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1. Clinical outcomes and predictors of success with Impella weaning in cardiogenic shock: a single-center experience

Author

Matassini, M. V., primary, Marini, M., additional, Angelozzi, A., additional, Angelini, L., additional, Shkoza, M., additional, Compagnucci, P., additional, Falanga, U., additional, Battistoni, I., additional, Pongetti, G., additional, Francioni, M., additional, Piva, T., additional, Mucaj, A., additional, Nicolini, E., additional, Maolo, A., additional, Di Eusanio, M., additional, Munch, C., additional, Dello Russo, A., additional, and Perna, G., additional

Published
2023
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2. Prevalence, Characteristics, and Outcomes of COVID-19-Associated Acute Myocarditis

Author

Ammirati, E, Lupi, L, Palazzini, M, Hendren, N, Grodin, J, Cannistraci, C, Schmidt, M, Hekimian, G, Peretto, G, Bochaton, T, Hayek, A, Piriou, N, Leonardi, S, Guida, S, Turco, A, Sala, S, Uribarri, A, Van De Heyning, C, Mapelli, M, Campodonico, J, Pedrotti, P, Barrionuevo Sanchez, M, Ariza Sole, A, Marini, M, Matassini, M, Vourc'H, M, Cannata, A, Bromage, D, Briguglia, D, Salamanca, J, Diez-Villanueva, P, Lehtonen, J, Huang, F, Russel, S, Soriano, F, Turrini, F, Cipriani, M, Bramerio, M, Di Pasquale, M, Grosu, A, Senni, M, Farina, D, Agostoni, P, Rizzo, S, De Gaspari, M, Marzo, F, Duran, J, Adler, E, Giannattasio, C, Basso, C, Mcdonagh, T, Kerneis, M, Combes, A, Camici, P, De Lemos, J, Metra, M, Ammirati E., Lupi L., Palazzini M., Hendren N. S., Grodin J. L., Cannistraci C. V., Schmidt M., Hekimian G., Peretto G., Bochaton T., Hayek A., Piriou N., Leonardi S., Guida S., Turco A., Sala S., Uribarri A., Van De Heyning C. M., Mapelli M., Campodonico J., Pedrotti P., Barrionuevo Sanchez M. I., Ariza Sole A., Marini M., Matassini M. V., Vourc'H M., Cannata A., Bromage D. I., Briguglia D., Salamanca J., Diez-Villanueva P., Lehtonen J., Huang F., Russel S., Soriano F., Turrini F., Cipriani M., Bramerio M., Di Pasquale M., Grosu A., Senni M., Farina D., Agostoni P., Rizzo S., De Gaspari M., Marzo F., Duran J. M., Adler E. D., Giannattasio C., Basso C., McDonagh T., Kerneis M., Combes A., Camici P. G., De Lemos J. A., Metra M., Ammirati, E, Lupi, L, Palazzini, M, Hendren, N, Grodin, J, Cannistraci, C, Schmidt, M, Hekimian, G, Peretto, G, Bochaton, T, Hayek, A, Piriou, N, Leonardi, S, Guida, S, Turco, A, Sala, S, Uribarri, A, Van De Heyning, C, Mapelli, M, Campodonico, J, Pedrotti, P, Barrionuevo Sanchez, M, Ariza Sole, A, Marini, M, Matassini, M, Vourc'H, M, Cannata, A, Bromage, D, Briguglia, D, Salamanca, J, Diez-Villanueva, P, Lehtonen, J, Huang, F, Russel, S, Soriano, F, Turrini, F, Cipriani, M, Bramerio, M, Di Pasquale, M, Grosu, A, Senni, M, Farina, D, Agostoni, P, Rizzo, S, De Gaspari, M, Marzo, F, Duran, J, Adler, E, Giannattasio, C, Basso, C, Mcdonagh, T, Kerneis, M, Combes, A, Camici, P, De Lemos, J, Metra, M, Ammirati E., Lupi L., Palazzini M., Hendren N. S., Grodin J. L., Cannistraci C. V., Schmidt M., Hekimian G., Peretto G., Bochaton T., Hayek A., Piriou N., Leonardi S., Guida S., Turco A., Sala S., Uribarri A., Van De Heyning C. M., Mapelli M., Campodonico J., Pedrotti P., Barrionuevo Sanchez M. I., Ariza Sole A., Marini M., Matassini M. V., Vourc'H M., Cannata A., Bromage D. I., Briguglia D., Salamanca J., Diez-Villanueva P., Lehtonen J., Huang F., Russel S., Soriano F., Turrini F., Cipriani M., Bramerio M., Di Pasquale M., Grosu A., Senni M., Farina D., Agostoni P., Rizzo S., De Gaspari M., Marzo F., Duran J. M., Adler E. D., Giannattasio C., Basso C., McDonagh T., Kerneis M., Combes A., Camici P. G., De Lemos J. A., and Metra M.

Abstract

Background: Acute myocarditis (AM) is thought to be a rare cardiovascular complication of COVID-19, although minimal data are available beyond case reports. We aim to report the prevalence, baseline characteristics, in-hospital management, and outcomes for patients with COVID-19-associated AM on the basis of a retrospective cohort from 23 hospitals in the United States and Europe. Methods: A total of 112 patients with suspected AM from 56 963 hospitalized patients with COVID-19 were evaluated between February 1, 2020, and April 30, 2021. Inclusion criteria were hospitalization for COVID-19 and a diagnosis of AM on the basis of endomyocardial biopsy or increased troponin level plus typical signs of AM on cardiac magnetic resonance imaging. We identified 97 patients with possible AM, and among them, 54 patients with definite/probable AM supported by endomyocardial biopsy in 17 (31.5%) patients or magnetic resonance imaging in 50 (92.6%). We analyzed patient characteristics, treatments, and outcomes among all COVID-19-associated AM. Results: AM prevalence among hospitalized patients with COVID-19 was 2.4 per 1000 hospitalizations considering definite/probable and 4.1 per 1000 considering also possible AM. The median age of definite/probable cases was 38 years, and 38.9% were female. On admission, chest pain and dyspnea were the most frequent symptoms (55.5% and 53.7%, respectively). Thirty-one cases (57.4%) occurred in the absence of COVID-19-associated pneumonia. Twenty-one (38.9%) had a fulminant presentation requiring inotropic support or temporary mechanical circulatory support. The composite of in-hospital mortality or temporary mechanical circulatory support occurred in 20.4%. At 120 days, estimated mortality was 6.6%, 15.1% in patients with associated pneumonia versus 0% in patients without pneumonia (P=0.044). During hospitalization, left ventricular ejection fraction, assessed by echocardiography, improved from a median of 40% on admission to 55% at discharge

Published
2022

3. P83 EFFICACY AND SAFETY OF LEVOSIMENDAN IN AN ISCHEMIC CARDIOGENIC SHOCK POPULATION: A 10–YEARS SINGLE CENTRE RETROSPECTIVE STUDY

Author

Belfioretti, L, primary, Marini, M, additional, Francioni, M, additional, Battistoni, I, additional, Angelini, L, additional, Pongetti, G, additional, Shkoza, M, additional, Matassini, M, additional, Piangerelli, L, additional, Corinaldesi, C, additional, Patani, F, additional, Pupita, G, additional, Compagnucci, P, additional, and Perna, G, additional

Published
2023
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4. P408 PREVALENCE CHARACTERISTICS AND OUTCOMES OF COVID 19 ASSOCIATED ACUTE MYOCARDITIS

Author

Palazzini, M, primary, Ammirati, E, additional, Lupi, L, additional, Giannattasio, C, additional, Soriano, F, additional, Pedrotti, P, additional, Briguglia, D, additional, Mapelli, M, additional, Campodonico, J, additional, Agostoni, P, additional, Leonardi, S, additional, Turco, A, additional, Guida, S, additional, Peretto, G, additional, Sala, S, additional, Camici, P, additional, Marzo, F, additional, Grosu, A, additional, Senni, M, additional, Turrini, F, additional, Bramerio, M, additional, Marini, M, additional, Matassini, M, additional, Rizzo, S, additional, Basso, C, additional, De Gaspari, M, additional, Hendren, N, additional, Schmidt, M, additional, Bochaton, T, additional, Piriou, N, additional, Ubarri, A, additional, Van De Heyning, C, additional, Ariza Sole, A, additional, Cannatà, A, additional, Salamanca, J, additional, Lehtonen, J, additional, Huang, F, additional, Adler, E, additional, and Metra, M, additional

Published
2023
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5. P336 PROCALCITONIN AS PREDICTOR OF IN–HOSPITAL MORTALITY IN A CARDIOGENIC SHOCK POPULATION: A 10–YEARS SINGLE CENTRE RETROSPECTIVE STUDY

Author

Belfioretti, L, primary, Marini, M, additional, Francioni, M, additional, Battistoni, I, additional, Angelini, L, additional, Pongetti, G, additional, Shkoza, M, additional, Matassini, M, additional, Paolini, E, additional, Piangerelli, L, additional, Patani, F, additional, Compagnucci, P, additional, and Perna, G, additional

Published
2023
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6. C25 TEMPORAL TREND MORTALITY AND IN–HOSPITAL MORTALITY PREDICTORS IN AN ISCHEMIC CARDIOGENIC SHOCK POPULATION: A 10 YEARS SINGLE–CENTRE RETROSPECTIVE STUDY

Author

Belfioretti, L, primary, Marini, M, additional, Francioni, M, additional, Battistoni, I, additional, Angelini, L, additional, Matassini, M, additional, Pongetti, G, additional, Shkoza, M, additional, Piva, T, additional, Compagnucci, P, additional, Munch, C, additional, Dello Russo, A, additional, Di Eusanio, M, additional, and Perna, G, additional

Published
2023
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7. Temporal trend mortality and in-hospital mortality predictors in an ischemic cardiogenic shock population: a 10 years single-centre retrospective study

Author

Belfioretti, L, primary, Marini, M, additional, Francioni, M, additional, Battistoni, I, additional, Angelini, L, additional, Matassini, M V, additional, Angelozzi, A, additional, Pongetti, G, additional, Shkoza, M, additional, Piva, T, additional, Compagnucci, P, additional, Munch, C, additional, Dello Russo, A, additional, Di Eusanio, M, additional, and Perna, G P, additional

Published
2022
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8. Old and new equations for maximal heart rate prediction in patients with heart failure and reduced ejection fraction on beta-blockers treatment: results from the MECKI score data set

Author

Magri D., Piepoli M., Gallo G., Corra U., Metra M., Paolillo S., Filardi P. P., Maruotti A., Salvioni E., Mapelli M., Vignati C., Senni M., Limongelli G., Lagioia R., Scrutinio D., Emdin M., Passino C., Parati G., Sinagra G., Correale M., Badagliacca R., Sciomer S., Di Lenarda A., Agostoni P., Apostolo A., Palermo P., Contini M., Farina S., De Martino F., Mantegazza V., Bonomi A., Mattavelli I., Rocca M. D., Pezzuto B., Bandera F., Rovai S., Giordano A., Ricci R., Ferraironi A., Arcari L., Lombardi C., Carubelli V., Matassini M., Shkoza M., Malfatto G., Caravita S., Pacileo G., Cicoira M., Passantino A., Raimondo R., Confalonieri M., Zaffalon D., Carriere C., Ferraretti A., Bussotti M., Marchese G., Iorio A., Pastormerlo L., Gargiulo P., Halasz G., Capelli B., Villani G. Q., Oliva F., Santolamazza C., Re F., La Franca E., Herberg R., Magri, D., Piepoli, M., Gallo, G., Corra, U., Metra, M., Paolillo, S., Filardi, P. P., Maruotti, A., Salvioni, E., Mapelli, M., Vignati, C., Senni, M., Limongelli, G., Lagioia, R., Scrutinio, D., Emdin, M., Passino, C., Parati, G., Sinagra, G., Correale, M., Badagliacca, R., Sciomer, S., Di Lenarda, A., Agostoni, P., Apostolo, A., Palermo, P., Contini, M., Farina, S., De Martino, F., Mantegazza, V., Bonomi, A., Mattavelli, I., Rocca, M. D., Pezzuto, B., Bandera, F., Rovai, S., Giordano, A., Ricci, R., Ferraironi, A., Arcari, L., Lombardi, C., Carubelli, V., Matassini, M., Shkoza, M., Malfatto, G., Caravita, S., Pacileo, G., Cicoira, M., Passantino, A., Raimondo, R., Confalonieri, M., Zaffalon, D., Carriere, C., Ferraretti, A., Bussotti, M., Marchese, G., Iorio, A., Pastormerlo, L., Gargiulo, P., Halasz, G., Capelli, B., Villani, G. Q., Oliva, F., Santolamazza, C., Re, F., La Franca, E., and Herberg, R.

Subjects
MECKI score, cardiopulmonary exercise test, chronotropic incompetence, heart failure, maximal heart rate, kidney, Epidemiology, exercise test, Chronotropic incompetence, ventricular dysfunction, Heart failure, test, mecki score, adrenergic beta-antagonists, heart rate, humans, stroke volume, left, Ventricular Dysfunction, Left, Cardiology and Cardiovascular Medicine, Maximal heart rate, Cardiopulmonary exercise test
Abstract

Aims Predicting maximal heart rate (MHR) in heart failure with reduced ejection fraction (HFrEF) still remains a major concern. In such a context, the Keteyian equation is the only one derived in a HFrEF cohort on optimized β-blockers treatment. Therefore, using the Metabolic Exercise combined with Cardiac and Kidney Indexes (MECKI) data set, we looked for a possible MHR equation, for an external validation of Keteyien formula and, contextually, for accuracy of the historical MHR formulas and their relationship with the HR measured at the anaerobic threshold (AT). Methods and results Data from 3487 HFrEF outpatients on optimized β-blockers treatment from the MECKI data set were analyzed. Besides excluding all possible confounders, the new equation was derived by using HR data coming from maximal cardiopulmonary exercise test. The simplified derived equation was [109–(0.5*age) + (0.5*HR rest) + (0.2*LVEF)–(5 if haemoglobin Conclusion The derived equation to estimate the MHR in HFrEF patients, by accounting also for the systolic dysfunction degree and anaemia, improved slightly the Keteyian formula. Both formulas might be helpful in identifying the true maximal effort during an exercise test and the intensity domain during a rehabilitation programme.

Published
2022

9. Pick Your Threshold: A Comparison Among Different Methods of Anaerobic Threshold Evaluation in Heart Failure Prognostic Assessment

Author

Salvioni, E., Mapelli, M., Bonomi, A., Magri, D., Piepoli, M., Frigerio, M., Paolillo, S., Corra, U., Raimondo, R., Lagioia, R., Badagliacca, R., Filardi, P. P., Senni, M., Correale, M., Cicoira, M., Perna, E., Metra, M., Guazzi, M., Limongelli, G., Sinagra, G., Parati, G., Cattadori, G., Bandera, F., Bussotti, M., Re, F., Vignati, C., Lombardi, C., Scardovi, A. B., Sciomer, S., Passantino, A., Emdin, M., Passino, C., Santolamazza, C., Girola, D., Zaffalon, D., De Martino, F., Agostoni, P., Farina, S., Pezzuto, B., Apostolo, A., Palermo, P., Contini, M., Gugliandolo, P., Mattavelli, I., Della Rocca, M., Gallo, G., Moscucci, F., Iorio, A., Halasz, G., Capelli, B., Binno, S., Pacileo, G., Valente, F., Vastarella, R., Carriere, C., Mase, M., Cittar, M., Di Lenarda, A., Caravita, S., Vigano, E., Marchese, G., Ricci, R., Arcari, L., Scrutinio, D., Battaia, E., Moretti, M., Matassini, M. V., Shkoza, M., Herberg, R., Cittadini, A., Salzano, A., Marra, A., Lafranca, E., and Vitale, G.

Subjects
heart failure, prognosis, anaerobic threshold, cardiopulmonary exercise test
Published
2022

12. LMNA–RELATED DILATED CARDIOMYOPATHY PRESENTING WITH REGIONAL WALL AKINESIS AND TRANSMURAL LATE GADOLINIUM ENHANCEMENT

Author

Pongetti, G, Lofiego, C, Vagnarelli, F, Maurizi, K, Capodaglio, I, Patani, F, Matassini, M, Battistoni, I, Tofoni, P, Brugiatelli, L, Pietrucci, F, Tortora, G, Schicchi, N, Marini, M, Dello Russo, A, and Perna, G

Abstract

A 26–year–old girl was admitted at hospital in December 2022 for a syncopal episode. She referred fatigue and dyspnea in the last 2 months. EKG was markedly abnormal showing peripheral low voltages, poor R wave progression in prechordial leads, negative T waves V4–V6, DII, DIII and aVF, fragmented QRS (Fig.1). Echo showed moderately dilated left ventricle (LV) with apical akinesia and apical aneurysm (no thrombi) and hypo–akinesia and hyperechoic appearance of the middle segments of the infero–posterior and lateral wall (Fig.2a). EF was 38%. There was no family history for sudden cardiac death and cardiomyopathy. Creatine kinase and neurological examination were normal. The diagnostic work–up included: myocardial scintigraphy which showed fixed tracer uptake deficit at apical and posterolateral levels (Fig.2b); cardiac magnetic resonance (CMR): apical aneurysm with extended late gadolinium enhancement (LGE) due to fibrosis, focally transmural, on the left ventricle’s midapical and infero–lateral thinned–hypokinetic myocardial walls (Fig.3a, 3b); Coronary angiography showed no stenosis. Due to myocardial aneurysm in absence of CAD, Chagas disease was excluded. We performed LV endomyocardial biopsy which showed cardiomyopathic changes and replacement fibrosis. Due to fibrosis extension, complex ventricular extrasystoles detected on monitoring and syncope, ICD was implanted. Finally genetic testing showed c.1621C>Tp.Arg541Cys LMNA pathogenetic mutation leading to the diagnosis of LMNA–related LV cardiomyopathy, with extensive fibrosis in multiple areas of left ventricle including the apical segments at a very young age. Patients with LMNA mutation-related heart disease are characterized by conduction abnormalities, ventricular tachyarrhythmias (VA) and high risk of sudden cardiac death with mildly impaired systolic function, often without chamber dilation. About 88% LMNA– cardiomyopathy have typical myocardial fibrosis, predominantly in the mid-myocardium of the basal septum. However, our patient and previous reported cases with the same p.R541 LMNA mutation presents with a specific phenotype including regional LV akinesis, segmental transmural LGE, significant LV dilatation and systolic dysfunction and VA without conduction abnormality. Of note, EKG shows normal A–V conduction but low voltage and negative T waves in precordial and inferior leads. These features are not typical for LMNA–disease and underline the phenotypic variability of cardiomyopathies.

Published
2024
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13. Current Therapeutic Options for Heart Failure in Elderly Patients

Author

Guerra, F., Brambatti, M., Matassini, M. V., and Capucci, A.

Subjects
Article Subject
Abstract

Heart failure (HF) is a major and growing public health problem with high morbidity and mortality (Ponikowski et al., 2016). It affects 1-2% of the general population in developed countries, and the average age at diagnosis is 76 years. Because of a better management of acute phase and comorbidities, HF incidence is increasing in elderly patients, with a prevalence rising to 10% among people aged 65 years or older (Mozaffarian et al., 2014). Therefore, a substantial number of elderly patients need to be treated. However, because of clinical trial exclusion criteria or coexisting comorbidities, currently recommended therapies are widely based on younger population with a much lower mean age. In this review, we will focus on available pharmacological, electrical, and mechanical therapies, underlining pros, cons, and practical considerations of their use in this specific patient population.

Published
2017
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14. Exercise: A 'new drug' for elderly patients with chronic heart failure

Author

Antonicelli, R, Spazzafumo, L, Scalvini, S, Olivieri, F, Matassini, M, Parati, G, Del Sindaco, D, Gallo, R, Lattanzio, F, Lattanzio, F., PARATI, GIANFRANCO, Antonicelli, R, Spazzafumo, L, Scalvini, S, Olivieri, F, Matassini, M, Parati, G, Del Sindaco, D, Gallo, R, Lattanzio, F, Lattanzio, F., and PARATI, GIANFRANCO

Abstract

Patients with chronic heart failure (CHF) experience progressive deterioration of functional capacity and quality of life (QoL). This prospective, randomized, controlled trial assesses the effect of exercise training (ET) protocol on functional capacity, rehospitalization, and QoL in CHF patients older than 70 years compared with a control group. A total of 343 elderly patients with stable CHF (age, 76.90±5.67, men, 195, 56.9%) were randomized to ET (TCG, n=170) or usual care (UCG, n=173). The ET protocol involved supervised training sessions for 3 months in the hospital followed by home-telemonitored sessions for 3 months. Assessments, performed at baseline and at 3 and 6 months, included: ECG, resting echocardiography, NTproBNP, 6-minute walk test (6MWT), Minnesota Living with Heart Failure Questionnaire, and comprehensive geriatric assessment with the InterRAI-HC instrument. As compared to UCG, ET patients at 6 months showed: i) significantly increased 6MWT distance (450±83 vs. 290±97 m, p<0.001); ii) increased ADL scores (5.00±2.49 vs. 6.94±5.66, p=0.037); iii) 40% reduced risk of rehospitalisation (hazard ratio=0.558, 95%CI, 0.326-0.954, p=0.033); and iv) significantly improved perceived QoL (28.6±12.3 vs. 44.5±12.3, p<0.001). In hospital and home-based telemonitored exercise confer significant benefits on the oldest CHF patients, improving functional capacity and subjective QoL and reducing risk of rehospitalisation.

Published
2016

17. Prevalence, Characteristics, and Outcomes of COVID-19-Associated Acute Myocarditis

Author

Enrico Ammirati, Laura Lupi, Matteo Palazzini, Nicholas S. Hendren, Justin L. Grodin, Carlo V. Cannistraci, Matthieu Schmidt, Guillaume Hekimian, Giovanni Peretto, Thomas Bochaton, Ahmad Hayek, Nicolas Piriou, Sergio Leonardi, Stefania Guida, Annalisa Turco, Simone Sala, Aitor Uribarri, Caroline M. Van de Heyning, Massimo Mapelli, Jeness Campodonico, Patrizia Pedrotti, Maria Isabel Barrionuevo Sánchez, Albert Ariza Sole, Marco Marini, Maria Vittoria Matassini, Mickael Vourc’h, Antonio Cannatà, Daniel I. Bromage, Daniele Briguglia, Jorge Salamanca, Pablo Diez-Villanueva, Jukka Lehtonen, Florent Huang, Stéphanie Russel, Francesco Soriano, Fabrizio Turrini, Manlio Cipriani, Manuela Bramerio, Mattia Di Pasquale, Aurelia Grosu, Michele Senni, Davide Farina, Piergiuseppe Agostoni, Stefania Rizzo, Monica De Gaspari, Francesca Marzo, Jason M. Duran, Eric D. Adler, Cristina Giannattasio, Cristina Basso, Theresa McDonagh, Mathieu Kerneis, Alain Combes, Paolo G. Camici, James A. de Lemos, Marco Metra, Ammirati, E, Lupi, L, Palazzini, M, Hendren, N, Grodin, J, Cannistraci, C, Schmidt, M, Hekimian, G, Peretto, G, Bochaton, T, Hayek, A, Piriou, N, Leonardi, S, Guida, S, Turco, A, Sala, S, Uribarri, A, Van De Heyning, C, Mapelli, M, Campodonico, J, Pedrotti, P, Barrionuevo Sanchez, M, Ariza Sole, A, Marini, M, Matassini, M, Vourc'H, M, Cannata, A, Bromage, D, Briguglia, D, Salamanca, J, Diez-Villanueva, P, Lehtonen, J, Huang, F, Russel, S, Soriano, F, Turrini, F, Cipriani, M, Bramerio, M, Di Pasquale, M, Grosu, A, Senni, M, Farina, D, Agostoni, P, Rizzo, S, De Gaspari, M, Marzo, F, Duran, J, Adler, E, Giannattasio, C, Basso, C, Mcdonagh, T, Kerneis, M, Combes, A, Camici, P, De Lemos, J, Metra, M, CarMeN, laboratoire, Niguarda Hospital [Milan, Italy], University of Brescia, University of Texas Southwestern Medical Center [Dallas], Tsinghua University [Beijing] (THU), Center for Systems Biology Dresden [Dresden, Germany] (CSBD), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Universita Vita Salute San Raffaele = Vita-Salute San Raffaele University [Milan, Italie] (UniSR), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Université de Lyon, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Università degli Studi di Pavia = University of Pavia (UNIPV), Fondazione IRCCS Policlinico San Matteo [Pavia], Hospital Clinico Universitario de Valladolid [Castilla y León, Spain] (HCUV), Instituto de Salud Carlos III [Madrid] (ISC), University of Antwerp (UA), Università degli Studi di Milano = University of Milan (UNIMI), IRCCS Istituto Nazionale dei Tumori [Milano], Bellvitge University Hospital [Barcelona, Spain], Presidio Ospedaliero 'G. Salesi' AN = Ancona Hospital Salesi [Ancona, Italy] (POGSA-AHS), Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Centre hospitalier universitaire de Nantes (CHU Nantes), Thérapeutiques cliniques et expérimentales des infections (EA 3826) (EA 3826), Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), King‘s College London, King's College Hospital (KCH), Mater Domini Humanitas Hospital [Castellanza, Italy] (MD2H), Hospital Universitario de La Princesa, Helsinki University Hospital [Finland] (HUS), Hôpital Foch [Suresnes], Ospedale Civile di Baggiovara [Modena, Italy] (OCB), Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), Azienda Ospedale Università di Padova = Hospital-University of Padua (AOUP), Ospedale 'Infermi' di Rimini [Rimini, Italy] (OIR), University of California [San Diego] (UC San Diego), University of California (UC), and Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB)

Subjects
Adult, Male, outcome, SARS-CoV-2, cardiac, [SDV]Life Sciences [q-bio], Left, COVID-2019, MRI, myocarditis, Female, Humans, Prevalence, Retrospective Studies, Stroke Volume, Ventricular Function, Left, COVID-19, Myocarditis, [SDV] Life Sciences [q-bio], myocarditi, Physiology (medical), Ventricular Function, Human medicine, Cardiology and Cardiovascular Medicine
Abstract

Background: Acute myocarditis (AM) is thought to be a rare cardiovascular complication of COVID-19, although minimal data are available beyond case reports. We aim to report the prevalence, baseline characteristics, in-hospital management, and outcomes for patients with COVID-19–associated AM on the basis of a retrospective cohort from 23 hospitals in the United States and Europe. Methods: A total of 112 patients with suspected AM from 56 963 hospitalized patients with COVID-19 were evaluated between February 1, 2020, and April 30, 2021. Inclusion criteria were hospitalization for COVID-19 and a diagnosis of AM on the basis of endomyocardial biopsy or increased troponin level plus typical signs of AM on cardiac magnetic resonance imaging. We identified 97 patients with possible AM, and among them, 54 patients with definite/probable AM supported by endomyocardial biopsy in 17 (31.5%) patients or magnetic resonance imaging in 50 (92.6%). We analyzed patient characteristics, treatments, and outcomes among all COVID-19–associated AM. Results: AM prevalence among hospitalized patients with COVID-19 was 2.4 per 1000 hospitalizations considering definite/probable and 4.1 per 1000 considering also possible AM. The median age of definite/probable cases was 38 years, and 38.9% were female. On admission, chest pain and dyspnea were the most frequent symptoms (55.5% and 53.7%, respectively). Thirty-one cases (57.4%) occurred in the absence of COVID-19–associated pneumonia. Twenty-one (38.9%) had a fulminant presentation requiring inotropic support or temporary mechanical circulatory support. The composite of in-hospital mortality or temporary mechanical circulatory support occurred in 20.4%. At 120 days, estimated mortality was 6.6%, 15.1% in patients with associated pneumonia versus 0% in patients without pneumonia ( P =0.044). During hospitalization, left ventricular ejection fraction, assessed by echocardiography, improved from a median of 40% on admission to 55% at discharge (n=47; P Conclusions: AM occurrence is estimated between 2.4 and 4.1 out of 1000 patients hospitalized for COVID-19. The majority of AM occurs in the absence of pneumonia and is often complicated by hemodynamic instability. AM is a rare complication in patients hospitalized for COVID-19, with an outcome that differs on the basis of the presence of concomitant pneumonia.

Published
2022

18. Exercise: A 'new drug' for elderly patients with chronic heart failure

Author

Fabrizia Lattanzio, Liana Spazzafumo, Maria Vittoria Matassini, Simonetta Scalvini, Roberto Antonicelli, Raffaella Gallo, Gianfranco Parati, Fabiola Olivieri, Donatella Del Sindaco, Antonicelli, R, Spazzafumo, L, Scalvini, S, Olivieri, F, Matassini, M, Parati, G, Del Sindaco, D, Gallo, R, and Lattanzio, F

Subjects
Drug, Male, Quality of life, Aging, medicine.medical_specialty, QoL, media_common.quotation_subject, Physical exercise, 030204 cardiovascular system & hematology, law.invention, elderly CHF patients, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, elderly CHF patient, Randomized controlled trial, law, physical exercise, Surveys and Questionnaires, Natriuretic Peptide, Brain, 6MWT, medicine, Humans, Exercise, Geriatric Assessment, media_common, Aged, Aged, 80 and over, Heart Failure, medicine.diagnostic_test, business.industry, Hazard ratio, Geriatric assessment, Cell Biology, medicine.disease, Peptide Fragments, Chronic heart failure, Exercise Therapy, Treatment Outcome, Heart failure, Chronic Disease, Physical therapy, Exercise Test, Female, business, 030217 neurology & neurosurgery, Research Paper
Abstract

Patients with chronic heart failure (CHF) experience progressive deterioration of functional capacity and quality of life (QoL). This prospective, randomized, controlled trial assesses the effect of exercise training (ET) protocol on functional capacity, rehospitalization, and QoL in CHF patients older than 70 years compared with a control group. A total of 343 elderly patients with stable CHF (age, 76.90±5.67, men, 195, 56.9%) were randomized to ET (TCG, n=170) or usual care (UCG, n=173). The ET protocol involved supervised training sessions for 3 months in the hospital followed by home-telemonitored sessions for 3 months. Assessments, performed at baseline and at 3 and 6 months, included: ECG, resting echocardiography, NT-proBNP, 6-minute walk test (6MWT), Minnesota Living with Heart Failure Questionnaire, and comprehensive geriatric assessment with the InterRAI-HC instrument. As compared to UCG, ET patients at 6 months showed: i) significantly increased 6MWT distance (450±83 vs. 290±97 m, p=0.001); ii) increased ADL scores (5.00±2.49 vs. 6.94±5.66, p=0.037); iii) 40% reduced risk of rehospitalisation (hazard ratio=0.558, 95%CI, 0.326-0.954, p=0.033); and iv) significantly improved perceived QoL (28.6±12.3 vs. 44.5±12.3, p=0.001). In hospital and home-based telemonitored exercise confer significant benefits on the oldest CHF patients, improving functional capacity and subjective QoL and reducing risk of rehospitalisation.

Published
2016

19. Acute heart failure: differential diagnosis and treatment.

Author

Marini M, Manfredi R, Battistoni I, Francioni M, Vittoria Matassini M, Pongetti G, Angelini L, Shkoza M, Bontempo A, Belfioretti L, and Piero Perna G

Abstract

Acute heart failure is a heterogeneous clinical syndrome and is the first cause of unplanned hospitalization in people >65 years. Patients with heart failure may have different clinical presentations according to clinical history, pre-existing heart disease, and pattern of intravascular congestion. A comprehensive assessment of clinical, echocardiographic, and laboratory data should aid in clinical decision-making and treatment. In some cases, a more accurate evaluation of patient haemodynamics via a pulmonary artery catheter may be necessary to undertake and guide escalation and de-escalation of therapy, especially when clinical, echo, and laboratory data are inconclusive or in the presence of right ventricular dysfunction. Similarly, a pulmonary artery catheter may be useful in patients with cardiogenic shock undergoing mechanical circulatory support. With the subsequent de-escalation of therapy and haemodynamic stabilization, the implementation of guideline-directed medical therapy should be pursued to reduce the risk of subsequent heart failure hospitalization and death, paying particular attention to the recognition and treatment of residual congestion., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2023
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20. Evolution of clinical diagnosis in patients presenting with unexplained cardiac arrest or syncope due to polymorphic ventricular tachycardia.

Author

Vittoria Matassini M, Krahn AD, Gardner M, Champagne J, Sanatani S, Birnie DH, Gollob MH, Chauhan V, Simpson CS, Hamilton RM, Talajic M, Ahmad K, Gerull B, Chakrabarti S, and Healey JS

Subjects
Adult, Arrhythmias, Cardiac diagnosis, Cardiomyopathies diagnosis, Diagnosis, Differential, Electrocardiography, Female, Follow-Up Studies, Humans, Long QT Syndrome diagnosis, Male, Middle Aged, Registries, Ventricular Fibrillation diagnosis, Heart Arrest diagnosis, Syncope diagnosis, Tachycardia, Ventricular complications
Abstract

Background: A systematic evaluation of patients with unexplained cardiac arrest (UCA) yields a diagnosis in 50% of the cases. However, evolution of clinical phenotype, identification of new disease-causing mutations, and description of new syndromes may revise the diagnosis., Objective: To assess the evolution in diagnosis among patients with initially UCA., Methods: Diagnoses were reviewed for all patients with UCA recruited from the Cardiac Arrest Survivors with Preserved Ejection Fraction Registry with at least 1 year of follow-up., Results: After comprehensive investigation of 68 patients (age 45.2 ± 14.9 years; 63% men), the initial diagnosis was as follows: idiopathic ventricular fibrillation (n = 34 [50%]), a primary arrhythmic disorder (n = 21 [31%]), and an occult structural cause (n = 13 [19%]). Patients were followed for 30 ± 17 months, during which time the diagnosis changed in 12 (18%) patients. A specific diagnosis emerged for 7 patients (21%) with an initial diagnosis of idiopathic ventricular fibrillation. A structural cardiomyopathy evolved in 2 patients with an initial diagnosis of primary electrical disorder, while the specific structural cardiomyopathy was revised for 1 patient. Two patients with an initial diagnosis of a primary arrhythmic disorder were subsequently considered to have a different primary arrhythmic disorder. A follow-up resting electrocardiogram was the test that most frequently changed the diagnosis (67% of the cases), followed by genetic testing (17%)., Conclusions: The reevaluation of patients presenting with UCA may lead to a change in diagnosis in up to 20%. This emphasizes the need to actively monitor the phenotype and also has implications for the treatment of these patients and the screening of their relatives., (© 2014 Heart Rhythm Society Published by Heart Rhythm Society All rights reserved.)

Published
2014
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