Publications by authors named "Marco DI Maio"
Prevalence and Prognostic Significance of Right Ventricular Dysfunction in Patients With Severe Low-Flow, Low-Gradient Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement.
J Am Heart Assoc
November 2024
Article Synopsis
- This study investigates how right ventricular (RV) dysfunction affects the outcomes of patients with low-flow, low-gradient aortic stenosis (LFLG-AS) who are undergoing transcatheter aortic valve replacement (TAVR).
- Utilizing data from two Italian centers, it was found that RV dysfunction is linked to a significantly increased risk of all-cause death and major cardiovascular events after one year.
- The findings suggest that assessing RV dysfunction before TAVR can enhance the ability to predict patient prognosis.
Article Synopsis
- Despite improvements in treatment strategies for post-acute coronary syndrome (ACS) patients, there remains a high occurrence of recurrent ischemic events, highlighting the need for new therapeutic targets to reduce cardiovascular risk.
- Chronic inflammation, specifically the role of inflammasomes, has been linked to the development of atherosclerosis, leading to interest in drugs like colchicine and monoclonal antibodies that may enhance cardiovascular outcomes.
- Additionally, lipoprotein(a) and gut microbiome alterations are emerging as significant risk factors, with potential therapies for lowering Lp(a) showing promise, while targeted microbiome studies still require further research.
Article Synopsis
- * Recent guidelines recommend complete revascularization as the standard treatment for significant non-culprit lesions (NCLs), but careful risk-benefit evaluations are necessary before proceeding.
- * The article reviews MVD management in STEMI patients and highlights the main techniques for guiding revascularization in this high-risk group, noting that optimal assessment timing and methods for NCLs remain inconsistent.
Article Synopsis
- A multicenter study analyzed the effectiveness and safety of intravenous antiplatelet therapies, cangrelor and tirofiban, in STEMI patients undergoing PPCI at seven Italian centers.
- The primary outcome measured was the incidence of TIMI flow < 3 after the procedure and the risk of bleeding (BARC 2-5) in patients receiving either treatment.
- Results showed that cangrelor led to better myocardial blood flow post-PPCI compared to tirofiban, without a higher risk of significant bleeding complications.
The number of primary total hip arthroplasties (THAs) and revisions is expected to steadily grow in the future. The femoral revision surgery can be technically demanding whether severe bone defects need to be addressed. The femoral revision aims to obtain a proper primary stability of the stem with a more proximal fixation as possible.
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- 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.
Article Synopsis
- Over the past few decades, bioprosthetic heart valves have become more common than mechanical valves in surgical aortic valve replacements, but structural valve deterioration is a frequent issue that may require further intervention.
- * The innovation of valve-in-valve transcatheter aortic valve replacement (ViV TAVR) has emerged as a practical solution for patients with failed bioprosthetic valves, especially those at high surgical risk.
- * This review highlights the importance of multidisciplinary planning, current clinical evidence, procedural techniques, and potential complications to optimize ViV TAVR outcomes for both surgical and transcatheter heart valve failures.
The paper entitled "Sacubitril/valsartan improves left ventricular longitudinal deformation in heart failure patients with reduced ejection fraction" by Renato De Vecchis et al., which was published in Minerva Cardioangiologica 2019 December;67(6):456-63, has been retracted by the Publisher due to self-plagiarism.
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- The study aimed to assess the prognostic value of the SYNTAX score (SS) and SYNTAX score II (SS-II) in myocardial infarction (MI) patients who underwent percutaneous coronary intervention (PCI).
- Conducted at the University Hospital of Salerno from January 2015 to April 2020, the study included 915 MI patients and found that both SS and SS-II were linked to increased risks of all-cause and cardiovascular mortality. However, only SS-II was associated with recurrent MI.
- The results indicated that SS-II was more effective than SS in predicting long-term mortality, with a better ability to differentiate risk levels over a five-year follow-up period.
Objectives: The differential diagnosis between pulmonary arterial hypertension (PAH) and postcapillary pulmonary hypertension (PH) in heart failure with preserved ejection fraction (HFpEF) is sometimes difficult despite guidelines-derived standardized step-by-step diagnostic algorithms. We therefore explored the added value of lung ultrasound to a previously validated echocardiographic score of right heart catheterization measurements.
Methods: Patients referred for PH underwent a right heart catheterization, echocardiography, and lung ultrasound before and after rapid infusion of 7 mL/kg of saline.
Aims: The aim of this study was to investigate the long-term outcome of takotsubo syndrome (TTS) patients with and without hypertension (HT) and to evaluate the effectiveness of treatment with beta-blockers (BBs) and/or renin-angiotensin-aldosterone system inhibitors (RAASi).
Methods And Results: The study population includes a register-based, multicentre cohort of consecutive patients with TTS, divided into two groups according to the history of HT. Further stratification was performed for BB/RAASi prescription at discharge.
Patients with acute coronary syndrome and multivessel disease experience several recurrent adverse events that lead to poor outcomes. Given the complexity of treating these patients, and the extremely high risk of long-term adverse events, the assessment of non-culprit lesions becomes crucial. Recently, two trials have shown a possible clinical benefit into treat non-culprit lesions using a fraction flow reserve (FFR)-guided approach, compared to culprit-lesion-only PCI.
View Article and Find Full Text PDFBackground: Single-stage hardware removal and total hip arthroplasty is a complex surgical procedure, comparable to revision surgery. The purpose of the current study is to evaluate single-stage hardware removal and THA outcomes, compare this technique with a matched control group that has undergone primary THA and assess the risk of periprosthetic joint infection with a 24-month minimum follow-up.
Methods: This study included all those cases treated with THA and concomitant hardware removal from 2008 to 2018.
Background: Preoperative diagnosis of periprosthetic joint infections (PJIs) poses an unmet clinical challenge. The long pentraxin PTX3 is a component of the innate immune system involved in infection immunity. This study evaluated the potential of synovial and plasmatic PTX3 in the diagnosis of hip and knee PJIs.
View Article and Find Full Text PDFAims: The athlete's heart in power training is characterized by physiologic concentric remodeling. Our aim was to analyze left ventricular (LV) myocardial deformation and contractile reserve (CR) in top-level power athletes (PA) at rest and during exercise and their possible correlations with functional capacity.
Methods: Standard echo, lung ultrasound, and LV 2D speckle-tracking strain were performed at rest and during exercise in PA and in age- and sex-comparable healthy controls.
Introduction: The aim of this study was to evaluate the association of lipoprotein(a) [Lp(a)] levels with long-term outcome in patients with recent history of myocardial infarction (MI), and to investigate if diabetes may influence this association.
Methods: Consecutive MI patients who underwent urgent/emergent coronary angiography from February 2013 to June 2019 were prospectively collected. The primary outcome was the composite of MI recurrence and all-cause death.
SARS-CoV2 infection, responsible for the COVID-19 disease, can determine cardiac as well as respiratory injury. In COVID patients, viral myocarditis can represent an important cause of myocardial damage. Clinical presentation of myocarditis is heterogeneous.
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- The study aimed to assess the long-term benefits of beta-blocker treatment in patients recovering from Takotsubo syndrome (TTS) after discharge, considering the impact of catecholamines on the condition.
- Conducted across multiple centers, the research involved 825 patients diagnosed with TTS, comparing outcomes between those who were prescribed beta-blockers and those who weren't over a median follow-up period of 24 months.
- Results indicated that patients on beta-blockers had significantly lower risks of all-cause and non-cardiac death, particularly benefiting those with hypertension or cardiogenic shock during the acute phase of TTS.
Background andObjectives: Current guidelines on cardiac rehabilitation (CR) suggest moderate-intensity physical activity after acute coronary syndrome (ACS). Recent report have shown that high-intensity interval training (HIIT) could be more effective than moderate-intensity continuous training (MCT) in improving cardiac performance. Our aim was to analyze the effects of HIIT protocol after ACS on advanced echocardiographic parameters of myocardial function.
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- Pre-existing atrial fibrillation (AF) is common in COVID-19 patients and the study aimed to determine its impact on disease severity and mortality.
- Out of 467 hospitalized COVID-19 patients, 26.1% had a history of AF, with most cases being persistent or permanent in nature.
- The study found that while pre-existing AF increased the risk of developing severe acute respiratory distress syndrome (ARDS), it did not significantly affect the risk of in-hospital mortality.
Article Synopsis
- - The study focused on assessing the long-term clinical outcomes of hospitalized COVID-19 patients, specifically examining the relationship between right ventricular (RV) dysfunction and 1-year mortality rates in a cohort of 224 patients from seven hospitals in Italy.
- - RV dysfunction was found in 28% of patients; those affected were older, had a higher prevalence of coronary artery disease, and lower heart function compared to those without RV dysfunction.
- - The research concluded that patients with RV dysfunction had significantly higher 1-year mortality rates (67% vs. 28%) and indicated that RV dysfunction is a common issue in COVID-19 patients, correlating with increased long-term mortality risk.
Coronary artery ectasia (CAE) is defined as a diffuse or focal dilation of an epicardial coronary artery, which diameter exceeds by at least 1. 5 times the normal adjacent segment. The term ectasia refers to a diffuse dilation, involving more than 50% of the length of the vessel, while the term aneurysm defines a focal vessel dilation.
View Article and Find Full Text PDFBackground: According to current guidelines, the diagnosis of pulmonary hypertension (PH) relies on echocardiographic probability followed by right heart catheterisation (RHC). How echocardiography predicts PH recently redefined by mean pulmonary arterial pressure (mPAP) >20 mmHg instead of ≥25 mmHg and pulmonary vascular disease defined by pulmonary vascular resistance (PVR) ≥3 or >2 WU has not been established.
Methods: A total of 278 patients referred for PH underwent comprehensive echocardiography followed by RHC.
Aims: Pulmonary involvement in Coronavirus disease 2019 (COVID-19) may affect right ventricular (RV) function and pulmonary pressures. The prognostic value of tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (PAPS), and TAPSE/PAPS ratios have been poorly investigated in this clinical setting.
Methods And Results: This is a multicenter Italian study, including consecutive patients hospitalized for COVID-19.
Article Synopsis
- This study evaluates the effectiveness of the Academic Research Consortium High Bleeding Risk (ARC-HBR) criteria in identifying patients at risk for bleeding and ischemic events post-percutaneous coronary intervention (PCI).
- It analyzes data from 10 studies with a total of 67,862 patients, revealing that nearly 45% met HBR criteria, and these patients had more than double the risk of major bleeding compared to those not classified as HBR.
- Findings indicate that while HBR patients had higher rates of certain adverse events like myocardial infarction and stent thrombosis, their need for follow-up procedures (target lesion revascularization) was similar to the non-HBR group.