Publications by authors named "Antonella Lombardo"

According to current guidelines, patients with heart valve disease should be followed by Heart Valve Clinics (HVCs). Regular quality analysis is a major prerequisite of an HVC's program, but few data have been reported so far. We retrospectively collected patients with isolated, native aortic valve stenosis who had been visited in our HVC at least once between 2021 and 2024.

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Background: Aetiological diagnosis and targeted antibiotic therapy are essential to improve the prognosis of patients with infective endocarditis. Molecular tests on blood have been reported to be effective in identifying the causative organism and are recommended when blood cultures are negative. The role of molecular tests on the surgically excised valve is still unclear and needs further investigation.

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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.

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Background: Hemodynamic impact of residual mitral regurgitation (MR) after transcatheter edge-to-edge repair (TEER) is not always univocally measured by transesophageal echocardiographic (TEE) assessment alone. When analyzing TEER procedure result, operators often encounter discrepancy between TEE guidance and invasive hemodynamic monitoring.

Objectives: This study sought to investigate the role of invasive hemodynamic monitoring during mitral valve TEER procedure on top of TEE guidance.

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Background: Evidence about early cardiac mechanics abnormalities in patients with mitochondrial diseases (MDs) before overt cardiomyopathy is limited.

Methods: In this prospective study, we performed a comparative analysis of conventional and speckle tracking echocardiographic parameters between patients with genetically identified MDs and no overt cardiomyopathy vs controls matched for age, sex and cardiovascular risk factors. The Newcastle mitochondrial disease adult scale (NMDAS) was calculated, using a threshold of > 21 as indicator of high disease severity.

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Aims: Lung ultrasound (LUS) is a sensitive tool to assess pulmonary congestion (PC). Few data are available on LUS-PC evaluation in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). The aim of this study was to assess the prevalence and prognostic impact of LUS-PC in patients with severe AS before and after TAVI.

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Article Synopsis
  • Iron deficiency (ID) is prevalent in heart failure (HF) patients and negatively impacts their health, even if they aren't anemic; iron supplementation can improve exercise and quality of life in these individuals.
  • An online survey of 256 cardiologists revealed that most defined ID correctly and screened more than half of their patients, but only 54.3% did periodic screenings; intravenous iron was the most commonly prescribed treatment.
  • The survey results point to a need for better, standardized practices for ID screening and management in HF patients, as many physicians view ID as an overlooked issue in this group.
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Sodium-glucose cotransporter 2 inhibitors (SGLT2i), a new drug class initially designed and approved for treatment of diabetes mellitus, have been shown to exert pleiotropic metabolic and direct cardioprotective and nephroprotective effects that extend beyond their glucose-lowering action. These properties prompted their use in two frequently intertwined conditions, heart failure and chronic kidney disease. Their unique mechanism of action makes SGLT2i an attractive option also to lower the rate of cardiac events and improve overall survival of oncological patients with preexisting cardiovascular risk and/or candidate to receive cardiotoxic therapies.

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  • The study looked at a new heart valve procedure called VIV-TAVI, which helps replace old heart valves.
  • It aimed to find a way to predict a problem called patient-prosthesis mismatch (PPM) that can happen with these valve replacements, which may make them less effective.
  • Researchers found that certain tests before the procedure could help identify patients at risk for PPM, and those with severe PPM had a higher chance of complications later on.
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  • The CARdio-Tox study investigated the cardiovascular complications associated with Chimeric Antigen Receptor-T (CAR-T) cell therapy, particularly focusing on the incidence of cancer therapy-related cardiac dysfunction (CTRCD) amidst cytokine release syndrome (CRS).* -
  • Patients with blood malignancies underwent echocardiography before and at 7 and 30 days post-CAR-T infusion, revealing a high CTRCD incidence of 59.3% at 7 days, especially in those experiencing CRS.* -
  • The study found significant correlations between early declines in heart function metrics and inflammatory markers, emphasizing the need for ongoing patient monitoring to address potential cardiac issues related to CAR-T therapy.*
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Heart failure (HF) patients have a significantly higher risk of new-onset cancer and cancer-associated mortality, compared to subjects free of HF. While both the prevention and treatment of new-onset HF in patients with cancer have been investigated extensively, less is known about the prevention and treatment of new-onset cancer in patients with HF, and whether and how guideline-directed medical therapy (GDMT) for HF should be modified when cancer is diagnosed in HF patients. The purpose of this review is to elaborate and discuss the effects of pillar HF pharmacotherapies, as well as digoxin and diuretics on cancer, and to identify areas for further research and novel therapeutic strategies.

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Background: Fabry disease (FD) and transthyretin cardiac amyloidosis (TTR CA) are cardiomyopathies with hypertrophic phenotype that share several features, including left atrial (LA) enlargement and dysfunction, but direct comparative data are lacking. Aim of the present study was to perform a comparative analysis of LA remodelling between the two diseases.

Methods And Results: In this prospective study, a total of 114 patients (31 FD and 83 TTR CA) were included; all of them had left ventricular hypertrophy (LVH), defined as left ventricular (LV) wall thickness ≥ 12 mm.

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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.
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Recently, prognosis and survival of cancer patients has improved due to progression and refinement of cancer therapies; however, cardiovascular sequelae in this population augmented and now represent the second cause of death in oncological patients. Initially, the main issue was represented by heart failure and coronary artery disease, but a growing body of evidence has now shed light on the increased arrhythmic risk of this population, atrial fibrillation being the most frequently encountered. Awareness of arrhythmic complications of cancer and its treatments may help oncologists and cardiologists to develop targeted approaches for the management of arrhythmias in this population.

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Article Synopsis
  • - This study aimed to classify patients with Fabry disease (FD) into four stages based on the severity of cardiac damage, using echocardiography to evaluate heart conditions.
  • - An analysis of 314 FD patients revealed that more severe stages of cardiac damage led to a higher risk of adverse cardiovascular events over an 8-year period.
  • - The findings suggest that the new staging system provides significant prognostic value for assessing cardiovascular risks in FD patients, potentially improving risk stratification strategies.
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Background: There is limited evidence regarding the association between right ventricular-to-pulmonary artery (RV-PA) coupling and outcomes after transcatheter aortic valve replacement (TAVR).

Objectives: This study aimed to explore the evolution of RV-PA coupling in patients with severe aortic stenosis undergoing TAVR and its prognostic impact.

Methods: A total of 900 patients who underwent TAVR in 2 tertiary centers and with echocardiographic analysis performed within 3 months before and after the procedure were included.

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Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy.

Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website.

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Article Synopsis
  • A recent study observed the effects of the drug Sacubitril/Valsartan on patients with heart failure and reduced ejection fraction (HFrEF), indicating significant improvements in heart function over 12 months.
  • Researchers analyzed echocardiographic data from 66 patients, finding that changes in left ventricular global longitudinal strain (LVGLS) and left atrial reservoir strain (LARS) after three months were key predictors of long-term recovery in heart function.
  • The results suggest that measuring LV and LA strain should become a standard part of assessing treatment effectiveness in HFrEF patients.
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Background: The use of Impella support is increasingly adopted to "protect" patients with severe coronary artery disease (CAD) and left ventricle (LV) dysfunction undergoing percutaneous coronary intervention (PCI).

Aims: To evaluate the impact of Impella-protected (Abiomed, Danvers, Massachusetts, USA) PCIs on myocardial function recovery.

Methods: Patients with significant LV dysfunction undergoing multi-vessel PCIs with pre-intervention Impella implantation were evaluated by echocardiography before PCI and at median follow up of 6 months: global and segmental LV contractile function were assessed by LV ejection fraction (LVEF) and wall motion score index (WMSI), respectively.

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