Publications by authors named "Luna Gargani"

Background: Pulmonary hypertension (PH) is a pathophysiological problem that may involve several clinical symptoms and be linked to various respiratory and cardiovascular illnesses. Its diagnosis is made invasively by Right Cardiac Catheterization (RHC), which is difficult to perform routinely. Aim of the current study was to develop a Machine Learning (ML) algorithm based on the analysis of anamnestic data to predict the presence of an invasively measured PH.

View Article and Find Full Text PDF

Aims: Uncertainty exists about defining true iron deficiency (ID) in heart failure (HF) patients. We assessed the relationship of different ID definitions with cardiac structure and function, congestion, exercise capacity, and prognosis in HF outpatients.

Methods And Results: Iron deficiency was defined according to guidelines (G-ID: ferritin <100 ng/ml or ferritin 100-299 ng/ml with transferrin saturation [TSAT] <20%).

View Article and Find Full Text PDF

In heart failure (HF), congestion is a key pathophysiologic hallmark and a major contributor to morbidity and mortality. However, the presence of congestion is often overlooked in both acute and chronic settings, particularly when it is not clinically evident, which can have important clinical consequences. Ultrasound (US) is a widely available, non-invasive, sensitive tool that might enable clinicians to detect and quantify the presence of (subclinical) congestion in different organs and tissues and guide therapeutic strategies.

View Article and Find Full Text PDF

Background: Lower extremity arterial disease (LEAD) and increased aortic stiffness are associated with higher mortality in patients with chronic coronary syndrome, while their prognostic significance after an acute coronary syndrome (ACS) is less known.

Methods: We analyzed prevalence, clinical phenotypes and association of LEAD - assessed by the ankle-brachial index (ABI) - and increased aortic stiffness - assessed by the aortic pulse wave velocity (PWV) - with all-cause mortality and major adverse cardiovascular events (MACE) in patients admitted with an ACS.

Results: Among 270 patients admitted for ACS (mean age 67 years, 80% males), 41 (15%) had an ABI ≤0.

View Article and Find Full Text PDF
Article Synopsis
  • Lung ultrasonography (LUS) is a useful, non-invasive tool for diagnosing respiratory conditions, particularly in resource-limited settings, as it reduces radiation exposure and quantifies regional loss of aeration.
  • A study assessed the agreement among 20 experienced LUS operators by having them evaluate 25 video clips, revealing strong but not perfect inter-rater reliability, with varying levels of consensus on the scores assigned to the clips.
  • Despite some discrepancies, the findings indicate that LUS scoring can reliably inform severity assessments in respiratory diseases, making it a valuable clinical tool.
View Article and Find Full Text PDF

Tricuspid regurgitation (TR) carries an unfavourable prognosis and often leads to progressive right ventricular (RV) failure. Secondary TR accounts for over 90% of cases and is caused by RV and/or tricuspid annulus dilation, in the setting of left heart disease or pulmonary hypertension. Surgical treatment for isolated TR entails a high operative risk and is seldom performed.

View Article and Find Full Text PDF

Imaging plays an integral role in all aspects of managing heart disease and cardiac imaging is a core competency of cardiologists. The adequate delivery of cardiac imaging services requires expertise in both imaging methodology-with specific adaptations to imaging of the heart-as well as intricate knowledge of heart disease. The European Society of Cardiology (ESC) and the European Association of Cardiovascular Imaging have developed and implemented a successful education and certification programme for all cardiac imaging modalities.

View Article and Find Full Text PDF
Article Synopsis
  • * Cardiopulmonary exercise testing (CPET) helps assess metabolic and ventilatory issues causing exercise intolerance, while exercise-stress echocardiography (ESE) better evaluates cardiovascular function; combining these methods offers a comprehensive understanding of the condition.
  • * This review aims to enhance clinicians' knowledge about exercise intolerance's underlying mechanisms and the practical use of CPET-ESE to improve diagnosis and treatment strategies for patients with undetermined causes of dyspnea and specific heart conditions.
View Article and Find Full Text PDF

Lung ultrasound (LUS) is an effective tool for diagnosing acute heart failure (AHF). However, several imaging protocols currently exist and how to best use LUS remains undefined. We aimed at developing a lung ultrasound-based model for AHF diagnosis using machine learning.

View Article and Find Full Text PDF

Aims: Lung ultrasound (LUS) is often used to assess congestion in heart failure (HF). In this study, we assessed the prognostic role of LUS in patients with HF at admission and hospital discharge, and in an outpatient setting, and explored whether clinical factors [age, sex, left ventricular ejection fraction (LVEF), and atrial fibrillation] impact the prognostic value of LUS findings. Further, we assessed the incremental prognostic value of LUS on top of the following two clinical risk scores: (i) the atrial fibrillation, haemoglobin, elderly, abnormal renal parameters, diabetes mellitus (AHEAD) and (ii) the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) clinical risk scores.

View Article and Find Full Text PDF
Article Synopsis
  • Recent research indicates that lung ultrasound can detect hidden pulmonary congestion in patients with pulmonary arterial hypertension (PAH), revealing a relationship between right heart failure and increased lung water content.
  • A study involving 102 PAH patients demonstrated that 75% had pulmonary congestion indicated by B-lines on lung ultrasound, with various factors such as sex, age, and NT-proBNP levels correlating with these findings.
  • The results suggest that pulmonary congestion is tied to right ventricular dysfunction and increased central venous pressure, which may hinder lymphatic drainage.
View Article and Find Full Text PDF

Background: Cardiac involvement in systemic sclerosis (SSc) affects the prognosis of the disease. Echocardiography is the first line imaging tool to detect cardiac involvement, but it is not able to routinely detect myocardial fibrosis. Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) is the gold standard for replacement myocardial fibrosis assessment, but its availability is currently limited.

View Article and Find Full Text PDF
Article Synopsis
  • Exercise echocardiography is vital for evaluating the right ventricle and pulmonary circulation, but there's a need for clearer understanding of normal ranges and disease-specific variations.
  • The study involved 2,228 participants including healthy individuals, athletes, and patients with different heart and lung conditions, who underwent echocardiography at rest and during exercise.
  • Key findings indicate that certain measurements can predict increased mortality risk, highlighting significant differences in responses to exercise between healthy subjects and various patient groups.
View Article and Find Full Text PDF

Introduction: The achievement of alimentary competencies is a milestone in the development of preterm neonates. Ten percent of neonates <37 weeks of gestational age and 25% of those VLBW experience swallowing disorders, with an increased risk of problems in the early phase of life (failure to thrive, growth retardation, inhalation, and consequent risk of pulmonary infection) and later in life due to delayed development of oromotor skills.The main diagnostic tools for swallowing disorders are endoscopic (fiber-optic endoscopic examination of swallowing, FEES) or radiographic (videofluoroscopic swallowing study, VFSS) exams.

View Article and Find Full Text PDF

Introduction: Heart involvement is a common problem in systemic sclerosis. Recently, a definition of systemic sclerosis primary heart involvement had been proposed. Our aim was to establish consensus guidance on the screening, diagnosis and follow-up of systemic sclerosis primary heart involvement patients.

View Article and Find Full Text PDF

Aims: Degenerative aortic valve stenosis with preserved ejection fraction (ASpEF) and heart failure with preserved ejection fraction (HFpEF) display intriguing similarities. This study aimed to provide a non-invasive, comparative analysis of ASpEF versus HFpEF at rest and during exercise.

Methods And Results: We prospectively enrolled 148 patients with HFpEF and 150 patients with degenerative moderate-to-severe ASpEF, together with 66 age- and sex-matched healthy controls.

View Article and Find Full Text PDF

Imaging plays an integral role in all aspects of managing heart disease and cardiac imaging is a core competency of cardiologists. The adequate delivery of cardiac imaging services requires expertise in both imaging methodology-with specific adaptations to imaging of the heart-as well as intricate knowledge of heart disease. The European Society of Cardiology (ESC) and the European Association of Cardiovascular Imaging have developed and implemented a successful education and certification programme for all cardiac imaging modalities.

View Article and Find Full Text PDF
Article Synopsis
  • Cardiac imaging is essential for heart disease management and requires cardiologists to have expertise in both imaging techniques and heart disease knowledge.
  • The European Society of Cardiology has created a comprehensive education and certification program to ensure cardiologists are well-trained in all aspects of cardiac imaging.
  • This training focuses on competency in the entire imaging process, which is crucial for delivering optimal and efficient patient care.
View Article and Find Full Text PDF

Background: Lung ultrasound congestion scoring (LUS-CS) is a congestion severity biomarker. The BLUSHED-AHF trial demonstrated feasibility for LUS-CS-guided therapy in acute heart failure (AHF). We investigated two questions: 1) does change (∆) in LUS-CS from emergency department (ED) to hospital-discharge predict patient outcomes, and 2) is the relationship between in-hospital decongestion and adverse events moderated by baseline risk-factors at admission?

Methods: We performed a secondary analysis of 933 observations/128 patients from 5 hospitals in the BLUSHED-AHF trial receiving daily LUS.

View Article and Find Full Text PDF