Publications by authors named "Pergola V"

Aim: Computed tomography (CT)-derived extracellular volume fraction (ECV) is a non-invasive method to quantify myocardial fibrosis. Evaluating CT-ECV during aortic valve replacement (AVR) planning CT in severe aortic stenosis (AS) may aid prognostic stratification. This meta-analysis evaluated the prognostic significance of CT-ECV in severe AS necessitating AVR.

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Almost 25 years have now passed since the first identification of (). It can cause infections both in immunocompetent and immunocompromised hosts. However, it has been rarely described as an aetiology of infectious endocarditis.

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Arrhythmogenic cardiomyopathy (ACM) is a genetic disorder characterized by fibrofatty replacement of myocardial tissue, predominantly affecting the right ventricle (RV), but often involving the left ventricle (LV) as well. The early detection of fibrosis, crucial for risk stratification, has been enhanced by advanced imaging techniques. Global longitudinal strain (GLS) has shown promise as a surrogate marker for late enhancement (LE) in identifying myocardial fibrosis, yet precise cut-off values for strain are lacking.

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Coronary artery disease (CAD) is the leading global cause of mortality, accounting for approximately 30% of all deaths. It is primarily characterized by the accumulation of atherosclerotic plaques within the coronary arteries, leading to reduced blood flow to the heart muscle. Early detection of atherosclerotic plaques is crucial to prevent major adverse cardiac events.

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Cardioneuroablation (CNA) is a novel interventional procedure for the treatment of recurrent vasovagal syncope (VVS) and advanced atrioventricular block secondary to hyperactivation of vagal tone in young patients. By damaging the cardiac parasympathetic ganglia, CNA seems to be able to mitigate and/or abolish the excessive vagal activity and improve patients' outcome. This review is intended to give a detailed and comprehensive overview of the current evidences regarding (1) the clinical applications of CNA (2) the identification of ablation targets and procedural endpoints (3) the medium-long term effect of the procedure and its future perspectives.

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  • Caseous calcification of the mitral annulus (CCMA) is a rare condition that impacts the heart's mitral valve area, requiring various diagnostic methods for accurate identification.
  • An 82-year-old woman with worsening heart failure was found to have a large, fixed mass affecting her mitral valve, leading to severe mitral regurgitation as shown by echocardiograms and CT scans.
  • Due to her age, traditional surgery was deemed unsuitable, so a less invasive transcatheter repair procedure was performed, resulting in only mild residual heart valve leakage.
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  • - The study investigates the use of cardiac computed tomography angiography (CCTA) as a non-invasive alternative to invasive coronary angiography (ICA) for assessing cardiac allograft vasculopathy (CAV) after heart transplantation.
  • - Conducted from March 2021 to February 2023, the research included 260 heart transplant patients, revealing that those undergoing CCTA had significantly lower costs and shorter hospital stays compared to those who underwent ICA.
  • - The findings suggest that CCTA is a safer and more cost-effective option for CAV surveillance post-heart transplantation, using less contrast and radiation than ICA.
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  • The study aimed to investigate the occurrence and outcomes of significant tricuspid valve regurgitation (TRI) following transvenous lead extraction (TLE) using mechanical rotational sheaths in patients with previously implanted leads.
  • Out of 158 patients monitored, 5.7% experienced significant TRI post-extraction linked to prolonged lead implantation, tricuspid valve damage, and reasons for extraction like infection.
  • Notably, severe TRI was identified as an independent mortality risk factor, emphasizing the need for physicians to closely observe patients for this complication during the TLE procedure.
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Left ventricular assist devices (LVADs) are gaining increasing importance as therapeutic strategy in advanced heart failure (HF), not only as bridge to recovery or to transplant but also as destination therapy. Even though long-term LVADs are considered a precious resource to expand the treatment options and improve clinical outcome of these patients, these are limited by peri-operative and post-operative complications, such as device-related infections, haemocompatibility-related events, device mis-positioning, and right ventricular failure. For this reason, a precise pre-operative, peri-operative, and post-operative evaluation of these patients is crucial for the selection of LVAD candidates and the management LVAD recipients.

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  • * There's a big debate among doctors about whether to use anatomical tests (like CCTA) or functional tests (like stress echocardiography) first to check how bad the heart problem is.
  • * New tests that combine both approaches, like stress computed tomography perfusion, may help doctors make better decisions for patients, especially those who are at high risk or have already had heart procedures.
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  • Complete transposition of the great arteries (C-TGA) is a congenital heart defect where the main arteries are switched, making early detection and management essential for successful outcomes.
  • Imaging techniques, including fetal echocardiography, transthoracic echocardiography (TTE), cardiovascular magnetic resonance (CMR), and cardiac computed tomography (CCT), are crucial for diagnosing, planning treatment, and monitoring C-TGA patients over time.
  • A combined use of TTE, CMR, and CCT can significantly improve the accuracy of assessments, inform surgical and treatment decisions, and enhance long-term care and outcomes for those affected by this condition.
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Cardiovascular magnetic resonance (CMR) and computed tomography (CCT) are advanced imaging modalities that recently revolutionized the conventional diagnostic approach to congenital heart diseases (CHD), supporting echocardiography and often replacing cardiac catheterization. This is the second of two complementary documents, endorsed by experts from the Working Group of the Italian Society of Pediatric Cardiology and the Italian College of Cardiac Radiology of the Italian Society of Medical and Interventional Radiology, aimed at giving updated indications on the appropriate use of CMR and CCT in different clinical CHD settings, in both pediatrics and adults. In this article, support is also given to radiologists, pediatricians, cardiologists, and cardiac surgeons for indications and appropriateness criteria for CMR and CCT in the most referred CHD, following the proposed new criteria presented and discussed in the first document.

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  • - The European AAOCA Registry (EURO-AAOCA) is a study evaluating how different European centers manage patients with Anomalous Aortic Origin of a Coronary Artery (AAOCA), a rare heart defect, from January 2019 to June 2023.
  • - Out of 262 patients with a median age of 33 years, common symptoms included chest pain and syncope, with right-AAOCA being the most frequent type identified.
  • - There is currently no standard approach for diagnosing and treating AAOCA in Europe, though surgery has proven safe; future studies aim to improve patient selection for revascularization versus conservative treatment.
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  • Arrhythmogenic Cardiomyopathy (AC) is a genetic heart disease that leads to heart muscle replacement with fat and fibrous tissue, increasing the risk of sudden cardiac death from irregular heartbeats.
  • A combination of imaging techniques—echocardiography, cardiac magnetic resonance (CMR), and cardiac computed tomography (CCT)—is crucial for diagnosing AC, assessing risks, and monitoring the condition to enhance patient care and prevent sudden cardiac death.
  • Echocardiography is mainly used for evaluating heart structure and function, CMR gives detailed images over time, while CCT helps identify other heart issues early on, making these methods complementary in managing AC.
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This article provides comprehensive insights into the evaluation of simple congenital heart diseases (CHDs) in adults, emphasizing the pivotal role of echocardiography. By focusing on conditions such as congenital aortic stenosis, aortic coarctation, patent ductus arteriosus, atrial septal defects (ASDs), and ventricular septal defects (VSDs), the review underscores echocardiography's intricate contributions to precise clinical decision-making. Echocardiography serves as the primary imaging modality, offering high-resolution visualization of anatomical anomalies and quantification of hemodynamic parameters.

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Background: In recent years, it has become evident that arrhythmogenic cardiomyopathy (ACM) displays a wide spectrum of ventricular involvement. Furthermore, the influence of various clinical phenotypes on the prognosis of the disease is currently being assessed.

Objectives: The purpose of this study was to evaluate the impact of phenotypic expression in ACM on patient outcomes.

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Background: Mechanical cardiac support is currently an effective strategy to reduce morbidity and mortality in pediatric patients. However, solid evidence regarding the feasibility of intracorporeal devices in children still needs to be provided. We report our 10-year experience with intracorporeal left ventricular assist devices (LVAD) in children.

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  • The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to investigate stress echocardiography (SE) practices across Italy, collecting data from 228 laboratories in November 2022.
  • The survey revealed that out of 179 centers performing SE, most were located in northern Italy, and the study categorized them into low, moderate, and high volume of activity based on the number of SE examinations.
  • Key findings indicated differences in the use of stressors, with a tendency for high-volume centers to employ multiple stress techniques and incorporate advanced evaluations like coronary flow velocity reserve (CFVR) more frequently than low and moderate volume centers.
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  • - The left atrium (LA) is essential for heart function, serving as a reservoir and helping fill the left ventricle (LV), impacting overall cardiac output.
  • - Abnormal LA function is linked to serious heart conditions like heart failure and atrial fibrillation, as it can cause increased filling pressures that lead to diastolic dysfunction and other cardiovascular risks.
  • - This article reviews LA anatomy and function, highlights its clinical significance, addresses diagnostic methods for assessing LA performance, and emphasizes the need for more research to enhance treatment strategies in managing cardiovascular diseases.
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Paradoxical low flow-low gradient aortic valve stenosis (AVS) is an increasing phenotype in the general population, particularly after the seventh decade of life. It is an AVS in which, despite the preserved ejection fraction, the mean transvalvular gradient is not suggestive of severe AVS (<40 mmHg). The pathophysiology is often intertwined with conditions resulting in heart failure with preserved ejection fraction, such as arterial hypertension and cardiac amyloidosis.

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Advanced heart failure (AHF) presents a complex landscape with challenges spanning diagnosis, management, and patient outcomes. In response, the integration of multimodality imaging techniques has emerged as a pivotal approach. This comprehensive review delves into the profound significance of these imaging strategies within AHF scenarios.

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Vascular inflammation is recognized as the primary trigger of acute coronary syndrome (ACS). However, current noninvasive methods are not capable of accurately detecting coronary inflammation. Epicardial adipose tissue (EAT) and pericoronary adipose tissue (PCAT), in addition to their role as an energy reserve system, have been found to contribute to the development and progression of coronary artery calcification, inflammation, and plaque vulnerability.

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