Publications by authors named "Cappelletti Alberto"

Article Synopsis
  • The study aimed to assess malnutrition's prevalence and impact on patients with severe heart failure (HF), defined by specific clinical markers, using the geriatric nutritional risk index (GNRI).
  • Among 510 patients analyzed, 35.1% were classified as malnourished (GNRI ≤98), with lower body mass index (BMI) and higher natriuretic peptide levels linked to this condition.
  • Results indicated that malnourished patients had significantly higher one-year mortality rates (41.1%) compared to non-malnourished patients (22.4%), highlighting malnutrition as a critical risk factor for mortality in severe HF cases.
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  • A study aimed to validate the multi-domain definition of frailty proposed by the HFA-ESC in patients with heart failure, highlighting its high prevalence.
  • The analysis of 854 patients revealed that the risk of death and hospitalization increased with the number of frailty domains fulfilled, indicating a direct relationship between frailty and adverse health outcomes.
  • The Frailty Index (FI) demonstrated slightly better effectiveness than the domain count in predicting mortality risk, showcasing its potential as a useful tool for assessing frailty in heart failure patients.
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  • A research study aimed to assess the impact of tricuspid regurgitation on outcomes for patients with advanced heart failure, utilizing data from the multicenter HELP-HF registry.
  • The study included 1,085 patients, revealing that those with severe tricuspid regurgitation had significantly higher 1-year all-cause mortality rates compared to those with mild or moderate regurgitation.
  • Key factors linked to severe tricuspid regurgitation included atrial fibrillation and pulmonary hypertension, highlighting the importance of managing this condition for improving patient outcomes.
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  • Hospitalization for heart failure significantly affects outcomes in patients with advanced heart failure, with inpatients showing worse overall health compared to outpatients.
  • In a study of 1149 patients, those hospitalized at enrollment had a higher one-year all-cause mortality or heart failure hospitalization rate (50.9%) than outpatients (36.8%).
  • The findings suggest that hospitalization indicates a poor prognosis, highlighting the need for targeted interventions like mechanical support or heart transplantation for these high-risk patients.
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Background: The changing demographic of heart failure (HF) increases the exposure to non-cardiovascular (non-CV) events. We investigated the distribution of non-CV mortality/morbidity and the characteristics associated with higher risk of non-CV events in patients with advanced HF.

Methods: Patients from the HELP-HF registry were stratified according to the number of 2018 HFA-ESC criteria for advanced HF.

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Aim: Persistent symptoms despite guideline-directed medical therapy (GDMT) and poor tolerance of GDMT are hallmarks of patients with advanced heart failure (HF) with reduced ejection fraction (HFrEF). However, real-world data on GDMT use, dose, and prognostic implications are lacking.

Methods And Results: We included 699 consecutive patients with HFrEF and at least one 'I NEED HELP' marker for advanced HF enrolled in a multicentre registry.

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Background: The "I Need Help" markers have been proposed to identify patients with advanced heart failure (HF). We evaluated the prognostic impact of these markers on clinical outcomes in a real-world, contemporary, multicenter HF population.

Methods: We included consecutive patients with HF and at least 1 high-risk "I Need Help" marker from 4 centers.

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Aims: Patients with heart failure (HF) with reduced ejection fraction (EF) (HFrEF), mildly reduced EF (HFmrEF), and preserved EF (HFpEF) may all progress to advanced HF, but the impact of EF in the advanced setting is not well established. Our aim was to assess the prognostic impact of EF in patients with at least one 'I NEED HELP' marker for advanced HF.

Methods And Results: Patients with HF and at least one high-risk 'I NEED HELP' criterion from four centres were included in this analysis.

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Article Synopsis
  • The study focuses on patients with advanced heart failure (HF), specifically analyzing the impact of ischemic etiology on prognosis within this high-risk group, based on the updated 2018 HFA-ESC criteria.
  • Ischemic causes were found to be the most common type of heart failure in patients with both advanced and nonadvanced HF, with statistically significant differences in hospitalization and mortality rates.
  • The research indicates that patients with ischemic heart failure among these groups face a greater risk of death and hospitalization when compared to those with nonischemic causes, emphasizing the need for targeted care strategies.
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In the last decades, advances in percutaneous coronary intervention (PCI) strategies have significantly reduced the risk of procedural complications and in-hospital mortality of patients with acute coronary syndromes (ACS), thus increasing the population of stable post-ACS patients. This novel epidemiological scenario emphasizes the importance of implementing secondary preventive and follow-up strategies. The follow-up of patients after ACS or elective PCI should be based on common pathways and on the close collaboration between hospital cardiologists and primary care physicians.

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Intra-Aortic Balloon Pump (IABP) efficacy is critically affected by the inflation/deflation timing. Balloon deflation may cause a sucking effect, and a steal phenomenon on carotid flow. Delaying IABP deflation reduces the degree of this flow reversal, but at the same time exposes patients to the risk of increased proto-systolic afterload with detrimental effects on the LV.

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Background: Left ventricular (LV) remodelling (REM) ensuing after ST-elevation myocardial infarction (STEMI), has typically been studied by echocardiography, which has limitations, or cardiac magnetic resonance (CMR) in early phase that may overestimate infarct size (IS) due to tissue edema and stunning. This prospective, multicenter study investigated LV-REM performing CMR in the subacute phase, and 6 months after STEMI.

Methods And Results: patients with first STEMI undergoing successful primary angioplasty were consecutively enrolled.

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Background: Atrial fibrillation (AF) is the most common heart arrhythmia, and its prevalence increases with age. Oral Anticoagulant Therapy (OAT) with non-vitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonists (VKAs) is essential to avoid thromboembolic events in AF. However, this treatment is associated with a high risk of bleeding and low adherence in elderly patients.

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Aim: The pulmonary artery catheter (PAC)-derived cardiac power index (CPI) has been found of prognostic value in cardiogenic shock (CS) patients. The original CPI equation included the right atrial pressure (RAP), accounting for heart filling pressure as a determinant of systolic myocardial work, but this term was subsequently omitted. We hypothesized that the original CPI formula (CPI ) is superior to current CPI for risk stratification in CS.

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Erdheim-Chester disease (ECD) is a rare multisystemic disorder of non-Langerhans histiocytic cells with a pleomorphic clinical presentation. It affects bones, skin, central nervous system, pituitary gland, ocular tissue, kidneys and perirenal tissue and lungs. Cardiac involvement presents usually with pericardial effusion and right atrial masses, but rarely with conduction system infiltration and subsequent arrhythmic events.

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Aims: The Heart Failure Association of the European Society of Cardiology (HFA-ESC) proposed a definition of advanced heart failure (HF) that has not been validated, yet. We assessed its prognostic impact in a consecutive series of patients with high-risk HF.

Methods And Results: The HELP-HF registry enrolled consecutive patients with HF and at least one high-risk 'I NEED HELP' marker, evaluated at four Italian centres between 1 January 2020 and 30 November 2021.

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Background: In contemporary Cardiac Intensive Care Unit (CICU), bedside intra-aortic balloon pump (IABP) insertion under echocardiographic guidance may be an attractive option for selected patients with cardiogenic shock (CS). Currently available data on this approach are limited.

Aim: This study aimed to assess the feasibility and safety of bedside IABP insertion, as compared to fluoroscopic-guided insertion in the Catheterization Laboratory (CathLab), and to describe the clinical features of patients receiving bedside IABP insertion using a standardized technique in real-world CICU practice.

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Article Synopsis
  • The left ventricular ejection fraction (EF) is the main measure used to assess heart function without invasive procedures.
  • Various imaging techniques can evaluate LVEF, each with its own strengths and weaknesses.
  • The review aims to rank these imaging methods according to their accuracy and reliability for clinical use.
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Trials on intra-aortic balloon pump (IABP) use in cardiogenic shock related to acute myocardial infarction have shown disappointing results. The role of IABP in cardiogenic shock treatment remains unclear, and new (potentially more potent) mechanical circulatory supports with arguably larger device profile are emerging. A reappraisal of the physiological premises of intra-aortic counterpulsation may underpin the rationale to maintain IABP as a valuable therapeutic option for patients with acute decompensated heart failure and tissue hypoperfusion.

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