Publications by authors named "Carlo G Tocchetti"

Article Synopsis
  • * Advanced techniques such as adeno-associated viral vectors and CRISPR-Cas9 are proving to be efficient for gene delivery and repairing genetic issues in humans.
  • * The statement reviews various gene therapy approaches for heart failure and its causes, discusses their clinical applications, and highlights safety concerns and regulatory challenges for future development.
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Article Synopsis
  • Left ventricular assist devices (LVADs) are commonly used to treat advanced heart failure, improving survival but leading to high rates of arrhythmias (20-50%) within a year after implantation.
  • Arrhythmias in these patients increase the risk of complications, such as additional shocks from implantable defibrillators and potential worsening of right ventricular failure, highlighting the need for tailored management strategies.
  • Effective treatment for these arrhythmias may involve specialized approaches like catheter ablation, though unique challenges exist in accessing arrhythmogenic areas after LVAD surgery, making pre-implantation procedures potentially beneficial.
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Cancer is a remarkable prothrombotic disease, and cancer-associated thrombosis acts as a dreadful omen for poor prognosis. The cornerstone of venous thromboembolism therapy is anticoagulation; however, in patients with venous thromboembolism who are not suitable for anticoagulation (contraindication, failure, or complication), the inferior vena cava filter appears a valuable option in the therapeutic arsenal. The recently heightened trend of steady rise in filter placement mirrors the spread of retrievable devices, together with improvements in physicians' insertion ability, medico-legal issue, and novel and fewer thrombogenic materials.

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Aims: This survey investigates natriuretic peptide (NP) testing in community and hospital settings, assessing awareness, accessibility, and utilization.

Methods And Results: This investigator-initiated survey, conceived within the HFA of the European Society of Cardiology, comprised 14 questions. It underwent validation and pilot testing to ensure question readability and online system functionality.

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Article Synopsis
  • Immunological therapies, including immune checkpoint inhibitors (ICIs) and cell-based therapies like CAR-T, have transformed cancer treatment by enabling the immune system to target cancer cells.
  • While these therapies are generally effective, they can cause immune-related adverse events (irAEs) that vary in severity and timing, from mild skin rashes to serious complications such as myocarditis or cytokine release syndrome.
  • The statement discusses the growing understanding of cardiovascular toxicities associated with these therapies, outlines their diagnosis and management, and identifies gaps in current research that need further exploration.
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Right heart failure (RHF) following implantation of a left ventricular assist device (LVAD) is a common and potentially serious condition with a wide spectrum of clinical presentations with an unfavourable effect on patient outcomes. Clinical scores that predict the occurrence of right ventricular (RV) failure have included multiple clinical, biochemical, imaging and haemodynamic parameters. However, unless the right ventricle is overtly dysfunctional with end-organ involvement, prediction of RHF post-LVAD implantation is, in most cases, difficult and inaccurate.

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Cardiovascular disease (CVD) is the leading cause of morbimortality in Europe and worldwide. CVD imposes a heterogeneous spectrum of cardiac remodelling, depending on the insult nature, that is, pressure or volume overload, ischaemia, arrhythmias, infection, pathogenic gene variant, or cardiotoxicity. Moreover, the progression of CVD-induced remodelling is influenced by sex, age, genetic background and comorbidities, impacting patients' outcomes and prognosis.

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Article Synopsis
  • Pulmonary hypertension (PH) linked to left heart failure (PH-LHF) is a common condition that worsens symptoms, reduces physical ability, and harms right heart function, leading to a poor outlook for patients.
  • Despite various drugs being tested, there are currently no specific treatments for PH-LHF, highlighting significant gaps in understanding its pathophysiology and clinical management.
  • The document calls for improved research on pulmonary venous changes, patient categorization for tailored therapies, and rigorous pre-clinical studies to enhance clinical trials and expand treatment options beyond current methods used for pulmonary arterial hypertension.
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Serum biomarkers represent a reproducible, sensitive, minimally invasive and inexpensive method to explore possible adverse cardiovascular effects of antineoplastic treatments. They are useful tools in risk stratification, the early detection of cardiotoxicity and the follow-up and prognostic assessment of cancer patients. In this literature review, we aim at describing the current state of knowledge on the meaning and the usefulness of cardiovascular biomarkers in patients with cancer; analyzing the intricate relationship between cancer and cardiovascular disease (especially HF) and how this affects cardiovascular and tumor biomarkers; exploring the role of cardiovascular biomarkers in the risk stratification and in the identification of chemotherapy-induced cardiotoxicity; and providing a summary of the novel potential biomarkers in this clinical setting.

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  • Implantable devices help patients with heart failure by working alongside medicines to treat the condition and improve their health.
  • While some devices are supported by strong evidence and show positive effects, others need more research before they can be widely used.
  • The Heart Failure Association and European Heart Rhythm Association suggest a better way to use these devices in care programs to help patients more effectively.
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The population of cancer survivors is rapidly increasing due to improving healthcare. However, cancer therapies often have long-term side effects. One example is cancer therapy-related cardiac dysfunction (CTRCD) caused by doxorubicin: up to 9% of the cancer patients treated with this drug develop heart failure at a later stage.

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Despite improvements in cancer survival, cancer therapy-related cardiovascular toxicity has risen to become a prominent clinical challenge. This has led to the growth of the burgeoning field of cardio-oncology, which aims to advance the cardiovascular health of cancer patients and survivors, through actionable and translatable science. In these Global Cardio-Oncology Symposium 2023 scientific symposium proceedings, we present a focused review on the mechanisms that contribute to common cardiovascular toxicities discussed at this meeting, the ongoing international collaborative efforts to improve patient outcomes, and the bidirectional challenges of translating basic research to clinical care.

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In recent years, important advances have been made in the field of Cardio-Oncology. The 2022 ESC Guidelines on Cardio-Oncology proposed a baseline cardiovascular risk stratification for cancer patients and preventive strategies in patients at high and very-high risk of cardiotoxicity. Cardiovascular toxic effects of anti-cancer drugs are being extensively studied; surveillance programs have been proposed, based on the baseline cardiovascular risk.

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Right-sided heart failure and tricuspid regurgitation are common and strongly associated with poor quality of life and an increased risk of heart failure hospitalizations and death. While medical therapy for right-sided heart failure is limited, treatment options for tricuspid regurgitation include surgery and, based on recent developments, several transcatheter interventions. However, the patients who might benefit from tricuspid valve interventions are yet unknown, as is the ideal time for these treatments given the paucity of clinical evidence.

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Cardio-oncology is a rapidly growing field of cardiovascular (CV) medicine that has resulted from the continuously increasing clinical demand for specialized CV evaluation, prevention and management of patients suffering or surviving from malignant diseases. Dealing with CV disease in patients with cancer requires special knowledge beyond that included in the general core curriculum for cardiology. Therefore, the European Society of Cardiology (ESC) has developed a special core curriculum for cardio-oncology, a consensus document that defines the level of experience and knowledge required for cardiologists in this particular field.

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While chronic heart failure (CHF) treatment has considerably improved patient prognosis and survival, the therapeutic management of acute heart failure (AHF) has remained virtually unchanged in the last decades. This is partly due to the scarcity of pre-clinical models for the pathophysiological assessment and, consequently, the limited knowledge of molecular mechanisms involved in the different AHF phenotypes. This scientific statement outlines the different trajectories from acute to CHF originating from the interaction between aetiology, genetic and environmental factors, and comorbidities.

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Background: Anthracycline-related cardiac toxicity is a recognized consequence of cancer therapies. We assess resting cardiac and skeletal muscle energetics and myocyte, sarcomere, and mitochondrial integrity in patients with breast cancer receiving epirubicin.

Methods: In a prospective, mechanistic, observational, longitudinal study, we investigated chemotherapy-naive patients with breast cancer receiving epirubicin versus sex- and age-matched healthy controls.

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