Publications by authors named "D Magri"
Background: Little evidence is available about heart rate (HR) response to exercise as well as its relationship with functional capacity in amyloid cardiomyopathy. Then, in a multicentre cohort of patients with amyloid cardiomyopathy, we investigated the prevalence of chronotropic incompetence (CI) and its relationships with cardiopulmonary exercise testing (CPET) variables.
Methods: Data from 172 outpatients with amyloid cardiomyopathy who performed a maximal CPET and who had no significant rhythm disorders were analysed.
Aims: Amyloid cardiomyopathy is caused by the deposition of light chain (AL) or transthyretin amyloid (ATTR) fibrils, that leads to a restrictive cardiomyopathy, often resulting in heart failure (HF) with preserved or reduced ejection fraction. This study aimed to determine whether cardiac output reduction or ventilation inefficiency plays a predominant role in limiting exercise in patients with amyloid cardiomyopathy.
Methods: We conducted a multicentre prospective study in patients with AL or ATTR cardiomyopathy who underwent cardiopulmonary exercise testing across four centres.
Article Synopsis
- The HF syndrome involves an imbalance in the autonomic nervous system, leading to an increase in sympathetic activity and various cardiac changes that result in chronotropic incompetence (CI), or the inability to raise heart rate with activity.
- CI is linked to decreased exercise capacity and poorer health outcomes, and the definition of CI can vary, complicating its assessment.
- While β-blockers can lower peak heart rate, they improve prognosis in heart failure, and strategies like rate-adapting pacing are being explored to address the reduced heart rate response during exercise.
Article Synopsis
- * Analyzed data from 7948 HF patients over a minimum of 2 years, employing topological data analysis (TDA) to find 19 patient clusters and trajectory analysis to outline disease evolution.
- * Findings included a 5-year survival rate across clusters ranging from 20% to 100%, with strong validation results from external and internal cohorts, confirming the reliability of the identified patient pathways.