Publications by authors named "Barbati G"
Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) and type 2 myocardial infarction (MI), both presenting as non-ST-elevation MI (NSTEMI), are often grouped together due to overlapping symptoms. The aim of our study is to compare their characteristics and prognosis to distinguish between them.
Methods: Among 7815 patients with NSTEMI who underwent coronary angiography between 2005 and 2022 we identified 538 patients with diagnosis of MINOCA (n = 301; 3,9 %) and type 2 MI (n = 237; 3 %).
Article Synopsis
- A study analyzed long-term outcomes in 1,184 patients with implantable cardioverter defibrillators (ICDs) to compare the risks of appropriate interventions and overall survival between those with ischemic heart disease (IHD) and non-ischemic heart disease (NIHD).
- Findings revealed that all-cause mortality was significantly higher in patients with IHD (60%) compared to those with NIHD (43%), but the rate of appropriate ICD interventions did not differ significantly over ten years (34% for IHD vs. 40% for NIHD).
- Additionally, within NIHD, certain types of heart disease like valvular disease and chemotherapy-related dilated cardiomyopathy showed higher mortality rates, while inappropriate
Article Synopsis
- This study investigates the use of artificial intelligence to detect transthyretin amyloid cardiomyopathy (ATTR-CM) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI).
- Researchers analyzed a variety of data including clinical, lab, and imaging results to develop machine learning models for detection and outcome prediction.
- Results showed that while echocardiography and 4D-CT-strain had good to high detection performances, the multi-modality model incorporating various data types did not significantly outperform the 4D-CT-strain model alone.
Article Synopsis
- LDL cholesterol is a major focus for preventing cardiovascular events, and Proprotein Convertase Subtilisin-Kexin type 9 inhibitors (PCSK9-i) have become an important treatment to lower LDL levels.
- A recent study aimed to understand how many people qualify for PCSK9-i treatment and how effective it is by analyzing electronic health records from 2017 to 2020.
- Results showed that only 8% of eligible individuals received PCSK9-i, but those treated experienced a significant reduction in the risk of death and hospitalizations compared to those who didn't receive the treatment.
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.
Article Synopsis
- - Sepsis is a complicated and serious condition, and this study aimed to improve prognosis and patient grouping by examining specific immune response biomarkers known as regulatory immune checkpoints.
- - Researchers analyzed 12 immune response biomarkers in 113 patients with bacterial sepsis, finding that two biomarkers, IRAK-M and Galectin-1, were strong indicators of short-term (7-day and 30-day) mortality and could help categorize patients based on immune response.
- - The study concluded that IRAK-M and Galectin-1 could serve as prognostic tools to identify different sepsis phenotypes, which may assist in treatment decisions and future clinical trials aimed at targeted therapies.
Article Synopsis
- A study analyzed the long-term cost-effectiveness of a single-pill combination (SPC) of three antihypertensive drugs compared to a two-pill combination in Italy, finding that the SPC improves medication adherence.
- The study evaluated data from over 95,000 patients using advanced modeling to assess costs and life expectancy, showing that the SPC resulted in an increase of 0.86 years of life at a slightly lower mean cost.
- The savings from reduced hospitalization costs outweighed the higher drug costs of the SPC, establishing it as a more cost-effective treatment strategy.
Background: The prognostic impact of catheter ablation (CA) of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) patients has not yet been satisfactorily elucidated.
Objectives: The aim of the study was to assess the impact of CA of AF on clinical outcomes in a large cohort of HCM patients.
Methods: In this retrospective multicenter study, 555 HCM patients with AF were enrolled, 140 undergoing CA and 415 receiving medical therapy.
Background: It remains unclear today whether risk scores created specifically to predict early mortality after cardiac operations for infective endocarditis (IE) outperform or not the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II).
Methods: Perioperative data and outcomes from a European multicenter series of patients undergoing surgery for definite IE were retrospectively reviewed. Only the cases with known pathogen and without missing values for all considered variables were retained for analyses.
Objective: Trimethylamine N-oxide (TMAO) has been associated with atherosclerosis and poor outcome. We evaluated the prognostic impact of intra-hospital TMAO variation on patient outcome.
Methods And Results: Blood samples from 149 patients with acute myocardial infarction (AMI) were taken on admission and discharge.
Article Synopsis
- This study distinguishes between nondilated left ventricular cardiomyopathy (NDLVC) and dilated cardiomyopathy (DCM) by using cardiac magnetic resonance (CMR) and genetic testing on 462 patients across four centers.
- Findings showed that NDLVC patients had better heart function and a higher prevalence of specific genetic variants compared to those with DCM, highlighting significant differences in their conditions.
- The presence of septal late gadolinium enhancement and other factors like LV dilatation, age, and arrhythmias were identified as strong predictors for serious cardiac events, such as sudden cardiac death.
Objectives: This study aims to show the application of flexible statistical methods in real-world cost-effectiveness analyses applied in the cardiovascular field, focusing specifically on the use of proprotein convertase subtilisin-kexin type 9 inhibitors for hyperlipidemia.
Methods: The proposed method allowed us to use an electronic health database to emulate a target trial for cost-effectiveness analysis using multistate modeling and microsimulation. We formally established the study design and provided precise definitions of the causal measures of interest while also outlining the assumptions necessary for accurately estimating these measures using the available data.
Article Synopsis
- This study investigates the relationship between myocardial bone tracer uptake in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) and outcomes like all-cause mortality.
- It involves 1,422 patients who underwent imaging to classify cardiac uptake levels and assess right ventricular (RV) uptake patterns, finding that diffuse RV uptake correlates with higher mortality rates.
- Multivariable analysis identified several factors, including age and specific genetic variants, that also impact survival outcomes in these patients.
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.
Background: The performance of heart failure (HF) risk models is validated in the general population with HF but in specific aetiological settings, and specifically in dilated cardiomyopathy (DCM), has scarcely been explored. We tested eight of the main prognostic scores used in HF in a large real-world population of patients with DCM.
Methods: We included 784 consecutive DCM patients enrolled, both inpatients and outpatients, enrolled between January 2000 and December 2017.
Article Synopsis
- Epidemiologic, genetic, and clinical studies indicate that low-density lipoprotein cholesterol (LDL-C) plays a key role in developing atherosclerotic cardiovascular disease (ASCVD), but variability in LDL-C levels may increase ASCVD risk even in statin-treated patients.
- A retrospective study followed 3,398 patients with stable cardiovascular disease for a median of 56 months, finding that the percentage achieving LDL-C levels below 70 mg/dL increased from 20.7% to 31.9%.
- Results show that for every 20 mg/dL increase in LDL-C levels, the risk of any adverse event rose by 6%, emphasizing the importance of consistently lowering LDL-C for cardiovascular benefits in patients receiving
Article Synopsis
- * It included 216 DCM patients and found that despite stable echocardiographic values, a significant number showed worsening functional capacity, correlating with higher risks of severe health outcomes.
- * The findings suggest that retesting CPET in DCM patients who do not show left ventricular reverse remodeling can help identify those at greater risk for adverse events.
Background: Machine learning (ML) methods to build prediction models starting from electrocardiogram (ECG) signals are an emerging research field. The aim of the present study is to investigate the performances of two ML approaches based on ECGs for the prediction of new-onset atrial fibrillation (AF), in terms of discrimination, calibration and sample size dependence.
Methods: We trained two models to predict new-onset AF: a convolutional neural network (CNN), that takes as input the raw ECG signals, and an eXtreme Gradient Boosting model (XGB), that uses the signal's extracted features.
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.
Association of Tricuspid Regurgitation With Outcome in Acute Heart Failure.
Circ Cardiovasc Imaging
July 2023
Article Synopsis
- Tricuspid regurgitation (TR) is a common issue in chronic heart failure and negatively impacts prognosis, especially in patients admitted for acute heart failure (HF); however, this study investigates the relationship between TR and mortality in acute HF cases.* -
- The research included 1,176 patients, finding that 29.9% had moderate to severe TR, which correlated with older age and more health complications; moderate-severe TR significantly increased the risk of death within one year regardless of other health factors.* -
- Specifically, those with both moderate-severe TR and pulmonary hypertension faced a threefold increase in one-year mortality risk compared to those without TR or PH, highlighting the critical impact of concurrent conditions on patient
Article Synopsis
- * The study analyzed electronic health records from over 10,600 patients who were evaluated for heart conditions but had no prior heart failure diagnosis, tracking developments over an average of 65 months.
- * Two AI models were developed, with a deep neural network model (PHNN) proving more effective than a traditional Cox model in predicting heart failure risks, identifying 20 key predictors relevant to clinical practice.
Left ventricular ejection function (LVEF) is not reliable in identifying subtle systolic dysfunction. Speckle Tracking (ST) plays a promising role and hemodynamic forces (HDFs) are emerging as marker of LV function. The role of LV myocardial deformation and HDFs was investigated in a cohort of patients with aortic stenosis (AS) and normal LVEF.
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- In a study of 1,131 patients with dilated cardiomyopathy (DCM), researchers found that the use and dosage of loop diuretics (LD) are linked to worse health outcomes.
- They categorized patients based on their furosemide-equivalent dose (FED) changes over 24 months, finding that both increased doses and stable doses correlated with higher risks of adverse events compared to those who never used LD.
- Discontinuing loop diuretics showed an improved prognosis, highlighting that avoiding or reducing LD may benefit DCM patients significantly.
Article Synopsis
- Conducting randomized control trials in clinical settings can be challenging, leading researchers to rely on observational registries that provide longitudinal data on treatments and outcomes.
- This research proposes an innovative method that combines marginal structural models with recurrent event analysis to estimate treatment effects in situations where both recurrent events and survival outcomes are important.
- The study specifically focuses on evaluating the impact of beta-blockers in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC/D), utilizing data from the Trieste Heart Muscle Disease Registry for this analysis.