Publications by authors named "Nicola Bernardi"

Article Synopsis
  • - Sacubitril/valsartan is known for its benefits in treating heart failure with reduced ejection fraction, but its impact on endothelial dysfunction and arterial stiffness was less explored in this study.
  • - In a study involving 15 patients, various noninvasive tests showed that while arterial stiffness parameters didn’t change significantly after 6 months, there was a notable improvement in endothelial function and other heart measures like ejection fraction and diastolic dysfunction.
  • - Despite some limitations, the findings suggest that sacubitril/valsartan positively affects heart function in patients with dilated cardiomyopathy but does not significantly impact arterial stiffness over the studied period.
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Coeliac disease (CD) is an autoimmune condition with a high prevalence among general population and multisystemic involvement: a more complex scene than a merely gastrointestinal disease. Therefore, an early diagnosis and treatment with a gluten-free diet is mainly important to reduce mortality and comorbidities. Together with autoimmune diseases (as Hashimoto thyroiditis, insulin-dependent diabetes mellitus, autoimmune liver disease and connective tissue diseases), also an accelerated progression of atherosclerosis and a higher prevalence of heart disease have been reported in coeliacs.

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It has been widely reported that the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) attaches human cells by using the Angiotensin Converting Enzyme 2 (ACE2) receptor, but vascular impairment described during coronavirus disease 2019 (COVID-19) infection is primarily due to the direct involvement of the endothelial cells by the virus or secondarily to the inflammatory host response is currently unknown. We therefore aimed to demonstrate in vivo the presence of endothelial dysfunction in six COVID-19 patients without cardiovascular risk factors or pre-existing cardiac condition, using the Endo-PAT 2000, a device able to measure endothelial vasodilation function in a rapid and non-invasive way. Four patients were positive for endothelial dysfunction, with RHI values between 1.

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Aims: This review aims to provide an update of available methods for imaging calcification activity and potential therapeutic options.

Data Synthesis: Aortic valve calcification represents the most common heart valve condition requiring treatment among adults in Western societies. No medical therapies are proven to be effective in treating symptoms or reducing disease progression.

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Article Synopsis
  • The COVID-19 pandemic is linked to coagulopathy, even though pneumonia is the most prominent symptom, and the exact rate of thromboembolic events remains unclear.
  • Research highlights the role of a cytokine storm, driven by inflammatory markers, as a key factor in increased blood clotting risks for COVID-19 patients.
  • This review seeks to detail the epidemiology and biological mechanisms of hypercoagulability in COVID-19, while also offering prevention strategies for thromboembolic events.
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Background: COVID-19 may induce a coagulation dysregulation resulting in a prothrombotic state with a higher risk of arterial and venous thrombosis. This abnormal thrombotic diathesis can lead to pulmonary embolism, stroke, and intracardiac thrombosis.

Case Summary: We present two cases of unusual intracardiac thrombosis in patients hospitalized for COVID-19.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is mainly responsible for respiratory involvement but cardiac complications are also reported. Nevertheless, potential life-threatening conditions in young people have not been described. A 19-year-old male autistic patient was admitted with fever and cough.

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The efficacy and safety of bempedoic acid, including the occurrence of muscle-related adverse events, have been addressed by phase 2 and phase 3 clinical trials. Phase 3 clinical trials demonstrated that in patients with atherosclerotic cardiovascular disease and/or familial hypercholesterolemia who were treated with statins at maximum tolerated dose, with or without further lipid-lowering drugs, bempedoic acid treatment was associated with a significant reduction in low-density lipoprotein cholesterol in different groups of patients with a favorable safety profile. An ongoing phase 3 study is currently evaluating the effect of longer-term (median duration of 3-4 years) treatment with bempedoic acid on the incidence of cardiovascular events.

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Stage A heart failure (HF) patients do not show HF symptoms or any structural heart disease but are at risk of HF development. Cardiovascular risk factors (hypertension, diabetes, metabolic syndrome, sedentary lifestyle, poor diet, and exposure to cardiotoxic agents) characterize subjects affected by stage A HF. It is essential to identify these subjects early and ensure that, despite being asymptomatic, they grasp the importance of undertaking correct lifestyle and therapeutic interventions.

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Aim: To evaluate the long-term prognostic significance of right ventricular (RV) deformation and RV-arterial coupling in a cohort of patients with heart failure (HF) due to severe aortic stenosis (AS) candidate for trans-catheter aortic valve implantation (TAVI).

Methods: The study is a retrospective analysis of 56 patients undergoing echocardiography before TAVI execution. RV function was defined by tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), peak systolic myocardial velocity by tissue Doppler imaging (RVSm) and RV longitudinal strain (RVLS).

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Left ventricle thrombus is considered a rare complication of Takotsubo syndrome. However, both a stress condition predisposing to Takotsubo syndrome and coagulation abnormalities coexist in COVID-19. We describe a case of a patient with COVID-19 with Takotsubo syndrome.

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A 34-year-old man was admitted with acute lung injury and COVID-19 pneumonia. In the intensive care unit, he experienced episodes of prolonged asystole accompanied by hypotension without loss of consciousness. Once reversible causes were excluded, symptoms were related to dysfunction of the sinus node, and the patient underwent implantation of a pacemaker.

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There is some evidence that Covid 19 pneumonia is associated with prothrombotic status and increased risk of venous thromboembolic events (deep venous thrombosis and pulmonary embolism). Over a two-week period we admitted in our Unit 25 patients with Covid-19 pneumonia, of these pulmonary embolism was diagnosed using computed tomography angiography in 7. We report on clinical and biochemical features of these patients.

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In literature, there are conflicting opinions on the development of cardiovascular disease risk in patients with coeliac disease (CD). The aim of the research was to identify in young subjects without cardiovascular risk factor and newly diagnosed CD, alterations in different instrumental parameters that are associated with an augmented cardiovascular risk. Twenty-one consecutive young adults with a new diagnosis of CD and without cardiovascular risk factors were prospectively enrolled and underwent transthoracic echocardiography to analyse ascending aorta elastic properties [including tissue Doppler imaging strain (TDI-ε)] and left ventricular 2D strains (global longitudinal, radial and circumferential), and applanation tonometry by SphygmoCor.

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