Publications by authors named "Giuseppe Uccello"

Article Synopsis
  • HFpEF is a complex condition influenced by factors like age, genetics, and various health issues, including kidney disease, which significantly affects its progression and management.
  • The relationship between heart failure (HF) and chronic kidney disease (CKD) is intricate, as both share similar biological pathways and pose challenges for effective treatment due to patients often not being well-represented in clinical trials.
  • Newer medications, particularly SGLT2 inhibitors, show promise for treating patients with both HFpEF and CKD, highlighting the importance of understanding their cardiorenal interactions for improved management strategies.
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  • Acute myocarditis presents a range of clinical forms, from mild to severe, all characterized by inflammation of the heart muscle, which can lead to complications like unstable blood flow and irregular heart rhythms.
  • * Chronic inflammatory cardiomyopathy is a long-lasting condition that results in heart failure symptoms and an increased risk of arrhythmias, showing a connection between acute and chronic heart issues.
  • * Early diagnosis is crucial, with tools like cardiac MRI and endomyocardial biopsy being important for identifying the condition, along with genetic counseling if genetic links are suspected for better patient outcomes.*
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Aims: Conduction abnormalities, requiring a permanent pacemaker (PPM), are the most common electrical complications after transcatheter aortic valve implantation (TAVI). The exact mechanism for conduction system defects is not yet clear. The local inflammatory process and edema are thought to play a role in the development of electrical disorders.

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  • * A study involving over 16,600 STEMI patients found a 16% reduction in PPCI procedures in 2020 compared to 2019, with the elderly experiencing the most significant delays.
  • * Consequently, there was a notable increase in 30-day mortality rates during the pandemic, particularly among older patients, attributed to longer ischemia times and treatment delays.
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  • The COVID-19 pandemic significantly reduced the number of primary percutaneous coronary interventions (PPCIs) for ST-segment elevation myocardial infarction (STEMI) patients by 16% in 2020 compared to 2019.
  • Despite this reduction affecting both genders equally, 30-day mortality rates increased notably for female patients during the pandemic, while male patients did not show a significant change.
  • The analysis highlights the importance of addressing gender-specific outcomes in cardiac care during public health crises.
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Article Synopsis
  • - Hypertrophic cardiomyopathy (HCM) exhibits diverse progression patterns toward serious issues like heart failure and sudden cardiac death, necessitating a tailored approach rather than a one-size-fits-all method seen in other heart conditions.
  • - Utilizing multiple imaging techniques combined with artificial intelligence can enhance the diagnosis and management of HCM, but requires deep understanding of clinical progression and patient-specific features.
  • - The review emphasizes the significance of recognizing specific "red alerts" to better connect the genetic and phenotypic characteristics of patients with sarcomeric HCM, while also addressing ongoing challenges in imaging standardization and timing.
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Therapeutic approaches based on gene silencing technologies represent a new opportunity to manage hypercholesterolemia. Inclisiran is a small interfering RNA that targets proprotein convertase subtilisin/kexin type 9 (PCSK9) mRNA. Clinical studies have demonstrated that inclisiran is effective, safe, and well-tolerated in reducing low-density lipoprotein cholesterol (LDL-C) in patients with familial hypercholesterolemia, atherosclerotic cardiovascular disease, and atherosclerotic cardiovascular disease risk equivalents.

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Background: Transcatheter aortic valve replacement (TAVR) is an effective treatment option for patients with severe, symptomatic AS, regardless of the transcatheter heart valve (THV) implanted. Prior studies demonstrated a higher device success with lower paravalvular leak (PVL) using the balloon-expandable (BE) Sapien/XT THV vs. a self-expanding (SE) THV.

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Article Synopsis
  • SARS-CoV-2 infection in patients undergoing primary percutaneous coronary intervention (PPCI) for STEMI is linked to increased thrombotic complications due to inflammation and endothelial dysfunction.
  • In a study of 62 SARS-CoV-2 positive STEMI patients compared to 310 matched negative controls, the positive group showed significantly higher in-hospital mortality (29% vs 5.5%) and complications like stent thrombosis and heart failure.
  • The findings highlight the need for careful management of STEMI patients infected with SARS-CoV-2, as they may experience worse outcomes compared to non-infected patients.
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Background: Patients affected by the human immunodeficiency virus (HIV) show an increased risk of myocardial infarction. Clinical and angiographic features of HIV positive (HIV+) patients presenting with the first episode of an acute coronary syndrome (ACS) are not well defined in previous studies.

Objective: To demonstrate that HIV + patients with acute coronary syndrome had different features than non-HIV patients.

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Background: Concerns have been raised on a potential interaction between renin-angiotensin system inhibitors (RASI) and the susceptibility to coronavirus disease 2019 (COVID-19). No data have been so far reported on the prognostic impact of RASI in patients suffering from ST-elevation myocardial infarction (STEMI) during COVID-19 pandemic, which was the aim of the present study.

Methods: STEMI patients treated with primary percutaneous coronary intervention (PPCI) and enrolled in the ISACS-STEMI COVID-19 registry were included in the present sub-analysis and divided according to RASI therapy at admission.

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Background: It has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes-ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19.

Methods: The ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April).

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Background: The fear of contagion during the coronavirus disease-2019 (COVID-19) pandemic may have potentially refrained patients with ST-segment elevation myocardial infarction (STEMI) from accessing the emergency system, with subsequent impact on mortality.

Objectives: The ISACS-STEMI COVID-19 registry aims to estimate the true impact of the COVID-19 pandemic on the treatment and outcome of patients with STEMI treated by primary percutaneous coronary intervention (PPCI), with identification of "at-risk" patient cohorts for failure to present or delays to treatment.

Methods: This retrospective registry was performed in European high-volume PPCI centers and assessed patients with STEMI treated with PPPCI in March/April 2019 and 2020.

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Endocarditis due to Lactobacillus species is extremely rare. We report an uncommon case of Lactobacillus plantarum bioprosthetic aortic valve endocarditis, presenting with severe aortic steno-regurgitation, which responded to conventional medical and surgical treatment. This case provides a better understanding of the disease process of L.

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Tissue factor pathway inhibitor (TFPI) is a serine-protease inhibitor, which modulates coagulation tissue factor-dependent (TF). It binds directly and inhibits the TF-FVII/FVIIa complex as well as FXa. Time to reperfusion of acute ischemic myocardium is essential for tissue salvage.

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Epidemiological evidence has shown that abdominal obesity is closely associated with the development of cardiovascular (CV) disease, suggesting that it might be considered as an independent CV risk factor. However, the pathophysiological mechanisms responsible for the association between these 2 clinical entities remain largely unknown. Adipocytes are considered able to produce and secrete chemical mediators known as "adipokines" that may exert several biological actions, including those on heart and vessels.

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