Publications by authors named "Adamo Marianna"
Aims: Accurate selection of patients with severe heart failure (HF) who might benefit from advanced therapies is crucial. The present study investigates the performance of the available risk scores aimed at predicting the risk of mortality in patients with severe HF.
Methods And Results: The risk of 1-year mortality was estimated in patients with severe HF enrolled in the HELP-HF cohort according to the MAGGIC, 3-CHF, ADHF/NT-proBNP, and GWTG-HF risk scores, the number of criteria of the 2018 HFA-ESC definition of advanced HF, I NEED HELP markers, domains fulfilled of the 2019 HFA-ESC definition of frailty, the frailty index, and the INTERMACS profile.
Aims: To evaluate the association between transcatheter edge-to-edge repair (TEER) and outcomes in patients with significant mitral regurgitation (MR) following acute myocardial infarction (MI), focusing on the aetiology of acute post-MI MR in high-risk surgical patients.
Methods And Results: The International Registry of MitraClip in Acute Mitral Regurgitation following Acute Myocardial Infarction (IREMMI) includes 187 patients with severe MR post-MI managed with TEER. Of these, 176 were included in the analysis, 23 (13%) patients had acute papillary muscle rupture (PMR) and 153 (87%) acute secondary MR.
: Cangrelor provides rapid platelet inhibition, making it a potential option for out-of-hospital cardiac arrest (OHCA) survivors undergoing percutaneous coronary intervention (PCI). However, clinical data on its use after OHCA are limited. This study investigates in-hospital outcomes of cangrelor use in this population.
View Article and Find Full Text PDFAims: Secondary mitral regurgitation (SMR) and tricuspid regurgitation (TR) are the most common valvular heart diseases in patients with heart failure (HF). Transcatheter edge-to-edge repair (TEER) devices designed for treating MR and TR have been successfully tested in randomized controlled trials, but methodological issues have often challenged their interpretation. This manuscript aimed to provide an overview of TEER registries on SMR and TR in HF, highlighting their key features, describing clinical characteristics and outcomes of patients receiving these devices, and exploring the available data limitations.
View Article and Find Full Text PDFBackground: Multivessel coronary artery disease (MVD) represents a common finding at invasive coronary angiography (ICA) among out-of-hospital cardiac arrest (OHCA) survivors. However, optimal invasive treatment strategy for MVD in OHCA remains unknown. Our study aims to assess if complete revascularization improves one-year clinical outcomes in these patients.
View Article and Find Full Text PDFAims: Few data are available regarding the role of tricuspid annulus plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP), a measurement of right ventricular to pulmonary artery coupling, in patients with chronic heart failure and left ventricular systolic dysfunction.
Methods And Results: This retrospective single-centre study included outpatients with left ventricular systolic dysfunction (ejection fraction ≤ 50%) evaluated between January 2022 and December 2022. TAPSE/PASP was evaluated as a continuous variable and as tertiles according to its value on the first visit.
Worldwide, valvular heart disease (VHD) is a common cause of hospitalization for acute heart failure. In acute heart failure caused by VHD, symptoms result from rapid haemodynamic changes and subsequent decline in cardiac function, and if left untreated, leads to acute decompensation and cardiogenic shock. Current evidence remains scarce and recommendations regarding the management of acute heart failure caused by VHD are lacking in most recent international guidelines.
View Article and Find Full Text PDFAtrial Secondary Tricuspid Regurgitation: Insights Into the EuroTR Registry.
JACC Cardiovasc Interv
December 2024
Article Synopsis
- Atrial secondary tricuspid regurgitation (A-STR) is a subtype of secondary tricuspid regurgitation (STR) that is often treated with transcatheter tricuspid valve edge-to-edge repair (T-TEER), showing distinct patient characteristics and treatment outcomes.
- A study involving 641 patients revealed that 31% had A-STR, which was linked to better heart function, a higher presence of atrial fibrillation, and more effective TR reduction post-procedure compared to nonatrial STR patients.
- A-STR patients experienced improved survival rates and lower symptomatic burdens after treatment; only 38% remained symptomatic (NYHA class ≥III) after 2 years, compared to 46
Article Synopsis
- Tethering is a common issue in mitral valve problems, often seen in patients with serious regurgitation, but its true effects on treatment outcomes are not well understood.
- A study involving over 2,200 patients found that while those with tethering had higher initial rates of cardiac death and rehospitalization, after adjusting for other factors, tethering did not significantly impact long-term outcomes.
- Consequently, the study suggests that having tethering should not prevent suitable patients from undergoing transcatheter edge-to-edge repair (TEER) for mitral valve issues.
Aims: Conventional parameters of right ventricular (RV) function are load-dependent and therefore do not accurately reflect contractility in patients with relevant tricuspid regurgitation (TR). RV adaptability to load has been characterized using the Dandel's index in patients with heart failure, but its prognostic value in patients undergoing tricuspid transcatheter edge-to-edge repair (T-TEER) has not been investigated so far.
Methods And Results: From the EuroTR registry (2019 to 2022), patients with complete datasets and a minimum of 2-years of follow-up were included.
Background: The prognostic importance of residual congestion after acute heart failure (AHF) hospitalization is still debated.
Objectives: The authors aimed to assess the impact of residual congestion in a large cohort of patients with AHF enrolled in the RELAX-AHF-2 (Relaxin in Acute Heart Failure 2) trial.
Methods: Residual congestion was assessed at day 5 after admission among hospitalized patients using an established composite congestion score (CCS) based on the presence of orthopnea, peripheral edema, and increased jugular venous pressure, ranging from 0 to 8 points.
Article Synopsis
- Balloon-expandable valves (BEVs) and self-expanding valves (SEVs) are compared for their effects on patients with Sievers type 1 bicuspid aortic valve (BAV) stenosis undergoing transcatheter aortic valve replacement.
- The analysis, based on a registry of 955 patients, found no significant difference in midterm major adverse events or technical success between BEVs and SEVs after adjusting for baseline differences.
- However, BEVs had lower risks of new permanent pacemaker implantation and moderate or greater paravalvular regurgitation, but a higher risk of severe patient-prosthesis mismatch compared to SEVs.
Cardiogenic shock is a complex syndrome defined by systemic hypoperfusion and inadequate cardiac output arising from a wide array of underlying causes. Although the understanding of cardiogenic shock epidemiology, specific subphenotypes, haemodynamics, and cardiogenic shock severity staging has evolved, few therapeutic interventions have shown survival benefit. Results from seminal randomised controlled trials support early revascularisation of the culprit vessel in infarct-related cardiogenic shock and provide evidence of improved survival with the use of temporary circulatory support in selected patients.
View Article and Find Full Text PDFBackground: Mitral valve transcatheter edge-to-edge repair (M-TEER) reduces secondary mitral regurgitation (MR) in heart failure and impacts survival in selected patients as demonstrated in the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) trial. However, long-term outcome data after M-TEER under real-world conditions are lacking.
Objectives: This study sought to assess long-term efficacy and survival after M-TEER in a large real-world registry.
Large clinical data underscore that heart failure is independently associated to an increased risk of negative cognitive outcome and dementia. Emerging evidence suggests that cerebral hypoperfusion, stemming from reduced cardiac output and vascular pathology, may contribute to the largely overlapping vascular dementia and Alzheimer's disease. Despite these insights, cognitive outcomes remain largely overlooked in heart failure management.
View Article and Find Full Text PDFArticle Synopsis
- The study examined the effects of pulmonary hypertension (PH) on patients receiving transcatheter tricuspid valve edge-to-edge repair (T-TEER), focusing on survival rates and heart failure hospitalization outcomes.
- Results showed that higher systolic pulmonary artery pressure (sPAP) was linked to increased risks of death or hospitalization within two years, with a notable threshold of sPAP > 46 mmHg identifying those at greater risk.
- However, both the severity of heart failure symptoms and tricuspid regurgitation improved after T-TEER, regardless of whether patients had pre- or postcapillary PH.
Background: In acute heart failure (AHF) patients, non-invasive estimation of left ventricular filling pressures (LVFPs) appears crucial to guide management. Although poorly investigated, left atrial (LA) mechanics play a pivotal role in this setting. This report sought to assess the correlation of echocardiographic LA stiffness index with invasive LVFPs and its diagnostic accuracy as compared to other parameters used in clinical practice.
View Article and Find Full Text PDFArticle Synopsis
- Patients with a heart condition called atrial fibrillation (AF) who have strokes can still be at very high risk of having more strokes, even when taking medication to prevent them.
- Left atrial appendage occlusion (LAAO) is a special procedure aimed at helping these patients avoid future strokes.
- A study compared two groups – one that had LAAO and one that only continued their usual medication – and found that there was still a risk of strokes in both groups over a two-year period.
Background: Transcatheter tricuspid valve intervention (TTVI) has been increasingly adopted in recent years for the treatment of patients with tricuspid regurgitation (TR). However, no dedicated risk stratification has been established for patients undergoing TTVI.
Objectives: The aim of the present study was to propose a dedicated risk score for patients affected by severe TR undergoing TTVI.
Article Synopsis
- A study collected data from 2,626 patients who underwent Transcatheter Aortic Valve Replacement (TAVR) in Italy from 2007 to 2017, focusing on those with normal or reduced Left Ventricular Ejection Fraction (LVEF).
- Reduced LVEF patients were further divided into ischemic and nonischemic groups, with the main goal being to track all-cause death and rehospitalizations over 8 years.
- Results showed that patients with reduced LVEF faced a higher risk of death and rehospitalizations, particularly those with an ischemic cause, highlighting the long-term challenges for these patients post-TAVR.
Article Synopsis
- The study examines the characteristics and outcomes of patients with tapered raphe-type bicuspid aortic valve (BAV) when undergoing trans-catheter aortic valve replacement (TAVR), focusing on the safety and effectiveness of modern heart valves.
- Researchers analyzed data from 897 patients, finding that those with tapered configurations showed similar success rates and safety between two sizing strategies: annular and supra-annular.
- The results indicate that TAVR is a safe and effective procedure for these patients, regardless of the sizing method used, maintaining a high rate of clinical efficacy at mid-term follow-up.
Article Synopsis
- - Anemia is a common issue among heart failure patients, affecting their treatment outcomes, and this study aimed to examine how anemia prevalence changes and its relationship with clinical results in heart failure patients from the STRONG-HF study.
- - In the study of 1077 patients, anemia rates rose from 27.2% at enrollment to 32.1% at 90 days, with a slightly higher primary composite outcome observed in anemic patients, but the difference wasn't statistically significant.
- - Patients with baseline anemia showed less improvement in health-related quality of life, while the incidence of anemia was higher in those receiving high-intensity care compared to usual care; factors like male sex and non-European regions were linked to a higher