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1. Echocardiographic left atrial stiffness index predicts high left ventricular filling pressures in patients with acute heart failure: an observational study

Author

Camilli, Massimiliano, Amore, Ludovica, Ballacci, Federico, Iannaccone, Giulia, Del Buono, Marco Giuseppe, Giordano, Federica, Graziani, Francesca, Sanna, Tommaso, Pedicino, Daniela, Burzotta, Francesco, Trani, Carlo, Lanza, Gaetano Antonio, Montone, Rocco Antonio, Aspromonte, Nadia, Lupi, Laura, Adamo, Marianna, Crea, Filippo, and Lombardo, Antonella

Published
2024
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12. A multimodal approach to predict prosthesis-patient mismatch in patients undergoing valve-in-valve trans-catheter aortic valve implantation

Author

Bianchini, Francesco, Romagnoli, Enrico, Aurigemma, Cristina, Lombardi, Marco, Graziani, Francesca, Iannaccone, Giulia, Locorotondo, Gabriella, Busco, Marco, Malara, Silvia, Nesta, Marialisa, Bruno, Piergiorgio, Girlando, Nunzio, Corrado, Michele, Natale, Luigi, Lombardo, Antonella, Burzotta, Francesco, and Trani, Carlo

Published
2024
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13. Early improvement of strain imaging parameters predicts long-term response to sacubitril/valsartan in patients with heart failure with reduced ejection fraction: An observational prospective study

Author

Camilli, Massimiliano, Iannaccone, Giulia, Russo, Michele, Meucci, Maria Chiara, Chiorazzo, Gisberta, Natali, Rosaria, Mango, Federica, Bonanni, Alice, Montone, Rocco Antonio, Graziani, Francesca, Locorotondo, Gabriella, Massetti, Massimo, Lanza, Gaetano Antonio, Aspromonte, Nadia, Crea, Filippo, and Lombardo, Antonella

Published
2023
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14. Impact of Impella protected-percutaneous coronary intervention on left ventricle function recovery of patients with extensive coronary disease and poor left ventricular function

Author

Romagnoli, Enrico, Burzotta, Francesco, Cerracchio, Emma, Russo, Giulio, Aurigemma, Cristina, Pedicino, Daniela, Locorotondo, Gabriella, Graziani, Francesca, Leone, Antonio Maria, D'Amario, Domenico, Lombardo, Antonella, Malara, Silvia, Fulco, Linda, Bianchini, Francesco, Sanna, Tommaso, and Trani, Carlo

Published
2023
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17. Pulmonary congestion assessed by lung ultrasound in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation: Prevalence and prognostic implications.

Author

Lillo, Rosa, Cangemi, Stefano, Graziani, Francesca, Locorotondo, Gabriella, Pedicino, Daniela, Aurigemma, Cristina, Romagnoli, Enrico, Malara, Silvia, Meucci, Maria Chiara, Iannaccone, Giulia, Bianchini, Francesco, Nesta, Marialisa, Bruno, Piergiorgio, Lombardo, Antonella, Trani, Carlo, and Burzotta, Francesco

Subjects
AORTIC stenosis, HEART valve prosthesis implantation, TREATMENT effectiveness, HEART failure, PROGNOSIS, REGRESSION analysis
Abstract

Aims: Lung ultrasound (LUS) is a sensitive tool to assess pulmonary congestion (PC). Few data are available on LUS‐PC evaluation in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). The aim of this study was to assess the prevalence and prognostic impact of LUS‐PC in patients with severe AS before and after TAVI. Methods and results: We designed a single‐centre prospective study in patients referred for TAVI for severe AS (ClinicalTrials.gov identification number: NCT05024942). All patients underwent echocardiography and LUS (according to a simplified 8‐zone scanning protocol) the day before and within 72 h after the procedure. The primary endpoint was the composite of all‐cause mortality, hospitalization for heart failure and urgent medical visits for worsening dyspnoea at 12‐month follow‐up. A total of 127 patients were enrolled (mean age 81.1 ± 5.8 years; 54.3% female). Pre‐TAVI LUS‐PC was documented in 65 patients (51%). After TAVI, the prevalence of LUS‐PC significantly decreased as compared to pre‐TAVI evaluation, being documented in only 28 patients (22% vs. 51%, p < 0.001) with a median B‐lines score of 4 (interquartile range [IQR] 0–11) versus 11 (IQR 6–19) pre‐TAVI (p < 0.001). During a median follow‐up of 12 (12–17) months, 25 patients (19.6%) met the composite endpoint. On multivariable Cox regression analysis, pre‐TAVI LUS‐PC was independently associated with cardiovascular events (hazard ratio 2.764, 95% confidence interval 1.114–6.857; p = 0.028). Conclusions: Lung ultrasonography reveals a high prevalence of PC in patients with severe AS undergoing TAVI, which is significantly reduced by the procedure. Pre‐TAVI PC, measured by LUS, is an independent predictor of 1‐year clinical outcome. [ABSTRACT FROM AUTHOR]

Published
2024
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18. HYPERTENSION EXAGGERATES LEFT VENTRICULAR HYPERTROPHY IN FABRY PATIENTS

Author

Gambardella, Jessica, primary, Spinelli, Letizia, additional, Fiordelisi, Antonella, additional, Aria, Massimo, additional, Cerasuolo, Federica Andrea, additional, Avvisato, Roberta, additional, Buonaiuto, Antonietta, additional, Borghi, Claudio, additional, Graziani, Francesca, additional, Muiesan, Maria Lorenza, additional, Biagini, Elena, additional, Pieroni, Maurizio, additional, Riccio, Eleonora, additional, Pisani, Antonio, additional, Virdis, Agostino, additional, Sorriento, Daniela, additional, and Iaccarino, Guido, additional

Published
2024
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21. Reply

Author

Meucci, Maria Chiara, primary, Lillo, Rosa, additional, and Graziani, Francesca, additional

Published
2024
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22. Isolated Valve Amyloid Deposition in Aortic Stenosis: Potential Clinical and Pathophysiological Relevance

Author

Conte, Maddalena, primary, Poggio, Paolo, additional, Monti, Maria, additional, Petraglia, Laura, additional, Cabaro, Serena, additional, Bruzzese, Dario, additional, Comentale, Giuseppe, additional, Caruso, Aurelio, additional, Grimaldi, Mariagabriella, additional, Zampella, Emilia, additional, Gencarelli, Annarita, additional, Cervasio, Maria Rosaria, additional, Cozzolino, Flora, additional, Monaco, Vittoria, additional, Myasoedova, Veronika, additional, Valerio, Vincenza, additional, Ferro, Adele, additional, Insabato, Luigi, additional, Bellino, Michele, additional, Galasso, Gennaro, additional, Graziani, Francesca, additional, Pucci, Pietro, additional, Formisano, Pietro, additional, Pilato, Emanuele, additional, Cuocolo, Alberto, additional, Perrone Filardi, Pasquale, additional, Leosco, Dario, additional, and Parisi, Valentina, additional

Published
2024
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23. Temporal trends of frame expansion and paravalvular leak reduction after transcatheter aortic valve replacement with self-expandable prostheses

Author

RUSSO, Giulio, primary, ZAMBRANO, Aniello, additional, BURZOTTA, Francesco, additional, PEDICINO, Daniela, additional, GRAZIANI, Francesca, additional, CANGEMI, Stefano, additional, BIANCHINI, Francesco, additional, BRUNO, Piergiorgio, additional, LOCOROTONDO, Gabriella, additional, CALABRESE, Michele, additional, AURIGEMMA, Cristina, additional, ROMAGNOLI, Enrico, additional, and TRANI, Carlo, additional

Published
2023
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24. Double pathogenic variant in an ATTRv patient with mixed phenotype.

Author

Sciarrone, Maria Ausilia, Lillo, Rosa, Romano, Angela, Vitali, Francesca, Guglielmino, Valeria, Meucci, Maria Chiara, Graziani, Francesca, and Luigetti, Marco

Subjects
GLOBAL longitudinal strain, RADIONUCLIDE imaging, NERVE conduction studies, CARDIAC amyloidosis, SYMPTOMS, VENTRICULAR septum
Abstract

This article presents a case study of a 77-year-old White woman with suspected transthyretin-related (TTR) cardiac amyloidosis. The patient exhibited symptoms of dyspnea and xerophthalmia, and diagnostic tests revealed increased left ventricular mass, reduced global longitudinal strain, and diffuse subendocardial late gadolinium enhancement. Although bone scintigraphy was negative, genetic testing identified two pathogenic variants (V122I/F64L) in the TTR gene. The patient refused further invasive testing but underwent cardiological follow-up and started gene-silencing therapy with Patisiran, which resulted in stable clinical outcomes. The article highlights the variability of phenotypic presentation in TTR-related amyloidosis and emphasizes the importance of neurological and neurophysiological follow-up in patients with cardiac involvement. [Extracted from the article]

Published
2024
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25. Unexpected Left Ventricle Pseudoaneurysm With Unusual Origin: History of a Diseased Annulus Broken Into a Diseased Myocardium

Author

Restivo, Attilio, Maggio, Luca, Locorotondo, Gabriella, Costa, Federico, Savino, Giancarlo, Lombardo, Antonella, Aurigemma, Cristina, Romagnoli, Enrico, Trani, Carlo, Graziani, Francesca, Burzotta, Francesco, Maggio, Luca (ORCID:0000-0001-6358-7775), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Trani, Carlo (ORCID:0000-0001-9777-013X), Graziani, Francesca (ORCID:0000-0002-4520-5689), Burzotta, Francesco (ORCID:0000-0002-6569-9401), Restivo, Attilio, Maggio, Luca, Locorotondo, Gabriella, Costa, Federico, Savino, Giancarlo, Lombardo, Antonella, Aurigemma, Cristina, Romagnoli, Enrico, Trani, Carlo, Graziani, Francesca, Burzotta, Francesco, Maggio, Luca (ORCID:0000-0001-6358-7775), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Trani, Carlo (ORCID:0000-0001-9777-013X), Graziani, Francesca (ORCID:0000-0002-4520-5689), and Burzotta, Francesco (ORCID:0000-0002-6569-9401)

Abstract

N/A

Published
2023

26. Left atrial strain analysis improves left ventricular filling pressures non-invasive estimation in the acute phase of Takotsubo syndrome

Author

Iannaccone, Giulia, Graziani, Francesca, Del Buono, Marco Giuseppe, Camilli, Massimiliano, Lillo, Rosa, Caffè, Andrea, Moroni, Francesco, La Vecchia, Giulia, Pedicino, Daniela, Sanna, Tommaso, Trani, Carlo, Lombardo, Antonella, Lanza, Gaetano Antonio, Massetti, Massimo, Crea, Filippo, Montone, Rocco Antonio, Graziani, Francesca (ORCID:0000-0002-4520-5689), Sanna, Tommaso (ORCID:0000-0002-5760-6885), Trani, Carlo (ORCID:0000-0001-9777-013X), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Lanza, Gaetano Antonio (ORCID:0000-0003-2187-6653), Massetti, Massimo (ORCID:0000-0002-7100-8478), Crea, Filippo (ORCID:0000-0001-9404-8846), Montone, Rocco A, Iannaccone, Giulia, Graziani, Francesca, Del Buono, Marco Giuseppe, Camilli, Massimiliano, Lillo, Rosa, Caffè, Andrea, Moroni, Francesco, La Vecchia, Giulia, Pedicino, Daniela, Sanna, Tommaso, Trani, Carlo, Lombardo, Antonella, Lanza, Gaetano Antonio, Massetti, Massimo, Crea, Filippo, Montone, Rocco Antonio, Graziani, Francesca (ORCID:0000-0002-4520-5689), Sanna, Tommaso (ORCID:0000-0002-5760-6885), Trani, Carlo (ORCID:0000-0001-9777-013X), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Lanza, Gaetano Antonio (ORCID:0000-0003-2187-6653), Massetti, Massimo (ORCID:0000-0002-7100-8478), Crea, Filippo (ORCID:0000-0001-9404-8846), and Montone, Rocco A

Abstract

Aims The aim of our study is to assess the ability of left atrial (LA) strain values to improve left ventricular and diastolic pressure (LVEDP) non-invasive estimation as compared with traditional echocardiographic indexes in the acute phase of Takotsubo syndrome (TTS) and to predict adverse in-hospital outcomes in this population. Methods and results Consecutive TTS patients were prospectively enrolled. Left ventricular and diastolic pressure was measured at the time of catheterization. Transthoracic echocardiography was performed within 48 h from hospital admission. In-hospital complications (acute heart failure, death from any cause, and life-threatening arrhythmias) were collected. A total of 62 patients were analysed (72.2 +/- 10.1 years, female 80%) and in-hospital complications occurred in 25 (40.3%). Left ventricular and diastolic pressure mean value was 24.53 +/- 7.92 mmHg. Left atrial reservoir and pump strain values presented higher correlation with LVEDP (r -0.859, P < 0.001 and r -0.848, P < 0.001, respectively) in comparison with E/e ' ratio, left atrial volume index (LAVi), and tricuspid regurgitation (TR) peak velocity. In addition, at receiver-operating characteristic curve analysis, LA reservoir and pump strain resulted to be better predictors of LVEDP above the mean of our population [0.909 (95% CI 0.818-0.999, P < 0.001) and 0.889 (95% CI 0.789-0.988, P < 0.001)], respectively] as compared with E/e ' ratio, LAVi, and TR peak velocity. Finally, LA reservoir strain resulted to be an independent predictor of worse in-hospital outcomes, together with LVEDP and left ventricular ejection fraction (all P < 0.001). Conclusion In our study, lower LA reservoir and pump strain values were better predictors of LVEDP as compared with traditional echocardiographic indexes in the acute phase of TTS syndrome. Moreover, LA reservoir strain was an independent predictor of adverse in-hospital outcomes.

Published
2023

27. Valvular heart disease and cardiomyopathy: reappraisal of their interplay

Author

Ajmone Marsan, Nina, Graziani, Francesca, Meucci, Maria Chiara, Wu, Hoi W, Lillo, Rosa, Bax, Jeroen J, Burzotta, Francesco, Massetti, Massimo, Wouter Jukema, J, Crea, Filippo, Graziani, Francesca (ORCID:0000-0002-4520-5689), Burzotta, Francesco (ORCID:0000-0002-6569-9401), Massetti, Massimo (ORCID:0000-0002-7100-8478), Crea, Filippo (ORCID:0000-0001-9404-8846), Ajmone Marsan, Nina, Graziani, Francesca, Meucci, Maria Chiara, Wu, Hoi W, Lillo, Rosa, Bax, Jeroen J, Burzotta, Francesco, Massetti, Massimo, Wouter Jukema, J, Crea, Filippo, Graziani, Francesca (ORCID:0000-0002-4520-5689), Burzotta, Francesco (ORCID:0000-0002-6569-9401), Massetti, Massimo (ORCID:0000-0002-7100-8478), and Crea, Filippo (ORCID:0000-0001-9404-8846)

Abstract

Cardiomyopathies and valvular heart diseases are typically considered distinct diagnostic categories with dedicated guidelines for their management. However, the interplay between these conditions is increasingly being recognized and they frequently coexist, as in the paradigmatic examples of dilated cardiomyopathy and hypertrophic cardiomyopathy, which are often complicated by the occurrence of mitral regurgitation. Moreover, cardiomyopathies and valvular heart diseases can have a shared aetiology because several genetic or acquired diseases can affect both the cardiac valves and the myocardium. In addition, the association between cardiomyopathies and valvular heart diseases has important prognostic and therapeutic implications. Therefore, a better understanding of their shared pathophysiological mechanisms, as well as of the prevalence and predisposing factors to their association, might lead to a different approach in the risk stratification and management of these diseases. In this Review, we discuss the different scenarios in which valvular heart diseases and cardiomyopathies coexist, highlighting the need for an improved classification and clustering of these diseases with potential repercussions in the clinical management and, particularly, personalized therapeutic approaches.

Published
2023

28. Atypical Thrombosis Following Mitral Transcatheter Edge-to-Edge Repair: Face to Face Between Scar and Clip

Author

Locorotondo, Gabriella, Leone, Antonio Maria, Aurigemma, Cristina, Romagnoli, Enrico, Graziani, Francesca, Lombardo, Antonella, Burzotta, Francesco, Trani, Carlo, Leone, Antonio Maria (ORCID:0000-0002-1276-9883), Graziani, Francesca (ORCID:0000-0002-4520-5689), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Burzotta, Francesco (ORCID:0000-0002-6569-9401), Trani, Carlo (ORCID:0000-0001-9777-013X), Locorotondo, Gabriella, Leone, Antonio Maria, Aurigemma, Cristina, Romagnoli, Enrico, Graziani, Francesca, Lombardo, Antonella, Burzotta, Francesco, Trani, Carlo, Leone, Antonio Maria (ORCID:0000-0002-1276-9883), Graziani, Francesca (ORCID:0000-0002-4520-5689), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Burzotta, Francesco (ORCID:0000-0002-6569-9401), and Trani, Carlo (ORCID:0000-0001-9777-013X)

Abstract

N/A

Published
2023

29. Comparison of De-Kay repair versus De Vega suture for functional tricuspid regurgitation: a preliminary experience

Author

Bruno, Piergiorgio, Grandinetti, Maria, Farina, Piero, D'Avino, Serena, Graziani, Francesca, Calabrese, Maria, Lillo, Rosa, Pasquini, Annalisa, Chiariello, Giovanni Alfonso, Cammertoni, Federico, Nesta, Marialisa, Pavone, Natalia, Massetti, Massimo, Bruno, Piergiorgio (ORCID:0000-0002-1075-5808), Graziani, Francesca (ORCID:0000-0002-4520-5689), Massetti, Massimo (ORCID:0000-0002-7100-8478), Bruno, Piergiorgio, Grandinetti, Maria, Farina, Piero, D'Avino, Serena, Graziani, Francesca, Calabrese, Maria, Lillo, Rosa, Pasquini, Annalisa, Chiariello, Giovanni Alfonso, Cammertoni, Federico, Nesta, Marialisa, Pavone, Natalia, Massetti, Massimo, Bruno, Piergiorgio (ORCID:0000-0002-1075-5808), Graziani, Francesca (ORCID:0000-0002-4520-5689), and Massetti, Massimo (ORCID:0000-0002-7100-8478)

Abstract

BACKGROUND: In patients undergoing mitral valve surgery, restrictive suture annuloplasty (De Vega) for less-than-severe functional tricuspid regurgitation has been proven to be safe and effective. The aim of this study is to determine whether the adjunct of the plication of the posterior tricuspid leaflet with the same running suture (bicuspidized De Vega or "De Kay") is equally safe and effective.METHODS: Single center, retrospective study on patients submitted to suture repair of the tricuspid valve during mitral valve surgery, with either conventional or De Kay, between January 2014 and December 2020. Comparison was based on degree of residual tricuspid valve regurgitation and right ventricular assessment at discharge.RESULTS: Over the course of the study period, 255 patients undergoing mitral valve surgery had a dilated (>40 mm or >20 mm/m2) tricuspid valve annulus, with less-than-severe tricuspid regurgitation. Conventional De Vega was employed in 166 patients (65.1%) and De Kay in the remaining 89 (34.9%). At discharge the adjunct of postero-septal commissure plication has similar outcomes to the classic De Vega repair. ItCONCLUSIONS: De Kay repair guarantees the same tricuspidal regurgitation reduction as compared with conventional De Vega early after (Cite this article as: Bruno P, Grandinetti M, Farina P, D'Avino S, Graziani F, Calabrese M, et al. Comparison of De-Kay repair versus De Vega suture for functional tricuspid regurgitation: a preliminary experience. J Cardiovasc Surg 2023;64:437-42. DOI: 10.23736/S0021-9509.23.12565-1)

Published
2023

30. Temporal trends of frame expansion and paravalvular leak reduction after transcatheter aortic valve replacement with self-expandable prostheses

Author

Russo, Giulio, Zambrano, Aniello, Burzotta, Francesco, Pedicino, Daniela, Graziani, Francesca, Cangemi, Stefano, Bianchini, Francesco, Bruno, Piergiorgio, Locorotondo, Gabriella, Calabrese, Michele, Aurigemma, Cristina, Romagnoli, Enrico, Trani, Carlo, Burzotta, Francesco (ORCID:0000-0002-6569-9401), Graziani, Francesca (ORCID:0000-0002-4520-5689), Bruno, Piergiorgio (ORCID:0000-0002-1075-5808), Trani, Carlo (ORCID:0000-0001-9777-013X), Russo, Giulio, Zambrano, Aniello, Burzotta, Francesco, Pedicino, Daniela, Graziani, Francesca, Cangemi, Stefano, Bianchini, Francesco, Bruno, Piergiorgio, Locorotondo, Gabriella, Calabrese, Michele, Aurigemma, Cristina, Romagnoli, Enrico, Trani, Carlo, Burzotta, Francesco (ORCID:0000-0002-6569-9401), Graziani, Francesca (ORCID:0000-0002-4520-5689), Bruno, Piergiorgio (ORCID:0000-0002-1075-5808), and Trani, Carlo (ORCID:0000-0001-9777-013X)

Abstract

Background: Paravalvular leakage (PVL) is a common finding after transcatheter aortic valve replacement (TAVR) and affects late clinical outcome. It is more frequent with self-expandable (SE) transcatheter-heart-valve (THV). Few is known about SE-THV expansion after implantation. The purpose is to assess SE-THV frame expansion and its possible influence on PVL. Methods: We designed a prospective pilot study to assess the time-course of SE-THV frame dimensions and PVL after TAVR. Consecutive patients undergoing TAVR with SE-THV were enrolled. Prosthesis fluoroscopy and echocardiography were prospectively performed immediately after TAVR (T0) and before discharge (T1) to grade PVL. Prosthesis diameters were assessed in 2 fluoroscopic orthogonal views. PVL reduction ≥1+ from T0 to T1 at echocardiography was the primary study endpoint. Results: Twenty-five patients were enrolled. Mean interval between T0 and T1 evaluations was 5 days. Grade 1 or 2 was present in 76% of patients at T0 and in 68% at T1 (P=0.034). A total of 7 patients (28%) improved PVL ≥1 grade from T0 to T1. Differences between T0 and T1 fluoroscopic diameters were not statistically significant. When comparing the diameter changes according to PVL evolution, patients with PVL improvement (as compared with those without) had significantly larger minimum diameter increase at both annulus/inflow (P=0.016) and outflow/distal edge (P=0.027). Conclusions: PVL may improve in the early days after SE-THV and those patients with PVL improvement may have THV frame expansion. Further studies are needed to confirm such preliminary observations and to establish the clinical relevance of this phenomenon.

Published
2023

35. Prognostic Implications of the Extent of Cardiac Damage in Patients With Fabry Disease

Author

Meucci, Maria Chiara, primary, Lillo, Rosa, additional, Del Franco, Annamaria, additional, Monda, Emanuele, additional, Iannaccone, Giulia, additional, Baldassarre, Riccardo, additional, Di Nicola, Federico, additional, Parisi, Vanda, additional, Lombardo, Antonella, additional, Spinelli, Letizia, additional, Biagini, Elena, additional, Pieroni, Maurizio, additional, Pisani, Antonio, additional, Crea, Filippo, additional, Iaccarino, Guido, additional, Limongelli, Giuseppe, additional, Olivotto, Iacopo, additional, and Graziani, Francesca, additional

Published
2023
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39. Right Ventricular to Pulmonary Artery Coupling and Prognosis in Transthyretin Cardiac Amyloidosis

Author

Meucci, Maria Chiara, Laenens, Dorien, Lillo, Rosa, Lombardo, Antonella, Burzotta, Francesco, Stassen, Jan, Debonnaire, Philippe, Claeys, Mathias, Donal, Erwan, Droogmans, Steven, Cosyns, Bernard, Jurcut, Ruxandra, Pinto, Fausto J., Brito, Dulce, Yedidya, Idit, Van De Heyning, Caroline, Sturkenboom, Nicole, Graziani, Francesca, and Ajmone Marsan, Nina

Published
2024
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42. Impact of severe valvular heart disease in adult congenital heart disease patients

Author

Graziani, Francesca, Iannaccone, Giulia, Meucci, Maria Chiara, Lillo, Rosa, Delogu, Angelica Bibiana, Grandinetti, Maria, Perri, Gianluigi, Galletti, Lorenzo, Amodeo, Antonio, Butera, Gianfranco, Secinaro, Aurelio, Lombardo, Antonella, Lanza, Gaetano Antonio, Burzotta, Francesco, Crea, Filippo, Massetti, Massimo, Graziani, Francesca (ORCID:0000-0002-4520-5689), Delogu, Angelica Bibiana (ORCID:0000-0002-2283-3180), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Lanza, Gaetano Antonio (ORCID:0000-0003-2187-6653), Burzotta, Francesco (ORCID:0000-0002-6569-9401), Crea, Filippo (ORCID:0000-0001-9404-8846), Massetti, Massimo (ORCID:0000-0002-7100-8478), Graziani, Francesca, Iannaccone, Giulia, Meucci, Maria Chiara, Lillo, Rosa, Delogu, Angelica Bibiana, Grandinetti, Maria, Perri, Gianluigi, Galletti, Lorenzo, Amodeo, Antonio, Butera, Gianfranco, Secinaro, Aurelio, Lombardo, Antonella, Lanza, Gaetano Antonio, Burzotta, Francesco, Crea, Filippo, Massetti, Massimo, Graziani, Francesca (ORCID:0000-0002-4520-5689), Delogu, Angelica Bibiana (ORCID:0000-0002-2283-3180), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Lanza, Gaetano Antonio (ORCID:0000-0003-2187-6653), Burzotta, Francesco (ORCID:0000-0002-6569-9401), Crea, Filippo (ORCID:0000-0001-9404-8846), and Massetti, Massimo (ORCID:0000-0002-7100-8478)

Abstract

BackgroundThe clinical impact of valvular heart disease (VHD) in adult congenital heart disease (ACHD) patients is unascertained. Aim of our study was to assess the prevalence and clinical impact of severe VHD (S-VHD) in a real-world contemporary cohort of ACHD patients. Materials and methodsConsecutive patients followed-up at our ACHD Outpatient Clinic from September 2014 to February 2021 were enrolled. Clinical characteristics and echocardiographic data were prospectively entered into a digitalized medical records database. VHD at the first evaluation was assessed and graded according to VHD guidelines. Clinical data at follow-up were collected. The study endpoint was the occurrence of cardiac mortality and/or unplanned cardiac hospitalization during follow-up. ResultsA total of 390 patients (median age 34 years, 49% males) were included and S-VHD was present in 101 (25.9%) patients. Over a median follow-up time of 26 months (IQR: 12-48), the study composite endpoint occurred in 76 patients (19.5%). The cumulative endpoint-free survival was significantly lower in patients with S-VHD vs. patients with non-severe VHD (Log rank p < 0.001). At multivariable analysis, age and atrial fibrillation at first visit (p = 0.029 and p = 0.006 respectively), lower %Sat O-2, higher NYHA class (p = 0.005 for both), lower LVEF (p = 0.008), and S-VHD (p = 0.015) were independently associated to the study endpoint. The likelihood ratio test demonstrated that S-VHD added significant prognostic value (p = 0.017) to a multivariate model including age, severe CHD, atrial fibrillation, %Sat O2, NYHA, LVEF, and right ventricle systolic pressure > 45 mmHg. ConclusionIn ACHD patients, the presence of S-VHD is independently associated with the occurrence of cardiovascular mortality and hospitalization. The prognostic value of S-VHD is incremental above other established prognostic markers.

Published
2022

43. Non-invasive imaging of ventricular-atrial fistulization secondary to infective rupture of caseous calcification of the mitral annulus

Author

Locorotondo, Gabriella, Angelini, Alessio, Rocco, Erica, Manfredonia, Laura, Pasquini, Annalisa, Graziani, Francesca, Lombardo, Antonella, Graziani, Francesca (ORCID:0000-0002-4520-5689), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Locorotondo, Gabriella, Angelini, Alessio, Rocco, Erica, Manfredonia, Laura, Pasquini, Annalisa, Graziani, Francesca, Lombardo, Antonella, Graziani, Francesca (ORCID:0000-0002-4520-5689), and Lombardo, Antonella (ORCID:0000-0003-3162-1830)

Published
2022

44. Performance, clinical outcomes and implementation of an original heart valve clinic model

Author

Pavone, Natalia, Manfredonia, Laura, Burzotta, Francesco, Cammertoni, Federico, Vicchio, Luisa, Spalletta, Claudio, Graziani, Francesca, Locorotondo, Gabriella, Aurigemma, Cristina, Romagnoli, Enrico, Bruno, Piergiorgio, Del Zanna, Niccolò, Marzetti, Emanuele, Calabrese, Maria, Grandinetti, Maria, Nesta, Marialisa, Lombardo, Antonella, Trani, Carlo, Massetti, Massimo, Burzotta, Francesco (ORCID:0000-0002-6569-9401), Graziani, Francesca (ORCID:0000-0002-4520-5689), Bruno, Piergiorgio (ORCID:0000-0002-1075-5808), Marzetti, Emanuele (ORCID:0000-0001-9567-6983), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Trani, Carlo (ORCID:0000-0001-9777-013X), Massetti, Massimo (ORCID:0000-0002-7100-8478), Pavone, Natalia, Manfredonia, Laura, Burzotta, Francesco, Cammertoni, Federico, Vicchio, Luisa, Spalletta, Claudio, Graziani, Francesca, Locorotondo, Gabriella, Aurigemma, Cristina, Romagnoli, Enrico, Bruno, Piergiorgio, Del Zanna, Niccolò, Marzetti, Emanuele, Calabrese, Maria, Grandinetti, Maria, Nesta, Marialisa, Lombardo, Antonella, Trani, Carlo, Massetti, Massimo, Burzotta, Francesco (ORCID:0000-0002-6569-9401), Graziani, Francesca (ORCID:0000-0002-4520-5689), Bruno, Piergiorgio (ORCID:0000-0002-1075-5808), Marzetti, Emanuele (ORCID:0000-0001-9567-6983), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Trani, Carlo (ORCID:0000-0001-9777-013X), and Massetti, Massimo (ORCID:0000-0002-7100-8478)

Abstract

Background: Valvular heart disease (VHD) requires optimized outpatient management that is generally considered to be best delivered by a dedicated, multidisciplinary team (Heart Valve Clinic [HVC]). Although HVC is promoted by clinical guidelines and organized in many centers, real world outcome assessments are limited. Thus, we evaluated the performance, clinical and management outcomes during a 6-year experience with an original HVC model. Methods: By interrogating the local database, 1047 consecutive patients admitted to the HVC from January 2015 to October 2020 were found. Management and mortality were checked for all patients. After 3 years of HVC activity, in order to improve appropriateness and efficiency, access priority criteria were introduced. Thus, the study population was divided in two period subgroups (before and after access criteria introduction) that were compared. Results: A total of 1047 consecutive patients admitted to the HVC constituted the study population; 346 patients (33%) were recommended for invasive treatment. After a mean follow-up of 25.7±3.1 months, 37 patients (3.5%) died. When comparing study periods, statistically significant increase inpatients' complexity and VHD severity was noticed in Period 2, also translating into higher rate of referral to intervention (39.0% vs. 29.4% in Period 1; P=0.001). Finally, despite higher rate of elderly and frail patients, operative mortality was not jeopardized. Conclusions: The present study reports a comprehensive assessment of the characteristics and outcomes achieved through an original HVC model. Standardization of access criteria supports the HVC improvement.

Published
2022

45. Clinical Impact of Heart Team Decisions for Patients With Complex Valvular Heart Disease: A Large, Single-Center Experience

Author

Burzotta, Francesco, Graziani, Francesca, Trani, Carlo, Aurigemma, Cristina, Bruno, Piergiorgio, Lombardo, Antonella, Liuzzo, Giovanna, Nesta, Marialisa, Lanza, Gaetano Antonio, Romagnoli, Enrico, Locorotondo, Gabriella, Leone, Antonio Maria, Pavone, Natalia, Spalletta, Claudio, Pelargonio, Gemma, Sanna, Tommaso, Aspromonte, Nadia, Cavaliere, Franco, Crea, Filippo, Massetti, Massimo, Burzotta, Francesco (ORCID:0000-0002-6569-9401), Graziani, Francesca (ORCID:0000-0002-4520-5689), Trani, Carlo (ORCID:0000-0001-9777-013X), Bruno, Piergiorgio (ORCID:0000-0002-1075-5808), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Liuzzo, Giovanna (ORCID:0000-0002-5714-0907), Lanza, Gaetano Antonio (ORCID:0000-0003-2187-6653), Leone, Antonio Maria (ORCID:0000-0002-1276-9883), Sanna, Tommaso (ORCID:0000-0002-5760-6885), Cavaliere, Franco (ORCID:0000-0003-3278-1940), Crea, Filippo (ORCID:0000-0001-9404-8846), Massetti, Massimo (ORCID:0000-0002-7100-8478), Burzotta, Francesco, Graziani, Francesca, Trani, Carlo, Aurigemma, Cristina, Bruno, Piergiorgio, Lombardo, Antonella, Liuzzo, Giovanna, Nesta, Marialisa, Lanza, Gaetano Antonio, Romagnoli, Enrico, Locorotondo, Gabriella, Leone, Antonio Maria, Pavone, Natalia, Spalletta, Claudio, Pelargonio, Gemma, Sanna, Tommaso, Aspromonte, Nadia, Cavaliere, Franco, Crea, Filippo, Massetti, Massimo, Burzotta, Francesco (ORCID:0000-0002-6569-9401), Graziani, Francesca (ORCID:0000-0002-4520-5689), Trani, Carlo (ORCID:0000-0001-9777-013X), Bruno, Piergiorgio (ORCID:0000-0002-1075-5808), Lombardo, Antonella (ORCID:0000-0003-3162-1830), Liuzzo, Giovanna (ORCID:0000-0002-5714-0907), Lanza, Gaetano Antonio (ORCID:0000-0003-2187-6653), Leone, Antonio Maria (ORCID:0000-0002-1276-9883), Sanna, Tommaso (ORCID:0000-0002-5760-6885), Cavaliere, Franco (ORCID:0000-0003-3278-1940), Crea, Filippo (ORCID:0000-0001-9404-8846), and Massetti, Massimo (ORCID:0000-0002-7100-8478)

Abstract

N/A

Published
2022

46. Precision medicine versus standard of care for patients with myocardial infarction with non-obstructive coronary arteries (MINOCA): rationale and design of the multicentre, randomised PROMISE trial

Author

Montone, Rocco Antonio, Cosentino, Nicola, Graziani, Francesca, Gorla, Riccardo, Del Buono, Marco Giuseppe, La Vecchia, Giulia, Rinaldi, Riccardo, Marenzi, Giancarlo, Bartorelli, Antonio L, De Marco, Federico, Testa, Luca, Bedogni, Francesco, Trani, Carlo, Liuzzo, Giovanna, Niccoli, Giampaolo, Crea, Filippo, Graziani, Francesca (ORCID:0000-0002-4520-5689), Trani, Carlo (ORCID:0000-0001-9777-013X), Liuzzo, Giovanna (ORCID:0000-0002-5714-0907), Niccoli, Giampaolo (ORCID:0000-0002-3187-6262), Crea, Filippo (ORCID:0000-0001-9404-8846), Montone, Rocco Antonio, Cosentino, Nicola, Graziani, Francesca, Gorla, Riccardo, Del Buono, Marco Giuseppe, La Vecchia, Giulia, Rinaldi, Riccardo, Marenzi, Giancarlo, Bartorelli, Antonio L, De Marco, Federico, Testa, Luca, Bedogni, Francesco, Trani, Carlo, Liuzzo, Giovanna, Niccoli, Giampaolo, Crea, Filippo, Graziani, Francesca (ORCID:0000-0002-4520-5689), Trani, Carlo (ORCID:0000-0001-9777-013X), Liuzzo, Giovanna (ORCID:0000-0002-5714-0907), Niccoli, Giampaolo (ORCID:0000-0002-3187-6262), and Crea, Filippo (ORCID:0000-0001-9404-8846)

Abstract

N/A

Published
2022

47. Standard ECG for differential diagnosis between Anderson-Fabry disease and hypertrophic cardiomyopathy

Author

Vitale, Giovanni, Ditaranto, Raffaello, Graziani, Francesca, Tanini, Ilaria, Camporeale, Antonia, Lillo, Rosa, Rubino, Marta, Panaioli, Elena, Di Nicola, Federico, Ferrara, Valentina, Zanoni, Rossana, Caponetti, Angelo Giuseppe, Pasquale, Ferdinando, Graziosi, Maddalena, Berardini, Alessandra, Ziacchi, Matteo, Biffi, Mauro, Santostefano, Marisa, Liguori, Rocco, Taglieri, Nevio, Nardi, Elena, Linhart, Ale, Olivotto, Iacopo, Rapezzi, Claudio, Biagini, Elena, Graziani, Francesca (ORCID:0000-0002-4520-5689), Vitale, Giovanni, Ditaranto, Raffaello, Graziani, Francesca, Tanini, Ilaria, Camporeale, Antonia, Lillo, Rosa, Rubino, Marta, Panaioli, Elena, Di Nicola, Federico, Ferrara, Valentina, Zanoni, Rossana, Caponetti, Angelo Giuseppe, Pasquale, Ferdinando, Graziosi, Maddalena, Berardini, Alessandra, Ziacchi, Matteo, Biffi, Mauro, Santostefano, Marisa, Liguori, Rocco, Taglieri, Nevio, Nardi, Elena, Linhart, Ale, Olivotto, Iacopo, Rapezzi, Claudio, Biagini, Elena, and Graziani, Francesca (ORCID:0000-0002-4520-5689)

Abstract

Objectives To evaluate the role of the ECG in the differential diagnosis between Anderson-Fabry disease (AFD) and hypertrophic cardiomyopathy (HCM). Methods In this multicentre retrospective study, 111 AFD patients with left ventricular hypertrophy were compared with 111 patients with HCM, matched for sex, age and maximal wall thickness by propensity score. Independent ECG predictors of AFD were identified by multivariate analysis, and a multiparametric ECG score-based algorithm for differential diagnosis was developed. Results Short PR interval, prolonged QRS duration, right bundle branch block (RBBB), R in augmented vector left (aVL) >= 1.1 mV and inferior ST depression independently predicted AFD diagnosis. A point-by-point ECG score was then derived with the following diagnostic performances: c-statistic 0.80 (95% CI 0.74 to 0.86) for discrimination, the Hosmel-Lemeshow chi(2) 6.14 (p=0.189) for calibration, sensitivity 69%, specificity 84%, positive predictive value 82% and negative predictive value 72%. After bootstrap resampling, the mean optimism was 0.025, and the internal validated c-statistic for the score was 0.78. Conclusions Standard ECG can help to differentiate AFD from HCM while investigating unexplained left ventricular hypertrophy. Short PR interval, prolonged QRS duration, RBBB, R in aVL >= 1.1 mV and inferior ST depression independently predicted AFD. Their systematic evaluation and the integration in a multiparametric ECG score can support AFD diagnosis.

Published
2022

48. Myocardial infarction with non-obstructive coronary arteries in hypertrophic cardiomyopathy vs Fabry disease

Author

Graziani, Francesca, Lillo, Rosa, Biagini, Elena, Limongelli, Giuseppe, Autore, Camillo, Pieroni, Maurizio, Lanzillo, Chiara, Calò, Leonardo, Musumeci, Maria Beatrice, Ingrasciotta, Gessica, Minnucci, Matteo, Ditaranto, Raffaello, Milazzo, Alessandra, Zocchi, Chiara, Rubino, Marta, Lanza, Gaetano Antonio, Olivotto, Iacopo, Crea, Filippo, Graziani, Francesca (ORCID:0000-0002-4520-5689), Lanza, Gaetano Antonio (ORCID:0000-0003-2187-6653), Crea, Filippo (ORCID:0000-0001-9404-8846), Graziani, Francesca, Lillo, Rosa, Biagini, Elena, Limongelli, Giuseppe, Autore, Camillo, Pieroni, Maurizio, Lanzillo, Chiara, Calò, Leonardo, Musumeci, Maria Beatrice, Ingrasciotta, Gessica, Minnucci, Matteo, Ditaranto, Raffaello, Milazzo, Alessandra, Zocchi, Chiara, Rubino, Marta, Lanza, Gaetano Antonio, Olivotto, Iacopo, Crea, Filippo, Graziani, Francesca (ORCID:0000-0002-4520-5689), Lanza, Gaetano Antonio (ORCID:0000-0003-2187-6653), and Crea, Filippo (ORCID:0000-0001-9404-8846)

Published
2022

49. Comparative analysis of right ventricular strain in Fabry cardiomyopathy and sarcomeric hypertrophic cardiomyopathy

Author

Meucci, Maria Chiara, Lillo, Rosa, Lombardo, Antonella, Lanza, Gaetano A, Bootsma, Marianne, Butcher, Steele C, Massetti, Massimo, Manna, Raffaele, Bax, Jeroen J, Crea, Filippo, Ajmone Marsan, Nina, Graziani, Francesca, Lombardo, Antonella (ORCID:0000-0003-3162-1830), Lanza, Gaetano A (ORCID:0000-0003-2187-6653), Massetti, Massimo (ORCID:0000-0002-7100-8478), Manna, Raffaele (ORCID:0000-0003-1560-3907), Crea, Filippo (ORCID:0000-0001-9404-8846), Graziani, Francesca (ORCID:0000-0002-4520-5689), Meucci, Maria Chiara, Lillo, Rosa, Lombardo, Antonella, Lanza, Gaetano A, Bootsma, Marianne, Butcher, Steele C, Massetti, Massimo, Manna, Raffaele, Bax, Jeroen J, Crea, Filippo, Ajmone Marsan, Nina, Graziani, Francesca, Lombardo, Antonella (ORCID:0000-0003-3162-1830), Lanza, Gaetano A (ORCID:0000-0003-2187-6653), Massetti, Massimo (ORCID:0000-0002-7100-8478), Manna, Raffaele (ORCID:0000-0003-1560-3907), Crea, Filippo (ORCID:0000-0001-9404-8846), and Graziani, Francesca (ORCID:0000-0002-4520-5689)

Published
2022

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