Publications by authors named "Iliceto S"
Article Synopsis
- Prior research was limited in understanding how cardiometabolic risk factors (CVDRFs), like hypertension and diabetes, mediate the link between anxiety/depression and cardiovascular disease (CVD).
- The study followed over 71,000 participants for a decade to assess the impact of anxiety/depression on the development of CVDRFs and the role of neuro-immune mechanisms, with findings showing a clear association and effect differences based on age and sex.
- Results indicated that anxiety/depression significantly increases the risk of developing CVDRFs, especially in younger women, and this relationship may be influenced by neuro-immune pathways.
Article Synopsis
- Autoimmune rheumatic diseases (ARDs) lead to inappropriate immune responses that can significantly increase the risk of cardiovascular issues among patients, affecting their long-term health.
- Endothelial dysfunction and related factors contribute to conditions like atherosclerosis and coronary microvascular dysfunction (CMD), which impairs the heart's ability to respond to increased metabolic demands.
- Advanced imaging techniques, especially stress cardiac magnetic resonance (CMR) and the myocardial perfusion reserve index (MPRI), play a crucial role in detecting CMD in ARDs patients, allowing for early intervention to potentially prevent serious cardiac complications.
Redefining CAV surveillance strategies: Benefits of CCTA vs. ICA.
J Cardiovasc Comput Tomogr
July 2024
Article Synopsis
- - The study investigates the use of cardiac computed tomography angiography (CCTA) as a non-invasive alternative to invasive coronary angiography (ICA) for assessing cardiac allograft vasculopathy (CAV) after heart transplantation.
- - Conducted from March 2021 to February 2023, the research included 260 heart transplant patients, revealing that those undergoing CCTA had significantly lower costs and shorter hospital stays compared to those who underwent ICA.
- - The findings suggest that CCTA is a safer and more cost-effective option for CAV surveillance post-heart transplantation, using less contrast and radiation than ICA.
Background: Age and frailty are associated with underuse of anticoagulation in elderly patients with atrial fibrillation (AF).
Objectives: This study aimed at assessing major clinical outcomes in very elderly patients with AF treated with recommended dose edoxaban and look for a possible relation with frailty measured by a validated score.
Methods: This prospective multicenter cohort study enrolled consecutive very elderly (age ≥80 years) anticoagulation-naïve patients starting recommended doses of edoxaban.
The role of the immune system in myocarditis onset and progression involves a range of complex cellular and molecular pathways. Both innate and adaptive immunity contribute to myocarditis pathogenesis, regardless of its infectious or non-infectious nature and across different histological and clinical subtypes. The heterogeneity of myocarditis etiologies and molecular effectors is one of the determinants of its clinical variability, manifesting as a spectrum of disease phenotype and progression.
View Article and Find Full Text PDFAims: Standardized immunosuppressive therapy (IS) had been previously investigated in biopsy-proven (BP) lymphocytic myocarditis with heart failure (HF). This study evaluated efficacy and safety of tailored IS in BP immune-mediated myocarditis, irrespective of histology and clinical presentation.
Methods And Results: Consecutive BP myocarditis patients treated with long-term tailored IS on top of optimal medical therapy (OMT), were compared with OMT non-IS controls using propensity-score weighting.
: Cardiovascular magnetic resonance (CMR) has emerged as the most accurate, non-invasive method to support the diagnosis of clinically suspected myocarditis and as a risk-stratification tool in patients with cardiomyopathies. We aim to assess the diagnostic and prognostic role of CMR at diagnosis in patients with myocarditis. We enrolled consecutive single-center patients with 2013 ESC consensus-based endomyocardial biopsy (EMB)-proven or clinically suspected myocarditis undergoing CMR at diagnosis.
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- Cardiac amyloidosis (CA) is an infiltrative disease caused by the build-up of amyloid fibrils in the heart, primarily in two forms: amyloid light chain (AL) and transthyretin (ATTR) amyloidosis.
- Elevated levels of cardiac troponin (cTn) are often seen in CA and are key biomarkers for detecting heart injury, with several proposed mechanisms for injury linked to amyloid deposition.
- The review highlights the biology and measurement of cTn, explores the various mechanisms behind heart damage in CA, and discusses cTn's clinical relevance in managing both AL and ATTR amyloidosis.
Prediction of major arrhythmic events (MAEs) in dilated cardiomyopathy represents an unmet clinical goal. Computational models and artificial intelligence (AI) are new technological tools that could offer a significant improvement in our ability to predict MAEs. In this proof-of-concept study, we propose a deep learning (DL)-based model, which we termed Deep ARrhythmic Prevention in dilated cardiomyopathy (DARP-D), built using multidimensional cardiac magnetic resonance data (cine videos and hypervideos and LGE images and hyperimages) and clinical covariates, aimed at predicting and tracking an individual patient's risk curve of MAEs (including sudden cardiac death, cardiac arrest due to ventricular fibrillation, sustained ventricular tachycardia lasting ≥30 s or causing haemodynamic collapse in <30 s, appropriate implantable cardiac defibrillator intervention) over time.
View Article and Find Full Text PDFBackground: In recent years, it has become evident that arrhythmogenic cardiomyopathy (ACM) displays a wide spectrum of ventricular involvement. Furthermore, the influence of various clinical phenotypes on the prognosis of the disease is currently being assessed.
Objectives: The purpose of this study was to evaluate the impact of phenotypic expression in ACM on patient outcomes.
Article Synopsis
- - The study examined the link between specific autoantibodies (AT1R-AAs and ETAR-AAs) and left ventricular remodeling (LVR) in patients who experienced a myocardial infarction (heart attack), highlighting how these antibodies affect treatment outcomes.
- - Conducted on 131 patients treated for ST-segment-elevation myocardial infarction, researchers found a significant prevalence of these autoantibodies in those who developed LVR, with 39% of patients with LVR being seropositive for AT1R-AAs.
- - The findings indicate that AT1R-AAs not only correlate with LVR but also serve as a risk factor for future serious heart-related events, suggesting potential targets for improving
Determinants of Ventricular Arrhythmias in Mitral Valve Prolapse.
JACC Clin Electrophysiol
April 2024
Article Synopsis
- Mitral valve prolapse (MVP) can lead to ventricular arrhythmias (VA) even without significant valve regurgitation, which might be influenced by conditions like mitral annulus disjunction (MAD), curling, and myocardial fibrosis.
- A study with 108 MVP patients found that those with arrhythmic MVP had greater MAD, higher prevalence of curling, and more left ventricular fibrosis compared to non-arrhythmic patients.
- The results suggested that curling directly and indirectly affects VA, while MAD’s association with VA is completely mediated by myocardial fibrosis, indicating that more severe morphologic changes correlate with the severity of VA.
Background: Atrial fibrillation (AF) is common in patients with cardiac amyloidosis (CA) and is a significant risk factor for heart failure hospitalization and thromboembolic events.
Objective: This study was designed to investigate the atrial electrofunctional predictors of incident AF in CA.
Methods: A multicenter, observational study was conducted in 4 CA referral centers including sinus rhythm patients with light-chain (AL) and transthyretin (ATTR) CA undergoing electrocardiography and cardiac magnetic resonance imaging.
Article Synopsis
- LVADs are becoming more popular for treating advanced heart failure, and this study examines patients who had a subcutaneous ICD prior to LVAD surgery.
- The research involved 30 patients with a median age of 45, focusing on the performance and complications of using both devices together, with follow-up averaging 7 months.
- Results showed high compatibility but highlighted issues like electromagnetic interference affecting device sensing, leading to inappropriate shocks in some patients; careful monitoring for these problems is essential.
Article Synopsis
- - The study aimed to analyze the trends in hospitalizations due to systemic and cardiac amyloidosis in the Veneto Region of Northeastern Italy from 2010 to 2020, highlighting the need for better understanding of its epidemiology.
- - Using ICD-9 codes, the researchers found that the incidence of amyloidosis-related hospitalizations increased significantly, particularly among older male patients (>65 years), with an annual increase of 17% from 2015 to 2020.
- - By 2020, a majority (about 70%) of the hospitalized cases involved cardiac amyloidosis, and there was also a notable connection between patients undergoing carpal tunnel syndrome surgeries and subsequent cardiac issues, especially in men. *
Article Synopsis
- Left ventricular fibrosis is important for understanding arrhythmias in patients with mitral valve prolapse (MVP), and cardiac magnetic resonance imaging identifies this using late gadolinium enhancement (LGE) techniques, which currently lack standardized protocols.
- A study with 66 MVP patients assessed LV fibrosis using different methods, including semi-automated gray-scale thresholding based on standard deviations and compared them to visual assessments.
- Among the techniques, the 5-standard deviation gray-scale thresholding showed the best correlation with visual assessments and demonstrated high reproducibility in quantifying LGE in these patients.
Article Synopsis
- * A study aimed to investigate if patients with a history of myocarditis would experience relapses during the pandemic or after vaccination.
- * Out of 409 patients studied, none experienced myocarditis relapse due to COVID-19 infection or vaccination, and the rate of new myocarditis cases remained unchanged compared to before the pandemic.
Advanced heart failure (AHF) presents a complex landscape with challenges spanning diagnosis, management, and patient outcomes. In response, the integration of multimodality imaging techniques has emerged as a pivotal approach. This comprehensive review delves into the profound significance of these imaging strategies within AHF scenarios.
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- Unstable complete atrioventricular block is a serious condition needing immediate treatment, usually until a pacemaker can be implanted.
- While transcutaneous pacing is one option, it can be painful and sometimes ineffective, leading to consideration of drug therapies like atropine, dopamine, and epinephrine.
- A study showed that isoprenaline is safe and more effective than dopamine in treating unstable third-degree AV block, improving patient outcomes and reducing the need for temporary pacing.
Background: Pulmonary capillary wedge pressure (PCWP) assessment is fundamental for managing dilated cardiomyopathy (DCM) patients. Although cardiovascular magnetic resonance (CMR) has become the gold-standard imaging technique for evaluating cardiac chamber volume and function, PCWP is not routinely assessed with CMR. Therefore, this study aimed to validate the left atrial expansion index (LAEI), a LA reservoir function parameter able to estimate filling pressure with echocardiography, as a novel CMR-measured parameter for non-invasive PCWP estimation in DCM patients.
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- * This difference in how ischemic heart disease presents in women has significant implications for diagnosis and treatment, necessitating tailored approaches for female patients.
- * The review covers various methods to evaluate coronary microvascular function, highlighting the need for appropriate diagnostic tools based on the patient's sex to improve clinical outcomes.
Severe psoriasis is associated with an increased cardiovascular risk, which may be independent of the traditional risk factors. Coronary microvascular dysfunction (CMD) has been shown to predict a poor cardiovascular prognosis in the general population and in patients with psoriasis. In this study, we assessed the prevalence and predictors of CMD in a large cohort of patients with psoriasis without clinical cardiovascular disease.
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- Heart transplantation is a key treatment for severe heart failure, improving both survival and quality of life for patients, but requires ongoing monitoring for best results.
- Current guidelines on monitoring methods are not detailed, especially regarding the use of echocardiograms and cardiac magnetic resonance as alternatives to invasive procedures like endomyocardial biopsies.
- Recent advancements in non-invasive imaging techniques, such as advanced echocardiography and cardiac computed tomography, show potential for reducing invasive procedures while still providing valuable insights into heart health post-transplant.