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

Author

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

Abstract

Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy. Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website. Results: Data were obtained from 228 echocardiographic laboratories: 112 centers (49%) in the northern, 43 centers (19%) in the central, and 73 (32%) in the southern regions. During the month of observation, we collected 101,050 transthoracic echocardiography (TTE) examinations performed in all centers. As concern other modalities there were performed 5497 transesophageal echocardiography (TEE) examinations in 161/228 centers (71%); 4057 stress echocardiography (SE) examinations in 179/228 centers (79%); and examinations with ultrasound contrast agents (UCAs) in 151/228 centers (66%). We did not find significant regional variations between the different modalities. The usage of picture archiving and communication system (PACS) was significantly higher in the northern (84%) versus central (49%) and southern (45%) centers (P < 0.001). Lung ultrasound (LUS) was performed in 154 centers (66%), without difference between cardiology and noncardiology centers. The evaluation of left ventricular (LV) ejection fraction was evaluated mainly using the qualitative method in 223 centers (94%), occasionally with the Simpson method in 193 centers (85%), and with selective use of the three-dimensional (3D) method in only 23 centers (10%). 3D TTE was present in 137 centers (70%), and 3D TEE in all centers where TEE was done (71%). The assessment of LV diastolic function was done routinely in 80% of the centers. Right ventricular function was evaluated using tricuspid annular plane systolic excursion in all centers, using tricuspid valve annular systolic velocity by tissue

Published
2023

2. P483 IMPACT OF AN ENDOCARDITIS TEAM ON PROGNOSIS: PRELIMINARY RESULTS

Author

Di Domenico, A, primary, Carigi, S, additional, Amati, S, additional, Di Giannuario, G, additional, Di Cesare, A, additional, Farneti, L, additional, Sarti, A, additional, Tripodi, A, additional, Moscatelli, G, additional, Kety, L, additional, Vandi, G, additional, Mele, E, additional, Biagetti, C, additional, and Santarelli, A, additional

Published
2023
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4. [Transcranial color Doppler ultrasonography: methodology and usefulness for the study of patent foramen ovale in cryptogenic stroke]

Author

D'Andrea, A., Radmilovic, J., Mele, D., Di Giannuario, G., Rizzo, M., Campana, M., Riegler, L., Gimelli, A., Khoury, G., Strano, S., and Moreo, A.

Subjects
Ultrasonography, Doppler, Transcranial, Doppler, Middle cerebral artery, Color, Foramen Ovale, Patent, Cryptogenic stroke, Transcranial, Paradoxical embolism, Patent foramen ovale, Stroke, Cerebrovascular Disorders, Microembolic signals, Transcranial Doppler ultrasonography, Humans, Ultrasonography, Doppler, Color, Ischemic Stroke, Patent, Ultrasonography, Foramen Ovale
Abstract

Non-invasive Doppler ultrasonographic study of cerebral arteries (transcranial Doppler, TCD) has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency (≤2 MHz) transducer on the scalp of the patient over specific acoustic windows, in order to visualize the intracranial arterial vessels and to evaluate the cerebral blood flow velocity and its alteration in many different conditions. Nowadays a valid indication for TCD in the outpatient setting is the research of right-to-left shunting, responsible for the so-called "paradoxical embolism", most often due to patency of foramen ovale, which is responsible for the majority of cryptogenic strokes occurring in patients younger than 55 years. TCD also allows to classify the grade of severity of such shunts using the so-called "microembolic signal grading score". Therefore, TCD is an essential cardiological exam for the detection of patent foramen ovale, assuming an important role as a first-level examination to guide the subsequent diagnostic-therapeutic management. In addition, TCD has found many useful applications in neurocritical care practice. It is useful for the identification of intracranial vascular stenosis and for the assessment of critical conditions including vasospasm in subarachnoid hemorrhage, traumatic brain injury and brain stem death. It is also used to evaluate cerebral hemodynamic changes after stroke, to investigate cerebral pressure autoregulation, and for the clinical evaluation of cerebral vasomotor reactivity.

Published
2021

6. Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study

Author

Cameli, M, Miglioranza, M, Magne, J, Mandoli, G, Benfari, G, Ancona, R, Sibilio, G, Reskovic Luksic, V, Dejan, D, Griseli, L, Van De Heyning, C, Mortelmans, P, Michalski, B, Kupczynska, K, Di Giannuario, G, Devito, F, Dulgheru, R, Ilardi, F, Salustri, A, Abushahba, G, Morrone, D, Fabiani, I, Penicka, M, Katbeh, A, Sammarco, G, Esposito, R, Santoro, C, Pastore, M, Comenale Pinto, S, Kalinin, A, Pičkure, Ž, Ažman Juvan, K, Zupan Mežnar, A, Coisne, A, Coppin, A, Opris, M, Nistor, D, Paakkanen, R, Biering-Sørensen, T, Olsen, F, Lapinskas, T, Vaškelyté, J, Galian-Gay, L, Casas, G, Motoc, A, Papadopoulos, C, Loizos, S, Ágoston, G, Szabó, I, Hristova, K, Tsonev, S, Galli, E, Vinereanu, D, Mihaila Baldea, S, Muraru, D, Mondillo, S, Donal, E, Galderisi, M, Cosyns, B, Edvardsen, T, Popescu, B, Cameli, Matteo, Miglioranza, Marcelo Haertel, Magne, Julien, Mandoli, Giulia Elena, Benfari, Giovanni, Ancona, Roberta, Sibilio, Gerolamo, Reskovic Luksic, Vlatka, Dejan, Dosen, Griseli, Leonardo, Van De Heyning, Caroline M, Mortelmans, Philippe, Michalski, Blazej, Kupczynska, Karolina, Di Giannuario, Giovanna, Devito, Fiorella, Dulgheru, Raluca, Ilardi, Federica, Salustri, Alessandro, Abushahba, Galal, Morrone, Doralisa, Fabiani, Iacopo, Penicka, Martin, Katbeh, Asim, Sammarco, Giuseppe, Esposito, Roberta, Santoro, Ciro, Pastore, Maria Concetta, Comenale Pinto, Salvatore, Kalinin, Artem, Pičkure, Žanna, Ažman Juvan, Katja, Zupan Mežnar, Anja, Coisne, Augustine, Coppin, Amandine, Opris, Mihaela Maria, Nistor, Dan Octavian, Paakkanen, Riitta, Biering-Sørensen, Tor, Olsen, Flemming Javier, Lapinskas, Tomas, Vaškelyté, Jolanta Justina, Galian-Gay, Laura, Casas, Guillem, Motoc, Andreea Iulia, Papadopoulos, Constantinos Hristou, Loizos, Savvas, Ágoston, Gergely, Szabó, Istvan, Hristova, Krasimira, Tsonev, Svetlin Netkov, Galli, Elena, Vinereanu, Dragos, Mihaila Baldea, Sorina, Muraru, Denisa, Mondillo, Sergio, Donal, Erwan, Galderisi, Maurizio, Cosyns, Bernard, Edvardsen, Thor, Popescu, Bogdan A, Cameli, M, Miglioranza, M, Magne, J, Mandoli, G, Benfari, G, Ancona, R, Sibilio, G, Reskovic Luksic, V, Dejan, D, Griseli, L, Van De Heyning, C, Mortelmans, P, Michalski, B, Kupczynska, K, Di Giannuario, G, Devito, F, Dulgheru, R, Ilardi, F, Salustri, A, Abushahba, G, Morrone, D, Fabiani, I, Penicka, M, Katbeh, A, Sammarco, G, Esposito, R, Santoro, C, Pastore, M, Comenale Pinto, S, Kalinin, A, Pičkure, Ž, Ažman Juvan, K, Zupan Mežnar, A, Coisne, A, Coppin, A, Opris, M, Nistor, D, Paakkanen, R, Biering-Sørensen, T, Olsen, F, Lapinskas, T, Vaškelyté, J, Galian-Gay, L, Casas, G, Motoc, A, Papadopoulos, C, Loizos, S, Ágoston, G, Szabó, I, Hristova, K, Tsonev, S, Galli, E, Vinereanu, D, Mihaila Baldea, S, Muraru, D, Mondillo, S, Donal, E, Galderisi, M, Cosyns, B, Edvardsen, T, Popescu, B, Cameli, Matteo, Miglioranza, Marcelo Haertel, Magne, Julien, Mandoli, Giulia Elena, Benfari, Giovanni, Ancona, Roberta, Sibilio, Gerolamo, Reskovic Luksic, Vlatka, Dejan, Dosen, Griseli, Leonardo, Van De Heyning, Caroline M, Mortelmans, Philippe, Michalski, Blazej, Kupczynska, Karolina, Di Giannuario, Giovanna, Devito, Fiorella, Dulgheru, Raluca, Ilardi, Federica, Salustri, Alessandro, Abushahba, Galal, Morrone, Doralisa, Fabiani, Iacopo, Penicka, Martin, Katbeh, Asim, Sammarco, Giuseppe, Esposito, Roberta, Santoro, Ciro, Pastore, Maria Concetta, Comenale Pinto, Salvatore, Kalinin, Artem, Pičkure, Žanna, Ažman Juvan, Katja, Zupan Mežnar, Anja, Coisne, Augustine, Coppin, Amandine, Opris, Mihaela Maria, Nistor, Dan Octavian, Paakkanen, Riitta, Biering-Sørensen, Tor, Olsen, Flemming Javier, Lapinskas, Tomas, Vaškelyté, Jolanta Justina, Galian-Gay, Laura, Casas, Guillem, Motoc, Andreea Iulia, Papadopoulos, Constantinos Hristou, Loizos, Savvas, Ágoston, Gergely, Szabó, Istvan, Hristova, Krasimira, Tsonev, Svetlin Netkov, Galli, Elena, Vinereanu, Dragos, Mihaila Baldea, Sorina, Muraru, Denisa, Mondillo, Sergio, Donal, Erwan, Galderisi, Maurizio, Cosyns, Bernard, Edvardsen, Thor, and Popescu, Bogdan A

Abstract

Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume-pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference.

Published
2020

7. Echocardiographic features and behavior of cardiac structural abnormalities in mucopolysaccharidosis

Author

Saba, S, primary, Al Sergani, A, additional, Vriz, O, additional, Kholaif, N, additional, Ramzan, K, additional, Jawad Shah, S, additional, Ahmad, O, additional, Albayyat, R, additional, Di Michele, S, additional, Pergola, V, additional, Di Giannuario, G, additional, Elmahi, I, additional, Ibrahim, S, additional, Galzerano, D, additional, and Di Salvo, G, additional

Published
2021
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11. Contemporary application of the edge-to-edge repair

Author

Pozzoli, A, Vicentini, L, Di Giannuario, G, La Canna, G, DE BONIS, MICHELE, ALFIERI, OTTAVIO, Pozzoli, A, Vicentini, L, DE BONIS, Michele, Di Giannuario, G, La Canna, G, and Alfieri, Ottavio

Subjects
Masters of Cardiothoracic Surgery
Published
2015

12. Aortic Sutureless Perceval Valve for Small Root in Concomitant Mitral Valve Replacement

Author

Moriggia S, Trumello C, Buzzatti N, Iaci G, Di Giannuario G, ALFIERI , OTTAVIO, Moriggia, S, Trumello, C, Buzzatti, N, Iaci, G, Di Giannuario, G, and Alfieri, Ottavio

Abstract

Conventional valves have a sewing ring that reduces the effective orifice area for a given valve size. In patients with small aortic roots, the implantation of a stented conventional prosthesis can be very difficult or may lead to patient-prosthesis mismatch. In the case of the Sorin Perceval sutureless aortic valve, concomitant mitral valve replacement (MVR) is an exclusion criterion because the latter valve's rigid ring may interfere with the self-expandable stent anchorage of the Sorin Perceval sutureless valve, or cause it to become distorted. The case is reported of very small, 77-year-old woman with severe aortic valve stenosis, severe mitral regurgitation and asymmetric hypertrophy of the left ventricle with systolic anterior motion. The patient underwent MVR and concomitant off-label implantation of the Sorin Perceval S sutureless valve due to the extremely small size of the aortic annulus. Echocardiography performed on completion of surgery, at discharge from hospital and at after a four-month follow up, documented a normal mitral prosthesis position and function, a normal aortic prosthesis position, and mild central regurgitation in both valves.

Published
2015

24. Poster session 6: Saturday 6 December 2014, 08:30-12:30 * Location: Poster area

Author

Goirigolzarri Artaza, J, Gallego Delgado, M, Jaimes Castellanos, CP, Cavero Gibanel, MA, Pastrana Ledesma, MA, Alonso Pulpon, LA, Gonzalez Mirelis, J, Al Ansi, R Z, Sokolovic, S, Cerin, G, Szychta, W, Popa, B A, Botezatu, D, Benea, D, Manganiello, S, Corlan, A, Jabour, A, Igual Munoz, B, Osaca Asensi, JOA, Andres La Huerta, AALH, Maceira Gonzalez, AMG, Estornell Erill, JEE, Cano Perez, OCP, Sancho-Tello, MJSTDC, Alonso Fernandez, PAF, Sepulveda Sanchez, PSS, Montero Argudo, AMA, Palombo, C, Morizzo, C, Baluci, M, Kozakova, M, Panajotu, A, Karady, J, Szeplaki, G, Horvath, T, Tarnoki, DL, Jermendy, AL, Geller, L, Merkely, B, Maurovich-Horvat, P, Group, MTA-SE "Lendület" Cardiovascular Imaging Research, Moustafa, S, Mookadam, F, Youssef, M, Zuhairy, H, Connelly, M, Prieur, T, Alvarez, N, Ashikhmin, Y, Drapkina, O, Boutsikou, M, Demerouti, E, Leontiadis, E, Petrou, E, Karatasakis, G, Kozakova, M, Morizzo, C, Bianchi, V, Marchi, B, Federico, G, Palombo, C, Chatzistamatiou, E, Moustakas, G, Memo, G, Konstantinidis, D, Mpampatzeva Vagena, I, Manakos, K, Traxanas, K, Vergi, N, Feretou, A, Kallikazaros, I, Goto, M, Uejima, T, Itatani, K, Pedrizzetti, G, Mada, RO, Daraban, AM, Duchenne, J, Voigt, JU, Chiu, D Y Y, Green, D, Johnstone, L, Sinha, S, Kalra, PA, Abidin, N, Group, Salford Vascular Research, Sikora-Frac, M, Zaborska, B, Maciejewski, P, Bednarz, B, Budaj, A, Nemes, A, Sasi, V, Gavaller, H, Kalapos, A, Domsik, P, Katona, A, Szucsborus, T, Ungi, T, Forster, T, Ungi, I, Pluchinotta, FR, Arcidiacono, C, Saracino, A, Carminati, M, Bussadori, C, Dahlslett, T, Karlsen, S, Grenne, B, Sjoli, B, Bendz, B, Skulstad, H, Smiseth, OA, Edvardsen, T, Brunvand, H, Vereckei, A, Szelenyi, ZS, Szenasi, G, Santoro, C, Galderisi, M, Niglio, T, Santoro, M, Stabile, E, Rapacciuolo, A, Spinelli, L, De Simone, G, Esposito, G, Trimarco, B, Hubert, S, Jacquier, A, Fromonot, J, Resseguier, C, Tessier, A, Guieu, R, Renard, S, Haentjiens, J, Lavoute, C, Habib, G, Menting, M E, Koopman, LP, Mcghie, JS, Rebel, B, Gnanam, D, Helbing, WA, Van Den Bosch, AE, Roos-Hesselink, JW, Shiino, K, Yamada, A, Sugimoto, K, Takada, K, Takakuwa, Y, Miyagi, M, Iwase, M, Ozaki, Y, Placido, R, Ramalho, A, Nobre E Menezes, M, Cortez-Dias, N, Goncalves, S, Guimaraes, T, Robalo Martins, S, Francisco, AR, Almeida, AG, Nunes Diogo, A, Hayashi, T, Itatani, K, Inuzuka, R, Shindo, T, Hirata, Y, Shimizu, N, Miyaji, K, Henri, C, Dulgheru, R, Magne, J, Kou, S, Davin, L, Nchimi, A, Oury, C, Pierard, L, Lancellotti, P, Kovalyova, O, Honchar, O, Tengku, WINDA, Ketaren, ANDRE, Mingo Santos, S, Monivas Palomero, V, Restrepo Cordoba, A, Rodriguez Gonzalez, E, Goirigolzarri Artaza, J, Sayago Silva, I, Garcia Lunar, I, Mitroi, C, Cavero Gibanel, M, Segovia Cubero, J, Ryu, SK, Park, JY, Kim, SH, Choi, JW, Goh, CW, Byun, YS, Choi, JH, Westholm, C, Johnson, J, Jernberg, T, Winter, R, Rio, P, Moura Branco, L, Galrinho, A, Pinto Teixeira, P, Viveiros Monteiro, A, Portugal, G, Pereira-Da-Silva, T, Afonso Nogueira, M, Abreu, J, Cruz Ferreira, R, Mazzone, A, Botto, N, Paradossi, U, Chabane, A, Francini, M, Cerone, E, Baroni, M, Maffei, S, Berti, S, Tatu-Chitoiu, G P, Deleanu, D, Macarie, C, Chioncel, O, Dorobantu, M, Udroiu, C, Calmac, L, Diaconeasa, A, Vintila, V, Vinereanu, D, investigators, RO-STEMI, Ghattas, A, Shantsila, E, Griffiths, H, Lip, GY, Galli, E, Guirette, Y, Daudin, M, Auffret, V, Mabo, P, Donal, E, Fabiani, I, Conte, L, Scatena, C, Barletta, V, Pratali, S, De Martino, A, Bortolotti, U, Naccarato, AG, Di Bello, V, Falanga, G, Alati, E, Di Giannuario, G, Zito, C, Cusma' Piccione, M, Carerj, S, Oreto, G, Dattilo, G, Alfieri, O, La Canna, G, Generati, G, Bandera, F, Pellegrino, M, Alfonzetti, E, Labate, V, Guazzi, M, Cho, EJ, Park, S-J, Lim, HJ, Yoon, HR, Chang, S-A, Lee, S-C, Park, SW, Cengiz, B, Sahin, S T, Yurdakul, S, Kahraman, S, Bozkurt, A, Aytekin, S, Borges, I P, Peixoto, ECS, Peixoto, RTS, Peixoto, RTS, Marcolla, VF, Venkateshvaran, A, Sola, S, Dash, P K, Thapa, P, Manouras, A, Winter, R, Brodin, LA, Govind, S C, Mizariene, V, Verseckaite, R, Bieseviciene, M, Karaliute, R, Jonkaitiene, R, Vaskelyte, J, Arzanauskiene, R, Janenaite, J, Jurkevicius, R, Rosner, S, Orban, M, Nadjiri, J, Lesevic, H, Hadamitzky, M, Sonne, C, Manganaro, R, Carerj, S, Cusma-Piccione, MC, Caprino, A, Boretti, I, Todaro, MC, Falanga, G, Oreto, L, D'angelo, MC, Zito, C, Le Tourneau, T, Cueff, C, Richardson, M, Hossein-Foucher, C, Fayad, G, Roussel, JC, Trochu, JN, Vincentelli, A, Obase, K, Weinert, L, Lang, R, Cavalli, G, Muraru, D, Miglioranza, MH, Addetia, K, Veronesi, F, Cucchini, U, Mihaila, S, Tadic, M, Lang, RM, Badano, L, Polizzi, V, Pino, PG, Luzi, G, Bellavia, D, Fiorilli, R, Chialastri, C, Madeo, A, Malouf, J, Buffa, V, Musumeci, F, Gripari, P, Tamborini, G, Bottari, V, Maffessanti, F, Carminati, C, Muratori, M, Vignati, C, Bartorelli, A, Alamanni, F, Pepi, M, Polymeros, S, Dimopoulos, A, Spargias, K, Karatasakis, G, Athanasopoulos, G, Pavlides, G, Dagres, N, Vavouranakis, E, Stefanadis, C, Cokkinos, DV, Pradel, S, Mohty, D, Magne, J, Darodes, N, Lavergne, D, Damy, T, Beaufort, C, Aboyans, V, Jaccard, A, Mzoughi, K, Zairi, I, Jabeur, M, Ben Moussa, F, Ben Chaabene, A, Kamoun, S, Mrabet, K, Fennira, S, Zargouni, A, Kraiem, S, Jovanova, S, Arnaudova-Dezjulovic, F, Correia, C E, Cruz, I, Marques, N, Fernandes, M, Bento, D, Moreira, D, Lopes, L, Azevedo, O, GROUP, SUNSHINE, Keramida, K, Kouris, N, Kostopoulos, V, Psarrou, G, Giannaris, V, Olympios, CD, Marketou, M, Parthenakis, F, Kalyva, N, Pontikoglou, CH, Maragkoudakis, S, Zacharis, E, Patrianakos, A, Roufas, K, Papadaki, H, Vardas, P, Dominguez Rodriguez, F, Monivas Palomero, V, Mingo Santos, S, Arribas Rivero, B, Cuenca Parra, S, Zegri Reiriz, I, Vazquez Lopez-Ibor, J, Garcia-Pavia, P, Szulik, M, Streb, W, Wozniak, A, Lenarczyk, R, Sliwinska, A, Kalarus, Z, Kukulski, T, Nemes, A, Domsik, P, Kalapos, A, Forster, T, Serra, W, Lumetti, FL, Mozzani, FM, Del Sante, GDS, Ariani, AA, Corros, C, Colunga, S, Garcia-Campos, A, Diaz, E, Martin, M, Rodriguez-Suarez, ML, Leon, V, Fidalgo, A, Moris, C, De La Hera, JM, Kylmala, M M, Rosengard-Barlund, M, Groop, P H, Lommi, J, Bruin De- Bon, HACM, Bilt Van Der, IA, Wilde, AA, Brink Van Den, RBA, Teske, AJ, Rinkel, GJ, Bouma, BJ, Teixeira, R, Monteiro, R, Garcia, J, Silva, A, Graca, M, Baptista, R, Ribeiro, M, Cardim, N, Goncalves, L, Duszanska, A, Skoczylas, I, Kukulski, T, Polonski, L, Kalarus, Z, Choi, J-H, Park, JS, Ahn, JH, Lee, JW, Ryu, SK, Ahn, J, Kim, DH, Lee, HO, Przewlocka-Kosmala, M, Mlynarczyk, J, Rojek, A, Mysiak, A, Kosmala, W, Pellissier, A, Larochelle, E, Krsticevic, L, Baron, E, Le, V, Roy, A, Deragon, A, Cote, M, Garcia, D, Tournoux, F, Yiangou, K, Azina, C, Yiangou, A, Zitti, M, Ioannides, M, Ricci, F, Dipace, G, Aquilani, R, Radico, F, Cicchitti, V, Bianco, F, Miniero, E, Petrini, F, De Caterina, R, Gallina, S, Jardim Prista Monteiro, R, Teixeira, R, Garcia, J, Baptista, R, Ribeiro, M, Cardim, N, Goncalves, L, Chung, H, Kim, JY, Joung, B, Uhm, JS, Pak, HN, Lee, MH, Lee, KY, Ragab, AM, Abdelwahab, AMIR, Yazeed, YASER, El Naggar, WAEL, Spahiu, K, Spahiu, E, Doko, A, Liesting, C, Brugts, JJ, Kofflard, MJM, Kitzen, JJEM, Boersma, E, Levin, M-D, Coppola, C, Piscopo, G, Rea, D, Maurea, C, Caronna, A, Capasso, I, Maurea, N, Azevedo, O, Tadeu, I, Lourenco, M, Portugues, J, Pereira, V, Lourenco, A, Nesukay, E, Kovalenko, V, Cherniuk, S, Danylenko, O, Muhammedov, MB, Ahmedova, DM, Hojakuliyev, BG, Atayeva, D, Nemes, A, Domsik, P, Kalapos, A, Lengyel, C, Varkonyi, TT, Orosz, A, Forster, T, Castro, M, Abecasis, J, Dores, H, Madeira, S, Horta, E, Ribeiras, R, Canada, M, Andrade, MJ, Mendes, M, Morosin, M, Piazza, R, Leonelli, V, Leiballi, E, Pecoraro, R, Cinello, M, Dell' Angela, L, Cassin, M, Sinagra, G, Nicolosi, GL, Wierzbowska-Drabik, K, Hamala, P, Kasprzak, JD, O'driscoll, J, Rossato, C, Gargallo-Fernandez, P, Araco, M, Sharma, S, Sharma, R, Jakus, N, Baricevic, Z, Ljubas Macek, J, Skoric, B, Skorak, I, Velagic, V, Separovic Hanzevacki, J, Milicic, D, Cikes, M, Deljanin Ilic, M, Ilic, S, Kocic, G, Pavlovic, R, Stoickov, V, Ilic, V, Nikolic, LJ, Generati, G, Bandera, F, Pellegrino, M, Alfonzetti, E, Labate, V, Guazzi, M, Labate, V, Bandera, F, Generati, G, Pellegrino, M, Donghi, V, Alfonzetti, E, Guazzi, M, Zakarkaite, D, Kramena, R, Aidietiene, S, Janusauskas, V, Rucinskas, K, Samalavicius, R, Norkiene, I, Speciali, G, Aidietis, A, Kemaloglu Oz, T, Ozpamuk Karadeniz, F, Akyuz, S, Unal Dayi, S, Esen Zencirci, A, Atasoy, I, Osken, A, Eren, M, Fazendas, P R, Caldeira, D, Stuart, B, Cruz, I, Rocha Lopes, L, Almeida, A R, Sousa, P, Joao, I, Cotrim, C, Pereira, H, Fazendas, P R, Caldeira, D, Stuart, B, Cruz, I, Rocha Lopes, L, Almeida, A R, Joao, I, Cotrim, C, Pereira, H, Sinem Cakal, SC, Elif Eroglu, EE, Baydar, O, Beytullah Cakal, BC, Mehmet Vefik Yazicioglu, MVY, Mustafa Bulut, MB, Cihan Dundar, CD, Kursat Tigen, KT, Birol Ozkan, BO, Ali Metin Esen, A, Yagasaki, H, Kawasaki, M, Tanaka, R, Minatoguchi, S, Houle, H, Warita, S, Ono, K, Noda, T, Watanabe, S, Minatoguchi, S, Cho, E J, Park, S J, Lim, H J, Chang, S A, Lee, S C, Park, S W, Cho, E J, Park, S J, Lim, H J, Chang, S A, Lee, S C, Park, S W, Mornos, C, Cozma, D, Ionac, A, Mornos, A, Popescu, I, Ionescu, G, Pescariu, S, Melzer, L, Faeh-Gunz, A, Seifert, B, Attenhofer Jost, C H, Storve, S, Haugen, BO, Dalen, H, Grue, JF, Samstad, S, Torp, H, Ferrarotti, L, Maggi, E, Piccinino, C, Sola, D, Pastore, F, Marino, PN, Ranjbar, S, Karvandi, M, Hassantash, SA, Karvandi, M, Ranjbar, S, Tierens, S, Remory, I, Bala, G, Gillis, K, Hernot, S, Droogmans, S, Cosyns, B, Lahoutte, T, Tran, N, Poelaert, J, Al-Mallah, M, Alsaileek, A, Nour, K, Celeng, CS, Horvath, T, Kolossvary, M, Karolyi, M, Panajotu, A, Kitslaar, P, Merkely, B, Maurovich Horvat, P, Group, MTA-SE "Lendület" Cardiovascular Imaging Research, Aguiar Rosa, S, Ramos, R, Marques, H, Portugal, G, Pereira Da Silva, T, Rio, P, Afonso Nogueira, M, Viveiros Monteiro, A, Figueiredo, L, and Cruz Ferreira, R

Abstract

Introduction: The increase of left auricular volume (LAV) is a robust cardiovascular event predictor. Despite that echochardiography is more often used, cardiac MRI is considered more accurate. Our objetives are to validate "fast" LAV measures by MRI vs the considered gold standard (GS) and to compare Echo and MRI in a wide spectrum of patients. Methods: In a non-selected popullation with MRI study previously realized, we measured LAV by biplane method (BPMR) and by area-length in 4 chamber view (ALMR) and compared them with biplane (BPe) and discs method (MDDe) in 4 chamber view in echo. To validate MRI measurements, we measured LAV in short axis slices (Simpson Method, SM) in a group of patients and considered it the GS. Results: 186 patients were included (mean age 51 ± 17 age; 123 male; 14 in AF) with clinical indication of cardiac MRI (Philips 1,5 T). In 24 patients SM was calculated. 29% of cardiac MRI were considered normal. Mean underlying pathologies were myocardiopathy (27%), Ischemic myocardiopathy (17%), myopericarditis (10%), prior to AF ablation (4%), valvular disease (6%) and miscellaneous (7%). Excellent correlation was obtained between "fast" MRI measurements and SM in MRI (SM vs BPMR interclass correlation coefficient ICC=0.965 and SM vs ALMR, ICC=0.958; P<0.05) with low interobserver variability (ICC=0.983 for SM; ICC=0.949 for BPMR; ICC=0.931 for ALMR). "Fast" measurements by MRI showed stadistical correlation between them (CCI=0.910) (Figure). Correlation between Echo and MRI measures was only moderate. (BPRM vs BPe CCI=0,469 mean difference -30 ml; ALMR vs MDDe ICC=0,456 mean difference -24 mL). Conclusions: ‘fast’ LAV measures by MRI are comparable with the MRI GS and also between them. Echo values seem to underestimate compared to MRI, so its use may not be suitable.

Published
2014
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27. Novel anti-inflammatory effect of statins: reduction of CD4+CD28null T lymphocyte frequency in patients with unstable angina.

Author

Brugalelfa, S., Biasucc, L. M., Pinnelli, M., Biondi-Zoccai, G., Di Giannuario, G., Trotta, G., Liuzzo, G., and Crea, F.

Subjects
STATINS (Cardiovascular agents), ANTICHOLESTEREMIC agents, ENZYME inhibitors, T cells, LYMPHOCYTES, CD4 antigen, ANGINA pectoris, CORONARY disease
Abstract

The article investigates on the anti-inflammatory effect of statins as wells as its inhibitory effect of cholesterol biosynthesis. Significantly, the application of statins have direct antithrombotic and anti-inflammatory effects. Furthermore, statins were thought to reduce CD4 T lymphocyte frequency in patients with unstable angina. The result of the research have indicated a possible correlation between statin use and the reduction of CD4 T lymphocytes in patients with unstable angina.

Published
2006
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28. Reshaping of Italian Echocardiographic Laboratories Activities during the Second Wave of COVID-19 Pandemic and Expectations for the Post-Pandemic Era

Author

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

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

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

Published
2021
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29. Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study

Author

Roberta Esposito, Andreea Motoc, Giuseppe Sammarco, Tomas Lapinskas, Sorina Mihaila Baldea, Tor Biering-Sørensen, Žanna Pičkure, Svetlin Netkov Tsonev, István Szabó, Anja Zupan Mežnar, Gergely Ágoston, Giovanna Di Giannuario, Katja Ažman Juvan, Giovanni Benfari, Guillem Casas, Artem Kalinin, Sergio Mondillo, Flemming Javier Olsen, Alessandro Salustri, Dragos Vinereanu, Savvas Loizos, Elena Galli, Augustine Coisne, Marcelo Haertel Miglioranza, Roberta Ancona, Jolanta Vaskelyte, Mihaela Maria Opris, Erwan Donal, Gerolamo Sibilio, Maria Concetta Pastore, Ciro Santoro, Galal Abushahba, Laura Galian-Gay, Salvatore Comenale Pinto, Vlatka Rešković Lukšić, Błażej Michalski, Maurizio Galderisi, Constantinos Hristou Papadopoulos, Riitta Paakkanen, Federica Ilardi, Dosen Dejan, Bernard Cosyns, R Dulgheru, Amandine Coppin, Martin Penicka, Doralisa Morrone, Dan Octavian Nistor, Krasimira Hristova, Asim Katbeh, Giulia Elena Mandoli, Fiorella Devito, Leonardo Griseli, Philippe Mortelmans, Thor Edvardsen, Caroline M. Van De Heyning, Bogdan A. Popescu, Karolina Kupczyńska, Matteo Cameli, Iacopo Fabiani, Julien Magne, Denisa Muraru, Cameli, Matteo, Miglioranza, Marcelo Haertel, Magne, Julien, Mandoli, Giulia Elena, Benfari, Giovanni, Ancona, Roberta, Sibilio, Gerolamo, Reskovic Luksic, Vlatka, Dejan, Dosen, Griseli, Leonardo, Van De Heyning, Caroline M., Mortelmans, Philippe, Michalski, Blazej, Kupczynska, Karolina, Di Giannuario, Giovanna, Devito, Fiorella, Dulgheru, Raluca, Ilardi, Federica, Salustri, Alessandro, Abushahba, Galal, Morrone, Doralisa, Fabiani, Iacopo, Penicka, Martin, Katbeh, Asim, Sammarco, Giuseppe, Esposito, Roberta, Santoro, Ciro, Pastore, Maria Concetta, Comenale Pinto, Salvatore, Kalinin, Artem, Pičkure, Žanna, Ažman Juvan, Katja, Zupan Mežnar, Anja, Coisne, Augustine, Coppin, Amandine, Opris, Mihaela Maria, Nistor, Dan Octavian, Paakkanen, Riitta, Biering-Sørensen, Tor, Olsen, Flemming Javier, Lapinskas, Toma, Vaškelyté, Jolanta Justina, Galian-Gay, Laura, Casas, Guillem, Motoc, Andreea Iulia, Papadopoulos, Constantinos Hristou, Loizos, Savva, Ágoston, Gergely, Szabó, Istvan, Hristova, Krasimira, Tsonev, Svetlin Netkov, Galli, Elena, Vinereanu, Drago, Mihaila Baldea, Sorina, Muraru, Denisa, Mondillo, Sergio, Donal, Erwan, Galderisi, Maurizio, Cosyns, Bernard, Edvardsen, Thor, Popescu, Bogdan A., University of Helsinki, HUS Heart and Lung Center, Helsinki University Hospital Area, Università degli Studi di Siena = University of Siena (UNISI), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), 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), CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire Brugmann [Bruxelles] (CHU), University of Oslo (UiO), University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Cameli, M, Miglioranza, M, Magne, J, Mandoli, G, Benfari, G, Ancona, R, Sibilio, G, Reskovic Luksic, V, Dejan, D, Griseli, L, Van De Heyning, C, Mortelmans, P, Michalski, B, Kupczynska, K, Di Giannuario, G, Devito, F, Dulgheru, R, Ilardi, F, Salustri, A, Abushahba, G, Morrone, D, Fabiani, I, Penicka, M, Katbeh, A, Sammarco, G, Esposito, R, Santoro, C, Pastore, M, Comenale Pinto, S, Kalinin, A, Pičkure, Ž, Ažman Juvan, K, Zupan Mežnar, A, Coisne, A, Coppin, A, Opris, M, Nistor, D, Paakkanen, R, Biering-Sørensen, T, Olsen, F, Lapinskas, T, Vaškelyté, J, Galian-Gay, L, Casas, G, Motoc, A, Papadopoulos, C, Loizos, S, Ágoston, G, Szabó, I, Hristova, K, Tsonev, S, Galli, E, Vinereanu, D, Mihaila Baldea, S, Muraru, D, Mondillo, S, Donal, E, Galderisi, M, Cosyns, B, Edvardsen, T, Popescu, B, CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical sciences, Faculty of Medicine and Pharmacy, Cardiology, and Cardio-vascular diseases

Subjects
medicine.medical_specialty, Clinical Biochemistry, CONSENSUS DOCUMENT, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, GUIDELINES, RECOMMENDATIONS, Article, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, QRS complex, 0302 clinical medicine, Interquartile range, DEFORMATION, Internal medicine, Medicine, speckle tracking echocardiography, AMERICAN SOCIETY, reference point, EACVI/ASE/INDUSTRY TASK-FORCE, EUROPEAN ASSOCIATION, standardization, left atrial strain, multi-centric study, Reproducibility, Mitral regurgitation, lcsh:R5-920, business.industry, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, medicine.disease, DYSFUNCTION, Stenosis, Heart failure, 3121 General medicine, internal medicine and other clinical medicine, Cardiology, Population study, HEART-FAILURE, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Human medicine, Left atrial strain, Multi-centric study, Reference point, Standardization, Cardiology and Cardiovascular Medicine, business, lcsh:Medicine (General)
Abstract

International audience; Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume–pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference.

Published
2020

30. Optimal results immediately after MitraClip therapy or surgical edge-to-edge repair for functional mitral regurgitation: are they really stable at 4 years?

Author

Giovanna Di Giannuario, Elisabetta Lapenna, Davide Schiavi, Nicola Buzzatti, Alberto Pozzoli, Giovanni La Canna, Paolo Denti, F. Pappalardo, Micaela Cioni, Michele De Bonis, Ottavio Alfieri, De Bonis, M, Lapenna, E, Buzzatti, N, La Canna, G, Denti, P, Pappalardo, F, Schiavi, D, Pozzoli, A, Cioni, M, Di Giannuario, G, and Alfieri, O

Subjects
Male, Pulmonary and Respiratory Medicine, Cardiac Catheterization, medicine.medical_specialty, Mitral Valve Annuloplasty, medicine.medical_treatment, 030204 cardiovascular system & hematology, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Interquartile range, Mitral valve, Internal medicine, Mitral valve annuloplasty, medicine, Humans, Minimally Invasive Surgical Procedures, Aged, Mitral regurgitation, Mitral valve repair, Ejection fraction, business.industry, MitraClip, Hazard ratio, Mitral Valve Insufficiency, Prostheses and Implants, General Medicine, Middle Aged, Prognosis, Survival Analysis, Surgery, Treatment Outcome, medicine.anatomical_structure, 030228 respiratory system, Echocardiography, Cardiology, Mitral Valve, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

OBJECTIVES Recurrent mitral regurgitation (MR) is common after surgical and percutaneous (MitraClip) treatment of functional MR (FMR). However, the Everest II trial suggested that, in patients with secondary MR and initially successful MitraClip therapy, the results were sustained at 4 years and were comparable with surgery in terms of late efficacy. The aim of this study was to assess whether both those findings were confirmed by our own experience. METHODS We reviewed 143 patients who had an initial optimal result (residual MR ≤ 1+ at discharge) after MitraClip therapy (85 patients) or surgical edge-to-edge (EE) repair (58 patients) for severe secondary MR (mean ejection fraction 28 ± 8.5%). Patients with MR ≥ 2+ at hospital discharge were excluded. The two groups were comparable. Only age and logistic EuroSCORE were higher in the MitraClip group. RESULTS Follow-up was 100% complete (median 3.2 years; interquartile range 1.8;6.1). Freedom from cardiac death at 4 years (81 ± 5.2 vs 84 ± 4.6%, P = 0.5) was similar in the surgical and MitraClip group. The initial optimal MitraClip results did not remain stable. At 1 year, 32.5% of the patients had developed MR ≥ 2+ (P = 0.0001 compared with discharge). Afterwards, patients with an echocardiographic follow-up at 2 years (60 patients), 3 years (40 patients) and 4 years (21 patients) showed a significant increase in the severity of MR compared with the corresponding 1 year grade (all P < 0.01). Freedom from MR ≥ 3+ at 4 years was 75 ± 7.6% in the MitraClip group and 94 ± 3.3% in the surgical one (P = 0.04). Freedom from MR ≥ 2+ at 4 years was 37 ± 7.2 vs 82 ± 5.2%, respectively (P = 0.0001). Cox regression analysis identified the use of MitraClip as a predictor of recurrence of MR ≥ 2+ [hazard ratio (HR) 5.2, 95% confidence interval (CI) 2.5-10.8, P = 0.0001] as well as of MR ≥ 3 (HR 3.5, 95% CI 0.9-13.1, P = 0.05). CONCLUSIONS In patients with FMR and optimal mitral competence after MitraClip implantation, the recurrence of significant MR at 4 years is not uncommon. This study does not confirm previous observations reported in the Everest II randomized controlled trial indicating that, if the MitraClip therapy was initially successful, the results were sustained at 4 years. When compared with the surgical EE combined with annuloplasty, MitraClip therapy provides lower efficacy at 4 years.

Published
2016

31. MitraClip therapy and surgical edge-to-edge repair in patients with severe left ventricular dysfunction and secondary mitral regurgitation: mid-term results of a single-centre experience

Author

Maurizio Taramasso, Michele De Bonis, Giovanna Di Giannuario, Ottavio Alfieri, Micaela Cioni, Andrea Giacomini, Paolo Denti, Giovanni La Canna, Federico Pappalardo, Nicola Buzzatti, Elisabetta Lapenna, DE BONIS, Michele, Taramasso, M, Lapenna, E, Denti, P, La Canna, G, Buzzatti, N, Pappalardo, Federico, Di Giannuario, G, Cioni, M, Giacomini, A, Alfieri, Ottavio, University of Zurich, and De Bonis, Michele

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Percutaneous, medicine.medical_treatment, 610 Medicine & health, 030204 cardiovascular system & hematology, Severity of Illness Index, 2705 Cardiology and Cardiovascular Medicine, Ventricular Dysfunction, Left, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Interquartile range, Internal medicine, medicine, Humans, Minimally Invasive Surgical Procedures, Prospective Studies, Aged, Ultrasonography, Mitral valve repair, Mitral regurgitation, Ejection fraction, business.industry, MitraClip, Hazard ratio, Mitral Valve Insufficiency, Prostheses and Implants, General Medicine, Length of Stay, Middle Aged, Confidence interval, 10020 Clinic for Cardiac Surgery, 2746 Surgery, Surgery, Treatment Outcome, 030228 respiratory system, 2740 Pulmonary and Respiratory Medicine, Cardiology, Mitral Valve, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

OBJECTIVES To compare the surgical and percutaneous edge-to-edge (EE) repair in patients with severe left ventricular (LV) dysfunction and secondary mitral regurgitation (MR). METHODS We reviewed the prospectively collected data of the first 120 consecutive patients (age: 65 ± 9.8 years, EF: 28 ± 8.2%) treated with surgical (65 patients) or percutaneous (55 patients) EE repair for severe secondary MR in our institution. Age (P = 0.005) and logistic European System for Cardiac Operative Risk Evaluation (P < 0.0001) were significantly higher in the MitraClip group. LVEF (P = 0.37), end-diastolic (P = 0.83) and end-systolic (P = 0.68) volumes and systolic pulmonary artery pressure (SPAP) (P = 0.58) were similar. The follow-up was 100% complete [median: 4 years; interquartile range (IQR): 2.2-7.2]. RESULTS The length of hospital stay was 10 days (IQR: 8-13) for surgery and 5 days (IQR: 3.9-7.8) for MitraClip (P < 0.0001). Hospital mortality (3 vs 0%, P = 0.49) and freedom from cardiac death at 4 years (80.8 ± 4.9% vs 79.1 ± 5.9%, P = 0.9) were not significantly different in the surgical and MitraClip group, respectively. Residual MR ≥ 2+ at hospital discharge was 7.6% for surgery and 29% for MitraClip (P = 0.002). At 4 years, freedom from MR ≥ 2+ (74.9 ± 5.6% vs 51.4 ± 7.4%, P = 0.01) and freedom from MR ≥ 3+ (92.8 ± 3.4% vs 68.1 ± 7%, P = 0.002) were both significantly higher in the surgical group. Multivariate analysis identified the use of MitraClip as an independent predictor of recurrence of MR ≥ 2+ [Hazard ratio (HR): 2.1, 95% confidence interval (CI): 1.1-3.9, P = 0.02] as well as of MR ≥ 3 (HR: 6.1, 95% CI: 1.5-24.3, P = 0.01). In the surgical group, no predictors of cardiac mortality were identified. In the MitraClip group, left ventricular end-diastolic diameter (HR: 1.1, 95% CI: 1-1.2, P = 0.005) and SPAP (HR: 1, 95% CI: 1-1.1, P = 0.005) were independent predictors of cardiac death at the follow-up. CONCLUSIONS MitraClip therapy is a safe therapeutic option in selected high-risk patients with secondary MR and relevant comorbidities. The surgical EE provides higher efficacy both postoperatively and at the mid-term follow-up.

Published
2015

32. Clinical and anatomical predictors of MitraClip therapy failure for functional mitral regurgitation: single central clip strategy in asymmetric tethering

Author

Paolo Denti, Alberto Pozzoli, Giovanni La Canna, Ottavio Alfieri, Giovanna Di Giannuario, Azeem Latib, Nicola Buzzatti, Francesco Maisano, Maurizio Taramasso, Andrea Guidotti, Antonio Colombo, Taramasso, M, Denti, P, Latib, A, Guidotti, A, Buzzatti, N, Pozzoli, A, Di Giannuario, G, La Canna, G, Colombo, A, Alfieri, Ottavio, and Maisano, F.

Subjects
Heart Valve Prosthesis Implantation, Male, Mitral regurgitation, medicine.medical_specialty, Tethering, business.industry, MitraClip, Mitral Valve Insufficiency, Equipment Design, Surgical Instruments, medicine.disease, Echocardiography, Heart failure, Internal medicine, Practice Guidelines as Topic, medicine, Cardiology, Humans, Mitral Valve, Female, Cardiology and Cardiovascular Medicine, business, Functional mitral regurgitation, Aged, Retrospective Studies
Published
2015

33. Prognostic Value of Coronary Artery Calcification in Patients with COVID-19 and Interstitial Pneumonia: A Case-Control Study.

Author

Dall'Ara G, Piciucchi S, Carletti R, Vizzuso A, Gardini E, De Vita M, Dallaserra C, Campacci F, Di Giannuario G, Grosseto D, Rinaldi G, Vecchio S, Mantero F, Mellini L, Albini A, Giampalma E, Poletti V, and Galvani M

Abstract

Background: Patients suffering from coronavirus disease-19 (COVID-19)-related interstitial pneumonia have variable outcomes, and the risk factors for a more severe course have yet to be comprehensively identified. Cohort studies have suggested that coronary artery calcium (CAC), as estimated at chest computed tomography (CT) scan, correlated with patient outcomes. However, given that the prevalence of CAC is gender- and age-dependent, the influence of baseline confounders cannot be completely excluded. Methods: We designed a retrospective, multicenter case-control study including patients with COVID-19, with severe course cases selected based on death within 30 days or requiring invasive ventilation, whereas controls were age- and sex-matched patients surviving up to 30 days without invasive ventilation. The primary outcome was the analysis of moderate-to-severe CAC prevalence between cases and controls. Results: A total of 65 cases and 130 controls were included in the study. Cases had a significantly higher median pulmonary severity score at chest CT scan compared to controls (10 vs. 8, respectively; p = 0.0001), as well as a higher CAC score (5 vs. 2; p = 0.009). The prevalence of moderate-to-severe CAC in cases was significantly greater (41.5% vs. 23.8%; p = 0.013), a difference mainly driven by a higher prevalence in those who died within 30 days ( p = 0.000), rather than those requiring invasive ventilation ( p = 0.847). White blood cell count, moderate-to-severe CAC, the need for antibiotic therapy, and severe pneumonia at CT scan were independent primary endpoint predictors. Conclusions: This case-control study demonstrated that the CAC burden was higher in COVID-19 patients who did not survive 30 days or who required mechanical ventilation, and CAC played an independent prognostic role.

Published
2024
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34. Clinical Applications of Myocardial Work in Echocardiography: A Comprehensive Review.

Author

Trimarchi G, Carerj S, Di Bella G, Manganaro R, Pizzino F, Restelli D, Pelaggi G, Lofrumento F, Licordari R, Taverna G, Paradossi U, de Gregorio C, Micari A, Di Giannuario G, and Zito C

Abstract

Left ventricular (LV) global longitudinal strain (GLS) has recently garnered attention as a reliable and objective method for evaluating LV systolic function. One of the key advantages of GLS is its ability to detect subtle abnormalities even when the ejection fraction (EF) appears to be preserved. However, it is important to note that GLS, much like LVEF, is significantly influenced by load conditions. In recent years, researchers and clinicians have been exploring noninvasive myocardial work (MW) quantification as an innovative tool for assessing myocardial function. This method integrates measurements of strain and LV pressure, providing a comprehensive evaluation of the heart's performance. Notably, MW offers an advantage over GLS and LVEF because it provides a load-independent assessment of myocardial performance. The implementation of commercial echocardiographic software that facilitates the noninvasive calculation of MW has significantly broadened the scope of its application. This advanced technology is now being utilized in multiple clinical settings, including ischemic heart disease, valvular diseases, cardiomyopathies, cardio-oncology, and hypertension. One of the fundamental aspects of MW is its correlation with myocardial oxygen consumption, which allows for the assessment of work efficiency. Understanding this relationship is crucial for diagnosing and managing various cardiac conditions. The aim of this review is to provide an overview of the noninvasive assessment of myocardial by echocardiography, from basic principles and methodology to current clinical applications., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Cardiovascular Echography.)

Published
2024
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35. [Paradoxical low flow-low gradient aortic stenosis: lights and shadows].

Author

Polizzi V, Bonnì E, D'Andrea A, Di Giannuario G, Gimelli A, Khoury G, Mantovani F, Menafra G, Pergola V, Rabia G, Rizzo M, and Campana M

Subjects
Humans, Reproducibility of Results, Stroke Volume physiology, Echocardiography, Aortic Valve, Severity of Illness Index, Ventricular Function, Left physiology, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery
Abstract

Paradoxical low flow-low gradient aortic valve stenosis (AVS) is an increasing phenotype in the general population, particularly after the seventh decade of life. It is an AVS in which, despite the preserved ejection fraction, the mean transvalvular gradient is not suggestive of severe AVS (<40 mmHg). The pathophysiology is often intertwined with conditions resulting in heart failure with preserved ejection fraction, such as arterial hypertension and cardiac amyloidosis. Its management is rather controversial about the diagnosis and therapeutic management. The aims of this focus are: to clarify the role and reliability of the main available diagnostic methods, the efficacy of surgical and percutaneous treatments, and to develop a diagnostic-therapeutic algorithm for managing this condition in clinical practice. This algorithm will involve a multi-parametric evaluation, integrating standard echocardiographic assessment with three-dimensional planimetric valve area calculation, determination of the energy loss index), and calcium score calculation by computed tomography scan. This approach aims to ascertain the severity of the stenosis and determine the appropriate therapeutic management.

Published
2024
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36. Unlocking insights in bicuspid aortic valve management in adult patients: the vital role of cardiac imaging.

Author

Di Michele S, Parato VM, Di Giannuario G, Kholaif N, Al Admawi M, Aljheish S, Arbili L, Alshammari A, Parato AG, and Al Sergani H

Subjects
Adult, Humans, Quality of Life, Aortic Valve diagnostic imaging, Echocardiography methods, Retrospective Studies, Bicuspid Aortic Valve Disease complications, Bicuspid Aortic Valve Disease pathology, Heart Valve Diseases complications, Aortic Valve Stenosis
Abstract

The bicuspid aortic valve (BAV) presents a multifaceted clinical challenge due to its diverse morphologies and associated complications. This review aims to elucidate the critical role of cardiac imaging in guiding optimal management strategies for BAV patients. BAV, with a prevalence of 1-2%, has genetic underpinnings linked to the NOTCH1 gene mutation. Variability in BAV morphology necessitates tailored surgical approaches. The three primary types of BAV morphology - right-left cusp fusion, right-noncoronary cusp fusion, and left-noncoronary cusp fusion - demand nuanced considerations due to their distinct implications. Valvular dysfunction results in aortic stenosis or regurgitation, attributed to altered valve structure and turbulent hemodynamics. Cardiac imaging modalities, including echocardiography, magnetic resonance imaging, and computerized tomography, are instrumental in assessing valve function, aortic dimensions, and associated complications. Imaging helps predict potential complications, enabling informed treatment decisions. Regular follow-up is crucial to detecting alterations early and intervening promptly. Surgical management options encompass aortic valve repair or replacement, with patient-specific factors guiding the choice. Post-surgical surveillance plays a vital role in preventing complications and optimizing patient outcomes. The review underscores the significance of advanced cardiac imaging techniques in understanding BAV's complexities, facilitating personalized management strategies, and improving patient care. By harnessing the power of multimodal imaging, clinicians can tailor interventions, monitor disease progression, and ultimately enhance the prognosis and quality of life for individuals with BAV.

Published
2023
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37. Stress Echocardiography in Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.

Author

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

Abstract

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

Published
2023
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38. [Atrial cardiomyopathy as a link between atrial fibrillation and stroke. Clinical implications and future diagnostic-therapeutic implications].

Author

Mantovani F, D'Andrea A, Rizzo M, Gimelli A, Di Giannuario G, Khoury G, Pergola V, Polizzi V, Rabia G, and Campana M

Subjects
Humans, Heart Atria pathology, Atrial Fibrillation complications, Atrial Fibrillation diagnosis, Cardiomyopathies diagnosis, Cardiomyopathies etiology, Cardiomyopathies therapy, Stroke complications, Atrial Remodeling, Muscular Diseases complications, Muscular Diseases pathology
Abstract

Atrial myopathy is characterized by atrial fibrotic remodeling, together with electrical, mechanic and autonomic remodeling. Methods to identify atrial myopathy include atrial electrograms, tissue biopsy, cardiac imaging, and serum biomarkers. Accumulating data show that individuals with markers of atrial myopathy have an increased risk of developing both atrial fibrillation and strokes. The aim of the present review is to present atrial myopathy as a pathophysiologic and clinical entity, to describe methods for its detection and the possible implications on management and therapy in selected group of patients.

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

Author

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

Abstract

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

Published
2023
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40. [Ten questions on cardiac magnetic resonance in patients with heart failure: from etiological diagnosis to prognostic stratification].

Author

Carigi S, De Gennaro L, Gentile P, De Maria R, Di Giannuario G, Khoury G, Polizzi V, Gori M, Orso F, Tinti MD, Leonardi G, D'Andrea A, Mantovani F, Pergola V, Rabia G, Gimelli A, Rizzo M, Campana M, Marini M, Oliva F, and Colivicchi F

Subjects
Humans, Prognosis, Stroke Volume, Magnetic Resonance Spectroscopy, Heart Failure diagnostic imaging, Heart Failure etiology, Heart Failure therapy, Cardiomyopathy, Dilated
Abstract

Cardiac magnetic resonance (CMR) imaging has progressively become part of the imaging methods recommended in patients with heart failure. CMR represents the gold standard for assessing volumes, function, biventricular kinetics and providing tissue characterization through scans with and without contrast medium. In patients with heart failure with reduced ejection fraction (HFrEF) and ischemic dilated cardiomyopathy, CMR allows to search for viability, accurately estimate volumes and ejection fraction. It can assess scar extent for predicting response to cardiac resynchronization therapy and for establishing an indication for implanting a defibrillator in borderline cases. In patients with HFrEF and non-ischemic dilated cardiomyopathy, CMR helps to identify specific etiological subgroups and to estimate the arrhythmic risk beyond ejection fraction. In patients with heart failure with preserved ejection fraction, CMR offers the possibility of diagnosing specific phenotypes, including sarcomeric hypertrophic cardiomyopathy, amyloidosis or Fabry disease, and adds prognostic information. Both clinical and scientific interest in this imaging method is constantly expanding; the clinicians dealing with heart failure cannot fail to know the technique, the indications and all the potential that CMR can offer.

Published
2022
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41. Right-sided infective endocarditis and pulmonary embolism: a multicenter study.

Author

Galzerano D, Pergola V, Kinsara AJ, Vriz O, Elmahi I, Al Sergani A, Khaliel F, Cittadini A, Di Giannuario G, and Colonna P

Subjects
Adult, Aged, Humans, Male, Middle Aged, Echocardiography, Transesophageal methods, Staphylococcus aureus, Endocarditis complications, Endocarditis diagnostic imaging, Endocarditis epidemiology, Pulmonary Embolism diagnostic imaging, Pulmonary Embolism epidemiology, Staphylococcal Infections
Abstract

The incidence of right-sided infective endocarditis (RSIE) is steadily increasing and it has been reported to be associated with high risk of embolic events (EE). Aim of our study was to identify the clinical characteristics of patients with RSIE complicated by PE. Indeed, the identification of patients at high risk of significant PE who will benefit from a more aggressive therapeutic strategy may improve the prognosis. From January 2015 to September 2020, 176 patients (Pts) in 6 centers were found to have definite RSIE complicated by PE. Advanced imaging for PE including computed tomography pulmonary angiography (CTPA) was performed in 28 pts (16%) who represent our study group (24 male, mean age 50.6 ±18.29 years). They all underwent transesophageal echocardiography (TEE), in 12 cases (43%) also three-dimensional (3D) TEE, and 27 patients (99%) had both TEE and transthoracic echocardiography (TTE). A total of 53 vegetations (V) were detected. In 18 pts (64%) two or more vegetations were found. Native tricuspid valve was the most frequently involved valve (38 V, 71.7%), followed by catheter (5 V, 9.4%), tricuspid valve prosthesis (4 V, 7.5%), chordae and papillary muscle (2 V, 3.8%) and one vegetation (9%) in each of the following: pulmonic valve, inferior vena cava, eustachian valve, and right atrium. The most common location for vegetations was the anterior leaflet of the tricuspid valve (19 V, 35.8 %) followed by the posterior leaflet (11 V, 20.8%). The most common vegetations morphology was raceme-like shaped (35.8%). Staphylococcus aureus (S. aureus) was the most common causative pathogen (14 pts, 50%). The incidence of PE was very high in patients with vegetation length above 1.5 cm (median 17.6±6.5 mm by TEE). Our results suggest that a routine CTPA should be advised in the presence of vegetations larger than 1.5 cm and with S. aureus infection. This behavior would identify patients at high risk of PE who will benefit from a more aggressive therapeutic strategy, leading to an improvement in the prognosis. Further prospective studies are required to better confirm our hypothesis.

Published
2022
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42. Imaging of Cardiac Masses: An Updated Overview.

Author

Parato VM, Nocco S, Alunni G, Becherini F, Conti S, Cucchini U, Di Giannuario G, Di Nora C, Fabiani D, La Carrubba S, Leonetti S, Montericcio V, Tota A, and Petrella L

Abstract

Studying cardiac masses is one of the most challenging tasks for cardiac imagers. The aim of this review article is to focus on the modern imaging of cardiac masses proceeding through the most frequent ones. Cardiac benign masses such as myxoma, cardiac papillary fibroelastoma, rhabdomyoma, lipoma, and hemangioma are browsed considering the usefulness of most common cardiovascular imaging tools, such as ultrasound techniques, cardiac computed tomography, cardiac magnetic resonance, and in the diagnostic process. In the same way, the most frequent malignant cardiac masses, such as angiosarcoma and metastases, are highlighted. Then, the article browses through nontumoral masses such as cysts, mitral caseous degenerative formations, thrombi, and vegetations, highlighting the differential diagnosis between them. In addition, the article helps in recognizing anatomic normal variants that should not be misdiagnosed as pathological entities., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Cardiovascular Echography.)

Published
2022
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43. [Role of nuclear cardiology in clinical practice: state of art].

Author

Gimelli A, Campana M, D'Andrea A, Di Giannuario G, Khoury G, Mele D, Rizzo M, and Moreo A

Subjects
Heart, Humans, Cardiology, Cardiomyopathies, Endocarditis, Sarcoidosis diagnostic imaging
Abstract

Nuclear imaging plays a pivotal role not only in in the evaluation of myocardial ischemia, but also in the evaluation of cardiac infectious, inflammatory, infiltrative and innervation disorders. Myocardial ischemia and viability, cardiac amyloidosis, sarcoidosis, large vessel vasculitis, infective endocarditis, infected cardiac implantable electronic devices, vascular graft infection, and myocardial innervation dysfunction are the main indications for the use of nuclear medicine procedures in both diagnosis and response assessment. With this summarized paper we share a comprehensive review of the role and the use of nuclear cardiology in different cardiac diseases.

Published
2021
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44. [Lung ultrasonography: what the cardiologist should know].

Author

D'Andrea A, Mele D, Palermi S, Lombardi A, Di Giannuario G, Rizzo M, Campana M, Marrazzo G, Scarafile R, Gimelli A, Khoury G, and Moreo A

Subjects
Cardiologists, Diagnosis, Differential, Dyspnea diagnostic imaging, Humans, Lung virology, Lung Diseases diagnostic imaging, Lung Diseases physiopathology, Prognosis, COVID-19 diagnostic imaging, Lung diagnostic imaging, Ultrasonography methods
Abstract

In recent years, lung ultrasonography has acquired an important role as a valuable diagnostic tool in clinical practice. The lung is usually poorly explorable, but it provides more acoustic information in pathological conditions that modify the relationship between air, water and tissues. The different acoustic impedance of all these components makes the chest wall a powerful ultrasound reflector: this is responsible for the creation of several artifacts providing valuable information about lung pathophysiology. Lung ultrasonography helps in the diagnostic process of parenchymal and pleural pathologies, in the differential diagnosis of dyspnea and in the clinical and prognostic evaluation of the SARS-CoV-2 infection.

Published
2021
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45. Pulse-Cancellation Echocardiography for Clinical Evaluation of Myocardial Scar Burden.

Author

Gaibazzi N, Tuttolomondo D, Guaricci AI, and Di Giannuario G

Subjects
Contrast Media, Echocardiography, Humans, Magnetic Resonance Imaging, Myocardium pathology, Cardiomyopathy, Hypertrophic pathology, Cicatrix diagnostic imaging, Cicatrix pathology
Abstract

Purpose of Review: Echocardiography has been completely abandoned as far as myocardial tissue characterization is concerned, but recently, the possibility to detect scarred myocardial tissue has been revived. We review the most recent studies aiming to assess the presence of myocardial fibrosis or scar using echocardiography., Recent Findings: The use of a simple and clinically available ultrasound, such as method pulse-cancellation, is a promising add-on to standard echocardiography for the detection of scarred myocardial tissue, mostly, but not only, in the setting of post-myocardial infarction patients. Pulse-cancellation technique, available since at least 20 years ago on commercial ultrasound machines, is reasonably accurate to detect myocardial scar tissue caused by recent or prior myocardial infarction, the accuracy varying depending on the spatial distribution of myocardial scars in the left ventricle. Severe myocardial fibers disarray, as found in hypertrophic cardiomyopathy, can also be detected by this ultrasound method.

Published
2021
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46. Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study.

Author

Cameli M, Miglioranza MH, Magne J, Mandoli GE, Benfari G, Ancona R, Sibilio G, Reskovic Luksic V, Dejan D, Griseli L, Van De Heyning CM, Mortelmans P, Michalski B, Kupczynska K, Di Giannuario G, Devito F, Dulgheru R, Ilardi F, Salustri A, Abushahba G, Morrone D, Fabiani I, Penicka M, Katbeh A, Sammarco G, Esposito R, Santoro C, Pastore MC, Comenale Pinto S, Kalinin A, Pičkure Ž, Ažman Juvan K, Zupan Mežnar A, Coisne A, Coppin A, Opris MM, Nistor DO, Paakkanen R, Biering-Sørensen T, Olsen FJ, Lapinskas T, Vaškelyté JJ, Galian-Gay L, Casas G, Motoc AI, Papadopoulos CH, Loizos S, Ágoston G, Szabó I, Hristova K, Tsonev SN, Galli E, Vinereanu D, Mihaila Baldea S, Muraru D, Mondillo S, Donal E, Galderisi M, Cosyns B, Edvardsen T, and Popescu BA

Abstract

Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume-pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference.

Published
2020
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47. [Functional tricuspid regurgitation: imaging, surgical indications, reparative techniques and results].

Author

Settepani F, Berretta P, Fratto P, Di Giannuario G, D'Andrea A, Campana M, Murzi M, Iafrancesco M, Mangino D, Moreo A, and Di Eusanio M

Subjects
Echocardiography standards, Heart Valve Prosthesis Implantation, Humans, Magnetic Resonance Imaging, Treatment Outcome, Tricuspid Valve anatomy & histology, Tricuspid Valve diagnostic imaging, Tricuspid Valve physiopathology, Tricuspid Valve Insufficiency etiology, Tricuspid Valve Insufficiency physiopathology, Tricuspid Valve surgery, Tricuspid Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency surgery
Abstract

Although the indications for surgical management of severe functional tricuspid regurgitation (TR) are now generally accepted, controversy persists concerning the role of intervention for moderate TR. However, there is a trend for intervention in this setting, particularly in patients with annular dilation. Echocardiographic imaging is the gold standard to identify functional TR and distinguish it from a primitive or degenerative form. Currently, surgery remains the best approach for the interventional treatment of TR. Ring annuloplasty seems to provide better results than suture annuloplasty (De Vega technique) and rigid rings appear to be more reliable in the long term, in comparison with flexible bands. Tricuspid valve repair is more beneficial compared with replacement, except in highly selected cases of long-standing TR with multifactorial mechanism.

Published
2020
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48. [Follow-up after surgical treatment of type A acute aortic dissection: current evidence and controversies].

Author

Berretta P, Iafrancesco M, Settepani F, Mele D, Di Giannuario G, Murzi M, Fratto P, Pino PG, Mangino D, Moreo A, and Di Eusanio M

Subjects
Acute Disease, Aortic Dissection classification, Aortic Dissection diagnostic imaging, Aneurysm, False diagnostic imaging, Aorta diagnostic imaging, Aortic Aneurysm, Thoracic surgery, Aortic Valve, Blood Vessel Prosthesis Implantation, Disease Progression, Emergency Treatment, Follow-Up Studies, Heart Valve Prosthesis Implantation, Humans, Postoperative Complications diagnostic imaging, Prognosis, Replantation, Risk Factors, Rupture surgery, Aortic Dissection surgery, Aorta surgery, Postoperative Complications surgery, Tunica Intima injuries
Abstract

Type A acute aortic dissection (TA-AAD) is a catastrophic condition for which emergency surgery is the mainstay of therapy. Surgical treatment of TA-AAD is centered on excision of the proximal intimal tear, replacement of the ascending aorta and re-establishment of a dominant flow in the distal true lumen. In patients who survive surgery, a dissected distal and/or proximal aorta remains, posing a risk of subsequent aneurysmal degeneration, rupture and malperfusion, and secondary extensive interventions are often required. However, knowledge regarding the risk factors of progression of residual aortic dissection is limited, and no well-defined recommendations for clinical and imaging follow-up have been generated thus far. The aim of this paper is to review and discuss on the current evidence and controversies on the long-term management of patients operated on for TA-AAD.

Published
2020
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49. [Non-ischemic ventricular dysfunction in COVID-19 patients: characteristics and implications for cardiac imaging on the basis of current evidence].

Author

Mele D, D'Andrea A, Campana M, Di Giannuario G, Flamigni F, Gimelli A, Khoury G, Rizzo M, and Moreo A

Subjects
Acute Disease, Asymptomatic Infections, COVID-19, Coronavirus Infections blood, Coronavirus Infections diagnostic imaging, Cytokine Release Syndrome complications, Echocardiography, Electrocardiography, Heart Failure etiology, Humans, Myocarditis blood, Myocarditis etiology, Pandemics, Pneumonia, Viral blood, Pneumonia, Viral diagnostic imaging, SARS-CoV-2, Stroke Volume physiology, Takotsubo Cardiomyopathy diagnostic imaging, Takotsubo Cardiomyopathy etiology, Troponin blood, Ventricular Dysfunction, Left blood, Ventricular Dysfunction, Left etiology, Ventricular Dysfunction, Right blood, Ventricular Dysfunction, Right etiology, Betacoronavirus, Coronavirus Infections complications, Myocarditis diagnostic imaging, Pneumonia, Viral complications, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Dysfunction, Right diagnostic imaging
Abstract

Coronavirus 2019 disease (COVID-19), caused by SARS-CoV-2, can lead to cardiac impairment with various types of clinical manifestations, including heart failure and cardiogenic shock. A possible expression of cardiac impairment is non-ischemic ventricular dysfunction, which can be related to different pathological conditions, such as myocarditis, stress and cytokine-related ventricular dysfunction. The diagnosis of these pathological conditions can be challenging during COVID-19; furthermore, their prevalence and prognostic significance have not been elucidated yet. The purpose of this review is to take stock of the various aspects of non-ischemic ventricular dysfunction that may occur during COVID-19 and of the diagnostic implications related to the use of cardiac imaging techniques.

Published
2020
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50. [Imaging in acute aortic syndrome: not just dissection].

Author

Mele D, Rizzo M, Campana M, D'Andrea A, Di Giannuario G, Gimelli A, Khoury G, Pino PG, Berretta P, Settepani F, Chiodi E, Di Eusanio M, and Moreo A

Subjects
Acute Disease, Aortic Dissection surgery, Aortic Aneurysm, Thoracic diagnostic imaging, Aortic Aneurysm, Thoracic surgery, Aortic Diseases surgery, Echocardiography, Transesophageal, Hematoma surgery, Humans, Magnetic Resonance Imaging, Syndrome, Tomography, X-Ray Computed, Ulcer surgery, Aortic Dissection diagnostic imaging, Aortic Diseases diagnostic imaging, Hematoma diagnostic imaging, Ulcer diagnostic imaging
Abstract

Acute aortic syndrome includes three main pathological conditions: aortic dissection (AD), intramural hematoma (IMH) and penetrating aortic ulcer (PAU). These are life-threatening conditions, therefore early diagnosis and interventional/surgical treatment are fundamental for the survival of affected individuals. While anatomical findings of classical AD provided by imaging techniques are known to all cardiologists, imaging findings of IMH and PAU are less known, as are their prognostic implications and consequences on management and treatment strategies. This review aims to describe and discuss findings and role of imaging techniques in patients with IMH and PAU.

Published
2020
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