Publications by authors named "AnnaMaria Iorio"

Article Synopsis
  • * Analyzed data from 7948 HF patients over a minimum of 2 years, employing topological data analysis (TDA) to find 19 patient clusters and trajectory analysis to outline disease evolution.
  • * Findings included a 5-year survival rate across clusters ranging from 20% to 100%, with strong validation results from external and internal cohorts, confirming the reliability of the identified patient pathways.
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Article Synopsis
  • Heart failure with preserved ejection fraction (HFpEF) has been challenging to treat over the years, but recent therapies, including sodium-glucose cotransporter 2 inhibitors (SGLT2i), show promise in improving patient outcomes.
  • HFpEF is increasingly prevalent, influenced by longer life expectancies and rising health issues like diabetes and obesity, suggesting it's part of a wider cardio-nephro-metabolic syndrome.
  • The Cardiovascular Observatory of Friuli-Venezia Giulia plays a crucial role in identifying and managing HFpEF patients, highlighting the need for tailored therapeutic approaches, particularly with the emerging role of SGLT2i in treatment guidelines.
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Background: A sex-based evaluation of prognosis in heart failure (HF) is lacking.

Methods And Results: We analyzed the Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score registry, which includes HF with reduced ejection fraction (HFrEF) patients. A cross-validation procedure was performed to estimate weights separately for men and women of all MECKI score parameters: left ventricular ejection fraction (LVEF), hemoglobin, kidney function assessed by Modification of Diet in Renal Disease, blood sodium level, ventilation vs.

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Article Synopsis
  • * Differences in how drugs are metabolized by sex highlight the need for sex-specific medical approaches, yet awareness of this issue is still limited.
  • * The paper focuses on evaluating therapeutic strategies for managing common diseases affecting women, emphasizing the importance of individualized treatment guidelines based on gender.
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Article Synopsis
  • - Gender significantly influences cardiovascular risk factors and affects prevention, clinical pathways, diagnosis, and treatment, highlighting the need for a more inclusive approach in healthcare.
  • - Despite its importance, sex and gender differences in cardiovascular care are often overlooked, leading to disparities in patient outcomes and access to quality care.
  • - The paper emphasizes the necessity of increasing female representation in clinical trials and leadership roles, advocating for tailored treatment strategies that consider gender influences on cardiovascular diseases.
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Anderson-Fabry disease (AFD) is a lysosome storage disorder resulting from an X-linked inheritance of a mutation in the galactosidase A (GLA) gene encoding for the enzyme alpha-galactosidase A (α-GAL A). This mutation results in a deficiency or absence of α-GAL A activity, with a progressive intracellular deposition of glycosphingolipids leading to organ dysfunction and failure. Cardiac damage starts early in life, often occurring sub-clinically before overt cardiac symptoms.

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Aims: Improvement of left ventricular ejection fraction is a major goal of heart failure (HF) treatment. However, data on clinical characteristics, exercise performance and prognosis in HF patients who improved ejection fraction (HFimpEF) are scarce. The study aimed to determine whether HFimpEF patients have a distinct clinical phenotype, biology and prognosis than HF patients with persistently reduced ejection fraction (pHFrEF).

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Variants in desmoplakin gene ( MIM *125647) have been usually associated with Arrhythmogenic Cardiomyopathy (ACM), or Dilated Cardiomyopathy (DCM) inherited in an autosomal dominant manner. A cohort of 18 probands, characterized as heterozygotes for variants by a target Next Generation Sequencing (NGS) cardiomyopathy panel, was analyzed. Cardiological, genetic data, and imaging features were retrospectively collected.

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Article Synopsis
  • The study examines the impact of moderate hyperkalemia on patient outcomes in those with reduced ejection fraction heart failure (HFrEF).
  • It found that moderate hyperkalemia (potassium levels between 5.0 and 5.5 mEq/L) did not significantly affect cardiovascular mortality compared to normal potassium levels.
  • Overall, the research suggests that moderate hyperkalemia does not influence outcomes in a large group of well-managed HFrEF patients, potentially easing concerns over RAASi therapy adjustments.
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Introduction: The role of sex compared to comorbidities and other prognostic variables in patients with coronavirus disease (COVID-19) is unclear.

Methods: This 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.

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Article Synopsis
  • The management of atrial fibrillation (AF) involves a dilemma between rhythm control (restoring normal heart rhythm) and rate control (slowing heart rate), with electrical or pharmacological cardioversion (CV) often being used.
  • Recent guidelines emphasize the importance of anticoagulation based on the individual risk of blood clots, highlighting the shift from traditional Vitamin K antagonists (VKAs) to more effective non-vitamin K antagonist oral anticoagulants (NOACs).
  • In emergency situations or unstable patients, immediate electrical cardioversion (ECV) is necessary, and careful plans for anticoagulation must be followed, especially in cases of AF lasting over 48 hours to reduce thromboembolic risks.
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Article Synopsis
  • The study focused on hospitalized COVID-19 patients to evaluate the impact of a history of atrial fibrillation (AF) on their clinical outcomes.
  • Among the 696 patients, those with a history of AF had significantly higher mortality rates (38.7% vs 20.8%) and faced more in-hospital complications like new-onset AF and acute heart failure.
  • Even after adjusting for other serious health factors, the presence of AF remained a critical risk factor for worse outcomes in these patients.
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Aims: Myocardial injury (MI) in coronavirus disease-19 (COVID-19) is quite prevalent at admission and affects prognosis. Little is known about troponin trajectories and their prognostic role. We aimed to describe the early in-hospital evolution of MI and its prognostic impact.

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Article Synopsis
  • Glucocorticoid therapy has been found effective in reducing mortality in hospitalized COVID-19 patients, based on a study of 706 patients from the Cardio-COVID-Italy registry.
  • The study showed that patients treated with glucocorticoids had a significantly lower risk of in-hospital mortality (adjusted HR 0.44) compared to those who weren't treated, especially those with specific clinical conditions.
  • The benefits of glucocorticoids were particularly noticeable in patients with poor respiratory function (lower PaO/FiO ratio and oxygen saturation) and higher levels of systemic inflammation (higher CRP levels).
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Congenital heart disease (CHD) and cardiomyopathies represent the two most important causes of paediatric heart failure (HF) in developed countries. We made a review of the literature on pathophysiology and clinical presentation of paediatric HF in children with CHD. Two main pathophysiologic models can be identified: the 'over-circulation failure', characterised by signs and symptoms of congestion or hypoperfusion, due respectively to volume or pressure overload, and the 'pump failure'.

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Background: Coronavirus Disease 2019 (COVID-19) is a pandemic affecting all countries in the world. Italy has been particularly afflicted by the health emergency, and since the peak phase has passed, major concern regarding medium to long term complications due to COVID-19 is arising. Little is known in literature regarding thromboembolic complications once healed after COVID-19.

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The growing use of imaging examinations has led to increased detection of spontaneous coronary artery dissection (SCAD) as a non-atherosclerotic cause of acute coronary syndrome (ACS). Since a greater awareness of pathophysiologic mechanisms has relevant implications in clinical practice, we aim to provide an update to current knowledge of SCAD pathophysiology. We discuss the most common conditions associated with SCAD, including predisposing factors and triggers, and focus on potential mechanisms leading to SCAD development.

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Aims: To assess the prognostic value of a history of heart failure (HF) in patients with coronavirus disease 2019 (COVID-19).

Methods And Results: We enrolled 692 consecutive patients admitted for COVID-19 in 13 Italian cardiology centres between 1 March and 9 April 2020. Mean age was 67.

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Recreational drug use may cause coronary artery disease through several mechanisms. An increasing number of young patients with drug-related acute coronary syndrome have been reported over recent years. The present position statement reports the most recent epidemiological data on acute coronary syndrome in the setting of drug abuse, describes the main pathophysiological mechanisms underlying coronary artery disease and acute events in these patients, and provides practical recommendations on management and an overview of prognosis.

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Article Synopsis
  • Myocardial injury in COVID-19 patients, indicated by elevated troponin levels, correlates with higher mortality rates, especially in older and sicker populations in Europe and the US.
  • A multicenter study in Italy involved 614 hospitalized COVID-19 patients and found that 45.3% had elevated troponin levels.
  • Patients with elevated troponin were older and had higher rates of comorbidities like hypertension and heart disease, leading to a significant increase in their in-hospital mortality risk.
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Article Synopsis
  • The study aimed to assess sex-related differences in chronic heart failure patients and how these differences affect treatment and outcomes.
  • Among 2528 patients examined, females were more likely to have heart failure with preserved ejection fraction (HFpEF) and showed distinct health profiles compared to males.
  • Although overall mortality rates were similar between sexes, adjusted findings indicated that females had a lower risk of mortality in HFpEF and mid-range ejection fraction (HFmrEF) groups, largely due to non-cardiac comorbidities affecting their prognosis.
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Article Synopsis
  • * The condition is believed to have multiple, poorly understood underlying causes and is characterized by abnormalities in heart muscle cells, tissue, blood vessels, and metabolism.
  • * Cardiac magnetic resonance (CMR) imaging may help identify specific abnormalities in HFpEF, potentially leading to tailored treatment strategies and improved understanding of different patient profiles.
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Antithrombotic drugs, which include antiplatelets and anticoagulants, are effective in prevention and treatment of many cardiovascular disorders such as acute coronary syndromes, stroke, and venous thromboembolism and are among the drugs most commonly prescribed worldwide. The advent of direct oral anticoagulants, which are safer alternatives to vitamin K antagonists and do not require laboratory monitoring, has revolutionized the treatment of nonvalvular atrial fibrillation and venous thromboembolism. The combination of oral anticoagulant and antiplatelet therapy is required in many conditions of great clinical impact such as the coexistence of atrial fibrillation and coronary artery disease, with indication to percutaneous coronary intervention.

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