Publications by authors named "Bianchi Stefano"

Background: Gestational diabetes mellitus (GDM) is the most common complication in pregnancy, representing a serious risk for the mother and fetus. Identifying new biomarkers to ameliorate the screening and improving GDM diagnosis and treatment is crucial. During the last decade, a few studies have used speckle tracking echocardiography (STE) for assessing the myocardial deformation properties of fetuses (FGDM) and infants (IGDM) of GDM women, providing not univocal results.

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  • Many patients with atrial fibrillation (AF) are not receiving or are stopping oral anticoagulation therapy, despite its importance for stroke prevention.
  • While direct oral anticoagulants (DOACs) are available, issues like bleeding risks, poor compliance, and aversion to treatment contribute to this problem.
  • A recent expert consensus guide highlights left atrial appendage closure (LAAC) as a safe alternative for stroke prevention in patients who cannot use long-term anticoagulation, detailing the devices, implantation technique, and follow-up requirements for non-implanting physicians.
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  • Pulsed field ablation (PFA) is a new treatment for atrial fibrillation (AF) that shows strong safety and efficacy by specifically targeting heart muscle cells while sparing nearby tissues.
  • A meta-analysis comparing PFA with cryoballoon ablation (CRYO) found that PFA had higher procedural success rates and fewer complications, along with shorter procedural and fluoroscopy times.
  • However, there were no significant differences in major complications or freedom from atrial tachyarrhythmias after one year between the two techniques.
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  • Pulsed field ablation (PFA) is a new technique for heart tissue treatment that targets heart cells directly without damaging nearby tissues, but using it with mechanical heart valves can be tricky due to potential interference.* -
  • This study involved 30 patients with mechanical heart valves undergoing PFA for atrial fibrillation, and it found no major complications, with normal valve function post-procedure.* -
  • While PFA seems safe for patients with mechanical valves, careful management of the catheter is crucial to prevent electromagnetic interference that could affect the treatment.*
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Background: During the last two decades, a few studies have evaluated the common carotid artery (CCA) intima-media thickness (IMT) in women with previous history of pre-eclampsia (pPE) in comparison to women with uncomplicated pregnancies, providing not univocal results. This systematic review and meta-analysis has been designed to summarize the main findings of these studies and to examine the overall influence of pPE on CCA-IMT.

Methods: All studies assessing CCA-IMT in pPE women in comparison to women who had uncomplicated pregnancies, selected from PubMed and EMBASE databases, were included.

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A growing body of experimental and clinical evidence confirms that aldosterone contributes, independently from its classical homeostatic effects, to the pathogenesis and progression of chronic kidney disease (CKD). In fact, the activation of the mineralocorticoid receptor (MR) in the kidney, present at the podocyte, mesangial, endothelial as well as at the tubulointerstitial levels, has been linked to podocyte damage and consequent apoptosis, proliferation of mesangial cells, inflammation of the tubulointerstitial compartment and, more generally, to the final outcome of interstitial fibrosis and glomerular sclerosis. Therefore, blockade of the MR may represent an effective treatment of CKD.

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Background: Stereotactic arrhythmia radioablation (STAR) was introduced to treat ventricular tachycardia (VT) refractory to catheter ablation. No data are now available in the septal VT substrate setting, representing a challenge when using conventional techniques.

Objectives: This study sought to evaluate the arrhythmic burden in patients with septal VT treated with magnetic resonance-guided STAR (MRgSTAR).

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Extensive research has been conducted in image forensics on the analysis of double-compressed images, particularly in the widely adopted JPEG format. However, there is a lack of methods to detect double compression in the HEIF format, which has recently gained popularity since it allows for reduced file size while maintaining image quality. Traditional JPEG-based techniques do not apply to HEIF due to its distinct encoding algorithms.

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  • This study investigated how different anatomical variations of pulmonary veins (PV) and their cooling characteristics affect recurrence of atrial fibrillation (AF) after cryoballoon (CB) ablation, using data from a large multicenter registry.
  • Out of 429 patients with AF, 28 had anatomical variants; the study found no significant difference in AF recurrence rates between those with variants and those with standard anatomy.
  • Key factors associated with AF recurrence included shorter thaw and deflation times, while conditions like heart failure and persistent AF were linked to higher recurrence rates during follow-up.
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Introduction: The underdiagnosis of chronic kidney disease (CKD) remains a significant public health concern. The Early chroNic kiDney disease pOint of caRe Screening (ENDORSE) project aimed to evaluate the clinical and economic implications of a targeted training intervention for general practitioners (GPs) to enhance CKD awareness and early diagnosis.

Methods: Data on estimated Glomerular Filtration Rate (eGFR) and Urinary Albumin-Creatinine Ratio (uACR) were collected by 53 Italian GPs from 112,178 patients at baseline and after six months.

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  • Pulsed field ablation (PFA) is a new method for treating atrial fibrillation (AF) that focuses on ablating heart tissue while minimizing harm to nearby structures.
  • In the MANIFEST-17K study, data from 106 centers involved 17,642 patients and showed no serious complications like esophageal damage, with only a 1% major complication rate.
  • The results suggest that PFA has a strong safety profile and may change how AF is treated, compared to traditional thermal ablation methods.
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Objective: The influence of hypertensive disorders of pregnancy (HDP) on left atrial (LA) mechanics assessed by speckle tracking echocardiography (STE) has been poorly investigated. Accordingly, we performed a meta-analysis to summarize the main findings of STE studies who measured LA reservoir (LASr), conduit (LAScd) and contractile (LASct) strain in HDP women.

Study Design: All echocardiographic studies assessing LA strain parameters in HDP women vs.

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  • Recent data indicates that pulsed field ablation (PFA) technology for treating atrial fibrillation (AF) shows shorter procedural times as operators gain experience.
  • A study involving 752 patients found significant reductions in procedure time and fluoroscopy time as the number of PFA procedures increased among operators, with most procedures performed by those who had completed over 20 PFA cases.
  • The findings suggest that the PFA system is both efficient and safe for AF treatment, with a quick learning curve, enabling improved outcomes after just a small number of procedures.
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Objectives: The aim of this study was to describe the correlation between atrial electrogram duration map (AEDUM), spatiotemporal electrogram dispersion (STED) and low voltage areas (LVA) in patients with persistent atrial fibrillation (PsAF).

Background: The degree of left atrial (LA) tissue remodelling and augmented anisotropic conduction is one of the major issues related to PsAF ablation outcome.

Methods: This study enrolled consecutive patients with PsAF undergoing pulmonary vein isolation.

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  • - Bennet fractures, which are intra-articular fractures at the base of the first metacarpal, often lead to dislocation and need surgical intervention to avoid long-term joint problems.
  • - A case involving a 62-year-old man showed that an ultrasound (US) suspected a Bennet fracture after a fall, while standard X-rays appeared normal.
  • - This situation highlights the importance of including thorough bone assessments in routine musculoskeletal ultrasound exams, especially for patients who have suffered trauma, since US can identify fractures that X-rays may miss.
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  • Limited research exists on pulsed-field ablation (PFA) for patients with persistent atrial fibrillation (PeAF) undergoing left atrial posterior wall isolation (LAPWI), as highlighted in a study involving 249 patients across 9 Italian centers.
  • The study found that LAPWI was successfully performed in 57.6% of cases without any major complications, and only 2.4% experienced minor issues.
  • Results indicated that PFA is a feasible and rapid method for LAPWI, providing effective outcomes without significantly increasing procedural times, making it a promising option for PeAF treatments.
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A significant proportion of patients who suffer from atrial fibrillation (AF) and are in need of thromboembolic protection are not treated with oral anticoagulation or discontinue this treatment shortly after its initiation. This undertreatment has not improved sufficiently despite the availability of direct oral anticoagulants which are associated with less major bleeding than vitamin K antagonists. Multiple reasons account for this, including bleeding events or ischaemic strokes whilst on anticoagulation, a serious risk of bleeding events, poor treatment compliance despite best educational attempts, or aversion to drug therapy.

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Background: Estimation of muscle mass is a pivotal component in the diagnosis of protein-energy wasting and sarcopenia. While bioimpedance spectroscopy is a widely  accepted technique for the assessment of lean tissue related to the diagnosis of sarcopenia, to date skeletal muscle ultrasound (US) has not gained full acceptance for this purpose. The aim of this study was to assess the predictive value for mortality of the indexed thickness of the quadriceps vastus intermedius, as measured by US, compared to lean tissue index as estimated by bioimpedance spectroscopy, both combined with handgrip strength in a group of patients with end-stage kidney disease (ESKD) on maintenance hemodialysis (HD).

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  • Long-term oral anticoagulation is standard for preventing thromboembolic events in patients with atrial fibrillation, but left atrial appendage occlusion (LAAO) may offer a safe alternative for those with very high stroke risk profiles.
  • This study aimed to compare the safety and effectiveness of LAAO versus direct oral anticoagulants (DOACs) in patients with a high CHADS-VASc score (≥ 5), which indicates a higher stroke risk.
  • Results showed that LAAO had a lower incidence of composite cardiovascular events and bleeding compared to DOACs, suggesting it might be a preferable option for high-risk patients.
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Aims: Pulsed field ablation (PFA) has emerged as a novel, non-thermal energy source to selectively ablate cardiac tissue. We describe a multicentre experience on pulmonary vein isolation (PVI) via the pentaspline Farapulse™ PFA system vs. thermal-based technologies in a propensity score-matched population of paroxysmal atrial fibrillation (PAF) patients.

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