750 results on '"G. Tarantini"'
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2. PB2132: COPANLISIB PLUS RITUXIMAB-BENDAMUSTINE FOR RELAPSED-REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA: RECRUITMENT UPDATE ON AN ONGOING PHASE II TRIAL OF THE FONDAZIONE ITALIANA LINFOMI (FIL_COPA-RB)
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M. Novo, A. Castellino, A. Chiappella, G. Ciccone, M. Balzarotti, A. Arcari, E. Scarpa, A. Tucci, N. Di Renzo, G. Tarantini, G. Gini, M. Moretti, D. Mannina, A. Di Rocco, M. Spina, and U. Vitolo
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2022
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3. METABOLIC TREATMENT WITH L-CARNITINE IN ACUTE ANTERIOR ST SEGMENT ELEVATION MYOCARDIAL INFARCTION: A RANDOMISED CONTROLLED TRIAL
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G. Tarantini, D. Scrutinio, P. Bruzzi, L. Boni, P. Rizzon, and S. Iliceto
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acute myocardial infarction ,myocardial infarction ,pharmacotherapy ,metabolic protection ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Administration of L-carnitine in patients with anterior acute myocardial infarction (AMI) prevents left ventricular remodelling. Current study was aimed to assess the effect of L-carnitine administration on mortality and heart failure in patients with anterior AMI. CEDIM 2 trial was a randomized, double-blind, multicentre, placebo-controlled trial planned to enrol 4,000 patients with acute anterior AMI. The trial was interrupted after the enrolment of 2,330 patients because of the lower than expected enrolment rate. The primary end point was a composite of death and heart failure at 6 months; 5-day mortality was the secondary end point. During the 6-month follow-up, the primary endpoint was not significantly different between the L-carnitine and placebo group (9,2 vs. 10,5%, p=0,27). A reduction in mortality was seen in the L-carnitine arm on day 5 (secondary end-point) from randomization (HR=0,61, 95% CI 0,37–0,98, p=0,041). In CEDIM 2 trial L-carnitine therapy led to a reduction in early mortality (secondary end-point) without affecting the risk of death and heart failure at 6 months in patients with anterior AMI, leading to a non-significant finding with respect to the primary end-point.
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- 2011
4. P17: DARATUMUMAB (D) PLUS LENALIDOMIDE (R) AND DEXAMETHASONE (D) AS SALVAGE THERAPY FOR PATIENTS WITH REFRACTORY-RELAPSED MULTIPLE MYELOMA (RRMM): INITIAL FOLLOW-UP OF AN ITALIAN MULTICENTER RETROSPECTIVE CLINICAL EXPERIENCE BY 'RETE EMATOLOGICA PUGLIESE'
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G Mele, N Cascavilla, N Di Renzo, A Guarini, P Mazza, L Melillo, V Pavone, G Tarantini, P Curci, AP Falcone, C Germano, A Mele, G Palazzo, G Palumbo, G Reddiconto, B Rossini, G Specchia, P Musto, and D Pastore
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2022
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5. P18: DARATUMUMAB (D) PLUS BORTEZOMIB (V) AND DEXAMETHASONE (D) AS SALVAGE THERAPY FOR PATIENTS WITH REFRACTORY/RELAPSED MULTIPLE MYELOMA (RRMM): INITIAL FOLLOW-UP OF AN ITALIAN MULTICENTER RETROSPECTIVE CLINICAL EXPERIENCE BY 'RETE EMATOLOGICA PUGLIESE'
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G Mele, N Cascavilla, N Di Renzo, A Guarini, P Mazza, L Melillo, V Pavone, G Tarantini, P Curci, AP Falcone, C Germano, A Mele, G Palazzo, G Palumbo, G Reddiconto, B Rossini, G Specchia, P Musto, and D Pastore
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2022
- Full Text
- View/download PDF
6. Daratumumab plus bortezomib or daratumumab plus lenalidomide as salvage therapy for patients with myeloma: initial follow-up of an Italian multicentre retrospective clinical experience by ‘Rete Ematologica Pugliese’
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G. Mele, N. Cascavilla, N. Di Renzo, A. Guarini, P. Mazza, L. Melillo, V. Pavone, G. Tarantini, P. Curci, A. P. Falcone, C. Germano, A. Mele, G. Palazzo, G. Palumbo, G. Reddiconto, B. Rossini, G. Specchia, P. Musto, and D. Pastore
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Hematology ,General Medicine - Published
- 2022
7. C78 SPONTANEOUS CORONARY ARTERY DISSECTION: THE ROLE OF CORONARY CT ANGIOGRAPHY IN THE FOLLOW–UP MANAGEMENT
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M Savo, C Dellino, S Continisio, C Montonati, G Mattesi, E Cozza, F Amato, D Galzerano, G Tarantini, G De Conti, R Motta, S Iliceto, and V Pergola
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Cardiology and Cardiovascular Medicine - Abstract
Background Spontaneous coronary artery dissection (SCAD) is one of the causes of acute coronary syndrome, myocardial infarction (MI) and sudden death. Although the gold standard for diagnosis is invasive coronary angiography, Coronary Computed Tomography Angiography (CCTA) is a new useful tool for the diagnosis and follow–up (FU). Treatment could involve a conservative or an invasive approach with percutaneous coronary intervention (PCI) or coronary artery bypass grafting. AIMS: 1) analyze the clinical and CCTA features at baseline of patients with SCAD; 2) evaluate the clinical and anatomic patients outcome with conservative or invasive treatment; 3) evaluate in patients treated with the conservative approach the clinical and anatomic features of those dismissed with single (SAPT) or double (DAPT) antiplatelet therapy. Methods Clinical and anatomic data of 57 patients with SCAD, followed up with CCTA enrolled retrospectively between 2010 ad 2022, were collected at baseline and at the FU. The clinical endpoints evaluated were: all causes mortality, hospitalization for cardiovascular cause, SCAD or PCI ex–novo and MI. The anatomic endpoints were: patency of coronary artery and/or stents and length dissection changing from baseline. Results 46 (80,7%) patients underwent a conservative treatment and 11 (19,3%) under PCI. Patients treated with PCI were more smokers (45,5% vs 15,2%; p=0,042), had peripherical arteriopathy (18,2% vs 0%; p=0,034), higher troponin peak (40425,8 vs 13436; p=0,011) and lower ejection fraction (51,4±11,0 vs 57,1±7,6; p=0,050). Moreover the PCI population had a significant involvement of more than one coronary artery (72,7% vs 6,5%; p0,05). Among patients treated with conservative therapy, there was a more significant recurrence of SCAD in those treated with DAPT than in those treated with SAPT (33,3% vs 5,9%; p=0,033). Conclusions Patients with SCAD managed with PCI have more cardiovascular risk factors, a major myocardial infarction extension and a more complex coronary arteries involvement; conservative management is comparable to the PCI treatment for the clinical and anatomic endpoints evaluated. DAPT at discharge is associated with a higher rate of SCAD recurrence at FU.
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- 2023
8. Genetic characterization of biopsy-proven myocarditis: a pilot study
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M Bueno Marinas, A Baritussio, M Cason, R Celeghin, A Giordani, G Tarantini, S Rizzo, R Marcolongo, C Basso, S Iliceto, K Pilichou, and A L P Caforio
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Cardiology and Cardiovascular Medicine - Abstract
Background Myocarditis is characterized by the presence of an inflammatory infiltrate in the myocardium with degenerative/necrotic changes of cardiomyocytes, not-related to ischemic damage. Its clinical presentation is extremely heterogenous1. Endomyocardial Biopsy (EMB) is the diagnostic gold standard and provides etiopathogenetic diagnosis. Biopsy-proven myocarditis may be infectious, mainly viral, toxic o non-infectious immune-mediated/autoimmune. A complex interplay between genetic factors, environmental triggers (i.e. viral infection) and the immune response of the host is postulated at the basis of different disease evolution2. Purpose To determine the prevalence of pathogenic/likely pathogenic (P/LP) variants in cardiomyopathy-related genes in a well-characterized cohort of biopsy-proven myocarditis. Methods Sixty-six biopsy-proven myocarditis-affected patients (mean age 51±9, 41 males) underwent screening of 200 genes related to inherited cardiomyopathies. Definite/moderate gene association with Dilated Cardiomyopathy (DCM)3 and Arrhythmogenic Cardiomyopathy4 was based on the ClinGen framework. Variant prioritization was carried out using American College of Medical Genetics and Genomics rules5. Correlation with presence of virus on endomyocardial biopsy by polymerase chain reaction, family history and serum anti-heart autoantibodies (AHA) and/or aintiintercalated-disk autoantibodies (AIDA) was appraised. Results Nineteen of the 66 biopsy-proven myocarditis patients (28%) carried a P/LP variant in cardiac-related genes. Titin (TTN) was the most overrepresented gene accounting for 11% of cases (7/66), followed by Myosin Heavy Chain 7 (MYH7) and Myosin Binding Protein C3 (MYBPC3) each accounting for 3% of cases (2/66), respectively. Of note, 29 of the 66 of index cases (44%) referred family history for cardiomyopathy and/or sudden cardiac death. However only 13/29 patients with family history were genotype-positive (45%), indicating that other immunogenetic factors might contribute to triggering myocarditis. Circulating AHA and/or AIDA were detected in 31% of our genotype-positive cohort (6 of 19); a virus positive diagnosis was obtained in 15% of cases. Conclusion The prevalence of clinically actionable P/LP variants in cardiomyopathy-related genes is nearly one third of biopsy-proven viral or autoimmune myocarditis patients, most of them associated with DCM. On the other hand, positive family history (44%) in the absence of known cardiomyopathy-related genes indicates that additional immunogenetic factors might contribute to disease pathogenesis. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministero della Salute - Italy - Ricerca Sanitaria Finalizzata
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- 2022
9. Everolimus-eluting bioresorabable scaffold system in the treatment of cardiac allograft vasculopathy: the cardiac allograft reparative therapy (CART) prospective multicentre pilot study
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M Pighi, F Tomai, S Fezzi, G Pesarini, A Petrolini, L Spedicato, G Tarantini, M Ferlini, P Calabro, B Loi, N Tovar Forero, J Daemen, and F T Ribichini
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Cardiology and Cardiovascular Medicine - Abstract
Background Cardiac allograft vasculopathy (CAV) is still the main drawback of heart transplantation (HTx) and percutaneous coronary intervention (PCI) is a palliative measure because of the high incidence of PCI failure. The bioresorbable scaffolds (BRS) could represent a potential novel therapeutic tool for the treatment of coronary obstructions in CAV. Purpose To investigates the effects of BRS implantation in CAV patients in a Nationwide prospective study. Methods Multicentre, single-arm, prospective, open-label study that included patients affected by advanced CAV treated with PCI and second-generation ABSORB BRS. The primary endpoint was the incidence of 12-month angiographic in-segment scaffold restenosis (ISSR). Secondary endpoints were the composite of cardiac death, myocardial infarction, and target lesion revascularisation at 12-and 36-month follow-up and the incidence of ISSR at 36 months. A paired analysis of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) at baseline and follow-up was also performed. Results Between 2015–2017 35 HTx patients were enrolled and treated on 44 coronary lesions with 51 BRS. The primary endpoint occurred in 13.5% of the lesions (5/37), with a cumulative ISSR rate up to 3 years of 16.2% (6/37).Angiographic lumen loss was 0.40±0.62mm at 12 months and 0.53±0.57mm at 36 months. Overall survival was 91.4% and 74.3%, and MACEs 14.2% and 31.4% at 12 and 36 months, respectively. At the paired intracoronary imaging analysis a significant increase of the vessel external elastic membrane area in the treated segment of the BRS was described at the OCT, while some progression of CAV was detected proximally at the IVUS assessment. Conclusions BRS in CAV was feasible and safe, with an ISSR incidence similar to drug-eluting stents. For the first time, a positive remodeling was observed in HTx patients after PCI. Vessel enlargement and the lack of metallic stents may allow repeated PCI avoiding the vessel shrinkage caused by the addition of multiple metal layers, being CAV a complex clinical scenario with a high incidence of MACEs, mainly driven by PCI failure. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Partial funding by Abbott Vascular Italy
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- 2022
10. Long-term survival after TAVR in patients with low flow-low gradient vs high gradient aortic valve stenosis
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F Cardaioli, L Nai Fovino, G Rodino', T Fabris, M Napodano, M Massussi, A Scotti, C Fraccaro, G Masiero, G Lorenzoni, S Continisio, C Montonati, S Iliceto, and G Tarantini
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Cardiology and Cardiovascular Medicine - Abstract
Introduction Transcatheter aortic valve replacement (TAVR) has become the treatment of choice in elderly patients affected by severe aortic stenosis (AS). In patients with low-flow low-gradient (LFLG) AS, a clear benefit of TAVR over conservative treatment has been demonstrated. Notwithstanding, patients with classical LFLG (cLFLG) AS have shown worse early post-procedural outcomes compared to those with high-gradient (HG) AS. Purpose Given the absence of data, we aimed to evaluate long-term survival (up to 10 years) after TAVR in patients with cLFLG and paradoxical LFLG (pLFLG) AS as compared to those with HG-AS. Methods Consecutive patients undergoing TAVR at our center with a minimum 5-year follow up (i.e. treated between June 2007 and December 2016) were considered for this analysis. According to baseline echocardiography, patients were divided in three groups: 1) HG-AS (MG >40 mmHg); 2) cLFLG-AS (MG 50%). The study endpoint was post-procedural all-cause mortality. To test differences in long-term outcomes among groups, survival curves using the Kaplan Meier estimator were plotted and compared with the log-rank test. To adjust for possible baseline confounders, a propensity score weighted survival analysis was then performed (standard mean deviation Results A total of 574 subjects were included in the analysis (419 [73%] HG-AS; 91 [15%] pLFLG-AS; and 64 [11%] cLFLG-AS). Median survival time was 4.8 years [IQR 2.3–6.2], with a maximum of 12.3 years. Patients with cLFLG-AS presented higher baseline cardiovascular risk compared to those with both HG-AS and pLFLG-AS. At unadjusted survival analysis, patients with cLFLG-AS showed the worst long-term prognosis after TAVR (overall log-rank test p=0.023). However, after propensity weighted adjustment, the long-term survival of patients with cLFLG-AS was similar to those with HG-AS (p=0.77). Patients with pLFLG and HG-AS presented similar survival rate. Unadjusted (Panels A and C) and adjusted (Panels B and D) survival curves are reported in Figure 1. Out of 64 patients with cLFLG-AS, 43 (67%) presented an improvement in LV-EF (>15% from the baseline value) within the first year after TAVR. LV-EF improvement, but not baseline LV-EF, was apparently related to longer post-TAVR survival (Figure 2). Conclusion In the current study, patients with cLFLG-AS had worse long-term survival after TARV as compared to either HG or pLFLG-AS subjects. This difference was not present after adjusting for possible baseline confounders. Thus, the low-flow state condition per se might have a lower impact on long term prognosis of TAVR patients than previously hypothesized. Post-TAVR LV-EF recovery was common among patients with cLFLG-AS and was associated with improved long-term survival. Funding Acknowledgement Type of funding sources: None.
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- 2022
11. Right ventricular free wall longitudinal strain (RVFWSL) a new outcome predictor in patients candiate for TAVI
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C Dellino, V Pergola, F Torresan, A Cecchetto, P Aruta, G Tarantini, C Fraccaro, D Mele, and S Iliceto
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Cardiology and Cardiovascular Medicine - Abstract
Background Right ventricular (RV) systolic dysfunction is considered an outcome predictor in various cardiovascular diseases. RV dysfunction, assessed by RV free wall longitudinal strain (RVFWSL) in patients candidate for trans-catheter aortic valve implantation (TAVI), has not been extensively explored as an outcome predictor. Purpose Evaluate the prognostic value of pre intervention RVFWSL in patients undergoing TAVI. Methods Retrospective analysis of 100 patients who underwent transfemoral TAVI in our hospital from 2015 to 2019, with at least a pre and post-TAVI echocardiography. Clinical and echocardiographic data before and after TAVI and follow-up data were collected. We considered the value of [23.3]% the cut-off of normality for RVFWSL. The primary end-point was a composite of death from any cause and hospitalization for heart failure. Results The median age of the patients was 81 years (79–83) with a functional status NYHA II–III (81%) before the intervention. EF was preserved in most of the patients (median 56%, 55–58), while Right ventricle dysfunction assessed with RVFWLS was reduced in half of the patients at baseline. At a median follow-up of 1023 days (630–1387), the univariate analysis demonstrated a predictive value for a reduced RVFWSL ( Conclusions Among patients with severe aortic stenosis undergoing TAVI, a reduced pre-implant RVFWSL is able to predict long-term outcome. Funding Acknowledgement Type of funding sources: None.
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- 2022
12. Determinants and prognostic impact of afterload mismatch after MitraClip implantation
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F Angelini, S Pidello, S Frea, P Bocchino, P Boretto, C Gravinese, A Mandurino Mirizzi, G Masiero, C Montonati, L Biasco, M Pighi, F Giannini, A Montefusco, G Tarantini, and G M De Ferrari
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Cardiology and Cardiovascular Medicine - Abstract
Introduction Mitral transcatheter edge-to-edge repair (TEER) is a widespread option to treat mitral regurgitation in high-risk patients. The sudden reduction of mitral regurgitation (MR) following TEER abruptly eliminates the low-impedance regurgitant flow into the left atrium, leading to an increase in left ventricle (LV) afterload with possible impairment of LV systolic function, defined afterload mismatch (AM). Purpose To explore a new definition of AM and to analyze the determinants and prognostic role of AM in patients with functional MR (FMR) undergoing TEER. Methods This was an international multicenter case-control study including adult patients with severe FMR and LVEF ≤35% undergoing TEER between 2012 and 2020. AM was defined as the acute need to initiate or increase inotropic support by a vasoactive inotropic score ≥3 or the need for a mechanical circulatory support following TEER. Results 80 patients with AM were compared to 80 consecutive patients undergoing TEER not meeting the criteria for AM. Median age was 67 years, 79% of patients were male, had a median LVEDV of 240 ml with severely reduced LVEF (median 26%) and pulmonary hypertension (median 48 mmHg). Median EROA/LVEDV ratio was 0.17 (IQR 0.12–0.24) based on which 37% of the total population presented with proportionate MR. Levosimendan was administered before TEER in 42% of patients while intravenous vasodilators in 43%. In most patients more than 1 clip were needed (2 clips in 88 patients, 3 clips in 11). Patients presenting AM more commonly had a lower EROA/LVEDV ratio (0.14 vs. 0.18, p Conclusions In patients with LVEF ≤35% and severe FMR undergoing TEER, the development of AM predicted in-hospital mortality, while long-term outcomes were not affected by acute AM. The use of levosimendan or intravenous vasodilators during the pre-procedural phase reduced the risk of acute AM. Funding Acknowledgement Type of funding sources: None.
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- 2022
13. P152 CORONARY CT ANGIOGRAPHY A NEW PROMISING TOOL IN HEART TRANSPLANTED PATIENTS: FROM CLINICAL AND ECONOMICAL BENEFITS TO CORONARY INFLAMMATION DETECTION
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E Cozza, C Dellino, M Savo, F Amato, G De Conti, G Tarantini, R Motta, C Tessari, G Gerosa, S Iliceto, and V Pergola
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Cardiology and Cardiovascular Medicine - Abstract
Background Heart transplanted patients are usually monitored with invasive diagnostic techniques for detecting cardiac allograft vasculopathy (CAV). However coronary CT angiography (CCTA) is a new promising tool in the initial stages of CAV bringing clinical and economical benefits. Purpose: 1) assess the non–inferiority of CCTA in comparison to coronary angiography (CA), in terms of radiation and contrast dose, costs, hospitalization hours, complications and diagnostic accuracy; 2) analyse the different role of immunological and non–immunological risk factors predicting CAV in patients undergoing CCTA; 3) Investigate the rule of coronary inflammation through the pericoronary–fat–attenuation–index (pFAI) at CCTA in the progression of CAV. Methods 179 heart transplanted patients were retrospectively analysed: 78 performed a CCTA and 101 performed a CA between March 2021 and May 2022. Results CCTA and CA showed similar radiation doses (8.47 [1.46–30] versus 8.15 [1.38–87.34]; p=0.796) and rate of complications (0 (0%) vs 3 (3%); p=0,258). CCTA in comparison with CA required less hours of hospitalization (0.5 hours versus 23.7 ± 12.31 hours; p–70.1HU) and the progression of CAV (p=NS). Conclusions CCTA is similar to CA in terms of radiation dose and rate of complications and is superior in terms of hospitalization hours, costs and contrast agent injected. Diagnostic accurancy was equivalent between CCTA and CA. TNF was the only independent predictor in the progression of CAV. Pericoronary inflammation assessed by pFAI at CCTA was not associated with the progression of CAV.
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- 2023
14. P369 AUTOIMMUNE LYMPHOCYTIC MYOCARDITIS: ONE SIZE DOES NOT FIT ALL
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A Panza, A Giordani, P Naso, B Schiavon, L Leoni, A Baritussio, S Rizzo, C Basso, G Masiero, G Tarantini, M Perazzolo Marra, A Cecchetto, S Iliceto, R Marcolongo, and A Caforio
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Cardiology and Cardiovascular Medicine - Abstract
Fulminant myocarditis (MF) is an acute onset, rapidly progressive and potentially fatal inflammatory cardiomyopathy which could manifests with cardiogenic shock and incessant arrhythmias. There is often a need for aminic or mechanical support to the circulation in the acute phase, waiting to obtain a histological diagnosis as quickly as possible to establish a specific therapy. Mortality in the acute phases is high, with a worse prognosis than in other forms of presentation of myocarditis, even in the long term. We report the case of a 45–year–old Asian woman suffering from autoimmune hypothyroidism, who had been reporting atypical chest pain for about 3 days, associated with fever, asthenia, and vomiting. On admission, the patient was in cardiogenic shock; an echocardiogram revealed biventricular dysfunction. Pulmonary embolism and acute coronary syndrome were excluded. Blood tests showed a significant troponin rise, neutrophilic leukocytosis, and hypertransaminasemia. Anti heart antibodies (AHA) were negative. Amine support with dobutamine and norepinephrine was then started. The first EKG showed an advanced atrioventricular block with a ventricular escape with the need for emergency temporary PM placement. Right heart catheterization showed pressures in the pulmonary circulation at the upper limits with average resistance and reduced cardiac index. An endomyocardial biopsy (EMB) was performed, subsequently complicated by cardiac tamponade due to lead displacement, treated with urgent pericardiocentesis. At the end of the procedure, the appearance of incoming episodes of complete BAV was highlighted, for which ICD implantation was performed. The biopsy showed virus–negative diffuse acute lymphocytic myocarditis. Cortisone therapy was therefore started, with immediate benefit, until the aminic support was suspended. A follow–up echocardiogram showed a complete recovery of normal biventricular function. In MF, early diagnosis, and the possibility of establishing specific therapy are crucial to reduce mortality. EMB is the only method that allows you to make an etiological diagnosis and exclude a possible infectious genesis. The patient‘s prognosis, in fact, in addition to supportive therapy, depends on the possibility of establishing a targeted treatment as soon as possible, which in virus–negative autoimmune forms consists of an immunosuppressive therapy modulated on the patient‘s histological type and clinic.
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- 2023
15. C38 RIGHT VENTRICULAR FREE WALL LONGITUDINAL STRAIN (RVFWSL) A NEW OUTCOME PREDICTOR IN PATIENTS CANDIDATE FOR TAVI
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C Dellino, V Pergola, F Torresan, A Cecchetto, A Fiorencis, S Di Michele, G Tarantini, C Fraccaro, S Iliceto, and D Mele
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Cardiology and Cardiovascular Medicine - Abstract
Background Right ventricular (RV) systolic dysfunction is considered an outcome predictor in various cardiovascular diseases. RV dysfunction, assessed by RV free wall longitudinal strain (RVFWSL) in patients candidate for trans–catheter aortic valve implantation (TAVI), has not been extensively explored as an outcome predictor. Purpose Evaluate the prognostic value of pre intervention RVFWSL in patients undergoing TAVI. Methods: retrospective analysis of 100 patients who underwent transfemoral TAVI in our hospital from 2015 to 2019, with at least a pre and post–TAVI echocardiography. Clinical and echocardiographic data before and after TAVI and follow–up data were collected. We considered the value of [23.3]% the cut–off of normality for RVFWSL. The primary end–point was a composite of death from any cause and hospitalization for heart failure. Results The median age of the patients was 81 years (79–83) with a functional status NYHA II–III (81%) before the intervention. EF was preserved in most of the patients (median 56%, 55–58), while Right ventricle dysfunction assessed with RVFWLS was reduced in half of the patients at baseline. At a median follow–up of 1023 days (630–1387), the univariate analysis demonstrated a predictive value for a reduced RVFWSL ( Conclusions Among patients with severe aortic stenosis undergoing TAVI, a reduced pre–implant RVFWSL is able to predict long–term outcome.
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- 2022
16. P326 SURGICAL VERSUS TRANSCATHETER AORTIC VALVE REPLACEMENT WITH NEWER GENERATION DEVICES IN REAL–WORLD PRACTICE: ONE–YEAR OUTCOMES FROM THE ITALIAN OBSERVANT STUDIES
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S Rosato, F Biancari, P D‘errigo, G Tarantini, G Costa, G Baglio, F Seccareccia, and C Tamburino
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Cardiology and Cardiovascular Medicine - Abstract
Objective To compare the early and 1–year outcomes after transcatheter aortic valve replacement (TAVR) with new–generation devices over surgical replacement (SAVR) among patients with severe aortic stenosis (AS). Background TAVR is gaining acceptance for the treatment of lower risk patients with AS after several randomized and observational studies confirmed comparable early results to SAVR. On the other hand, clinical studies have shown that SAVR is still widely used in intermediate and high risk patients. There is need of data from large clinical registries to demonstrate the efficacy and safety of TAVR in the real–world setting, particularly after the introduction of new TAVR technology. Methods A total of 5706 AS patients who underwent SAVR and 2989 AS patients who underwent TAVR enrolled in the national, prospective OBSERVANT and OBSERVANT II studies, respectively in 2010–2012 and 2016–2018, were analyzed. Outcomes were adjusted using the propensity score matching. The primary outcomes of interest were all–cause mortality, major adverse cardiac and cerebrovascular events (MACCEs) and hospital readmission due to heart failure at 1–year. Secondary outcomes were major adverse events occurring during the index hospitalization. Results Among 1008 propensity score matched pairs, TAVR was associated with significantly lower 30–day mortality (1.8 vs. 3.5%, p = 0.020), stroke (0.8 vs. 2.3%, p = 0.005), acute kidney injury (0.6 vs. 8.2%, p Conclusions In a real–world setting, patients with intermediate operative risk treated with newer generation TAVR devices had a low risk of major adverse events during the index–hospitalization and at 1–year follow–up. TAVR could become the treatment of choice for AS in the elderly provided that its durability is proved by long–term follow–up studies.
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- 2022
17. C28 THE FINANCIAL BURDEN OF NEWER GENERATION TAVI DEVICES: RESULTS FROM THE ITALIAN OBSERVANT STUDIES
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P D‘Errigo, A Marcellusi, M Barbanti, F Biancari, G Tarantini, G Baglio, C Tamburino, S Rosato, and F Seccareccia
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Cardiology and Cardiovascular Medicine - Abstract
Objectives To estimate the financial burden of using newer generation transcatheter aortic valve implantation (TAVI) devices compared with older generation devices. Background TAVI is becoming the standard treatment for severe aortic stenosis in symptomatic elderly patients and is increasingly offered also to younger and lower risk patients. Resource utilization in performing TAVI has become an important focus due to the high likelihood of hospital readmissions, but it is unclear whether readmissions after TAVI contribute to a significant proportion of overall costs of TAVI to the healthcare system at mid–term follow up. Methods A probabilistic Markov model was developed in order to estimate the cost consequence of introducing newer generation TAVI devices were calculated as the absolute deterministic difference between a cohort of 6,000 patients treated with the newer TAVI devices (TAVI–new scenario) and the same cohort treated with old TAVI devices (TAVI–old scenario). Transition probability and hospitalization costs were retrieved among patients enrolled in the OBSERVANT I and OBSERVANT II studies; 1898 patients treated with older generation TAVI devices and 1417 patients treated with new generation TAVI devices were compared. Outcomes were adjusted using propensity score matching. Results Propensity score matching resulted in 853 pairs, whose baseline risk factors were well balanced. The mean EuroSCORE II (6.6 vs. 6.8; p = 0.76) and the mean age (82.0 vs 82.1; p = 0.62) of older generation TAVI patients and newer generation TAVI patients were similar. The use of newer generation TAVI devices determined a significant reduction of re–hospitalizations (–30.5% re–intervention, –25.2% major re–hospitalization and –30.8% minor re–hospitalization) and mortality (–20%). These reductions were associated with significant cost savings over a 1–year period (−€4.1 million in terms of direct costs and −€19.7 million considering the additional cost of the devices). The main cost–reduction was estimated for re–hospitalization that cover 79% of the overall cost reduction in the economic analysis without the costs of the devices. Conclusions After adjusting for baseline characteristics, patients undergoing TAVI with newer generation devices had lower risk of all–cause death and re–hospitalization. These reductions are leading to significant cost savings at 1 year, mainly due to the reduction in re–hospitalization costs.
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- 2022
18. Right ventricular free wall longitudinal strain (RVFWSL) a new outcome predictor in patients candiate for TAVI
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CM Dellino, V Pergola, F Torresan, G Baroni, A Cecchetto, P Aruta, A Florencis, C Fraccaro, G Tarantini, D Mele, and S Iliceto
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Radiology, Nuclear Medicine and imaging ,General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Funding Acknowledgements Type of funding sources: None. Background right ventricular systolic dysfunction is considered an outcome predictor in various cardiac diseases, sometimes stronger than ejection fraction (EF). We assume that right ventricular dysfunction, calculated with echocardiography in patients candidate for trans-catheter aortic valve implantation (TAVI), could be an outcome predictor. Purpose: evaluate the prognostic value of pre-TAVI right ventricular free wall longitudinal strain (RVFWSL) in patients with severe aortic stenosis undergoing TAVI. Methods: retrospective analysis of 100 patient underwent transfemoral TAVI in our hospital from January 2015 to September 2019, with at least a pre-TAVI and post-TAVI echocardiography. For each patients we collected clinical and echo data before and after TAVI and during the follow-up; we measured RVFWSL off-line at the same time. We considered the value of [23.3]% the cut-off of normality for RVFWSL. The primary end-point was a composite of death from any cause and hospitalization for heart failure. Results: the median age of the patients was 81 years (79-83) and EF was preserved in most patients (median 56%, 55-58,28%). At a median follow-up of 1023 days (630-1387), the univariate analysis demonstrated a predictive of a reduced RVFWSL before TAVI (
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- 2022
19. THE ELDERLY PROGNOSTIC INDEX (EPI) PREDICTS EARLY MORTALITY IN OLDER PATIENTS WITH DLBCL. A SUBSTUDY OF THE ELDERLY PROJECT BY THE FONDAZIONE ITALIANA LINFOMI (FIL)
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Luigi Marcheselli, Michele Spina, G. Tarantini, R. Sartori, Stefan Hohaus, A. L. Molinari, Benedetta Puccini, L. Flenghi, Agnese Re, Angela Ferrari, Sara Veronica Usai, Annalisa Arcari, Luca Nassi, Isabel Alvarez, Michele Merli, S. Kovalchuk, Dario Marino, Caterina Mammi, Alberto Fabbri, Stefano Luminari, Elsa Pennese, Barbara Botto, Chiara Bottelli, Francesca Re, Monica Balzarotti, Gerardo Musuraca, Emanuela Chimienti, Francesco Merli, G. Gini, Alice Di Rocco, G. Cabras, Emanuele Cencini, Simone Ferrero, Alessandra Tucci, Vittorio Ruggero Zilioli, Maria Christina Cox, Manuela Zanni, A. Lleshi, Luigi Rigacci, Monica Tani, and Federica Cavallo
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Cancer Research ,medicine.medical_specialty ,Index (economics) ,Oncology ,Older patients ,business.industry ,Internal medicine ,Medicine ,Hematology ,General Medicine ,business - Published
- 2021
20. Left ventricular thrombosis following apical myocardial infarction: may CMR strain analysis tell us something?
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G. Tarantini, Aldo Baritussio, Antonella Cecchetto, M Perazzolo Marra, G De Conti, Alberto Cipriani, Sabino Iliceto, Raffaella Motta, Benedetta Giorgi, Luisa Cacciavillani, M De Lazzari, Annagrazia Cecere, Giulia Brunetti, and Francesco Cardaioli
- Subjects
medicine.medical_specialty ,Ejection fraction ,business.industry ,Infarction ,Strain (injury) ,General Medicine ,medicine.disease ,Thrombosis ,Internal medicine ,medicine ,Cardiology ,Circumferential strain ,Radiology, Nuclear Medicine and imaging ,Myocardial infarction ,Thrombus ,Cardiology and Cardiovascular Medicine ,Ventricular thrombosis ,business - Abstract
Funding Acknowledgements Type of funding sources: None. Background Left ventricular thrombosis (LVT) is a possible complication following myocardial infarction (MI). Besides infarct size, risk factors for LVT include ST-elevated MI (STEMI), anterior and apical location, reduced left ventricular ejection fraction (LVEF) and the presence of microvascular obstruction. Echocardiography quantified myocardial strain has been associated with LVT following MI. Recently, global longitudinal strain, calculated with feature tracking (FT) - CMR, emerged as an independent predictor of major cardiovascular events following MI. Anyway, the relationship between abnormalities on FT-CMR and LVT following MI is still unexplored. Aim of our study is to investigate the possible association between abnormal strain on FT-CMR and LVT following apical STEMI. Methods We performed a retrospective analysis including all patients with a previous apical STEMI, who underwent CMR at our Institute between August 2013 and October 2020. Patients with ongoing anticoagulant therapy were excluded. Differences in global and segmental strain on CMR between patients with and without LVT were tested in a propensity-matched sample, using LVEF, age, gender, time from MI diagnosis and number of LV segments with transmural late gadolinium enhancement (LGE) as covariates to assign propensity score. Furthermore, difference in terms of apical to global radial strain percentual deviation (AGD), calculated as [(Global Radial Strain – Apical Radial Strain)/Global Radial Strain] * 100, was tested. Results Of 356 patients with apical STEMI undergoing CMR at our center, 37 (10.4%) were diagnosed with LVT. After performing a propensity score matching, we obtained a sample of 36 pairs, with a mean age of 65 (SD 11) years, and a median EF of 35% (IQR 27-42); 59 (82%) of them were male. A significant difference in terms of apical radial strain was found between the two groups, with a median strain of 10.75 (IQR 6.8–16.5) in patients without LVT compared to a value of 5.25 (IQR 2.7–9-6) in patients with LVT (p = 0.007). No differences were found in terms of global longitudinal, radial and circumferential strain (p = 0.19, p= 0.2 and p= 0.49 respectively) and segmental circumferential and longitudinal strain. When considering the AGD parameter, a significant difference was found between the two groups, with a median deviation of 12% (IQR -20; +48) in patients without LVT and 51% (IQR +47; +75) in patients with LVT (p= 0.0003). Furthermore, an AGD value of 26% was found to be the most accurate in terms of sensitivity and specificity applying a Receiver Operating Characteristic (ROC) curve analysis (AUC 0.74; CI 0.62-0.85). Conclusions Among patients with transmural MI involving LV apex, reduced apical radial strain on FT-CMR is associated with the presence of LV thrombosis. Furthermore, among patients developing LV thrombi, a greater apical radial strain deviation from the global one was found, with a threshold value of 26% at ROC curve analysis.
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- 2021
21. Added value of left atrial expansion index for non-invasive estimation of pulmonary capillary wedge pressure
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Anna Carrer, Marco Previtero, G. Tarantini, Sabino Iliceto, Davide Genovese, Francesco Tona, Luigi P. Badano, G Ferraris, Denisa Muraru, and M Perazzolo Marra
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medicine.medical_specialty ,Ejection fraction ,business.industry ,Non invasive ,Diastole ,Atrial fibrillation ,medicine.disease ,Left atrial ,Internal medicine ,medicine ,Added value ,Cardiology ,Systole ,Cardiology and Cardiovascular Medicine ,Pulmonary wedge pressure ,business - Abstract
Introduction Right heart catheterization (RHC) is the reference technique for pulmonary capillary wedge pressure (PCWP) measurement but remains invasive. Transthoracic echocardiography (TTE) diastolic parameters (DPs) are used as non-invasive surrogates but have suboptimal accuracy. Left atrial expansion index (LAEI), describing LA reservoir function, could be used for indirectly estimate PCWP. Purpose To evaluate the correlation between LAEI and PCWP and to compare LAEI accuracy against DPs in estimating PCWP. Methods We retrospectively included the patients admitted to our department from 05/2015 to 02/2018 who underwent both a clinically indicated RHC and TTE within 24 hours. PCWP was obtained during RHC. DPs were measured offline and LAEI was calculated from LA maximum volume (MaxVol) and LA minimum volume (MinVol) as LAEI = [(LAMaxVol − LAMinVol) / LAMinVol)] × 100. Results We enrolled 405 patients (left ventricular ejection fraction (LVEF)12mmHg n=209). LAEI showed a logarithmic correlation with PCWP. The log-transformed LAEI (lnLAEI) had an excellent linear correlation (r=−0.82; p12 mmHg (lnLAEI AUC 0.921, p Conclusions LAEI is a simple parameter strongly associated with PCWP which might be used for PCWP estimation. Funding Acknowledgement Type of funding source: None
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- 2020
22. Sex sub analysis from observational multicenter registry of patients treated with Impella mechanical circulatory support device in Italy: the IMP-IT women
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Elisa Nicolini, Carlo Trani, Matteo Montorfano, Alaide Chieffo, Carlo Briguori, Tommaso Piva, Francesco Burzotta, F Ziviello, M Scandroglio, Paolo Pagnotta, M Di Biasi, Vittorio Pazzanese, Giulia Masiero, F. De Marco, and G. Tarantini
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medicine.medical_specialty ,business.industry ,Circulatory system ,Emergency medicine ,medicine ,Observational study ,Cardiology and Cardiovascular Medicine ,business ,Impella - Abstract
Background Women-specific data on safety, effectiveness, and outcomes for mechanical support in the setting of cardiogenic shock (CS) and high-risk percutaneous coronary intervention (HR-PCI) are still unsettled. The IMP-IT study was a multicenter observational national registry that enrolled all patients treated with Impella 2.5, Impella CP, Impella 5.0 and Impella RP, both for CS and HR-PCI indications, across 17 Italian centers from 2004 to June 2018 Purpose To analyze the characteristics of female population enrolled in IMP-IT registry and to assess differences in presentation, timing to interventions and outcomes between men and women. Methods The Women-IMP-IT study is a multicenter observational national registry focusing on female population enrolled in IMP-IT study. Baseline, procedural and hemodynamics characteristics, such as outcome were collected. Differences between men and women were examined. Results Mean age of female population was 66.9±16.1 years, Body mass index was 26.3±5.5 kg/m2. There was a higher rate of cardiogenic shock (66.7% vs. 49.1%; p=0.06), NSTEMI (18% vs 9%, p=0.03) and acute myocarditis (9.6% vs 1.4%, p=0.01) in women vs men, associated with a lower rate of protected PCI (33.3% vs 50.9%, p=0.06). We did not observed a statistically difference in device related complications (27.4% vs 23.3%; p=0.50), respectively in women compared to men. In particular, no differences were observed in access site bleedings (10.8% vs 9%; p=0.70) and life threatening or severe bleeding (15.3% vs 11.4%; p=0.40). At one year, all-cause death rate was 45.1% in women vs 30.1% in men (p=0.016), and cardiac death rate was 42.5% in women and 27.5% in men (p=0.013). At 1-year no significant difference was observed in the rate of myocardial infarction (3.7% vs 2.3%; p=0.44), stroke (3.7% vs 2.6%; p=0.70), heat-failure hospitalization (7.7% vs 7.5%; p=1.0), need for left ventricular assist device or heart transplantation (1.3% vs 5.5%; p=0.21). Conclusions In our series, use of Impella is CS and HR-PCI is increasing in female population. Sex-differences in mortality are mostly explained by clinical differences at presentation. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): EAPCI Education and Training Grants
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- 2020
23. Predictors of death, heart transplantation and relapse in clinically suspected and biopsy-proven myocarditis in the pre-immunosuppression era
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G. Tarantini, Renzo Marcolongo, F Fachin, Mara Seguso, Sabino Iliceto, Chun-Yan Cheng, Nicoletta Gallo, D Marcolongo, F Vacirca, M Brunetti, Cristina Basso, M Perazzolo Marra, A.L.P. Caforio, Aldo Baritussio, and Stefania Rizzo
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Heart transplantation ,medicine.medical_specialty ,Myocarditis ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Biopsy ,medicine ,Immunosuppression ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,Surgery - Abstract
Background Myocarditis is an infectious or autoimmune inflammatory disease of the myocardium; diagnosis relies on the exclusion of an acute coronary syndrome, and is confirmed by endomyocardial biopsy (EMB). Prognosis is highly variable, outcome predictors are not well defined. Purpose To identify clinical, imaging and immunological predictors of death, heart transplantation (HTx) and relapse in patients with myocarditis in the pre-immunosuppression era. Methods From 1993 to 2012 we consecutively enrolled 466 patients (68% male, mean age 37±17 years), 216 with clinically suspected and 250 with EMB-proven myocarditis. All patients underwent coronary angiogram and transthoracic echocardiogram, 44% of patients underwent cardiac magnetic resonance (CMR). Circulating auto-antibodies were measured in patients' sera by indirect immunofluorescence. All patients were prospectively followed-up at the local Cardio-immunology outpatient clinic. Results After a median follow-up of 50 months (IQR 25–75), 366 patients (79%) were alive, while 42 (9%) were dead or underwent HTx; 58 were lost to follow-up. Ten-year survival free from death or HTx was overall 83%, but was lower in patients with EMB-proven myocarditis (76% vs 94% in patients with clinically suspected myocarditis, p Conclusions In the pre-immunosuppressive era, young age and a previous episode of myocarditis were independent predictors of relapse, female gender, left ventricular dysfunction at presentation and high-titre organ-specific AHA and ANA were independent predictors of death and HTx, suggesting that autoimmune features in myocarditis predict worse prognosis. Funding Acknowledgement Type of funding source: None
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- 2020
24. Predictors of death and heart transplantation in biopsy-proven myocarditis: a machine-learning approach
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D Marcolongo, Sabino Iliceto, G. Tarantini, Chun-Yan Cheng, A.L.P. Caforio, Cristina Basso, Giulia Lorenzoni, F Vacirca, Renzo Marcolongo, F Fachin, Dario Gregori, M Brunetti, and Aldo Baritussio
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Heart transplantation ,medicine.medical_specialty ,Myocarditis ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Hemothorax ,medicine.disease ,New York Heart Association Classification ,Internal medicine ,Heart failure ,Biopsy ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Risk stratification for death and heart transplantation (HTx) in myocarditis is complex. A random forest (RF) is a tree-based machine learning technique (MLT) which is being increasingly used for clinical data analysis; it allows the detection of complex relationships between the outcome of interest and the covariates, overcoming the limits of traditional statistical analysis (i.e. regression approaches). Purpose To assess the potential role of clinical and diagnostic features at presentation as predictors of death and HTx in biopsy (Bx)-proven myocarditis using RF. Methods From January 1993 to August 2019, we consecutively enrolled 357 patients with Bx-proven myocarditis (65% male, median age 39 years, interquartile range (IQR) 26–51). An RF approach for survival data was used. Variables included in the analysis were: histology type by Bx, NYHA, type of presentation (infarct-like, arrhythmia, heart failure), viral genome detection on Bx, serum antiheart (AHA), antiintercalated disk (AIDA), anticardiac endothelial cells (AECA), antinuclear (ANA) autoantibodies, immunosuppressive therapy, cardiac catheterisation (left ventricular enddiastolic volume (LVEDV), mean capillary wedge pressure, right and left ventricular enddiastolic pressure) and 2-D echocardiographic measures (LVEDV, left ventricular ejection fraction (LVEF) at presentation and at follow-up, right ventricular fractional area change (FAC%), right ventricular diastolic area). Results The median follow-up time was of 1352 days (IQR 423.25–2535.75). At the end of follow-up, 42 patients were dead or transplanted. The 1-year, 5-year, and 10-year survival probabilities were of 0.928, 0.854, and 0.817, respectively. The most relevant predictors of death or HTx identified by the RF algorithm (according to the variable importance measure) were histological type, NYHA, clinical presentation, LVEF, and FAC%. Among the circulating auto-antibodies AECA were found to be the most important. Histological type was the strongest predictor of death/HT (100% relative importance, (RI)), giant cell myocarditis having a lower survival probability compared to other types. The next stronger predictors were advanced (III-IV) NYHA and heart failure presentation with lower survival probabilities (90% and 84% RI respectively). AECA-positive patients had lower survival probability compared to AECA negative ones (20% RI). The RF algorithm revealed an excellent predictive performance in the correct identification of all alive patients, with only 5 dead patients being misclassified (balanced accuracy 94%). Conclusions Autoimmune features, i.e Giant cell myocarditis and AECA, as well as severity of heart failure and of left ventricular disfunction at presentation were the strongest predictors of dismal prognosis. Our RF approach provides a new automated powerful tool for accurate risk stratification for death/HTx in Bx-proven myocarditis. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Budget Integrato per la Ricerca dei Dipartimenti (BIRD, year 2019), Padova University, Padova, Italy (project Title: Myocarditis: genetic background, predictors of dismal prognosis and of response to immunosuppressive therapy.)
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- 2020
25. Diabetes mellitus in transfemoral transcatheter aortic valve implantation in 11,440 patients from the CENTER collaboration
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George Dangas, F S De Brito, R Blanco Mata, D Tchethce, Paola D'Errigo, Ronak Delewi, A.C Van Nieuwkerk, Azeem Latib, Raquel B. Santos, Mattia Lunardi, J Oteo-Dominguez, Ran Kornowski, G. Tarantini, J. Baan, and Nicolas Dumonteil
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medicine.medical_specialty ,Transcatheter aortic ,business.industry ,Diabetes mellitus ,Medicine ,Center (algebra and category theory) ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Surgery - Abstract
Background Diabetes mellitus (DM) is a well-known cardiovascular risk factor present in up to a third of patients undergoing transcatheter aortic valve implantation (TAVI). How DM might influence outcomes after TAVI procedures remains controversial. The aim of this study was to determine differences in outcomes after TAVI according to diabetes status. Methods The CENTER (Cerebrovascular EveNts in patients undergoing TranscathetER aortic valve implantation with balloon-expandable valves versus self-expandable valves)-collaboration was a global patient level dataset of patients undergoing transfemoral TAVI from 2007 to 2018. In this analysis, the study examined differences in baseline patient characteristics, 30-day stroke and mortality, and in-hospital outcomes between DM and non-DM patients. Results Of the 11,440 patients included, 31% (n=3,550) were diabetic and 69% (n=7,890) were non-diabetic. Diabetics were younger, had a higher body mass index (BMI) and overall a worse cardiovascular risk profile than non-diabetics. There were no differences between DM and non-DM patients regarding in-hospital mortality (4.8% vs 5.3%, RR: 0.9, 95% CI: 0.7–1.1, p=0.46), myocardial infarction (0.9% vs 0.7%, RR: 1.4, 95% CI: 0.9–2.2, p=0.17), stroke (1.7% vs 2.0%, RR: 0.9, 95% CI: 0.6–1.2, p=0.36), major or life threatening bleeding (5.9% vs 6.3%, RR: 0.9, 95% CI: 0.8–1.1, p=0.44) and permanent pacemaker implantation (13.6% vs 13.4%, RR: 1.0, 95% CI: 0.9–1.1, p=0.69). Similarly, 30-day rates of all-cause mortality (5.4% vs 6.1%, RR: 0.9, 95% CI: 0.8–1.1, p=0.30) and stroke (2.0% vs 2.4%, RR: 0.8, 95% CI: 0.6–1.1, p=0.23) did not differ between diabetic and non-diabetic patients. Accordingly, in multivariate analysis, DM was not an independent predictor of mortality. Conclusions In this global collaboration, diabetic patients undergoing transcatheter aortic valve replacement had more cardiovascular comorbidities, were younger and had a higher body mass index than non-diabetics. They had similar periprocedural complications, in-hospital and 30-day mortality rates. In multivariate analysis, diabetes was not associated with increased mortality. Predicted vs observed mortality in DM Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Dutch Heart Foundation; the Netherlands Organisation for Health Research and Development
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- 2020
26. P5559Biopsy-proven myocarditis: clinical and diagnostic correlates of late gadolinium enhancement
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Loira Leoni, Chun-Yan Cheng, Cristina Basso, G. Tarantini, Sabino Iliceto, A.L.P. Caforio, S Gianstefani, M Perazzolo Marra, Stefania Rizzo, Mara Seguso, Nicoletta Gallo, Mario Plebani, Renzo Marcolongo, and Aldo Baritussio
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Pathology ,medicine.medical_specialty ,Myocarditis ,business.industry ,Medicine ,Late gadolinium enhancement ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease - Abstract
Background Cardiovascular magnetic resonance (CMR) is an accurate diagnostic tool providing detailed myocardial tissue characterization. Correlates of late gadolinium enhancement (LGE) with clinical and diagnostic features are poorly defined in endomyocardial biopsy (EMB)-proven myocarditis. Purpose We sought to identify clinical, laboratory and imaging correlates of LGE in patients with EMB-proven myocarditis. Methods We analyzed our prospective cohort of patients with EMB-proven myocarditis (n=366) to identify patients who underwent CMR (n=154, aged 39±13, 108 males). Presence of LGE was qualitatively assessed. CMR and EMB were performed in all cases at the time of hospitalization. Clinical, laboratory, and imaging features at diagnosis were analyzed to identify correlates of LGE presence. Results Demographic characteristics (age, gender), cardiovascular risk factors (hypertension, diabetes) and cardiovascular therapy did not differ between patients with and without LGE. Patients with history of myocarditis tended to have a higher prevalence of LGE (25 vs 4 patients, p=0.07). There was a trend towards a higher prevalence of LGE in patients presenting with heart failure or acute coronary syndrome (p=0.07) as opposed to those presenting with arrhythmias. Patients with LGE were more symptomatic in the 6 months preceding diagnosis (palpitations, p=0.03, chest pain p=0.02). Clinical left and right ventricular systolic dysfunction at presentation were more common in patients with LGE (p=0.02, p=0.02 respectively). LGE presence failed to distinguish patients according to EMB findings (active vs. borderline myocarditis) (p=0.66) or to the histological type of myocarditis. Troponin I levels were higher in patients with LGE (p=0.03). There was no difference in bi-ventricular volumes and function, as assessed both by echocardiography and heart catheterization. There was no correlation between anti-heart antibodies and LGE presence, nor were patients with LGE more likely to receive immunosuppressive therapy; however, response to immunosuppression tended to be more common in patients without LGE (13/13 vs 29/38 patients, p=0.09). The rate of heart transplant, death and myocarditis relapse did not differ between patients with and without LGE. Conclusions Presence of LGE on CMR was associated with longer symptom duration before diagnosis, presentation with heart failure and higher troponin release, but failed to correlate with specific EMB features or myocarditis aetiopathogenetic markers. Acknowledgement/Funding None
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- 2019
27. P5638The gender issues and radiation risk in Italian cath lab: insights from a national survey
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Elisabetta Ricottini, Emanuela Piccaluga, Enrico Cerrato, A La Manna, Alaide Chieffo, Giulia Masiero, Chiara Bernelli, G. Tarantini, Giuseppe Musumeci, and Alessio Mattesini
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Radiation risk ,medicine.medical_specialty ,Cath lab ,business.industry ,Family medicine ,medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Females are continuously growing in interventional communities, but some unmet needs exist on the issue of gender's differences. Purposes To investigate gender's differences on job-habits and private-life in Italian Cath-Labs. Further, the topic of temporary abstention from the interventional activity for any cause (pregnancy, illness, injury) and radioprotection issues were also assessed. Methods A national survey supported by Italian Interventional Cardiology Society (GISE) was submitted by mail to overall 1,230 GISE-members. Questions were formulated in multiple-choice and some required an open answer or a scale definition. Categorical data are presented as numbers and percentages and compared using chi-square test. P-values Results Responders were 326 (26.5%). Sixty-six (20.2%) were young ( Conclusions The number of Young-females' Italian interventional cardiologists is increasing. According to this National survey there are not gender disparities in the working. Conversely several important differences exist in the private-life. There is the need of developing strategies for education, professional advancement in cases of Cath-Lab abstention as well as of sex-specific radio-exposure programs in the field of interventional cardiology. Acknowledgement/Funding None
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- 2019
28. P2695ABSORB bioresorbable scaffold versus Xience metallic stent in acute coronary syndromes with treated with percutaneous coronary intervention. A subanalysis of the COMPARE-ABSORB trial
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Javier Escaned, Chun-Chin Chang, Pieter C. Smits, T Gori, R.J. Van Geuns, J. G. P. Tijssen, Y Onuma, Bernard Chevalier, Stephan Achenbach, D Dudek, Emanuele Barbato, A Wlodarczyk, Nick E.J. West, G. Tarantini, and Viktor Kočka
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,medicine ,Percutaneous coronary intervention ,Stent ,Cardiology and Cardiovascular Medicine ,business ,Bioresorbable scaffold ,Surgery - Abstract
Background The safety and efficacy of the ABSORB scaffold in ACS patients remain unclear. The COMPARE-ABSORB trial compares the ABSORB to the Xience stent in lesions and patients at high risk for restenosis Patients with STEMI and urgent PCI for non-STEMI were not excluded. Methods Patients included in the COMPARE-ABSORB trial undergoing PCI for ACS were eligible. Predefined implantation techniques for ABSORB was mandatory. Primary endpoint is target lesion failure (TLF) at 1 year, defined as a composite of cardiac death, target vessel myocardial infarction and clinically indicated target lesion revascularization. Results Of 1670 patients, 842 were treated for ACS. At 1-year, TLF occurred in 22 patients (5.0%) of the ABSORB group and in 14 patients (3.5%) of the Xience group (HR 1.44%; 95% CI 0.74%-2.82%, P=0.284). Definite device thrombosis occurred in 9 patients (2.0%) of the ABSORB group and in 2 patients (0.5%) of the Xience group (HR 4.10%; 95% CI 0.89%-18.9%, P=0.071). Baseline characteristics ABSORB (n=442) XIENCE (n=400) Age, years (SD) 60.7 (9.6) 61.3 (9.1) Male 350/442 (79.2%) 313/400 (78.3%) Current smoker 159/439 (36.2%) 126/397 (31.7%) Diabetes mellitus 152/440 (34.5%) 138/399 (34.6%) Hypertension 298/442 (67.4%) 266/400 (66.5%) Hypercholesterolemia 255/442 (57.7%) 232/400 (58.0%) Family history of coronary artery disease 147/442 (33.3%) 103/400 (25.8%) Previous MI 61/442 (13.8%) 67/400 (16.8%) Established Peripheral Vascular Disease 27/442 (6.1%) 15/400 (3.8%) Previous PCI 83/442 (18.8%) 86/400 (21.5%) Previous CABG 1/442 (0.2%) 4/400 (1.0%) Previous stroke 15/442 (3.4%) 21/400 (5.3%) Renal Insufficiency 9/442 (2.0%) 13/400 (3.3%) Clinical presentation Unstable angina 149/442 (33.7%) 141/400 (35.3%) Non-ST elevation myocardial infarction 183/442 (41.4%) 156/400 (39.0%) ST elevation myocardial infarction 110/442 (24.9%) 103/400 (25.7%) KM plot for target lesion failure Conclusion The COMPARE-ABSORB trial showed no difference in the primary endpoint at one year for the ACS subgroup. The signal for increased thrombosis remained, even with the optimized implantation protocol Acknowledgement/Funding Maasstad Hospital, Rotterdam, the Netherlands
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- 2019
29. P3737Predictors, feasibility and outcomes of coronary interventions up to 3 years after TAVI with a balloon-expandable valve. Results from a large European multicenter registry
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F Vincent, Nicolas Dumonteil, Olivier Darremont, Tomas Hovorka, Marina Urena, G. Tarantini, A L Bartorelli, L. Nai Fovino, Patrick Ohlmann, Pascal Leprince, and O Wendler
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medicine.medical_specialty ,Balloon expandable stent ,business.industry ,Emergency medicine ,Psychological intervention ,medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background/Introduction Coronary artery disease (CAD) and aortic stenosis often coexist. Transcatheter aortic valve implantation (TAVI) is emerging as a favorable treatment for younger and lower surgical risk patients. The need for coronary angiography (CA) and percutaneous coronary intervention (PCI) after TAVI will thus increase. Purpose We retrospectively evaluated the outcome of PCI performed after TAVI with the balloon-expandable SAPIEN 3 transcatheter heart valve in the SOURCE 3 European registry. Methods Cardiovascular (CV) mortality was computed at 3 years for patients with PCI and for those without. Univariate and Cox multivariate models were developed to assess the potential impact of PCI on CV mortality. Results Out of 1939 TAVI patients, 44 (2.3%) underwent PCI within 3 years after TAVI (mean interval from TAVI: 428±341 days). Patients with PCI were 80.9 years old and 63.6% were male. They had higher baseline logistic EuroSCORE (22.6% vs. 18.3%, p=0.007), higher rate of prior CAD diagnosis (72.7% vs. 51.0%, p=0.005), prior PCI (45.5% vs. 33.6%, p=0.108) and previous CABG (25.0% vs. 11.0%, p=0.013) than other patients of the cohort. Coronary access (ability to cannulate selectively the coronaries) was feasible in 100% of patients; PCI was successful in all but one case. The univariate model showed that CV mortality was slightly higher in patients undergoing PCI compared with those without PCI (Hazard Ratio: 1.86 [0.96–3.59], p=0.07); CV mortality rate was even lower with the multivariate model (HR: 1.39, p=0.52). Conclusions Interventions of CA and PCI after TAVI with a balloon-expandable valve was feasible and successful in all but one case in this large European registry. There was a trend towards a worse CV mortality at 3 years in patients needing PCI, which did not reach statistical significance likely because of the low incidence of PCI in our TAVI population. Acknowledgement/Funding The SOURCE 3 registry is sponsored by Edwards Lifesciences
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- 2019
30. P5563Biopsy proven myocarditis: clinical and instrumental predictors of adverse prognosis at presentation
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Chun-Yan Cheng, M Perazzolo Marra, Cristina Basso, Renzo Marcolongo, Loira Leoni, Aldo Baritussio, A.L.P. Caforio, Mara Seguso, Stefania Rizzo, Mario Plebani, Sabino Iliceto, S Gianstefani, G. Tarantini, and Nicoletta Gallo
- Subjects
medicine.medical_specialty ,Myocarditis ,business.industry ,medicine ,Presentation (obstetrics) ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,medicine.disease ,business - Abstract
Background Myocarditis is an insidious and potentially fatal illness with different clinical presentations and an unpredictable course. Prompt recognition of high risk patients is of paramount importance in preventing major adverse events. Purpose To identify predictors of dismal prognosis in a large cohort of patients with biopsy proven myocarditis. Methods Univariate analysis was used to identify predictors of death and heart transplant in a prospective cohort of 366 patients with biopsy proven myocarditis (aged 38±17, male 66%) using student's test and contingency tables as appropriate. Results At the time of follow up 46 patients (13%) were dead or received heart transplant (DHTX), 283 (77%) were alive (A) and 37 (10%) lost at follow up. Age at presentation was 33±20 y in DHTX v.s 39±15 in A cohort (p=0.057). Clinical features predicting adverse prognosis included female gender (p=0.002), heart failure at presentation (p=0.000), NYHA class II to IV (p=0.000). Clinical and radiographic signs of both left and right heart failure suggested worse outcome (p=0.000) as well as ongoing anticoagulation therapy (p=0.009). On ECG right (R) or left (L) axis deviation was a strong predictor of events (p=0.000). From an echocardiography perspective the presence of mild to severe mitral regurgitation (p=0.03), reduced left ventricular systolic function (FE) (p=0.000), reduced right ventricular fractional area change (FAC) (p=0.035) was strongly correlated to death or heart transplant. On cardiac catheterization the variables predicting unfavourable outcome included reduced left ventricular systolic pressure (LVSP) (p=0.000), reduced mean aortic pressure (mAP) (p=0.002), increased mean right atrial pressure (RAP) (p=0.001), FE on angiography (p=0.000). On cardiac biopsy (Bx) negative predictors were giant cell histology type (p=0.000) and PCR positive for viral genome (p=0.02) particularly for parvovirus B19 (p=0.04), adenovirus (p=0.04), and Epstein Barr virus (EBV) (p=0.03). See Tab 1 Table 1 Conclusion Female gender, HF like presentation, reduced LV and RV systolic function, R or L axis deviation on ECG, presence of viral PCR or giant cell histology on Bx, reduced LVSP and mAP; increased RAP may be useful parameters to identify high risk patients on presentation. This may increase clinical efforts and surveillance in this subgroup in order to reduce the incidence of major adverse events.
- Published
- 2019
31. P1789Outcomes of different approaches for severe aortic stenosis: ''The Deferred-TAVI', a multicentre study investigating medical and percutaneous therapy in the era of TAVI
- Author
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F D'Ascenzo, M. La Torre, Maurizio D'Amico, P. Omede, C Dowling, G. Tarantini, Francesco Bruno, A Shamsi, Mauro Rinaldi, Stefano Salizzoni, Federico Conrotto, O De Filippo, and N Errica
- Subjects
medicine.medical_specialty ,business.industry ,medicine.disease ,Comorbidity ,Surgery ,Stenosis ,Patient referral ,Pharmacotherapy ,Aortic valve stenosis ,medicine ,Percutaneous therapy ,Operative risk ,Opium tincture ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background In the era of TAVI, also very high surgical risk patients can be treated and the importance of the Heart Team is to address the patient to the right therapy. In some cases due to comorbidities, lack of symptoms and patients' decision not always a final decision is achieved after the first clinical evaluation and the final strategy could be deferred for months. Purpose The study aims to analyze outcomes in patients with severe aortic stenosis differently treated according to the various approaches proposed by the Heart Team. Methods All the patients with a diagnosis of severe aortic stenosis considered at high and very high surgical risk were enrolled. Three international cardiology departments participated in this multicentre study. All the patients were divided into four groups according to the Heart Team decision of approach. Patients with indication to medical therapy only (DTO Drug therapy only), Patients first deferred from heart team decision, personal reasons or lack of symptoms and then addressed to medical therapy (D-DTO Deferred-Drug therapy only), Patients deferred and then addressed to TAVI within 3 months (D-TP Deferred TAVI Procedure), Patients with direct indication to TAVI (ITP Immediate TAVI procedure). Primary endpoint were overall survive at follow up comparing the differences between the four groups and the impact of the deferred strategy. Results 795 patients were enrolled (80 DTO, 451 ITP, 264 initially deferred and then 155 D-DTO and 109 D-TP). Median follow-up was 465 days. Overall survive of the four groups at 1 year was 74% DTO, 73% D-DTO, 77% D-TP and 78% ITP, at 2 years 62% DTO, 38% D-DTO, 62% D-TP and 68% ITP, at 3 years 39% DTO, 11% D-DTO, 25% D-TP and 56% ITP (p≤0,001 at log rank test). At the multivariate analysis, compared to the referral group DTO, D-DTO was associated with higher mortality (HR=1,90; IC [95%]: 1,05–3,58; p=0,03 at 2 years; HR 1,66; IC [95%]: 1,01–2,76; p Conclusions The Heart team decision on the approach of treatment strongly influence the survive of the patient. Compared to direct medical therapy, there is a higher risk of mortality for patients initially deferred and then treated with medical therapy and there is no survival benefit for patients initially deferred and then treated with TAVI. The choice of deferring the treatment of patients with severe aortic stenosis clearly decrease long term survive at follow up regardless the strategy of the approach.
- Published
- 2019
32. International Expert Consensus Document on Takotsubo Syndrome (Part I): Clinical Characteristics, Diagnostic Criteria, and Pathophysiology
- Author
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Ilan S. Wittstein, Abhishek Deshmukh, Takashi Ueyama, Keigo Dote, G. Tarantini, Patrick Meimoun, David E. Winchester, Jelena-Rima Ghadri, Elmir Omerovic, Leonarda Galiuto, Roberto Manfredini, Scott W. Sharkey, Thomas F. Lüscher, Federico Migliore, Abhiram Prasad, Charanjit S. Rihal, Tetsuro Yoshida, Masami Kosuge, Eduardo Bossone, Filippo Crea, Holger Nef, Hiroaki Shimokawa, Yoshihiro J. Akashi, Christian Templin, Domenico Corrado, John D. Horowitz, Satoshi Kurisu, Walter Desmet, Jeroen J. Bax, Amir Lerman, Shams Y. Hassan, Frank Ruschitzka, Rodolfo Citro, Victoria L. Cammann, Ingo Eitel, Alexander R. Lyon, Ghadri, Jr, Wittstein, I, Prasad, A, Sharkey, S, Dote, K, Akashi, Yj, Cammann, Vl, Crea, F, Galiuto, L, Desmet, W, Yoshida, T, Manfredini, R, Eitel, I, Kosuge, M, Nef, Hm, Deshmukh, A, Lerman, A, Bossone, E, Citro, R, Ueyama, T, Corrado, D, Kurisu, S, Ruschitzka, F, Winchester, D, Lyon, Ar, Omerovic, E, Bax, Jj, Meimoun, P, Tarantini, G, Rihal, C, Y-Hassan, S, Migliore, F, Horowitz, Jd, Shimokawa, H, Luescher, Tf, and Templin, C
- Subjects
Benign condition ,Cardiac & Cardiovascular Systems ,TAKO-TSUBO CARDIOMYOPATHY ,Heart disease ,030204 cardiovascular system & hematology ,EMOTIONAL-STRESS ,Coronary artery disease ,Takotsubo definition ,0302 clinical medicine ,ST-SEGMENT ELEVATION ,APICAL BALLOONING SYNDROME ,Broken heart syndrome ,F-18 FDG PET ,InterTAK Diagnostic Criteria ,Takotsubo syndrome, Broken heart syndrome, Takotsubo definition, Acute heart failure, Consensus statement, InterTAK Diagnostic Criteria ,WALL-MOTION ,OF-THE-LITERATURE ,DESCENDING CORONARY-ARTERY ,Consensus statement ,Acute heart failure ,Takotsubo syndrome ,Cardiology and Cardiovascular Medicine ,CORONARY-ARTERY-DISEASE ,MENTAL STRESS ,Life Sciences & Biomedicine ,ACUTE MYOCARDIAL-INFARCTION ,medicine.medical_specialty ,MEDLINE ,Socio-culturale ,1102 Cardiovascular Medicine And Haematology ,ADRENERGIC-RECEPTOR POLYMORPHISMS ,03 medical and health sciences ,LEFT-VENTRICULAR DYSFUNCTION ,Consensus Paper ,STRESS-INDUCED CARDIOMYOPATHY ,medicine ,Intensive care medicine ,Science & Technology ,STRESS CARDIOMYOPATHY ,business.industry ,TERTIARY CARDIOVASCULAR CENTERS ,Expert consensus ,medicine.disease ,Editor's Choice ,Cardiovascular System & Hematology ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,Cardiovascular System & Cardiology ,Etiology ,business ,030217 neurology & neurosurgery - Abstract
Takotsubo syndrome (TTS) is a poorly recognized heart disease that was initially regarded as a benign condition. Recently, it has been shown that TTS may be associated with severe clinical complications including death and that its prevalence is probably underestimated. Since current guidelines on TTS are lacking, it appears timely and important to provide an expert consensus statement on TTS. The clinical expert consensus document part I summarizes the current state of knowledge on clinical presentation and characteristics of TTS and agrees on controversies surrounding TTS such as nomenclature, different TTS types, role of coronary artery disease, and etiology. This consensus also proposes new diagnostic criteria based on current knowledge to improve diagnostic accuracy. ispartof: EUROPEAN HEART JOURNAL vol:39 issue:22 pages:2032-2046 ispartof: location:England status: published
- Published
- 2018
33. Vasculitis on Heart Transplant as an Emerging Prognostic Factor
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Giuseppe Toscano, Marny Fedrigo, Annalisa Angelini, G. De Silvestro, T. Bocca, Dario Gregori, A. Romano, T. Bottio, Giovanni Maria Vescovo, Ilaria Barison, Giulia Lorenzoni, Daniele Bottigliengo, Chiara Castellani, G. Tarantini, Angela Nocco, Francesco Tona, E. Benazzi, Gino Gerosa, and E. Gugole
- Subjects
Pulmonary and Respiratory Medicine ,Transplantation ,medicine.medical_specialty ,Prognostic factor ,business.industry ,medicine.medical_treatment ,medicine.disease ,Gastroenterology ,Organ transplantation ,Internal medicine ,Risk of mortality ,medicine ,Lung transplantation ,Surgery ,Registry data ,Clinical significance ,Mild form ,Cardiology and Cardiovascular Medicine ,business ,Vasculitis - Abstract
Purpose Vasculitis had been considered a histopathological marker in severe form of both cellular and humoral rejection. However, in mild forms of rejections, it has not been considered a diagnostic and prognostic histopathologic criterion. Aim of this study is to assess clinical relevance of vasculitis, in terms of mortality and cardiac allograft vasculopathy development, in the mild forms of rejection in heart transplanted patients. Methods We reviewed 2794 monitoring endomyocardial biopsies from 170 adult heart transplanted pts at our center. On endomyocardial biopsies, we evaluated the presence of vasculitis in the different types of rejection . Clinical data were collected during follow up. A Multi-State Markov model was applied to describe the rejection dynamic profile and hazard for mortality, persistence of rejection and CAV development.. We used as reference population the registry data of patients who underwent HTX from 2004 to 2018 provided by the International Society for Heart and Lung Transplantation (ISHLT) Thoracic Organ Transplant Registry Results Vasculitis was detected in 442 endomyocardial biopsies ( 442/2794, 15,8%) with an incremental percent distribution according to the severity of rejection. In ACR, vasculitis significantly increased the risk of mortality by 9% (HR [95% CI]: 1.09; [1.00-1.18]) the hazard of mortality if the patient was negative for ACR and by 14% (HR [95% CI]: 1.14; [1.02-1.37], if the patients was negative for ACR, and by 14% in a mild form of rejection (1R). Similar results were obtained for pAMR and mixed rejection. In ACR, pAMR and mixed rejection patients with vasculitis have a shorter life expectancy than patients without with a loss of four months at ten year follow up for ACR, and of 9 months for pAMR and mixed rejection. Conclusion Vasculitis when present, independently from the grade and type of rejection, carries a negative prognostic value. The worse histopathological feature was represented by the association of pAMR+ACR and vasculitis.
- Published
- 2021
34. 351Cannabinoids-induced toxic myocarditis underlying apical ballooning syndrome: a case proven by combined cardiac magnetic resonance and endomyocardial biopsy
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Luisa Cacciavillani, Cristina Basso, Stefania Rizzo, Anna Carrer, G. Tarantini, Sabino Iliceto, Alberto Cipriani, Benedetta Giorgi, M Perazzolo Marra, and Carmelo Lacognata
- Subjects
Pathology ,medicine.medical_specialty ,business.industry ,Apical Ballooning Syndrome ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Cardiology and Cardiovascular Medicine ,Cardiac magnetic resonance ,business ,Toxic myocarditis ,Endomyocardial biopsy - Published
- 2019
35. P110Twin CMRs, the same diagnosis?
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Cristina Basso, M P M Martina Perazzolo Marra, Anna Baritussio, Emilio Quaia, M De Lazzari, T Berno, Benedetta Giorgi, A Collevecchio, C Alderighi, G. Tarantini, Luciano Babuin, and Sabino Iliceto
- Subjects
medicine.medical_specialty ,business.industry ,medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business - Published
- 2019
36. International Expert Consensus Document on Takotsubo Syndrome (Part II): Diagnostic Workup, Outcome, and Management
- Author
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Domenico Corrado, Ilan S. Wittstein, Charanjit S. Rihal, Victoria L. Cammann, Satoshi Kurisu, John D. Horowitz, Abhiram Prasad, Alexander R. Lyon, Patrick Meimoun, Federico Migliore, Tetsuro Yoshida, Rodolfo Citro, Walter Desmet, Filippo Crea, Masami Kosuge, David E. Winchester, Holger Nef, Eduardo Bossone, Jeroen J. Bax, Amir Lerman, Shams Y. Hassan, Hiroaki Shimokawa, Thomas F. Lüscher, Yoshihiro J. Akashi, Abhishek Deshmukh, Jelena-Rima Ghadri, Leonarda Galiuto, Ingo Eitel, Christian Templin, Scott W. Sharkey, Elmir Omerovic, Roberto Manfredini, Takashi Ueyama, Keigo Dote, G. Tarantini, Frank Ruschitzka, Ghadri, Jr, Wittstein, I, Prasad, A, Sharkey, S, Dote, K, Akashi, Yj, Cammann, Vl, Crea, F, Galiuto, L, Desmet, W, Yoshida, T, Manfredini, R, Eitel, I, Kosuge, M, Nef, Hm, Deshmukh, A, Lerman, A, Bossone, E, Citro, R, Ueyama, T, Corrado, D, Kurisu, S, Ruschitzka, F, Winchester, D, Lyon, Ar, Omerovic, E, Bax, Jj, Meimoun, P, Tarantini, G, Rihal, C, Hassan, Sy, Migliore, F, Horowitz, Jd, Shimokawa, H, Luscher, Tf, and Templin, C
- Subjects
Cardiac & Cardiovascular Systems ,TAKO-TSUBO CARDIOMYOPATHY ,Computed Tomography Angiography ,RIGHT-VENTRICULAR INVOLVEMENT ,Diagnostic algorithm ,030204 cardiovascular system & hematology ,Coronary Angiography ,ACUTE CORONARY SYNDROME ,Outcome (game theory) ,Electrocardiography ,0302 clinical medicine ,Recurrence ,IN-HOSPITAL MORTALITY ,APICAL BALLOONING SYNDROME ,ST-SEGMENT ELEVATION ,030212 general & internal medicine ,Disease management (health) ,Broken heart syndrome ,Acute heart failure ,Consensus statement ,Takotsubo syndrome ,Cardiology and Cardiovascular Medicine ,LATE GADOLINIUM ENHANCEMENT ,Myocardial Perfusion Imaging ,Disease Management ,Magnetic Resonance Imaging ,Treatment Outcome ,Echocardiography ,CARDIOVASCULAR MAGNETIC-RESONANCE ,Risk stratification ,LIFE-THREATENING ARRHYTHMIAS ,Medical emergency ,Life Sciences & Biomedicine ,Algorithms ,ACUTE MYOCARDIAL-INFARCTION ,OUTFLOW TRACT OBSTRUCTION ,MEDLINE ,Socio-culturale ,takotsubo syndrome ,broken heart syndrome ,acute heart failure ,consensus statement ,diagnostic algorithm ,1102 Cardiovascular Medicine And Haematology ,Timely diagnosis ,03 medical and health sciences ,LEFT-VENTRICULAR DYSFUNCTION ,Takotsubo Cardiomyopathy ,Consensus Paper ,medicine ,Humans ,ANTERIOR MYOCARDIAL-INFARCTION ,Science & Technology ,business.industry ,Expert consensus ,Arrhythmias, Cardiac ,medicine.disease ,Clinical trial ,Editor's Choice ,Cardiovascular System & Hematology ,Takotsubo syndrome, Broken heart syndrome, Acute heart failure, Consensus statement, Diagnostic algorithm ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,Cardiovascular System & Cardiology ,business - Abstract
The clinical expert consensus statement on takotsubo syndrome (TTS) part II focuses on the diagnostic workup, outcome, and management. The recommendations are based on interpretation of the limited clinical trial data currently available and experience of international TTS experts. It summarizes the diagnostic approach, which may facilitate correct and timely diagnosis. Furthermore, the document covers areas where controversies still exist in risk stratification and management of TTS. Based on available data the document provides recommendations on optimal care of such patients for practising physicians. ispartof: EUROPEAN HEART JOURNAL vol:39 issue:22 pages:2047-2062 ispartof: location:England status: published
- Published
- 2018
37. P6342RANKL expression is increased in peripheral mononuclear cells of patients with severe aortic valve stenosis and promotes pro-calcific differentiation of valve cells
- Author
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Giacomo Zoppellaro, Sabino Iliceto, Paolo Pauletto, Zoran Olivari, Marcello Rattazzi, A. Daniotti, E. Covolo, Corrado Vassanelli, Roberta Buso, Elisabetta Faggin, Giovanni Benfari, P. Pantano, G. Tarantini, Giuseppe Faggian, and Elisa Bertacco
- Subjects
medicine.medical_specialty ,business.industry ,Aortic valve stenosis ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,Peripheral blood mononuclear cell ,Peripheral - Published
- 2017
38. Mid-term prognostic value of coronary artery disease in patients undergoing transcatheter aortic valve implantation: A meta-analysis of adjusted observational results
- Author
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Francesca Giordana, Martyn Thomas, Mauro Rinaldi, Marco Barbanti, Federico Conrotto, Massimo Napodano, Sebastiano Marra, Marco Rossi, Fiorenzo Gaita, John G. Webb, Maurizio D'Amico, Claudio Moretti, Moritz Seiffert, Corrado Tamburino, Mauro Gasparini, David Hildick-Smith, Ussia Gp, Renate B. Schnabel, M. Lupo, Z. Khawaja, M. La Torre, Stefano Salizzoni, Patrizia Presbitero, S. Wilde, G. Biondi Zoccai, Marco G. Mennuni, Valeria Gasparetto, P. Omede, G. Tarantini, Hendrik Treede, and Fabrizio D'Ascenzo
- Subjects
medicine.medical_specialty ,Time Factors ,cad ,tavi ,mid-term outcomes ,Coronary Artery Disease ,Transcatheter Aortic Valve Replacement ,Coronary artery disease ,Aortic valve replacement ,Median follow-up ,Internal medicine ,medicine ,Humans ,Framingham Risk Score ,Ejection fraction ,business.industry ,Aortic Valve Stenosis ,Prognosis ,medicine.disease ,Confidence interval ,Observational Studies as Topic ,Stenosis ,Meta-analysis ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Coronary artery disease (CAD) negatively affects prognosis in patients undergoing surgical aortic valve replacement, being currently evaluated in the most common used risk score. Our meta-analysis aims to clarify the prognostic role of CAD on mid-term survival in patients undergoing TAVI.Studies reporting multivariate predictors of adverse outcomes in patients undergoing TAVI were systematically searched for and pooled, when appropriate, using a random-effect method. 960 citations were first screened and finally 7 studies (2472 patients) were included. Diagnosis of CAD was reported in 52%(42-65) of patients and 1169 Edwards SAPIEN and 1303 CoreValve prostheses were implanted. After a median follow up of 452 days (357-585) 24% of patients (19-33) died, and 23 (14-32) for cardiovascular death. At pooled analysis of multivariate approach, diagnosis of coronary artery disease did not increase risk of death (OR 1.0, 95% CI, confidence interval, 0.67-1.50 I(2) 0%).CAD does not affect mid-term TAVI outcome: this finding should be weighted to accurately evaluate risk and strategies for patients with severe aortic stenosis.
- Published
- 2013
39. Coronary microvascular dysfunction correlates with the new onset of cardiac allograft vasculopathy in heart transplant patients with normal coronary angiography
- Author
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Annalisa Angelini, Alessandra Vecchiati, M Perazzolo Marra, Giulia Famoso, Sabino Iliceto, G. Tarantini, Marny Fedrigo, Roberto Bellu, Gino Gerosa, S. Tellatin, Elena Osto, G. Feltrin, M. Previato, G. Thiene, and Francesco Tona
- Subjects
Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Doppler echocardiography ,Coronary Angiography ,Group A ,Group B ,Basal (phylogenetics) ,Heart Rate ,Risk Factors ,Internal medicine ,Coronary Circulation ,medicine ,Immunology and Allergy ,Humans ,Pharmacology (medical) ,Vascular Diseases ,Aged ,Retrospective Studies ,Heart transplantation ,Transplantation ,medicine.diagnostic_test ,business.industry ,Coronary flow reserve ,Blood flow ,Middle Aged ,Prognosis ,Coronary Vessels ,Echocardiography, Doppler ,medicine.anatomical_structure ,Echocardiography ,cardiovascular system ,Cardiology ,Heart Transplantation ,Female ,business ,Blood Flow Velocity ,Immunosuppressive Agents ,Artery - Abstract
Coronary microvascular dysfunction is emerging as a strong predictor of outcome in heart transplantation (HT). We assessed the validity of microvascular dysfunction, defined by means of a reduced coronary flow reserve (CFR), as a factor associated with new onset epicardial cardiac allograft vasculopathy (CAV) or death. We studied 105 patients at 4 ± 1 years post-HT with a normal coronary angiography (CA). New onset CAV was assessed by CA. CFR was assessed in the left anterior descending (LAD) coronary artery by transthoracic Doppler echocardiography and calculated as the ratio of hyperaemic to basal blood flow velocity. A CFR ≤ 2.5 was considered abnormal. Epicardial CAV onset or death was assessed during a follow-up of 10 years. New onset CAV was diagnosed in 30 patients (28.6%) (Group A), and the CA was normal in the remaining 75 patients (71.4%) (Group B). Group A had reduced CFR compared with group B (2.4 ± 0.6 vs. 3.2 ± 0.7, p
- Published
- 2014
40. The prognostic value of myocardial fibrosis in nonischemic dilated cardiomyopathy: a study by endomyocardial biopsy and cardiac magnetic resonance
- Author
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Stefania Rizzo, Sabino Iliceto, Domenico Corrado, F Tona, M De Lazzari, Cristina Basso, M Perazzolo Marra, G. Tarantini, and G. Thiene
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiology ,Medicine ,Myocardial fibrosis ,Dilative cardiomyopathy ,Cardiology and Cardiovascular Medicine ,business ,Cardiac magnetic resonance ,Value (mathematics) ,Endomyocardial biopsy - Published
- 2013
41. Towards defining the role of drug eluting stents
- Author
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G, Tarantini, A, Ramondo, and R, Razzolini
- Subjects
Coronary Restenosis ,Sirolimus ,Clinical Trials as Topic ,Treatment Outcome ,Paclitaxel ,Humans ,Coronary Disease ,Drug Therapy, Combination ,Drug-Eluting Stents ,Angioplasty, Balloon, Coronary ,Immunosuppressive Agents - Published
- 2008
42. Lichen myxoedematosus in a patient with AIDS
- Author
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Simona Muratori, Cernuschi M, C. Carrera, Elvio Alessi, G. Tarantini, and R. Zerboni
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Papular eruption ,Pathology ,medicine.medical_specialty ,biology ,business.industry ,Dermatology ,medicine.disease ,biology.organism_classification ,medicine.anatomical_structure ,Lichen myxoedematosus ,Dermis ,Acquired immunodeficiency syndrome (AIDS) ,Immunopathology ,medicine ,Viral disease ,business ,Sida ,Papular mucinosis - Abstract
We report a patient with acquired immunodeficiency syndrome (AIDS) who developed a widespread papular eruption due to deposition of mucin in the dermis. Paraproteinaemia was demonstrated. Lichen myxoedematosus type 2 was diagnosed. This is the third case of this rare disorder reported in a human immunodeficiency virus (HIV)-seropositive subject.
- Published
- 1996
43. Oral Abstract Sessions * Do we really need 3D echo to access heart valve?: 3D-TTE
- Author
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I. Stankovic, R. Jasaityte, P. Claus, J. Voigt, D. Muraru, M. Cattarina, L. Dal Bianco, D. Peluso, G. Zoppellaro, B. Segafredo, C. Calore, U. Cucchini, S. Iliceto, L. Badano, G. Tamborini, P. Gripari, M. Muratori, S. Ghulam Ali, F. Maffessanti, L. Fusini, C. Ferrari, F. Alamanni, A. Bartorelli, M. Pepi, M. Napodano, G. Tarantini, C. Sarais, G. Kocabay, G. Isabella, A. Onofrio, G. Gerosa, W. Tsang, M. Meineri, R. Hahn, F. Veronesi, M. Osten, E. Horlick, and R. Lang
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Internal medicine ,Echo (computing) ,Cardiology ,Medicine ,Radiology, Nuclear Medicine and imaging ,General Medicine ,Heart valve ,Cardiology and Cardiovascular Medicine ,business - Published
- 2012
44. Serum IgG antibodies to human herpesvirus-6 (HHV-6) do not predict the progression of HIV disease to AIDS. Italian Seroconversion Study group
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M, Dorrucci, G, Rezza, M, Andreoni, P, Pezzotti, E, Nicastri, L, Ventura, M, Zignani, M B, Alliegro, G, Tarantini, B, Salassa, V, Colangeli, G, Mazzarello, M A, Ursitti, M, Barbanera, R, Pristerà, F, Castelli, and L, Ortona
- Subjects
Adult ,Acquired Immunodeficiency Syndrome ,Adolescent ,CD8 Antigens ,Herpesvirus 6, Human ,HIV Infections ,Middle Aged ,Antibodies, Viral ,Immunoglobulin G ,CD4 Antigens ,HIV Seropositivity ,Disease Progression ,Humans ,Longitudinal Studies ,Aged - Abstract
To evaluate if different levels of human herpesvirus 6 (HHV-6) antibodies can predict HIV disease progression.Longitudinal study of individuals with a documented date of HIV seroconversion.Clinical centers located throughout Italy.Individuals who serconverted for HIV between 1983 and 1995 in Italy.Sera were tested for IgG antibodies to HHV-6 using a commercial enzyme immunoassay. A serum sample with an optical density (OD)or =242 (i.e. the mean value of 10 negative controls +4x standard deviation) was considered as HHV-6 positive; the progression of HIV disease was evaluated estimating the relative hazards (RH) of AIDS (by Cox models) for individuals with higher levels vs. lower levels of HHV-6 antibodies or considering levels of antibodies based on 10% increase of the distribution (deciles). Rates of CD4 decline fitting linear regression were also estimated.A total of 381 persons were followed for a median time of 4 years (range: 0.15-9 years) following the date of collection of the serum sample. The median OD value of HHV-6 antibodies was 306, with an interquartile range of 241-440 and a range of 48-2330. A slight inverse correlation was found between HHV-6 antibody levels and age of the individual at the time of serum collection (Spearman rank correlation coefficient, -0.16; p = 0.0013). No association was found between HHV-6 and CD4 level or between HHV-6 and CD8 level at the date of serum collection. The unadjusted RH of progression to AIDS was 0.63 (95% CI: 0.42-0.96) for HHV-6 positive individuals vs. HHV-6 negative; when adjusting for possible confounders (CD4, age, pre-AIDS HIV-related pathologies at the date of sera collection, and previous anti-herpes treatment), the RH of AIDS increased to 0.80 (95% CI: 0.51-1.23). No particular association with HIV disease progression was found when using the deciles of the distribution of HHV-6 antibodies. The median CD4 cell loss was 5.0x10(6) cells/l per month among HHV-6 positive individuals and 5.7x10(6) cells/l per month among the others.The presence of high levels of HHV-6 antibodies does not seem to predict the clinical or immunologic progression of HIV disease.
- Published
- 1999
45. 306: Coronary Flow Reserve by Contrast-Enhanced Transthoracic Echocardiography Predicts Maximal Epicardial Intimal Thickness in Heart Transplant Patients with Normal Coronary Angiogram
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Sabino Iliceto, Andrea Angelini, A.L.P. Caforio, Francesco Tona, Elena Osto, G. Tarantini, and Gino Gerosa
- Subjects
Pulmonary and Respiratory Medicine ,Transplantation ,medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Coronary flow reserve ,Coronary angiogram ,Internal medicine ,medicine ,Cardiology ,Contrast (vision) ,Surgery ,Transplant patient ,Cardiology and Cardiovascular Medicine ,business ,media_common - Published
- 2008
46. 373: Potential Role of Circulating Progenitor Cells in Coronary Microvascular Dysfunction of Heart Transplant Patients with Normal Coronary Angiograms
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Sabino Iliceto, Angelo Avogaro, A.L.P. Caforio, Carlo Agostini, Elena Osto, Gino Gerosa, Ilenia Baesso, G. Tarantini, Andrea Angelini, Gian Paolo Fadini, and Francesco Tona
- Subjects
Pulmonary and Respiratory Medicine ,Transplantation ,medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiology ,Medicine ,Surgery ,Transplant patient ,Progenitor cell ,Cardiology and Cardiovascular Medicine ,business - Published
- 2008
47. Impact of diabetes on outcomes after TAVI procedure: a multicentre registry
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Federico Conrotto, Sebastiano Marra, Claudia Tamburino, G. Tarantini, Fiorenzo Gaita, Claudio Moretti, Maurizio D'Amico, Fabrizio D'Ascenzo, Stefano Salizzoni, and Patrizia Presbitero
- Subjects
medicine.medical_specialty ,business.industry ,Surrogate endpoint ,Incidence (epidemiology) ,Mortality rate ,Insulin ,medicine.medical_treatment ,medicine.disease ,Diabetes mellitus ,Internal medicine ,Clinical endpoint ,medicine ,Cardiology ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business ,Stroke - Abstract
Aims: Several factors have been identified as predictors of early and midterm events after TAVI, but incidence and prognostic impact of diabetes, especially if insulin dependent, on their short and mid outcomes remains to be defined. Methods and results: All consecutive patients undergoing TAVI at our Institutions were enrolled, and divided according to diabetes status. All-cause mortality at 30 days and at follow up was the primary end point, while periprocedural complications, rate of myocardial infarction, stroke, re-intervention at follow-up the secondary. All end points were adjudicated according to VARC. 511 patients were enrolled: 361 without diabetes, 78 with orally treated/diet controlled diabetes and 72 with insulin treated diabetes. Patients with orally treated diabetes were more frequently female and patients with insulin treated diabetes were younger. 30 days mortality was not significantly higher in patients with orally treated diabetes (6.4%) and insulin treated diabetes (9.7%) compared with not diabetic patients (4.7%, p=0.09). Bleedings, vascular complications, post procedural acute kidney injury and peri-procedural stroke were not significantly different in the three groups. At a median follow up of 400 days patients with insulin treated diabetes had a significantly higher mortality rate (33.3% Vs 18.6%, p=0.01), and higher myocardial infarction incidence (8.3% Vs 1.4%, p=0.002) if compared with patients without diabetes. Stroke and re-interventions at follow-up were similar in the three groups. After multivariable adjustment insulin treated diabetes was independently correlated with death (HR 1.75, 95% CI 1.1-2.8) and myocardial infarction (HR 5.6, 95% CI 1.5-20.5). Conclusion: Diabetes doesn't significantly affect rates of complications in TAVI patients. Insulin treated diabetes, but not orally treated diabetes, is independently associated with deaths and myocardial infarction at mid-term follow-up. Insulin treated diabetes should be included into dedicated scores to predict outcomes of patients after TAVI.
- Published
- 2013
48. Optical coherence tomography to detect the age of thrombus in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention
- Author
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Giulio Guagliumi, Kenichi Komukai, Davide Capodanno, G. Tarantini, Elena Ladich, Renu Virmani, Roberto Garbo, Vasile Sirbu, Gabriele Tumminello, and M. Coccato
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,Thrombus aspiration ,business.industry ,medicine.medical_treatment ,Percutaneous coronary intervention ,medicine.disease ,Optical coherence tomography ,Internal medicine ,medicine ,Cardiology ,In patient ,Radiology ,Myocardial infarction ,Thrombus ,Cardiology and Cardiovascular Medicine ,business - Published
- 2013
49. Clinical impact of mechanical supports for management of post-infarction cardiogenic shock: a balance between survival and hemorrhagic complications in a single tertiary centre
- Author
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Nicola Gasparetto, Luisa Cacciavillani, A. Marzari, F. Prevedello, C. Salotti, G. Tarantini, Sabino Iliceto, M Perazzolo Marra, Roberto Bianco, and Gino Gerosa
- Subjects
medicine.medical_specialty ,Post infarction ,business.industry ,medicine.medical_treatment ,Cardiogenic shock ,Infarction ,Revascularization ,medicine.disease ,Embolic stroke ,Internal medicine ,Hemorrhagic complication ,Emergency medicine ,medicine ,Cardiology ,Extracorporeal membrane oxygenation ,Cardiology and Cardiovascular Medicine ,business ,Balance (ability) - Published
- 2013
50. Acute decompensated heart failure in young woman with lymphoproliferative disorder
- Author
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G. Thiene, M Perazzolo Marra, Fausto Adami, Francesco Tona, Andrea Angelini, M De Lazzari, Marny Fedrigo, Federica Calabrò, G. Tarantini, and Sabino Iliceto
- Subjects
Pediatrics ,medicine.medical_specialty ,Myocarditis ,Ejection fraction ,Acute decompensated heart failure ,biology ,business.industry ,Sinus tachycardia ,Ischemia ,Lymphoproliferative disorders ,medicine.disease ,Troponin ,Edema ,biology.protein ,Medicine ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Published
- 2013
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