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2. ECG/echo indexes in the diagnostic approach to amyloid cardiomyopathy: A head-to-head comparison from the AC-TIVE study

Author

Pagura, L, Porcari, A, Cameli, M, Biagini, E, Canepa, M, Crotti, L, Imazio, M, Forleo, C, Pavasini, R, Limongelli, G, Perlini, S, Metra, M, Boriani, G, Emdin, M, Sinagra, G, Merlo, M, Longo, F, Rossi, M, Varrà, G, Saro, R, Dore, F, Girardi, F, Vergaro, G, Musumeci, B, Autore, C, Cappelli, F, Perfetto, F, Olivotto, I, Favale, S, Carella, M, Guaricci, A, Ciccone, M, Di Bella, G, Tomasoni, D, Rella, V, Branzi, G, Badano, L, Parati, G, Palmiero, G, Caiazza, M, Caponetti, A, Saturi, G, Labate, M, Andreis, A, Paneva, E, De Ferrari, G, Di Ienno, L, De Carli, G, Giacomin, E, Arzilli, C, Pagura L., Porcari A., Cameli M., Biagini E., Canepa M., Crotti L., Imazio M., Forleo C., Pavasini R., Limongelli G., Perlini S., Metra M., Boriani G., Emdin M., Sinagra G., Merlo M., Longo F., Rossi M., Varrà G. G., Saro R., Dore F., Girardi F., Vergaro G., Musumeci B., Autore C., Cappelli F., Perfetto F., Olivotto I., Favale S., Carella M. C., Guaricci A. I., Ciccone M. M., Di Bella G., Tomasoni D., Rella V., Branzi G., Badano L., Parati G., Palmiero G., Caiazza M., Caponetti A. G., Saturi G., Labate M. E., Andreis A., Paneva E., De Ferrari G. M., Di Ienno L., De Carli G., Giacomin E., Arzilli C., Pagura, L, Porcari, A, Cameli, M, Biagini, E, Canepa, M, Crotti, L, Imazio, M, Forleo, C, Pavasini, R, Limongelli, G, Perlini, S, Metra, M, Boriani, G, Emdin, M, Sinagra, G, Merlo, M, Longo, F, Rossi, M, Varrà, G, Saro, R, Dore, F, Girardi, F, Vergaro, G, Musumeci, B, Autore, C, Cappelli, F, Perfetto, F, Olivotto, I, Favale, S, Carella, M, Guaricci, A, Ciccone, M, Di Bella, G, Tomasoni, D, Rella, V, Branzi, G, Badano, L, Parati, G, Palmiero, G, Caiazza, M, Caponetti, A, Saturi, G, Labate, M, Andreis, A, Paneva, E, De Ferrari, G, Di Ienno, L, De Carli, G, Giacomin, E, Arzilli, C, Pagura L., Porcari A., Cameli M., Biagini E., Canepa M., Crotti L., Imazio M., Forleo C., Pavasini R., Limongelli G., Perlini S., Metra M., Boriani G., Emdin M., Sinagra G., Merlo M., Longo F., Rossi M., Varrà G. G., Saro R., Dore F., Girardi F., Vergaro G., Musumeci B., Autore C., Cappelli F., Perfetto F., Olivotto I., Favale S., Carella M. C., Guaricci A. I., Ciccone M. M., Di Bella G., Tomasoni D., Rella V., Branzi G., Badano L., Parati G., Palmiero G., Caiazza M., Caponetti A. G., Saturi G., Labate M. E., Andreis A., Paneva E., De Ferrari G. M., Di Ienno L., De Carli G., Giacomin E., and Arzilli C.

Abstract

Background and aims: The discordance between QRS voltages on electrocardiogram (ECG) and left ventricle (LV) wall thickness (LVWT) on echocardiogram (echo) is a recognized red flag (RF) of amyloid cardiomyopathy (AC) and can be measured by specific indexes. No head-to-head comparison of different ECG/echo indexes among subjects with echocardiographic suspicion of AC has yet been undertaken. The study aimed at evaluating the performance and the incremental diagnostic value of different ECG/echo indexes in this subset of patients. Methods: Electrocardiograms of subjects with LV hypertrophy, preserved ejection fraction and ≥ 1 echocardiographic RF of AC participating in the AC-TIVE study, an Italian prospective multicenter study, were independently analyzed by two cardiologists. Low QRS voltages and 8 different ECG/echo indexes were evaluated. Cohort specific cut-offs were computed. Results: Among 170 patients, 55 (32 %) were diagnosed with AC. Combination of low QRS voltages with interventricular septum ≥ 1,6 cm was the most specific (specificity 100 %, positive predictive value 100 %) ECG/echo index, while the ratio between the sum of all QRS voltages and LVWT <7,8 was the most sensitive and accurate (sensitivity 94 %, negative predictive value 97 %, accuracy 82 %). When the latter index was added to a model using easily-accessible clinical variables, the diagnostic accuracy for AC greatly increased (AUC from 0,84 to 0,95; p = 0,007). Conclusions: Among patients with non-dilated hypertrophic ventricles with normal ejection fraction and echocardiographic RF of AC, easily-measurable ECG/echo indexes, mainly when added to few clinical variables, can help the physician orient second level investigations. External validation of the results is warranted.

Published
2024

3. Mechanical load regulates the proliferation of multiple cell types in the heart

Author

Ciucci, G, primary, Colliva, A, additional, Vodret, S, additional, Texler, B, additional, Cardini, B, additional, Oberhuber, R, additional, Vuerich, R, additional, Zago, E, additional, Maglione, M, additional, Sinagra, G, additional, Giacca, M, additional, Eschenhagen, T, additional, Golino, P, additional, Loffredo, F, additional, and Zacchigna, S, additional

Published
2024
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4. SGLT2 Inhibitors in Patients with Advanced Heart Failure Awaiting Heart Transplant: Preliminary Results from The SGLT2i-HT Study

Author

Gallone, G., primary, Pidello, S., additional, Bertarelli, E., additional, Tedeschi, A., additional, Maione, D., additional, Cacioli, G., additional, Pradegan, N., additional, Tessari, C., additional, Di Nora, C., additional, Verde, A., additional, Perna, E., additional, Raineri, C., additional, Marro, M., additional, Simonato, E., additional, Breviario, F., additional, Cavallier, F., additional, Amarelli, C., additional, Turco, A., additional, Vendramin, I., additional, Gerosa, G., additional, Scelsi, L., additional, Lilla Della Monica, P., additional, Sinagra, G., additional, Garascia, A., additional, Merlo, M., additional, Rinaldi, M., additional, De Ferrari, G.M., additional, and Boffini, M., additional

Published
2024
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9. Congenital heart disease in the ESC EORP Registry of Pregnancy and Cardiac disease (ROPAC)

Author

Hall, Roger, Roos-Hesselink, Jolien, Stein, Joerg, Parsonage, William Anthony, Budts, Werner, De Backer, Julie, Grewal, Jasmin, Marelli, Ariane, Kaemmerer, Harald, Jondeau, Guillaume, Johnson, Mark, Maggioni, Aldo P., Tavazzi, Luigi, Thilen, Ulf, Elkayam, Uri, Otto, Catherine, Sliwa, Karen, Aquieri, A., Saad, A., Vega, H. Ruda, Hojman, J., Caparros, J.M., Blanco, M. Vazquez, Arstall, M., Chung, C.M., Mahadavan, G., Aldridge, E., Wittwer, M., Chow, Y.Y., Parsonage, W.A., Lust, K., Collins, N., Warner, G., Hatton, R., Gordon, A., Nyman, E., Stein, J., Donhauser, E., Gabriel, H., Bahshaliyev, A., Guliyev, F., Hasanova, I., Jahangirov, T., Gasimov, Z., Salim, A., Ahmed, C.M., Begum, F., Hoque, M.H., Mahmood, M., Islam, M.N., Haque, P.P., Banerjee, S.K., Parveen, T., Morissens, M., De Backer, J., Demulier, L., de Hosson, M., Budts, W., Beckx, M., Kozic, M., Lovric, M., Kovacevic-Preradovic, T., Chilingirova, N., Kratunkov, P., Wahab, N., McLean, S., Gordon, E., Walter, L., Marelli, A., Montesclaros, A.R., Monsalve, G., Rodriguez, C., Balthazar, F., Quintero, V., Palacio, W., Cadavid, L.A. Mejía, Ortiz, E. Munoz, Hoyos, F. Fortich, Guerrero, E. Arevalo, Ricardo, J. Gandara, Penagos, J. Velasquez, Vavera, Z., Prague, Popelova, J., Vejlstrup, N., Grønbeck, L., Johansen, M., Ersboll, A., Elrakshy, Y., Eltamawy, K., Abd-El Aziz, M. Gamal, El Nagar, A., Ebaid, H., Elenin, H. Abo, Saed, M., Farag, S., Makled, W., Sorour, K., Ashour, Z., El-Sayed, G., Meguid Mahdy, M. Abdel, Taha, N., Dardeer, A., Shabaan, M., Ali, M., Moceri, P., Duthoit, G., Gouton, M., Nizard, J., Baris, L., Cohen, S., Ladouceur, M., Khimoud, D., Iung, B., Berger, F., Olsson, A., Gembruch, U., Merz, W.M., Reinert, E., Clade, S., Kliesch, Y., Wald, C., Sinning, C., Kozlik-Feldmann, R., Blankenberg, S., Zengin-Sahm, E., Mueller, G., Hillebrand, M., Hauck, P., von Kodolitsch, Y., Zarniko, N., Baumgartner, Muenster H., Schmidt, R., Hellige, A., Tutarel, O., Kaemmerer, H., Kuschel, B., Nagdyman, N., Motz, R., Maisuradze, D., Frogoudaki, A., Iliodromitis, E., Anastasiou-Nana, M., Marousi, Triantafyllis, D., Bekiaris, G., Karvounis, H., Giannakoulas, G., Ntiloudi, D., Mouratoglou, S.A., Temesvari, A., Balint, H., Kohalmi, D., Merkely, B., Liptai, C., Nemes, A., Forster, T., Kalapos, A., Berek, K., Havasi, K., Ambrus, N., Shelke, A., Kawade, R., Patil, S., Martanto, E., Aprami, T.M., Purnomowati, A., Cool, C.J., Hasan, M., Akbar, R., Hidayat, S., Dewi, T.I., Permadi, W., Soedarsono, D.A., Ansari-Ramandi, M.M., Samiei, N., Tabib, A., Kashfi, F., Ansari-Ramandi, S., Rezaei, S., Farhan, H. Ali, Al-Hussein, A., Al-Saedi, G., Mahmood, G., Yaseen, I.F., Al-Yousuf, L., AlBayati, M., Mahmood, S., Raheem, S., AlHaidari, T., Dakhil, Z., Thornton, P., Donnelly, J., Bowen, M., Blatt, A., Elbaz-Greener, G., Shotan, A., Yalonetsky, S., Goland, S., Biener, M., Assenza, G. Egidy, Bonvicini, M., Donti, A., Bulgarelli, A., Prandstraller, D., Romeo, C., Crepaz, R., Sciatti, E., Metra, M., Orabona, R., Ali, L. Ait, Festa, P., Fesslova, V., Bonanomi, C., Calcagnino, M., Lombardi, F., Colli, A.M., Ossola, M.W., Gobbi, C., Gherbesi, E., Tondi, L., Schiavone, M., Squillace, M., Carmina, M.G., Maina, A., Macchi, C., Gollo, E., Comoglio, F.M., Montali, N., Re, P., Bordese, R., Todros, T., Donvito, V., Marra, W. Grosso, Sinagra, G., D'Agata Mottolese, B., Bobbo, M., Gesuete, V., Rakar, S., Ramani, F., Niwa, K., Mekebekova, D., Mussagaliyeva, A., Lee, T., Mirrakhimov, E., Abilova, S., Bektasheva, E., Neronova, K., Lunegova, O., Žaliūnas, R., Jonkaitienė, R., Petrauskaitė, J., Laucevicius, A., Jancauskaite, D., Lauciuviene, L., Gumbiene, L., Lankutiene, L., Glaveckaite, S., Laukyte, M., Solovjova, S., Rudiene, V., Chee, K.H., Yim, C.C.-W., Ang, H.L., Kuppusamy, R., Watson, T., Caruana, M., Estensen, M.-E., Kayani, M.G.A. Mahmood, Munir, R., Tomaszuk-Kazberuk, A., Sobkowicz, B., Przepiesc, J., Lesniak-Sobelga, A., Tomkiewicz-Pajak, L., Komar, M., Olszowska, M., Podolec, P., Wisniowska-Smialek, S., Lelonek, M., Faflik, U., Cichocka-Radwan, A., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Cruz, C., Ribeiro, V., Jovanova, S., Petrescu, V., Jurcut, R., Ginghina, C., Coman, I. Mircea, Musteata, M., Osipova, O., Golivets, T., Khamnagadaev, I., Golovchenko, O., Nagibina, A., Ropatko, I., Gaisin, I.R., Shilina, L. Valeryevna, Sharashkina, N., Shlyakhto, E., Irtyuga, O., Moiseeva, O., Karelkina, E., Zazerskaya, I., Kozlenok, A., Sukhova, I., Jovovic, L., Prokšelj, K., Koželj, M., Askar, A.O., Abdilaahi, A.A., Mohamed, M.H., Dirir, A.M., Sliwa, K., Manga, P., Pijuan-Domenech, A., Galian-Gay, L., Tornos, P., Subirana, M.T., T, M., Subirana, Oliver, J.M., Garcia-Aranda Dominguez, B., Gonzalez, I. Hernandez, Jimenez, J.F. Delgado, Subias, P. Escribano, Murga, N., Elbushi, A., Suliman, A., Jazzar, K., Murtada, M., Ahamed, N., Dellborg, M., Furenas, E., Jinesjo, M., Skoglund, K., Eriksson, P., Gilljam, T., Thilen, U., Tobler, D., Wustmann, K., Schwitz, F., Schwerzmann, M., Rutz, T., Bouchardy, J., Greutmann, M., Lopes, B.M. Santos, Meier, L., Arrigo, M., de Boer, K., Konings, T., Wajon, E., Wagenaar, L.J., Polak, P., Pieper, E.P.G., Roos-Hesselink, J., van Hagen, I., Duvekot, H., Cornette, J.M.J., De Groot, C., van Oppen, C., Sarac, L., Esen, O. Batukan, Enar, S. Catirli, Mondo, C., Ingabire, P., Nalwanga, B., Semu, T., Salih, B.T., Almahmeed, W.A.R., Wani, S., Farook, F.S. Mohamed, Ain, Al, Gerges, F., Komaranchath, A.M., Al bakshi, F., Al Mulla, A., Yusufali, A.H., Al Hatou, E.I., Bazargani, N., Hussain, F., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Money-Kyrle, A., Clifford, P., Ramrakha, P., Firoozan, S., Chaplin, J., Bowers, N., Adamson, D., Schroeder, F., Wendler, R., Hammond, S., Nihoyannopoulos, P., Norfolk, Norwich, Hall, R., Freeman, L., Veldtman, G., Kerr, J., Tellett, L., Scott, N., Bhatt, A.B., DeFaria Yeh, D., Youniss, M.A., Wood, M., Sarma, A.A., Tsiaras, S., Stefanescu, A., Duran, J.M., Stone, L., Majdalany, D.S., Chapa, J., Chintala, K., Gupta, P., Botti, J., Ting, J., Davidson, W.R., Wells, G., Sparks, D., Paruchuri, V., Marzo, K., Patel, D., Wagner, W., Ahanya, S.N., Colicchia, L., Jentink, T., Han, K., Loichinger, M., Parker, M., Longtin, C., Yetman, A., Erickson, K., Cramer, J., Tsai, S., Fletcher, B., Warta, S., Cohen, C., Lindblade, C., Puntel, R., Nagaran, K., Croft, N., Gurvitz, M., Otto, C., Talluto, C., Murphy, D., Perlroth, M.G., Ramlakhan, Karishma P., Johnson, Mark R., Lelonek, Malgorzata, Saad, Aly, Gasimov, Zaur, Sharashkina, Natalia V., Thornton, Patrick, Arstall, Margaret, and Roos-Hesselink, Jolien W.

Published
2021
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12. Uncertainties in cardiovascular risk factors: sodium-glucose cotransporter 2 inhibitors for all diabetic patients with high cardiovascular risk and in all patients with renal insufficiency, regardless of albuminuria? Glucagon-like peptide-1 receptor agonists as a weapon against obesity? [Incertezze nei fattori di rischio cardiovascolare: inibitori del cotrasportatore sodio-glucosio di tipo 2 per tutti i pazienti diabetici ad elevato rischio cardiovascolare e per tutti i pazienti con insufficienza renale indipendentemente dall’albuminuria? Agonisti del recettore del glucagon-like peptide-1 come arma contro l’obesità?]

Author

Avogaro, A, Corsini, A, Sinagra, G, Borghi, C, Sciatti, E, Trevisan, R, Fioretto, P, Calabrò, P, Di Pasquale, G, Senni, M, Avogaro A., Corsini A., Sinagra G., Borghi C., Sciatti E., Trevisan R., Fioretto P., Calabrò P., Di Pasquale G., Senni M., Avogaro, A, Corsini, A, Sinagra, G, Borghi, C, Sciatti, E, Trevisan, R, Fioretto, P, Calabrò, P, Di Pasquale, G, Senni, M, Avogaro A., Corsini A., Sinagra G., Borghi C., Sciatti E., Trevisan R., Fioretto P., Calabrò P., Di Pasquale G., and Senni M.

Abstract

The clinical guidelines, while representing an objective reference to perform correct therapeutic choices, contain grey zones, where the recommendations are not supported by solid evidence. In the fifth National Congress Grey Zones held in Bergamo in June 2022, an attempt was made to highlight some of the main grey zones in Cardiology and, through a comparison between experts, to draw shared conclusions that can illuminate our clinical practice. This manuscript contains the statements of the symposium concerning the controversies regarding cardiovascular risk factors. The manuscript represents the organization of the meeting, with an initial revision of the present guidelines on this topic, followed by an expert presentation of pros (White) and cons (Black) related to the identified "gaps of evidence". For every issue is then reported the "response" derived from the votes of the experts and the public, the discussion and, finally, the highlights, which are intended as practical "take home messages" to be used in the everyday clinical practice. The first gap in evidence discussed is the indication for therapy with sodium-glucose cotransporter 2 (SGLT2) inhibitors for all diabetic patients at high cardiovascular risk. The second examines the possibility of using SGLT2 inhibitors in all patients with renal insufficiency, regardless of albuminuria. The last gap in evidence regards the possible use of glucagon-like peptide-1 receptor agonists as a weapon against obesity.

Published
2023

13. Diagnostic pathways to wild-type transthyretin amyloid cardiomyopathy: a multicentre network study

Author

Tini, G, Milani, P, Zampieri, M, Caponetti, A, Fabris, F, Foli, A, Argiro, A, Mazzoni, C, Gagliardi, C, Longhi, S, Saturi, G, Vergaro, G, Aimo, A, Russo, D, Varra, G, Serenelli, M, Fabbri, G, De Michieli, L, Palmiero, G, Ciliberti, G, Carigi, S, Sessarego, E, Mandoli, G, Ricci Lucchi, G, Rella, V, Monti, E, Gardini, E, Bartolotti, M, Crotti, L, Merli, E, Mussinelli, R, Vianello, P, Cameli, M, Marzo, F, Guerra, F, Limongelli, G, Cipriani, A, Perlini, S, Obici, L, Perfetto, F, Autore, C, Porto, I, Rapezzi, C, Sinagra, G, Merlo, M, Musumeci, B, Emdin, M, Biagini, E, Cappelli, F, Palladini, G, Canepa, M, Tini G., Milani P., Zampieri M., Caponetti A. G., Fabris F., Foli A., Argiro A., Mazzoni C., Gagliardi C., Longhi S., Saturi G., Vergaro G., Aimo A., Russo D., Varra G. G., Serenelli M., Fabbri G., De Michieli L., Palmiero G., Ciliberti G., Carigi S., Sessarego E., Mandoli G. E., Ricci Lucchi G., Rella V., Monti E., Gardini E., Bartolotti M., Crotti L., Merli E., Mussinelli R., Vianello P. F., Cameli M., Marzo F., Guerra F., Limongelli G., Cipriani A., Perlini S., Obici L., Perfetto F., Autore C., Porto I., Rapezzi C., Sinagra G., Merlo M., Musumeci B., Emdin M., Biagini E., Cappelli F., Palladini G., Canepa M., Tini, G, Milani, P, Zampieri, M, Caponetti, A, Fabris, F, Foli, A, Argiro, A, Mazzoni, C, Gagliardi, C, Longhi, S, Saturi, G, Vergaro, G, Aimo, A, Russo, D, Varra, G, Serenelli, M, Fabbri, G, De Michieli, L, Palmiero, G, Ciliberti, G, Carigi, S, Sessarego, E, Mandoli, G, Ricci Lucchi, G, Rella, V, Monti, E, Gardini, E, Bartolotti, M, Crotti, L, Merli, E, Mussinelli, R, Vianello, P, Cameli, M, Marzo, F, Guerra, F, Limongelli, G, Cipriani, A, Perlini, S, Obici, L, Perfetto, F, Autore, C, Porto, I, Rapezzi, C, Sinagra, G, Merlo, M, Musumeci, B, Emdin, M, Biagini, E, Cappelli, F, Palladini, G, Canepa, M, Tini G., Milani P., Zampieri M., Caponetti A. G., Fabris F., Foli A., Argiro A., Mazzoni C., Gagliardi C., Longhi S., Saturi G., Vergaro G., Aimo A., Russo D., Varra G. G., Serenelli M., Fabbri G., De Michieli L., Palmiero G., Ciliberti G., Carigi S., Sessarego E., Mandoli G. E., Ricci Lucchi G., Rella V., Monti E., Gardini E., Bartolotti M., Crotti L., Merli E., Mussinelli R., Vianello P. F., Cameli M., Marzo F., Guerra F., Limongelli G., Cipriani A., Perlini S., Obici L., Perfetto F., Autore C., Porto I., Rapezzi C., Sinagra G., Merlo M., Musumeci B., Emdin M., Biagini E., Cappelli F., Palladini G., and Canepa M.

Abstract

Aim: Epidemiology of wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) remains poorly defined. A better characterization of pathways leading to ATTRwt-CA diagnosis is of key importance, and potentially informative of disease course and prognosis. The aim of this study was to describe the characteristics of contemporary pathways leading to ATTRwt-CA diagnosis, and their potential association with survival. Methods and results: This was a retrospective study of patients diagnosed with ATTRwt-CA at 17 Italian referral centres for CA. Patients were categorized into different ‘pathways’ according to the medical reason that triggered the diagnosis of ATTRwt-CA (hypertrophic cardiomyopathy [HCM] pathway, heart failure [HF] pathway, incidental imaging or incidental clinical pathway). Prognosis was investigated with all-cause mortality as endpoint. Overall, 1281 ATTRwt-CA patients were included in the study. The diagnostic pathway leading to ATTRwt-CA diagnosis was HCM in 7% of patients, HF in 51%, incidental imaging in 23%, incidental clinical in 19%. Patients in the HF pathway, as compared to the others, were older and had a greater prevalence of New York Heart Association (NYHA) class III–IV and chronic kidney disease. Survival was significantly worse in the HF versus other pathways, but similar among the three others. In multivariate model, older age at diagnosis, NYHA class III–IV and some comorbidities but not the HF pathway were independently associated with worse survival. Conclusions: Half of contemporary ATTRwt-CA diagnoses occur in a HF setting. These patients had worse clinical profile and outcome than those diagnosed either due to suspected HCM or incidentally, although prognosis remained primarily related to age, NYHA functional class and comorbidities rather than the diagnostic pathway itself.

Published
2023

14. Razionale e valore fondamentale della Rete Italiana integrata dell’Amiloidosi Cardiaca [Rationale and significance of the Italian Network for Cardiac Amyloidosis]

Author

Sinagra, G, Emdin, M, Merlo, M, Vergaro, G, Aimo, A, Biagini, E, Imazio, M, Porcari, A, Limongelli, G, Cipriani, A, Canepa, M, Musumeci, B, Cameli, M, Crotti, L, Di Bella, G, Di Lenarda, A, Cappelli, F, Chimenti, C, Obici, L, Iacoviello, M, Perlini, S, Pieroni, M, Metra, M, Oliva, F, Perrone Filardi, P, Colivicchi, F, Indolfi, C, Sinagra G., Emdin M., Merlo M., Vergaro G., Aimo A., Biagini E., Imazio M., Porcari A., Limongelli G., Cipriani A., Canepa M., Musumeci B., Cameli M., Crotti L., Di Bella G., Di Lenarda A., Cappelli F., Chimenti C., Obici L., Iacoviello M., Perlini S., Pieroni M., Metra M., Oliva F., Perrone Filardi P., Colivicchi F., Indolfi C., Sinagra, G, Emdin, M, Merlo, M, Vergaro, G, Aimo, A, Biagini, E, Imazio, M, Porcari, A, Limongelli, G, Cipriani, A, Canepa, M, Musumeci, B, Cameli, M, Crotti, L, Di Bella, G, Di Lenarda, A, Cappelli, F, Chimenti, C, Obici, L, Iacoviello, M, Perlini, S, Pieroni, M, Metra, M, Oliva, F, Perrone Filardi, P, Colivicchi, F, Indolfi, C, Sinagra G., Emdin M., Merlo M., Vergaro G., Aimo A., Biagini E., Imazio M., Porcari A., Limongelli G., Cipriani A., Canepa M., Musumeci B., Cameli M., Crotti L., Di Bella G., Di Lenarda A., Cappelli F., Chimenti C., Obici L., Iacoviello M., Perlini S., Pieroni M., Metra M., Oliva F., Perrone Filardi P., Colivicchi F., and Indolfi C.

Abstract

The perspective on amyloidosis has changed deeply over the last 10 years following major advances in diagnosis and treatment options, especially in cardiac amyloidosis. This intrinsically heterogeneous disease exposes to the risk of fragmentation of knowledge and requires the interaction among experts of different specialties and subspecialties. Suspicion of disease, timely recognition and confirmation of final diagnosis, prognostic stratification, clinical management and therapeutic strategies represent essential steps to be taken. Missing or delaying the diagnosis may have dramatic impact on patient outcome, as in the case of chemotherapy in unrecognized light-chain amyloidosis. Therefore, there is an urgent need for the foundation of an Italian Amyloidosis Network to deal with the challenges of this condition and orient clinical management at national and local levels. The present consensus document aims to provide the rationale and scopes of the Italian Amyloidosis Network, which has been conceived as an organizational framework for professionals managing patients with amyloidosis.

Published
2023

16. Genetic and phenotypic characterization of Nexilin (NEXN) related cardiomyopathy

Author

Perotto, M, primary, Sepp, R, additional, Prasad, S, additional, Verdonschot, J A J, additional, Elliott, P, additional, Parikh, V, additional, Olivotto, J, additional, Mazzarotto, F, additional, Fatkin, D, additional, Garcia Pavia, P, additional, Lakdawala, N, additional, Mckenna, W J, additional, Mestroni, L, additional, Sinagra, G, additional, and Dal Ferro, M, additional

Published
2023
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17. Risk assessment according to the presence of left heart disease phenotype in pulmonary arterial hypertension patients: a multicenter cohort study

Author

Toma, M, primary, Barbisan, D, additional, Lombardi, C M, additional, Airo, E, additional, Driussi, M, additional, Gentile, P, additional, Howard, L, additional, Moschella, M, additional, Di Poi, E, additional, Garascia, A, additional, Adamo, M, additional, Sinagra, G, additional, Lo Giudice, F, additional, Stolfo, D, additional, and Ameri, P, additional

Published
2023
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22. Phenotype and outcome correlates of high dose loop diuretics in type 1 pulmonary hypertension

Author

Stolfo, D, primary, Barbisan, D, additional, Lo Giudice, F, additional, Lombardi, C M, additional, Airo', E, additional, Driussi, M, additional, Gentile, P, additional, Howard, L, additional, Giannoni, A, additional, Collini, V, additional, Toma, M, additional, Garascia, A, additional, Metra, M, additional, Sinagra, G, additional, and Ameri, P, additional

Published
2023
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24. Performance of Prognostic Risk Scores in Chronic Heart Failure Patients Enrolled in the European Society of Cardiology Heart Failure Long-Term Registry

Author

Crespo-Leiro, M., Anker, S., Mebazaa, A., Coats, A., Filippatos, G., Ferrari, R., Maggioni, A.P., Piepoli, M.F., Amir, O., Chioncel, O., Dahlström, U., Delgado Jimenez, J.F., Drozdz, J., Erglis, A., Fazlibegovic, E., Fonseca, C., Fruhwald, F., Gatzov, P., Goncalvesova, E., Hassanein, M., Hradec, J., Kavoliuniene, A., Lainscak, M., Logeart, D., Merkely, B., Metra, M., Otljanska, M., Seferovic, P.M., Srbinovska Kostovska, E., Temizhan, A., Tousoulis, D., Ferreira, T., Andarala, M., Fiorucci, E., Folkesson Lefrancq, E., Glémot, M., Gracia, G., Konte, M., Laroche, C., McNeill, P.A., Missiamenou, V., Taylor, C., Auer, J., Ablasser, K., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Sobhy, M., El Messiry, F., El Shazly, A.H., Elrakshy, Y., Youssef, A., Moneim, A.A., Noamany, M., Reda, A., Abdel Dayem, T.K., Farag, N., Ibrahim Halawa, S., Abdel Hamid, M., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M.A., Ibrahim, B.S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M.-F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J.-C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Le Marcis, V., Ly, J.-F., Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Kosztin, A., Nyolczas, N., Csaba Nagy, A., Halmosi, R., Elber, J., Alony, I., Shotan, A., Vazan Fuhrmann, A., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M.G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Cadeddu Dessalvi, C., Marino, P.N., Di Ruocco, M.V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R.M., Pieri, P., Chirco, P.R., Ausilia Galifi, M., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S.G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F.G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J.D., Michalak, L., Wojtczak Soska, K., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A.-F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R.J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Tavares Aguiar, C., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queirós, C., Lourenço, C., Pereira, A., Castro, A., Andrade, A., Oliveira Guimaraes, T., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A.R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Sofia Correia, A., Peres, M., Marta, L., Ferreira da Silva, G., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Filipa Cordeiro, A., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C.-J., Macarie, C., Popescu, R., Daha, I., Dan, G.-A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Simeunovic, D., Ristic, A.D., Celic, V., Pavlovic-Kleut, M., Suzic Lazic, J., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Deljanin Ilic, M., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Cemerlic Adic, N., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Savnik Iskra, M., Ravnikar, T., Cernic Suligoj, N., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Pusnik Vrckovnik, M., Kladnik, M., Slemenik Pusnik, C., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Fernandez Anguita, M.J., Gallego Page, J.C., Salmeron Martinez, F.M., Andres, J., Genis, A.B., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Lopez Fernandez, S., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J.L., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M.J., Barge-Caballero, E., Laynez Cerdena, I., Famara Hernandez Baldomero, I., Lara Padron, A., Ofelia Rosillo, S., Dalmau Gonzalez-Gallarza, R., Salvador Montanes, O., Iniesta Manjavacas, A.M., Castro Conde, A., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Segovia Cubero, J., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Escribano Subias, P., Vicente Hernandez, M., Ruiz Cano, M.J., Gomez Sanchez, M.A., Barrios Garrido-Lestache, E., Garcia Pinilla, J.M., Garcia de la Villa, B., Sahuquillo, A., Bravo Marques, R., Torres Calvo, F., Perez-Martinez, M.T., Gracia-Rodenas, M.R., Garrido-Bravo, I.P., Pastor-Perez, F., Pascual-Figal, D.A., Diaz Molina, B., Orus, J., Epelde Gonzalo, F., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J.A., Mateo, I., ElAmrani, A., Fernandez-Vivancos, C., Bierge Valero, D., Almenar-Bonet, L., Sanchez-Lazaro, I.J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Lopez Diaz, J., Recio Platero, A., Arias, J.C., Blasco-Peiro, T., Sanz Julve, M., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hägglund, E., Stenberg, A., Lindahl, I.-M., Asserlund, B., Olsson, L., Afzelius, M., Karlström, P., Tengvall, L., Wiklund, P.-A., Olsson, B., Kalayci, S., Cavusoglu, Y., Gencer, E., Yilmaz, M.B., Gunes, H., Canepa, Marco, Fonseca, Candida, Chioncel, Ovidiu, Laroche, Cécile, Crespo-Leiro, Maria G., Coats, Andrew J.S., Mebazaa, Alexandre, Piepoli, Massimo F., Tavazzi, Luigi, and Maggioni, Aldo P.

Published
2018
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25. Anthracycline-induced cardiotoxicity: A multicenter randomised trial comparing two strategies for guiding prevention with enalapril: The International CardioOncology Society-one trial

Author

Cipolla, C.M., Cardinale, D., Ciceri, F., Latini, R., Sandri, M.T., Maggioni, A.P., Labianca, R., Tettamanti, M., Senni, M., Finzi, A., Grosso, F., Vago, T., Civelli, M., Gramenzi, S., Masson, S., Balconi, G., Bernasconi, R., Salvatici, M., Nicolis, E., Barlera, S., Magnoli, M., Buratti, M.G., Ojeda Fernandez, M.L., Franzosi, M.G., Staszewsky, L., Vasamì, A., Malossi, A., Sicuro, M., Thiebat, B., Barè, C., Corzani, A., Coccolo, F., Colecchia, S., Pellegrini, C., Bregni, M., Appio, L., Caico, I., G.Rossetti, Mesenzani, O., Campana, C., Giordano, M., Gilardoni, M., Scognamiglio, G., Corrado, G., Battagin, D., De Rosa, F., Carpino, C., Palazzo, S., Monopoli, A., Milandri, C., Giannessi, P.G., Zipoli, G., Ghisoni, F., Rizzo, A., Pastori, P., Callegari, S., Sesenna, C., Colombo, A., G.Curigliano, Fodor, C., Mangiavacchi, M., Cavina, R., Guiducci, D., Mazza, R., Turazza, F.M., Vallerio, P., Marbello, L., Sala, E., Fragasso, G., Trinca, S., Aquilina, M., Rocca, A., Farolfi, A., Andreis, D., Gori, S., Barbieri, E., Lanzoni, L., Marchetti, F., Falci, C., Bianchi, A., Mioranza, E., Banzato, A., Re, F., Gaibazzi, N., Gullo, M., Turina, M.C., Gervasi, E., Giaroli, F., Nassiacos, D., Verusio, C., Barco, B., Bertolini, A., Cucchi, G., Menatti, E., Sinagra, G., Aleksova, A., Guglielmi, A., Pinotti, G., Gueli, R., Mongiardi, C., Vallini, I., Cardinale, Daniela, Ciceri, Fabio, Latini, Roberto, Franzosi, Maria Grazia, Sandri, Maria Teresa, Civelli, Maurizio, Cucchi, GianFranco, Menatti, Elisabetta, Mangiavacchi, Maurizio, Cavina, Raffaele, Barbieri, Enrico, Gori, Stefania, Colombo, Alessandro, Curigliano, Giuseppe, Salvatici, Michela, Rizzo, Antonio, Ghisoni, Francesco, Bianchi, Alessandra, Falci, Cristina, Aquilina, Michele, Rocca, Andrea, Monopoli, Anna, Milandri, Carlo, Rossetti, Giuseppe, Bregni, Marco, Sicuro, Marco, Malossi, Alessandra, Nassiacos, Daniele, Verusio, Claudio, Giordano, Monica, Staszewsky, Lidia, Barlera, Simona, Nicolis, Enrico B., Magnoli, Michela, Masson, Serge, and Cipolla, Carlo M.

Published
2018
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28. Uncertainties in cardiovascular risk factors: sodium-glucose cotransporter 2 inhibitors for all diabetic patients with high cardiovascular risk and in all patients with renal insufficiency, regardless of albuminuria? Glucagon-like peptide-1 receptor agonists as a weapon against obesity? [Incertezze nei fattori di rischio cardiovascolare: inibitori del cotrasportatore sodio-glucosio di tipo 2 per tutti i pazienti diabetici ad elevato rischio cardiovascolare e per tutti i pazienti con insufficienza renale indipendentemente dall’albuminuria? Agonisti del recettore del glucagon-like peptide-1 come arma contro l’obesità?]

Author

Avogaro A., Corsini A., Sinagra G., Borghi C., Sciatti E., Trevisan R., Fioretto P., Calabrò P., Di Pasquale G., Senni M., Avogaro, A, Corsini, A, Sinagra, G, Borghi, C, Sciatti, E, Trevisan, R, Fioretto, P, Calabrò, P, Di Pasquale, G, and Senni, M

Subjects
SGLT2 inibitori, GLP1 agonisti, albuminuria
Abstract

The clinical guidelines, while representing an objective reference to perform correct therapeutic choices, contain grey zones, where the recommendations are not supported by solid evidence. In the fifth National Congress Grey Zones held in Bergamo in June 2022, an attempt was made to highlight some of the main grey zones in Cardiology and, through a comparison between experts, to draw shared conclusions that can illuminate our clinical practice. This manuscript contains the statements of the symposium concerning the controversies regarding cardiovascular risk factors. The manuscript represents the organization of the meeting, with an initial revision of the present guidelines on this topic, followed by an expert presentation of pros (White) and cons (Black) related to the identified "gaps of evidence". For every issue is then reported the "response" derived from the votes of the experts and the public, the discussion and, finally, the highlights, which are intended as practical "take home messages" to be used in the everyday clinical practice. The first gap in evidence discussed is the indication for therapy with sodium-glucose cotransporter 2 (SGLT2) inhibitors for all diabetic patients at high cardiovascular risk. The second examines the possibility of using SGLT2 inhibitors in all patients with renal insufficiency, regardless of albuminuria. The last gap in evidence regards the possible use of glucagon-like peptide-1 receptor agonists as a weapon against obesity.

Published
2023

29. Razionale e valore fondamentale della Rete Italiana integrata dell’Amiloidosi Cardiaca [Rationale and significance of the Italian Network for Cardiac Amyloidosis]

Author

Sinagra G., Emdin M., Merlo M., Vergaro G., Aimo A., Biagini E., Imazio M., Porcari A., Limongelli G., Cipriani A., Canepa M., Musumeci B., Cameli M., Crotti L., Di Bella G., Di Lenarda A., Cappelli F., Chimenti C., Obici L., Iacoviello M., Perlini S., Pieroni M., Metra M., Oliva F., Perrone Filardi P., Colivicchi F., Indolfi C., Sinagra, G, Emdin, M, Merlo, M, Vergaro, G, Aimo, A, Biagini, E, Imazio, M, Porcari, A, Limongelli, G, Cipriani, A, Canepa, M, Musumeci, B, Cameli, M, Crotti, L, Di Bella, G, Di Lenarda, A, Cappelli, F, Chimenti, C, Obici, L, Iacoviello, M, Perlini, S, Pieroni, M, Metra, M, Oliva, F, Perrone Filardi, P, Colivicchi, F, and Indolfi, C

Subjects
Treatment, Clinical management, Cardiac amyloidosi, Differential diagnosi, Perspective
Abstract

The perspective on amyloidosis has changed deeply over the last 10 years following major advances in diagnosis and treatment options, especially in cardiac amyloidosis. This intrinsically heterogeneous disease exposes to the risk of fragmentation of knowledge and requires the interaction among experts of different specialties and subspecialties. Suspicion of disease, timely recognition and confirmation of final diagnosis, prognostic stratification, clinical management and therapeutic strategies represent essential steps to be taken. Missing or delaying the diagnosis may have dramatic impact on patient outcome, as in the case of chemotherapy in unrecognized light-chain amyloidosis. Therefore, there is an urgent need for the foundation of an Italian Amyloidosis Network to deal with the challenges of this condition and orient clinical management at national and local levels. The present consensus document aims to provide the rationale and scopes of the Italian Amyloidosis Network, which has been conceived as an organizational framework for professionals managing patients with amyloidosis.

Published
2023

30. Acute Myocarditis Associated With Desmosomal Gene Variants

Author

Ammirati, E, Raimondi, F, Piriou, N, Sardo Infirri, L, Mohiddin, S, Mazzanti, A, Shenoy, C, Cavallari, U, Imazio, M, Aquaro, G, Olivotto, I, Pedrotti, P, Sekhri, N, Van de Heyning, C, Broeckx, G, Peretto, G, Guttmann, O, Dellegrottaglie, S, Scatteia, A, Gentile, P, Merlo, M, Goldberg, R, Reyentovich, A, Sciamanna, C, Klaassen, S, Poller, W, Trankle, C, Abbate, A, Keren, A, Horowitz-Cederboim, S, Cadrin-Tourigny, J, Tadros, R, Annoni, G, Bonoldi, E, Toquet, C, Marteau, L, Probst, V, Trochu, J, Kissopoulou, A, Grosu, A, Kukavica, D, Trancuccio, A, Gil, C, Tini, G, Pedrazzini, M, Torchio, M, Sinagra, G, Gimeno, J, Bernasconi, D, Valsecchi, M, Klingel, K, Adler, E, Camici, P, Cooper, L, Ammirati E., Raimondi F., Piriou N., Sardo Infirri L., Mohiddin S. A., Mazzanti A., Shenoy C., Cavallari U. A., Imazio M., Aquaro G. D., Olivotto I., Pedrotti P., Sekhri N., Van de Heyning C. M., Broeckx G., Peretto G., Guttmann O., Dellegrottaglie S., Scatteia A., Gentile P., Merlo M., Goldberg R. I., Reyentovich A., Sciamanna C., Klaassen S., Poller W., Trankle C. R., Abbate A., Keren A., Horowitz-Cederboim S., Cadrin-Tourigny J., Tadros R., Annoni G. A., Bonoldi E., Toquet C., Marteau L., Probst V., Trochu J. N., Kissopoulou A., Grosu A., Kukavica D., Trancuccio A., Gil C., Tini G., Pedrazzini M., Torchio M., Sinagra G., Gimeno J. R., Bernasconi D., Valsecchi M. G., Klingel K., Adler E. D., Camici P. G., Cooper L. T., Ammirati, E, Raimondi, F, Piriou, N, Sardo Infirri, L, Mohiddin, S, Mazzanti, A, Shenoy, C, Cavallari, U, Imazio, M, Aquaro, G, Olivotto, I, Pedrotti, P, Sekhri, N, Van de Heyning, C, Broeckx, G, Peretto, G, Guttmann, O, Dellegrottaglie, S, Scatteia, A, Gentile, P, Merlo, M, Goldberg, R, Reyentovich, A, Sciamanna, C, Klaassen, S, Poller, W, Trankle, C, Abbate, A, Keren, A, Horowitz-Cederboim, S, Cadrin-Tourigny, J, Tadros, R, Annoni, G, Bonoldi, E, Toquet, C, Marteau, L, Probst, V, Trochu, J, Kissopoulou, A, Grosu, A, Kukavica, D, Trancuccio, A, Gil, C, Tini, G, Pedrazzini, M, Torchio, M, Sinagra, G, Gimeno, J, Bernasconi, D, Valsecchi, M, Klingel, K, Adler, E, Camici, P, Cooper, L, Ammirati E., Raimondi F., Piriou N., Sardo Infirri L., Mohiddin S. A., Mazzanti A., Shenoy C., Cavallari U. A., Imazio M., Aquaro G. D., Olivotto I., Pedrotti P., Sekhri N., Van de Heyning C. M., Broeckx G., Peretto G., Guttmann O., Dellegrottaglie S., Scatteia A., Gentile P., Merlo M., Goldberg R. I., Reyentovich A., Sciamanna C., Klaassen S., Poller W., Trankle C. R., Abbate A., Keren A., Horowitz-Cederboim S., Cadrin-Tourigny J., Tadros R., Annoni G. A., Bonoldi E., Toquet C., Marteau L., Probst V., Trochu J. N., Kissopoulou A., Grosu A., Kukavica D., Trancuccio A., Gil C., Tini G., Pedrazzini M., Torchio M., Sinagra G., Gimeno J. R., Bernasconi D., Valsecchi M. G., Klingel K., Adler E. D., Camici P. G., and Cooper L. T.

Abstract

Background: The risk of adverse cardiovascular events in patients with acute myocarditis (AM) and desmosomal gene variants (DGV) remains unknown. Objectives: The purpose of this study was to ascertain the risk of death, ventricular arrhythmias, recurrent myocarditis, and heart failure (main endpoint) in patients with AM and pathogenic or likely pathogenetic DGV. Methods: In a retrospective international study from 23 hospitals, 97 patients were included: 36 with AM and DGV (DGV[+]), 25 with AM and negative gene testing (DGV[−]), and 36 with AM without genetics testing. All patients had troponin elevation plus findings consistent with AM on histology or at cardiac magnetic resonance (CMR). In 86 patients, CMR changes in function and structure were re-assessed at follow-up. Results: In the DGV(+) AM group (88.9% DSP variants), median age was 24 years, 91.7% presented with chest pain, and median left ventricular ejection fraction (LVEF) was 56% on CMR (P = NS vs the other 2 groups). Kaplan-Meier curves demonstrated a higher risk of the main endpoint in DGV(+) AM compared with DGV(−) and without genetics testing patients (62.3% vs 17.5% vs 5.3% at 5 years, respectively; P < 0.0001), driven by myocarditis recurrence and ventricular arrhythmias. At follow-up CMR, a higher number of late gadolinium enhanced segments was found in DGV(+) AM. Conclusions: Patients with AM and evidence of DGV have a higher incidence of adverse cardiovascular events compared with patients with AM without DGV. Further prospective studies are needed to ascertain if genetic testing might improve risk stratification of patients with AM who are considered at low risk.

Published
2022

31. Unmasking the prevalence of amyloid cardiomyopathy in the real world: results from Phase 2 of the AC-TIVE study, an Italian nationwide survey

Author

Merlo, M, Pagura, L, Porcari, A, Cameli, M, Vergaro, G, Musumeci, B, Biagini, E, Canepa, M, Crotti, L, Imazio, M, Forleo, C, Cappelli, F, Perfetto, F, Favale, S, Di Bella, G, Dore, F, Girardi, F, Tomasoni, D, Pavasini, R, Rella, V, Palmiero, G, Caiazza, M, Carella, M, Igoren Guaricci, A, Branzi, G, Caponetti, A, Saturi, G, La Malfa, G, Merlo, A, Andreis, A, Bruno, F, Longo, F, Rossi, M, Varra, G, Saro, R, Di Ienno, L, De Carli, G, Giacomin, E, Arzilli, C, Limongelli, G, Autore, C, Olivotto, I, Badano, L, Parati, G, Perlini, S, Metra, M, Emdin, M, Rapezzi, C, Sinagra, G, Merlo M., Pagura L., Porcari A., Cameli M., Vergaro G., Musumeci B., Biagini E., Canepa M., Crotti L., Imazio M., Forleo C., Cappelli F., Perfetto F., Favale S., Di Bella G., Dore F., Girardi F., Tomasoni D., Pavasini R., Rella V., Palmiero G., Caiazza M., Carella M. C., Igoren Guaricci A., Branzi G., Caponetti A. G., Saturi G., La Malfa G., Merlo A. C., Andreis A., Bruno F., Longo F., Rossi M., Varra G. G., Saro R., Di Ienno L., De Carli G., Giacomin E., Arzilli C., Limongelli G., Autore C., Olivotto I., Badano L., Parati G., Perlini S., Metra M., Emdin M., Rapezzi C., Sinagra G., Merlo, M, Pagura, L, Porcari, A, Cameli, M, Vergaro, G, Musumeci, B, Biagini, E, Canepa, M, Crotti, L, Imazio, M, Forleo, C, Cappelli, F, Perfetto, F, Favale, S, Di Bella, G, Dore, F, Girardi, F, Tomasoni, D, Pavasini, R, Rella, V, Palmiero, G, Caiazza, M, Carella, M, Igoren Guaricci, A, Branzi, G, Caponetti, A, Saturi, G, La Malfa, G, Merlo, A, Andreis, A, Bruno, F, Longo, F, Rossi, M, Varra, G, Saro, R, Di Ienno, L, De Carli, G, Giacomin, E, Arzilli, C, Limongelli, G, Autore, C, Olivotto, I, Badano, L, Parati, G, Perlini, S, Metra, M, Emdin, M, Rapezzi, C, Sinagra, G, Merlo M., Pagura L., Porcari A., Cameli M., Vergaro G., Musumeci B., Biagini E., Canepa M., Crotti L., Imazio M., Forleo C., Cappelli F., Perfetto F., Favale S., Di Bella G., Dore F., Girardi F., Tomasoni D., Pavasini R., Rella V., Palmiero G., Caiazza M., Carella M. C., Igoren Guaricci A., Branzi G., Caponetti A. G., Saturi G., La Malfa G., Merlo A. C., Andreis A., Bruno F., Longo F., Rossi M., Varra G. G., Saro R., Di Ienno L., De Carli G., Giacomin E., Arzilli C., Limongelli G., Autore C., Olivotto I., Badano L., Parati G., Perlini S., Metra M., Emdin M., Rapezzi C., and Sinagra G.

Abstract

Aim: To investigate the prevalence of amyloid cardiomyopathy (AC) and the diagnostic accuracy of echocardiographic red flags of AC among consecutive adult patients undergoing transthoracic echocardiogram for reason other than AC in 13 Italian institutions. Methods and results: This is an Italian prospective multicentre study, involving a clinical and instrumental work-up to assess AC prevalence among patients ≥55 years old with an echocardiogram suggestive of AC (i.e. at least one echocardiographic red flag of AC in hypertrophic, non-dilated left ventricles with preserved ejection fraction). The study was registered at ClinicalTrials.gov (NCT04738266). Overall, 381 patients with an echocardiogram suggestive of AC were identified among a cohort of 5315 screened subjects, and 217 patients completed the investigations. A final diagnosis of AC was made in 62 patients with an estimated prevalence of 29% (95% confidence interval 23%–35%). Transthyretin-related AC (ATTR-AC) was diagnosed in 51 and light chain-related AC (AL-AC) in 11 patients. Either apical sparing or a combination of ≥2 other echocardiographic red flags, excluding interatrial septum thickness, provided a diagnostic accuracy >70%. Conclusion: In a cohort of consecutive adults with echocardiographic findings suggestive of AC and preserved left ventricular ejection fraction, the prevalence of AC (either ATTR or AL) was 29%. Easily available echocardiographic red flags, when combined together, demonstrated good diagnostic accuracy.

Published
2022

32. Patient adherence to drug treatment in a community based-sample of patients with chronic heart failure

Author

Rea, F, Iorio, A, Barbati, G, Bessi, R, Castrichini, M, Nuzzi, V, Scagnetto, A, Senni, M, Corrao, G, Sinagra, G, Di Lenarda, A, Rea F., Iorio A., Barbati G., Bessi R., Castrichini M., Nuzzi V., Scagnetto A., Senni M., Corrao G., Sinagra G., Di Lenarda A., Rea, F, Iorio, A, Barbati, G, Bessi, R, Castrichini, M, Nuzzi, V, Scagnetto, A, Senni, M, Corrao, G, Sinagra, G, Di Lenarda, A, Rea F., Iorio A., Barbati G., Bessi R., Castrichini M., Nuzzi V., Scagnetto A., Senni M., Corrao G., Sinagra G., and Di Lenarda A.

Published
2022

33. Combined Role of Troponin and Natriuretic Peptides Measurements in Patients With Covid-19 (from the Cardio-COVID-Italy Multicenter Study)

Author

Iorio, A, Lombardi, C, Specchia, C, Merlo, M, Nuzzi, V, Ferraro, I, Peveri, G, Oriecuia, C, Pozzi, A, Inciardi, R, Carubelli, V, Bellasi, A, Canale, C, Camporotondo, R, Catagnano, F, Dalla Vecchia, L, Giovinazzo, S, Maccagni, G, Mapelli, M, Margonato, D, Monzo, L, Provenzale, G, Sarullo, F, Tomasoni, D, Ameri, P, Gnecchi, M, Leonardi, S, Agostoni, P, Carugo, S, Danzi, G, Guazzi, M, La Rovere, M, Mortara, A, Piepoli, M, Porto, I, Volterrani, M, Sinagra, G, Senni, M, Metra, M, Iorio A., Lombardi C. M., Specchia C., Merlo M., Nuzzi V., Ferraro I., Peveri G., Oriecuia C., Pozzi A., Inciardi R. M., Carubelli V., Bellasi A., Canale C., Camporotondo R., Catagnano F., Dalla Vecchia L., Giovinazzo S., Maccagni G., Mapelli M., Margonato D., Monzo L., Provenzale G., Sarullo F., Tomasoni D., Ameri P., Gnecchi M., Leonardi S., Agostoni P., Carugo S., Danzi G. B., Guazzi M., La Rovere M. T., Mortara A., Piepoli M., Porto I., Volterrani M., Sinagra G., Senni M., Metra M., Iorio, A, Lombardi, C, Specchia, C, Merlo, M, Nuzzi, V, Ferraro, I, Peveri, G, Oriecuia, C, Pozzi, A, Inciardi, R, Carubelli, V, Bellasi, A, Canale, C, Camporotondo, R, Catagnano, F, Dalla Vecchia, L, Giovinazzo, S, Maccagni, G, Mapelli, M, Margonato, D, Monzo, L, Provenzale, G, Sarullo, F, Tomasoni, D, Ameri, P, Gnecchi, M, Leonardi, S, Agostoni, P, Carugo, S, Danzi, G, Guazzi, M, La Rovere, M, Mortara, A, Piepoli, M, Porto, I, Volterrani, M, Sinagra, G, Senni, M, Metra, M, Iorio A., Lombardi C. M., Specchia C., Merlo M., Nuzzi V., Ferraro I., Peveri G., Oriecuia C., Pozzi A., Inciardi R. M., Carubelli V., Bellasi A., Canale C., Camporotondo R., Catagnano F., Dalla Vecchia L., Giovinazzo S., Maccagni G., Mapelli M., Margonato D., Monzo L., Provenzale G., Sarullo F., Tomasoni D., Ameri P., Gnecchi M., Leonardi S., Agostoni P., Carugo S., Danzi G. B., Guazzi M., La Rovere M. T., Mortara A., Piepoli M., Porto I., Volterrani M., Sinagra G., Senni M., and Metra M.

Abstract

Data concerning the combined prognostic role of natriuretic peptide (NP) and troponin in patients with COVID-19 are lacking. The aim of the study is to evaluate the combined prognostic value of NPs and troponin in hospitalized COVID-19 patients. From March 1, 2020 to April 9, 2020, consecutive patients with COVID-19 and available data on cardiac biomarkers at admission were recruited. Patients admitted for acute coronary syndrome were excluded. Troponin levels were defined as elevated when greater than the 99th percentile of normal values. NPs were considered elevated if above the limit for ruling in acute heart failure (HF). A total of 341 patients were included in this study, mean age 68 ± 13 years, 72% were men. During a median follow-up period of 14 days, 81 patients (24%) died. In the Cox regression analysis, patients with elevated both NPs and troponin levels had higher risk of death compared with those with normal levels of both (hazard ratio 2.94; 95% confidence interval 1.31 to 6.64; p = 0.009), and this remained significant after adjustment for age, gender, oxygen saturation, HF history, and chronic kidney disease. Interestingly, NPs provided risk stratification also in patients with normal troponin values (hazard ratio 2.86; 95% confidence interval 1.21 to 6.72; p = 0.016 with high NPs levels). These data show the combined prognostic role of troponin and NPs in COVID-19 patients. NPs value may be helpful in identifying patients with a worse prognosis among those with normal troponin values. Further, NPs’ cut-point used for diagnosis of acute HF has a predictive role in patients with COVID-19.

Published
2022

34. Position paper of the Italian Society of Cardiology: The renin-angiotensin-aldosterone system (RAAS) blockade in heart failure patients - Part I: From RAAS identification to clinical trials [Position paper della Società Italiana di Cardiologia: Il blocco del sistema renina-angiotensina-aldosterone (RAAS) nel paziente con scompenso cardiaco – Parte I: Dalla scoperta del RAAS ai trial clinici]

Author

Filardi, P, Paolillo, S, Indolfi, C, Agostoni, P, Basso, C, Barilla, F, Correale, M, Curcio, A, Mancone, M, Merlo, M, Metra, M, Muscoli, S, Nodari, S, Palazzuoli, A, Pedrinelli, R, Pontremoli, R, Senni, M, Volpe, M, Sinagra, G, Filardi P. P., Paolillo S., Indolfi C., Agostoni P., Basso C., Barilla F., Correale M., Curcio A., Mancone M., Merlo M., Metra M., Muscoli S., Nodari S., Palazzuoli A., Pedrinelli R., Pontremoli R., Senni M., Volpe M., Sinagra G., Filardi, P, Paolillo, S, Indolfi, C, Agostoni, P, Basso, C, Barilla, F, Correale, M, Curcio, A, Mancone, M, Merlo, M, Metra, M, Muscoli, S, Nodari, S, Palazzuoli, A, Pedrinelli, R, Pontremoli, R, Senni, M, Volpe, M, Sinagra, G, Filardi P. P., Paolillo S., Indolfi C., Agostoni P., Basso C., Barilla F., Correale M., Curcio A., Mancone M., Merlo M., Metra M., Muscoli S., Nodari S., Palazzuoli A., Pedrinelli R., Pontremoli R., Senni M., Volpe M., and Sinagra G.

Abstract

L’inibizione del sistema renina-angiotensina-aldosterone (RAAS) rappresenta un caposaldo del trattamento farmacologico dello scompenso cardiaco a ridotta frazione di eiezione ed è stato potenziato dall’arrivo degli inibitori del recettore dell’angiotensina e della neprilisina (ARNI) che combinano l’inibizione del RAAS con l’inibizione della neprilisina responsabile di un incremento delle attività favorevoli dei peptidi natriuretici. Sacubitril/valsartan ha dimostrato nello studio PARADIGM-HF un netto vantaggio rispetto ad enalapril in termini di riduzione di mortalità ed ospedalizzazioni per insufficienza cardiaca e numerosi altri trial randomizzati e studi clinici ne hanno testato l’efficacia in differenti contesti. Dai risultati di questi studi è derivata la raccomandazione di classe I per l’utilizzo del farmaco in pazienti con frazione di eiezione ridotta. La prima parte di questo position paper esplora la storia dell’inibizione del RAAS per passare poi ad una dettagliata analisi dei risultati ottenuti negli studi clinici con gli ARNI che ne supportano le raccomandazioni delle più recenti linee guida., Renin-angiotensin-aldosterone (RAAS) system inhibition is a mainstay of the pharmacological treatment of heart failure with reduced ejection fraction and has been implemented by the introduction of angiotensin receptor-neprilysin inhibitors (ARNI), that combine RAAS inhibition with the inhibition of neprilysin, enhancing the favorable effects of natriuretic peptides. The PARADIGM-HF trial demonstrated a favorable effect of sacubitril/valsartan over enalapril in terms of mortality and heart failure hospitalization rate reduction. Then several randomized clinical trials and observational studies confirmed the favorable role of ARNI in different clinical scenarios, supporting the guideline class I recommendation for the use of sacubitrilvalsartan in patients with reduced systolic function. The first part of this position paper summarizes the history of RAAS inhibition and reports the results of ARNI trials that support the recommendations of the most recent guidelines.

Published
2022

35. Position paper of the Italian Society of Cardiology: The renin-angiotensin-aldosterone system blockade in heart failure patients - Part II: Mechanistic effects of sacubitril/valsartan, placement in current guidelines and use in clinical practice [Position paper della Società Italiana di Cardiologia: Il blocco del sistema renina-angiotensina-aldosterone nel paziente con scompenso cardiaco – Parte II: Effetti meccanicistici di sacubitril/valsartan, posizionamento nelle linee guida ed utilizzo nella pratica clinica]

Author

Filardi, P, Indolfi, C, Paolillo, S, Agostoni, P, Basso, C, Barilla, F, Correale, M, Curcio, A, Mancone, M, Merlo, M, Metra, M, Muscoli, S, Nodari, S, Palazzuoli, A, Pedrinelli, R, Pontremoli, R, Senni, M, Volpe, M, Sinagra, G, Filardi P. P., Indolfi C., Paolillo S., Agostoni P., Basso C., Barilla F., Correale M., Curcio A., Mancone M., Merlo M., Metra M., Muscoli S., Nodari S., Palazzuoli A., Pedrinelli R., Pontremoli R., Senni M., Volpe M., Sinagra G., Filardi, P, Indolfi, C, Paolillo, S, Agostoni, P, Basso, C, Barilla, F, Correale, M, Curcio, A, Mancone, M, Merlo, M, Metra, M, Muscoli, S, Nodari, S, Palazzuoli, A, Pedrinelli, R, Pontremoli, R, Senni, M, Volpe, M, Sinagra, G, Filardi P. P., Indolfi C., Paolillo S., Agostoni P., Basso C., Barilla F., Correale M., Curcio A., Mancone M., Merlo M., Metra M., Muscoli S., Nodari S., Palazzuoli A., Pedrinelli R., Pontremoli R., Senni M., Volpe M., and Sinagra G.

Abstract

Il trattamento con sacubitril/valsartan ha assunto un ruolo di primo piano nelle ultime linee guida sia europee che americane, ed è attualmente raccomandato in classe I per il trattamento dei pazienti con ridotta frazione di eiezione. Accanto ai ben noti effetti sulla mortalità, sacubitril/valsartan agisce positivamente sulla riduzione dei valori di NT-proBNP e su parametri di rimodellamento ventricolare sinistro, determinando un rimodellamento inverso riconosciuto come uno degli effetti meccanicistici del farmaco atto a spiegare in parte il suo effetto favorevole sulla prognosi. Un’attenta valutazione del profilo di ogni singolo paziente consente un utilizzo più mirato e meglio tollerato del farmaco, garantendo anche in ambito di insufficienza cardiaca la strada della medicina di precisione. La seconda parte di questo position paper esplora gli effetti meccanicistici degli inibitori del recettore dell’angiotensina e della neprilisina e il loro posizionamento nelle linee guida, proponendo in ultima analisi un uso di sacubitril/valsartan in specifici contesti clinici., The use of sacubitril/valsartan has been fully recognized in the most recent European and American guidelines that recommend in class I the prescription of this drug in heart failure patients with reduced systolic function. Besides the effects on cardiovascular mortality and heart failure hospitalization, sacubitril/valsartan significantly reduces NT-proBNP levels and improves cardiac remodeling, recognized as one of the mechanistic effects of the drug that is linked to favorable prognostic effects. A careful evaluation of the patients' clinical profile is needed to implement the use of sacubitril/valsartan into clinical practice and to make the treatment successful. This second part of the position paper focuses on the mechanistic effects of angiotensin receptor-neprilysin inhibitors and on its placement in current guidelines, also suggesting the use of sacubitril/valsartan in specific clinical settings.

Published
2022

36. Renin-angiotensin-aldosterone system inhibition in patients affected by heart failure: efficacy, mechanistic effects and practical use of sacubitril/valsartan. Position Paper of the Italian Society of Cardiology

Author

Perrone-Filardi, P, Paolillo, S, Agostoni, P, Basile, C, Basso, C, Barilla, F, Correale, M, Curcio, A, Mancone, M, Merlo, M, Metra, M, Muscoli, S, Nodari, S, Palazzuoli, A, Pedrinelli, R, Pontremoli, R, Senni, M, Volpe, M, Indolfi, C, Sinagra, G, Perrone-Filardi P., Paolillo S., Agostoni P., Basile C., Basso C., Barilla F., Correale M., Curcio A., Mancone M., Merlo M., Metra M., Muscoli S., Nodari S., Palazzuoli A., Pedrinelli R., Pontremoli R., Senni M., Volpe M., Indolfi C., Sinagra G., Perrone-Filardi, P, Paolillo, S, Agostoni, P, Basile, C, Basso, C, Barilla, F, Correale, M, Curcio, A, Mancone, M, Merlo, M, Metra, M, Muscoli, S, Nodari, S, Palazzuoli, A, Pedrinelli, R, Pontremoli, R, Senni, M, Volpe, M, Indolfi, C, Sinagra, G, Perrone-Filardi P., Paolillo S., Agostoni P., Basile C., Basso C., Barilla F., Correale M., Curcio A., Mancone M., Merlo M., Metra M., Muscoli S., Nodari S., Palazzuoli A., Pedrinelli R., Pontremoli R., Senni M., Volpe M., Indolfi C., and Sinagra G.

Abstract

Renin-angiotensin-aldosterone system (RAAS) inhibition is a mainstay of the pharmacological treatment of heart failure with reduced ejection fraction (HFrEF). In the last years RAAS blockade has been improved by the introduction of the Angiotensin Receptor-Neprilysin Inhibitor (ARNI) sacubitril/valsartan, that combines RAAS inhibition with the block of neprilysin, boosting the positive effects of natriuretic peptides. The PARADIGM-HF trial demonstrated a significant advantage of sacubitril/valsartan over enalapril on the reduction of cardiovascular (CV) mortality and heart failure hospitalizations rates. Then, several randomized clinical trials and observational studies investigated its role in different clinical settings and its efficacy has been fully recognized in the most recent HFrEF European and USA guidelines. The effects of sacubitril/valsartan on major CV outcomes are associated with reduction of NT-proBNP levels and reverse cardiac remodeling and mitral regurgitation, recognized as one of the mechanistic effects of the drug explaining the favorable prognostic effects. A careful evaluation of patients’ clinical profile is relevant to implement the use of ARNI in the clinical practice and to obtain the maximal treatment efficacy. The present Position Paper reports the opinion of the Italian Society of Cardiology on the optimal blockade of the RAAS system in HF patients with the aim of fostering widespread implementation of scientific evidence and practice guidelines in the medical community.

Published
2022

37. Sex-related differences in patients with coronavirus disease 2019: Results of the Cardio-COVID-Italy multicentre study

Author

Lombardi, C, Specchia, C, Conforti, F, Rovere, M, Carubelli, V, Agostoni, P, Carugo, S, Danzi, G, Guazzi, M, Mortara, A, Piepoli, M, Porto, I, Sinagra, G, Volterrani, M, Ameri, P, Gnecchi, M, Leonardi, S, Merlo, M, Iorio, A, Bellasi, A, Canale, C, Camporotondo, R, Catagnano, F, Dalla Vecchia, L, Di Pasquale, M, Giovinazzo, S, Maccagni, G, Mapelli, M, Margonato, D, Monzo, L, Nuzzi, V, Oriecuia, C, Pala, L, Peveri, G, Pozzi, A, Provenzale, G, Sarullo, F, Adamo, M, Tomasoni, D, Inciardi, R, Senni, M, Metra, M, Lombardi C. M., Specchia C., Conforti F., Rovere M. T. L., Carubelli V., Agostoni P., Carugo S., Danzi G. B., Guazzi M., Mortara A., Piepoli M., Porto I., Sinagra G., Volterrani M., Ameri P., Gnecchi M., Leonardi S., Merlo M., Iorio A., Bellasi A., Canale C., Camporotondo R., Catagnano F., Dalla Vecchia L. A., Di Pasquale M., Giovinazzo S., Maccagni G., Mapelli M., Margonato D., Monzo L., Nuzzi V., Oriecuia C., Pala L., Peveri G., Pozzi A., Provenzale G., Sarullo F., Adamo M., Tomasoni D., Inciardi R. M., Senni M., Metra M., Lombardi, C, Specchia, C, Conforti, F, Rovere, M, Carubelli, V, Agostoni, P, Carugo, S, Danzi, G, Guazzi, M, Mortara, A, Piepoli, M, Porto, I, Sinagra, G, Volterrani, M, Ameri, P, Gnecchi, M, Leonardi, S, Merlo, M, Iorio, A, Bellasi, A, Canale, C, Camporotondo, R, Catagnano, F, Dalla Vecchia, L, Di Pasquale, M, Giovinazzo, S, Maccagni, G, Mapelli, M, Margonato, D, Monzo, L, Nuzzi, V, Oriecuia, C, Pala, L, Peveri, G, Pozzi, A, Provenzale, G, Sarullo, F, Adamo, M, Tomasoni, D, Inciardi, R, Senni, M, Metra, M, Lombardi C. M., Specchia C., Conforti F., Rovere M. T. L., Carubelli V., Agostoni P., Carugo S., Danzi G. B., Guazzi M., Mortara A., Piepoli M., Porto I., Sinagra G., Volterrani M., Ameri P., Gnecchi M., Leonardi S., Merlo M., Iorio A., Bellasi A., Canale C., Camporotondo R., Catagnano F., Dalla Vecchia L. A., Di Pasquale M., Giovinazzo S., Maccagni G., Mapelli M., Margonato D., Monzo L., Nuzzi V., Oriecuia C., Pala L., Peveri G., Pozzi A., Provenzale G., Sarullo F., Adamo M., Tomasoni D., Inciardi R. M., Senni M., and Metra M.

Abstract

IntroductionThe role of sex compared to comorbidities and other prognostic variables in patients with coronavirus disease (COVID-19) is unclear.MethodsThis is a retrospective observational study on patients with COVID-19 infection, referred to 13 cardiology units. The primary objective was to assess the difference in risk of death between the sexes. The secondary objective was to explore sex-based heterogeneity in the association between demographic, clinical and laboratory variables, and patients' risk of death.ResultsSeven hundred and one patients were included: 214 (30.5%) women and 487 (69.5%) men. During a median follow-up of 15-days, deaths occurred in 39 (18.2%) women and 126 (25.9%) men. In a multivariable Cox regression model, men had a nonsignificantly higher risk of death vs. women (P = 0.07).The risk of death was more than double in men with a low lymphocytes count as compared with men with a high lymphocytes count [overall survival hazard ratio (OS-HR) 2.56, 95% confidence interval (CI) 1.72-3.81]. In contrast, lymphocytes count was not related to death in women (P=0.03).Platelets count was associated with better outcome in men (OS-HR for increase of 50-×-103units: 0.88 95% CI 0.78-1.00) but not in women. The strength of association between higher PaO2/FiO2ratio and lower risk of death was larger in women (OS-HR for increase of 50-mmHg/%: 0.72, 95% CI 0.59-0.89) vs. men (OS-HR: 0.88, 95% CI 0.80-0.98; P-=-0.05).ConclusionsPatients' sex is a relevant variable that should be taken into account when evaluating risk of death from COVID-19. There is a sex-based heterogeneity in the association between baseline variables and patients' risk of death.

Published
2022

39. How to fill the gap in the symptomatic HF patient journey between optimal medical therapy and advanced heart failure treatment: two Italian surveys

Author

Spadotto, A, primary, Ziacchi, M, additional, Ghio, S, additional, Pellegrino, M, additional, Masarone, D, additional, Caracciolo, M, additional, Inserra, C A, additional, Ammirati, F, additional, Ciccarelli, M, additional, Colivicchi, F, additional, Bianchi, S, additional, Oliva, F, additional, Biffi, M, additional, and Sinagra, G, additional

Published
2023
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43. P123 TRANSCATHETER ABLATION OF SUPRAVENTRICULAR ARRHYTHMIAS IN PATIENTS SUFFERING FROM HYPERTROPHIC CARDIOMYOPATHY: A PROPENSITY SCORE–BASED ANALYSIS

Author

Pierri, A, primary, Albani, S, additional, Buongiorno, A, additional, Ricotti, A, additional, Grossi, S, additional, De Rosa, C, additional, Mabritto, B, additional, Bongioanni, S, additional, Luceri, S, additional, Negri, F, additional, Grilli, G, additional, Barbisan, D, additional, Burelli, M, additional, Biondi, F, additional, Cireddu, M, additional, Berg, J, additional, Musumeci, M, additional, Di Donna, P, additional, Vianello, P, additional, Del Franco, A, additional, Scaglione, M, additional, Barbati, G, additional, Berchialla, P, additional, Russo, V, additional, Imazio, M, additional, Porto, I, additional, Canepa, M, additional, Peretto, G, additional, Francia, P, additional, Autore, C, additional, Castagno, D, additional, Gaita, F, additional, Olivotto, I, additional, Merlo, M, additional, Sinagra, G, additional, and Musumeci, G, additional

Published
2023
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47. P206 DO WE NEED LOWER CUT–OFFS OF LEFT VENTRICULAR WALL THICKNESS TO SUSPECT CARDIAC TRANSTHYRETIN AMYLOIDOSIS IN WOMEN?

Author

Aimo, A, primary, Tomasoni, D, additional, Porcari, A, additional, Adamo, M, additional, Bonfioli, G, additional, Lombardi, C, additional, Nardi, M, additional, Varrà, G, additional, Saro, R, additional, Rossi, M, additional, Merlo, M, additional, Castiglione, V, additional, Vergaro, G, additional, Passino, C, additional, Metra, M, additional, Sinagra, G, additional, and Emdin, M, additional

Published
2023
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48. C81 ROLE OF RESTRICTIVE DIASTOLIC DYSFUNCTION FOR RISK STRATIFICATION OF PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY: A BAYESIAN MODEL AVERAGING

Author

Buongiorno, A, primary, Albani, S, additional, Grilli, G, additional, Merlo, M, additional, Berchialla, P, additional, Ricotti, A, additional, Pierri, A, additional, De Luca, A, additional, Barbisan, D, additional, Mabritto, B, additional, Bongioanni, S, additional, Luceri, S, additional, Porto, I, additional, Musumeci, G, additional, and Sinagra, G, additional

Published
2023
Full Text
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