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2. Cardiac Magnetic Resonance for Prophylactic Implantable-Cardioverter Defibrillator Therapy in Ischemic Cardiomyopathy: The DERIVATE–ICM International Registry

Author

Pontone, G, Guaricci, A, Fusini, L, Baggiano, A, Guglielmo, M, Muscogiuri, G, Volpe, A, Abete, R, Aquaro, G, Barison, A, Bogaert, J, Camastra, G, Carigi, S, Carrabba, N, Casavecchia, G, Censi, S, Cicala, G, De Cecco, C, De Lazzari, M, Di Giovine, G, Di Roma, M, Dobrovie, M, Focardi, M, Gaibazzi, N, Gismondi, A, Gravina, M, Lanzillo, C, Lombardi, M, Lorenzoni, V, Lozano-Torres, J, Martini, C, Marzo, F, Masi, A, Memeo, R, Moro, C, Nese, A, Palumbo, A, Pavon, A, Pedrotti, P, Marra, M, Pica, S, Pradella, S, Presicci, C, Rabbat, M, Raineri, C, Rodriguez-Palomares, J, Sbarbati, S, Schoepf, U, Squeri, A, Sverzellati, N, Symons, R, Tat, E, Timpani, M, Todiere, G, Valentini, A, Varga-Szemes, A, Masci, P, Schwitter, J, Pontone G., Guaricci A. I., Fusini L., Baggiano A., Guglielmo M., Muscogiuri G., Volpe A., Abete R., Aquaro G., Barison A., Bogaert J., Camastra G., Carigi S., Carrabba N., Casavecchia G., Censi S., Cicala G., De Cecco C. N., De Lazzari M., Di Giovine G., Di Roma M., Dobrovie M., Focardi M., Gaibazzi N., Gismondi A., Gravina M., Lanzillo C., Lombardi M., Lorenzoni V., Lozano-Torres J., Martini C., Marzo F., Masi A., Memeo R., Moro C., Nese A., Palumbo A., Pavon A. G., Pedrotti P., Marra M. P., Pica S., Pradella S., Presicci C., Rabbat M. G., Raineri C., Rodriguez-Palomares J. F., Sbarbati S., Schoepf U. J., Squeri A., Sverzellati N., Symons R., Tat E., Timpani M., Todiere G., Valentini A., Varga-Szemes A., Masci P. -G., Schwitter J., Pontone, G, Guaricci, A, Fusini, L, Baggiano, A, Guglielmo, M, Muscogiuri, G, Volpe, A, Abete, R, Aquaro, G, Barison, A, Bogaert, J, Camastra, G, Carigi, S, Carrabba, N, Casavecchia, G, Censi, S, Cicala, G, De Cecco, C, De Lazzari, M, Di Giovine, G, Di Roma, M, Dobrovie, M, Focardi, M, Gaibazzi, N, Gismondi, A, Gravina, M, Lanzillo, C, Lombardi, M, Lorenzoni, V, Lozano-Torres, J, Martini, C, Marzo, F, Masi, A, Memeo, R, Moro, C, Nese, A, Palumbo, A, Pavon, A, Pedrotti, P, Marra, M, Pica, S, Pradella, S, Presicci, C, Rabbat, M, Raineri, C, Rodriguez-Palomares, J, Sbarbati, S, Schoepf, U, Squeri, A, Sverzellati, N, Symons, R, Tat, E, Timpani, M, Todiere, G, Valentini, A, Varga-Szemes, A, Masci, P, Schwitter, J, Pontone G., Guaricci A. I., Fusini L., Baggiano A., Guglielmo M., Muscogiuri G., Volpe A., Abete R., Aquaro G., Barison A., Bogaert J., Camastra G., Carigi S., Carrabba N., Casavecchia G., Censi S., Cicala G., De Cecco C. N., De Lazzari M., Di Giovine G., Di Roma M., Dobrovie M., Focardi M., Gaibazzi N., Gismondi A., Gravina M., Lanzillo C., Lombardi M., Lorenzoni V., Lozano-Torres J., Martini C., Marzo F., Masi A., Memeo R., Moro C., Nese A., Palumbo A., Pavon A. G., Pedrotti P., Marra M. P., Pica S., Pradella S., Presicci C., Rabbat M. G., Raineri C., Rodriguez-Palomares J. F., Sbarbati S., Schoepf U. J., Squeri A., Sverzellati N., Symons R., Tat E., Timpani M., Todiere G., Valentini A., Varga-Szemes A., Masci P. -G., and Schwitter J.

Abstract

Background: Implantable cardioverter-defibrillator (ICD) therapy is the most effective prophylactic strategy against sudden cardiac death (SCD) in patients with ischemic cardiomyopathy (ICM) and left ventricle ejection fraction (LVEF) ≤35% as detected by transthoracic echocardiograpgy (TTE). This approach has been recently questioned because of the low rate of ICD interventions in patients who received implantation and the not-negligible percentage of patients who experienced SCD despite not fulfilling criteria for implantation. Objectives: The DERIVATE-ICM registry (CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy; NCT03352648) is an international, multicenter, and multivendor study to assess the net reclassification improvement (NRI) for the indication of ICD implantation by the use of cardiac magnetic resonance (CMR) as compared to TTE in patients with ICM. Methods: A total of 861 patients with ICM (mean age 65 ± 11 years, 86% male) with chronic heart failure and TTE-LVEF <50% participated. Major adverse arrhythmic cardiac events (MAACE) were the primary endpoints. Results: During a median follow-up of 1,054 days, MAACE occurred in 88 (10.2%). Left ventricular end-diastolic volume index (HR: 1.007 [95% CI: 1.000-1.011]; P = 0.05), CMR-LVEF (HR: 0.972 [95% CI: 0.945-0.999]; P = 0.045) and late gadolinium enhancement (LGE) mass (HR: 1.010 [95% CI: 1.002-1.018]; P = 0.015) were independent predictors of MAACE. A multiparametric CMR weighted predictive derived score identifies subjects at high risk for MAACE compared with TTE-LVEF cutoff of 35% with a NRI of 31.7% (P = 0.007). Conclusions: The DERIVATE-ICM registry is a large multicenter registry showing the additional value of CMR to stratify the risk for MAACE in a large cohort of patients with ICM compared with standard of care.

Published
2023

3. Effect of Migalastat on cArdiac Involvement in FabRry Disease: MAIORA study

Author

Camporeale, A, Bandera, F, Pieroni, M, Pieruzzi, F, Spada, M, Bersano, A, Econimo, L, Lanzillo, C, Rubino, M, Mignani, R, Motta, I, Olivotto, I, Tanini, I, Valaperta, R, Chow, K, Baroni, I, Boveri, S, Graziani, F, Pica, S, Tondi, L, Guazzi, M, Lombardi, M, Camporeale A., Bandera F., Pieroni M., Pieruzzi F., Spada M., Bersano A., Econimo L., Lanzillo C., Rubino M., Mignani R., Motta I., Olivotto I., Tanini I., Valaperta R., Chow K., Baroni I., Boveri S., Graziani F., Pica S., Tondi L., Guazzi M., Lombardi M., Camporeale, A, Bandera, F, Pieroni, M, Pieruzzi, F, Spada, M, Bersano, A, Econimo, L, Lanzillo, C, Rubino, M, Mignani, R, Motta, I, Olivotto, I, Tanini, I, Valaperta, R, Chow, K, Baroni, I, Boveri, S, Graziani, F, Pica, S, Tondi, L, Guazzi, M, Lombardi, M, Camporeale A., Bandera F., Pieroni M., Pieruzzi F., Spada M., Bersano A., Econimo L., Lanzillo C., Rubino M., Mignani R., Motta I., Olivotto I., Tanini I., Valaperta R., Chow K., Baroni I., Boveri S., Graziani F., Pica S., Tondi L., Guazzi M., and Lombardi M.

Abstract

Background: A small but significant reduction in left ventricular (LV) mass after 18 months of migalastat treatment has been reported in Fabry disease (FD). This study aimed to assess the effect of migalastat on FD cardiac involvement, combining LV morphology and tissue characterisation by cardiac magnetic resonance (CMR) with cardiopulmonary exercise testing (CPET). Methods: Sixteen treatment-naïve patients with FD (4 women, 46.4±16.2 years) with cardiac involvement (reduced T1 values on CMR and/or LV hypertrophy) underwent ECG, echocardiogram, troponin T and NT-proBNP (N-Terminal prohormone of Brain Natriuretic Peptide) assay, CMR with T1 mapping, and CPET before and after 18 months of migalastat. Results: No change in LV mass was detected at 18 months compared to baseline (95.2 g/m2 (66.0-184.0) vs 99.0 g/m2 (69.0-121.0), p=0.55). Overall, there was an increase in septal T1 of borderline significance (870.0 ms (848-882) vs 860.0 ms (833.0-875.0), p=0.056). Functional capacity showed an increase in oxygen consumption (VO2) at anaerobic threshold (15.50 mL/kg/min (13.70-21.50) vs 14.50 mL/kg/min (11.70-18.95), p=0.02), and a trend towards an increase in percent predicted peak VO2 (72.0 (63.0-80.0) vs 69.0 (53.0-77.0), p=0.056) was observed. The subset of patients who showed an increase in T1 value and a reduction in LV mass (n=7, 1 female, age 40.5 (28.6-76.0)) was younger and at an earlier disease stage compared to the others, and also exhibited greater improvement in exercise tolerance. Conclusion: In treatment-naïve FD patients with cardiac involvement, 18-month treatment with migalastat stabilised LV mass and was associated with a trend towards an improvement in exercise tolerance. A tendency to T1 increase was detected by CMR. The subset of patients who had significant benefits from the treatment showed an earlier cardiac disease compared to the others. Trial registration number: NCT03838237.

Published
2023

5. Effect of Migalastat on cArdiac Involvement in FabRry Disease: MAIORA study

Author

Camporeale, Antonia, Bandera, F., Pieroni, M., Pieruzzi, F., Spada, Marina, Bersano, A., Econimo, L., Lanzillo, C., Rubino, M., Mignani, R., Motta, I., Olivotto, I., Tanini, I., Valaperta, R., Chow, K., Baroni, I., Boveri, S., Graziani, Francesca, Pica, S., Tondi, L., Guazzi, M., Lombardi, M., Camporeale A., Spada M., Graziani F. (ORCID:0000-0002-4520-5689), Camporeale, Antonia, Bandera, F., Pieroni, M., Pieruzzi, F., Spada, Marina, Bersano, A., Econimo, L., Lanzillo, C., Rubino, M., Mignani, R., Motta, I., Olivotto, I., Tanini, I., Valaperta, R., Chow, K., Baroni, I., Boveri, S., Graziani, Francesca, Pica, S., Tondi, L., Guazzi, M., Lombardi, M., Camporeale A., Spada M., and Graziani F. (ORCID:0000-0002-4520-5689)

Abstract

Background: A small but significant reduction in left ventricular (LV) mass after 18 months of migalastat treatment has been reported in Fabry disease (FD). This study aimed to assess the effect of migalastat on FD cardiac involvement, combining LV morphology and tissue characterisation by cardiac magnetic resonance (CMR) with cardiopulmonary exercise testing (CPET). Methods: Sixteen treatment-naïve patients with FD (4 women, 46.4±16.2 years) with cardiac involvement (reduced T1 values on CMR and/or LV hypertrophy) underwent ECG, echocardiogram, troponin T and NT-proBNP (N-Terminal prohormone of Brain Natriuretic Peptide) assay, CMR with T1 mapping, and CPET before and after 18 months of migalastat. Results: No change in LV mass was detected at 18 months compared to baseline (95.2 g/m2 (66.0-184.0) vs 99.0 g/m2 (69.0-121.0), p=0.55). Overall, there was an increase in septal T1 of borderline significance (870.0 ms (848-882) vs 860.0 ms (833.0-875.0), p=0.056). Functional capacity showed an increase in oxygen consumption (VO2) at anaerobic threshold (15.50 mL/kg/min (13.70-21.50) vs 14.50 mL/kg/min (11.70-18.95), p=0.02), and a trend towards an increase in percent predicted peak VO2 (72.0 (63.0-80.0) vs 69.0 (53.0-77.0), p=0.056) was observed. The subset of patients who showed an increase in T1 value and a reduction in LV mass (n=7, 1 female, age 40.5 (28.6-76.0)) was younger and at an earlier disease stage compared to the others, and also exhibited greater improvement in exercise tolerance. Conclusion: In treatment-naïve FD patients with cardiac involvement, 18-month treatment with migalastat stabilised LV mass and was associated with a trend towards an improvement in exercise tolerance. A tendency to T1 increase was detected by CMR. The subset of patients who had significant benefits from the treatment showed an earlier cardiac disease compared to the others. Trial registration number: NCT03838237.

Published
2023

6. Myocardial Fibrosis at Cardiac MRI Helps Predict Adverse Clinical Outcome in Patients with Mitral Valve Prolapse

Author

Figliozzi, S, Georgiopoulos, G, Lopes, P, Bauer, K, Moura-Ferreira, S, Tondi, L, Mushtaq, S, Censi, S, Pavon, A, Bassi, I, Servato, M, Teske, A, Biondi, F, Filomena, D, Pica, S, Torlasco, C, Muraru, D, Monney, P, Quattrocchi, G, Maestrini, V, Agati, L, Monti, L, Pedrotti, P, Vandenberk, B, Squeri, A, Lombardi, M, Ferreira, A, Schwitter, J, Aquaro, G, Chiribiri, A, Rodríguez Palomares, J, Yilmaz, A, Andreini, D, Florian, A, Leiner, T, Abecasis, J, Badano, L, Bogaert, J, Masci, P, Figliozzi, Stefano, Georgiopoulos, Georgios, Lopes, Pedro M, Bauer, Klemens B, Moura-Ferreira, Sara, Tondi, Lara, Mushtaq, Saima, Censi, Stefano, Pavon, Anna Giulia, Bassi, Ilaria, Servato, Maria Luz, Teske, Arco J, Biondi, Federico, Filomena, Domenico, Pica, Silvia, Torlasco, Camilla, Muraru, Denisa, Monney, Pierre, Quattrocchi, Giuseppina, Maestrini, Viviana, Agati, Luciano, Monti, Lorenzo, Pedrotti, Patrizia, Vandenberk, Bert, Squeri, Angelo, Lombardi, Massimo, Ferreira, António M, Schwitter, Juerg, Aquaro, Giovanni Donato, Chiribiri, Amedeo, Rodríguez Palomares, José F, Yilmaz, Ali, Andreini, Daniele, Florian, Anca, Leiner, Tim, Abecasis, João, Badano, Luigi, Bogaert, Jan, Masci, Pier-Giorgio, Figliozzi, S, Georgiopoulos, G, Lopes, P, Bauer, K, Moura-Ferreira, S, Tondi, L, Mushtaq, S, Censi, S, Pavon, A, Bassi, I, Servato, M, Teske, A, Biondi, F, Filomena, D, Pica, S, Torlasco, C, Muraru, D, Monney, P, Quattrocchi, G, Maestrini, V, Agati, L, Monti, L, Pedrotti, P, Vandenberk, B, Squeri, A, Lombardi, M, Ferreira, A, Schwitter, J, Aquaro, G, Chiribiri, A, Rodríguez Palomares, J, Yilmaz, A, Andreini, D, Florian, A, Leiner, T, Abecasis, J, Badano, L, Bogaert, J, Masci, P, Figliozzi, Stefano, Georgiopoulos, Georgios, Lopes, Pedro M, Bauer, Klemens B, Moura-Ferreira, Sara, Tondi, Lara, Mushtaq, Saima, Censi, Stefano, Pavon, Anna Giulia, Bassi, Ilaria, Servato, Maria Luz, Teske, Arco J, Biondi, Federico, Filomena, Domenico, Pica, Silvia, Torlasco, Camilla, Muraru, Denisa, Monney, Pierre, Quattrocchi, Giuseppina, Maestrini, Viviana, Agati, Luciano, Monti, Lorenzo, Pedrotti, Patrizia, Vandenberk, Bert, Squeri, Angelo, Lombardi, Massimo, Ferreira, António M, Schwitter, Juerg, Aquaro, Giovanni Donato, Chiribiri, Amedeo, Rodríguez Palomares, José F, Yilmaz, Ali, Andreini, Daniele, Florian, Anca, Leiner, Tim, Abecasis, João, Badano, Luigi, Bogaert, Jan, and Masci, Pier-Giorgio

Abstract

Background: Patients with mitral valve prolapse (MVP) may develop adverse outcomes even in the absence of mitral regurgitation or left ventricular (LV) dysfunction. Purpose: To investigate the prognostic value of mitral annulus disjunction (MAD) and myocardial fibrosis at late gadolinium enhancement (LGE) cardiac MRI in patients with MVP without moderate-to-severe mitral regurgitation or LV dysfunction. Materials and Methods: In this longitudinal retrospective study, 118 144 cardiac MRI studies were evaluated between October 2007 and June 2020 at 15 European tertiary medical centers. Follow-up was from the date of cardiac MRI examination to June 2020; the minimum and maximum follow-up intervals were 6 months and 156 months, respectively. Patients were excluded if at least one of the following conditions was present: cardiomyopathy, LV ejection fraction less than 40%, ischemic heart disease, congenital heart disease, inflammatory heart disease, moderate or worse mitral regurgitation, participation in competitive sport, or electrocardiogram suggestive of channelopathies. In the remainder, cardiac MRI studies were reanalyzed, and patients were included if they were aged 18 years or older, MVP was diagnosed at cardiac MRI, and clinical information and electrocardiogram monitoring were available within 3 months from cardiac MRI examination. The end point was a composite of adverse outcomes: sustained ventricular tachycardia (VT), sudden cardiac death (SCD), or unexplained syncope. Multivariable Cox regression analysis was performed. Results: A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 women) were included. Over a median follow-up of 3.3 years, 18 patients (4%) reached the study end point. LGE presence (hazard ratio, 4.2 [95% CI: 1.5, 11.9]; P = .006) and extent (hazard ratio, 1.2 per 1% increase [95% CI: 1.1, 1.4]; P = .006), but not MAD presence (P = .89), were associated with clinical outcome. LGE presence had incremental prognostic value over MVP severi

Published
2023

8. ECG-based score estimates the probability to detect Fabry Disease cardiac involvement

Author

Figliozzi, S, Camporeale, A, Boveri, S, Pieruzzi, F, Pieroni, M, Lusardi, P, Spada, M, Mignani, R, Burlina, A, Graziani, F, Pica, S, Tondi, L, Bernardini, A, Chow, K, Namdar, M, Lombardi, M, Figliozzi S., Camporeale A., Boveri S., Pieruzzi F., Pieroni M., Lusardi P., Spada M., Mignani R., Burlina A., Graziani F., Pica S., Tondi L., Bernardini A., Chow K., Namdar M., Lombardi M., Figliozzi, S, Camporeale, A, Boveri, S, Pieruzzi, F, Pieroni, M, Lusardi, P, Spada, M, Mignani, R, Burlina, A, Graziani, F, Pica, S, Tondi, L, Bernardini, A, Chow, K, Namdar, M, Lombardi, M, Figliozzi S., Camporeale A., Boveri S., Pieruzzi F., Pieroni M., Lusardi P., Spada M., Mignani R., Burlina A., Graziani F., Pica S., Tondi L., Bernardini A., Chow K., Namdar M., and Lombardi M.

Abstract

Objectives: To elaborate an ECG-based nomogram estimating the probability to detect cardiac involvement by cardiac magnetic resonance (CMR) in Fabry Disease (FD). Methods: 119 FD patients and 26 healthy controls underwent ECG and CMR. Test (n = 88, 60%) and validation cohorts (n = 57, 40%) were randomly derived. Cardiac involvement was defined as the presence of low myocardial T1 value, a CMR-surrogate of myocardial glycosphingolipid storage. ECG changes associated with low T1 value were identified in the test cohort, included in the nomogram and then tested in the validation cohort. Results: Sokolow-Lyon index (AUC = 0.769), ratio between P-wave and PR-segment durations (Pwave/PRsegment) (AUC = 0.778), QRS duration (AUC = 0.703), QT (AUC = 0.769) duration were independently associated with the presence of low T1 on CMR at multivariate analysis. An ECG-based nomogram including these four parameters was accurate in identifying patients with CMR evidence of glycosphingolipid storage (c-index of the derived-nomogram = 0.90 in the test group; 0.81 in the validation group). Conclusion: We propose a practical ECG-based nomogram accurately estimating the probability to detect low T1 values by CMR in FD patients. The application of this tool in clinical practice could improve early detection of FD cardiac involvement.

Published
2021

9. CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Ischaemic dilated CardioMyopathy: an international Registry

Author

Guaricci, A, Masci, P, Muscogiuri, G, Guglielmo, M, Baggiano, A, Fusini, L, Lorenzoni, V, Martini, C, Andreini, D, Pavon, A, Aquaro, G, Barison, A, Todiere, G, Rabbat, M, Tat, E, Raineri, C, Valentini, A, Varga-Szemes, A, Schoepf, U, De Cecco, C, Bogaert, J, Dobrovie, M, Symons, R, Focardi, M, Gismondi, A, Lozano-Torres, J, Rodriguez-Palomares, J, Lanzillo, C, Di Roma, M, Moro, C, Di Giovine, G, Margonato, D, De Lazzari, M, Perazzolo Marra, M, Nese, A, Casavecchia, G, Gravina, M, Marzo, F, Carigi, S, Pica, S, Lombardi, M, Censi, S, Squeri, A, Palumbo, A, Gaibazzi, N, Camastra, G, Sbarbati, S, Pedrotti, P, Masi, A, Carrabba, N, Pradella, S, Timpani, M, Cicala, G, Presicci, C, Puglisi, S, Sverzellati, N, Santobuono, V, Pepi, M, Schwitter, J, Pontone, G, Guaricci AI, Masci PG, Muscogiuri G, Guglielmo M, Baggiano A, Fusini L, Lorenzoni V, Martini C, Andreini D, Pavon AG, Aquaro GD, Barison A, Todiere G, Rabbat MG, Tat E, Raineri C, Valentini A, Varga-Szemes A, Schoepf UJ, De Cecco CN, Bogaert J, Dobrovie M, Symons R, Focardi M, Gismondi A, Lozano-Torres J, Rodriguez-Palomares JF, Lanzillo C, Di Roma M, Moro C, Di Giovine G, Margonato D, De Lazzari M, Perazzolo Marra M, Nese A, Casavecchia G, Gravina M, Marzo F, Carigi S, Pica S, Lombardi M, Censi S, Squeri A, Palumbo A, Gaibazzi N, Camastra G, Sbarbati S, Pedrotti P, Masi A, Carrabba N, Pradella S, Timpani M, Cicala G, Presicci C, Puglisi S, Sverzellati N, Santobuono VE, Pepi M, Schwitter J, Pontone G, Guaricci, A, Masci, P, Muscogiuri, G, Guglielmo, M, Baggiano, A, Fusini, L, Lorenzoni, V, Martini, C, Andreini, D, Pavon, A, Aquaro, G, Barison, A, Todiere, G, Rabbat, M, Tat, E, Raineri, C, Valentini, A, Varga-Szemes, A, Schoepf, U, De Cecco, C, Bogaert, J, Dobrovie, M, Symons, R, Focardi, M, Gismondi, A, Lozano-Torres, J, Rodriguez-Palomares, J, Lanzillo, C, Di Roma, M, Moro, C, Di Giovine, G, Margonato, D, De Lazzari, M, Perazzolo Marra, M, Nese, A, Casavecchia, G, Gravina, M, Marzo, F, Carigi, S, Pica, S, Lombardi, M, Censi, S, Squeri, A, Palumbo, A, Gaibazzi, N, Camastra, G, Sbarbati, S, Pedrotti, P, Masi, A, Carrabba, N, Pradella, S, Timpani, M, Cicala, G, Presicci, C, Puglisi, S, Sverzellati, N, Santobuono, V, Pepi, M, Schwitter, J, Pontone, G, Guaricci AI, Masci PG, Muscogiuri G, Guglielmo M, Baggiano A, Fusini L, Lorenzoni V, Martini C, Andreini D, Pavon AG, Aquaro GD, Barison A, Todiere G, Rabbat MG, Tat E, Raineri C, Valentini A, Varga-Szemes A, Schoepf UJ, De Cecco CN, Bogaert J, Dobrovie M, Symons R, Focardi M, Gismondi A, Lozano-Torres J, Rodriguez-Palomares JF, Lanzillo C, Di Roma M, Moro C, Di Giovine G, Margonato D, De Lazzari M, Perazzolo Marra M, Nese A, Casavecchia G, Gravina M, Marzo F, Carigi S, Pica S, Lombardi M, Censi S, Squeri A, Palumbo A, Gaibazzi N, Camastra G, Sbarbati S, Pedrotti P, Masi A, Carrabba N, Pradella S, Timpani M, Cicala G, Presicci C, Puglisi S, Sverzellati N, Santobuono VE, Pepi M, Schwitter J, and Pontone G

Abstract

Aims: The aim of this registry was to evaluate the additional prognostic value of a composite cardiac magnetic resonance (CMR)-based risk score over standard-of-care (SOC) evaluation in a large cohort of consecutive unselected non-ischaemic cardiomyopathy (NICM) patients. Methods and results: In the DERIVATE registry (www.clinicaltrials.gov/registration: RCT#NCT03352648), 1000 (derivation cohort) and 508 (validation cohort) NICM patients with chronic heart failure (HF) and left ventricular ejection fraction [removed]3 segments with midwall fibrosis on late gadolinium enhancement (LGE) were the only independent predictors of all-cause mortality (HR: 1.036, 95% CI: 1.0117-1.056, P < 0.001 and HR: 2.077, 95% CI: 1.211-3.562, P = 0.008, respectively). For MAACE, the independent predictors were male gender, left ventricular end-diastolic volume index by CMR (CMR-LVEDVi), and >3 segments with midwall fibrosis on LGE (HR: 2.131, 95% CI: 1.231-3.690, P = 0.007; HR: 3.161, 95% CI: 1.750-5.709, P < 0.001; and HR: 1.693, 95% CI: 1.084-2.644, P = 0.021, respectively). A composite clinical and CMR-based risk score provided a net reclassification improvement of 63.7% (P < 0.001) for MAACE occurrence when added to the model based on SOC evaluation. These findings were confirmed in the validation cohort. Conclusion: In a large multicentre, multivendor cohort registry reflecting daily clinical practice in NICM work-up, a composite clinical and CMR-based risk score provides incremental prognostic value beyond SOC evaluation, which may have impact on the indication of implantable cardioverter-defibrillator implantation.

Published
2021

10. Atrial Dysfunction Assessed by Cardiac Magnetic Resonance as an Early Marker of Fabry Cardiomyopathy

Author

Bernardini, A, Camporeale, A, Pieroni, M, Pieruzzi, F, Figliozzi, S, Lusardi, P, Spada, M, Mignani, R, Burlina, A, Carubbi, F, Battaglia, Y, Graziani, F, Pica, S, Tondi, L, Chow, K, Boveri, S, Olivotto, I, Lombardi, M, Bernardini A., Camporeale A., Pieroni M., Pieruzzi F., Figliozzi S., Lusardi P., Spada M., Mignani R., Burlina A., Carubbi F., Battaglia Y., Graziani F., Pica S., Tondi L., Chow K., Boveri S., Olivotto I., Lombardi M., Bernardini, A, Camporeale, A, Pieroni, M, Pieruzzi, F, Figliozzi, S, Lusardi, P, Spada, M, Mignani, R, Burlina, A, Carubbi, F, Battaglia, Y, Graziani, F, Pica, S, Tondi, L, Chow, K, Boveri, S, Olivotto, I, Lombardi, M, Bernardini A., Camporeale A., Pieroni M., Pieruzzi F., Figliozzi S., Lusardi P., Spada M., Mignani R., Burlina A., Carubbi F., Battaglia Y., Graziani F., Pica S., Tondi L., Chow K., Boveri S., Olivotto I., and Lombardi M.

Published
2020

11. Cardiac Magnetic Resonance Features of Fabry Disease: From Early Diagnosis to Prognostic Stratification

Author

Camporeale, Antonia, Diano, A., Tondi, L., Pica, S., Pasqualin, G., Ciabatti, M., Graziani, Francesca, Pieroni, M., Lombardi, M., Camporeale A., Graziani F. (ORCID:0000-0002-4520-5689), Camporeale, Antonia, Diano, A., Tondi, L., Pica, S., Pasqualin, G., Ciabatti, M., Graziani, Francesca, Pieroni, M., Lombardi, M., Camporeale A., and Graziani F. (ORCID:0000-0002-4520-5689)

Abstract

In the past few years, the wide application of cardiac magnetic resonance (CMR) significantly changed the approach to the study of cardiac involvement in Fabry Disease (FD). The possibility to perform non-invasive tissue characterization, including new sequences such as T1/T2 mapping, offered a powerful tool for differential diagnosis with other forms of left ventricular hypertrophy. In patients with confirmed diagnosis of FD, CMR is the most sensitive non-invasive technique for early detection of cardiac involvement and it provides new insight into the evolution of cardiac damage, including gender-specific features. Finally, CMR multiparametric detection of subtle changes in cardiac morphology, function and tissue composition is potentially useful for monitoring the efficacy of specific treatment over time. This paper aims to provide a comprehensive review of current knowledge regarding the application of CMR in FD cardiac involvement and its clinical implication.

Published
2022

12. Trabecular complexity as an early marker of cardiac involvement in Fabry disease

Author

Camporeale, A, Moroni, F, Lazzeroni, D, Garibaldi, S, Pieroni, M, Pieruzzi, F, Lusardi, P, Spada, M, Mignani, R, Burlina, A, Carubbi, F, Econimo, L, Battaglia, Y, Graziani, F, Pica, S, Chow, K, Camici, P, Lombardi, M, Camporeale, Antonia, Moroni, Francesco, Lazzeroni, Davide, Garibaldi, Silvia, Pieroni, Maurizio, Pieruzzi, Federico, Lusardi, Paola, Spada, Marco, Mignani, Renzo, Burlina, Alessandro, Carubbi, Francesca, Econimo, Laura, Battaglia, Yuri, Graziani, Francesca, Pica, Silvia, Chow, Kelvin, Camici, Paolo G, Lombardi, Massimo, Camporeale, A, Moroni, F, Lazzeroni, D, Garibaldi, S, Pieroni, M, Pieruzzi, F, Lusardi, P, Spada, M, Mignani, R, Burlina, A, Carubbi, F, Econimo, L, Battaglia, Y, Graziani, F, Pica, S, Chow, K, Camici, P, Lombardi, M, Camporeale, Antonia, Moroni, Francesco, Lazzeroni, Davide, Garibaldi, Silvia, Pieroni, Maurizio, Pieruzzi, Federico, Lusardi, Paola, Spada, Marco, Mignani, Renzo, Burlina, Alessandro, Carubbi, Francesca, Econimo, Laura, Battaglia, Yuri, Graziani, Francesca, Pica, Silvia, Chow, Kelvin, Camici, Paolo G, and Lombardi, Massimo

Abstract

AIMS: Fabry cardiomyopathy is characterized by glycosphingolipid storage and increased myocardial trabeculation has also been demonstrated. This study aimed to explore by cardiac magnetic resonance whether myocardial trabecular complexity, quantified by endocardial border fractal analysis, tracks phenotype evolution in Fabry cardiomyopathy. METHODS AND RESULTS: Study population included 20 healthy controls (12 males, age 32±9) and 45 Fabry patients divided into three groups: 15 left ventricular hypertrophy (LVH)-negative patients with normal T1 (5 males, age 28±13; Group 1); 15 LVH-negative patients with low T1 (9 males, age 33±9.6; Group 2); 15 LVH-positive patients (11 males, age 53.5±9.6; Group 3). Trabecular fractal dimensions (Dfs) (total, basal, mid-ventricular, and apical) were evaluated on cine images. Total Df was higher in all Fabry groups compared to controls, gradually increasing from controls to Group 3 (1.27±0.02 controls vs. 1.29±0.02 Group 1 vs. 1.30±0.02 Group 2 vs. 1.34±0.02 Group 3; P<0.001). Group 3 showed significantly higher values of all Dfs compared to the other Groups. Both basal and total Dfs were significantly higher in Group 1 compared with controls (basal: 1.30±0.03 vs. 1.26±0.04, P =0.010; total: 1.29±0.02 vs. 1.27±0.02, P=0.044). Total Df showed significant correlations with: (i) T1 value (r=-0.569; P<0.001); (ii) LV mass (r=0.664, P<0.001); (iii) trabecular mass (r=0.676; P <0.001); (iv) Mainz Severity Score Index (r=0.638; P<0.001). CONCLUSION: Fabry cardiomyopathy is characterized by a progressive increase in Df of endocardial trabeculae together with shortening of T1 values. Myocardial trabeculation is increased before the presence of detectable sphingolipid storage, thus representing an early sign of cardiac involvement. Published on behalf of the European Society of Cardiology.

Published
2022

14. Predictors of Clinical Evolution in Prehypertrophic Fabry Disease

Author

Camporeale, A, Pieroni, M, Pieruzzi, F, Lusardi, P, Pica, S, Spada, M, Mignani, R, Burlina, A, Bandera, F, Guazzi, M, Graziani, F, Crea, F, Greiser, A, Boveri, S, Ambrogi, F, Lombardi, M, Camporeale A., Pieroni M., Pieruzzi F., Lusardi P., Pica S., Spada M., Mignani R., Burlina A., Bandera F., Guazzi M., Graziani F., Crea F., Greiser A., Boveri S., Ambrogi F., Lombardi M., Camporeale, A, Pieroni, M, Pieruzzi, F, Lusardi, P, Pica, S, Spada, M, Mignani, R, Burlina, A, Bandera, F, Guazzi, M, Graziani, F, Crea, F, Greiser, A, Boveri, S, Ambrogi, F, Lombardi, M, Camporeale A., Pieroni M., Pieruzzi F., Lusardi P., Pica S., Spada M., Mignani R., Burlina A., Bandera F., Guazzi M., Graziani F., Crea F., Greiser A., Boveri S., Ambrogi F., and Lombardi M.

Abstract

BACKGROUND: In prehypertrophic Fabry disease, low myocardial T1 values, reflecting sphingolipid storage, are associated with early structural and ECG changes. The correlations between T1 values and functional parameters have not been explored. Furthermore, the potential prognostic role of T1 in predicting disease worsening is still unknown. METHODS: ECG, 2D echocardiography, cardiopulmonary test, and cardiac magnetic resonance were performed in 44 Fabry patients without left ventricular hypertrophy (35.7±14.5 years, 68.2% females). After a 12-month follow-up, clinical stability was evaluated using Fabry Stabilization Index. RESULTS: At baseline, T1 values showed a negative correlation with left ventricular mass ( r=-0.79; P<0.0001), maximum wall thickness ( r=-0.79; P<0.0001), Sokolow-Lyon Index ( r=-0.54; P<0.0001), left atrial volume ( r=-0.49; P<0.0002), and Mainz Severity Score Index ( r=-0.61; P<0.0001). No significant differences in systo-diastolic function and exercise capacity were observed comparing normal and low T1 Fabry patients. Arrhythmias were reported in 2 females with low T1 and late gadolinium enhancement. Five patients (40.0±12.4 years, 2 females) showed clinical worsening (Fabry Stabilization Index >20%) at follow-up. Higher left ventricular wall thickness (odds ratio, 2.61; CI, 1.04-6.57; P=0.04), left atrial volume (odds ratio, 1.24; CI, 1.02-1.51; P=0.03), and lower T1 values (odds ratio, 0.98; CI, 0.96-0.99; P=0.03) at baseline were independently associated with clinical worsening at follow-up. CONCLUSIONS: In prehypertrophic Fabry disease, low T1 values correlate with early electrocardiographic, morphological cardiac changes, and worsening of global disease severity but are not associated with functional abnormalities. The presence of low T1 values is a risk factor for disease worsening, thus representing a potential new tool in prognostic stratification and therapeutic approach.

Published
2019

15. Late gadolinium enhancement predicts adverse clinical outcome in patients with mitral valve prolapse/mitral annulus disjunction

Author

Figliozzi, S, primary, Georgiopoulos, G, additional, Aquaro, GD, additional, Bauer, K, additional, Monti, L, additional, Filomena, D, additional, Pica, S, additional, Censi, S, additional, Lopez, P, additional, Quattrocchi, G, additional, Servato, ML, additional, Schwitter, J, additional, Andreini, D, additional, Bogaert, J, additional, and Masci, PG, additional

Published
2021
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19. Interaction of stroke volume and myocardial phenotype in patients with severe aortic stenosis referred for intervention: outcome data from the BSCMR AS700 study

Author

Thornton, GD, primary, Musa, TA, additional, Rigolli, M, additional, Loudon, M, additional, Chin, C, additional, Pica, S, additional, Malley, T, additional, Foley, JRJ, additional, Vassiliou, VS, additional, Davies, RH, additional, Captur, G, additional, Dobson, LE, additional, Singh, A, additional, and Treibel, TA, additional

Published
2021
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20. Poster session: Aortic stenosis

Author

Pica, S, Ghio, S, Raineri, C, Camporotondo, R, Rordorf, R, Previtali, M, Landolina, ME, Valentini, A, Turco, A, and Visconti, LO

Published
2012

24. Prognostic Stratification of Patients With ST-Segment-Elevation Myocardial Infarction (PROSPECT): A Cardiac Magnetic Resonance Study

Author

Pontone, G, Guaricci, A, Andreini, D, Ferro, G, Guglielmo, M, Baggiano, A, Fusini, L, Muscogiuri, G, Lorenzoni, V, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Carità, P, Verdecchia, M, Pica, S, Fazzari, F, Cosentino, N, Marenzi, G, Rabbat, M, Agostoni, P, Bartorelli, A, Pepi, M, Masci, P, Pontone G, Guaricci AI, Andreini D, Ferro G, Guglielmo M, Baggiano A, Fusini L, Muscogiuri G, Lorenzoni V, Mushtaq S, Conte E, Annoni A, Formenti A, Mancini ME, Carità P, Verdecchia M, Pica S, Fazzari F, Cosentino N, Marenzi G, Rabbat MG, Agostoni P, Bartorelli AL, Pepi M, Masci PG., Pontone, G, Guaricci, A, Andreini, D, Ferro, G, Guglielmo, M, Baggiano, A, Fusini, L, Muscogiuri, G, Lorenzoni, V, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Carità, P, Verdecchia, M, Pica, S, Fazzari, F, Cosentino, N, Marenzi, G, Rabbat, M, Agostoni, P, Bartorelli, A, Pepi, M, Masci, P, Pontone G, Guaricci AI, Andreini D, Ferro G, Guglielmo M, Baggiano A, Fusini L, Muscogiuri G, Lorenzoni V, Mushtaq S, Conte E, Annoni A, Formenti A, Mancini ME, Carità P, Verdecchia M, Pica S, Fazzari F, Cosentino N, Marenzi G, Rabbat MG, Agostoni P, Bartorelli AL, Pepi M, and Masci PG.

Abstract

Background-Cardiac magnetic resonance (CMR) is a robust tool to evaluate left ventricular ejection fraction (LVEF), myocardial salvage index, microvascular obstruction, and myocardial hemorrhage in patients with ST-segment-elevation myocardial infarction. We evaluated the additional prognostic benefit of a CMR score over standard prognostic stratification with global registry of acute coronary events (GRACE) score and transthoracic echocardiography LVEF measurement. Methods and Results-Two hundred nine consecutive patients with ST-segment-elevation myocardial infarction (age, 61.4±11.4 years; 162 men) underwent transthoracic echocardiography and CMR after succesful primary percutaneous coronary intervention. Major adverse cardiac events (MACE) were assessed at a mean follow-up of 2.5±1.2 years. MACE occurred in 24 (12%) patients who at baseline showed higher GRACE risk score (P<0.01), lower LVEF with both transthoracic echocardiography and CMR, lower myocardial salvage index, and higher per-patient myocardial hemorrhage and microvascular obstruction prevalence and amount as compared with patients without MACE (P<0.01). The best cut-off values of transthoracic echocardiography-LVEF, CMR-LVEF, myocardial salvage index, and microvascular obstruction to predict MACE were 46.7%, 37.5%, 0.4, and 2.6% of left ventricular mass, respectively. Accordingly, a weighted CMR score, including the following 4 variables (CMR-LVEF, myocardial salvage index, microvascular obstruction, and myocardial hemorrhage), with a maximum of 17 points was calculated and included in the multivariable analysis showing that only CMR score (hazard ratio, 1.867 per SD increase [1.311-2.658]; P<0.001) was independently associated with MACE with the highest net reclassification improvement as compared to GRACE score and transthoracic echocardiography-LVEF measurement. Conclusions-CMR score provides incremental prognostic stratification as compared with GRACE score and transthoracic echocardiogr

Published
2017

26. 480Right ventricular dysfunction is associated with late mortality in severe aortic stenosis: results from a multi-centre outcome study in patients undergoing aortic valve replacement

Author

Rigolli, M, primary, Musa, T A, additional, Treibel, T A, additional, Loudon, M, additional, Vassiliou, V S, additional, Captur, G, additional, Singh, A, additional, Chin, C, additional, Dobson, L E, additional, Pica, S, additional, Malley, T, additional, Foley, J R J, additional, Bijsterveld, P, additional, Law, G R, additional, and Myerson, S G, additional

Published
2019
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27. 515Right ventricular dysfunction detected by cardiovascular magnetic resonance is associated with late mortality in severe aortic stenosis

Author

Rigolli, M, primary, Musa, T A, additional, Treibel, T A, additional, Loudon, M, additional, Vassiliou, V S, additional, Captur, G, additional, Singh, A, additional, Chin, C, additional, Bijsterveld, P, additional, Dobson, L E, additional, Pica, S, additional, Malley, T, additional, Foley, J R J, additional, Law, G R, additional, and Myerson, S G, additional

Published
2019
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28. P147Reliability of single breath hold three-dimensional cine kat-ARC for the assessment of biventricular dimensions and function

Author

Muscogiuri, G, primary, Gatti, M, additional, Dell"aversana, S, additional, Pica, S, additional, Andreini, D, additional, Guaricci, A I, additional, Guglielmo, M, additional, Baggiano, A, additional, Mushtaq, S, additional, Conte, E, additional, Gripari, P, additional, Annoni, A, additional, Rabbat, M G, additional, Pepi, M, additional, and Pontone, G, additional

Published
2019
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30. 5234D flow CMR for diastolic function assessment in cardiac amyloidosis

Author

Pica, S, primary, Piatti, F, additional, Milani, P, additional, Mussinelli, R, additional, Foli, A, additional, Basset, M, additional, Camporeale, A, additional, Geppert, C, additional, Giese, D, additional, Chow, K, additional, Perlini, S, additional, Merlini, G, additional, Palladini, G, additional, and Lombardi, M, additional

Published
2019
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32. 251Predictors of clinical evolution in prehypertrophic Fabry Disease

Author

Camporeale, A, primary, Pieroni, M, additional, Pieruzzi, F, additional, Lusardi, P, additional, Pica, S, additional, Spada, M, additional, Mignani, R, additional, Burlina, A, additional, Bandera, F, additional, Guazzi, M, additional, Graziani, F, additional, Chow, K, additional, Boveri, S, additional, Ambrogi, F, additional, and Lombardi, M, additional

Published
2019
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33. Optimal intercooler layout arrangement for Formula 1 racing engines

Author

PIANCASTELLI, LUCA, FRIZZIERO, LEONARDO, DONNICI, GIAMPIERO, Pica, S., Piancastelli, L., Frizziero, L., Pica, S., and Donnici, G.

Subjects
Turbocharger, Intercooler, Compressor, Formula 1, ERS, Turbine
Abstract

This paper demonstrates that efficiency and torque output of the actual Formula 1 power units depends mostly on the turbocharger (TC) efficiency. Compressor and turbine off-design efficiency and turbine energy recovery capability should be maximized to maximize the torque to fuel ratio. Since larger TCs increase turbolag, a new layout for the intercooler is proposed in this paper. This solution reduces turbolag and make it possible to focus on the TC efficiency as a thermal machine. In fact, not only the TC design choices can radically alter the efficiency of the TC itself, but also influence the efficiency of the ICE and of the MGU (Motor Generator Units). Energy evaluation of the TC readily exploits the concept. © 2006-2016 Asian Research Publishing Network (ARPN). All rights reserved.

Published
2016

34. High altitude operations with piston engines powerplant design optimization part III: The diffuser critical design

Author

PIANCASTELLI, LUCA, DONNICI, GIAMPIERO, Pica, S, Piancastelli, L., Pica, S, ., and Donnici, G

Subjects
Optimization, UAV, Diffuser, HALE, Meredith effect, Cooling
Abstract

Low BSFC (Brake Specific Fuel Consumption) and flat-altitude-rating make piston engines ideal choice for subsonic flight at altitudes up to 20, 000m-65, 000ft. These propulsion systems are more complex than traditional applications that are normally limited to 5, 000-7, 000m (16, 000-23, 000ft). In fact, the air propulsion (propeller or fan), the air intake and the cooling system take part have huge volumes. Therefore, their design influences vehicle aerodynamics as a whole. The cooling system is an integral part of aircraft design. As assessed from WWII design heritage, the cooling duct can be a static subsonic ramjet: the Meredith cooling duct. At high altitudes, the Meredith duct air is taken from highpressure areas into an alternate, extremely optimized, path. This path should end with a nozzle in a low pressure, high turbulence area of the aerial vehicle. In subsonic ramjet cooling ducts, the "static compressor" or diffuser is the most critical part. In fact the maximum compression ratio is below 1.5. Its efficiency highly influences the total thrust and the cooling efficacy of the duct. The Meredith duct should be embedded in the fuselage or in the wing to avoid excessive external drag. Only the air intake is positioned outside. In propeller systems, the intake is positioned in the lower part of the aircraft at about 2/3 of the wing chord, where the pressure reaches its maximum. In propeller systems, the high altitude engine intake can be positioned at the end of diffuser to increase the engine boost. In this way the turbomachinery mass and volume is reduced and the power to mass ratio of the propulsion system is increased. In fan systems, higher pressure is present inside the fan duct. In this paper, the preliminary design of the cooling duct is introduced. However, a CFD/wind tunnel optimization is strictly necessary to achieve a fully effective system. In any case, the requirements of low weight, high reliability and long endurance HALE (High Altitude Long Endurance) UAVs (Unmanned Aerial Vehicle) requires further work on this specific subject.

Published
2016

35. High altitude operations with piston engines powerplant design optimization part II: Turbo-charging, turbo matching, efficiency and serial arrangement optimization

Author

PIANCASTELLI, LUCA, DONNICI, GIAMPIERO, Pica, S., Piancastelli, L, Donnici, G, and Pica, S

Subjects
Optimization, Turbocharger, UAV, HALE, Propulsion, Serial cascade arrangement
Abstract

Low BSFC (Brake Specific Fuel Consumption) and flat-altitude-rating make piston engines ideal choice for altitudes up to 20,000m-65,000ft. These propulsion systems are more complex than traditional applications that are normally limited to 5,000-7,000m (16,000-23,000ft). In fact, the air propulsion (propeller or fan), the air intake, the fuel system, the turbocharging, the exhaust and the cooling system take part to the design optimization process. An integrated design is strictly necessary. At high altitudes, the intake air is taken from high-pressure areas into an alternate, extremely optimized, path. In propeller systems, a diffuser is usually positioned in the lower part of the aircraft. It converts kinetic energy into pressure. In fan systems, a little amount of "high pressure" air is taken from the high-pressure area of the fan. In lower power units, automotive-derived turbochargers can achieve the required pressure ratio. However, this option is limited by the maximum amount of volumetric flow rate. Moreover, automotive turbocharger housings have to be redesigned to use low-weight inconel alloys instead of heavier cast-iron. A complete redesign of the high pressure turbocharger (the unit closer to the engine manifold) can achieve pressure ratios from 8:1 to 10:1. This expensive process increases the power to mass ratio of the propulsion system. For higher power rating over about 200 kW axial compressorturbine assemblies derived from small turboshafts can be used as a turbocharging unit. In this case the burner is substituted by the piston engine. Especially for diesel engines, the advantage lies in the efficiency (BSFC). In fact, the maximum temperature reached in the diesel combustion chamber is about 4200K and the air flow is much lower than traditional turboshafts. Hybrid and turbocompound solutions are also possible. The exhaust and the intake of the piston engine have to be redesigned. However, the requirements of low weight, high reliability and long endurance HALE (High Altitude Long Endurance) UAVs (Unmanned Aerial Vehicle) requires further work on this specific subject.

Published
2016

37. Intraoperative transfusion practices in Europe

Author

Meier, J., Filipescu, D., Kozek Langenecker, S., Llau Pitarch, J., Mallett, S., Martus, P., Matot, I., ETPOS collaborators: Accurso, G., Ahrens, N., Akan, M., Åkeröy, K., Aksoy, O., Alanoğlu, Z., Alfredo, M., Alkis, N., Almeida, V., Alousi, M., Alves, C., Amaral, J., Ambrosi, X., Ana, I., Anastase, D., Andersson, M., Andreou, A., Anthopoulos, G., Apanaviciute, D., Arbelaez, A., Arcade, A., Arion Balescu, C., Arun, O., Azenha, M., Bacalbasa, N., Baeten, W., Balandin, A., Barquero López, M., Barsan, V., Bascuas, B., Basora, M., Baumann, H., Bayer, A., Bell, A., Belmonte Cuenca, J., Bengisun, Z., Bento, C., Beran, M., Bermudez Lopez, M., Bernardino, A., Berthelsen, K., Bigat, Z., Bilshiene, D., Bilska, M., Bisbe Vives, E., Biscioni, T., Björn, H., Blom, T., Bogdan Prodan, A., Bogdanovic Dvorscak, M., Boisson, M., Bolten, J., Bona, F., Borg, F., Boros, C., Borys, M., Boveroux, P., Boztug Uz, N., Brettner, F., Brisard, L., Britta de, W., Browne, G., Budow, K., Buerkle, H., Buggy, D., Cain, A., Calancea, E., Calarasu, F., Calder, V., Camci, A., Campiglia, L., Campos, B., Camps, A., Carlos, D., Carreira, C., Carrilho, A., Carvalho, P., Cassinello, C., Cattan, A., Cenni, L., Cerny, V., Ceyda Meço, B., Chesov, I., Chishti, A., Chupin, A., Cikova, A., Cindea, I., Cintula, D., Ciobanasu, R., Clements, D., Cobiletchi, S., Coburn, M., Coghlan, L., Collyer, T., Copotoiu, S., Copotoiu, R., Corneci, D., CORTEGIANI, Andrea, Coskunfirat, O., Costea, D., Czuczwar, M., Davies, K., De Baerdemaeker, L., De Hert, S., Debernardi, F., Decagny, S., Deger Coskunfirat, N., Diana, T., Diana, G., Dias, S., Dickinson, M., Dobisova, A., Dragan, A., Droc, G., Duarte, S., Dunk, N., Ekelund, K., Ekmekçi, P., Elena, C., Ellimah, T., Espie, L., Everett, L., Ferguson, A., Fernandes, M., Fernández, J., Ferner, M., Ferreira, D., Ferrie, R., Flassikova, Z., Fleischer, A., Font, A., Galkova, K., Garcia, I., Garner, M., Gasenkampf, A., Gelmanas, A., Gherghina, V., Gilsanz, F., Giokas, G., Goebel, U., Gomes, P., Gonçalves Aguiar, J., Gonzalez Monzon, V., Gottschalk, A., Gouraud, J., Gramigni, E., Grintescu, I., Grynyuk, A., Grytsan, A., Guasch, E., Gustin, D., Hans, G., Harazim, H., Hervig, T., Hidalgo, F., Higham, C., Hirschauer, N., Hoeft, A., Innerhofer, P., Innerhofer Pompernigg, N., Jacobs, S., Jakobs, N., Jamaer, L., James, S., Jawad, M., Jesus, J., Jhanji, S., Jipa Lavina, N., Jokinen, J., Jovanovic, G., Jubera, M., Kahn, D., Karjagin, J., Kasnik, D., Katsanoulas, K., Kelle, H., Kelleher, M., Kessler, F., Kirigin, B., Kiskira, O., Kivik, P., Klimi, P., Klučka, J., Koers, L., Kontrimaviciut, E., Koopman van Gemert, A., Korfiotis, D., Kosinová, M., Koursoumi, E., Kranke, P., Kresic, M., Krobot, R., Kropman, L., Kulikov, A., Kvolik, S., Kvrgic, I., Kyttari, A., Lagarto, F., Lance, M., Laufenberg, R., Lauwick, S., Lecoq, J., Leech, L., Lidzborski, L., Liliana, H., Linda, F., Lopes, A., Lopez, L., Lopez Alvarez, A., Lorenzi, I., Lorre, G., Lucian, H., Lupis, T., Lupu, M., Macas, A., Macedo, A., Maggi, G., Mallor, T., Manoleli, A., Manolescu, R., Manrique, S., Maquoi, I., Marios Konstantinos, T., Markovic Bozic, J., Markus, W., Marques, M., Martinez, R., Martinez, E., Martínez, E., Martinho, H., Martins, D., Martires, E., Matias, F., Mauff, S., Meale, P., Merz, H., Meybohm, P., Militello, M., Mincu, N., Miranda, M., Mirea, L., Moghildea, V., Moise, A., Molano Diaz, P., Moltó, L., Monedero, P., Moral, V., Moreira, Z., Moret, E., Mulders, F., Munteanu, A., Nadia Diana, K., Nair, A., Neskovic, V., Ninane, V., Nitu, D., Oberhofer, D., Odeberg Wernerman, S., Oganjan, J., Omur, D., Orallo Moran, M., Ozkardesler, S., Pacasová, R., Paklar, N., Pandazi, A., Papaspyros, F., Paraskeuopoulos, T., Parente, S., Paunescu, M., Pavičić Šarić, J., Pereira, F., Pereira, E., Pereira, L., Perry, C., Petri, A., Petrovic, U., Pica, S., Pinheiro, F., Pinto, J., Pinto, F., Piwowarczyk, P., Platteau, S., Poeira, R., Popescu, R., Popica, G., Poredos, P., Prasser, C., Preckel, B., Prospiech, A., Pujol, R., Raimundo, A., RAINERI, Santi Maurizio, Rakic, D., Ramadan, M., Ramazanoğlu, A., Rantis, A., Raquel, F., Rätsep, I., Real, C., Reikvam, T., Reis, L., Rigal, J., Rohner, A., Rokk, A., Roman Fernandez, A., Rosenberger, P., Rossaint, R., Rozec, B., Rudolph, T., Saeed, Y., Safonov, S., Saka, E., Samama, C., Sánchez López, Ó., Sanchez Perez, D., Sanchez Sanchez, Y., Sandeep, V., Sandu, M., Sanlı, S., Saraiva, A., Scarlatescu, E., Schiraldi, R., Schittek, G., Schnitter, B., Schuster, M., Seco, C., Selvi, O., Senard, M., Serra, S., Serrano, H., Shmigelsky, A., Silva, L., Simeson, K., Singh, R., Sipylaite, J., Skitek, K., Skok, I., Smékalová, O., Smirnova, N., Sofia, M., Soler Pedrola, M., Söndergaard, S., Sõrmus, A., Sørvoll, I., Soumelidis, C., Spindler Yesel, A., Stefan, M., Stevanovic, A., Stevikova, J., Stivan, S., Štourač, P., Striteska, J., Strys, L., Suljevic, I., Tania, M., Tareco, G., Tena, B., Theodoraki, K., Tifrea, M., Tikuisis, R., Tolós, R., Tomasi, R., Tomescu, D., Tomkute, G., Tormos, P., Trepenaitis, D., Troyan, G., Unic Stojanovic, D., Unterrainer, A., Uranjek, J., Valsamidis, D., van Dasselaar, N., Van Limmen, J., van Noord, P., van Poorten, J., Vanderlaenen, M., Varela Garcia, O., Velasco, A., Veljovic, M., Vera Bella, J., Vercauteren, M., Verdouw, B., Verenkin, V., Veselovsky, T., Vieira, H., Villar, T., Visnja, I., Voje, M., von Dossow Hanfstingl, V., Von Langen, D., Vorotyntsev, S., Vujanovič, V., Vukovic, R., Watt, P., Werner, E., Wernerman, J., Wittmann, M., Wright, M., Wunder, C., Wyffels, P., Yakymenko, Y., Yıldırım, Ç., Yılmaz, H., Zacharowski, K., Záhorec, R., Zarif, M., Zielinska Skitek, E., Zsisku, L., Selçuk Üniversitesi, Meier, J., Filipescu, D., Kozek-Langenecker, S., Llau Pitarch, J., Mallett, S., Martus, P., Matot, I., ETPOS collaborators: Accurso, G., Ahrens, N., Akan, M., Åkeröy, K., Aksoy, O., Alanoğlu, Z., Alfredo, M., Alkis, N., Almeida, V., Alousi, M., Alves, C., Amaral, J., Ambrosi, X., Ana, I., Anastase, D., Andersson, M., Andreou, A., Anthopoulos, G., Apanaviciute, D., Arbelaez, A., Arcade, A., Arion-Balescu, C., Arun, O., Azenha, M., Bacalbasa, N., Baeten, W., Balandin, A., Barquero López, M., Barsan, V., Bascuas, B., Basora, M., Baumann, H., Bayer, A., Bell, A., Belmonte Cuenca, J., Bengisun, Z., Bento, C., Beran, M., Bermudez Lopez, M., Bernardino, A., Berthelsen, K., Bigat, Z., Bilshiene, D., Bilska, M., Bisbe Vives, E., Biscioni, T., Björn, H., Blom, T., Bogdan Prodan, A., Bogdanovic Dvorscak, M., Boisson, M., Bolten, J., Bona, F., Borg, F., Boros, C., Borys, M., Boveroux, P., Boztug Uz, N., Brettner, F., Brisard, L., Britta de, W., Browne, G., Budow, K., Buerkle, H., Buggy, D., Cain, A., Calancea, E., Calarasu, F., Calder, V., Camci, A., Campiglia, L., Campos, B., Camps, A., Carlos, D., Carreira, C., Carrilho, A., Carvalho, P., Cassinello, C., Cattan, A., Cenni, L., Cerny, V., Ceyda Meço, B., Chesov, I., Chishti, A., Chupin, A., Cikova, A., Cindea, I., Cintula, D., Ciobanasu, R., Clements, D., Cobiletchi, S., Coburn, M., Coghlan, L., Collyer, T., Copotoiu, S., Copotoiu, R., Corneci, D., Cortegiani, A., Coskunfirat, O., Costea, D., Czuczwar, M., Davies, K., De Baerdemaeker, L., De Hert, S., Debernardi, F., Decagny, S., Deger Coskunfirat, N., Diana, T., Diana, G., Dias, S., Dickinson, M., Dobisova, A., Dragan, A., Droc, G., Duarte, S., Dunk, N., Ekelund, K., Ekmekçi, P., Elena, C., Ellimah, T., Espie, L., Everett, L., Ferguson, A., Fernandes, M., Fernández, J., Ferner, M., Ferreira, D., Ferrie, R., Flassikova, Z., Fleischer, A., Font, A., Galkova, K., Garcia, I., Garner, M., Gasenkampf, A., Gelmanas, A., Gherghina, V., Gilsanz, F., Giokas, G., Goebel, U., Gomes, P., Gonçalves Aguiar, J., Gonzalez Monzon, V., Gottschalk, A., Gouraud, J., Gramigni, E., Grintescu, I., Grynyuk, A., Grytsan, A., Guasch, E., Gustin, D., Hans, G., Harazim, H., Hervig, T., Hidalgo, F., Higham, C., Hirschauer, N., Hoeft, A., Innerhofer, P., Innerhofer-Pompernigg, N., Jacobs, S., Jakobs, N., Jamaer, L., James, S., Jawad, M., Jesus, J., Jhanji, S., Jipa Lavina, N., Jokinen, J., Jovanovic, G., Jubera, M., Kahn, D., Karjagin, J., Kasnik, D., Katsanoulas, K., Kelle, H., Kelleher, M., Kessler, F., Kirigin, B., Kiskira, O., Kivik, P., Klimi, P., Klučka, J., Koers, L., Kontrimaviciut, E., Koopman-van Gemert, A., Korfiotis, D., Kosinová, M., Koursoumi, E., Kozek Langenecker, S., Kranke, P., Kresic, M., Krobot, R., Kropman, L., Kulikov, A., Kvolik, S., Kvrgic, I., Kyttari, A., Lagarto, F., Lance, M., Laufenberg, R., Lauwick, S., Lecoq, J., Leech, L., Lidzborski, L., Liliana, H., Linda, F., Lopes, A., Lopez, L., Lopez Alvarez, A., Lorenzi, I., Lorre, G., Lucian, H., Lupis, T., Lupu, M., Macas, A., Macedo, A., Maggi, G., Mallor, T., Manoleli, A., Manolescu, R., Manrique, S., Maquoi, I., Marios-Konstantinos, T., Markovic Bozic, J., Markus, W., Marques, M., Martinez, R., Martinez, E., Martínez, E., Martinho, H., Martins, D., Martires, E., Matias, F., Mauff, S., Meale, P., Merz, H., Meybohm, P., Militello, M., Mincu, N., Miranda, M., Mirea, L., Moghildea, V., Moise, A., Molano Diaz, P., Moltó, L., Monedero, P., Moral, V., Moreira, Z., Moret, E., Mulders, F., Munteanu, A., Nadia Diana, K., Nair, A., Neskovic, V., Ninane, V., Nitu, D., Oberhofer, D., Odeberg-Wernerman, S., Oganjan, J., Omur, D., Orallo Moran, M., Ozkardesler, S., Pacasová, R., Paklar, N., Pandazi, A., Papaspyros, F., Paraskeuopoulos, T., Parente, S., Paunescu, M., Pavičić Šarić, J., Pereira, F., Pereira, E., Pereira, L., Perry, C., Petri, A., Petrovic, U., Pica, S., Pinheiro, F., Pinto, J., Pinto, F., Piwowarczyk, P., Platteau, S., Poeira, R., Popescu, R., Popica, G., Poredos, P., Prasser, C., Preckel, B., Prospiech, A., Pujol, R., Raimundo, A., Raineri, S., Rakic, D., Ramadan, M., Ramazanoğlu, A., Rantis, A., Raquel, F., Rätsep, I., Real, C., Reikvam, T., Reis, L., Rigal, J., Rohner, A., Rokk, A., Roman Fernandez, A., Rosenberger, P., Rossaint, R., Rozec, B., Rudolph, T., Saeed, Y., Safonov, S., Saka, E., Samama, C., Sánchez López, Ó., Sanchez Perez, D., Sanchez Sanchez, Y., Sandeep, V., Sandu, M., Sanlı, S., Saraiva, A., Scarlatescu, E., Schiraldi, R., Schittek, G., Schnitter, B., Schuster, M., Seco, C., Selvi, O., Senard, M., Serra, S., Serrano, H., Shmigelsky, A., Silva, L., Simeson, K., Singh, R., Sipylaite, J., Skitek, K., Skok, I., Smékalová, O., Smirnova, N., Sofia, M., Soler Pedrola, M., Söndergaard, S., Sõrmus, A., Sørvoll, I., Soumelidis, C., Spindler Yesel, A., Stefan, M., Stevanovic, A., Stevikova, J., Stivan, S., Štourač, P., Striteska, J., Strys, L., Suljevic, I., Tania, M., Tareco, G., Tena, B., Theodoraki, K., Tifrea, M., Tikuisis, R., Tolós, R., Tomasi, R., Tomescu, D., Tomkute, G., Tormos, P., Trepenaitis, D., Troyan, G., Unic-Stojanovic, D., Unterrainer, A., Uranjek, J., Valsamidis, D., van Dasselaar, N., Van Limmen, J., van Noord, P., van Poorten, J., Vanderlaenen, M., Varela Garcia, O., Velasco, A., Veljovic, M., Vera Bella, J., Vercauteren, M., Verdouw, B., Verenkin, V., Veselovsky, T., Vieira, H., Villar, T., Visnja, I., Voje, M., von Dossow-Hanfstingl, V., Von Langen, D., Vorotyntsev, S., Vujanovič, V., Vukovic, R., Watt, P., Werner, E., Wernerman, J., Wittmann, M., Wright, M., Wunder, C., Wyffels, P., Yakymenko, Y., Yıldırım, Ç., Yılmaz, H., Zacharowski, K., Záhorec, R., Zarif, M., Zielinska-Skitek, E., Zsisku, L., Anesthesiology, Graduate School, ACS - Amsterdam Cardiovascular Sciences, and AII - Amsterdam institute for Infection and Immunity

Subjects
AUSTRIAN BENCHMARK, Male, Blood transfusion, medicine.medical_treatment, 610 Medizin, anaemia, anesthesia, blood transfusion, surgery, transfusion trigger, 030204 cardiovascular system & hematology, GUIDELINES, surgery, Cohort Studies, 0302 clinical medicine, 030202 anesthesiology, Medicine and Health Sciences, Medicine, Prospective Studies, Prospective cohort study, ddc:610, Research Support, Non-U.S. Gov't, Middle Aged, Hospitals, Europe, Female, Allogeneic transfusion, Cohort study, medicine.medical_specialty, Transfusion rate, Observational Study, anesthesia, blood transfusion, ELECTIVE SURGERY, Clinical Practice, 03 medical and health sciences, Journal Article, anaemia, transfusion trigger, Humans, Blood Transfusion, Elective surgery, CHLC ANS, Intensive care medicine, Intraoperative Care, business.industry, PREOPERATIVE ANEMIA, PATIENT BLOOD MANAGEMENT, Clinical trial, Anesthesiology and Pain Medicine, Emergency medicine, business, Packed red blood cells, REQUIREMENTS
Abstract

PubMed: 26787795, Background: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. Methods: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. Results: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl-1 and increased to 9.8 (1.8) g dl-1 after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). Conclusions: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl-1), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold. © 2016 The Author. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.

Published
2016

40. These abstracts have been selected for presentation in 4 sessions throughout the meeting. Please refer to the PROGRAM for more details.

Author

Munch, F., primary, Retel, J., additional, Jeuthe, S., additional, van Rossum, B., additional, Oh-Ici, D., additional, Berger, F., additional, Kuhne, T., additional, Oschkinat, H., additional, Messroghli, D., additional, Rodriguez Palomares, J., additional, Gutierrez Garcia Moreno, L., additional, Maldonado, G., additional, Garcia, G., additional, Otaegui, I., additional, Garcia Del Blanco, B., additional, Barrabes, J., additional, Gonzalez Alujas, M., additional, Evangelista, A., additional, Garcia Dorado, D., additional, Barison, A., additional, Del Torto, A., additional, Chiappino, S., additional, Del Franco, A., additional, Pugliese, N., additional, Aquaro, G., additional, Positano, V., additional, Passino, C., additional, Emdin, M., additional, Masci, P., additional, Fischer, K., additional, Guensch, D., additional, Shie, N., additional, Friedrich, M., additional, Captur, G., additional, Zemrak, F., additional, Muthurangu, V., additional, Chunming, L., additional, Petersen, S., additional, Kawel-Boehm, N., additional, Bassett, P., additional, Elliott, P., additional, Lima, J., additional, Bluemke, D., additional, Moon, J., additional, Pontone, G., additional, Bertella, E., additional, Loguercio, M., additional, Baggiano, A., additional, Mushtaq, S., additional, Salerni, S., additional, Rossi, C., additional, Andreini, D., additional, Ucar, E., additional, Baydes, R., additional, Ngah, N., additional, Kuo, Y., additional, Dabir, D., additional, Cummins, C., additional, Higgins, D., additional, Schaeffter, T., additional, Gaddum, N., additional, Chowienczyk, P., additional, Carr-White, G., additional, Marber, M., additional, Ucar, S., additional, Reinstadler, S., additional, Klug, G., additional, Feistritzer, H., additional, Greber, K., additional, Mair, J., additional, Schocke, M., additional, Franz, W., additional, Metzler, B., additional, Moschetti, K., additional, Pilz, G., additional, Wasserfallen, J., additional, Lombardi, M., additional, Korosoglou, G., additional, Van Rossum, A., additional, Bruder, O., additional, Mahrholdt, H., additional, Schwitter, J., additional, Ferreira Gonzalez, I., additional, Pineda, V., additional, Ruiz Salmeron, R., additional, San Roman, A., additional, Fernandez Aviles, F., additional, Winkler, S., additional, Allison, T., additional, Conn, H., additional, Bandettini, P., additional, Shanbhag, S., additional, Kellman, P., additional, Hsu, L., additional, Arai, A., additional, Pernter, B., additional, Pica, S., additional, Sado, D., additional, Maestrini, V., additional, Fontana, M., additional, White, S., additional, Treibel, T., additional, Anderson, S., additional, Piechnik, S., additional, Robson, M., additional, Lachmann, R., additional, Murphy, E., additional, Mehta, A., additional, Hughes, D., additional, Ferreira, V., additional, Dall'Armellina, E., additional, Karamitsos, T., additional, Francis, J., additional, Choudhury, R., additional, Banning, A., additional, Channon, K., additional, Kharbanda, R., additional, Forfar, C., additional, Ormerod, O., additional, Prendergast, B., additional, Kardos, A., additional, Newton, J., additional, Neubauer, S., additional, Vergaro, G., additional, Mirizzi, G., additional, Florian, A., additional, Ludwig, A., additional, Rosch, S., additional, Sechtem, U., additional, Yilmaz, A., additional, Greulich, S., additional, Kitterer, D., additional, Latus, J., additional, Bentz, K., additional, Birkmeier, S., additional, Alscher, M., additional, Braun, N., additional, Perfetto, F., additional, Secchi, F., additional, Petrini, M., additional, Cannao, P., additional, Di Leo, G., additional, Sardanelli, F., additional, Yoshihara, H., additional, Bastiaansen, J., additional, Berthonneche, C., additional, Comment, A., additional, Gerber, B., additional, Noppe, G., additional, Marquet, N., additional, Buchlin, P., additional, Vanoverschelde, J., additional, Bertrand, L., additional, Horman, S., additional, Dorota, P., additional, Piotr, W., additional, Marek, G., additional, Almeida, A., additional, Cortez-Dias, N., additional, de Sousa, J., additional, Carpinteiro, L., additional, Magalhaes, A., additional, Silva, G., additional, Bernardes, A., additional, Pinto, F., additional, and Nunes Diogo, A., additional

Published
2014
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47. P147 Reliability of single breath hold three-dimensional cine kat-ARC for the assessment of biventricular dimensions and function.

Author

Muscogiuri, G, Gatti, M, Dell"aversana, S, Pica, S, Andreini, D, Guaricci, A I, Guglielmo, M, Baggiano, A, Mushtaq, S, Conte, E, Gripari, P, Annoni, A, Rabbat, M G, Pepi, M, and Pontone, G

Subjects
CONFERENCES & conventions, HEART physiology, HEART ventricles, MAGNETIC resonance imaging, THREE-dimensional imaging, VENTRICULAR ejection fraction
Published
2019
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