Left atrial appendage occlusion (LAAO) is an increasingly used alternative to oral anticoagulation in patients with atrial fibrillation, especially in patients with absolute/relative contraindications to these therapies. This review will cover three main aspects of the procedure. In the fist part of the manuscript, we focus on patient selection.
View Article and Find Full Text PDFBackground The relative contribution of amyloid and fibrosis to extracellular volume expansion in cardiac amyloidosis (CA) has never been defined. Methods and Results We included all patients diagnosed with amyloid light-chain (AL) or transthyretin cardiac amyloidosis at a tertiary referral center between 2014 to 2020 and undergoing a left ventricular endomyocardial biopsy. Patients (n=37) were more often men (92%), with a median age of 72 years (interquartile range, 68-81).
View Article and Find Full Text PDFBackground And Objectives: The absence of obstructive coronary artery disease (CAD) in patients with angina is common, but its prognosis is debated. We investigated outcomes of such patients to identify predictors of cardiovascular events.
Methods: We selected 1014 patients with angina, evidence of myocardial ischemia at the electrocardiogram (ECG) exercise test or imaging stress tests, and nonobstructive CAD (absence of lumen diameter reduction ≥50%) at coronary angiography between 1999 and 2015.
Aims: This study aimed to evaluate a novel echocardiographic algorithm for quantitative estimation of pulmonary artery wedge pressure (PAWP) and pulmonary vascular resistance (PVR) in patients with heart failure and pulmonary hypertension (PH) scheduled to right heart catheterization (RHC).
Methods And Results: In this monocentric study, 795 consecutive patients (427 men; age 68.4 ± 12.
Rationale: Despite advances in treatment of acute myocardial infarction (AMI), many patients suffer significant myocardial damage with cardiac dysfunction. Sympathetic renal denervation (RD) may reduce adrenergic activation following AMI.
Objective: To investigate the potential role of RD limiting myocardial damage and remodeling when performed immediately after AMI.
G Ital Cardiol (Rome)
April 2020
The impressive advances in structural heart disease interventions in the last decade led to renewed interest in intracardiac echocardiography (ICE). The potential of ICE to avoid transesophageal echocardiography with its known limits, has supported ICE technology progress and wider clinical use. This review summarizes relevant evidence about ICE and provides the structural interventionalist with an illustrative guide on the use of ICE to guide various structural heart interventions.
View Article and Find Full Text PDFCoron Artery Dis
January 2020
Aims: To assess the long-term outcomes of patients treated with sirolimus-eluting Stentys stent in a real-life setting.
Background: Few data regarding the safety and effectiveness of self-apposing sirolimus-eluting Stentys stent are available.
Methods: 278 patients (30% stable coronary artery disease, 70% acute coronary syndromes, and 54% on unprotected left main) treated with sirolimus eluting Stentys stent were retrospectively included in the self-aPposing, bAlloon-delivered, siRolimus-eluting stent for the Treatment of the coronary Artery disease multicenter registry.
Catheter Cardiovasc Interv
February 2019
Objectives: To compare the effectiveness and safety of self-expandable, sirolimus-eluting Stentys stents (SES) and second-generation drug-eluting stents (DES-II) for the treatment of the unprotected left main (ULM).
Background: SES may provide a valuable option to treat distal ULM, particularly when significant caliber gaps with side branches are observed.
Methods: Patients from the multicenter SPARTA (clinicaltrials.
Background: In the last decades, interventional cardiology has received fast and wide implementation as an effective alternative treatment to surgery for several congenital and acquired diseases. In this scenario, imaging provides solutions for most clinical needs, from diagnosis to prognosis and risk stratification, as well as anatomical and functional assessment.
Methods: In this review article, we present recent innovations in medical imaging for structural heart disease and coronary artery disease, emphasizing the progress achieved in the field of multimodality imaging and the solutions proposed to some as-yet unresolved technical problems for safe and effective procedural performance.
The aim of this report is to analyse trends in Italian cathlab activity between 2010 and 2015. Data were obtained from the national database of the Italian Society of Interventional Cardiology (GISE), which includes 97% of Italian cardiac catheterisation laboratories. The number of percutaneous coronary interventions (PCI) has remained relatively stable in the past five years.
View Article and Find Full Text PDFObjective: Percutaneous left atrial appendage (LAA) occlusion has been developed as a viable option for stroke and thromboembolism prevention in patients with non-valvular atrial fibrillation (NVAF) and at high risk for cerebral cardioembolic events. Data on device implantation and long-term follow-up from large cohorts are limited.
Methods: 110 consecutive patients with NVAF and contraindications to oral anticoagulants (OACs) underwent LAA occlusion procedures and achieved a longer than 1 year follow-up.
Aim: Self-expanding stents represent a re-emerging option for percutaneous coronary interventions. Their application covers a wide spectrum of angiographic situations, i.e.
View Article and Find Full Text PDFIn remote ischemic conditioning (RIC), several cycles of ischemia and reperfusion render distant organ and tissues more resistant to the ischemia-reperfusion injury. The intermittent ischemia can be applied before the ischemic insult in the target site (remote ischemic preconditioning), during the ischemic insult (remote ischemic perconditioning) or at the onset of reperfusion (remote ischemic postconditioning). The mechanisms of RIC have not been completely defined yet; however, these mechanisms must be represented by the release of humoral mediators and/or the activation of a neural reflex.
View Article and Find Full Text PDFElevation of resting high-sensitivity troponin (hs-Tn) holds prognostic value in heart failure (HF), but its pathophysiological meaning is unclear. We aimed to investigate hs-Tn elevation after maximal exercise in patients with systolic HF and its neurohormonal and hemodynamic correlates: 30 patients diagnosed with systolic HF (left ventricular ejection fraction 32 ± 8%, mean ± SD), on guideline-directed medical therapy and not recognized inducible ischemia, underwent maximal cardiopulmonary stress test, with assay of plasma N-terminal proB-type natriuretic peptide (NT-proBNP), norepinephrine (NE), and hs-TnT (hs-TnT) at baseline, peak, and 1 and 4 hours after exercise. Cardiac output (CO) was measured during effort, with a rebreathing technique.
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