Publications by authors named "Giuseppe Princi"
Background: Several implant-based remote monitoring strategies are currently tested to optimize heart failure (HF) management by anticipating clinical decompensation and preventing hospitalization. Among these solutions, the modern implantable cardioverter-defibrillator and cardiac resynchronization therapy devices have been equipped with sensors allowing continuous monitoring of multiple preclinical markers of worsening HF, including factors of autonomic adaptation, patient activity, and intrathoracic impedance.
Objectives: We aimed to assess whether implant-based multiparameter remote monitoring strategy for guided HF management improves clinical outcomes when compared to standard clinical care.
Article Synopsis
- * MB is linked with a condition called MINOCA (myocardial infarction with non-obstructed coronary arteries), due to mechanisms like artery spasm, plaque issues, and artery dissection, making it important to identify the specific cause for effective treatment.
- * The review discusses the latest findings on MINOCA related to MB, including diagnostic techniques during angiography and different treatment approaches based on the underlying mechanisms involved.
Article Synopsis
- The study investigates different diagnostic strategies for detecting coronary artery disease (CAD) to determine which approach yields better health outcomes for patients suspected of stable CAD.
- The analysis, based on randomized clinical trials, focuses on comparing coronary computed tomography angiography (CCTA) against other methods like invasive coronary angiography (ICA), exercise electrocardiography (ECG), and SPECT-MPI.
- Findings suggest that while CCTA reduces the need for invasive procedures without increasing risks of serious cardiovascular events, it leads to more revascularization procedures and less follow-up testing compared to exercise ECG.
Aims: Coronary artery disease (CAD) is a common cause of heart failure (HF). Whether coronary revascularization improves outcomes in patients with HF receiving guideline-recommended pharmacological therapy (GRPT) remains uncertain; therefore, we conducted a systematic review and meta-analysis of relevant randomized controlled trials (RCTs).
Methods And Results: We searched in public databases for RCTs published between 1 January 2001 and 22 November 2022, investigating the effects of coronary revascularization on morbidity and mortality in patients with chronic HF due to CAD.
Background And Aims: Edoxaban proved to be safe and effective also in fragile patients, but its administration through percutaneous endoscopic gastrostomy (PEG) has not been previously investigated. The purpose of this study was to evaluate the feasibility and the preliminary safety and efficacy profiles of edoxaban administered PEG in patients with an indication for long-term oral anticoagulation.
Methods: ORIGAMI was a prospective, single-arm, observational study (NCT04271293).
Adenosine as adjunctive therapy in acute coronary syndrome: a meta-analysis of randomized controlled trials.
Eur Heart J Cardiovasc Pharmacother
February 2023
Article Synopsis
- The study aimed to review randomized controlled trials (RCTs) testing adenosine's effectiveness in reducing coronary microvascular obstruction during myocardial revascularization in patients with acute coronary syndrome (ACS).
- A total of 26 trials with 5,843 patients were analyzed, revealing that adenosine did not improve major adverse cardiac events or survival, but it did increase the risk of serious heart rhythm issues, especially in cases where ischaemic time was over 3 hours.
- Overall, while adenosine was supposed to help, it actually posed more risks without offering any significant benefits in managing ACS.
Myocardial bridging (MB) is the most frequent congenital coronary anomaly in which a segment of an epicardial coronary artery takes a tunneled course under a bridge of the myocardium. This segment is compressed during systole, resulting in the so-called "milking effect" at coronary angiography. As coronary blood flow occurs primarily during diastole, the clinical relevance of MB is heterogeneous, being usually considered an asymptomatic bystander.
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- Ischemic heart disease (IHD) shows different clinical presentations and risks for men and women, with women having higher thrombotic risk due to biological and reproductive factors.
- Women also face increased risks of bleeding, influenced by factors like smaller blood vessels, lower body weight, and potential for inappropriate medication dosing.
- Despite comprising a significant proportion of cardiovascular patients, women are often underrepresented in clinical trials, leading to a need for dedicated research to enhance personalized antithrombotic treatment for them.
Background And Aims: The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for the treatment of cardiogenic shock (CS) may result in left ventricle overload and distension. Percutaneous microaxial flow pump Impella in addition to VA-ECMO (ECPELLA) is an emerging option to overcome these collateral effects. Aim of this study is to assess whether the addition of Impella to VA-ECMO is an effective and safe unloading strategy.
View Article and Find Full Text PDFAims: Pre-clinical congestion markers of worsening heart failure (HF) can be monitored by devices and may support the management of patients with HF. We aimed to assess whether congestion-guided HF management according to device-based remote monitoring strategies is more effective than standard therapy.
Methods And Results: A comprehensive literature research for randomized controlled trials (RCTs) comparing device-based remote monitoring strategies for congestion-guided HF management versus standard therapy was performed on PubMed, Embase, and CENTRAL databases.
Background: Takotsubo syndrome (TTS) is an emerging disease characterized by an acute and reversible myocardial dysfunction which may have an influence on clinical status and prognosis. Despite extensive research, its pathophysiology has not been completely elucidated; among other hypothesis, a heart-brain interaction has been proposed.
Methods: The aim of this study was to assess the impact of psychiatric disorders and of some personality types on the pathogenesis of TTS.
Background: Despite continuous advancement in the field, heart failure (HF) remains the leading cause of hospitalization among the elderly and the overall first cause of hospital readmission in developed countries. Implantable hemodynamic monitoring is being tested to anticipate the clinical exacerbation onset, potentially preventing an emergent acute decompensation. To date, only pulmonary artery pressure (PAP) sensor received the approval to be implanted in symptomatic heart failure patients with reduced ejection fraction.
View Article and Find Full Text PDFAims: The aims of this study is to assess by an updated meta-analysis the clinical outcomes related to permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) at long-term (≥12 months) follow-up (LTF).
Methods And Results: A comprehensive literature research was performed on PubMed and EMBASE. The primary endpoint was all-cause death.
Platypnoea-orthodeoxia syndrome (POS) is an uncommon but challenging clinical condition characterised by positional dyspnoea (platypnoea) and arterial desaturation (orthodeoxia) in the upright position that improve in the supine position. Since its first description, many cases have been reported and many conditions have been associated with this syndrome. Herein, we review the clinical presentation, pathophysiology, diagnostic work-up and management of patients with POS, aiming to increase the awareness of this often misdiagnosed condition.
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- * Colchicine, traditionally used for non-ischemic cardiovascular conditions, has shown promise in reducing cardiovascular events in patients with CAD through its anti-inflammatory properties and other beneficial effects on the cardiovascular system.
- * Despite its benefits, colchicine's safety profile raises concerns about its association with increased non-cardiovascular deaths, suggesting the need for a tailored approach to treatment that carefully weighs potential risks and benefits.