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21 results on '"Suarez, S. Martin"'

6. Medium-Long Term Results of Cardiac Transplantation from Donors Assessed with the “Aged Donor Heart Rescue by Stress Echo” (ADONHERS) Protocol

Author

Suarez, S. Martin, primary, Fiorentino, M., additional, Murana, G., additional, Botta, L., additional, Loforte, A., additional, Santamaria, V., additional, Pagano, V., additional, Prestinenzi, P., additional, Sabatino, M., additional, Bombardini, A., additional, Sangiorgi, G., additional, Potena, L., additional, and Pacini, D., additional

Published
2022
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9. Telemedicine (TM) during SARS-CoV-2 Outbreak

Author

Masetti, M., primary, Toniolo, S., additional, Adorno, A., additional, Giovannini, L., additional, Prestinenzi, P., additional, Sabatino, M., additional, Russo, A., additional, Suarez, S. Martin, additional, Loforte, A., additional, Pacini, D., additional, and Potena, L., additional

Published
2021
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21. Restrictive Physiology: Playing with Rhc Between Cav and Amr.

Author

Masetti, M., Scuppa, M., Giovannini, L., Sabatino, M., Suarez, S. Martin, and Potena, L.

Subjects
*GRAFT rejection, *PHYSIOLOGY, *CORONARY angiography, *HEMODYNAMICS, *ORTHOSTATIC hypotension
Abstract

As for ISHLT guidelines, cardiac allograft vasculopathy (CAV) can be graded as 3 if there is a restrictive physiology. However, the prognostic role of hemodynamics in CAV classification is unknown; moreover, CAV can be associated with antibody-mediated rejection (AMR).The aim of this study is to investigate the role of hemodynamics assessed by right heart cath (RHC) in CAV classification and its interplay with AMR. In our Center RHC is perfomed at every biopsy (EMB); coronary angiography (CA) is made at 1 and 5 years after HT. We included all patients (pts) undergoing to a EMB for surveillance or clinical suspicion after the first month from HT in 2016-17; the follow-up was started after the first abnormal RHC finding or, if no abnormal values were found, after the last EMB performed. The endpoint was the combined incidence of MACE at 2 years. Among 586 EMBs in 113 pts (5% for symptoms), no one had restrictive physiology by using the values of ISHLT classification. We defined the following patterns: restrictive physiology (R) with less impaired values (RAP>8 mmHg, CWP>15 mmHg, CI <2.5 l/min/sm) diastolic dysfunction (D), (high filling pressures, normal CI), low CI (L), normal (N). 8.3% of pts had R, 22.2% D, 16.6% L, 52.8% N. Pts with R had the greatest risk of MACE, those with D were in an intermediate risk category, similar to those with L (p<0.001).R was more frequent in CAV (37.5% vs 33.3% vs 3.9% vs 6.2% grade 3 vs 2 vs 1 vs 0, p<0.01), and, among patients without CAV, in those with AMR (20.0% vs 3.5%, AMR+ vs AMR-, p<0.05). D was numerically more frequent in AMR, whereas it was not influenced by CAV. CAV prevalence was 33.6% (25.6%, 2.6%, 7.7% CAV-1,2,3 respectively). Among 11 pts with CAV-3, 2 were in this group for R. ISHLT classification predicted MACE (36.3±14.3% vs 77.4±8.1% vs 87.8±4.0%, CAV-3 vs CAV-1-2 vs CAV-0, p<0.01). Patients with D and those without CAV but with R had as increased risk of MACE, in an intermediate risk category between CAV-3 and CAV-1/2 (36.3±14.3% vs 50.0±5.3% vs 66.6±13.6% vs 76.2±9.2% vs 91.6±3.6%, CAV-3 vs CAV-0+ R vs D vs CAV 1-2 vs 0, p<0.01). Defining CAV using restrictive physiology, with less impaired values than ISHLT classification, stratifies the prognosis. Diastolic dysfunction or restrictive physiology without CAV indicate an high risk of MACE and may be signs of latent AMR. Our data support the systematic use of RHC to predict MACE and define graft function. [ABSTRACT FROM AUTHOR]

Published
2023
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