Publications by authors named "Andrea Antonello"
Heart and lung sharing the same anatomical space are influenced by each other. Spontaneous breathing induces dynamic changes in intrathoracic pressure, impacting cardiac function, particularly the right ventricle. In intensive care units (ICU), mechanical ventilation (MV) and therefore positive end-expiratory pressure (PEEP) are often applied, and this inevitably influences cardiac function.
View Article and Find Full Text PDFInterest in advanced echocardiographic imaging methods is growing. Left atrial strain (LAS) is among recently developed echocardiographic parameters. LAS represents an index of tissue deformation of the left atrium (LA).
View Article and Find Full Text PDFDespite great progress in treating atrial fibrillation (AF), especially with the development of increasingly effective invasive techniques for AF ablation, many unanswered questions remain regarding the pathogenic mechanism of the arrhythmia and its prevention methods. The development of AF is based on anatomical and functional alterations in the cardiomyocyte resulting from altered ionic fluxes and cardiomyocyte electrophysiology. Electric instability and electrical remodeling underlying the arrhythmia may result from oxidative stress, also caused by possible mitochondrial dysfunction.
View Article and Find Full Text PDFPurpose: The prognostic significance of noninvasive myocardial work (MW) indices in patients undergoing transcatheter aortic valve implantation (TAVI) has not been adequately examined.
Methods: We retrospectively selected 88 consecutive patients (mean age 79.9 ± 6.
Nearly 35 years after its initial publication in 1989, the Italian Society of Sports Cardiology and the Italian Federation of Sports Medicine (FMSI), in collaboration with other leading Italian Cardiological Scientific Associations (ANCE - National Association of Outpatient Cardiology, ANMCO - National Association of Inpatient Cardiology, SIC - Italian Society of Cardiology), proudly present the 2023 version of the Cardiological Guidelines for Competitive Sports Eligibility. This publication is an update of the previous guidelines, offering a comprehensive and detailed guide for the participation of athletes with heart disease in sports. This edition incorporates the latest advances in cardiology and sports medicine, providing current information and recommendations.
View Article and Find Full Text PDFHypercontractile phenotype (HP) of the left ventricle (LV) is an actionable therapeutic target in patients with chronic coronary syndromes (CCS) or heart failure (HF), but its clinical recognition remains difficult. To assess the clinical variables associated with the HP. In a prospective, observational, multicenter study, we recruited 5122 patients (age 65 ± 11 years, 2974 males, 58%) with CCS and/or HF with preserved ejection fraction (EF).
View Article and Find Full Text PDFArticle Synopsis
- Cardiac arrest (CA) is a critical condition, and survivors often experience post-cardiac arrest syndrome (PCAS), making echocardiograms essential for evaluating their condition.
- The study reviews existing literature to highlight the significance of transthoracic and transesophageal echocardiograms during and after cardiac arrest.
- The conclusion emphasizes that these echocardiogram techniques play crucial roles in diagnosing and predicting outcomes for patients during the CA phase and beyond.
Objective: Concerns exist about the possible detrimental effects of exercise training on aortic size and valve function in individuals with bicuspid aortic valve (BAV). This multicentre international study aimed to determine the characteristics of aortic size and valve function in athletes versus non-athletes with BAV and athletes with tricuspid aortic valve (TAV).
Methods: We enrolled competitive athletes with BAV and age- and sex-matched athletes with TAV and non-athletes with BAV.
Article Synopsis
- * A total of 202 patients were followed for about 22 months, showing very low rates of major bleeding and cardiovascular events, along with 99% adherence to the treatment regimen.
- * Although most patients adhered to DPI therapy, 13.4% discontinued treatment mainly due to minor bleeding, indicating that DPI is generally safe and well-tolerated in a real-world clinical setting.
Article Synopsis
- Heart failure (HF) and atrial fibrillation (AF) are common and serious heart-related conditions that lead to increased health issues, hospital visits, and healthcare costs.
- These two diseases often occur together and influence each other, especially through the damaging effects of oxidative stress caused by reactive oxygen species (ROS), which can worsen heart structure and function.
- New medications for heart failure also help manage atrial fibrillation by reducing oxidative stress, and this review focuses on how these treatments can prevent and improve AF in patients with HF.
Article Synopsis
- Heart failure (HF) is a condition marked by structural and functional heart issues that lead to poor blood flow and elevated heart pressures, often stemming from injuries or diseases affecting the heart.
- Early detection of the causes of HF is crucial for accurate diagnosis and treatment; echocardiography is the primary tool for identifying both obvious and subtle heart problems.
- Stress echocardiography (SE) is gaining recognition not just for diagnosing ischemic heart disease, but also for assessing other types of heart failure and guiding treatment plans, highlighting its added value in patient management.
Article Synopsis
- Aortic regurgitation (AR) in people with a bicuspid valve (BAV) can be tricky to diagnose because the way blood flows can look different and make measurements hard to judge.
- Traditional methods like echocardiography aren't always helpful for these patients.
- Using a mix of different imaging techniques, like ultrasound, MRI, and CT scans, can help doctors better understand AR and decide if someone needs a valve replacement.
Article Synopsis
- * The SPREAD study is a multinational research project aimed at understanding the impact of sports on BAV disease through two phases: a comparative cross-sectional analysis and a longitudinal follow-up.
- * The ultimate goal of the study is to provide data that can help guide decisions on sports participation and assess risk for individuals with BAV.
Article Synopsis
- Transthoracic echocardiography (TTE) is essential for screening athletes, particularly those under 40 with symptoms or family histories related to cardiac issues, as well as in follow-up cases of cardiovascular disease.
- It is a cost-effective imaging tool for assessing heart changes from intense training (the athlete's heart) and for identifying serious conditions that could lead to sudden cardiac death, such as cardiomyopathies.
- An expert opinion from the Italian Society of Sports Cardiology highlights scenarios for TTE use, differentiating between normal and abnormal heart adaptations, and recommends a standardized dataset for reporting TTE findings in sports cardiology.
Article Synopsis
- Coronary embolism, while rare, can lead to acute coronary syndrome, as illustrated by a case involving a 68-year-old woman with a myocardial infarction.
- This patient had a background of a bioprosthetic aortic valve and a history of atrial fibrillation, complicating her condition.
- To monitor her heart function and determine future treatment options, she was given an implantable loop recorder before being discharged.
The Lipid-Lowering Efficacy of a Nutraceutical Combination Including Leucoselect Phytosome, Red Yeast Rice, Policosanol and Folic Acid in Dyslipidaemia Patients: Real-World Insights.
Pharmaceuticals (Basel)
March 2024
Background: Cardiovascular disease is a global health concern and reducing plasma LDL-C levels is a major goal in cardiovascular prevention. Our study aimed to evaluate the effectiveness of a nutraceutical formulation including leucoselect phytosome, red yeast rice, policosanol and folic acid on LDL-c levels in patients at low cardiovascular risk with dyslipidemia.
Materials And Methods: We prospectively enrolled all consecutive patients with dyslipidemia at low cardiovascular risk who were unresponsive to diet and physical activity.
Article Synopsis
- Left ventricular arrhythmogenic cardiomyopathy (ALVC) is a rare heart condition that has been reclassified as a type of non-dilated cardiomyopathy, and the review highlights its background, diagnosis, and risks of sudden cardiac death.
- There is limited data on ALVC, but it is recognized as a specific disease affecting the left ventricle, necessitating updated management strategies and understanding of associated risks.
- Diagnosis involves a comprehensive approach using cardiac magnetic resonance imaging and genetic testing, which are crucial for assessing the risk of sudden cardiac death and improving patient management, with more research needed to enhance knowledge about the condition.
Article Synopsis
- Coronary artery disease (CAD) is a major global health issue, requiring effective diagnosis, particularly for acute coronary syndromes (ACSs).
- Traditional methods like electrocardiograms (ECGs) are essential, but echocardiography has greatly improved cardiac care by offering valuable insights into heart function.
- This article advocates for the routine use of focused echocardiography in the cardiac catheterization lab for patients with ST-Elevation Myocardial Infarction (STEMI), highlighting its benefits in improving diagnostic accuracy and guiding treatment decisions.
Article Synopsis
- The study investigated the prevalence of out-of-range plasma levels of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) who underwent elective cardiac procedures, focusing on proper timing of DOAC withdrawal.
- Out of 90 AF patients evaluated, 82.22% had DOAC concentrations outside expected ranges; about 41% had levels below the trough, which is the minimum effective concentration of the drug.
- Key predictors for low DOAC levels included inappropriate withdrawal periods and increased kidney function (creatinine clearance), while diabetes was linked to higher DOAC levels above the trough range.
Article Synopsis
- International Guidelines use left ventricular ejection fraction (LVEF) to classify heart failure patients and determine treatments, but LVEF has technical limitations and may not predict outcomes in advanced cases.
- Analysis of left ventricular flow metrics and non-invasive pressure evaluations can provide better prognostic insights for heart failure patients.
- Speckle tracking echocardiography (STE) effectively reveals underlying myocardial dysfunction, particularly in patients with preserved LVEF, and offers valuable metrics like global peak atrial longitudinal strain (PALS) for assessing left ventricular filling pressure and function.*
Article Synopsis
- Recent research indicates that lung ultrasound can detect hidden pulmonary congestion in patients with pulmonary arterial hypertension (PAH), revealing a relationship between right heart failure and increased lung water content.
- A study involving 102 PAH patients demonstrated that 75% had pulmonary congestion indicated by B-lines on lung ultrasound, with various factors such as sex, age, and NT-proBNP levels correlating with these findings.
- The results suggest that pulmonary congestion is tied to right ventricular dysfunction and increased central venous pressure, which may hinder lymphatic drainage.
Article Synopsis
- - Myotonic dystrophy is a genetic condition that affects multiple systems in the body, including the nervous and cardiovascular systems.
- - The Italian Neuro-Cardiology Network (INCN-RNC) is a collaboration between neurology and cardio-arrhythmology units aimed at improving patient care.
- - INCN helps establish integrated teams in Neuromuscular Disease Centers to better manage the cardiovascular issues associated with myotonic dystrophy type 1 (MD1).
Cardiac resynchronization therapy (CRT) is a device-based treatment applied to patients with a specific profile of heart failure. According to current guidelines, indication for CRT is given on the basis of QRS morphology and duration, and traditional transthoracic echocardiography is mainly used to estimate left ventricular (LV) ejection fraction. However, the identification of patients who may benefit from CRT remains challenging, since the application of the above-mentioned guidelines is still associated with a high rate of non-responders.
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- AI technologies are transforming sports cardiology by improving risk assessment, diagnosis, treatment planning, and monitoring of athletes.
- The article discusses AI applications in imaging, genetic testing, and wearable devices, highlighting machine learning's role in analyzing complex data.
- Ethical concerns like informed consent, algorithmic fairness, and data privacy need to be addressed, emphasizing the need for collaboration between AI and physician expertise to enhance patient care.
Stress Echocardiography in Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.
J Cardiovasc Echogr
November 2023
Article Synopsis
- The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to investigate stress echocardiography (SE) practices across Italy, collecting data from 228 laboratories in November 2022.
- The survey revealed that out of 179 centers performing SE, most were located in northern Italy, and the study categorized them into low, moderate, and high volume of activity based on the number of SE examinations.
- Key findings indicated differences in the use of stressors, with a tendency for high-volume centers to employ multiple stress techniques and incorporate advanced evaluations like coronary flow velocity reserve (CFVR) more frequently than low and moderate volume centers.