Publications by authors named "Fumagalli C"
Article Synopsis
- The study analyzed changes in electrocardiographic (ECG) characteristics in patients with different types of cardiac amyloidosis (AL, ATTRv, and ATTRwt) and looked at their predictive value for patient outcomes.
- In a large sample of 356 patients, it was found that those with ATTRwt had more conduction issues, while AL patients exhibited more signs of low QRS voltage and T wave inversion.
- Overall, the ECG abnormalities progressed similarly in all subtypes, but a longer QRS duration at baseline was associated with worse survival, indicating it could be a potential marker for advanced disease.
Treatment options for hypertrophic obstructive cardiomyopathy: a patient-centric review.
Expert Rev Cardiovasc Ther
November 2024
Article Synopsis
- Hypertrophic cardiomyopathy (HCM) is a condition characterized by thickening of the heart's left ventricle walls, affecting 1 in 200-500 people, with 60% of cases being hereditary.
- The review discusses various treatments for HCM, including medications (like beta-blockers and calcium channel blockers) and surgical options, along with the importance of personalized patient care in improving outcomes.
- Future treatments, such as new drugs and gene therapies, are also highlighted, emphasizing the significance of tailoring management strategies to individual patient needs and preferences.
Article Synopsis
- Septal reduction therapy (SRT) significantly improves symptoms for patients with obstructive hypertrophic cardiomyopathy (HCM), but its long-term results and predictors of adverse outcomes still need more study.* -
- An analysis of data from the SHARE registry revealed that among 1,832 patients who underwent SRT, the 30-day mortality rate was low at 0.4%, and after approximately 6.8 years, rates for HCM-related death, heart failure, and ventricular arrhythmias were relatively low.* -
- Key findings included that older age at SRT increases risks for HCM death and heart failure outcomes, while female patients showed higher susceptibility to heart failure complications post-treatment.*
Article Synopsis
- Transthyretin cardiac amyloidosis (ATTR-CA) primarily impacts older adults with various chronic health issues, leading to significant physical and emotional difficulties.
- New drugs show promise in early treatment stages, prompting a need for thorough assessments of patients' functional abilities and quality of life.
- Incorporating comprehensive geriatric assessment tools into standard care can help identify early signs of frailty and improve management strategies for older ATTR-CA patients.
Poor long-term survival in localized high-risk soft tissue sarcomas (STSs) of the extremities and trunk highlights the need to identify new prognostic factors. CXCR4 is a chemokine receptor involved in tumor progression, angiogenesis, and metastasis. The aim of this study was to evaluate the association between CXCR4 expression in tumor tissue and survival in STSs patients treated with neoadjuvant therapy.
View Article and Find Full Text PDFBackground: In patients with Hypertrophic Cardiomyopathy (HCM) S-ICD is usually the preferred option as pacing is generally not indicated. However, limited data are available on its current practice adoption and long-term follow-up.
Methods: Consecutive HCM patients with S-ICD implanted between 2013 and 2021 in 3 international centers were enrolled in this observational study.
Article Synopsis
- * It analyzed data from 2,141 ATTR-CA patients, revealing that those who walked less than 350 meters on the 6MWT had a significantly higher mortality risk, with mortality rates increasing as walking distance decreased.
- * The findings suggest that monitoring changes in 6MWT performance can enhance risk assessment and disease progression understanding, offering valuable insights beyond conventional measures like N-terminal pro-B-type natriuretic peptide levels.
Article Synopsis
- The study aimed to create an Italian version of the Leicester Cough Questionnaire (LCQ) to assess how chronic cough affects patients' daily lives.
- Sixty-five patients completed the LCQ, along with other measurements, over two visits spaced eight weeks apart, ensuring reliable comparisons.
- Results showed strong correlations between the LCQ, cough severity, and disturbance scores, indicating that the Italian LCQ is valid and beneficial for measuring chronic cough's impact.
Article Synopsis
- This study compares two surgical methods, Hartmann's procedure (HP) and resection with primary anastomosis (RPA), for treating acute left-sided colonic emergencies among 1215 patients from 204 centers globally.
- Results showed that while HP was the more common treatment (57.3%), RPA was favored for younger patients with fewer health issues and those needing surgery sooner.
- The study concluded that although HP is still widely used, RPA might be the better option, emphasizing the importance of patient characteristics and surgeon experience in determining treatment choice.
Background And Aim: Ductal carcinoma in situ (DCIS) is a non-obligate precursor of invasive breast cancer with highly variable clinical behavior, but risk stratification is still challenging. We sought to identify immune-related gene expression signatures of pure DCIS associated with different risks of breast cancer recurrence.
Methods: A retrospective nested case-control study of 143 pure DCIS was performed including 70 women with subsequent ipsilateral breast event (IBE, in situ or invasive; cases) and 73 DCIS women with no IBE and matched for age, tumor size, treatment, hormone receptors/HER2 status, and follow-up time (controls).
Article Synopsis
- Diabetes Mellitus (DM) patients have a higher risk of severe outcomes from COVID-19, and the role of metformin in reducing mortality has been debated in various studies.
- A retrospective study analyzed COVID-19 positive patients with DM in two Italian hospitals, focusing on the effect of metformin on in-hospital mortality while accounting for other risk factors using the COVID-19 Mortality Risk Score (MRS).
- Results indicated that while initial findings suggested a reduction in mortality associated with metformin, this significance disappeared after adjusting for confounding factors, highlighting the importance of using validated risk assessment tools in future research.
Article Synopsis
- - The study explores the relationship between frailty and health status in older patients with transthyretin cardiac amyloidosis (ATTR-CA), utilizing the Kansas City Cardiomyopathy Questionnaire (KCCQ) for health assessment.
- - Out of 168 patients screened, 138 were enrolled, revealing that 14.5% were frail and the median health status score was 66.
- - Results indicated that factors like age and frailty level significantly impacted health status, suggesting future research could further clarify how frailty affects quality of life and prognosis in these patients.
Background: Histopathological and molecular features have been proposed to hold prognostic information, but few have been validated. The aim of this retrospective study was to validate the Genetic And Morphological Evaluation ('GAME') score and assess the impact of histological characteristics on the prognosis in patients with colorectal liver metastases.
Methods: Data were collected from 176 patients with metastatic colorectal cancer undergoing liver resection at Hospital de la Santa Creu i Sant Pau.
Article Synopsis
- * Atrial fibrillation (AF) is a significant concern for HCM patients, indicating disease progression and increasing risks related to heart failure, blood clots, and overall quality of life.
- * The review focuses on understanding how AF develops in HCM, particularly through changes in the left atrium, and discusses the unique challenges in managing AF for these patients.
Article Synopsis
- A study was conducted to investigate the combined effect of two diabetes medications, SGLT-2 inhibitors and GLP-1 receptor agonists, on heart-related health in patients with type 2 diabetes and acute heart attacks.
- *The research involved 443 patients over two years, finding that those on the combination therapy had fewer major cardiovascular events compared to those on individual medications.
- *Results showed that the combination therapy also improved myocardial salvage index, indicating better heart recovery post-attack.
Background: Endometrial cancers with more than one molecular feature- mutations (POLEmut), mismatch repair protein deficiency (MMRd), p53 abnormality (p53abn)-are called 'multiple classifiers'.
Objective: To describe our cohort of multiple classifiers and to report the results of a review on their incidence and the techniques used to identify them.
Methods: Multiple classifiers identified at the European Institute of Oncology, Milan, between April 2019 and Decmber 2022, were included.
Undifferentiated sarcomas characterized by a primitive monomorphic round to spindle cell phenotype and often non-specific immunoprofile remain difficult to subclassify outside molecular analysis. The increased application of RNA sequencing in clinical practice led to significant advances and discoveries of novel gene fusions that furthered our understanding and refined classification of otherwise undifferentiated neoplasms. In this study, we report an undifferentiated round to spindle cell sarcoma arising in the femur of a 34-year-old female.
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- Cardiac magnetic resonance (CMR) is crucial for diagnosing and assessing recovery in patients with acute myocarditis (AM), but the best timing for repeat scans is debated.
- In a study of 33 AM patients, assessments at 3 months (CMR-2) revealed significant improvements in edema, late gadolinium enhancement (LGE), and left ventricular function compared to initial scans (CMR-1).
- Most patients showed resolution of edema by 3 months, suggesting that further CMR scans should mainly focus on those with ongoing edema, as the extent of LGE at that point can predict the risk of persistent ventricular arrhythmias.
Article Synopsis
- A study was conducted using a large administrative database from Italy to assess the effects of oral anticoagulant treatment on patients with non-valvular atrial fibrillation, revealing only 61.1% of patients received appropriate anticoagulants while a significant number were under-treated.
- When analyzing outcomes over approximately 2.9 years, vitamin-K antagonists (VKAs) showed slightly better results in preventing ischemic strokes compared to direct oral anticoagulants (DOACs), although this difference varied based on specific patient treatments.
- The research emphasized that despite better clinical outcomes with DOACs, a large percentage of patients remain inadequately treated, highlighting the necessity for educational initiatives to ensure proper anticoagulant use.
Thyroid nodules are commonly encountered in clinical practice, affecting up to 50% of the population. The large majority of thyroid lumps are benign incidental findings detected by imaging, while approximately 5-15% harbor malignancy. For a target patient's care, it is of paramount importance to identify and treat thyroid malignancy, while preventing unnecessary invasive surgery in patients with benign lesions.
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- The study investigates the occurrence of new atrial fibrillation (AF) in patients with wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) and highlights the need for focused screening for arrhythmias.
- It included 266 patients followed for a median of 19 months, finding that a significant portion had de novo AF, with notable factors contributing to its development, including prolonged PR and QRS intervals and left atrial diameter.
- Almost 70% of the patients had AF by the study's conclusion, and those with multiple risk factors faced a significantly higher risk of developing de novo AF.
Article Synopsis
- A study was conducted to assess the long-term outcomes of women with hypertrophic cardiomyopathy (HCM) in relation to pregnancy, revealing that the pregnancy status did not adversely affect their health outcomes over time.
- Out of 379 women studied, 63% had pregnancies, mostly occurring before their HCM diagnosis, and while some had major cardiovascular events during the peri-partum period, pregnancy overall was linked to a lower risk of such events.
- The findings suggest that pregnancy is generally safe for women with HCM unless they have severe heart failure symptoms or other high-risk conditions, meaning that it's not something to be discouraged for most patients.
Article Synopsis
- The study focuses on two sarcomere genes linked to hypertrophic cardiomyopathy (HCM), specifically MYBPC3 and MYH7, and examines their impact on heart function over time.
- Researchers reviewed echocardiograms of 402 HCM patients and found MYBPC3 mutation carriers experienced a higher rate of severe left ventricular dysfunction compared to MYH7 mutation carriers, despite both groups showing a small decline in heart function over time.
- The findings suggest that while both gene mutations lead to HCM, MYBPC3 mutations are associated with a greater risk of long-term systolic dysfunction, underscoring the need for tailored monitoring and management strategies in affected patients.