Publications by authors named "Paolo Camici"
Article Synopsis
- The study focuses on identifying markers that can predict adverse events in patients who had acute myocarditis (AM) to optimize follow-up care.
- Researchers analyzed data from 248 AM patients, revealing that complicated clinical presentation (CCP) is a strong predictor of major cardiac events compared to other factors like septal late gadolinium enhancement and left ventricular ejection fraction.
- Findings indicate that while major events post-AM are rare, using CCP, LGE, and LVEF<50% together is effective for identifying those at risk, aiding clinicians in patient monitoring.
Formal assessment of myocardial viability (MV) is challenging in acute myocardial infarction-related cardiogenic shock (AMI-CS) patients receiving Impella mechanical circulatory support, as the cardiac magnetic resonance gold standard technique is not feasible due to the metallic components of the device. 18-fluorodesoxyglucose metabolic myocardial positron emission tomography (FDG-PET) may represent a valid and feasible alternative to obtain semi-quantitative and objective evidence of MV during Impella support. We hereby report the first series of sequential AMI-CS patients who received FDG-PET scanning to assess MV during Impella support to demonstrate the safety and feasibility of this approach.
View Article and Find Full Text PDFBackground: Clinical evaluation of central venous pressure is difficult, depends on experience, and is often inaccurate in patients with chronic advanced heart failure. We assessed the ultrasound-assessed internal jugular vein (JV) distensibility by ultrasound as a noninvasive tool to identify patients with normal right atrial pressure (RAP ≤7 mm Hg) in this population.
Methods: We measured JV distensibility as the Valsalva-to-rest ratio of the vein diameter in a calibration cohort (N=100) and a validation cohort (N=101) of consecutive patients with chronic heart failure with reduced ejection fraction who underwent pulmonary artery catheterization for advanced heart failure therapies workup.
Aims: Clinical features and risk stratification of patients with viral myocarditis (VM) complicated by ventricular arrhythmias (VA) are incompletely understood. We aim to describe arrhythmia patterns and outcomes in patients with VM and early-onset VA.
Methods And Results: We present a single-centre study, enrolling patients with VM proven by endomyocardial biopsy, and evidence of VA within 24 h of hospitalization.
Objectives: To ascertain whether invasive assessment of coronary physiology soon after recanalisation of the culprit artery by primary percutaneous coronary intervention is associated with the development of microvascular obstruction by cardiac magnetic resonance in patients with ST-segment elevation myocardial infarction (STEMI).
Methods: Between November 2020 and December 2021, 102 consecutive patients were prospectively enrolled in five tertiary centres in Italy. Coronary flow reserve (CFR) and index of microvascular resistance (IMR) were measured in the culprit vessel soon after successful primary percutaneous coronary intervention.
Women with obstructive coronary artery disease (CAD) have a relatively lower quality of life (QoL) compared to men, but our understanding of sex differences in QoL in ischemia with no obstructive coronary artery disease (INOCA) is limited. We conducted a survey of patient members of INOCA International with an assessment of self-reported health measures. Functional capacity was retrospectively estimated using the Duke Activity Status Index (DASI), assessing levels of activities performed before and after INOCA symptom onset.
View Article and Find Full Text PDFArticle Synopsis
- Angina and dyspnea in patients with normal coronary arteries present a diagnostic challenge, with many possibly suffering from coronary microvascular dysfunction (CMD) rather than traditional coronary artery disease.
- Positron emission tomography (PET) is used to measure myocardial blood flow (MBF) and reserve (MFR), which helps noninvasively detect CMD, leading to better understanding of patients' symptoms.
- A consensus document is in development to standardize the diagnosis and reporting for CMD to improve treatment decisions and patient outcomes, involving experts from around the world.
Myocardial ischemia is an established pathophysiological feature of hypertrophic cardiomyopathy (HCM) that impacts various clinical features, including heart failure (HF) and sudden cardiac death (SCD). The major determinant of myocardial ischemia in HCM is coronary microvascular dysfunction (CMD) in the absence of epicardial coronary artery abnormalities. Despite the impossibility to directly visualize microcirculation in vivo, a multimodality approach can allow a detailed assessment of microvascular dysfunction and ischemia.
View Article and Find Full Text PDFBackground: Left ventricular (LV) remodelling (REM) ensuing after ST-elevation myocardial infarction (STEMI), has typically been studied by echocardiography, which has limitations, or cardiac magnetic resonance (CMR) in early phase that may overestimate infarct size (IS) due to tissue edema and stunning. This prospective, multicenter study investigated LV-REM performing CMR in the subacute phase, and 6 months after STEMI.
Methods And Results: patients with first STEMI undergoing successful primary angioplasty were consecutively enrolled.
Unlabelled: BackgroudThe aim of this study was to assess the prognostic association of plasma levels of -terminal prohormone of brain natriuretic peptide (NT-proBNP) with clinical outcomes of patients with microvascular angina (MVA).
Methods: In this international prospective cohort study of MVA by the Coronary Vasomotor Disorders International Study (COVADIS) group, we examined the association between plasma NT-proBNP levels and the incidence of major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization due to heart failure or unstable angina.
Results: We examined a total of 226 MVA patients (M/F 66/160, 61.
Objective: Coronary microvascular dysfunction (CMD) is a key pathophysiological feature of hypertrophic cardiomyopathy (HCM), contributing to myocardial ischemia and representing a critical determinant of patients' adverse outcome. The molecular mechanisms underlying the morphological and functional changes of CMD are still unknown. Aim of this study was to obtain insights on the molecular pathways associated with microvessel remodeling in HCM.
View Article and Find Full Text PDFBackground: The risk of adverse cardiovascular events in patients with acute myocarditis (AM) and desmosomal gene variants (DGV) remains unknown.
Objectives: The purpose of this study was to ascertain the risk of death, ventricular arrhythmias, recurrent myocarditis, and heart failure (main endpoint) in patients with AM and pathogenic or likely pathogenetic DGV.
Methods: In a retrospective international study from 23 hospitals, 97 patients were included: 36 with AM and DGV (DGV[+]), 25 with AM and negative gene testing (DGV[-]), and 36 with AM without genetics testing.
Background: There is limited information available regarding evidence of ischemia with no obstructive coronary arteries (INOCA) and quality of life.
Purpose: To determine associations between INOCA and self-reported physical, social, and mental health.
Methods: We conducted a survey of all members (n = 1579) of the INOCA International patient support group.
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy. The molecular mechanisms determining HCM phenotypes are incompletely understood. Myocardial biopsies were obtained from a group of patients with obstructive HCM (n = 23) selected for surgical myectomy and from 9 unused donor hearts (controls).
View Article and Find Full Text PDFBoth the latest European guidelines on chronic coronary syndromes and the American guidelines on chest pain have underlined the importance of noninvasive imaging to select patients to be referred to invasive angiography. Nevertheless, although coronary stenosis has long been considered the main determinant of inducible ischemia and symptoms, growing evidence has demonstrated the importance of other underlying mechanisms (e.g.
View Article and Find Full Text PDFArticle Synopsis
- Acute myocarditis (AM) is recognized as a rare but serious cardiovascular complication in COVID-19 patients, with a study analyzing data from 112 suspected cases in hospitalized patients across the U.S. and Europe.
- The prevalence of definite/probable AM was found to be 2.4 per 1000 hospitalizations, with common symptoms including chest pain and dyspnea, particularly in younger adults averaging 38 years of age.
- The study revealed significant challenges, such as 20.4% experiencing in-hospital mortality or requiring advanced support, with a notably higher mortality rate in patients who also had pneumonia.