P Conclusion MHDS is common in CHF and independently associated with increased all-cause mortality and cardiovascular hospitalization, representing a promising therapeutic target. Trial registration ClinicalTrials.gov identifier: NCT023358017

Published
2021

10. Factors Influencing Access to Transplant, Waitlist Mortality, and Post-Transplant Survival in the Italian National Heart Transplant Database

Author

Frigerio, M, Varrenti, M, Santolamazza, C, Bernasconi, D, Costa, A, Oliveti, A, Puoti, F, Bottio, T, Gerosa, G, Russo, C, Giannattasio, C, Tursi, V, Livi, U, Maiello, C, Amarelli, C, Potena, L, Martin Suarez, S, Boffini, M, Pace Napoleone, C, Clemenza, F, Musumeci, F, Maccherini, M, Faggian, G, Pellegrini, C, Terzi, A, Tramontin, C, De Angelis, D, Milano, A, Valsecchi, M, Frigerio, M., Varrenti, M., Santolamazza, C., Bernasconi, D. P., Costa, A. Nanni, Oliveti, A., Puoti, F., Bottio, T., Gerosa, G., Russo, C. F., Giannattasio, C., Tursi, V., Livi, U., Maiello, C., Amarelli, C., Potena, L., Martin Suarez, S., Boffini, M., Pace Napoleone, C., Clemenza, F., Musumeci, F., Maccherini, M., Faggian, G., Pellegrini, C., Terzi, A., Tramontin, C., De Angelis, D., Milano, A. D., Valsecchi, M., Frigerio, M, Varrenti, M, Santolamazza, C, Bernasconi, D, Costa, A, Oliveti, A, Puoti, F, Bottio, T, Gerosa, G, Russo, C, Giannattasio, C, Tursi, V, Livi, U, Maiello, C, Amarelli, C, Potena, L, Martin Suarez, S, Boffini, M, Pace Napoleone, C, Clemenza, F, Musumeci, F, Maccherini, M, Faggian, G, Pellegrini, C, Terzi, A, Tramontin, C, De Angelis, D, Milano, A, Valsecchi, M, Frigerio, M., Varrenti, M., Santolamazza, C., Bernasconi, D. P., Costa, A. Nanni, Oliveti, A., Puoti, F., Bottio, T., Gerosa, G., Russo, C. F., Giannattasio, C., Tursi, V., Livi, U., Maiello, C., Amarelli, C., Potena, L., Martin Suarez, S., Boffini, M., Pace Napoleone, C., Clemenza, F., Musumeci, F., Maccherini, M., Faggian, G., Pellegrini, C., Terzi, A., Tramontin, C., De Angelis, D., Milano, A. D., and Valsecchi, M.

Published
2019

13. Multiple hormonal and metabolic deficiency syndrome in chronic heart failure: rationale, design, and demographic characteristics of the T.O.S.CA. Registry

Author

Bossone, E., Arcopinto, M., Iacoviello, M., Triggiani, V., Cacciatore, F., Maiello, C., Limongelli, G., Masarone, D., Perticone, F., Sciacqua, A., Perrone-Filardi, P., Mancini, A., Volterrani, M., Vriz, O., Castello, R., Passantino, A., Campo, M., Modesti, P. A., de Giorgi, A., Monte, I., Puzzo, A., Ballotta, A., Caliendo, L., D’Assante, R., Marra, A. M., Salzano, A., Suzuki, T., Cittadini, A., Saccà, L., Monti, M. G., Napoli, R., Matarazzo, M., Stagnaro, F. M., Schiavo, A., Valente, P., Ferrara, F., Russo, V., Malinconico, M., Citro, R., Guastalamacchia, E., Leone, M., Amarelli, C., Mattucci, I., Calabrò, P., Calabrò, R., D’Andrea, A., Maddaloni, V., Pacileo, G., Scarafile, R., Belfiore, A., Cimellaro, A., Perrone Filardi, P., Casaretti, L., Paolillo, S., Gargiulo, P., Favuzzi, A. M. R., Di Segni, C., Bruno, C., Vergani, E., Massaro, R., Grimaldi, F., Frigo, A., Sorrentino, M. R., Malandrino, D., Manfredini, R., Fabbian, F., Ragusa, L., Carbone, L., Frigiola, A., Generali, T., Giacomazzi, F., de Vincentiis, C., Garofalo, P., Malizia, G., Milano, S., Misiano, G., Heaney, L. M., Bruzzese, D., Bossone E., Arcopinto M., Iacoviello M., Triggiani V., Cacciatore F., Maiello C., Limongelli G., Masarone D., Perticone F., Sciacqua A., Perrone-Filardi P., Mancini A., Volterrani M., Vriz O., Castello R., Passantino A., Campo M., Modesti P.A., De Giorgi A., Monte I., Puzzo A., Ballotta A., Caliendo L., D'Assante R., Marra A.M., Salzano A., Suzuki T., Cittadini A., Sacca L., Monti M.G., Napoli R., Matarazzo M., Stagnaro F.M., Schiavo A., Valente P., Ferrara F., Russo V., Malinconico M., Citro R., Guastalamacchia E., Leone M., Amarelli C., Mattucci I., Calabro P., Calabro R., D'Andrea A., Maddaloni V., Pacileo G., Scarafile R., Belfiore A., Cimellaro A., Casaretti L., Paolillo S., Gargiulo P., Favuzzi A.M.R., DiSegni C., Bruno C., Vergani E., Massaro R., Grimaldi F., Frigo A., Sorrentino M.R., Malandrino D., Manfredini R., DeGiorgi A., Fabbian F., Ragusa L., Carbone L., Frigiola A., Generali T., Giacomazzi F., DeVincentiis C., Garofalo P., Malizia G., Milano S., Misiano G., Heaney L.M., Bruzzese D., Bossone, E, Arcopinto, M, Iacoviello, M, Triggiani, V, Cacciatore, F, Maiello, C, Limongelli, G, Masarone, D, Perticone, F, Sciacqua, A, Perrone-Filardi, P, Mancini, A, Volterrani, M, Vriz, O, Castello, R, Passantino, A, Campo, M, A Modesti, P, De Giorgi, A, Monte, I, Puzzo, A, Ballotta, A, Caliendo, L, D'Assante, R, M Marra, A, Salzano, A, Suzuki, T, Cittadini, A, Investigators, Tosca, Bossone, E., Arcopinto, M., Iacoviello, M., Triggiani, V., Cacciatore, F., Maiello, C., Limongelli, G., Masarone, D., Perticone, F., Sciacqua, A., Perrone-Filardi, P., Mancini, A., Volterrani, M., Vriz, O., Castello, R., Passantino, A., Campo, M., Modesti, P. A., de Giorgi, A., Monte, I., Puzzo, A., Ballotta, A., Caliendo, L., D’Assante, R., Marra, A. M., Salzano, A., Suzuki, T., Cittadini, A., Saccà, L., Monti, M. G., Napoli, R., Matarazzo, M., Stagnaro, F. M., Schiavo, A., Valente, P., Ferrara, F., Russo, V., Malinconico, M., Citro, R., Guastalamacchia, E., Leone, M., Amarelli, C., Mattucci, I., Calabrò, P., Calabrò, R., D’Andrea, A., Maddaloni, V., Pacileo, G., Scarafile, R., Belfiore, A., Cimellaro, A., Perrone Filardi, P., Casaretti, L., Paolillo, S., Gargiulo, P., Favuzzi, A. M. R., Di Segni, C., Bruno, C., Vergani, E., Massaro, R., Grimaldi, F., Frigo, A., Sorrentino, M. R., Malandrino, D., Manfredini, R., Fabbian, F., Ragusa, L., Carbone, L., Frigiola, A., Generali, T., Giacomazzi, F., de Vincentiis, C., Garofalo, P., Malizia, G., Milano, S., Misiano, G., Heaney, L. M., and Bruzzese, D.

Subjects
Male, Anabolism, medicine.medical_treatment, 030204 cardiovascular system & hematology, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Clinical endpoint, Medicine, Deficiency Disease, 030212 general & internal medicine, Prospective Studies, Registries, Prospective cohort study, Testosterone, Anabolic deficiency, Chronic heart failure, Heart failure metabolism, Multiple hormonal deficiency syndrome, Registry, Aged, Biomarkers, Chronic Disease, Deficiency Diseases, Disease Progression, Female, Heart Failure, Humans, Italy, Metabolic Diseases, Middle Aged, Internal Medicine, Emergency Medicine, Human, medicine.medical_specialty, Anabolic deficiency, Chronic heart failure, Heart failure metabolism, Multiple hormonal deficiency syndrome, Registry, Socio-culturale, 03 medical and health sciences, Internal medicine, business.industry, Settore MED/13 - ENDOCRINOLOGIA, Biomarker, medicine.disease, Metabolic Disease, Prospective Studie, Heart failure, Observational study, Hormone therapy, business
Abstract

Recent evidence supports the concept that progression of chronic heart failure (CHF) depends upon an imbalance of catabolic forces over the anabolic drive. In this regard, multiple hormonal deficiency syndrome (MHDS) significantly has impacts upon CHF progression, and is associated with a worse clinical status and increased mortality. The T.O.S.CA. (Trattamento Ormonale nello Scompenso CArdiaco; Hormone Therapy in Heart Failure) Registry (clinicaltrial.gov = NCT02335801) tests the hypothesis that anabolic deficiencies reduce survival in a large population of mild-to-moderate CHF patients. The T.O.S.CA. Registry is a prospective multicenter observational study coordinated by “Federico II” University of Naples, and involves 19 centers situated throughout Italy. Thyroid hormones, insulin-like growth factor-1, total testosterone, dehydroepiandrosterone , and insulin are measured at baseline and every year for a patient-average follow-up of 3years. Subjects with CHF are divided into two groups: patients with one or no anabolic deficiency, and patients with two or more anabolic deficiencies at baseline. The primary endpoint is the composite of all-cause mortality and cardiovascular hospitalization. Secondary endpoints include the composite of all-cause mortality and hospitalization, the composite of cardiovascular mortality and cardiovascular hospitalization, and change of VO 2 peak. Patient enrollment started in April 2013, and was completed in July 2017. Demographics and main clinical characteristics of enrolled patients are provided in this article. Detailed cross-sectional results will be available in late 2018. The T.O.S.CA. Registry represents the most robust prospective observational trial on MHDS in the field of CHF. The study findings will advance our knowledge with regard to the intimate mechanisms of CHF progression and hopefully pave the way for future randomized clinical trials of single or multiple hormonal replacement therapies in CHF.

Published
2017

17. “A BROKEN TRANSPLANTED HEART”: A CASE OF TAKOTSUBO SYNDROME IN A HEART TRANSPLANT RECIPIENT

Author

Delle Femine, F, Liccardo, B, Loffredo, F, Pezzullo, E, D‘Arienzo, D, Amarelli, C, and Golino, P

Abstract

75–year–old female patient went to the emergency department for oppressive chest pain radiating to the left arm and dyspnea, developed after an argument with family members. The patient underwent heart transplant in 2010 because of chronic ischemic heart disease. In history: systemic arterial hypertension, former smoking, dyslipidemia, and chronic renal failure. At blood tests: TnIHS 78.4 ng/L (<29 ng/L), CK–MB 1.9 microg/L, PROBNP–NT 43,000 pg/ml, creatinine 2 mg/dL. ECG showed inverted T waves in DI, AVL and V4 to V6 (fig 1). Transthoracic echocardiography was remarkable for a moderate reduction in systolic function (EF 38%), akinesia of apical portion, mid–segment of the IVS and mid–segment of posterior wall. Coronarography showed epicardial coronaries free of angiographically significant lesions. We decided to not perform ventriculography to avoid worsening renal function. At clinical stabilization, the patient underwent cardiac MRI with evidence of hypokinesia of the mid–ventricular segments with preserved global systolic function and hypo/akinesia of right ventricular apex with endocavitary thrombosis. Tissue characterization images were compatible with the presence of diffuse phlogistic involvement of the left ventricular myocardium (most evident at the mid–ventricular segments), in the absence of areas of myocardial necrosis. On pre–dimission echocardiogram, global left ventricular systolic function appeared markedly improved (auto EF 52%). DISCUSSION Our case is a rare case of Takotsubo syndrome (TS) in a transplanted heart. While TS accounts for 1–2% of all ACS in the general population, there is no precise data on its prevalence in heart transplant recipients. Although the pathophysiological mechanism underlying TS is still debated, there is evidence of hyperactivation of the sympathetic system with excessive catecholamine release. What is particular in our clinical case is that transplanted heart is denervated (because of resection of the post–ganglionic neural axons), although in some patients there is progressive reinnervation starting around the second year. Myocardial scintigraphy with iodine–123 meta iodobenzylguanidine can be used to study reinnervation. In our case, the presence of typical angor may be a clinical indicator of reinnervation, as many transplant patients present with CAV in the absence of chest pain.

Published
2024
Full Text
View/download PDF

21. Optimizing the Safety Profile of Everolimus by Delayed Initiation in De Novo Heart Transplant Recipients: Results of the Prospective Randomized Study EVERHEART

Author

Potena, L., Pellegrini, C., Grigioni, F., Amarelli, C., Livi, U., Maccherini, M., Masciocco, G., Faggian, G., Lilla Della Monica, P., Gerosa, G., Marraudino, N., Corda, M., Boffini, M., De Santo, L. S., Tona, F., Poggio, D., Savini, C., Ambrogi, F., Bernazzali, S., D'Armini, A. M., Mattiucci, G., Rinaldi, M., Ribezzo, M., Porcu, M., Musumeci, F., Gambino, A., Maiello, C., Frigerio, M., Guzzi, G., Forni, A., and Capone, G.

Subjects
Male, medicine.medical_specialty, Pleural effusion, medicine.medical_treatment, 030204 cardiovascular system & hematology, 030230 surgery, Pericardial effusion, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Cumulative incidence, Everolimus, Prospective Studies, Prospective cohort study, Heart transplantation, Transplantation, business.industry, Original Clinical Science—General, medicine.disease, Surgery, Discontinuation, Heart Transplantation, Female, Immunosuppressive Agents, business, medicine.drug
Abstract

Background Although everolimus potentially improves long-term heart transplantation (HTx) outcomes, its early postoperative safety profile had raised concerns and needs optimization. Methods This 6-month, open-label, multicenter randomized trial was designed to compare the cumulative incidence of a primary composite safety endpoint comprising wound healing delays, pericardial effusion, pleural effusion needing drainage, and renal insufficiency events (estimated glomerular filtration rate ≤30/mL/min per 1.73 m2) in de novo HTx recipients receiving immediate everolimus (EVR-I) (≤144 hours post-HTx) or delayed everolimus (EVR-D) (4-6 weeks post-HTx with mycophenolate mofetil as a bridge) with reduced-dose cyclosporine A. Cumulative incidence of biopsy-proven rejection ≥ 2R, rejection with hemodynamic compromise, graft loss, or death was the secondary composite efficacy endpoint. Results Overall, 181 patients were randomized to the EVR-I (n = 89) or EVR-D (n = 92) arms. Incidence of primary safety endpoint was higher for EVR-I than EVR-D arm (44.9% vs 32.6%; P = 0.191), mainly driven by a higher rate of pericardial effusion (33.7% vs 19.6%; P = 0.04); wound healing delays, acute renal insufficiency events, and pleural effusion occurred at similar frequencies in the study arms. Efficacy failure was not significantly different in EVR-I arm versus EVR-D arm (37.1% vs 28.3%; P = 0.191). Three patients in the EVR-I arm and 1 in the EVR-D arm died. Incidence of clinically significant adverse events leading to discontinuation was higher in EVR-I arm versus EVR-D arm (P = 0.02). Conclusions Compared with immediate initiation, delayed everolimus initiation appeared to provide a clinically relevant early safety benefit in de novo HTx recipients, without compromising efficacy., The 6-month, open-label, multicenter randomized trial is designed to compare primary safety endpoints in de novo heart transplantation and delayed everolimus initiation seems to provide a clinically relevant early safety benefit compared to immediate initiation without compromising efficacy. Supplemental digital content is available in the text.

Published
2018

23. P4543Steatosis in explanted heart of type 2 diabetic patients with end-stage heart failure: progression of intra-myocytes fat accumulation in non-diabetic heart implanted in diabetic patients

Author

Marfella, R, primary, Cacciatore, F, additional, Balestrieri, M L, additional, Esposito, S, additional, Mansueto, G, additional, Paolisso, P, additional, Golino, P, additional, Amarelli, C, additional, Maiello, C, additional, Ursomando, F, additional, Salerno, G, additional, Palmieri, V, additional, Benincasa, G, additional, Paolisso, G, additional, and Napoli, C, additional

Published
2019
Full Text
View/download PDF

24. Factors Influencing Access to Transplant, Waitlist Mortality, and Post-Transplant Survival in the Italian National Heart Transplant Database

Author

Frigerio, M., primary, Varrenti, M., additional, Santolamazza, C., additional, Bernasconi, D.P., additional, Costa, A. Nanni, additional, Oliveti, A., additional, Puoti, F., additional, Bottio, T., additional, Gerosa, G., additional, Russo, C.F., additional, Giannattasio, C., additional, Tursi, V., additional, Livi, U., additional, Maiello, C., additional, Amarelli, C., additional, Potena, L., additional, Martin Suarez, S., additional, Boffini, M., additional, Pace Napoleone, C., additional, Clemenza, F., additional, Musumeci, F., additional, Maccherini, M., additional, Faggian, G., additional, Pellegrini, C., additional, Terzi, A., additional, Tramontin, C., additional, De Angelis, D., additional, Milano, A.D., additional, and Valsecchi, M., additional

Published
2019
Full Text
View/download PDF

25. Mechanical Circulatory Support as Bridge to Pediatric Heart Transplantation

Author

Loforte, Antonio, Montalto, Andrea, Amarelli, Cristiano, Loforte, A ( Antonio ), Montalto, A ( Andrea ), Amarelli, C ( Cristiano ), Schweiger, Martin, Hübler, Michael, Loforte, Antonio, Montalto, Andrea, Amarelli, Cristiano, Loforte, A ( Antonio ), Montalto, A ( Andrea ), Amarelli, C ( Cristiano ), Schweiger, Martin, and Hübler, Michael

Abstract

Fueled by the uncertainty and the time required to obtain a donor heart, mechanical circulatory support (MCS) forms an essential part of end-stage heart failure. Extracorporeal membrane oxygenation (ECMO) use is limited to a few days before serious complications like bleeding occur. Prolonged support in terms of ventricular assist device (VAD) as a bridge to transplantation (BTT) became mandatory to overcome death on the waiting list. Within the last decade, VADs in adults have evolved drastically with the introduction of continuous flow (cf) devices. Increased miniaturization of VADs and new support strategies have increased its use in the pediatric population even in small children and patients with congenital heart disease (CHD). Nevertheless, patient and device selection in this patient population remain challenging to achieve optimal outcome and decrease complication rates. This comes with the need for care providers specialized in this field. Size issues and anatomical diversity make decision making complex and unique when compared to general adult practice. Neonates with single ventricle physiology are the highest risk candidates for VADs. This chapter reviews the most relevant durable VADs used in children including the rapid evolution of using adult designed cf-VADs to support children with anatomical normal hearts and CHD.

Published
2018

26. Multiple hormonal and metabolic deficiency syndrome in chronic heart failure: rationale, design, and demographic characteristics of the T.O.S.CA. Registry

Author

Bossone, E., Arcopinto, M., Iacoviello, M., Triggiani, V., Cacciatore, F., Maiello, C., Limongelli, G., Masarone, D., Perticone, F., Sciacqua, A., Perrone-Filardi, P., Mancini, Antonio, Volterrani, M., Vriz, O., Castello, R., Passantino, A., Campo, Marco, Modesti, P. A., De Giorgi, A., Monte, I., Puzzo, A., Ballotta, A., Caliendo, L., D'Assante, R., Marra, A. M., Salzano, A., Suzuki, T., Cittadini, Achille Renato Maria, Sacca, L., Monti, M. G., Napoli, R., Matarazzo, M., Stagnaro, F. M., Schiavo, A., Valente, P., Ferrara, F., Russo, V., Malinconico, M., Citro, R., Guastalamacchia, E., Leone, M., Amarelli, C., Mattucci, I., Calabro, P., Calabro, R., D'Andrea, A., Maddaloni, V., Pacileo, G., Scarafile, R., Belfiore, A., Cimellaro, A., Casaretti, L., Paolillo, S., Gargiulo, P., Favuzzi, Angela Maria Rita, Disegni, C., Bruno, C., Vergani, Edoardo, Massaro, R., Grimaldi, F., Frigo, A., Sorrentino, M. R., Malandrino, D., Manfredini, R., Fabbian, F., Ragusa, L., Carbone, Luigi, Frigiola, A., Generali, T., Giacomazzi, F., Devincentiis, C., Garofalo, P., Malizia, G., Milano, S., Misiano, G., Heaney, L. M., Bruzzese, D., Mancini A. (ORCID:0000-0002-7707-4564), Campo M., Cittadini A., Favuzzi A. M. R., Vergani E., Carbone L., Bossone, E., Arcopinto, M., Iacoviello, M., Triggiani, V., Cacciatore, F., Maiello, C., Limongelli, G., Masarone, D., Perticone, F., Sciacqua, A., Perrone-Filardi, P., Mancini, Antonio, Volterrani, M., Vriz, O., Castello, R., Passantino, A., Campo, Marco, Modesti, P. A., De Giorgi, A., Monte, I., Puzzo, A., Ballotta, A., Caliendo, L., D'Assante, R., Marra, A. M., Salzano, A., Suzuki, T., Cittadini, Achille Renato Maria, Sacca, L., Monti, M. G., Napoli, R., Matarazzo, M., Stagnaro, F. M., Schiavo, A., Valente, P., Ferrara, F., Russo, V., Malinconico, M., Citro, R., Guastalamacchia, E., Leone, M., Amarelli, C., Mattucci, I., Calabro, P., Calabro, R., D'Andrea, A., Maddaloni, V., Pacileo, G., Scarafile, R., Belfiore, A., Cimellaro, A., Casaretti, L., Paolillo, S., Gargiulo, P., Favuzzi, Angela Maria Rita, Disegni, C., Bruno, C., Vergani, Edoardo, Massaro, R., Grimaldi, F., Frigo, A., Sorrentino, M. R., Malandrino, D., Manfredini, R., Fabbian, F., Ragusa, L., Carbone, Luigi, Frigiola, A., Generali, T., Giacomazzi, F., Devincentiis, C., Garofalo, P., Malizia, G., Milano, S., Misiano, G., Heaney, L. M., Bruzzese, D., Mancini A. (ORCID:0000-0002-7707-4564), Campo M., Cittadini A., Favuzzi A. M. R., Vergani E., and Carbone L.

Abstract

Recent evidence supports the concept that progression of chronic heart failure (CHF) depends upon an imbalance of catabolic forces over the anabolic drive. In this regard, multiple hormonal deficiency syndrome (MHDS) significantly has impacts upon CHF progression, and is associated with a worse clinical status and increased mortality. The T.O.S.CA. (Trattamento Ormonale nello Scompenso CArdiaco; Hormone Therapy in Heart Failure) Registry (clinicaltrial.gov = NCT02335801) tests the hypothesis that anabolic deficiencies reduce survival in a large population of mild-to-moderate CHF patients. The T.O.S.CA. Registry is a prospective multicenter observational study coordinated by “Federico II” University of Naples, and involves 19 centers situated throughout Italy. Thyroid hormones, insulin-like growth factor-1, total testosterone, dehydroepiandrosterone , and insulin are measured at baseline and every year for a patient-average follow-up of 3 years. Subjects with CHF are divided into two groups: patients with one or no anabolic deficiency, and patients with two or more anabolic deficiencies at baseline. The primary endpoint is the composite of all-cause mortality and cardiovascular hospitalization. Secondary endpoints include the composite of all-cause mortality and hospitalization, the composite of cardiovascular mortality and cardiovascular hospitalization, and change of VO2 peak. Patient enrollment started in April 2013, and was completed in July 2017. Demographics and main clinical characteristics of enrolled patients are provided in this article. Detailed cross-sectional results will be available in late 2018. The T.O.S.CA. Registry represents the most robust prospective observational trial on MHDS in the field of CHF. The study findings will advance our knowledge with regard to the intimate mechanisms of CHF progression and hopefully pave the way for future randomized clinical trials of single or multiple hormonal replacement therapies in CHF.

Published
2018

27. UNLOADING STRATEGIES IN ADVANCED HEART FAILURE: THE ROLE OF POINT–OF–CARE ULTRASOUND

Author

Del Giudice, C, Caputo, A, D‘Arienzo, D, Delle Femmine, F, Liccardo, B, Amarelli, C, Marra, C, Loffredo, F, Varricchio, A, and Golino, P

Abstract

Patients with advanced heart failure (HF) exhibit repeated episodes of fluid retention (pulmonary and/or systemic congestion) and/or of reduced cardiac output at rest (peripheral hypoperfusion) requiring hospitalization along with diuretics/inotropic infusion. Pulmonary artery catheter (PAC) provides haemodynamic information to guide the therapy, however PAC is invasive and time consuming. Point of care ultrasonography (POCUS) represents a promising diagnostic tool at the bedside, performed by the physician to assess non invasively volume status, cardiac output and monitor decongestive therapy. Recently, abnormal Doppler flow patterns due to increased right atrial pressure have been described in the hepatic, portal, and intrarenal veins. Thus, the recent venous excess ultrasound score (VExUS) has been used to describe fluid status along with the diameter and collapsibility of the inferior vena cava. Furthermore HF patients show high filling pressures, therefore they often require mechanical or medical unloading. In this regard, point of care ultrasound represents a valid tool to monitor non invasively the filling pressures and the responsiveness to those treatments. Here, we illustrate with several clinical cases where VExUS/POCUS were pivotal in clinical management.

Published
2024
Full Text
View/download PDF

30. Reply to Petricevic et al

Author

De Santo LS, Amarelli C, Scardone M, Romano G, DE SANTO, Luca Salvatore, Amarelli, C, Scardone, M, and Romano, G

Published
2013

33. Biological properties of cardiac stem cells in normal and pathological conditions - matrix makes a difference

Author

MIRAGLIA, RITA, ROMANO, VERONICA, DI MEGLIO, FRANCA, NURZYNSKA, DARIA ANNA, CASTALDO, CLOTILDE, MONTAGNANI, STEFANIA, Sacco AM, Latino F, Bancone C, Amarelli C, Maiello C, Della Corte A, Miraglia, Rita, Sacco, Am, Romano, Veronica, Latino, F, DI MEGLIO, Franca, Nurzynska, DARIA ANNA, Castaldo, Clotilde, Bancone, C, Amarelli, C, Maiello, C, Della Corte, A, and Montagnani, Stefania

Abstract

Chronic ischemic heart disease is characterized by an imbalance between cardiac cell death and regeneration. The local non-invasive activation of cardiac stem cells offers the possibility to influence the course of cardiomyopathy and to inhibit or reverse the pathological remodelling. In patients with coronary artery disease, low energy shock wave (SW) therapy was found to improve symptoms and ameliorate ischemia. The aim of our study was to evaluate the effects of SW on cardiac resident primitive cells in vitro. CD117(+) cells were isolated from the atria of adult human normal (n=7, males, mean age 51±5.6 years) and pathological hearts with ischemic cardiomyopathy (n=11, males, mean age 55±3.2 years), and treated with 800 shots of SW at the energy flux density of 0.05mJ/mm². Phospho-MAPK protein expression was assayed with proteome profiler array after 1 hour and total mRNA was examined by signal transduction specific PCR-based array 72 hours after the treatment. Gene expression profiling revealed in CD117(+) cells from pathological heart the down-regulation of genes relevant to the hedgehog pathway (EN1, BMP4, FOXA2), that is active in the early stages of the developmental process, or belonging to the induction and positive regulation of programmed cell death functional groups (CDKN2A, CDKN2B, CDKN1A, TP53I3, TNF), while the transcriptionally up-regulated genes included CSF2, CCL20, BIRC3, IL8, and IL1A that are involved in NFκB survival pathway and CEBPB, HK2, LEP involved in insulin pathway and myogenesis. Although SW treatment resulted in the significant increase in phospho-ERK1/2 in both cell populations, the phosphorylation of its downstream substrate RSK1 increased only in the normal cells. Similarly, in the normal cells the phosphorylation of p38-MAPKα, β and γ increased 4, 4-, 1, 2- and 4,2-fold, respectively, while only 1,3- and 2,2-fold increase in phosphorylated p38α and γ was observed in pathological cells. Moreover, the prosurvival kinase Akt1 resulted activated only in the normal cells. We conclude that the application of SW activates survival pathways and protects from apoptosis, although different signal transduction pathways can be responsible for these effects in cardiac primitive cells from normal and pathological heart with ischemic cardiomyopathy.

Published
2012

39. Comunicazione orale: Trapianto cardiaco non complicato in paziente con infezione da HIV

Author

Maiello C, Pinto D, Sbreglia C, LIMONGELLI, Giuseppe, Amarelli C, Perrella A, Romano G, Marra C, Pacileo G, De Santo LS, UTILI, Riccardo, DURANTE MANGONI, Emanuele, Maiello, C, Pinto, D, Sbreglia, C, Limongelli, Giuseppe, Amarelli, C, Perrella, A, Romano, G, Marra, C, Pacileo, G, DE SANTO, Luca Salvatore, Utili, Riccardo, and DURANTE MANGONI, Emanuele

Published
2011

40. Insufficienza renale acuta dopo chirurgia cardiaca: prevedibile?

Author

DE SANTO LS, ROMANO G, AMARELLI C, DELLA CORTE, Alessandro, BANCONE C, CAROZZA A, TORELLA M, PETRONE G, NAPPI, Gianantonio, DE FEO, Marisa, DE SANTO, Luca Salvatore, Romano, G, Amarelli, C, DE FEO, Marisa, DELLA CORTE, Alessandro, Bancone, C, Carozza, A, Torella, M, Petrone, G, and Nappi, Gianantonio

Published
2011

41. Off pump versus on-pump CADG su pazienti ad alto rischio operatorio: a confronto l'esperienza del singolo chirurgo

Author

DE FEO, Marisa, BANCONE C, DELLA CORTE, Alessandro, AMARELLI C, DE SANTO LS, CERASUOLO F, PIROZZI F, TORELLA, Michele, BORRELLI M, CITARELLA AG, BUONOCORE M, LA MARCA F, NAPPI, Gianantonio, DE FEO, Marisa, Bancone, C, DELLA CORTE, Alessandro, Amarelli, C, DE SANTO, Luca Salvatore, Cerasuolo, F, Pirozzi, F, Torella, Michele, Borrelli, M, Citarella, Ag, Buonocore, M, LA MARCA, F, and Nappi, Gianantonio

Published
2010

48. Preemptive strategy for the treatment of CMV infection. Lights and shadows on a 8 year single-centre experience of 260 patients

Author

UTILI, Riccardo, Amarelli C, Romano GP, De Santo LS, Marra C, Ursomando F, Mastroianni C, Casillo R, Ragone E, Maiello C, Cotrufo M., DURANTE MANGONI, Emanuele, Utili, Riccardo, Amarelli, C, Romano, Gp, DE SANTO, Luca Salvatore, Marra, C, Ursomando, F, Mastroianni, C, DURANTE MANGONI, Emanuele, Casillo, R, Ragone, E, Maiello, C, and Cotrufo, M.

Abstract

Abs #P180

Published
2007

Catalog

Books, media, physical & digital resources
See catalog results