Publications by authors named "Filio Billia"

Background: Cardiogenic shock (CS) is a complex, life-threatening condition that requires timely care of patients. The purpose of this study is to evaluate the characteristics and outcomes of patients transferred to a cardiac intensive-care unit from outside hospitals, compared to those of patients admitted directly to a CS centre.

Methods: Patients admitted with CS (January 1, 2014-December 31, 2019) were analyzed.

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To maintain homeostasis in the heart, endothelial cells and cardiomyocytes engage in dynamic cross-talk through paracrine signals that regulate both cardiac development and function. Here, we review the paracrine signals that endothelial cells release to regulate cardiomyocyte growth, hypertrophy and contractility, and the factors that cardiomyocytes release to influence angiogenesis and vascular tone. Dysregulated communication between these cell types can drive pathophysiology of disease, as seen in ischemia-reperfusion injury, diabetes, maladaptive hypertrophy, and chemotherapy-induced cardiotoxicity.

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Background: Peak oxygen uptake (pVO) predicts mortality in patients with heart failure on left ventricular assist device (LVAD) support. This follow-up of the PRO-VAD study examines the prognostic value of repeated pVO measurements during long-term follow-up.

Methods: This multicenter follow-up study included patients from the original PRO-VAD cohort who performed a cardiopulmonary exercise test (CPET) twice.

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Cyclin-dependent kinase 1 () is a master regulator of the G2-M transition between DNA replication and cell division. This study investigates the regulation of cardiomyocyte (CM) proliferation during the early neonatal period and following ischemic injury in adult mice. We analyzed cell cycle dynamics with the assessment of DNA synthesis, and cytokinesis in murine hearts during the first 15 days after birth.

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Aims: The heterogeneous phenotype of hypertrophic cardiomyopathy (HCM) is still not fully understood. Clonal haematopoiesis (CH) is emerging as a cardiovascular risk factor potentially associated with adverse clinical events. The prevalence, phenotype and outcomes related to CH in HCM patients were evaluated.

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Background: Cardiogenic shock (CS) mortality remains near 40%. In addition to inadequate cardiac output, patients with severe CS may exhibit vasodilation. We aimed to examine the prevalence and consequences of vasodilation in CS.

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Article Synopsis
  • Diaphragm atrophy can worsen breathing issues in heart failure patients, possibly linked to medication effects on the brain.
  • A study of 624 heart failure patients examined the respiratory benefits of central-acting vs peripheral-acting drugs through cardiopulmonary exercise tests (CPET).
  • Results showed that patients on central-acting drugs had improved respiratory function and potentially fewer adverse outcomes, highlighting their effectiveness in managing heart failure symptoms.
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Background: Cardiogenic shock (CS) is associated with high in-hospital mortality. Objective assessment of its severity and prognosis is paramount for timely therapeutic interventions. This study aimed to evaluate the efficacy of the shock index (SI) and its variants as prognostic indicators for in-hospital mortality.

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Pathogenic variants in MYH7 and MYBPC3 account for the majority of hypertrophic cardiomyopathy (HCM). Targeted drugs like myosin ATPase inhibitors have not been evaluated in children. We generate patient and variant-corrected iPSC-cardiomyocytes (CMs) from pediatric HCM patients harboring single variants in MYH7 (V606M; R453C), MYBPC3 (G148R) or digenic variants (MYBPC3 P955fs, TNNI3 A157V).

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Background: Cardiac allograft vasculopathy (CAV) is the leading cause of late graft dysfunction in heart transplantation. Building on previous unsupervised learning models, we sought to identify CAV clusters using serial maximal intimal thickness and baseline clinical risk factors to predict the development of early CAV.

Methods: This is a single-center retrospective study including adult heart transplantation recipients.

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Heart failure with preserved ejection fraction (HFpEF) afflicts over half of all patients with heart failure and is a debilitating and fatal syndrome affecting postmenopausal women more than any other demographic. This bias toward older females calls into question the significance of menopause in the development of HFpEF, but this question has not been probed in detail. In this study, we report the first investigation into the impact of ovary-intact menopause in the context of HFpEF.

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Article Synopsis
  • - The study focused on patients with cardiogenic shock (CS) and evaluated the impact of pulmonary artery catheters (PACs) on their clinical outcomes, specifically in-hospital mortality rates and use of advanced therapies.
  • - Analysis of 1,043 patients revealed that those receiving PACs had a lower in-hospital mortality rate (29.3% vs 36.2%) and were more likely to receive advanced heart failure treatments, such as mechanical circulation support.
  • - The findings suggest that PACs are beneficial in managing CS, particularly for patients in more severe stages (SCAI D and E), though their use was also linked to longer stays in intensive care and hospitals.
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Article Synopsis
  • * A lack of high-quality evidence makes it challenging to establish standardized practices for managing heart failure-related cardiogenic shock (HF-CS), which constitutes over half of CS cases.
  • * An international conference aimed to create a consensus on defining and managing HF-CS, involving 54 experts from various fields to review literature and discuss clinical practices for better outcomes.
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Purpose Of Review: Heart transplantation (HT) remains the optimal therapy for patients living with end-stage heart disease. Despite recent improvements in peri-transplant management, the median survival after HT has remained relatively static, and complications of HT, including infection, rejection, and allograft dysfunction, continue to impact quality of life and long-term survival.

Recent Findings: Omics technologies are becoming increasingly accessible and can identify novel biomarkers for, and reveal the underlying biology of, several disease states.

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Left ventricular assist devices (LVADs) are increasingly used in patients with end-stage heart failure (HF). There is a significant risk of HF admissions and hemocompatibility-related adverse events that can be minimized by optimizing the LVAD support. Invasive hemodynamic assessment, which is currently underutilized, allows personalization of care for patients with LVAD, and may decrease the need for recurrent hospitalizations.

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Article Synopsis
  • * The rise in PGD cases might be due to better detection or changes in transplant practices, and using organs from donors after circulatory death may influence PGD development.
  • * Improved understanding and management of risk factors, along with collaboration to create better prediction models, could help lower PGD rates and reduce early mortality in heart transplant patients.
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Article Synopsis
  • Circulatory shock is traditionally defined as low blood pressure with poor tissue blood supply, categorized into subtypes like distributive and hypovolemic based on different causes, such as infection or trauma.
  • Recent findings suggest that there is significant variability in how patients respond to treatments, which may complicate the understanding of previous clinical trial results.
  • The review emphasizes the importance of identifying specific biological markers in patients to tailor treatments better, promoting a more personalized approach in intensive care settings.
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Objectives: There is limited data regarding the impact of exercise on phenotypic expression in hypertrophic cardiomyopathy (HCM). We aimed to investigate whether such an association exists in a cohort of genotype-positive HCM patients.

Methods: In this cross-sectional study of genotype-positive HCM families, we used structured questionnaires to obtain data regarding intensity and duration of exercise of participants starting at the age of 10, as well as data regarding exercise recommendations and their impact on quality of life (QOL).

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The management of chronic heart failure over the past decade has witnessed tremendous strides in medical optimization and device therapy including the use of left ventricular assist devices (LVAD). What we once thought of as irreversible damage to the myocardium is now demonstrating signs of reverse remodeling and recovery. Myocardial recovery on the structural, molecular, and hemodynamic level is necessary for sufficient recovery to withstand explant and achieve sustained recovery post-LVAD.

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