Publications by authors named "Emiliano Calvi"

Introduction: Transvenous lead extraction (TLE) is generally considered a safe procedure, albeit not without risks. While gender-based disparities have been noted in short-term outcomes following TLE, a notable gap exists in understanding the long-term consequences of this procedure. The objective of this analysis was to investigate sex differences in both acute and long-term outcomes among patients who underwent TLE at a tertiary referral center.

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  • This study investigated patients with Brugada syndrome (BrS) who received implantable loop recorders (ILR) to monitor their heart rhythms.
  • Out of 147 patients, 29% received ILRs, while some got implantable cardioverter-defibrillators (ICD) or continued regular follow-up.
  • Results showed that ILR patients had more episodes of suspected arrhythmic syncope and gene mutations and were generally younger; continuous monitoring helped diagnose rhythm issues without any reported adverse effects.
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  • Transvenous lead extraction (TLE) is generally safe and effective for patients with cardiac devices, but long-term outcomes have not been extensively studied.
  • This study analyzed 191 patients who underwent TLE from 2014 to 2016, focusing on long-term survival and factors influencing outcomes, particularly differentiating between infections and non-infection reasons for the procedure.
  • Results revealed that patients with infections had significantly worse event-free survival rates and higher mortality compared to those with non-infection cases, with specific indicators like vegetation and positive blood cultures linked to poorer prognoses.
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Aims: In the latest years an emerging interest has risen towards the role of endothelial dysfunction (ED) in the pathogenesis of heart failure (HF) since the very first steps of the disease. Since the prevalent etiology of HF is ischemic cardiomyopathy (ICM), it is still not clear whether the connection with ED is linked to HF itself or to atherosclerosis. The aim is to determine the presence of ED in subjects with idiopathic dilated cardiomyopathy (IDCM) compared to ICM.

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  • - Sacubitril/valsartan is known for its benefits in treating heart failure with reduced ejection fraction, but its impact on endothelial dysfunction and arterial stiffness was less explored in this study.
  • - In a study involving 15 patients, various noninvasive tests showed that while arterial stiffness parameters didn’t change significantly after 6 months, there was a notable improvement in endothelial function and other heart measures like ejection fraction and diastolic dysfunction.
  • - Despite some limitations, the findings suggest that sacubitril/valsartan positively affects heart function in patients with dilated cardiomyopathy but does not significantly impact arterial stiffness over the studied period.
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Lots of meta-analysis emphasize that a great number of hospitalized patients with moderate and severe forms of COVID-19 developed acute myocardial damage, defined as an increase of cardiac biomarkers, such N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), creatine kinase-myocardial band (CK-MB) and of all type of troponins. The highest mortality rate is related with progressively increasing biomarkers levels and with a history of cardiovascular disease. In fact, the biomarkers dosage should be considered as a prognostic marker in all patients with COVID-19 disease at admission, during hospitalization and in the case of clinical deterioration.

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It has been widely reported that the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) attaches human cells by using the Angiotensin Converting Enzyme 2 (ACE2) receptor, but vascular impairment described during coronavirus disease 2019 (COVID-19) infection is primarily due to the direct involvement of the endothelial cells by the virus or secondarily to the inflammatory host response is currently unknown. We therefore aimed to demonstrate in vivo the presence of endothelial dysfunction in six COVID-19 patients without cardiovascular risk factors or pre-existing cardiac condition, using the Endo-PAT 2000, a device able to measure endothelial vasodilation function in a rapid and non-invasive way. Four patients were positive for endothelial dysfunction, with RHI values between 1.

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Purpose Of Review: Loop diuretics are the cornerstone of the treatment of congestion in heart failure patients. The manuscript aims to summarize the most updated information regarding the use of loop diuretics in heart failure.

Recent Findings: Diuretic response can be highly variable between patients and needs to be carefully evaluated during and after the hospitalization.

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  • The COVID-19 pandemic is linked to coagulopathy, even though pneumonia is the most prominent symptom, and the exact rate of thromboembolic events remains unclear.
  • Research highlights the role of a cytokine storm, driven by inflammatory markers, as a key factor in increased blood clotting risks for COVID-19 patients.
  • This review seeks to detail the epidemiology and biological mechanisms of hypercoagulability in COVID-19, while also offering prevention strategies for thromboembolic events.
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Background: COVID-19 may induce a coagulation dysregulation resulting in a prothrombotic state with a higher risk of arterial and venous thrombosis. This abnormal thrombotic diathesis can lead to pulmonary embolism, stroke, and intracardiac thrombosis.

Case Summary: We present two cases of unusual intracardiac thrombosis in patients hospitalized for COVID-19.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is mainly responsible for respiratory involvement but cardiac complications are also reported. Nevertheless, potential life-threatening conditions in young people have not been described. A 19-year-old male autistic patient was admitted with fever and cough.

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Stage A heart failure (HF) patients do not show HF symptoms or any structural heart disease but are at risk of HF development. Cardiovascular risk factors (hypertension, diabetes, metabolic syndrome, sedentary lifestyle, poor diet, and exposure to cardiotoxic agents) characterize subjects affected by stage A HF. It is essential to identify these subjects early and ensure that, despite being asymptomatic, they grasp the importance of undertaking correct lifestyle and therapeutic interventions.

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Left ventricle thrombus is considered a rare complication of Takotsubo syndrome. However, both a stress condition predisposing to Takotsubo syndrome and coagulation abnormalities coexist in COVID-19. We describe a case of a patient with COVID-19 with Takotsubo syndrome.

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A 34-year-old man was admitted with acute lung injury and COVID-19 pneumonia. In the intensive care unit, he experienced episodes of prolonged asystole accompanied by hypotension without loss of consciousness. Once reversible causes were excluded, symptoms were related to dysfunction of the sinus node, and the patient underwent implantation of a pacemaker.

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