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1. Impact of Left Ventricular Ejection Fraction on Procedural and Long-Term Outcomes of Bifurcation Percutaneous Coronary Intervention

Author: Guglielmo Gallone, Jeehoon Kang, Francesco Bruno, Jung-Kyu Han, Ovidio De Filippo, Han-Mo Yang, Mattia Doronzo, Kyung-Woo Park, Gianluca Mittone, Hyun-Jae Kang, Radoslaw Parma, Hyeon-Cheol Gwon, Enrico Cerrato, Woo Jung Chun, Grzegorz Smolka, Seung-Ho Hur, Gerard Helft, Seung Hwan Han, Saverio Muscoli, Young Bin Song, Filippo Figini, Ki Hong Choi, Giacomo Boccuzzi, Soon-Jun Hong, Daniela Trabattoni, Chang-Wook Nam, Massimo Giammaria, Hyo-Soo Kim, Federico Conrotto, Javier Escaned, Carlo Di Mario, Fabrizio D'Ascenzo, Bon-Kwon Koo, Gaetano Maria de Ferrari, Università degli studi di Torino = University of Turin (UNITO), Seoul National University Hospital, Medical University of Silesia (SUM), Samsung Medical Center Sungkyunkwan University School of Medicine, Institute Division of Hematology/Oncology, Ospedale di Rivoli [Rivoli, Italy] (OR), Keimyung University, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Gachon University Gil Medical Center [Incheon, Republic of Korea], University of Rome 'Tor Vergeta', Università degli Studi di Roma Tor Vergata [Roma], Clinica Pederzoli [Peschiera del Garda, Italy] (CP), Ospedale S.Giovanni Bosco, Korea University [Seoul], Monzino Cardiology Center [Milan, Italy] (M2C), Maria Vittoria Hospital [Turin], Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Careggi University Hospital [Florence, Italie], and Lesnik, Philippe
Subjects: [SDV] Life Sciences [q-bio], Ventricular Dysfunction, Left, Percutaneous Coronary Intervention, Treatment Outcome, [SDV]Life Sciences [q-bio], Humans, Drug-Eluting Stents, Stroke Volume, Coronary Artery Disease, Registries, Cardiology and Cardiovascular Medicine, Ventricular Function, Left, Retrospective Studies
Abstract: International audience; The association of left ventricular ejection fraction (LVEF) with procedural and long-term outcomes after state-of-the-art percutaneous coronary intervention (PCI) of bifurcation lesions remains unsettled. A total of 5,333 patients who underwent contemporary coronary bifurcation PCI were included in the intercontinental retrospective combined insights from the unified RAIN (veRy thin stents for patients with left mAIn or bifurcatioN in real life) and COBIS (COronary BIfurcation Stenting) III bifurcation registries. Of 5,003 patients (93.8%) with known baseline LVEF, 244 (4.9%) had LVEF
Published: 2022

2. Long COVID and the cardiovascular system—elucidating causes and cellular mechanisms in order to develop targeted diagnostic and therapeutic strategies : A joint Scientific Statement of the ESC Working Groups on Cellular Biology of the Heart and Myocardial and Pericardial Diseases

Author: Mariann Gyöngyösi, Pilar Alcaide, Folkert W Asselbergs, Bianca J J M Brundel, Giovanni G Camici, Paula da Costa Martins, Péter Ferdinandy, Marianna Fontana, Henrique Girao, Massimiliano Gnecchi, Can Gollmann-Tepeköylü, Petra Kleinbongard, Thomas Krieg, Rosalinda Madonna, Melanie Paillard, Antonis Pantazis, Cinzia Perrino, Maurizio Pesce, Gabriele G Schiattarella, Joost P G Sluijter, Sabine Steffens, Carsten Tschöpe, Sophie Van Linthout, Sean M Davidson, Martins, Paula da Costa [0000-0002-0695-1187], Fontana, Marianna [0000-0002-9233-9831], Girao, Henrique [0000-0002-5786-8447], Gnecchi, Massimiliano [0000-0001-7435-4328], Kleinbongard, Petra [0000-0003-3576-3772], Krieg, Thomas [0000-0002-5192-580X], Perrino, Cinzia [0000-0002-2274-0048], Pesce, Maurizio [0000-0002-3097-8961], Sluijter, Joost PG [0000-0003-2088-9102], Steffens, Sabine [0000-0002-6892-9751], Van Linthout, Sophie [0000-0002-7581-7870], Apollo - University of Cambridge Repository, Medizinische Universität Wien = Medical University of Vienna, Tufts University School of Medicine [Boston], University Medical Center [Utrecht], Utrecht University [Utrecht], University College of London [London] (UCL), Amsterdam UMC - Amsterdam University Medical Center, Vrije Universiteit Amsterdam [Amsterdam] (VU), Universität Zürich [Zürich] = University of Zurich (UZH), University hospital of Zurich [Zurich], Maastricht University [Maastricht], Semmelweis University [Budapest], Pharmahungary Group [Szeged, Hungary] (PG), University of Coimbra [Portugal] (UC), Coimbra Institute for Clinical and Biomedical Research [Coimbra, Portugal] (iCBR - Faculty of Medicine), Università degli Studi di Pavia = University of Pavia (UNIPV), Fondazione IRCCS Policlinico San Matteo [Pavia], Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), Universitätsklinikum Essen [Universität Duisburg-Essen] (Uniklinik Essen), Addenbrooke's Hospital, Cambridge University NHS Trust, University of Pisa - Università di Pisa, Jefferson (Philadelphia University + Thomas Jefferson University), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Imperial College London, Royal Brompton and Harefield NHS Foundation Trust, University of Naples Federico II = Università degli studi di Napoli Federico II, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), Max Delbrück Center for Molecular Medicine [Berlin] (MDC), Helmholtz-Gemeinschaft = Helmholtz Association, Utrecht Brain Center [UMC], Ludwig-Maximilians-Universität München (LMU), Charité Campus Virchow-Klinikum (CVK), The Hatter Cardiovascular Institute (THCI), CarMeN, laboratoire, Gyöngyösi, Mariann, Alcaide, Pilar, Asselbergs, Folkert W, Brundel, Bianca J J M, Camici, Giovanni G, da Costa Martins, Paula, Ferdinandy, Péter, Fontana, Marianna, Girao, Henrique, Gnecchi, Massimiliano, Gollmann-Tepeköylü, Can, Kleinbongard, Petra, Krieg, Thoma, Madonna, Rosalinda, Paillard, Melanie, Pantazis, Antoni, Perrino, Cinzia, Pesce, Maurizio, Schiattarella, Gabriele G, Sluijter, Joost P G, Steffens, Sabine, Tschöpe, Carsten, Van Linthout, Sophie, and Davidson, Sean M
Subjects: Long COVID, Heart Diseases, Physiology, SARS-CoV-2, [SDV]Life Sciences [q-bio], Myocardium, Medizin, COVID-19, Heart, virus, Post COVID, Cardiovascular, [SDV] Life Sciences [q-bio], Post-Acute COVID-19 Syndrome, COVID-19 Testing, Cardiovascular and Metabolic Diseases, Physiology (medical), Humans, Cardiology and Cardiovascular Medicine, Cardiac
Abstract: Long COVID has become a world-wide, non-communicable epidemic, caused by long-lasting multiorgan symptoms that endure for weeks or months after SARS-CoV-2 infection has already subsided. This scientific document aims to provide insight into the possible causes and therapeutic options available for the cardiovascular manifestations of long COVID. In addition to chronic fatigue, which is a common symptom of long COVID, patients may present with chest pain, ECG abnormalities, postural orthostatic tachycardia, or newly developed supraventricular or ventricular arrhythmias. Imaging of the heart and vessels has provided evidence of chronic, post-infectious perimyocarditis with consequent left or right ventricular failure, arterial wall inflammation, or microthrombosis in certain patient populations. Better understanding of the underlying cellular and molecular mechanisms of long COVID will aid in the development of effective treatment strategies for its cardiovascular manifestations. A number of mechanisms have been proposed, including those involving direct effects on the myocardium, microthrombotic damage to vessels or endothelium, or persistent inflammation. Unfortunately, existing circulating biomarkers, coagulation, and inflammatory markers, are not highly predictive for either the presence or outcome of long COVID when measured 3 months after SARS-CoV-2 infection. Further studies are needed to understand underlying mechanisms, identify specific biomarkers, and guide future preventive strategies or treatments to address long COVID and its cardiovascular sequelae.
Published: 2023

3. Sequencing and Titrating Approach of Therapy in Heart Failure with Reduced Ejection Fraction Following the 2021 ESC guidelines: an International Cardiology Survey

Author: Fauvel, Charles, Bonnet, Guillaume, Mullens, Wilfried, Giraldo, Clara Ines Saldarriaga, Mežnar, Anja Zupan, Barasa, Anders, Tokmakova, Mariya, Shchendrygina, Anastasia, Costa, Francisco Moscoso, Mapelli, Massimo, Zemrak, Filip, Tops, Laurens, Jakus, Nina, Sultan, Arian, Bahouth, Fadel, Hadjseyd, Chahr‐eddine, Salvat, Muriel, Anselmino, Matteo, Messroghli, Daniel, Weberndörfer, Vanessa, Giverts, Ilya, Bochaton, Thomas, Berthelot, Emmanuelle, Legallois, Damien, Beauvais, Florence, Bauer, Fabrice, Lamblin, Nicolas, Damy, Thibaud, Girerd, Nicolas, Sebbag, Laurent, Pezel, Théo, Cohen-Solal, Alain, Rosano, Giuseppe, Roubille, François, Mewton, Nathan, CHU Rouen, Normandie Université (NU), Ohio State University [Columbus] (OSU), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Ziekenhuis Oost-Limburg (ZOL), Hasselt University (UHasselt), Universidad Pontificia Bolivariana (UPB), University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Glostrup Hospital, Medical University of Plovdiv, Sechenov First Moscow State Medical University, Hospital de Santa Cruz, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Università degli Studi di Milano = University of Milan (UNIMI), St Bartholomew's Hospital (London), Leiden University Medical Center (LUMC), Universiteit Leiden, University Hospital Centre Zagreb, Partenaires INRAE, Universitätsklinikum Köln (Uniklinik Köln), Bnai Zion Hospital, Centre d'Investigation Clinique [Bron] (CIC1407), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupement Hospitalier Est [Bron], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Grenoble, Università degli studi di Torino = University of Turin (UNITO), German Heart Institute Berlin [Berlin, Germany] (GHIB), Cardiovascular Research Institute Maastricht (CARIM), Maastricht University [Maastricht], Maastricht University Medical Centre (MUMC), Massachusetts General Hospital [Boston], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Service de cardiologie et de pathologie vasculaire [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU), CHU Lille, Université de Lille, Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP), CHU Henri Mondor [Créteil], Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS San Raffaele Pisana), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Subjects: Pharmacology, Treatment, [SDV]Life Sciences [q-bio], Heart failure, Guideline
Abstract: International audience; Aims: In symptomatic patients with heart failure and reduced ejection fraction (HFrEF), recent international guidelines recommend initiating four major therapeutic classes rather than sequential initiation. It remains unclear how this change in guidelines is perceived by practicing cardiologists versus heart failure (HF) specialists.Methods and results: An independent academic web-based survey was designed by a group of HF specialists and posted by email and through various social networks to a broad community of cardiologists worldwide 1 year after the publication of the latest European HF guidelines. Overall, 615 cardiologists (38 [32-47] years old, 63% male) completed the survey, of which 58% were working in a university hospital and 26% were HF specialists. The threshold to define HFrEF was ≤40% for 61% of the physicians. Preferred drug prescription for the sequential approach was angiotensin-converting enzyme inhibitors or angiotensin receptor-neprilysin inhibitors first (74%), beta-blockers second (55%), mineralocorticoid receptor antagonists third (52%), and sodium-glucose cotransporter 2 inhibitors (53%) fourth. Eighty-four percent of participants felt that starting all four classes was feasible within the initial hospitalization, and 58% felt that titration is less important than introducing a new class. Age, status in training, and specialization in HF field were the principal characteristics that significantly impacted the answers.Conclusion: In a broad international cardiology community, the 'historical approach' to HFrEF therapies remains the preferred sequencing approach. However, accelerated introduction and uptitration are also major treatment goals. Strategy trials in treatment guidance are needed to further change practices.
Published: 2022

4. COVID-19-related cardiac complications from clinical evidences to basic mechanisms: opinion paper of the ESC Working Group on Cellular Biology of the Heart

Author: Can Gollmann-Tepeköylü, Sabine Steffens, Ivan Tancevski, Sean M. Davidson, Maurizio Pesce, Joost P.G. Sluijter, Piergiuseppe Agostoni, Raffaele De Caterina, Sandrine Lecour, Bianca J.J.M. Brundel, Jean-Sébastien Hulot, Cinzia Perrino, Péter Ferdinandy, Hans-Erik Bøtker, Henrique Girão, Mariann Gyöngyösi, Rainer Schulz, Rosalinda Madonna, Carsten Tschöpe, Sophie Van Linthout, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Università degli Studi di Milano = University of Milan (UNIMI), Aarhus University Hospital, Amsterdam UMC - Amsterdam University Medical Center, University College of London [London] (UCL), University of Pisa - Università di Pisa, Semmelweis University [Budapest], University of Coimbra [Portugal] (UC), Medizinische Universität Wien = Medical University of Vienna, CIC - HEGP (CIC 1418), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CArdiovasculaire Rénal Transplantation nEurovasculaire [Paris] (DMU CARTE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), University of Cape Town, University of Naples Federico II = Università degli studi di Napoli Federico II, Justus-Liebig-Universität Gießen = Justus Liebig University (JLU), Utrecht University [Utrecht], Ludwig-Maximilians-Universität München (LMU), Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), Charité Campus Virchow-Klinikum (CVK), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), The University of Texas Medical School at Houston, and HULOT, Jean-Sébastien
Subjects: 0301 basic medicine, Heart Diseases, Physiology, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Inflammation, Disease, 030204 cardiovascular system & hematology, Bioinformatics, Vascular occlusion, 03 medical and health sciences, 0302 clinical medicine, Viral entry, Physiology (medical), medicine, Coagulopathy, Animals, Humans, Myocytes, Cardiac, Blood Coagulation, Cause of death, Myocytes, Ventricular Remodeling, SARS-CoV-2, business.industry, COVID-19, Heart, medicine.disease, Omics, Disease modelling, Infection, Myocardial injury, Biomarkers, Fibrosis, Host-Pathogen Interactions, Inflammation Mediators, [SDV] Life Sciences [q-bio], 030104 developmental biology, Cytokine, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Cardiac
Abstract: The pandemic of coronavirus disease (COVID)-19 is a global threat, causing high mortality, especially in the elderly. The main symptoms and the primary cause of death are related to interstitial pneumonia. Viral entry also into myocardial cells mainly via the angiotensin converting enzyme type 2 (ACE2) receptor and excessive production of pro-inflammatory cytokines, however, also make the heart susceptible to injury. In addition to the immediate damage caused by the acute inflammatory response, the heart may also suffer from long-term consequences of COVID-19, potentially causing a post-pandemic increase in cardiac complications. Although the main cause of cardiac damage in COVID-19 remains coagulopathy with micro- (and to a lesser extent macro-) vascular occlusion, open questions remain about other possible modalities of cardiac dysfunction, such as direct infection of myocardial cells, effects of cytokines storm, and mechanisms related to enhanced coagulopathy. In this opinion paper, we focus on these lesser appreciated possibilities and propose experimental approaches that could provide a more comprehensive understanding of the cellular and molecular bases of cardiac injury in COVID-19 patients. We first discuss approaches to characterize cardiac damage caused by possible direct viral infection of cardiac cells, followed by formulating hypotheses on how to reproduce and investigate the hyperinflammatory and pro-thrombotic conditions observed in the heart of COVID-19 patients using experimental in vitro systems. Finally, we elaborate on strategies to discover novel pathology biomarkers using omics platforms.
Published: 2021

5. ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1—epidemiology, pathophysiology, and diagnosis

Author: Baigent, Colin, Windecker, Stephan, Andreini, Daniele, Arbelo, Elena, Barbato, Emanuele, Bartorelli, Antonio, Baumbach, Andreas, Behr, Elijah, Berti, Sergio, Bueno, Héctor, Capodanno, Davide, Cappato, Riccardo, Chieffo, Alaide, Collet, Jean-Philippe, Cuisset, Thomas, de Simone, Giovanni, Delgado, Victoria, Dendale, Paul, Dudek, Dariusz, Edvardsen, Thor, Elvan, Arif, González-Juanatey, José, Gori, Mauro, Grobbee, Diederick, Guzik, Tomasz, Halvorsen, Sigrun, Haude, Michael, Heidbuchel, Hein, Hindricks, Gerhard, Ibanez, Borja, Karam, Nicole, Katus, Hugo, Klok, Fredrikus, Konstantinides, Stavros, Landmesser, Ulf, Leclercq, Christophe, Leonardi, Sergio, Lettino, Maddalena, Marenzi, Giancarlo, Mauri, Josepa, Metra, Marco, Morici, Nuccia, Mueller, Christian, Petronio, Anna Sonia, Polovina, Marija, Potpara, Tatjana, Praz, Fabien, Prendergast, Bernard, Prescott, Eva, Price, Susanna, Pruszczyk, Piotr, Rodríguez-Leor, Oriol, Roffi, Marco, Romaguera, Rafael, Rosenkranz, Stephan, Sarkozy, Andrea, Scherrenberg, Martijn, Seferovic, Petar, Senni, Michele, Spera, Francesco, Stefanini, Giulio, Thiele, Holger, Tomasoni, Daniela, Torracca, Lucia, Touyz, Rhian, Wilde, Arthur, Williams, Bryan, Bern University Hospital [Berne] (Inselspital), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), 'Federico II' University of Naples Medical School, St George's, University of London, Fondazione Toscana Gabriele Monasterio, Hospital Universitario 12 de Octubre [Madrid], Centro Nacional de Investigaciones Cardiovasculares Carlos III [Madrid, Spain] (CNIC), Instituto de Salud Carlos III [Madrid] (ISC), University of Catania [Italy], IRCCS San Raffaele Scientific Institute [Milan, Italie], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital de la Timone [CHU - APHM] (TIMONE), Leiden University Medical Center (LUMC), Universiteit Leiden, Hasselt University (UHasselt), Jessa Ziekenhuis [Hasselt], Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Oslo University Hospital [Oslo], Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), University College of London [London] (UCL), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Myocarditis, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV]Life Sciences [q-bio], Pulmonary embolism, ACE2, COVID-19, Heart failure, Thrombosis, Acute coronary syndromes, Arrhythmias, Cardiogenic shock, Biomarkers, Venous thromboembolism
Abstract: International audience; Aims - Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two-part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular disease (CVD) in association with COVID-19. Methods and results - A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, reported here, focuses on the epidemiology, pathophysiology, and diagnosis of cardiovascular (CV) conditions that may be manifest in patients with COVID-19. The second part, which will follow in a later edition of the journal, addresses the topics of care pathways, treatment, and follow-up of CV conditions in patients with COVID-19. Conclusion - This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities.
Published: 2022

6. Neutrophil to lymphocyte ratio is not related to carotid atherosclerosis progression and cardiovascular events in the primary prevention of cardiovascular disease: Results from the IMPROVE study

Author: Mannarino, M. R., Bianconi, V., Gigante, B., Strawbridge, R. J., Savonen, K., Kurl, S., Giral, P., Smit, A., Eriksson, P., Tremoli, E., Veglia, F., Baldassarre, D., Pirro, M., Groningen Kidney Center (GKC), Translational Immunology Groningen (TRIGR), Università degli Studi di Perugia (UNIPG), Karolinska Institutet [Stockholm], University of Glasgow, University of Kuopio, University of Eastern Finland, Service d’Endocrinologie, Métabolisme et Prévention des Risques Cardio-Vasculaires [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), University Medical Center Groningen [Groningen] (UMCG), Maria Cecilia Hospital [Cotignola], Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), and Università degli Studi di Milano [Milano] (UNIMI)
Subjects: Carotid Artery Diseases, IMT, Neutrophils, cardiovascular, fungi, neutrophil, lymphocyte, prospective, Carotid Intima-Media Thickness, NLR, Primary Prevention, carotid, Cardiovascular Diseases, Risk Factors, cardiovascular system, Humans, cardiovascular diseases, Lymphocytes, Prospective Studies, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Inflammation is a component of the pathogenesis of atherosclerosis and is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). The neutrophil to lymphocyte ratio (NLR) is a possible inflammation metric for the detection of ASCVD risk, although results of prospective studies are highly inconsistent on this topic. We investigated the cross-sectional relationship between NLR and carotid intima-media thickness (cIMT) in subjects at moderate-to-high ASCVD risk. The prospective association between NLR, cIMT progression, and incident vascular events (VEs) was also explored. In 3341 subjects from the IMT-Progression as Predictors of VEs (IMPROVE) study, we analyzed the association between NLR, cIMT, and its 15-month progression. The association between NLR and incident VEs was also investigated. NLR was positively associated with cross-sectional measures of cIMT, but not with cIMT progression. The association between NLR and cross-sectional cIMT measures was abolished when adjusted for confounders. No association was found between NRL and incident VEs. Similarly, there were no significant differences in the hazard ratios (HRs) of VEs across NLR quartiles. NLR was neither associated with the presence and progression of carotid atherosclerosis, nor with the risk of VEs. Our findings do not support the role of NLR as a predictor of the risk of atherosclerosis progression and ASCVD events in subjects at moderate-to-high ASCVD risk, in primary prevention. However, the usefulness of NLR for patients at a different level of ASCVD risk cannot be inferred from this study.
Published: 2022

7. Genetic variation in CADM2 as a link between psychological traits and obesity

Author: Daniel J. Smith, Laura M. Lyall, Keira J.A. Johnston, Angela Silveira, Bruna Gigante, Joey Ward, Amy Ferguson, Hugh Watkins, Bengt Sennblad, Anuj Goel, Philippe Giral, Fabrizio Veglia, Breda Cullen, Damiano Baldassarre, Steve E. Humphries, Julia Morris, Anders Hamsten, Elena Tremoli, Donald M. Lyall, Rona J. Strawbridge, Ulf de Faire, Nicholas Graham, Mark E.S. Bailey, Andries J. Smit, University of Glasgow, Università degli Studi di Milano [Milano] (UNIMI), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), The Institute of Environmental Medicine [Stockholm] (IMM), Karolinska Institutet [Stockholm], Service d’Endocrinologie, Métabolisme et Prévention des Risques Cardio-Vasculaires [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Radcliffe Department of Medicine [Oxford], University of Oxford [Oxford], The Wellcome Trust Centre for Human Genetics [Oxford], University College of London [London] (UCL), University of Edinburgh, Stockholm Bioinformatics Center (SBC), Stockholm University, Uppsala University, University Medical Center Groningen [Groningen] (UMCG), University of Groningen [Groningen], and Groningen Kidney Center (GKC)
Subjects: 0301 basic medicine, Male, Bipolar Disorder, [SDV]Life Sciences [q-bio], Obesity/genetics, LOCI, lcsh:Medicine, Genome-wide association study, Bioinformatics, 0302 clinical medicine, Genetics research, lcsh:Science, RISK, Multidisciplinary, Bipolar Disorder/genetics, Endocrine system and metabolic diseases, Middle Aged, Neuroticism, Anxiety Disorders, 3. Good health, INSIGHTS, Cardiovascular diseases, Medical genetics, Major depressive disorder, Female, Cell Adhesion Molecules/genetics, Depressive Disorder, Major/genetics, Medical Genetics, EXPRESSION, medicine.medical_specialty, Quantitative Trait Loci, Quantitative trait locus, Biology, Polymorphism, Single Nucleotide, Article, 03 medical and health sciences, Risk-Taking, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Genetic variation, medicine, Humans, Genetic Predisposition to Disease, Bipolar disorder, Obesity, GENOME-WIDE ASSOCIATION, COMMON, METAANALYSIS, Medicinsk genetik, Aged, [SDV.GEN]Life Sciences [q-bio]/Genetics, Depressive Disorder, Major, ENERGY HOMEOSTASIS, lcsh:R, Genetic Variation, medicine.disease, BODY-MASS INDEX, Affect, 030104 developmental biology, VISUALIZATION, lcsh:Q, Psychiatric disorders, Anxiety Disorders/genetics, Cell Adhesion Molecules, 030217 neurology & neurosurgery
Abstract: CADM2 has been associated with a range of behavioural and metabolic traits, including physical activity, risk-taking, educational attainment, alcohol and cannabis use and obesity. Here, we set out to determine whether CADM2 contributes to mechanisms shared between mental and physical health disorders. We assessed genetic variants in the CADM2 locus for association with phenotypes in the UK Biobank, IMPROVE, PROCARDIS and SCARFSHEEP studies, before performing meta-analyses. A wide range of metabolic phenotypes were meta-analysed. Psychological phenotypes analysed in UK Biobank only were major depressive disorder, generalised anxiety disorder, bipolar disorder, neuroticism, mood instability and risk-taking behaviour. In UK Biobank, four, 88 and 172 genetic variants were significantly (p −5) associated with neuroticism, mood instability and risk-taking respectively. In meta-analyses of 4 cohorts, we identified 362, 63 and 11 genetic variants significantly (p −5) associated with BMI, SBP and CRP respectively. Genetic effects on BMI, CRP and risk-taking were all positively correlated, and were consistently inversely correlated with genetic effects on SBP, mood instability and neuroticism. Conditional analyses suggested an overlap in the signals for physical and psychological traits. Many significant variants had genotype-specific effects on CADM2 expression levels in adult brain and adipose tissues. CADM2 variants influence a wide range of both psychological and metabolic traits, suggesting common biological mechanisms across phenotypes via regulation of CADM2 expression levels in adipose tissue. Functional studies of CADM2 are required to fully understand mechanisms connecting mental and physical health conditions.
Published: 2019

8. Prediction of All-Cause Mortality Following Percutaneous Coronary Intervention in Bifurcation Lesions Using Machine Learning Algorithms

Author: Jacopo Burrello, Guglielmo Gallone, Alessio Burrello, Daniele Jahier Pagliari, Eline H. Ploumen, Mario Iannaccone, Leonardo De Luca, Paolo Zocca, Giuseppe Patti, Enrico Cerrato, Wojciech Wojakowski, Giuseppe Venuti, Ovidio De Filippo, Alessio Mattesini, Nicola Ryan, Gérard Helft, Saverio Muscoli, Jing Kan, Imad Sheiban, Radoslaw Parma, Daniela Trabattoni, Massimo Giammaria, Alessandra Truffa, Francesco Piroli, Yoichi Imori, Bernardo Cortese, Pierluigi Omedè, Federico Conrotto, Shao-Liang Chen, Javier Escaned, Rosaly A. Buiten, Clemens Von Birgelen, Paolo Mulatero, Gaetano Maria De Ferrari, Silvia Monticone, Fabrizio D’Ascenzo, Università degli studi di Torino = University of Turin (UNITO), University of Bologna/Università di Bologna, Polytechnic University of Turin, Thorax Centrum Twente [Enschede, The Netherlands] (TCT), Ospedale San Giovanni Bosco [Turin, Italy] (OSGB), Ospedale San Giovanni Evangelista [Rome, Italy] (OSGE), University Hospital 'Maggiore della Carità' [Novara, Italy], Azienda Ospedaliero-Universitaria San Luigi Gonzaga/San Luigi Gonzaga University Hospital (SLGUH), Medical University of Silesia (SUM), AOU Policlinico Vittorio-Emanuele [Catania, Italia], Careggi University Hospital [Florence, Italie], Aberdeen Royal Infirmary [Aberdeen, UK] (ARI), Institut de cardiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Università degli Studi di Roma Tor Vergata [Roma], Nanjing Medical University, Clinica Pederzoli [Peschiera del Garda, Italy] (CP), Medical University of Warsaw - Poland, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Maria Vittoria Hospital [Turin], Ospedale Civile Cardinal Massaia, Nippon Medical School [Tokyo, Japon], Clinica San Carlo [Milan, Italy] (CSC), Nanjing First Hospital (NFH), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), and Lesnik, Philippe
Subjects: [SDV] Life Sciences [q-bio], percutaneous coronary intervention, coronary bifurcation, machine learning, prognosis, [SDV]Life Sciences [q-bio], Medicine (miscellaneous)
Abstract: International audience; Stratifying prognosis following coronary bifurcation percutaneous coronary intervention (PCI) is an unmet clinical need that may be fulfilled through the adoption of machine learning (ML) algorithms to refine outcome predictions. We sought to develop an ML-based risk stratification model built on clinical, anatomical, and procedural features to predict all-cause mortality following contemporary bifurcation PCI. Multiple ML models to predict all-cause mortality were tested on a cohort of 2393 patients (training, n = 1795; internal validation, n = 598) undergoing bifurcation PCI with contemporary stents from the real-world RAIN registry. Twenty-five commonly available patient-/lesion-related features were selected to train ML models. The best model was validated in an external cohort of 1701 patients undergoing bifurcation PCI from the DUTCH PEERS and BIO-RESORT trial cohorts. At ROC curves, the AUC for the prediction of 2-year mortality was 0.79 (0.74–0.83) in the overall population, 0.74 (0.62–0.85) at internal validation and 0.71 (0.62–0.79) at external validation. Performance at risk ranking analysis, k-center cross-validation, and continual learning confirmed the generalizability of the models, also available as an online interface. The RAIN-ML prediction model represents the first tool combining clinical, anatomical, and procedural features to predict all-cause mortality among patients undergoing contemporary bifurcation PCI with reliable performance.
Published: 2022

9. Intake of food rich in saturated fat in relation to subclinical atherosclerosis and potential modulating effects from single genetic variants

Author: Laguzzi, Federica, Maitusong, Buamina, Strawbridge, Rona J., Baldassarre, Damiano, Veglia, Fabrizio, Humphries, Steve E., Rauramaa, Rainer, Kurl, Sudhir, Smit, Andries J., Giral, Philippe, Silveira, Angela, Tremoli, Elena, Hamsten, Anders, de Faire, Ulf, Gigante, Bruna, Leander, Karin, Sirtori, C. R., Calabresi, L., Amato, M., Frigerio, B., Ravani, A., Sansaro, D., Tedesco, C., Coggi, D., Capra, N., Bonomi, A., Eriksson, P., Cooper, J., Acharya, J., Savonen, K., Huttunen, K., Rauramaa, E., Penttila, I. M., Törrönen, J., van Gessel, A. I., van Roon, A. M., Nicolai, A., Mulder, D. J., Kontush, A., Carrié, A., Gallo, A., Karppi, J., Nurmi, T., Nyyssönen, K., Tuomainen, T. P., Tuomainen, J., Kauhanen, J., Sennblad, B., Pirro, M., Vaudo, G., Siepi, D., Lupattelli, G., Mannarino, M. R., Bianconi, V., Groningen Kidney Center (GKC), Translational Immunology Groningen (TRIGR), Karolinska Institutet [Stockholm], Xinjiang University, University of Glasgow, Università degli Studi di Milano [Milano] (UNIMI), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), University College of London [London] (UCL), University of Kuopio, University of Eastern Finland, University Medical Center Groningen [Groningen] (UMCG), Service d’Endocrinologie, Métabolisme et Prévention des Risques Cardio-Vasculaires [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Male, medicine.medical_specialty, Multivariate analysis, Cross-sectional study, Science, [SDV]Life Sciences [q-bio], Saturated fat, Cardiology, Disease, 030204 cardiovascular system & hematology, Logistic regression, Carotid Intima-Media Thickness, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Genetics, Medicine, Humans, Genetic Predisposition to Disease, 030212 general & internal medicine, Aged, Multidisciplinary, business.industry, Middle Aged, Atherosclerosis, Dietary Fats, 3. Good health, Endocrinology, Blood pressure, Intima-media thickness, Cohort, cardiovascular system, Dietary Fats/adverse effects, Female, Atherosclerosis/epidemiology, business, Biomarkers
Abstract: The relationship between intake of saturated fats and subclinical atherosclerosis, as well as the possible influence of genetic variants, is poorly understood and investigated. We aimed to investigate this relationship, with a hypothesis that it would be positive, and to explore whether genetics may modulate it, using data from a European cohort including 3,407 participants aged 54–79 at high risk of cardiovascular disease. Subclinical atherosclerosis was assessed by carotid intima-media thickness (C-IMT), measured at baseline and after 30 months. Logistic regression (OR; 95% CI) was employed to assess the association between high intake of food rich in saturated fat (vs. low) and: (1) the mean and the maximum values of C-IMT in the whole carotid artery (C-IMTmean, C-IMTmax), in the bifurcation (Bif-), the common (CC-) and internal (ICA-) carotid arteries at baseline (binary, cut-point ≥ 75th), and (2) C-IMT progression (binary, cut-point > zero). For the genetic-diet interaction analyses, we considered 100,350 genetic variants. We defined interaction as departure from additivity of effects. After age- and sex-adjustment, high intake of saturated fat was associated with increased C-IMTmean (OR:1.27;1.06–1.47), CC-IMTmean (OR:1.22;1.04–1.44) and ICA-IMTmean (OR:1.26;1.07–1.48). However, in multivariate analysis results were no longer significant. No clear associations were observed between high intake of saturated fat and risk of atherosclerotic progression. There was no evidence of interactions between high intake of saturated fat and any of the genetic variants considered, after multiple testing corrections. High intake of saturated fats was not independently associated with subclinical atherosclerosis. Moreover, we did not identify any significant genetic-dietary fat interactions in relation to risk of subclinical atherosclerosis.
Published: 2021

10. Cardiac procedural myocardial injury, infarction, and mortality in patients undergoing elective percutaneous coronary intervention: a pooled analysis of patient-level data

Author: Silvain, Johanne, Zeitouni, Michel, Paradies, Valeria, Zheng, Huili, Ndrepepa, Gjin, Cavallini, Claudio, Feldman, Dimitri, Sharma, Samin, Mehilli, Julinda, Gili, Sebastiano, Barbato, Emanuele, Tarantini, Giuseppe, Ooi, Sze, von Birgelen, Clemens, Jaffe, Allan, Thygesen, Kristian, Montalescot, Gilles, Bulluck, Heerajnarain, Hausenloy, Derek, Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Maasstad Hospital, National University Health System [Singapore] (NUHS), Deutsches Herzzentrum München (DHM), Ospedale 'Santa Maria della Misericordia' = University Hospital 'Santa Maria della Misericordia', Weill Medical College of Cornell University [New York], Icahn School of Medicine at Mount Sinai [New York] (MSSM), Ludwig-Maximilians-Universität München (LMU), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), University of Naples Federico II, University of Padua, Prince of Wales Hospital, University of Twente [Netherlands], Mayo Clinic [Rochester], Aarhus University Hospital, Norwich University, University College of London [London] (UCL), Duke-National University of Singapore Graduate Medical School, Silvain, Johanne, Zeitouni, Michel, Paradies, Valeria, Zheng, Huili L, Ndrepepa, Gjin, Cavallini, Claudio, Feldman, Dimitri N, Sharma, Samin K, Mehilli, Julinda, Gili, Sebastiano, Barbato, Emanuele, Tarantini, Giuseppe, Ooi, Sze Y, von Birgelen, Clemen, Jaffe, Allan S, Thygesen, Kristian, Montalescot, Gille, Bulluck, Heerajnarain, and Hausenloy, Derek J
Subjects: heart mortality, Procedural complication, Myocardial infarction, Elective PCI, Myocardial injury, Procedural myocardial infarction, Procedural myocardial injury, percutaneous coronary intervention, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, health care economics and organizations
Abstract: International audience; AimsThe prognostic importance of cardiac procedural myocardial injury and myocardial infarction (MI) in chronic coronary syndrome (CCS) patients undergoing elective percutaneous coronary intervention (PCI) is still debated.Methods and resultsWe analysed individual data of 9081 patients undergoing elective PCI with normal pre-PCI baseline cardiac troponin (cTn) levels. Multivariate models evaluated the association between post-PCI elevations in cTn and 1-year mortality, while an interval analysis evaluated the impact of the size of the myocardial injury on mortality. Our analysis was performed in the overall population and also according to the type of cTn used [52.0% had high-sensitivity cTn (hs-cTn)]. Procedural myocardial injury, as defined by the Fourth Universal Definition of MI (UDMI) [post-PCI cTn elevation ≥1 × 99th percentile upper reference limit (URL)], occurred in 52.8% of patients and was not associated with 1-year mortality [adj odds ratio (OR), 1.35, 95% confidence interval (CI) (0.84–1.77), P = 0.21]. The association between post-PCI cTn elevation and 1-year mortality was significant starting ≥3 × 99th percentile URL. Major myocardial injury defined by post-PCI ≥5 × 99th percentile URL occurred in 18.2% of patients and was associated with a two-fold increase in the adjusted odds of 1-year mortality [2.29, 95% CI (1.32–3.97), P = 0.004]. In the subset of patients for whom periprocedural evidence of ischaemia was collected (n = 2316), Type 4a MI defined by the Fourth UDMI occurred in 12.7% of patients and was strongly associated with 1-year mortality [adj OR 3.21, 95% CI (1.42–7.27), P = 0.005]. We also present our results according to the type of troponin used (hs-cTn or conventional troponin).ConclusionOur analysis has demonstrated that in CCS patients with normal baseline cTn levels, the post-PCI cTn elevation of ≥5 × 99th percentile URL used to define Type 4a MI is associated with 1-year mortality and could be used to detect ‘major’ procedural myocardial injury in the absence of procedural complications or evidence of new myocardial ischaemia.
Published: 2021

11. The Association between HDL-C and Subclinical Atherosclerosis Depends on CETP Plasma Concentration: Insights from the IMPROVE Study

Author: Colombo, Gualtiero, Bianconi, Vanessa, Bonomi, Alice, Simonelli, Sara, Amato, Mauro, Frigerio, Beatrice, Ravani, Alessio, Vitali, Cecilia, Sansaro, Daniela, Coggi, Daniela, Mannarino, Massimo, Savonen, Kai, Kurl, Sudhir, Gigante, Bruna, Smit, Andries, Giral, Philippe, Tremoli, Elena, Calabresi, Laura, Veglia, Fabrizio, Pirro, Matteo, Baldassarre, Damiano, Group, on behalf of the IMPROVE Study, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Università degli Studi di Perugia (UNIPG), Università degli Studi di Milano [Milano] (UNIMI), Perelman School of Medicine, University of Pennsylvania [Philadelphia], University of Eastern Finland, Karolinska Institutet [Stockholm], University Medical Center Groningen [Groningen] (UMCG), Service d’Endocrinologie, Métabolisme et Prévention des Risques Cardio-Vasculaires [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), and Groningen Kidney Center (GKC)
Subjects: Carotid intima‐media thickness, carotid intima-media thickness, [SDV]Life Sciences [q-bio], cholesteryl ester transfer protein, Single‐nucleotide polymorphisms, Article, carbohydrates (lipids), HDL‐C, lcsh:Biology (General), single-nucleotide polymorphisms, cardiovascular system, lipids (amino acids, peptides, and proteins), HDL-C, cardiovascular diseases, atherosclerosis, lcsh:QH301-705.5
Abstract: The impact of cholesteryl ester transfer protein (CETP) on atherosclerosis is highly debated. This study aimed to investigate the associations between plasma CETP or CETP genotypes and carotid intima-media thickness (cIMT) and the influence of high-density lipoprotein cholesterol (HDL-C) on these associations. Plasma CETP and HDL-C concentrations were measured in 552 subjects free of any pharmacological treatment from the IMPROVE cohort, which includes 3711 European subjects at high cardiovascular risk. CETP single-nucleotide polymorphisms (SNPs) and cIMT measures (cIMTmax, cIMTmean–max of bifurcations, common and internal carotids, plaque-free common carotid [PF CC]-IMTmean) were available for the full cohort. In drug-free subjects, plasma CETP correlated with HDL-C levels (r = 0.19, p &lt, 0.0001), but not with cIMT variables. When stratified according to HDL-C quartiles, CETP positively correlated with cIMTmax and cIMTmean–max, but not with PF CC-IMTmean, in the top HDL-C quartile only. Positive associations between the CETP concentration and cIMTmax or cIMTmean–max were found in the top HDL-C quartile, whereas HDL-C levels were negatively correlated with cIMTmax and cIMTmean–max when the CETP concentration was below the median (HDL-C × CETP interaction, p = 0.001 and p = 0.003 for cIMTmax and cIMTmean–max, respectively). In the full cohort, three CETP SNPs (rs34760410, rs12920974, rs12708968) were positively associated with cIMTmax. rs12444708 exhibited a significant interaction with HDL-C levels in the prediction of cIMTmax. In conclusion, a significant interplay was found between plasma CETP and/or CETP genotype and HDL-C in the prediction of carotid plaque thickness, as indexed by cIMTmax. This suggests that the association of HDL-C with carotid atherosclerosis is CETP-dependent.
Published: 2021

12. Impact of stent thickness on clinical outcomes in small vessel and bifurcation lesions: a RAIN-CARDIOGROUP VII sub-study

Author: Ovidio De Filippo, Wojciech Wańha, Satoru Mitomo, Nicola Ryan, Radosław Parma, Imad Sheiban, Luca Franchin, Giuseppe Venuti, Bernardo Cortese, Francesco Piroli, Gérard Helft, Iván J. Núñez-Gil, Andrea Montabone, Andrea Rognoni, Saverio Muscoli, Yoichi Imori, Zenon Huczek, Giorgio Quadri, Ferdinando Varbella, Daniela Trabattoni, Gaetano M. De Ferrari, Fabrizio D'Ascenzo, Wojciech Wojakowski, Filippo Figini, Università degli studi di Torino = University of Turin (UNITO), Clínico San Carlos University Hospital, Medical University of Silesia (SUM), Nippon Medical School [Tokyo, Japon], Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Medical University of Warsaw - Poland, AOU Policlinico Vittorio-Emanuele [Catania, Italia], University of Catania [Italy], Department of Public Health and Cell Biology, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy, Ospedale San Giovanni Bosco [Turin, Italy] (OSGB), University Hospital 'Maggiore della Carità' [Novara, Italy], Clinica Pederzoli [Peschiera del Garda, Italy] (CP), IRCCS Ospedale San Raffaele [Milan, Italy], Ospedale 'Infermi' di Rimini [Rimini, Italy] (OIR), Azienda Ospedaliero-Universitaria San Luigi Gonzaga/San Luigi Gonzaga University Hospital (SLGUH), Clinica San Carlo [Milan, Italy] (CSC), Institut de cardiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Lesnik, Philippe
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, Coronary Artery Disease, 030204 cardiovascular system & hematology, Prosthesis Design, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Risk Factors, Internal medicine, medicine, Clinical endpoint, Humans, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, education, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, business.industry, Coronary Thrombosis, Hazard ratio, Stent, General Medicine, Middle Aged, medicine.disease, [SDV] Life Sciences [q-bio], Treatment Outcome, Italy, Conventional PCI, Cardiology, Female, Stents, Small vessel, Cardiology and Cardiovascular Medicine, business, Mace
Abstract: Background The clinical impact of stent strut thickness in coronary bifurcation lesions in small vessels has not been assessed in a real-world population. Methods and results All 506 patients enrolled in the RAIN study, undergoing PCI in a vessel with a diameter 2.5 mm or less were retrospectively evaluated and divided into two groups according to stent strut thickness: 74 μm (n = 206) versus 81 μm (n = 300); 87.1% of the lesions involved bifurcations. TLF [defined as a composite of myocardial infarction (MI) and target lesion revascularization (TLR)] was the primary endpoint, with MACE (a composite of death, MI and TLR), its components and stent thrombosis the secondary endpoint. After 16 (14-18) months, a lower incidence of TLF (4.3 vs. 9.8%, P = 0.026) and ST (1.0 vs. 3.0%, P = 0.042) was seen in the 74 μm group, whereas MACE occurred in 60 of 506 patients, with no statistical difference between the two groups (9.7 vs. 13.3%, P = 0.070). At multivariate analysis, chronic renal failure increased the risk of TLF while thinner strut was an independent protective factor (hazard ratio 0.51, CI 0.17-0.85, P = 0.005). Conclusion In this real-world population, patients being treated for small vessels lesions with thinner strut stents had lower rates of TLF, MI and ST.
Published: 2021

13. Heart failure in COVID-19: the multicentre, multinational PCHF-COVICAV registry

Author: Nathan Mewton, Tor Biering-Sørensen, Marcus Dörr, Andreas J. Flammer, Michał Marchel, Wilfried Mullens, Domenico D'Amario, Yuya Matsue, Huseyin A. Cakmak, Gianfranco Sinagra, Davide Stolfo, Kristoffer Grundtvig Skaarup, Claire Bouleti, Marzia Lilliu, Felix Schoenrath, Edgard Prihadi, Irene Mattavelli, Justyna M. Sokolska, Carlos Eduardo Lucena Montenegro, Daniel Messroghli, Anne-Catherine Pouleur, Frank Ruschitzka, Matthias Paul, Nana K. Poku, Lampros K. Michalis, Mateusz Sokolski, Jérôme Costa, Alessandra Chiodini, Viktoria Muster, Jeroen Dauw, Goran Loncar, Peter P. Rainer, Philippe Meyer, Eduardo Barge-Caballero, Massimo Mapelli, Aris Bechlioulis, Fran Mikulicic, Ahmet Çelik, Piotr Ponikowski, Klemens Ablasser, Chiara Minoia, Judith Schwaiger, Sander Trenson, Markus Wallner, Lars Lund, Giuseppe M.C. Rosano, P S Heiniger, Mats Christian Højbjerg Lassen, Margherita Gaudenzi, Irina Cabac-Pogorevici, Stephan Winnik, University of Wrocław [Poland] (UWr), University hospital of Zurich [Zurich], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Geneva University Hospital (HUG), Herlev and Gentofte Hospital, University of Copenhagen = Københavns Universitet (UCPH), Complejo Hospitalario Universitario A Coruña [A Coruña, Spain] (CHUAC), Instituto de Investigación Biomédica de A Coruña [La Corogne, Espagne] (INIBIC), A Coruña University Hospital [La Corogne, Espagne], Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares [Spain] (CIBERCV), Cliniques universitaires St Luc [Bruxelles], Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain = Catholic University of Louvain (UCL), Università degli studi di Trieste = University of Trieste, Medical University of Graz, Temple University [Philadelphia], Pennsylvania Commonwealth System of Higher Education (PCSHE), Center for Biomarker Research in Medicine [Graz, Austria] (CBmed GmbH), Mustafakemalpasa State Hospital [Bursa, Turkey] (MSH), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Università degli Studi di Milano = University of Milan (UNIMI), Johns Hopkins University Applied Physics Laboratory [Laurel, MD] (APL), Luzerner Kantonsspital [Lucerne, Switzerland] (LUKS), University Nicolae Testemitanu [Kishinev, Moldova] (UNT), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospital 'Magalini' Villafranca - ULSS 9 Scaligera [Verona, Italy], Public Health Company Valle Olona [Busto Arsizio, Italy] (PHCVO), Ziekenhuis Oost-Limburg (ZOL), Hasselt University (UHasselt), Centre Hospitalier Universitaire de Reims (CHU Reims), Mersin University, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Centre d'Investigation Clinique [Bron] (CIC1407), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupement Hospitalier Est [Bron], Universidade Federal de Pernambuco [Recife] (UFPE), Juntendo University Hospital [Tokyo], Institute for Cardiovascular Diseases Dedinje [Belgrade, Serbia] (IC2D), University of Belgrade [Belgrade], Medical University of Warsaw - Poland, University Hospital of Ioannina, University of Medicine Greifswald, German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), ZNA Heart Centre [Antwerp, Belgium], German Heart Institute Berlin [Berlin, Germany] (GHIB), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Deutsches Herzzentrum Berlin, Karolinska Institute, Karolinska University Hospital [Stockholm], IRCCS San Raffaele [Rome, Italy], Wrocław Medical University, CarMeN, laboratoire, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de cardiologie, Mapelli, Massimo/0000-0001-9985-7407, celik, Ahmet/0000-0002-9417-7610, Sokolski, Mateusz/0000-0001-9925-3566, Sokolska, Justyna/0000-0002-4759-5879, Lassen, Mats/0000-0002-2255-582X, Skaarup, Kristoffer/0000-0002-2690-7511, Sokolski, Mateusz, Trenson, Sander, Sokolska, Justyna M., D'Amario, Domenico, Meyer, Philippe, Poku, Nana K., Biering-Sorensen, Tor, Lassen, Mats C. Hojbjerg, Skaarup, Kristoffer G., Barge-Caballero, Eduardo, Pouleur, Anne-Catherine, Stolfo, Davide, Sinagra, Gianfranco, Ablasser, Klemens, Muster, Viktoria, Rainer, Peter P., Wallner, Markus, Chiodini, Alessandra, Heiniger, Pascal S., Mikulicic, Fran, Schwaiger, Judith, Winnik, Stephan, Cakmak, Huseyin A., Gaudenzi, Margherita, Mapelli, Massimo, Mattavelli, Irene, Paul, Matthias, Cabac-Pogorevici, Irina, Bouleti, Claire, Lilliu, Marzia, Minoia, Chiara, DAUW, Jeroen, Costa, Jerome, Celik, Ahmet, Mewton, Nathan, Montenegro, Carlos E. L., Matsue, Yuya, Loncar, Goran, Marchel, Michal, Bechlioulis, Aris, Michalis, Lampros, Dorr, Marcus, Prihadi, Edgard, Schoenrath, Felix, Messroghli, Daniel R., MULLENS, Wilfried, Lund, Lars H., Rosano, Giuseppe M. C., Ponikowski, Piotr, Ruschitzka, Frank, and Flammer, Andreas J.
Subjects: Male, Cardiac & Cardiovascular Systems, [SDV]Life Sciences [q-bio], Disease, 030204 cardiovascular system & hematology, 0302 clinical medicine, Interquartile range, Original Research Articles, Clinical endpoint, Original Research Article, Hospital Mortality, Registries, 030212 general & internal medicine, Incidence (epidemiology), Cardiovascular disease, 3. Good health, [SDV] Life Sciences [q-bio], Female, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine, medicine.medical_specialty, SARS‐CoV2, Heart failure, CORONAVIRUS DISEASE 2019, SARS-CoV2, 03 medical and health sciences, COVID‐19, Diabetes mellitus, Internal medicine, medicine, Diseases of the circulatory (Cardiovascular) system, Humans, Aged, Retrospective Studies, Heart Failure, Science & Technology, SARS-CoV-2, business.industry, COVID-19, Odds ratio, medicine.disease, Confidence interval, Risk factors, RC666-701, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Cardiovascular System & Cardiology, INHIBITORS, business
Abstract: AIMS: We assessed the outcome of hospitalized coronavirus disease 2019 (COVID-19) patients with heart failure (HF) compared with patients with other cardiovascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia). We further wanted to determine the incidence of HF events and its consequences in these patient populations. METHODS AND RESULTS: International retrospective Postgraduate Course in Heart Failure registry for patients hospitalized with COVID-19 and CArdioVascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia) was performed in 28 centres from 15 countries (PCHF-COVICAV). The primary endpoint was in-hospital mortality. Of 1974 patients hospitalized with COVID-19, 1282 had cardiovascular disease and/or risk factors (median age: 72 [interquartile range: 62-81] years, 58% male), with HF being present in 256 [20%] patients. Overall in-hospital mortality was 25% (n = 323/1282 deaths). In-hospital mortality was higher in patients with a history of HF (36%, n = 92) compared with non-HF patients (23%, n = 231, odds ratio [OR] 1.93 [95% confidence interval: 1.44-2.59], P
Published: 2021

14. SCN5A Mutation Type and a Genetic Risk Score Associate Variably with Brugada Syndrome Phenotype in SCN5A Families

Author: Peter Lichtner, Thomas Meitinger, Wataru Shimizu, Alison Muir, F. Kyndt, Michael W.T. Tanck, Seiko Ohno, Martina Muggenthaler, Michael J. Ackerman, Vincent Probst, Stephen P. Page, Jean-Jacques Schott, Silvia Castelletti, Hariharan Raju, Jean-Baptiste Gourraud, Joseph Galvin, Taisuke Ishikawa, Eline A. Nannenberg, Dan M. Roden, Doris Škorić-Milosavljević, Kazuhiro Takahashi, Pascal P. McKeown, Federica Dagradi, Lia Crotti, Yanushi D. Wijeyeratne, Julien Barc, Yuka Mizusawa, Peter J. Schwartz, Michael Papadakis, Margherita Torchio, Sanjay Sharma, Velislav N. Batchvarov, Naomasa Makita, Richard Redon, Christian Veltmann, Elijah R. Behr, Takeshi Aiba, Martin Borggrefe, Rafik Tadros, Connie R. Bezzina, J. Martijn Bos, David J. Tester, Isabelle Denjoy, Minoru Horie, Arthur A.M. Wilde, St George's, University of London, Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Centro Cardiologico Monzino [Milano], Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI), Mayo Clinic [Rochester], Belfast Health and Social Care Trust, Hannover Medical School [Hannover] (MHH), University of Shiga Prefecture, National Cerebral and Cardiovascular Center (NCCC - OSAKA), Osaka University [Osaka], Leeds Teaching Hospitals NHS Trust, University of Dublin, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Helmholtz-Zentrum München (HZM), Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Iwate Prefectural University [Takizawa], Vanderbilt University School of Medicine [Nashville], University of Heidelberg, Medical Faculty, Wijeyeratne, Y, Tanck, M, Mizusawa, Y, Batchvarov, V, Barc, J, Crotti, L, Bos, J, Tester, D, Muir, A, Veltmann, C, Ohno, S, Page, S, Galvin, J, Tadros, R, Muggenthaler, M, Raju, H, Denjoy, I, Schott, J, Gourraud, J, Skoric-Milosavljevic, D, Nannenberg, E, Redon, R, Papadakis, M, Kyndt, F, Dagradi, F, Castelletti, S, Torchio, M, Meitinger, T, Lichtner, P, Ishikawa, T, Wilde, A, Takahashi, K, Sharma, S, Roden, D, Borggrefe, M, Mckeown, P, Shimizu, W, Horie, M, Makita, N, Aiba, T, Ackerman, M, Schwartz, P, Probst, V, Bezzina, C, Behr, E, Unité de recherche de l'institut du thorax (ITX-lab), Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Helmholtz Zentrum München = German Research Center for Environmental Health, HAL-SU, Gestionnaire, Epidemiology and Data Science, APH - Methodology, Graduate School, ACS - Heart failure & arrhythmias, Amsterdam Reproduction & Development (AR&D), Human Genetics, Cardiology, ACS - Pulmonary hypertension & thrombosis, and ACS - Atherosclerosis & ischemic syndromes
Subjects: genetics, human, congenital, hereditary, and neonatal diseases and abnormalities, Scn5a gene, phenotype, BIO/18 - GENETICA, 030204 cardiovascular system & hematology, risk score, 03 medical and health sciences, 0302 clinical medicine, Brugada Syndrome, Genetics, Human, Penetrance, Phenotype, Risk Score, Medicine, genetics, Brugada syndrome, 030212 general & internal medicine, human, cardiovascular diseases, Genetic risk, penetrance, Genetics, Framingham Risk Score, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, fungi, General Medicine, Original Articles, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, medicine.disease, Human genetics, 3. Good health, Brugada ECG Pattern, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, cardiovascular system, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Supplemental Digital Content is available in the text., Background: Brugada syndrome (BrS) is characterized by the type 1 Brugada ECG pattern. Pathogenic rare variants in SCN5A (mutations) are identified in 20% of BrS families in whom incomplete penetrance and genotype-negative phenotype-positive individuals are observed. E1784K-SCN5A is the most common SCN5A mutation identified. We determined the association of a BrS genetic risk score (BrS-GRS) and SCN5A mutation type on BrS phenotype in BrS families with SCN5A mutations. Methods: Subjects with a spontaneous type 1 pattern or positive/negative drug challenge from cohorts harboring SCN5A mutations were recruited from 16 centers (n=312). Single nucleotide polymorphisms previously associated with BrS at genome-wide significance were studied in both cohorts: rs11708996, rs10428132, and rs9388451. An additive linear genetic model for the BrS-GRS was assumed (6 single nucleotide polymorphism risk alleles). Results: In the total population (n=312), BrS-GRS ≥4 risk alleles yielded an odds ratio of 4.15 for BrS phenotype ([95% CI, 1.45–11.85]; P=0.0078). Among SCN5A-positive individuals (n=258), BrS-GRS ≥4 risk alleles yielded an odds ratio of 2.35 ([95% CI, 0.89–6.22]; P=0.0846). In SCN5A-negative relatives (n=54), BrS-GRS ≥4 alleles yielded an odds ratio of 22.29 ([95% CI, 1.84–269.30]; P=0.0146). Among E1784K-SCN5A positive family members (n=79), hosting ≥4 risk alleles gave an odds ratio=5.12 ([95% CI, 1.93–13.62]; P=0.0011). Conclusions: Common genetic variation is associated with variable expressivity of BrS phenotype in SCN5A families, explaining in part incomplete penetrance and genotype-negative phenotype-positive individuals. SCN5A mutation genotype and a BrS-GRS associate with BrS phenotype, but the strength of association varies according to presence of a SCN5A mutation and severity of loss of function.
Published: 2020

15. The impact of chronic kidney disease in women undergoing transcatheter aortic valve replacement: Analysis from the Women's INternational Transcatheter Aortic Valve Implantation (WIN‐TAVI) registry

Author: Nicholas Dumonteil, Piera Capranzaro, Samantha Sartori, Bimmer E. Claessen, Roxana Mehran, Daniela Trabattoni, Davide Cao, Thierry Lefèvre, Didier Tchetche, Usman Baber, Alaide Chieffo, Anna Sonia Petronio, Rishi Chandiramani, Dhrubajyoti Bandyopadhyay, Chiara Fraccaro, Annapoorna Kini, Christoph Naber, Patrizia Presbitero, Nicolas M. Van Mieghem, Jaya Chandrasekhar, Marie Claude Morice, Ghada W. Mikhail, Gennaro Sardella, Julinda Mehilli, Icahn School of Medicine at Mount Sinai [New York] (MSSM), Clinique Pasteur [Toulouse], Ludwig-Maximilians-Universität München (LMU), Hôpital Privé Jacques Cartier [Massy], Istituto Clinico Humanitas [Milan] (IRCCS Milan), Humanitas University [Milan] (Hunimed), University of Catania [Italy], Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Erasmus University Medical Center [Rotterdam] (Erasmus MC), Hôpital de Rangueil, CHU Toulouse [Toulouse], Universita degli Studi di Padova, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Imperial College London, San Raffaele Scientific Institute, Vita-Salute San Raffaele University and Center for Translational Genomics and Bioinformatics, and Cardiology
Subjects: medicine.medical_treatment, [SDV]Life Sciences [q-bio], aortic valve stenosis, 030204 cardiovascular system & hematology, urologic and male genital diseases, time factors, renal insufficiency, 0302 clinical medicine, Valve replacement, 80 and over, risk factors, 030212 general & internal medicine, Myocardial infarction, humans, Aged, 80 and over, glomerular filtration rate, Hazard ratio, risk assessment, General Medicine, aortic valve, female genital diseases and pregnancy complications, 3. Good health, chronic, aged, retrospective studies, female, Cardiology, transcatheter aortic valve replacement, Hemodialysis, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, kidney, Renal function, aortic stenosis, chronic kidney disease, WIN-TAVI registry, aged, 80 and over, registries, severity of illness index, sex factors, treatment outcome, renal insufficiency, chronic, 03 medical and health sciences, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, Renal Insufficiency, Chronic, business.industry, Percutaneous coronary intervention, EuroSCORE, medicine.disease, business, Kidney disease
Abstract: International audience; Background: The prevalence of both chronic kidney disease (CKD) and aortic stenosis (AS) increase with age. Although baseline CKD is frequent in patients undergoing transcatheter aortic valve replacement (TAVR), its significance among women is largely unknown.Methods: Women's INternational Transcatheter Aortic Valve Implantation (WIN-TAVI) is a multinational, prospective registry of women undergoing TAVR for severe AS. We included patients with available baseline estimated glomerular filtration rate (eGFR) and completed 1-year follow-up. Patients were categorized into three groups based on their eGFR: No CKD (normal kidney function to stage 2 CKD: eGFR ≥60 ml/min/1.73 m2 ); (b) mild CKD (stage 3a CKD: eGFR = 45-59 ml/min/1.73 m2 ); and (c) moderate/severe CKD (stage ≥3b CKD: eGFR
Published: 2020

16. Comparison of bioresorbable vs durable polymer drug-eluting stents in unprotected left main (from the RAIN-CARDIOGROUP VII Study)

Author: Baldassarre Doronzo, Christian Templin, Francesco Tomassini, Mauro Rinaldi, Andrea Montabone, Zenon Huczek, Enrico Cerrato, Maurizio D'Amico, Carlo Di Mario, Radosław Parma, Giuseppe Venuti, Nicola Ryan, Giorgio Quadri, Thomas F. Lüscher, Iván J. Núñez-Gil, Giacomo Boccuzzi, Alaide Chieffo, Antonia Bassignana, Imad Sheiban, Bernardo Cortese, Fabrizio D'Ascenzo, Sebastiano Gili, Javier Escaned, Andrea Rognoni, Pierluigi Omedè, Michele Autelli, Gérard Helft, Davide Capodanno, Grzegorz Smolka, Michele De Benedictis, Mario Iannaccone, Alessio Mattesini, Ferdinando Varbella, Wojciech Wojakowski, Umberto Barbero, Yoichi Imori, Wojciech Wańha, Daniela Trabattoni, Leonardo De Luca, Delio Tedeschi, Civil Hospital SS. Annunziata [Savigliano, Italy] (CH2SA), Nippon Medical School [Tokyo, Japon], Ospedale di Rivoli [Rivoli, Italy] (OR), San Luigi Gonzaga University Hospital [Turin, Italy] (SLGUH Orbassano), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Università degli Studi di Milano = University of Milan (UNIMI), Hospital Clínico San Carlos [Madrid, Spain], AOU Policlinico Vittorio-Emanuele [Catania, Italia], Careggi University Hospital [Florence, Italie], Medical University of Silesia (SUM), University Hospital 'Maggiore della Carità' [Novara, Italy], Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), University of Warsaw (UW), Clinica Pederzoli [Peschiera del Garda, Italy] (CP), Ospedale San Giovanni Bosco [Turin, Italy] (OSGB), University hospital of Zurich [Zurich], Medical University of Warsaw - Poland, ASST Fatebenefratelli-Sacco [Milan, Italy], IRCCS San Raffaele Scientific Institute [Milan, Italie], Azienda Ospedalerio - Universitaria Città della Salute e della Scienza di Torino = University Hospital Città della Salute e della Scienza di Torino, Civic Hospital of Brescia, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), and Lesnik, Philippe
Subjects: Male, lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Coronary Artery Disease, 030204 cardiovascular system & hematology, Prosthesis Design, Percutaneous coronary intervention, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Absorbable Implants, medicine, Left main, Humans, Registries, 030212 general & internal medicine, Myocardial infarction, cardiovascular diseases, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Coronary Stenosis, Stent, Drug-Eluting Stents, Middle Aged, medicine.disease, Drug eluting stents, Struts thickness, [SDV] Life Sciences [q-bio], Stenosis, Treatment Outcome, Coronary bifurcation, lcsh:RC666-701, Drug-eluting stent, Conventional PCI, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Mace, Research Article
Abstract: Background There are limited data regarding the impact of bioresorbable polymer drug eluting stent (BP-DES) compared to durable polymer drug eluting stent (DP-DES) in patients treated with percutaneous coronary intervention using ultrathin stents in left main or bifurcations. Methods In the RAIN registry (ClinicalTrials NCT03544294, june 2018 retrospectively registered) patients with a ULM or bifurcation stenosis treated with PCI using ultrathin stents (struts thinner than 81 μm) were enrolled. The primary endpoint was the rate of target lesion revascularization (TLR); major adverse cardiovascular events (MACE, a composite of all-cause death, myocardial infarction, TLR and stent thrombosis) and its components, along with target vessel revascularization (TVR) were the secondary ones. A propensity score with matching analysis to compare patients treated with BP-DES versus DP-DES was also assessed. Results From 3001 enrolled patients, after propensity score analysis 1400 patients (700 for each group) were selected. Among them, 352 had ULM disease and 1048 had non-LM bifurcations. At 16 months (12–22), rates of TLR (3.7% vs 2.9%, p = 0.22) and MACE were similar (12.3% vs. 11.6%, p = 0.74) as well as for the other endpoints. Sensitivity analysis of outcomes after a two-stents strategy, showed better outcome in term of MACE (20.4% vs 10%, p = 0.03) and TVR (12% vs 4.6%, p = 0.05) and a trend towards lower TLR in patients treated with BP-DES. Conclusion In patients with bifurcations or ULM treated with ultrathin stents BP-DES seems to perform similarly to DP-DES: the trends toward improved clinical outcomes in patients treated with the BP-DES might potentially be of value for speculating the stent choice in selected high-risk subgroups of patients at increased risk of ischemic events. Trial registration ClinicalTrials.gov Identifier: NCT03544294. Retrospectively registered June 1, 2018.
Published: 2020

17. Alcohol consumption in relation to carotid subclinical atherosclerosis and its progression: results from a European longitudinal multicentre study

Author: Laguzzi, F., Baldassarre, D., Veglia, F., Strawbridge, R. J., Humphries, S. E., Rauramaa, R., Smit, A. J., Giral, P., Silveira, A., Tremoli, E., Hamsten, A., de Faire, U., Frumento, P., Leander, K., Sirtori, C. R., Castelnuovo, S., Amato, M., Frigerio, B., Ravani, A., Sansaro, D., Tedesco, C., Coggi, D., Bonomi, A., Eriksson, M. J., Cooper, J., Acharya, J., Huttunen, K., Rauramaa, E., Pekkarinen, H., Penttila, I. M., Torronen, J., van Gessel, A. I., van Roon, A. M., Teune, G. C., Kuipers, W. D., Bruin, M., Nicolai, A., Haarsma-Jorritsma, P., Mulder, D. J., Bilo, H. J. G., Smeets, G. H., Beaudeux, J. L., Kahn, J. F., Carreau, V., Kontush, A., Karppi, J., Nurmi, T., Nyyssonen, K., Salonen, R., Tuomainen, T. P., Tuomainen, J., Kauhanen, J., Vaudo, G., Alaeddin, A., Siepi, D., Lupattelli, G., Mannarino, E., Groningen Kidney Center (GKC), The Institute of Environmental Medicine [Stockholm] (IMM), Karolinska Institutet [Stockholm], Università degli Studi di Milano [Milano] (UNIMI), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), University of Glasgow, Institute of Cardiovascular and Medical Sciences [Glasgow], University College of London [London] (UCL), University of Kuopio, University Medical Center Groningen [Groningen] (UMCG), University of Groningen [Groningen], Service d’Endocrinologie, Métabolisme et Prévention des Risques Cardio-Vasculaires [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Karolinska University Hospital [Stockholm]
Subjects: Male, medicine.medical_specialty, Epidemiology, [SDV]Life Sciences [q-bio], Physical activity, Medicine (miscellaneous), Alcohol drinking, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine.artery, Internal medicine, medicine, Humans, 030212 general & internal medicine, Carotid intima-media thickness, Finland, Netherlands, Sweden, Nutrition and Dietetics, Progression, business.industry, Confounding, European population, Original Contribution, Atherosclerosis, 3. Good health, Italy, Subclinical atherosclerosis, Cardiology, Female, France, Internal carotid artery, business, Alcohol consumption, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background/Aim The association between alcohol consumption and subclinical atherosclerosis is still unclear. Using data from a European multicentre study, we assess subclinical atherosclerosis and its 30-month progression by carotid intima-media thickness (C-IMT) measurements, and correlate this information with self-reported data on alcohol consumption. Methods Between 2002–2004, 1772 men and 1931 women aged 54–79 years with at least three risk factors for cardiovascular disease (CVD) were recruited in Italy, France, Netherlands, Sweden, and Finland. Self-reported alcohol consumption, assessed at baseline, was categorized as follows: none (0 g/d), very-low (0 − 5 g/d), low (> 5 to ≤ 10 g/d), moderate (> 10 to ≤ 20 g/d for women, > 10 to ≤ 30 g/d for men) and high (> 20 g/d for women, > 30 g/d for men). C-IMT was measured in millimeters at baseline and after 30 months. Measurements consisted of the mean and maximum values of the common carotids (CC), internal carotid artery (ICA), and bifurcations (Bif) and whole carotid tree. We used quantile regression to describe the associations between C-IMT measures and alcohol consumption categories, adjusting for sex, age, physical activity, education, smoking, diet, and latitude. Results Adjusted differences between median C-IMT values in different levels of alcohol consumption (vs. very-low) showed that moderate alcohol consumption was associated with lower C-IMTmax[− 0.17(95%CI − 0.32; − 0.02)], and Bif-IMTmean[− 0.07(95%CI − 0.13; − 0.01)] at baseline and decreasing C-IMTmean[− 0.006 (95%CI − 0.011; − 0.000)], Bif-IMTmean[− 0.016(95%CI − 0.027; − 0.005)], ICA-IMTmean[− 0.009(95% − 0.016; − 0.002)] and ICA-IMTmax[− 0.016(95%: − 0.032; − 0.000)] after 30 months. There was no evidence of departure from linearity in the association between alcohol consumption and C-IMT. Conclusion In this European population at high risk of CVD, findings show an inverse relation between moderate alcohol consumption and carotid subclinical atherosclerosis and its 30-month progression, independently of several potential confounders.
Published: 2020

18. Sex-specific predictors of PCSK9 levels in a European population: The IMPROVE Study

Author: Ferri, Nicola, Ruscica, Massimiliano, Coggi, Daniela, Bonomi, Alice, Amato, Mauro, Frigerio, Beatrice, Sansaro, Daniela, Ravani, Alessio, Veglia, Fabrizio, Capra, Nicolò, Lupo, Maria, Macchi, Chiara, Castelnuovo, Samuela, Savonen, Kai, Silveira, Angela, Kurl, Sudhir, Giral, Philippe, Pirro, Matteo, Strawbridge, Rona, Gigante, Bruna, Smit, Andries, Tremoli, Elena, Colombo, Gualtiero, Baldassarre, Damiano, Groningen Kidney Center (GKC), Translational Immunology Groningen (TRIGR), Universita degli Studi di Padova, Università degli Studi di Milano [Milano] (UNIMI), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Karolinska Institutet [Stockholm], University of Eastern Finland, Service d’Endocrinologie, Métabolisme et Prévention des Risques Cardio-Vasculaires [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Università degli Studi di Perugia (UNIPG), University of Glasgow, and University Medical Center Groningen [Groningen] (UMCG)
Subjects: Male, Sweden, RISK, [SDV]Life Sciences [q-bio], SUBTILISIN/KEXIN TYPE 9, DETERMINANTS, ASSOCIATION, Atherosclerosis, PCSK9 predictors, INTIMA-MEDIA THICKNESS, MECHANISMS, Europe, Italy, CIRCULATING PCSK9, CARDIOVASCULAR-DISEASE, Sex differences, Humans, Female, France, Proprotein Convertase 9, PLASMA PCSK9, Biomarkers, Finland, Cardiovascular risk factors, Netherlands
Abstract: International audience; Background and aims: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is one of the key regulators of low-density lipoprotein cholesterol plasma levels. Circulating PCSK9, which differs between genders, represents a valid pharmacological target for preventing cardiovascular (CV) events. We aimed to investigate sex-related associations between PCSK9 plasma levels and biochemical and anthropomorphic factors, and familial and personal morbidities, in a large European cohort (n = 3673) of men (47.9%) and women (52.1%).Methods: Individuals (aged 54-79 years) free of CV diseases were enrolled in seven centers of five European countries: Finland, France, Italy, the Netherlands, and Sweden. PCSK9 plasma levels were measured by ELISA.Results: PCSK9 was higher in women than in men. Multiple linear regression analysis showed that latitude, sex, and treatments with statins and fibrates were the strongest predictors of PCSK9 in the whole group. These variables, together with triglycerides and high-density lipoprotein cholesterol, were also associated with PCSK9 in men or women. Mean corpuscular hemoglobin concentration and pack-years were PCSK9 independent predictors in women, whereas hypercholesterolemia and physical activity were independent predictors in men. The associations between PCSK9 and latitude, uric acid, diabetes, hypercholesterolemia and physical activity were significantly different in men and women (pinteraction
Published: 2020

19. Genetic Variants Associated with Non-Alcoholic Fatty Liver Disease Do Not Associate with Measures of Sub-Clinical Atherosclerosis: Results from the IMPROVE Study

Author: Castaldo, Luigi, Laguzzi, Federica, Strawbridge, Rona J., Baldassarre, Damiano, Veglia, Fabrizio, Vigo, Lorenzo, Tremoli, Elena, de Faire, Ulf, Eriksson, Per, Smit, Andries J., Aubrecht, Jiri, Leander, Karin, Pirro, Matteo, Giral, Philippe, Ritieni, Alberto, Di Minno, Giovanni, Mälarstig, Anders, Gigante, Bruna, 'Federico II' University of Naples Medical School, Karolinska Institutet [Stockholm], University of Glasgow, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), University of Milan, University Medical Center Groningen [Groningen] (UMCG), Takeda Pharmaceuticals International GmbH, Perugia General Hospital, Service d’Endocrinologie, Métabolisme et Prévention des Risques Cardio-Vasculaires [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groningen Kidney Center (GKC), Castaldo, L., Laguzzi, F., Strawbridge, R. J., Baldassarre, D., Veglia, F., Vigo, L., Tremoli, E., de Faire, U., Eriksson, P., Smit, A. J., Aubrecht, J., Leander, K., Pirro, M., Giral, P., Ritieni, A., Di Minno, G., Malarstig, A., and Gigante, B.
Subjects: Male, lcsh:QH426-470, carotid intima-media thickness, Polymorphism, Single Nucleotide, INTIMA-MEDIA THICKNESS, Article, TM6SF2, Carotid intima-media thickne, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, cardiovascular diseases, CONFERS SUSCEPTIBILITY, Genetic Association Studies, POPULATION, Aged, RISK, CHOLESTEROL, non-alcoholic fatty liver disease, Alanine Transaminase, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Atherosclerosis, lcsh:Genetics, Carotid Arteries, Amino Acid Substitution, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, CARDIOVASCULAR-DISEASE, cardiovascular system, CORONARY-ARTERY-DISEASE, HEART, Female, alanine aminotransferase and genetic association study, GCKR
Abstract: Non-alcoholic fatty liver disease (NAFLD) and atherosclerosis-related cardiovascular diseases (CVD) share common metabolic pathways. We explored the association between three NAFLD-associated single nucleotide polymorphisms (SNPs) rs738409, rs10401969, and rs1260326 with sub-clinical atherosclerosis estimated by the carotid intima-media thickness (c-IMT) and the inter-adventitia common carotid artery diameter (ICCAD) in patients free from clinically overt NAFLD and CVD. The study population is the IMPROVE, a multicenter European study (n = 3711). C-IMT measures and ICCAD were recorded using a standardized protocol. Linear regression with an additive genetic model was used to test for association of the three SNPs with c-IMT and ICCAD. In secondary analyses, the association of the three SNPs with c-IMT and ICCAD was tested after stratification by alanine aminotransferase levels (ALT). No associations were found between rs738409, rs1260326, rs10401969, and c-IMT or ICCAD. Rs738409-G and rs10401969-C were associated with ALT levels (p &lt, 0.001). In patients with ALT levels above 28 U/L (highest quartile), we observed an association between rs10401969-C and c-IMT measures of c-IMTmax and c-IMTmean-max (p = 0.018 and 0.021, respectively). In conclusion, NAFLD-associated SNPs do not associate with sub-clinical atherosclerosis measures. However, our results suggest a possible mediating function of impaired liver function on atherosclerosis development.
Published: 2020

20. Towards Precision Medicine With Human iPSCs for Cardiac Channelopathies

Author: Peter J. Schwartz, Joseph C. Wu, Yoshinori Yoshida, Bjorn C. Knollmann, Priyanka Garg, Shinya Yamanaka, Lior Gepstein, Jean-Sébastien Hulot, CIC - HEGP (CIC 1418), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Center for iPS Cell Research and Application (CiRA), Kyoto University [Kyoto], Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), and Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)
Subjects: Lineage (genetic), Physiology, [SDV]Life Sciences [q-bio], Induced Pluripotent Stem Cells, Computational biology, Disease, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Genome editing, Medicine, CRISPR, Humans, Clustered Regularly Interspaced Short Palindromic Repeats, Precision Medicine, Induced pluripotent stem cell, 030304 developmental biology, Genetic testing, 0303 health sciences, medicine.diagnostic_test, business.industry, Precision medicine, 3. Good health, Long QT Syndrome, DECIPHER, Channelopathies, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Long-QT syndrome, a frequently fatal inherited arrhythmia syndrome caused by genetic variants (congenital) or drugs (acquired), affects 1 in 2000 people worldwide. Its sentinel event is often sudden cardiac death, which makes preclinical diagnosis by genetic testing potentially life-saving. Unfortunately, clinical experience with genetic testing has shown that it is difficult to correctly identify genetic variants as disease causing. These current deficiencies in accurately assigning pathogenicity led to the discovery of increasing numbers of rare variants classified as variant of uncertain significance. To overcome these challenges, new technologies such as clustered regularly interspaced short palindromic repeats (CRISPR) genome editing can be combined with human induced pluripotent stem cell-derived cardiomyocytes to provide a new approach to decipher pathogenicity of variants of uncertain significance and to better predict arrhythmia risk. To that end, the overarching goal of our network is to establish the utility of induced pluripotent stem cell-based platforms to solve major clinical problems associated with long-QT syndrome by determining how to (1) differentiate pathogenic mutations from background genetic noise, (2) assess existing and novel variants associated with congenital and acquired long-QT syndrome, and (3) provide genotype-and phenotype-guided risk stratification and pharmacological management of long-QT syndrome. To achieve these goals and to further advance the use of induced pluripotent stem cells in disease modeling and drug discovery, our team of investigators for this Leducq Foundation Transatlantic Networks of Excellence proposal will work together to (1) improve differentiation efficiency, cellular maturation, and lineage specificity, (2) develop new assays for high throughput cellular phenotyping, and (3) train young investigators to clinically implement patient-specific genetic modeling.
Published: 2019

21. Safety and efficacy of polymer‐free biolimus‐eluting stents versus ultrathin stents in unprotected left main or coronary bifurcation: A propensity score analysis from the RAIN and CHANCE registries

Author: Zenon Huczek, Roberto Latini, Francesco Romeo, Maurizio Di Biasi, Fabrizio D'Ascenzo, Alfonso Ielasi, Gaetano M. De Ferrari, Luca Gaido, Davide Capodanno, Javier Escaned, Imad Sheiban, Maurizio D'Urbano, Andrea Rognoni, Arnaldo Poli, Alaide Chieffo, Bernardo Cortese, Daniela Trabattoni, Fabrizio Ugo, Massimo Giammaria, Ferdinando Varbella, Satoru Mitomo, Fabio Piazza, Gérard Helft, Grzegorz Smolka, Andrea Gangor, Carlo Di Mario, Andrea Saglietto, Alessandro Bernardi, Leonardo De Luca, Vincenzo Infantino, Alfonso Franzé, University of Turin, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), University of Milan, Sorbonne Université (SU), University of Silesia in Katowice, Medical University of Warsaw - Poland, IRCCS San Raffaele Scientific Institute [Milan, Italie], and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC)
Subjects: Male, Time Factors, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Coronary artery disease, chemistry.chemical_compound, 0302 clinical medicine, Clinical Protocols, Risk Factors, Registries, 030212 general & internal medicine, Myocardial infarction, Aged, 80 and over, stent thrombosis, Drug-Eluting Stents, General Medicine, Middle Aged, 3. Good health, Drug-eluting stent, Cardiology, Female, Cardiology and Cardiovascular Medicine, drug eluting stent, coronary artery disease, stent restenosis, medicine.medical_specialty, Prosthesis Design, Risk Assessment, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Umirolimus, medicine, Humans, Radiology, Nuclear Medicine and imaging, Propensity Score, Aged, Retrospective Studies, Sirolimus, business.industry, percutaneous coronary intervention, percutaneous coronary intervention complex, Percutaneous coronary intervention, Cardiovascular Agents, medicine.disease, chemistry, Cardiovascular agent, Propensity score matching, business, Mace
Abstract: International audience; OBJECTIVES:Evaluate safety and efficacy of polymer-free biolimus-eluting stents (PF-BESs) versus ultrathin stents in unprotected left main (ULM) or bifurcation.BACKGROUND:PF-BESs due to reduced length of dual antiplatelet therapy (DAPT) are increasingly used. However, there are limited data about safety and efficacy for ULM or bifurcation.METHODS:We selected all-patients treated for ULM or bifurcation from two multicenter real life registries (RAIN [NCT03544294] evaluating ultrathin stents, CHANCE [NCT03622203] appraising PF-BES). After propensity score with matching, the primary endpoint was major adverse cardiac events (MACE; a composite of all-cause death, myocardial infarction, target lesion revascularization [TLR], and stent thrombosis [ST]), while its components along with target vessel revascularization (TVR) secondary endpoints.RESULTS:Three thousand and three patients treated with ultrathin stents and 446 with PF-BESs, resulting respectively in 562 and 281 after propensity score with matching (33 and 22%, respectively, with ULM disease). After 12 (8-20) months, rates of MACE were similar (9 vs. 8%, p = 0.56) without difference in TLR and ST (3.0 vs. 1.7%, p = .19 and 1.8 vs. 1.1%, p = .42). These results were consistent for ULM group (3 vs. 1.7% and 1.8 vs. 1.1%, p = .49 and .76), for non-ULM group (2.1 vs. 3.4%, p = .56 and 1.2 vs. 1.7%, p = .78) and for two-stent strategy (8.7 vs. 4.5% and 4.3 vs. 3.2%, p = .75 and .91). Among patients treated with 1 month of DAPT in both groups, those with ultrathin stents experienced higher rates of MACE related to all-cause death (22 vs. 12%, p = .04) with higher although not significant rates of ST (3 vs. 0%, p = .45).CONCLUSIONS:PF-BES implanted on ULM or BiF offered freedom from TLR and ST comparable to ultrathin stents. PF-BESs patients assuming DAPT for 1 month experienced a lower despite not significant incidence of ST.
Published: 2019

22. Long-Term Follow-Up of Idiopathic Ventricular Fibrillation in a Pediatric Population: Clinical Characteristics, Management, and Complications

Author: Konstantinos Vlachos, Riccardo Cappato, Isabelle Deisenhofer, Yoshifusa Aizawa, Graham Stuart, Thomas Pambrun, Juan Pablo Kaski, Antonio Frontera, Ivan Blankoff, Pierre Bordachar, Linda Koutbi, Takeshi Kitamura, Daniel Scherr, Nicolas Derval, Patrice Scanu, Gerard J. Fahy, Philippe Ritter, Pascal Defaye, Frederic Sacher, Michel Haïssaguerre, Arnaud Denis, Philippe Maury, Martin Manninger, Alice Maltret, Mélèze Hocini, Christelle Marquié, Jean-Luc Pasquié, Saagar Mahida, Pierre Jaïs, Joris Ector, Xavier Pillois, Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Chest Hospital, Hôpital Charles Perrens, Cork University Hospital, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Bristol Heart Institute, Cardiac Stimulation and Rhythmology, CHU Grenoble, Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), UCL Institute of Cardiovascular Science London, Department of Cardiology [K.U.Leuven], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven)-University Hospital Gasthuisberg, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de cardiologie et de pathologie vasculaire [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Herzzentrum München, Centre Hospitalier, Division of Cardiology, Niigata University Graduate School of Medical and Dental Science Niigata Japan., Département de cardiologie, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Toulouse [Toulouse], CHU Necker - Enfants Malades [AP-HP], MORNET, Dominique, Centre hospitalier Charles Perrens [Bordeaux], Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven)-University Hospital Gasthuisberg [Leuven], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Male, Pediatrics, Cardiac & Cardiovascular Systems, Heart disease, [SDV]Life Sciences [q-bio], Arrhythmias, 030204 cardiovascular system & hematology, Ventricular tachycardia, GUIDELINES, Sudden Cardiac Death, NAV1.5 Voltage-Gated Sodium Channel, Electrocardiography, 0302 clinical medicine, Recurrence, Interquartile range, Arrhythmia and Electrophysiology, Longitudinal Studies, Child, 10. No inequality, Original Research, Hypertrophic cardiomyopathy, Defibrillators, Implantable, 3. Good health, [SDV] Life Sciences [q-bio], Electrophysiology, Natural history, Long QT Syndrome, Phenotype, syncope, Cohort, idiopathic, Female, ventricular tachycardia, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine, STANDARDS, medicine.medical_specialty, Adolescent, complications, Long QT syndrome, 03 medical and health sciences, defibrillator, Cardiomyopathy, Hypertrophic, Familial, medicine, Humans, Science & Technology, Myosin Heavy Chains, business.industry, ECG, Ryanodine Receptor Calcium Release Channel, 030208 emergency & critical care medicine, medicine.disease, ventricular fibrillation, Ventricular fibrillation, Tachycardia, Ventricular, Cardiovascular System & Cardiology, business, Cardiac Myosins
Abstract: Background The natural history and long‐term outcome in pediatric patients with idiopathic ventricular fibrillation ( IVF ) are poorly characterized. We sought to define the clinical characteristics and long‐term outcomes of a pediatric cohort with an initial diagnosis of IVF . Methods and Results Patients were included from an International Registry of IVF (consisting of 496 patients). Inclusion criteria were: (1) VF with no identifiable cause following comprehensive analysis for ischemic, electrical or structural heart disease and (2) age ≤16 years. These included 54 pediatric IVF cases (age 12.7±3.7 years, 59% male) among whom 28 (52%) had a previous history of syncope (median 2 syncopal episodes [interquartile range 1]). Thirty‐six (67%) had VF in situations associated with high adrenergic tone. During a median 109±12 months of follow‐up, 31 patients (57%) had recurrence of ventricular arrhythmias, mainly VF . Two patients developed phenotypic expression of an inherited arrhythmia syndrome during follow‐up (hypertrophic cardiomyopathy and long QT syndrome, respectively). A total of 15 patients had positive genetic testing for inherited arrhythmia syndromes. Ten patients (18%) experienced device‐related complications. Three patients (6%) died, 2 due to VF storm. Conclusions In pediatric patients with IVF , a minority develop a definite clinical phenotype during long‐term follow‐up. Recurrent VF is common in this patient group.
Published: 2019

23. Long-Term Outcome and Valve Surgery for Infective Endocarditis in the Systematic Analysis of a Community Study

Author: Providência, Rui, Marijon, Eloi, Lambiase, Pier, Bouzeman, Abdeslam, Defaye, Pascal, Klug, Didier, Amet, Denis, Perier, Marie‐cécile, Gras, Daniel, Algalarrondo, Vincent, Deharo, Jean‐claude, Leclercq, Christophe, Fauchier, Laurent, Babuty, Dominique, Bordachar, Pierre, Sadoul, Nicolas, Piot, Olivier, Boveda, Serge, Beganton, Frankie, Wilkoff, Bruce, Stiles, Martin, Morillo, Carlos, Al-Khatib, Sana, Almendral, Jesús, Aguinaga, Luis, Berger, Ronald, Cuesta, Alejandro, Daubert, James, Dubner, Sergio, Ellenbogen, Kenneth, Mark Estes, N.A., Fenelon, Guilherme, Garcia, Fermin, Gasparini, Maurizio, Haines, David, Healey, Jeff, Hurtwitz, Jodie, Keegan, Roberto, Kolb, Christof, Kuck, Karl-Heinz, Marinskis, Germanas, Martinelli, Martino, Mcguire, Mark, Molina, Luis, Okumura, Ken, Proclemer, Alessandro, Russo, Andrea, Singh, Jagmeet, Swerdlow, Charles, Teo, Wee Siong, Uribe, William, Viskin, Sami, Wang, Chun-Chieh, Zhang, Shu, Pericart, Lauriane, Bourguignon, Thierry, Bernard, Louis, Angoulvant, Denis, Delahaye, François, Bernard, Anne, Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), The Heart Hospital [London], University College of London [London] (UCL), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier de Versailles André Mignot (CHV), CHU Grenoble, Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Biospectroscopie Translationnelle - EA 7506 (BIOSPECT), Université de Reims Champagne-Ardenne (URCA), Clinique Pasteur [Toulouse], Duke University Medical Center, Virginia Commonwealth University (VCU), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Hospital Privado Del Sur, Université Francois Rabelais [Tours], Service de Cardiologie A (TOURS - Cardiologie A), Cellules Dendritiques, Immunomodulation et Greffes, Hopital Cardio-Thoracique et Vasculaire Louis Pradel, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), and QFAB Bioinformatics
Subjects: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Prosthesis-Related Infections, Time Factors, Heart Valve Diseases, 030204 cardiovascular system & hematology, [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Endocarditis, Hospital Mortality, Registries, 030212 general & internal medicine, Survival rate, Aged, Retrospective Studies, Heart Valve Prosthesis Implantation, business.industry, Mortality rate, Hazard ratio, Retrospective cohort study, Middle Aged, medicine.disease, Confidence interval, Surgery, Survival Rate, Echocardiography, Infective endocarditis, Cohort, Female, France, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract: International audience; Background There are limited data describing sex specificities regarding implantable cardioverter defibrillators (ICDs) in the real‐world European setting. Methods and Results Using a large multicenter cohort of consecutive patients referred for ICD implantation for primary prevention (2002–2012), in ischemic and nonischemic cardiomyopathy, we examined the sex differences in subjects' characteristics and outcomes. Of 5539 patients, only 837 (15.1%) were women and 53.8% received cardiac resynchronization therapy. Compared to men, women presented a significantly higher proportion of nonischemic cardiomyopathy (60.2% versus 36.2%, P 120 ms: 74.6% versus 68.5%, P =0.003), higher New York Heart Association functional class (≥III in 54.2%♀ versus 47.8%♂, P =0.014), and lower prevalence of atrial fibrillation (18.7% versus 24.9%, P
Published: 2016

24. Segmentation of the left ventricular endocardium from magnetic resonance images by using different statistical shape models

Author: Enrico G. Caiani, Mark Potse, Roberto M. Lang, Lynn Weinert, Mauro Pepi, Angelo Auricchio, M. Chiara Carminati, Rolf Krause, Gloria Tamborini, Concetta Piazzese, Andrea Colombo, Politecnico di Milano [Milan] (POLIMI), Center for Computational Medicine in Cardiology [Lugano], Università della Svizzera italiana = University of Italian Switzerland (USI), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Modélisation et calculs pour l'électrophysiologie cardiaque (CARMEN), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut de Mathématiques de Bordeaux (IMB), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), University of Chicago, University of Zurich, Piazzese, Concetta, Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Institut de Mathématiques de Bordeaux (IMB), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-IHU-LIRYC, and Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-CHU Bordeaux [Bordeaux]
Subjects: Male, Models, Anatomic, Computer science, Echocardiography, Three-Dimensional, 030218 nuclear medicine & medical imaging, Ventricular Dysfunction, Left, 0302 clinical medicine, Active shape model, Cardiac MRI, Image segmentation, Left ventricular volume, Statistical shape model, Cardiology and Cardiovascular Medicine, Segmentation, medicine.diagnostic_test, Cardiac cycle, Models, Cardiovascular, Middle Aged, medicine.anatomical_structure, Echocardiography, Principal component analysis, cardiovascular system, Cardiology, Female, medicine.medical_specialty, Magnetic Resonance Imaging, Cine, 610 Medicine & health, Sensitivity and Specificity, 11171 Cardiocentro Ticino, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Humans, Computer Simulation, Endocardium, Models, Statistical, business.industry, Reproducibility of Results, Magnetic resonance imaging, Pattern recognition, Ventricle, Subtraction Technique, Artificial intelligence, business, 030217 neurology & neurosurgery
Abstract: International audience; We evaluate in this paper different strategies for the construction of a statistical shape model (SSM) of the left ventricle (LV) to be used for segmentation in cardiac magnetic resonance (CMR) images. From a large database of LV surfaces obtained throughout the cardiac cycle from 3D echocardiographic (3DE) LV images, different LV shape models were built by varying the considered phase in the cardiac cycle and the registration procedure employed for surface alignment. Principal component analysis was computed to describe the statistical variability of the SSMs, which were then deformed by applying an active shape model (ASM) approach to segment the LV endocardium in CMR images of 45 patients. Segmentation performance was evaluated by comparing LV volumes derived by ASM segmentation with different SSMs and those obtained by manual tracing, considered as a reference. A high correlation (r2 > 0.92) was found in all cases, with better results when using the SSM models comprising more than one frame of the cardiac cycle.
Published: 2016

25. Non-invasive treatment planning of tandem coronary artery lesions using an interactive planner for PCI

Author: Jeroen Sonck, Daniele Andreini, Yosuke Miyazaki, Damien Mandry, Université libre de Bruxelles (ULB), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), BIRKER, Juliette, Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), and Cardiology
Subjects: medicine.medical_specialty, medicine.medical_treatment, MEDLINE, [INFO.INFO-IM] Computer Science [cs]/Medical Imaging, Coronary Artery Disease, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030204 cardiovascular system & hematology, Balloon, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Coronary artery disease, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Angioplasty, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, 030212 general & internal medicine, Angioplasty, Balloon, Coronary, Radiation treatment planning, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Percutaneous coronary intervention, medicine.disease, 3. Good health, Treatment Outcome, medicine.anatomical_structure, Conventional PCI, Radiology, Cardiology and Cardiovascular Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Artery
Abstract: International audience
Published: 2018

26. One-year outcomes after rapid-deployment aortic valve replacement

Author: Gianluca Polvani, Francesco Alamanni, Christophe Giot, Olivier Bouchot, Günther Laufer, José Aramendi, Marco Solinas, Ugolino Livi, Alfred Kocher, Kim Terp, Bruno K. Podesser, Massimo Massetti, Christopher Young, Mattia Glauber, Jose Arribas, Dipartimento di Ingegneria dell'informazione e scienze matematiche [Siena] (DIISM), Università degli Studi di Siena = University of Siena (UNISI), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Service d'urologie, and Centre hospitalier universitaire de Nantes (CHU Nantes)
Subjects: Aortic valve, Male, aortic valve replacement, bioprosthesis, heart valve, hemodynamics, Time Factors, Mean pressure, Hemodynamics, 030204 cardiovascular system & hematology, 0302 clinical medicine, Postoperative Complications, Aortic valve replacement, Risk Factors, Prospective Studies, Registries, Settore MED/23 - CHIRURGIA CARDIACA, ComputingMilieux_MISCELLANEOUS, Aorta, New York Heart Association Class I, Aged, 80 and over, Heart Valve Prosthesis Implantation, Effective orifice area, Middle Aged, Constriction, 3. Good health, Europe, medicine.anatomical_structure, Treatment Outcome, Thoracotomy, Aortic Valve, Heart Valve Prosthesis, Cardiology, Female, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, Reoperation, medicine.medical_specialty, Aortic Valve Insufficiency, Operative Time, 03 medical and health sciences, Internal medicine, medicine, Product Surveillance, Postmarketing, Humans, Heart valve, Adverse effect, Aged, business.industry, Aortic Valve Stenosis, Recovery of Function, medicine.disease, Sternotomy, Surgery, 030228 respiratory system, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: OBJECTIVE: The goals of rapid-deployment aortic valve replacement include facilitation of minimally invasive surgery and reduced aortic crossclamp time. We report the short-term outcomes of a series of 493 patients undergoing rapid-deployment aortic valve replacement with the EDWARDS INTUITY valve system (Edwards Lifesciences, LLC, Irvine, Calif).METHODS: Assessing Standard oF Care and Clinical Outcomes UsiNg the EDWARDS INTUITY VAlve SysTem in a European multI-center, Active, pOst-market surveillaNce Study was a prospective, multicenter (n = 26) European registry designed to evaluate the safety and performance of the valve system. During rapid-deployment aortic valve replacement, device technical success and crossclamp time were assessed. Procedural outcomes, hemodynamic performance, and various adverse events and clinical outcomes were evaluated up to 2 years.RESULTS: Between 2012 and 2014, 493 of 517 enrolled patients successfully received implants with the study valve (95.4% technical success). Mean crossclamp times for 163 full sternotomies, 128 mini-upper sternotomies, and 36 right anterior thoracotomies isolated aortic valve replacements were 47.3, 52.0, and 73.3 minutes, respectively. Mean follow-up was 1.8 years, with 870 total patient-years of follow-up. Mean effective orifice area increased from 0.72 (baseline) to 1.88 cm2, and mean pressure gradient decreased from 47.6 to 9.6 mm Hg (1 year). Mean effective orifice area index increased (0.39-1.01 cm2/m2), and 28 of 287 patients (9.8%) exhibited severe prosthesis-patient mismatch at 1 year. After 1 year, 68.1% and 21.7% of patients were in New York Heart Association class I and II, respectively. Freedom from death, major bleeding, major perivalvular leak, reoperation, and device explant at 1 year were 0.935, 0.939, 0.976, 0.975, and 0.983, respectively.CONCLUSIONS: These results demonstrate commendable safety and performance of the test valve system over the short term in a broad European setting.
Published: 2018

27. Do we need a holistic approach for the design of secure IoT systems?

Author: Giorgio Di Natale, Thomas Pöppelmann, Mauro Conti, Nele Mentens, Annelie Heuser, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Test and dEpendability of microelectronic integrated SysTems (TEST), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Threat Analysis and Mitigation for Information Security (TAMIS), Inria Rennes – Bretagne Atlantique, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-LANGAGE ET GÉNIE LOGICIEL (IRISA-D4), Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Infineon Technologies AG [München], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), TEST (TEST), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Rennes 1 (UR1), Institut National des Sciences Appliquées (INSA)-Université de Rennes (UNIV-RENNES)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), and Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)
Subjects: Cloud computing security, Computer science, 02 engineering and technology, Computer security model, Computer security, computer.software_genre, Security information and event management, 020202 computer hardware & architecture, Security engineering, [INFO.INFO-CR]Computer Science [cs]/Cryptography and Security [cs.CR], Security service, Software security assurance, 0202 electrical engineering, electronic engineering, information engineering, Security through obscurity, Security convergence, 020201 artificial intelligence & image processing, computer
Abstract: International audience; In this paper, four cryptography and security experts point out to future research directions in internet-of-things (IoT) security. Coming from different research domains, the experts address a broad range of issues related to IoT security. In preparation to a panel discussion at the International Workshop on Malicious Software and Hardware in the Internet of Things (MalIoT), they indicate which aspects are important in the design of secured IoT systems, and to which extent we need a holistic approach that integrates security measures at all levels of design abstraction.
Published: 2017

28. Exertional dyspnoea in cardiorespiratory disorders: the clinical use of cardiopulmonary exercise testing

Author: Pierantonio Laveneziana, Piergiuseppe Agostoni, Neurophysiologie Respiratoire Expérimentale et Clinique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée - R3S', Pôle PRAGUES, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), University of Milan, HAL-UPMC, Gestionnaire, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Explorations Fonctionnelles de la Respiration, de l’Exercice et de la Dyspnée [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Università degli Studi di Milano = University of Milan (UNIMI), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Pulmonary disease, 030204 cardiovascular system & hematology, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Risk Factors, Humans, Medicine, Exercise, Lung, lcsh:RC705-779, business.industry, Respiration, Cardiopulmonary exercise testing, Cardiorespiratory fitness, lcsh:Diseases of the respiratory system, Exertional dyspnoea, 3. Good health, Dyspnea, 030228 respiratory system, Exercise Test, Physical therapy, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, business
Abstract: International audience; Is dyspnoea worth documenting and accurately assessing? The answer is undoubtedly yes, for at least the following reasons. 1) Activity-related dyspnoea is usually the earliest and most troublesome complaint for which patients with cardiopulmonary diseases seek medical attention. 2) This symptom progresses relentlessly as the underlying disease advances, leading invariably to avoidance of activity with consequent skeletal muscle deconditioning and an impoverished quality of life. 3) It is estimated that up to a quarter of the general population and half of severely ill patients are affected by it. 4) Dyspnoea is also an important predictor of quality of life, exercise tolerance and mortality in various conditions. In patients with chronic obstructive pulmonary disease (COPD), it has been shown to be a better predictor of mortality than forced expiratory volume in 1 s. In patients with heart disease referred for clinical exercise testing, it is a better predictor of mortality than angina. 5) Dyspnoea is also associated with decreased functional status and worse psychological health in older individuals living at home. 6) It is also a factor in the low adherence to exercise training programmes in sedentary adults and in patients with COPD. 7) The effective management of exertional dyspnoea remains a major challenge for caregivers and modern treatment strategies that are based on attempts to reverse the underlying chronic condition are only partially successful [1–7].
Published: 2016

29. Prognostic value of cardiopulmonary exercise testing in Idiopathic Dilated Cardiomyopathy

Author: Damiano Magrì, Concetta Di Nora, Elena Zambon, Davide Stolfo, Piergiuseppe Agostoni, Giulia Barbati, Andrea Di Lenarda, Marco Merlo, Emanuela Berton, Cosimo Carriere, Stefania Paolillo, Annamaria Iorio, Antonio Cannatà, Gaia Cattadori, Marco Confalonieri, Gianfranco Sinagra, Sinagra, Gianfranco, Iorio, Annamaria, Merlo, Marco, Cannatà, Antonio, Stolfo, Davide, Zambon, Elena, DI NORA, Concetta, Paolillo, Stefania, Barbati, Giulia, Berton, Emanuela, Carriere, Cosimo, Magrì, Damiano, Cattadori, Gaia, Confalonieri, Marco, DI LENARDA, Andrea, Agostoni, Piergiuseppe, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), University of Milan, Harvard Medical School [Boston] (HMS), Dpt di Scienze Cardiovascolari [Milano], and Centro Cardiologico Monzino, IRCCS
Subjects: Male, medicine.medical_treatment, [SDV]Life Sciences [q-bio], heart failure, 030204 cardiovascular system & hematology, prognostic risk stratification, Electrocardiography, 0302 clinical medicine, Interquartile range, 030212 general & internal medicine, Prospective cohort study, Heart transplantation, education.field_of_study, Medicine (all), Area under the curve, Idiopathic Dilated Cardiomyopathy, Middle Aged, Prognosis, 3. Good health, cardiology and cardiovascular medicine, Italy, Cardiology, Female, Cardiology and Cardiovascular Medicine, Anaerobic exercise, circulatory and respiratory physiology, cardiopulmonary exercise testing, idiopathic dilated cardiomyopathy, medicine (all), Adult, Cardiomyopathy, Dilated, medicine.medical_specialty, Prognostic risk stratification, Population, Heart failure, 03 medical and health sciences, Internal medicine, Idiopathic dilated cardiomyopathy, medicine, Humans, education, Retrospective Studies, business.industry, medicine.disease, Cardiopulmonary exercise testing, Exercise Test, business, human activities
Abstract: International audience; Background: Although cardiopulmonary exercise testing (CPET) is considered as animportant tool in risk stratification of patients with heart failure (HF), prognostic data in the specific setting of Idiopathic Dilated Cardiomyopathy (iDCM) are still undetermined. The aim of the study was to test the prognostic value of CPET in a large cohort of iDCM patients. Methods and results: We analyzed 381 iDCM patients who consecutively performed CPET. The study end-point was a composite of cardiovascular death/urgent heart transplantation (CVD/HTx). In the overall population the average values of peak oxygen consumption (peak VO2/kg) and percent-predicted peak VO2 (peak VO2%) were 17.1 +/- 5.1 ml/kg/min and 59 +/- 15%, respectively. Mean VE/VCO2 slope was 29.8 +/- 6.1. During a median follow-up of 47 months (interquartile range 23-84), 83 patients experienced CVD/HTx. Peak VO2% (Area Under the Curve [AUC] 0.74; 95% CI 0.71-0.85, p < 0.001) and VE/VCO2 slope (AUC 0.78; 95% CI 0.74-0.84, p < 0.001) were more accurate in predicting CVD/HTx compared to peak VO2/kg (AUC 0.60; 95% CI 0.54-0.68, p = 0.003) (p < 0.001 for both comparisons). The most accurate threshold values for outcome prediction in our iDCM cohort were
Published: 2016

30. Exertional dyspnoea in chronic heart failure: the role of the lung and respiratory mechanical factors

Author: Pierantonio Laveneziana, Piergiuseppe Agostoni, Bruno-Pierre Dubé, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Università degli Studi di Milano = University of Milan (UNIMI), Neurophysiologie Respiratoire Expérimentale et Clinique, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), University of Milan, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée - R3S', Pôle PRAGUES, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service d'Explorations Fonctionnelles de la Respiration, de l’Exercice et de la Dyspnée [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and HAL-UPMC, Gestionnaire
Subjects: Pulmonary and Respiratory Medicine, Inotrope, medicine.medical_specialty, Hemodynamics, Respiratory physiology, Disease, 030204 cardiovascular system & hematology, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Internal medicine, medicine, Humans, Intensive care medicine, Exercise, Lung, Tidal volume, Heart Failure, lcsh:RC705-779, Exercise Tolerance, business.industry, lcsh:Diseases of the respiratory system, medicine.disease, Prognosis, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine.anatomical_structure, Dyspnea, 030228 respiratory system, Heart failure, Chronic Disease, Breathing, Cardiology, Disease Progression, Respiratory Mechanics, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, business
Abstract: Exertional dyspnoea is among the dominant symptoms in patients with chronic heart failure and progresses relentlessly as the disease advances, leading to reduced ability to function and engage in activities of daily living. Effective management of this disabling symptom awaits a better understanding of its underlying physiology.Cardiovascular factors are believed to play a major role in dyspnoea in heart failure patients. However, despite pharmacological interventions, such as vasodilators or inotropes that improve central haemodynamics, patients with heart failure still complain of exertional dyspnoea. Clearly, dyspnoea is not determined by cardiac factors alone, but likely depends on complex, integrated cardio-pulmonary interactions.A growing body of evidence suggests that excessively increased ventilatory demand and abnormal “restrictive” constraints on tidal volume expansion with development of critical mechanical limitation of ventilation, contribute to exertional dyspnoea in heart failure. This article will offer new insights into the pathophysiological mechanisms of exertional dyspnoea in patients with chronic heart failure by exploring the potential role of the various constituents of the physiological response to exercise and particularly the role of abnormal ventilatory and respiratory mechanics responses to exercise in the perception of dyspnoea in patients with heart failure.
Published: 2016

31. Uninterrupted rivaroxaban vs. uninterrupted vitamin K antagonists for catheter ablation in non-valvular atrial fibrillation

Author: L. Eugene Fields, Gerald V. Naccarelli, Christian de Chillou, Burkhard J. Hügl, Richard Balasubramaniam, Andrea Natale, Riccardo Cappato, Darryl S. Wells, Johan Vijgen, Susanne Hess, Stefan H. Hohnloser, George Juang, David J. Wilber, Francis E. Marchlinski, C.S. Ma, D. Wyn Davies, Jim Xiang, Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Second Arrhytmia and EP Unit (SA and EP Unit - BERGAMO), GAVAZZENI Hospital, Section of Cardiac Electrophysiology (SCE - PHILADELPHIA), Perelman School of Medicine, University of Pennsylvania [Philadelphia]-University of Pennsylvania [Philadelphia], Division of Clinical Electrophysiology (DCE - FRANKFURT), J.W.Goethe University Hospital, Heart and Vascular Institute (HVI - HERSHEY), Pennsylvania State University (Penn State), Penn State System-Penn State System, Biostatistics and Programming (Biostat Program - Janssen Research), Janssen Research & Development, Department of Cardiology, Loyola University [Chicago], Cardiology Division (Cardio Div - BEIJING), Capital Medical University, Beijing, Medical Affairs (MA - BAYER), Bayer HealthCare Pharmaceuticals Inc [Whippany], Cardiac Electrophysiology (Card Electro - SEATTLE), Swedish Heart and Vascular Institute, Heart and Arrhythmia, Heart and Arrhythmia Care of New York (HACNW), Division of Cardiac Electrophysiology (Div Card Elec - HASSELT), JESSA HOSPITALS, Department of Cardiology and Rhythmology (Dep Card Rhythmo - NEUWIED), Marienhaus Klinikum St Elisabeth (MK St Elisabeth), Department of Cardiology (Dep Cardio - BOURNEMOUTH), Royal Bournemouth Hospital, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Waller Department of Cardiology (Waller Dep Cardiol - LONDON), Imperial College London, Department of Medical and Scientific Affairs, Janssen EMEA, Texas Cardiac Arrhythmia Institute (Texas Card Arrh Ins - AUSTIN), and St David's Medical Center (St D Med Center - AUSTIN)
Subjects: Male, Reoperation, medicine.medical_specialty, Vitamin K, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Operative Time, Activated clotting time, Blood Loss, Surgical, Catheter ablation, Drug Administration Schedule, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Rivaroxaban, Recurrence, Internal medicine, Thromboembolism, Atrial Fibrillation, medicine, Clinical endpoint, Humans, Single-Blind Method, Myocardial infarction, Prospective Studies, Stroke, medicine.diagnostic_test, Surrogate endpoint, business.industry, Atrial fibrillation, Middle Aged, medicine.disease, 3. Good health, Treatment Outcome, Pulmonary Veins, Anesthesia, Cardiology, Catheter Ablation, Oral anticoagulant, Female, Cardiology and Cardiovascular Medicine, business, Uninterrupted, Anti-Arrhythmia Agents, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug, Factor Xa Inhibitors
Abstract: Aims VENTURE-AF is the first prospective randomized trial of uninterrupted rivaroxaban and vitamin K antagonists (VKAs) in patients with non-valvular atrial fibrillation (NVAF) undergoing catheter ablation (CA). Methods and results Trial size was administratively set at 250, the protocol-specified target. Events were independently and blindly adjudicated. We randomly assigned 248 NVAF patients to uninterrupted rivaroxaban (20 mg once-daily) or to an uninterrupted VKA prior to CA and for 4 weeks afterwards. The primary endpoint was major bleeding events after CA. Secondary endpoints included thromboembolic events (composite of stroke, systemic embolism, myocardial infarction, and vascular death) and other bleeding or procedure-attributable events. Patients were 59.5 ± 10 years of age, 71% male, 74% paroxysmal AF, and had a CHA2DS2-VASc score of 1.6. The average total heparin dose used to manage activated clotting time (ACT) was slightly higher (13 871 vs. 10 964 units; P < 0.001) and the mean ACT level attained slightly lower (302 vs. 332 s; P < 0.001) in rivaroxaban and VKA arms, respectively. The incidence of major bleeding was low (0.4%; 1 major bleeding event). Similarly, thromboembolic events were low (0.8%; 1 ischemic stroke and 1 vascular death). All events occurred in the VKA arm and all after CA. The number of any adjudicated events (26 vs. 25), any bleeding events (21 vs. 18), and any other procedure-attributable events (5 vs. 5) were similar. Conclusion In patients undergoing CA for AF, the use of uninterrupted oral rivaroxaban was feasible and event rates were similar to those for uninterrupted VKA therapy. Name of the Trial Registry Clinicaltrials.gov trial registration number is [NCT01729871][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01729871&atom=%2Fehj%2F36%2F28%2F1805.atom
Published: 2015

32. Mitral valve patient-specific finite element modeling from 3-D real time echocardiography: a potential new tool for surgical planning

Author: Votta, Emiliano, Arnoldi, Alice, Invernizzi, Alice, Ponzini, Raffaele, Veronesi, Federico, Tamborini, Gloria, Pepi, Mauro, Alamanni, Francesco, Redaelli, Alberto, Caiani, Enrico G., Department of Bioengineering [Politecnico Milano], Politecnico di Milano [Milan] (POLIMI), Consorzio Interuniversitario Lombardo per l'Elaborazione Automatica [Milano] (CILEA), CILEA, Alma Mater Studiorum Università di Bologna [Bologna] (UNIBO), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), and Session 02 : Hemodynamics and Computational Fluid Dynamics
Subjects: [INFO.INFO-IM]Computer Science [cs]/Medical Imaging
Abstract: International audience; Mitral valve (MV) physiopathological function and the effects of surgical repair can be studied through finite element models (FEMs). However, this approach assumes idealized morphology and boundary conditions limiting the analysis to paradigmatic scenarios and precluding patient-specific surgical planning. To overcome this limitation, we integrated into a MV FEM the patient-specific information about leaflets, annulus and papillary muscles geometry and dynamics, obtained from real-time 3D echocardiography. An ad-hoc web platform was created to facilitate FEM development from remote users, and grant access to parallel computing facilities. This approach was tested simulating MV closure in three normal subjects. Modelled valvular dynamics and quantitative results were consistent with experimental findings from literature. FEMs implementation required about 6 min, while simulations required about 7.5 hours on 32 parallel CPUs. Our approach appears reliable, reproducible and reasonably fast and may constitute the basis for the development of patient-specific tools for MV surgery. Introduction
Published: 2009

33. ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2—care pathways, treatment, and follow-up

Author: Baigent, C., Windecker, S., Andreini, D., Arbelo, E., Barbato, E., Bartorelli, A.L., Baumbach, A., Behr, E.R., Berti, S., Bueno, H., Capodanno, D., Cappato, R., Chieffo, A., Collet, J.P., Cuisset, T., Simone, G. de, Delgado, V., Dendale, P., Dudek, D., Edvardsen, T., Elvan, A., Gonzalez-Juanatey, J.R., Gori, M., Grobbee, D., Guzik, T.J., Halvorsen, S., Haude, M., Heidbuchel, H., Hindricks, G., Ibanez, B., Karam, N., Katus, H., Klok, F.A., Konstantinides, S.V., Landmesser, U., Leclercq, C., Leonardi, S., Lettino, M., Marenzi, G., Mauri, J., Metra, M., Morici, N., Mueller, C., Petronio, A.S., Polovina, M.M., Potpara, T., Praz, F., Prendergast, B., Prescott, E., Price, S., Pruszczyk, P., Rodriguez-Leor, O., Roffi, M., Romaguera, R., Rosenkranz, S., Sarkozy, A., Scherrenberg, M., Seferovic, P., Senni, M., Spera, F.R., Stefanini, G., Thiele, H., Tomasoni, D., Torracca, L., Touyz, R.M., Wilde, A.A., Williams, B., European Soc Cardiology, Behr, Elijah/0000-0002-8731-2853, BUENO, HECTOR/0000-0003-0277-7596, Rodriguez-Leor, Oriol/0000-0003-2657-5657, Karam, Nicole/0000-0002-3861-6914, Williams, Bryan/0000-0002-8094-1841, Baigent, Colin, Windecker, Stephan, Andreini, Daniele, Arbelo, Elena, Barbato, Emanuele, Bartorelli, Antonio L., Baumbach, Andreas, Behr, Elijah R., Berti, Sergio, Bueno, Hector, Capodanno, Davide, Cappato, Riccardo, Chieffo, Alaide, Collet, Jean-Philippe, Cuisset, Thomas, de Simone, Giovanni, Delgado, Victoria, DENDALE, Paul, Dudek, Dariusz, Edvardsen, Thor, Elvan, Arif, Gonzalez-Juanatey, Jose R., Gori, Mauro, Grobbee, Diederick, Guzik, Tomasz J., Halvorsen, Sigrun, Haude, Michael, HEIDBUCHEL, Hein, Hindricks, Gerhard, Ibanez, Borja, Karam, Nicole, Katus, Hugo, Klok, Fredrikus A., Konstantinides, Stavros, V, Landmesser, Ulf, Leclercq, Christophe, Leonardi, Sergio, Lettino, Maddalena, Marenzi, Giancarlo, Mauri, Josepa, Metra, Marco, Morici, Nuccia, Mueller, Christian, Petronio, Anna Sonia, Polovina, Marija M., Potpara, Tatjana, Praz, Fabien, Prendergast, Bernard, Prescott, Eva, Price, Susanna, Pruszczyk, Piotr, Rodriguez-Leor, Oriol, Roffi, Marco, Romaguera, Rafael, Rosenkranz, Stephan, Sarkozy, Andrea, Scherrenberg, Martijn, Seferovic, Petar, Senni, Michele, Spera, Francesco R., Stefanini, Giulio, Thiele, Holger, Tomasoni, Daniela, Torracca, Lucia, Touyz, Rhian M., Wilde, Arthur A., Williams, Bryan, Cardiology, ACS - Heart failure & arrhythmias, Bern University Hospital [Berne] (Inselspital), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), 'Federico II' University of Naples Medical School, St George's, University of London, Fondazione Toscana Gabriele Monasterio, Hospital Universitario 12 de Octubre [Madrid], Centro Nacional de Investigaciones Cardiovasculares Carlos III [Madrid, Spain] (CNIC), Instituto de Salud Carlos III [Madrid] (ISC), University of Catania [Italy], IRCCS San Raffaele Scientific Institute [Milan, Italie], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Leiden University Medical Center (LUMC), Hasselt University (UHasselt), Jessa Ziekenhuis [Hasselt], Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Oslo University Hospital [Oslo], Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), University College of London [London] (UCL), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Universiteit Leiden, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), SCHERRENBERG, Martijn, Torracca, Luccia, Cardiology, Task Force for the management of COVID-19 of the European Society of, European Soc Cardiology, and Task Force for the management of COVID-19 of the European Society of Cardiology
Subjects: medicine.medical_specialty, COVID-19/diagnosis, Coronavirus disease 2019 (COVID-19), Physiology, [SDV]Life Sciences [q-bio], ACE2, Heart failure, Disease, Acute coronary syndromes, Arrhythmias, Pulmonary embolism, Thrombosis, Special Article, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), Non-invasive imaging, Pandemic, Humans, Medicine, AcademicSubjects/MED00200, Prospective Studies, shock, COVID-19, Myocarditis, Venous thromboembolism, Intensive care medicine, Pandemics, Cardiogenic shock, Cardiovascular Diseases/diagnosis, business.industry, Biomarkers, Cardiogenic, Cardiovascular Diseases, Myocardial injury, Critical Pathways, Human medicine, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract: Aims Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular (CV) disease in association with COVID-19. Methods and results A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, which was reported previously, focused on the epidemiology, pathophysiology, and diagnosis of CV conditions that may be manifest in patients with COVID-19. This second part addresses the topics of: care pathways and triage systems and management and treatment pathways, both of the most commonly encountered CV conditions and of COVID-19; and information that may be considered useful to help patients with CV disease (CVD) to avoid exposure to COVID-19. Conclusion This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities., Graphical Abstract Graphical Abstract
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34. [Contemporary diagnosis and treatment of tricuspid regurgitation: from neglected valve to primetime].

Author: Montalto C, Tognola C, Ghidini S, Monticelli M, Nava S, Soriano F, Munafò AR, Tavoletta P, Bruschi G, Esposito G, Mangieri A, Giannattasio C, De Marco F, Oliva F, and Oreglia JA
Subjects: Humans, Practice Guidelines as Topic, Quality of Life, Tricuspid Valve surgery, Heart Valve Prosthesis Implantation methods, Tricuspid Valve Insufficiency therapy, Tricuspid Valve Insufficiency diagnosis, Tricuspid Valve Insufficiency surgery, Tricuspid Valve Insufficiency physiopathology
Abstract: Tricuspid insufficiency has long been considered an entity with low prognostic importance and associated with symptoms and signs only secondarily to left heart pathology. Scientific research in recent years has debunked this myth, demonstrating a key role in determining symptoms and signs of right heart failure, even in advanced stages. In parallel, advances in transcatheter technologies have opened up treatment options even for patients with increased surgical risk, who were previously excluded from traditional surgical options, with increasingly convincing results in reducing symptoms and improving the quality of life of our patients. The contemporary challenge is to translate these messages into everyday clinical practice and to encourage the centralization of patients in centers that currently have the expertise for feasibility evaluation and subsequent treatment. In this Review, we will analyze the most recent evidence on the pathophysiology and diagnosis of tricuspid insufficiency, the latest recommendations from European guidelines, and we will try to illustrate the most common technologies for percutaneous treatment and the abundant evidence supporting them.
Published: 2024
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35. Evaluation of Left Ventricular Overload and Use of Unloading Techniques in Venoarterial Extracorporeal Life Support: A Nationwide Survey.

Author: Meani P, Veronese G, Todaro S, Marchese G, Mondellini GM, Protti I, de Arroyabe BM, Epis F, Pappalardo F, Pedrazzini G, Munch C, Margari V, Grazioli L, Lorini FL, Cattaneo S, Montisci A, Ballotta A, Raffa GM, Carboni P, Lucchelli M, Avalli L, Babuin L, Belliato M, Bertini P, Guarracino F, Paternoster G, Ajello V, Catena E, Scolletta S, Franchi F, Musazzi A, Pacini D, Sangalli F, Attisani M, Rinaldi M, Grasselli G, Mondino M, Ranucci M, and Lorusso R
Subjects: Humans, Shock, Cardiogenic, Heart Ventricles, Heart Failure surgery
Abstract: Competing Interests: The authors have no conflicts of interest to report.
Published: 2024
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36. EMID2 is a novel biotherapeutic for aggressive cancers identified by in vivo screening.

Author: Cappelletto A, Alfì E, Volf N, Vu TVA, Bortolotti F, Ciucci G, Vodret S, Fantuz M, Perin M, Colliva A, Rozzi G, Rossi M, Ruozi G, Zentilin L, Vuerich R, Borin D, Lapasin R, Piazza S, Chiesa M, Lorizio D, Triboli L, Kumar S, Morello G, Tripodo C, Pinamonti M, Piperno GM, Benvenuti F, Rustighi A, Jo H, Piccolo S, Del Sal G, Carrer A, Giacca M, and Zacchigna S
Subjects: Animals, Humans, Mice, Cell Nucleus, Disease Models, Animal, Early Detection of Cancer, Collagen metabolism, Cancer-Associated Fibroblasts, Pancreatic Neoplasms drug therapy, Pancreatic Neoplasms genetics
Abstract: Background: New drugs to tackle the next pathway or mutation fueling cancer are constantly proposed, but 97% of them are doomed to fail in clinical trials, largely because they are identified by cellular or in silico screens that cannot predict their in vivo effect., Methods: We screened an Adeno-Associated Vector secretome library (> 1000 clones) directly in vivo in a mouse model of cancer and validated the therapeutic effect of the first hit, EMID2, in both orthotopic and genetic models of lung and pancreatic cancer., Results: EMID2 overexpression inhibited both tumor growth and metastatic dissemination, consistent with prolonged survival of patients with high levels of EMID2 expression in the most aggressive human cancers. Mechanistically, EMID2 inhibited TGFβ maturation and activation of cancer-associated fibroblasts, resulting in more elastic ECM and reduced levels of YAP in the nuclei of cancer cells., Conclusion: This is the first in vivo screening, precisely designed to identify proteins able to interfere with cancer cell invasiveness. EMID2 was selected as the most potent protein, in line with the emerging relevance of the tumor extracellular matrix in controlling cancer cell invasiveness and dissemination, which kills most of cancer patients., (© 2024. The Author(s).)
Published: 2024
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37. [How to optimize Audit&Feedback: experience from the EASY-NET programme].

Author: Acampora A, Angioletti C, D'Agostino M, Deroma L, Tullio A, Pagano E, Ciccone G, Marchesini G, Grilli R, Bonomi A, Marenzi G, Giusti A, Venturella R, Ciurleo R, Bramanti P, Davoli M, and Agabiti N
Subjects: Humans, Feedback, Italy, Quality Improvement
Abstract: This is the second of a series of papers dedicated to the EASY-NET research programme (NET-2016-02364191). The rationale, structure and methodologies are described in the previous contribution. Scientific literature demonstrated that Audit & Feedback (A&F) is an effective strategy for continuous quality improvement and its effectiveness varies considerably according to factors that are currently little known. Some recent publication pointed out, with the contribution of an international group of experts, 15 suggestions to optimize A&F and developed a tool to evaluate their application. This tool, called REFLECT-52, includes 52 items related to the 15 suggestions and organized into four categories relating to the "Nature of the desired action", to the "Nature of the data available for feedback", to the "Feedback Display" and to the "Intervention delivery". Then, the aim of this work was to evaluate the level of adherence of A&F interventions tested in EASY-NET to suggestions from the literature by using a slightly adapted version of the REFLECT-52 tool, in its original language. In EASY-NET, 14 A&F interventions with different characteristics and in different clinical and organizational contexts were tested in seven Italian regions, each of these was evaluated by the respective research groups. Overall, the level of adherence was high in three of the four categories analysed, with some difficulties reported regarding the nature of the data available for feedback. In fact, contrary to what the literature suggests, it was not possible to send repeated feedback for some interventions and, in some cases, the data available for feedback presented a delay longer than one year. In summary, this analysis has confirmed a high level of compliance of the interventions tested with the suggestions from the literature, but it has also allowed researchers to identify critical aspects that need to be addressed for the future development of these strategies.
Published: 2023
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38. [Management of patients with myocardial ischemia/infarction with non-obstructive coronary artery disease in Italian catheterization laboratories: results of the SICI-GISE national survey promoted by the GISE Young Committee].

Author: Demola P, Beneduce A, Masiero G, Serino F, Baldi E, Polimeni A, Attisano T, Contarini M, Castiglioni B, De Marco F, Fineschi M, Menozzi A, Musto C, Tarantini G, Saia F, and Esposito G
Subjects: Humans, MINOCA, Laboratories, Coronary Angiography methods, Catheterization, Coronary Vessels, Coronary Artery Disease diagnosis, Coronary Artery Disease therapy, Myocardial Infarction diagnosis, Myocardial Infarction therapy, Myocardial Ischemia diagnosis, Myocardial Ischemia therapy
Abstract: Background: Myocardial ischemia (INOCA) and acute myocardial infarction with non-obstructive coronary artery disease (MINOCA) represent emerging entities in the landscape of interventional cardiology. These conditions have heterogeneous pathophysiological mechanisms and clinical presentations, complex diagnostics, and high prognostic significance., Methods: This survey was carried out jointly by the GISE Young Committee with the support of the SICI-GISE Society and the ICOT group with the aim of evaluating the implementation of diagnostic-therapeutic pathways in cases of suspected/confirmed INOCA and MINOCA diseases. A web-based questionnaire based on 22 questions was distributed to SICI-GISE and ICOT members., Results: The survey was distributed to 1550 physicians with 104 (7%) responses. The majority of participants included interventional cardiologists (70%), in two-thirds of cases working in centers with high volume of procedures (>1000 coronary angiographies/year), who estimated a <10% annual rate of INOCA and MINOCA cases in their case load. Approximately 25% of the participants stated that they do not have the option of performing any investigation for the evaluation of patients with suspected INOCA, and less than 50% make use of advanced invasive testing for the diagnosis of MINOCA, including physiology and intravascular imaging tests. It also turns out that about 50% of respondents reported the present and future absence of dedicated diagnostic-therapeutic pathways. Even with a high perception of the clinical relevance of these diseases, about 40% of the respondents rely on clinical experience or do not deal with their management, also reporting a low prevalence of dedicated follow-up care (20% of cases followed at dedicated outpatient clinics). Factors predominantly limiting the prevalence of appropriate diagnostic and treatment pathways included the cost of materials, lack of training and expertise of practitioners, and of solid data on the long-term clinical efficacy of treatments., Conclusions: Currently, the proper management of INOCA and MINOCA disease is widely advocated but poorly implemented in clinical practice. To reverse the trend and solve the remaining controversies, it is necessary to enhance awareness, produce robust scientific data, and implement dedicated pathways for patients.
Published: 2023
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39. Anterior mitral line in patients with persistent atrial fibrillation and anterior scar: A multicenter matched comparison-The MiLine study.

Author: Bergonti M, Spera FR, Ferrero TG, Nsahlai M, Bonomi A, Boris W, Saenen J, Huybrechts W, Miljoen H, Vandaele L, Wittock A, Heidbuchel H, Valderrábano M, Rodríguez-Mañero M, and Sarkozy A
Subjects: Humans, Female, Middle Aged, Aged, Male, Retrospective Studies, Cicatrix diagnosis, Cicatrix etiology, Treatment Outcome, Electrophysiologic Techniques, Cardiac, Tachycardia, Recurrence, Atrial Fibrillation complications, Atrial Fibrillation surgery, Catheter Ablation, Pulmonary Veins surgery
Abstract: Background: The benefit of an anterior mitral line (AML) in patients with persistent atrial fibrillation (AF) and anterior atrial scar undergoing ablation has never been investigated., Objective: The purpose of this study was to evaluate the outcomes of AML in addition to standard treatment compared to standard treatment alone (no AML) in this subset of patients., Methods: Patients with persistent AF and anterior low-voltage zone (LVZ) treated with AML in 3 centers were retrospectively enrolled. The patients were matched in 1:1 fashion with patients having persistent AF and anterior LVZ who underwent conventional ablation in the same centers. Matching parameters were age, LVZ burden, and repeated ablation. Primary endpoint was AF/atrial tachycardia (AT) recurrence., Results: One hundred eight-six patients (age 66 ± 9 years; 34% women) were selected and divided into 2 matched groups. Bidirectional conduction block was achieved in 95% of AML. After median follow-up of 2 years, AF/AT recurrence occurred in 29% of the patients in the AML group vs 48% in the no AML group (log-rank P = .024). On Cox regression multivariate analysis, left atrial volume (hazard ratio [HR] 1.03; P = .006) and AML (HR 0.46; P = .003) were significantly associated with the primary endpoint. On univariate logistic regression, lower body mass index, older age, extensive anterior LVZ, and position of the left atrial activation breakthrough away from the AML were associated with first-pass AML block., Conclusion: In this retrospective matched analysis of patients with persistent AF and anterior scar, AML in addition to standard treatment was associated with improved AF/AT-free survival compared to standard treatment alone., (Copyright © 2023 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
Published: 2023
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40. [SICI-GISE/SICOA Consensus document: Clinical follow-up of patients after acute coronary syndrome or percutaneous coronary intervention].

Author: Guarini P, Saia F, Sidiropulos M, Silverio A, Dellegrottaglie S, Scatteia A, De Stefano F, Tedeschi C, Dalla Vecchia LA, Cappelletti AM, Regazzoli D, Benassi A, Donatelli F, America R, Nosso G, Capranzano P, Oliva A, Piccolo R, Testa L, Attisano T, Battistina C, Contarini M, De Marco F, Fineschi M, Menozzi A, Musto C, Stefanini G, Tarantini G, Caiazza F, and Esposito G
Subjects: Humans, Stroke Volume, Follow-Up Studies, Consensus, Ventricular Function, Left, Treatment Outcome, Acute Coronary Syndrome diagnosis, Percutaneous Coronary Intervention
Abstract: In the last decades, advances in percutaneous coronary intervention (PCI) strategies have significantly reduced the risk of procedural complications and in-hospital mortality of patients with acute coronary syndromes (ACS), thus increasing the population of stable post-ACS patients. This novel epidemiological scenario emphasizes the importance of implementing secondary preventive and follow-up strategies. The follow-up of patients after ACS or elective PCI should be based on common pathways and on the close collaboration between hospital cardiologists and primary care physicians. However, the follow-up strategies of these patients are still poorly standardized. This SICI-GISE/SICOA consensus document was conceived as a proposal for the long-term management of post-ACS or post-PCI patients based on their individual residual risk of cardiovascular adverse events. We defined five patient risk classes and five follow-up strategies including medical visits and examinations according to a specific time schedule. We also provided a short guidance for the selection of the appropriate imaging technique for the assessment of left ventricular ejection fraction and of non-invasive anatomical or functional tests for the detection of obstructive coronary artery disease. Physical and pharmacological stress echocardiography was identified as the first-line imaging technique in most of cases, while cardiovascular magnetic resonance should be preferred when an accurate evaluation of left ventricular ejection fraction is needed. The standardization of the follow-up pathways of patients with a history of ACS or elective PCI, shared between hospital doctors and primary care physicians, could result in a more cost-effective use of resources and potentially improve patient's long-term outcome.
Published: 2023
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41. [The EASY-NET research programme: background, structure, and methodology].

Author: Acampora A, Deroma L, Ciccone G, Marchesini Reggiani G, Marenzi G, Venturella R, Bramanti P, Grilli R, Di Martino M, Spadea T, De Fiore L, and Agabiti N
Subjects: Pregnancy, Humans, Female, Sicily, Hospitals, Health Services, Cesarean Section, Heart Diseases
Abstract: This is the first contribution of a series of interventions describing the EASY-NET research program (Bando Ricerca Finalizzata 2016, funds 2014-2015; NET-2016-02364191). Here, the objective is to illustrate the background and the research question, the structure and organization, the methodologies and the expected results of the programme. The main theme is audit&feedback (A&F), a proven and widespread technique for improving the quality of health care. EASY-NET, funded by the Italian Ministry of Health and by the governments of the participating Italian Regions, starts its research activities in 2019 with the aim of evaluating the effectiveness of A&F in improving care for different clinical conditions in various organizational and legislative contexts. The research network involves seven Italian Regions, each conducting specific research activities described by as many work packages (WP): Lazio (the leading Region, coordinator of the research activities), Friuli Venezia Giulia, Piedmont, Lombardy, Emilia-Romagna, Calabria, and Sicily. The involved clinical areas include the management of chronic diseases, emergency care for acute conditions, surgery in the oncological area, the treatment of heart disease, obstetrics, and the use of caesarean section and post-acute rehabilitation. The involved settings concern the community, the hospital, the emergency room, and the rehabilitation facilities. Different experimental or quasi-experimental study designs are applied in each WP to achieve specific objectives of the specific clinical and organizational context. In all WPs, the process and outcome indicators are calculated on the basis of the Health Information Systems (HIS) and, in some cases, they are integrated with measures obtained from ad hoc data collections. The programme aims to contribute to the scientific evidence on A&F also exploring the obstacles and favourable factors for its effectiveness and to promote its implementation in the health service, with the ultimate aim of improving the access to healthcare and the health outcomes for citizens.
Published: 2023
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42. [Sex-related differences in the treatment of coronary artery disease].

Author: Di Franco A, Bonalumi G, and Gaudino M
Subjects: Humans, Male, Female, Coronary Artery Bypass, Sex Factors, Risk Factors, Treatment Outcome, Coronary Artery Disease surgery, Percutaneous Coronary Intervention adverse effects
Abstract: Differential outcomes between men and women following the treatment of coronary artery disease are currently under investigation. An increasing amount of evidence supports the concept that the differential anatomical features, functional characteristics, and risk factors between the two sexes should be considered in decision making for the therapeutic strategy to adopt in patients with coronary artery disease. Most risk scores have been developed based on predominantly male populations and might not work well for predicting cardiovascular risk in women. Moreover, there are currently no specific recommendations for a differential diagnostic work-up or treatment based on sex. We review and discuss the latest evidence on the outcomes of men and women undergoing treatment of coronary artery disease by means of percutaneous or surgical revascularization.
Published: 2022
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43. Intraoperative 3D TrueVue transesophageal echo imaging in cardiac mass: Bridge between cardiac anesthesiologist and surgeon.

Author: L'Acqua C, Piazzoni N, Muratori M, and Mazzanti V
Subjects: Echocardiography, Transesophageal methods, Heart, Humans, Anesthesiologists, Echocardiography, Three-Dimensional methods
Abstract: Competing Interests: None
Published: 2022
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44. The "P-stitch": A simplified strategy to achieve valvular symmetry during Ozaki procedure.

Author: Pirola S, Mastroiacovo G, Bisleri G, and Polvani G
Subjects: Humans, Aortic Valve surgery, Catheters
Abstract: During Ozaki procedure, relocating a valvular commissure could be technically demanding. This novel technique provides an easy tool to achieve valvular symmetry avoiding commissure shifting., (© 2022 Wiley Periodicals LLC.)
Published: 2022
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45. Excimer laser technology in percutaneous coronary interventions: Cardiovascular laser society's position paper.

Author: Golino L, Caiazzo G, Calabrò P, Colombo A, Contarini M, Fedele F, Gabrielli G, Galassi AR, Golino P, Scotto di Uccio F, Tarantini G, Argentino V, Balbi M, Bernardi G, Boccalatte M, Bonmassari R, Bottiglieri G, Caramanno G, Cesaro F, Cigala E, Chizzola G, Di Lorenzo E, Intorcia A, Fattore L, Galli S, Gerosa G, Giannotta D, Grossi P, Monda V, Mucaj A, Napodano M, Nicosia A, Perrotta R, Pieri D, Prati F, Ramazzotti V, Romeo F, Rubino A, Russolillo E, Spedicato L, Tuccillo B, Tumscitz C, Vigna C, Bertinato L, Armigliato P, and Ambrosini V
Subjects: Coronary Angiography, Humans, Lasers, Excimer therapeutic use, Technology, Treatment Outcome, Atherectomy, Coronary methods, Percutaneous Coronary Intervention methods
Abstract: Excimer Laser Coronary Atherectomy (ELCA) is a well-established therapy that emerged for the treatment of peripheral vascular atherosclerosis in the late 1980s, at a time when catheters and materials were rudimentary and associated with the most serious complications. Refinements in catheter technology and the introduction of improved laser techniques have led to their effective use for the treatment of a wide spectrum of complex coronary lesions, such as thrombotic lesions, severe calcific lesions, non-crossable or non-expandable lesions, chronic occlusions, and stent under-expansion. The gradual introduction of high-energy strategies combined with the contrast infusion technique has enabled us to treat an increasing number of complex cases with a low rate of periprocedural complications. Currently, the use of the ELCA has also been demonstrated to be effective in acute coronary syndrome (ACS), especially in the context of large thrombotic lesions., (Copyright © 2021 Elsevier B.V. All rights reserved.)
Published: 2022
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46. Implementing Coronary Computed Tomography Angiography in the Catheterization Laboratory.

Author: Collet C, Sonck J, Leipsic J, Monizzi G, Buytaert D, Kitslaar P, Andreini D, and De Bruyne B
Subjects: Catheterization, Coronary Angiography, Humans, Laboratories, Predictive Value of Tests, Tomography, X-Ray Computed, Computed Tomography Angiography, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease therapy
Abstract: Coronary computed tomography angiography (CCTA) is now an established tool in the diagnostic work-up of patients suspected to have coronary artery disease. Yet, its usefulness beyond this phase has not been fully explored. The current review focuses on the implementation of CCTA as a tool to plan and guide coronary interventions in the catheterization laboratory. Specifically, we explore the potential of CCTA to improve patient selection for percutaneous revascularization, provide the rationale for better resource use, and present a novel approach to incorporate 3-dimensional CT guidance for percutaneous coronary interventions., Competing Interests: Funding Support and Author Disclosures Dr. Collet has received research grants from Biosensors, Heart Flow Inc., and Abbott Vascular; and consultancy fees from Opsens, Boston Scientific, HeartFlow Inc., and Philips Volcano. Dr. Sonck has received research grants provided by the Cardiopath PhD program. Dr. Kitslaar is an employee of Medis Medical Imaging Systems. Dr. De Bruyne has received institutional consultancy fees and/or research grants from Abbott, Boston Scientific, and Biotronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Published: 2021
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47. Pediatric athletes' ECG and diagnostic performance of contemporary ECG interpretation criteria.

Author: Halasz G, Cattaneo M, Piepoli M, Romano S, Biasini V, Menafoglio A, Gasperetti A, Badini M, Villa M, Dall'Ara L, Roberto M, Cassina T, and Capelli B
Subjects: Adolescent, Adult, Arrhythmias, Cardiac, Child, Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac prevention & control, Humans, Mass Screening, Athletes, Electrocardiography
Abstract: Background: Electrocardiographic (ECG) pre-participation screening(PPS) can prevent sudden cardiac death(SCD) but the Interpretation of the athlete's ECG is based on specific criteria addressed for adult athletes while few data exist about the pediatric athlete's ECG. We aimed to assess the features of pediatric athletes' ECG and compared the diagnostic performance of 2017 International ECG recommendation, 2010 European Society of Cardiology recommendation and 2013-Seattle criteria in detecting clinical conditions at risk of SCD., Methods: 886 consecutive pediatric athletes (mean age 11.7 ± 2.5 years; 7-16-years) were enrolled and prospectively evaluated with medical history, physical examination, resting and exercise ECG and transthoracic echocardiography during their PPS., Results: The most common physiological ECG patterns in pediatric athletes were isolated left ventricular hypertrophy criteria (26.9%), juvenile T-wave pattern (22%) and early repolarization pattern (13.2%). The most frequent borderline abnormalities were left axis deviation (1.8%) and right axis deviation (0.9%) while T-wave inversion (0.8%) especially located in inferior leads (0.7%) was the most prevalent abnormal findings. Seven athletes (0.79%) were diagnosed with a condition related to SCD. Compared to Seattle and ESC, the International improved ECG specificity (International = 98% ESC = 64% Seattle = 95%) with lower sensitivity (ESC and Seattle 86%vs International 57%). The false-positive rate decreases from 36% of ESC to 2.2% of International but the latter showed a higher false-negative rate(0.34%)., Conclusion: Pediatric athletes like the adult counterpart exhibit a high prevalence of ECG abnormalities mostly representing training-related ECG adaptation. The International criteria showed a lower false-positive rate but at the cost of loss of sensitivity., (Copyright © 2021 Elsevier B.V. All rights reserved.)
Published: 2021
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48. Optimizing cryoballoon pulmonary vein isolation: lessons from >1000 procedures- the Frankfurt approach.

Author: Bordignon S, Chen S, Bologna F, Thohoku S, Urbanek L, Willems F, Zanchi S, Bianchini L, Trolese L, Konstantinou A, Fuernkranz A, Schmidt B, and Chun JKR
Subjects: Aged, Female, Humans, Male, Middle Aged, Recurrence, Treatment Outcome, Atrial Fibrillation diagnosis, Atrial Fibrillation surgery, Catheter Ablation, Cryosurgery adverse effects, Pulmonary Veins surgery
Abstract: Aims: Cryoballoon (CB) pulmonary vein isolation (PVI) is an accepted ablation strategy for rhythm control in atrial fibrillation (AF). We describe efficacy and safety in a high volume centre with a long experience in the use of the second-generation CB (CB2)., Methods and Results: Consecutive paroxysmal AF (PAF) or persistent AF (persAF) patients undergoing CB2-PVI were enrolled. Procedural data, efficacy, and safety issues were systematically collected. The 28 mm CB2 was used in combination with an inner lumen spiral catheter, a luminal oesophageal temperature (LET) probe was used with a cut-off of 15°C, the phrenic nerve (PN) monitored during septal PVs ablation. Freeze duration was mainly set at 240 s with a bonus application in case of delayed time-to-isolation (TTI > 75 s). A total of 1017 CB2 procedures were analysed (58% male, 66 ± 12 years old, 70% with PAF). 3964 PVs were identified, 99.8% PVs isolated using solely the 28 mm CB. Mean procedure time was 69 ± 25 min, TTI during the first application was recorded in 77% of PVs after a mean of 48 ± 31 s. We recorded 0.2% cardiac tamponade, 4.8% PN injury (1.6% of PN palsy), and 19% of LET < 15°C. Among 725 patients with follow-up data, 84% with PAF and 75% with persAF were in stable SR at 1 year. Shorter freezing duration and longer TTI were procedural predictors for recurrence., Conclusion: Cryoballoon procedures are fast and associated with a benign safety profile. Shorter TTI and longer freeze durations are associated with sinus rhythm during follow-up., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.)
Published: 2021
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49. Vasopressor Therapy in Cardiac Surgery-An Experts' Consensus Statement.

Author: Guarracino F, Habicher M, Treskatsch S, Sander M, Szekely A, Paternoster G, Salvi L, Lysenko L, Gaudard P, Giannakopoulos P, Kilger E, Rompola A, Häberle H, Knotzer J, Schirmer U, Fellahi JL, Hajjar LA, Kettner S, Groesdonk HV, and Heringlake M
Subjects: Consensus, Humans, Norepinephrine, Vasoconstrictor Agents therapeutic use, Vasopressins, Cardiac Surgical Procedures, Shock
Abstract: Hemodynamic conditions with reduced systemic vascular resistance commonly are observed in patients undergoing cardiac surgery and may range from moderate reductions in vascular tone, as a side effect of general anesthetics, to a profound vasodilatory syndrome, often referred to as vasoplegic shock. Therapy with vasopressors is an important pillar in the treatment of these conditions. There is limited guidance on the appropriate choice of vasopressors to restore and optimize systemic vascular tone in patients undergoing cardiac surgery. A panel of experts in the field convened to develop statements and evidence-based recommendations on clinically relevant questions on the use of vasopressors in cardiac surgical patients, using a critical appraisal of the literature following the GRADE system and a modified Delphi process. The authors unanimously and strongly recommend the use of norepinephrine and/or vasopressin for restoration and maintenance of systemic perfusion pressure in cardiac surgical patients; despite that, the authors cannot recommend either of these drugs with respect to the risk of ischemic complications. The authors unanimously and strongly recommend against using dopamine for treating post-cardiac surgery vasoplegic shock and against using methylene blue for purposes other than a rescue therapy. The authors unanimously and weakly recommend that clinicians consider early addition of a second vasopressor (norepinephrine or vasopressin) if adequate vascular tone cannot be restored by a monotherapy with either norepinephrine or vasopressin and to consider using vasopressin as a first-line vasopressor or to add vasopressin to norepinephrine in cardiac surgical patients with pulmonary hypertension or right-sided heart dysfunction., Competing Interests: Declaration of Competing Interest All authors received travel support and expense allowances for the participation in the consensus meetings in Vienna and Ghent. Additionally, F.G. reports honoraria for lectures, scientific advice, and travel support by Orion Pharma and Amomed Pharma outside this work; M. Ha. reports honoraria for lectures, scientific advice, and travel support by Edwards Lifesciences, and Amomed Pharma outside this work; S.T. received honoraria for lectures, scientific advice, and travel support by Edwards Lifesciences, scientific advice, and travel support by Orion Pharma, Medtronic, CSL Behring, Edwards Lifesciences, and Amomed Pharma outside this work. All other authors state that they have no further interest to declare., (Copyright © 2020 Elsevier Inc. All rights reserved.)
Published: 2021
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50. Incidence and characterization of acute pulmonary embolism in patients with SARS-CoV-2 pneumonia: A multicenter Italian experience.

Author: Loffi M, Regazzoni V, Toselli M, Cereda A, Palmisano A, Vignale D, Moroni F, Pontone G, Andreini D, Mancini EM, Monello A, Iannopollo G, Casella G, Monetti F, Monti L, Ferrillo G, Liccardo G, Tonet E, Zucchetti O, Cossu A, Dugo M, Patelli G, Sergio P, Esposito A, Colombo A, Giannini F, Piccolo R, and Danzi GB
Subjects: Acute Disease, Aged, COVID-19 blood, COVID-19 diagnostic imaging, Computed Tomography Angiography, Female, Fibrin Fibrinogen Degradation Products analysis, Humans, Incidence, Italy epidemiology, Male, Middle Aged, Pulmonary Embolism blood, Pulmonary Embolism diagnostic imaging, Risk Factors, SARS-CoV-2 isolation & purification, COVID-19 complications, Pulmonary Embolism etiology
Abstract: Background and Aims: Several studies reported a high incidence of pulmonary embolism (PE) among patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, but detailed data about clinical characteristics, risk factors of these patients and prognostic role of PE are still lacking. We aim to evaluate the occurrence of pulmonary embolism among patients with SARS-CoV-2 infection, and to describe their risk factors, clinical characteristics, and in-hospital clinical outcomes., Methods: This is a multicenter Italian study including 333 consecutive SARS-CoV-2 patients admitted to seven hospitals from February 22 to May 15, 2020. All the patients underwent computed tomography pulmonary angiography (CTPA) for PE detection. In particular, CTPA was performed in case of inadequate response to high-flow oxygen therapy (Fi02≥0.4 to maintain Sp02≥92%), elevated D-dimer (>0.5μg/mL), or echocardiographic signs of right ventricular dysfunction. Clinical, laboratory and radiological data were also analyzed., Results: Among 333 patients with laboratory confirmed SARS-CoV-2 pneumonia and undergoing CTPA, PE was detected in 109 (33%) cases. At CTPA, subsegmental, segmental, lobar and central thrombi were detected in 31 (29%), 50 (46%), 20 (18%) and 8 (7%) cases, respectively. In-hospital death occurred in 29 (27%) patients in the PE-group and in 47 (21%) patients in the non-PE group (p = 0.25). Patients in PE-group had a low rate of traditional risk factors and deep vein thrombosis was detected in 29% of patients undergoing compression ultrasonography. In 71% of cases with documented PE, the thrombotic lesions were located in the correspondence of parenchymal consolidation areas., Conclusions: Despite a low rate of risk factors for venous thromboembolism, PE is present in about 1 out 3 patients with SARS-CoV-2 pneumonia undergoing CTPA for inadequate response to oxygen therapy, elevated D-dimer level, or echocardiographic signs of right ventricular dysfunction. In most of the cases, the thromboses were located distally in the pulmonary tree and were mainly confined within pneumonia areas., Competing Interests: The authors also have declared that no competing interests exist.
Published: 2021
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