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2. Pre- and in-hospital anticoagulation therapy in coronavirus disease 2019 patients: a propensity-matched analysis of in-hospital outcomes

Author

Battistoni, Ilaria, Francioni, Matteo, Morici, Nuccia, Rubboli, Andrea, Podda, Gian Marco, Pappalardo, Andrea, Abdelrahim, Mohamed E.A., El Gendy, Osama S., Khalaf, Ahmed M., Hamied, Ahmed Abdel M., Garcés, Héctor Hernández, Abdelhamid, Omar E.S., Tawfik, Karim A.M., Zeduri, Anna, Bassi, Gabriele, Pongetti, Giulia, Angelini, Luca, Giovinazzo, Stefano, Garcia, Pablo Martinez, Serino, Francesco Saverio, Polistina, Giorgio Emanuele, Fiorentino, Giuseppe, Barbati, Giovanni, Toniolo, Anna, Fabbrizioli, Azzurra, Belenguer-Muncharaz, Alberto, Porto, Italo, Ocak, Sibel, Minuz, Pietro, Bernal, Francisco, Hermosilla, Irina, and Borovac, Josip A.

Published
2021
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5. Reshaping of Italian Echocardiographic Laboratories Activities during the Second Wave of COVID-19 Pandemic and Expectations for the Post-Pandemic Era

Author

Ciampi, Quirino, Antonini-Canterin, Francesco, Barbieri, Andrea, Barchitta, Agata, Benedetto, Frank, Cresti, Alberto, Miceli, Sofia, Monte, Ines, Petrella, Licia, Trocino, Giuseppe, Aquila, Iolanda, Barbati, Giovanni, Barletta, Valentina, Barone, Daniele, Beraldi, Monica, Bergandi, Gianluigi, Bilardo, Giuseppe, Boriani, Giuseppe, Bossone, Eduardo, Bongarzoni, Amedeo, Bovolato, Francesca, Bursi, Francesca, Cammalleri, Valeria, Carbonella, Marco, Casavecchia, Grazia, Cicco, Sebastiano, Cioffi, Giovanni, Cocchia, Rosangela, Colonna, Paolo, Cortigiani, Lauro, Cucchini, Umberto, D'Alfonso, Maria, D’Andrea, Antonello, Dell'Angela, Luca, Dentamaro, Ilaria, Paolis, Marcella De, Stefanis, Paola De, Deste, Wanda, Fulvio, Maria Di, Giannuario, Giovanna Di, Lisi, Daniela Di, Nora, Concetta Di, Fabiani, Iacopo, Esposito, Roberta, Fazzari, Fabio, Ferrara, Luigi, Filice, Gemma, Forno, Davide, Giorgi, Mauro, Giustiniano, Enrico, Greco, Cosimo, Iannuzzi, Gian, Izzo, Annibale, Lanzone, Alberto, Malagoli, Alessandro, Mantovani, Francesca, Manuppelli, Vincenzo, Mega, Simona, Merli, Elisa, Ministeri, Margherita, Morrone, Doralisa, Napoletano, Cosimo, Nunziata, Luigi, Pastorini, Guido, Pedone, Chiara, Petruccelli, Enrica, Polito, Maria, Polizzi, Vincenzo, Prota, Costantina, Rigo, Fausto, Rivaben, Dante, Saponara, Silvio, Sciacqua, Angela, Sartori, Chiara, Scarabeo, Virginia, Serra, Walter, Severino, Sergio, Spinelli, Luciano, Tamborini, Gloria, Tota, Antonio, Villari, Bruno, Carerj, Scipione, Picano, Eugenio, Pepi, Mauro, (SIECVI), SIECoVId Study Group, on Behalf of the Italian Society of Echocardiography and Cardiovascular Imaging, Ciampi, Q., Antonini-Canterin, F., Barbieri, A., Barchitta, A., Benedetto, F., Cresti, A., Miceli, S., Monte, I., Petrella, L., Trocino, G., Aquila, I., Barbati, G., Barletta, V., Barone, D., Beraldi, M., Bergandi, G., Bilardo, G., Boriani, G., Bossone, E., Bongarzoni, A., Bovolato, F. E., Bursi, F., Cammalleri, V., Carbonella, M., Casavecchia, G., Cicco, S., Cioffi, G., Cocchia, R., Colonna, P., Cortigiani, L., Cucchini, U., D'Alfonso, M. G., D'Andrea, A., Dell'Angela, L., Dentamaro, I., De Paolis, M., De Stefanis, P., Deste, W., Di Fulvio, M., Di Giannuario, G., Di Lisi, D., Di Nora, C., Fabiani, I., Esposito, R., Fazzari, F., Ferrara, L., Filice, G., Forno, D., Giorgi, M., Giustiniano, E., Greco, C. A., Iannuzzi, G. L., Izzo, A., Lanzone, A. M., Malagoli, A., Mantovani, F., Manuppelli, V., Mega, S., Merli, E., Ministeri, M., Morrone, D., Napoletano, C., Nunziata, L., Pastorini, G., Pedone, C., Petruccelli, E., Polito, M. V., Polizzi, V., Prota, C., Rigo, F., Rivaben, D. E., Saponara, S., Sciacqua, A., Sartori, C., Scarabeo, V., Serra, W., Severino, S., Spinelli, L., Tamborini, G., Tota, A., Villari, B., Carerj, S., Picano, E., and Pepi, M.

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), COVID-19, Lung ultrasound, Point-of-care cardiac ultrasound, Carbon dioxide production, Article, Settore MED/11, Internal medicine, Pandemic, Stress Echocardiography, Medicine, echocardiography, Cardiac imaging, COVID-19, lung ultrasound, point-of-care cardiac ultrasound, lung ultrasound, point-of-care cardiac ultrasound, business.industry, speckle tracking multilayer, General Medicine, echocardiography, speckle tracking multilayer, Cardiology, Cardiac Imaging Techniques, business, Personal protection equipment
Abstract

Background: Cardiology divisions reshaped their activities during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to analyze the organization of echocardiographic laboratories and echocardiography practice during the second wave of the COVID-19 pandemic in Italy, and the expectations for the post-COVID era. Methods: We analyzed two different time periods: the month of November during the second wave of the COVID-19 pandemic (2020) and the identical month during 2019 (November 2019). Results: During the second wave of the COVID-19 pandemic, the hospital activity was partially reduced in 42 (60%) and wholly interrupted in 3 (4%) echocardiographic laboratories, whereas outpatient echocardiographic activity was partially reduced in 41 (59%) and completely interrupted in 7 (10%) laboratories. We observed an important change in the organization of activities in the echocardiography laboratory which reduced the operator-risk and improved self-protection of operators by using appropriate personal protection equipment. Operators wore FFP2 in 58 centers (83%) during trans-thoracic echocardiography (TTE), in 65 centers (93%) during transesophageal echocardiography (TEE) and 63 centers (90%) during stress echocardiography. The second wave caused a significant reduction in number of echocardiographic exams, compared to November 2019 (from 513 ± 539 to 341 ± 299 exams per center, −34%, p &lt, 0.001). On average, there was a significant increase in the outpatient waiting list for elective echocardiographic exams (from 32.0 ± 28.1 to 45.5 ± 44.9 days, +41%, p &lt, 0.001), with a reduction of in-hospital waiting list (2.9 ± 2.4 to 2.4 ± 2.0 days, −17%, p &lt, 0.001). We observed a large diffusion of point-of-care cardiac ultrasound (88%), with a significant increase of lung ultrasound usage in 30 centers (43%) during 2019, extended to all centers in 2020. Carbon dioxide production by examination is an indicator of the environmental impact of technology (100-fold less with echocardiography compared to other cardiac imaging techniques). It was ignored in 2019 by 100% of centers, and currently it is considered potentially crucial for decision-making in cardiac imaging by 65 centers (93%). Conclusions: In one year, major changes occurred in echocardiography practice and culture. The examination structure changed with extensive usage of point-of-care cardiac ultrasound and with lung ultrasound embedded by default in the TTE examination, as well as the COVID-19 testing.

Published
2021
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12. Pre- and in-hospital anticoagulation therapy in coronavirus disease 2019 patients: a propensity-matched analysis of in-hospital outcomes

Author

Battistoni, Ilaria, Francioni, Matteo, Morici, Nuccia, Rubboli, Andrea, Podda, Gian Marco, Pappalardo, Andrea, Abdelrahim, Mohamed E.A., Elgendy, Marwa O., Elgendy, Sara O., Khalaf, Ahmed M., Hamied, Ahmed Abdel M., Garcés, Héctor Hernández, Abdelhamid, Omar E.S., Tawfik, Karim A.M., Zeduri, Anna, Bassi, Gabriele, Pongetti, Giulia, Angelini, Luca, Giovinazzo, Stefano, Garcia, Pablo Martinez, Serino, Francesco Saverio, Polistina, Giorgio Emanuele, Fiorentino, Giuseppe, Barbati, Giovanni, Toniolo, Anna, Fabbrizioli, Azzurra, Belenguer-Muncharaz, Alberto, Porto, Italo, Ocak, Sibel, Minuz, Pietro, Bernal, Francisco, Hermosilla, Irina, and Borovac, Josip A.

Published
2022
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14. Myocardial fibrosis and diastolic dysfunction in patients on chronic haemodialysis

Author

Massimo Chiariello, Giovanni Barbati, Marco Del Prete, Bruno Memoli, Gerardo Carpinella, Carla Contaldi, Bruna Guida, Massimo Cavallaro, Angelica Fundaliotis, Lucia S. Parrella, Maria Angela Losi, Valentina Parisi, Sandro Betocchi, Losi, MARIA ANGELA, Memoli, Bruno, Contaldi, Carla, Barbati, Giovanni, DEL PRETE, Marco, Betocchi, Sandro, Cavallaro, M, Carpinella, Gerardo, Fundaliotis, A, Parrella, LUCIA SERENA, Parisi, Valentina, Guida, Bruna, and Chiariello, Massimo

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Population, Diastole, Doppler echocardiography, Ventricular Dysfunction, Left, Young Adult, Fibrosis, Renal Dialysis, Internal medicine, medicine, Humans, ESRD, education, Aged, Transplantation, education.field_of_study, medicine.diagnostic_test, business.industry, Myocardium, diastolic function, Odds ratio, Middle Aged, medicine.disease, Echocardiography, Doppler, Nephrology, myocardial fibrosi, Cardiology, Kidney Failure, Chronic, Myocardial fibrosis, Female, Hemodialysis, business, tissue characterization, Kidney disease
Abstract

BACKGROUND: Left ventricular (LV) diastolic dysfunction is linked to myocardial collagen content in many cardiac diseases. There are no data regarding such relationship in patients with end-stage renal disease (ESRD) undergoing haemodialysis. METHODS: Twenty-five patients with ESRD undergoing haemodialysis were studied by echocardiography. LV diastolic function was investigated by Doppler echocardiography, by analysing LV filling velocities at rest and during loading manoeuvres, which represent an estimate of LV filling pressure. According to the Doppler pattern, LV filling pressure in a given patient was judged to be normal or slightly increased or to be moderately or severely increased. The presence of myocardial fibrosis was estimated by ultrasound tissue characterization with integrated backscatter, which in diastole correlates with the collagen content of the myocardium. RESULTS: Integrated backscatter was higher in patients with moderate or severely increased than in patients with normal or slightly increased LV filling pressure (integrated backscatter: 51.0 +/- 9.8 vs 41.6 +/- 5.6%; P = 0.008). Integrated backscatter was a strong and independent determinant of diastolic dysfunction (odds ratio = 1.212; P = 0.040). CONCLUSION: Our data support the hypothesis that, in a selected population of patients with ESRD undergoing haemodialysis, myocardial fibrosis is associated with LV diastolic myocardial properties

Published
2010

15. Prognostic significance of left atrial volume dilatation in patients with hypertrophic cardiomyopathy

Author

Valentina Parisi, Carlo-Gabriele Tocchetti, Maria Angela Losi, Rosalba Romano, Carla Contaldi, Pastore F, Teresa Migliore, Sandro Betocchi, Armando Caputi, Giovanni Barbati, Massimo Chiariello, Losi, MARIA ANGELA, Betocchi, Sandro, Barbati, Giovanni, Parisi, Valentina, Tocchetti, CARLO GABRIELE, Pastore, Fabio, Migliore, Teresa, Contaldi, Carla, Caputi, Armando, Romano, Rosalba, and Chiariello, Massimo

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Echocardiography, Three-Dimensional, Cardiomyopathy, Risk Assessment, Sensitivity and Specificity, Sudden death, Risk Factors, Internal medicine, Prevalence, medicine, Humans, Radiology, Nuclear Medicine and imaging, Heart Atria, Survival rate, Survival analysis, Heart transplantation, business.industry, Hypertrophic cardiomyopathy, atrio, Reproducibility of Results, Odds ratio, Cardiomyopathy, Hypertrophic, Middle Aged, Prognosis, medicine.disease, Survival Analysis, Cardiomiopatia ipertrofica, Survival Rate, Italy, Echocardiography, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, prognosi, Dilatation, Pathologic, Volume (compression)
Abstract

To evaluate the prognostic role of left atrial (LA) volume in hypertrophic cardiomyopathy (HCM), LA volume was measured at baseline and during follow-up in 140 patients with HCM. Unfavorable outcome, defined as occurrence of sudden death, heart transplantation, or invasive reduction of obstruction, developed in 16 patients. In patients with enlarged LA volume (>27 mL/m(2)), there was an increased risk for unfavorable outcome (P = .0152). Patients with normal LA volume at baseline in whom volume increased more than 3 mL per year (fast dilating LA volume) had a worse prognosis than patients with normal and stable volume (P < .001) and similar to patients with dilated LA volume at baseline (P = not significant). LA volume dilated at baseline, fast dilating LA volume, and New York Heart Association functional class were independent predictors of unfavorable outcome development (odds ratio: 11.453; P = .021, P = 2.019, P = .020, respectively). The assessment of LA volume at baseline and during follow-up adds information regarding prognosis in patients with HCM. (J Am Soc Echocardiogr 2009; 22: 76-81.)

Published
2009

16. Stress Echocardiography in Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.

Author

Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D'Angelo M, Da Ros S, D'Andrea F, D'Andrea A, D'Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Del Giudice C, Dell'Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Bella G, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi RM, Inserra CA, Iori E, Izzo A, La Rosa G, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Picano E, and Carerj S

Abstract

Background: The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand the volumes of activity, modalities and stressors used during stress echocardiography (SE) in Italy., Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved through an electronic survey based on a structured questionnaire, uploaded on the SIECVI website., Results: Data were obtained from 228 echocardiographic laboratories, and SE examinations were performed in 179 centers (80.6%): 87 centers (47.5%) were in the northern regions of Italy, 33 centers (18.4%) were in the central regions, and 61 (34.1%) in the southern regions. We annotated a total of 4057 SE. We divided the SE centers into three groups, according to the numbers of SE performed: <10 SE (low-volume activity, 40 centers), between 10 and 39 SE (moderate volume activity, 102 centers) and ≥40 SE (high volume activity, 37 centers). Dipyridamole was used in 139 centers (77.6%); exercise in 120 centers (67.0%); dobutamine in 153 centers (85.4%); pacing in 37 centers (21.1%); and adenosine in 7 centers (4.0%). We found a significant difference between the stressors used and volume of activity of the centers, with a progressive increase in the prevalence of number of stressors from low to high volume activity ( P = 0.033). The traditional evaluation of regional wall motion of the left ventricle was performed in all centers, with combined assessment of coronary flow velocity reserve (CFVR) in 90 centers (50.3%): there was a significant difference in the centers with different volume of SE activity: the incidence of analysis of CFVR was significantly higher in high volume centers compared to low - moderate - volume (32.5%, 41.0% and 73.0%, respectively, P < 0.001). The lung ultrasound (LUS) was assessed in 67 centers (37.4%). Furthermore for LUS, we found a significant difference in the centers with different volume of SE activity: significantly higher in high volume centers compared to low - moderate - volume (25.0%, 35.3% and 56.8%, respectively, P < 0.001)., Conclusions: This nationwide survey demonstrated that SE was significantly widespread and practiced throughout Italy. In addition to the traditional indication to coronary artery disease based on regional wall motion analysis, other indications are emerging with an increase in the use of LUS and CFVR, especially in high-volume centers., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cardiovascular Echography.)

Published
2023
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17. Organization and Activity of Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.

Author

Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D'Angelo M, Ros SD, D'Andrea F, D'Andrea A, D'Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Giudice CD, Dell'Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi R, Inserra CA, Iori E, Izzo A, Rosa G, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Di Bella G, and Carerj S

Abstract

Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy., Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website., Results: Data were obtained from 228 echocardiographic laboratories: 112 centers (49%) in the northern, 43 centers (19%) in the central, and 73 (32%) in the southern regions. During the month of observation, we collected 101,050 transthoracic echocardiography (TTE) examinations performed in all centers. As concern other modalities there were performed 5497 transesophageal echocardiography (TEE) examinations in 161/228 centers (71%); 4057 stress echocardiography (SE) examinations in 179/228 centers (79%); and examinations with ultrasound contrast agents (UCAs) in 151/228 centers (66%). We did not find significant regional variations between the different modalities. The usage of picture archiving and communication system (PACS) was significantly higher in the northern (84%) versus central (49%) and southern (45%) centers ( P < 0.001). Lung ultrasound (LUS) was performed in 154 centers (66%), without difference between cardiology and noncardiology centers. The evaluation of left ventricular (LV) ejection fraction was evaluated mainly using the qualitative method in 223 centers (94%), occasionally with the Simpson method in 193 centers (85%), and with selective use of the three-dimensional (3D) method in only 23 centers (10%). 3D TTE was present in 137 centers (70%), and 3D TEE in all centers where TEE was done (71%). The assessment of LV diastolic function was done routinely in 80% of the centers. Right ventricular function was evaluated using tricuspid annular plane systolic excursion in all centers, using tricuspid valve annular systolic velocity by tissue Doppler imaging in 53% of the centers, and using fractional area change in 33% of the centers. When we divided into cardiology (179, 78%) and noncardiology (49, 22%) centers, we found significant differences in the SE (93% vs. 26%, P < 0.001), TEE (85% vs. 18%), UCA (67% vs. 43%, P < 0001), and STE (87% vs. 20%, P < 0.001). The incidence of LUS evaluation was similar between the cardiology and noncardiology centers (69% vs. 61%, P = NS)., Conclusions: This nationwide survey demonstrated that digital infrastructures and advanced echocardiography modalities, such as 3D and STE, are widely available in Italy with a notable diffuse uptake of LUS in the core TTE examination, a suboptimal diffusion of PACS recording, and conservative use of UCA, 3D, and strain. There are significant differences between northern and central-southern regions and echocardiographic laboratories that pertain to the cardiac unit. This inhomogeneous distribution of technology represents one of the main issues that must be solved to standardize the practice of echocardiography., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cardiovascular Echography.)

Published
2023
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18. [Right atrial appendage thrombosis during atrial fibrillation: an element to look for].

Author

Barbati G, De Domenico R, Rossi S, Vecchiato E, and Zeppellini R

Subjects
Humans, Male, Middle Aged, Atrial Appendage surgery, Atrial Fibrillation complications, Thrombosis etiology
Abstract

Oral anticoagulant therapy (OAT) is a mainstay of atrial fibrillation (AF) pharmacological treatment. Left atrial appendage closure is a possible treatment, when feasible, in patients with intracerebral hemorrhage during OAT. We report a case of right atrial appendage thrombosis in a patient with chronic AF admitted for syncope due to diuretic-induced orthostatic hypotension. Two years previously, he had undergone left atrial appendage closure with the Amplatzer Cardiac Plug device because of intracerebral hemorrhage during OAT. After neurological consult, OAT was resumed with apixaban 5 mg twice daily, and transesophageal echocardiography performed two months later showed complete resolution of the right atrial appendage thrombosis. This particular case underlines the importance of searching for a possible right atrial appendage thrombosis in patients affected by AF, and suggests that left atrial appendage closure in AF patients not suitable for OAT does not fully eliminate the risk of thromboembolism.

Published
2017
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