Publications by authors named "Marco Di Tullio"
Article Synopsis
- Heart failure (HF) is increasingly common in older adults, and left atrial (LA) dysfunction may play a role in its development, though this connection is not fully understood.
- A study involving 795 older adults without previous cardiovascular events used various echocardiography techniques to assess LA function and tracked the onset of HF over an average of 11.4 years.
- Results showed that LA stiffness and the LA coupling index (LACI) were significant predictors of new-onset HF, with LACI being a particularly strong independent indicator even after accounting for other risk factors.
Background: ARCADIA compared apixaban to aspirin for secondary stroke prevention in patients with cryptogenic stroke and atrial cardiopathy. One possible explanation for the neutral result is that biomarkers used did not optimally identify atrial cardiopathy. We examined the relationship between biomarker levels and subsequent detection of AF, the hallmark of atrial cardiopathy.
View Article and Find Full Text PDFAbsence of long-term structural and functional cardiac abnormalities on multimodality imaging in a multi-ethnic group of COVID-19 survivors from the early stage of the pandemic.
Eur Heart J Imaging Methods Pract
September 2023
Article Synopsis
- Many COVID-19 survivors from the early pandemic showed signs of cardiac injury, prompting investigations into long-term heart effects using cardiac imaging techniques like CMR and TTE.
- A study involving 40 COVID-19 survivors and 12 matched controls conducted TTE and CMR at an average of 308 days post-infection, revealing no significant differences in heart structure, function, or tissue abnormalities between the groups.
- The findings suggest that there is no lasting damage or inflammation to the heart in these survivors, despite previous reports of cardiac issues during acute COVID-19.
Article Synopsis
- A study examined the relationship between changes in arterial stiffness and left ventricular (LV) remodeling over time in 317 participants without cardiovascular disease.
- Results indicated that increased arterial stiffness, measured by cardio-ankle vascular index (CAVI), was linked to impaired LV global longitudinal strain (LVGLS), an important indicator of heart function.
- Notably, this association was observed primarily in women, highlighting that vascular health may significantly influence heart function even in early stages, contributing to heart failure risk.
Background And Objectives: Whether patent foramen ovale (PFO) closure benefits older patients with PFO and cryptogenic stroke is unknown because randomized controlled trials (RCTs) have predominantly enrolled patients younger than 60 years of age. Our objective was to estimate anticipated effects of PFO closure in older patients to predict the numbers needed to plan an RCT.
Methods: Effectiveness estimates are derived from major observational studies (Risk of Paradoxical Embolism [RoPE] Study and Oxford Vascular Study, together referred to as the "RoPE-Ox" database) and all 6 major RCTs (Systematic, Collaborative, PFO Closure Evaluation [SCOPE] Consortium).
Importance: Atrial cardiopathy is associated with stroke in the absence of clinically apparent atrial fibrillation. It is unknown whether anticoagulation, which has proven benefit in atrial fibrillation, prevents stroke in patients with atrial cardiopathy and no atrial fibrillation.
Objective: To compare anticoagulation vs antiplatelet therapy for secondary stroke prevention in patients with cryptogenic stroke and evidence of atrial cardiopathy.
Article Synopsis
- * In a study of 934 stroke-free participants, 69.1% had aortic arch plaques, with larger plaques correlating with a significantly higher rate of combined cardiovascular events in statin users.
- * Findings suggest that aortic arch plaques may indicate overall cardiovascular risk rather than serving solely as a source of embolic strokes.
Aims: Emerging evidence suggests an association between non-alcoholic fatty liver disease (NAFLD) and heart failure (HF). We investigated the relationship between NAFLD and left ventricular (LV) functional remodelling in a general population sample without overt cardiac and liver disease.
Methods And Results: We included 481 individuals without significant alcohol consumption who voluntarily underwent an extensive cardiovascular health check.
Article Synopsis
- Atrial fibrillation (AF) is common in older adults and linked to issues with the left atrium (LA), where reduced LA function may indicate early disease.
- A study of 824 older adults found that lower levels of left atrial strain (LAε) and strain rate (LASR) can predict new-onset AF, even in those without prior AF or stroke.
- The research suggests that measuring LA function can help identify individuals at higher risk for developing AF, potentially improving risk assessment strategies for older patients.
There is emerging evidence that the cardiac interatrial septum has an important role as a thromboembolic source for ischemic strokes. There is little consensus on treatment of patients with different cardiac interatrial morphologies or pathologies who have had stroke. In this paper, we summarize the important background, diagnostic, and treatment considerations for this patient population as presented during the Federation of American Societies for Experimental Biology (FASEB) Virtual Catalytic Conference on the Cardiac Interatrial Septum and Stroke Risk, held on December 7, 2022.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the link between premature ventricular contractions (PVCs) and nonsustained ventricular tachycardia (NSVT) with subtle left ventricular (LV) dysfunction in older adults whose LV ejection fraction appears normal.
- Out of 503 participants, a significant portion exhibited frequent PVCs and NSVT, both of which were tied to reduced LV global longitudinal strain (GLS), indicating early signs of LV dysfunction.
- The findings suggest that even minor reductions in LV GLS are associated with a greater risk of ventricular arrhythmias, highlighting the potential for early intervention in at-risk populations.
Article Synopsis
- A study evaluated the progression of aortic arch plaques (AAP) using transthoracic echocardiography (TTE) in older adults, finding a significant association with increased cardiovascular risks.
- Participants were part of two studies and had TTE assessments at two different times; out of 300 participants, over half showed progression of AAP after the follow-up.
- The study highlighted that despite a high incidence of AAP progression, no significant demographic or clinical factors predicted this progression, except that those with baseline lower plaque thickness were more likely to show AAP advancement.
Article Synopsis
- - Aortic valve calcification (AVC) is common in older adults and can lead to stenosis, but the factors influencing its progression are not fully understood.
- - In a study of 373 older participants, 37% exhibited AVC progression, with anti-hypertensive medication being the key clinical predictor alongside factors like age, BMI, and other health issues.
- - The study found higher levels of the serum biomarker TGF-β1 associated with AVC progression, indicating potential avenues for further research on vascular risk factors' combined effects.
Article Synopsis
- The study examines the potential link between left atrial strain (LAε) and left atrial strain rate (LASR) with the risk of ischemic stroke in older adults, particularly those without a history of stroke or atrial fibrillation.
- Conducted as part of the Cardiovascular Abnormalities and Brain Lesions study from 2005 to 2010, it involved 806 participants aged 55 or older, with follow-up interviews continuing until 2022.
- Findings aimed to evaluate the associations of LAε and LASR using advanced imaging techniques and statistical models while adjusting for common stroke risk factors.
Aims: Patients with chronic coronary syndrome (CCS) suffer from subsequent cardiovascular events, even after complete revascularization; thus, elucidation of the underlying pathophysiological mechanisms is required. Epicardial adipose tissue (EAT) is increasingly recognized as a metabolically active organ with a key role in the pathogenesis of metabolic-related cardiac diseases. The present study investigated the association between EAT burden and left heart remodelling in patients with CCS.
View Article and Find Full Text PDFPatients with chronic coronary syndrome (CCS), even when they have complete revascularization and normal left ventricular (LV) systolic function, experience subsequent cardiovascular disease (CVD), highlighting the importance of surrogate markers to prevent adverse consequences. Speckle-tracking echocardiography-derived left atrial (LA) reservoir strain has emerged as a sensitive marker for CVD in various clinical settings. The present study investigated the prevalence, determinants, and prognostic value of LA dysfunction in CCS.
View Article and Find Full Text PDFArticle Synopsis
- * The study involved 962 participants with normal heart structure, categorizing them into four groups based on AVS severity; 20% of participants showed some form of AVS, ranging from thickening to calcification.
- * Results indicate that those with AVS had higher rates of subclinical left ventricular (LV) dysfunction, with particularly significant links between AV thickening and diastolic impairment, and AV calcification affecting systolic function.
Article Synopsis
- The study investigates how changes in arterial structure (aortic root diameter) and function (estimated pulse wave velocity or ePWV) relate to heart remodeling in individuals without heart disease.
- It involves 539 participants, measuring their aortic size and ePWV, along with assessing left ventricular (LV) function and structure using echocardiography.
- Results indicate that both larger aortic root size and higher ePWV correlate with increased LV mass and impaired function, suggesting that these arterial properties could be early indicators linked to heart failure risk.
Article Synopsis
- * Researchers analyzed data from 1158 participants, using advanced echocardiography techniques to measure heart function indicators across different stages of CKD, finding that as kidney function declines, heart function measures also decrease.
- * The findings indicate that declines in heart strain metrics, particularly left ventricular global longitudinal strain and left atrial function, are linked to worsening kidney function, suggesting that monitoring heart strain could enhance risk assessment for CKD patients.
Article Synopsis
- Heart disease increases the risk of ischaemic stroke, and while reduced left ventricular ejection fraction (LVEF) is a known factor, its predictive value for stroke is debated.
- This study focused on left ventricular global longitudinal strain (LV GLS) as a potential predictor of stroke in a group of primarily elderly individuals without prior stroke history, finding that abnormal LV GLS was linked to a significantly higher risk of developing ischaemic stroke.
- The results suggest that LV GLS could improve stroke prevention strategies by providing a stronger prediction of stroke risk, particularly for cardioembolic or cryptogenic subtypes.
We examined the age-related differences in cardiovascular health (CVH) metrics for incident cardiovascular disease (CVD). Analyses were conducted using data from the JMDC Claims Database from 2005 to 2020 (n = 2,728,427; mean age 44.9 ± 11.
View Article and Find Full Text PDFArticle Synopsis
- * Out of 858 participants, those with systolic hypertension had the highest prevalence of abnormal LV global longitudinal strain (LVGLS), followed by those with isolated diastolic hypertension and elevated BP.
- * The results indicate that both isolated diastolic hypertension and systolic hypertension significantly increase the risk for impaired LVGLS, with elevated BP showing a notable link only in women, revealing potential sex-specific differences in cardiac health.
Background Left atrial (LA) and right ventricular (RV) performance play an integral role in the pathophysiology and prognosis of heart failure. We hypothesized that subclinical left ventricular dysfunction adversely affects LA/RV geometry and function even in a preclinical setting. This study aimed to investigate the atrioventricular and ventricular functional interdependence in a community-based cohort without overt cardiovascular disease.
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