Publications by authors named "Alessandro Fasolino"

Article Synopsis
  • A reversal of timing between early diastolic velocity (e') and mitral inflow (E) occurs with high left atrial pressure, but its potential application for assessing right atrial pressure has not been studied previously.
  • In a study comparing patients with pre-capillary pulmonary hypertension to healthy volunteers, it was found that the interval (T) is prolonged in those with pulmonary hypertension.
  • Strong correlations between T and measured right atrial pressure, along with a high predictive value for identifying elevated pressures, suggest T could be a valuable tool in understanding the cardiac function in pulmonary hypertension.
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  • Advanced heart failure (AdvHF) presents treatment difficulties, especially when options like mechanical support or transplants are not available, emphasizing a lack of solid medical management evidence.
  • A study of 406 AdvHF patients receiving nightly sodium nitroprusside (SNP) infusions revealed no significant hypotension-related discontinuation, and a notable increase in blood pressure was observed after treatment.
  • While the combination of SNP and dobutamine led to more weight loss, it also caused a higher rise in creatinine levels, suggesting a balance between effectiveness in improving patient outcomes and potential side effects.
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Mortality for cardiogenic shock is still high despite optimal pharmacological therapy. Therefore, active mechanical circulatory support devices are increasingly used; venoarterial extracorporeal membrane oxygenation (VA-ECMO) enables full circulatory and respiratory support. However, recent data show that in patients with infarct-related shock unselected early use of VA-ECMO does not improve survival and is associated with major bleeding and peripheral ischemic complications.

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Background: Evidence of the association between AMplitude Spectral Area (AMSA) of ventricular fibrillation and outcome after out-of-hospital cardiac arrest (OHCA) is limited to short-term follow-up. In this study, we assess whether AMSA can stratify the risk of death or poor neurological outcome at 30 days and 1 year after OHCA in patients with an initial shockable rhythm or with an initial non-shockable rhythm converted to a shockable one.

Methods: This is a multicentre retrospective study of prospectively collected data in two European Utstein-based OHCA registries.

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  • Transcatheter edge-to-edge repair (TEER) with MitraClip is a standard treatment for severe mitral regurgitation (MR), and the newer PASCAL system offers an alternative, although comparative evidence is limited.
  • A systematic review and meta-analysis of 1,315 patients found comparable procedural success rates and clinical outcomes between the PASCAL and MitraClip devices for reducing MR severity.
  • Both devices demonstrated low mortality rates and similar safety profiles, indicating they are equally effective and safe for treating symptomatic MR.
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The optimal energy for defibrillation has not yet been identified and very often the maximum energy is delivered. We sought to assess whether amplitude spectral area (AMSA) of ventricular fibrillation (VF) could predict low energy level defibrillation success in out-of-hospital cardiac arrest (OHCA) patients. This is a multicentre international study based on retrospective analysis of prospectively collected data.

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Background: Devices for mechanical cardiopulmonary resuscitation (CPR) are recommended when high quality CPR cannot be provided. Different devices are available, but the literature is poor in direct comparison studies. Our aim was to assess whether the type of mechanical chest compressor could affect the probability of return of spontaneous circulation (ROSC) and 30-day survival in Out-of-Hospital Cardiac Arrest (OHCA) patients as compared to manual standard CPR.

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Objective: Antiarrhythmic drugs are recommended for out of hospital cardiac arrest (OHCA) with shock-refractory ventricular fibrillation (VF). Amplitude Spectral Area (AMSA) of VF is a quantitative waveform measure that describes the amplitude-weighted mean frequency of VF, it correlates with intramyocardial adenosine triphosphate (ATP) concentration, it is a predictor of shock efficacy and an emerging indicator to guide defibrillation and resuscitation efforts. How AMSA might be influenced by amiodarone administration is unknown.

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Background Once the return of spontaneous circulation after out-of-hospital cardiac arrest is achieved, a 12-lead ECG is strongly recommended to identify candidates for urgent coronary angiography. ECG has no apparent role in mortality risk stratification. We aimed to assess whether ECG features could be associated with 30-day survival in patients with out-of-hospital cardiac arrest.

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  • Atrial fibrillation (AF) often occurs in patients with hypertrophic cardiomyopathy (HCM), and using anticoagulants can reduce stroke risk, but no direct comparison of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) has been done in randomized controlled trials (RCTs).
  • The study reviewed existing literature and performed a meta-analysis of five observational studies involving 6,919 patients to evaluate outcomes related to death, major bleeding, and thromboembolic events (TEs).
  • Results indicated that DOACs were linked to lower all-cause mortality compared to VKAs and had similar rates of major bleeding and TEs, suggesting DOACs might be a favorable option
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Background And Aim: Measurement of cardiac index (CI) is crucial in the hemodynamic assessment of critically ill patients in the intensive care unit (ICU). The most reliable trans-thoracic echocardiography (TTE) technique for CI estimation is the left ventricular outflow tract (LVOT) Doppler method that requires, among other parameters, the LVOT cross-sectional area (CSA) measurement. However, inherent and practical disadvantages, mostly related to the ICU setting, hamper LVOT-CSA assessment.

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Out-of-hospital cardiac arrest is one of the leading causes of mortality worldwide. The goal of resuscitation is often meant as the return of spontaneous circulation (ROSC). However, ROSC is only one of the steps towards survival.

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Background: Several electrocardiogram (ECG) criteria have been proposed to predict the location of the culprit occlusion in specific subsets of patients presenting with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to develop, through an independent validation of currently available criteria, a comprehensive and easy-to-use ECG algorithm, and to test its diagnostic performance in real-world clinical practice.

Methods: We analyzed ECG and angiographic data from 419 consecutive STEMI patients submitted to primary percutaneous coronary intervention over a one-year period, dividing the overall population into derivation (314 patients) and validation (105 patients) cohorts.

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Background: Several patients undergoing transcatheter aortic valve replacement (TAVR) also require oral anticoagulation (OAC) for atrial fibrillation (AF) or deep vein thromboembolism. However, the optimal type of OAC strategy (direct oral anticoagulants, DOACs, or vitamin K antagonists, VKA) is still unclear in this setting.

Method: We performed systematic literature research and meta-analysis in PubMed, Medline, and EMBASE databases for studies reporting either all-cause mortality, major/life-threatening bleeding or stroke events.

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Postoperative atrial fibrillation (POAF) is a frequently reported postcardiac surgery complication leading to increased in-hospital and long-term mortality rates. Many randomized controlled trials (RCTs) have recently suggested using statins to protect against POAF. Therefore, we performed a systematic literature search and meta-analysis in electronic databases for eligible studies published between January 2006 and January 2022.

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