Publications by authors named "Renato Maria Bragato"
Article Synopsis
- Mitral annular disjunction (MAD) is divided into pseudo-MAD (appears only during systole) and true-MAD (appears in both systole and diastole).
- A study of 290 patients indicated that 50% had MAD, with 35% classified as true-MAD and 16% as pseudo-MAD.
- The presence and extent of MAD were higher in patients with mitral valve prolapse (MVP), particularly in pseudo-MAD cases, and the inferior
Background And Aims: The increasing use of assisted reproductive technology (ART) has raised concerns regarding its long-term cardiovascular safety due to potential hormonal imbalances and pro-thrombotic states. This study aimed to assess the long-term cardiovascular risk associated with fertility treatments in women.
Methods: Following PRISMA guidelines, a systematic review and meta-analysis was conducted in MEDLINE (via PubMed) from inception to January 2024.
Article Synopsis
- - This study investigated how mitral valve prolapse (MVP) affects heart structure, particularly focusing on the right side of the heart, in patients without significant regurgitation.
- - Out of 49 MVP patients and 54 healthy controls, findings revealed that patients with MVP had enlarged tricuspid annuli and right atrial volumes compared to controls, even if they experienced tricuspid valve prolapse (TVP).
- - The study concluded that changes in right heart structures in MVP patients should be carefully monitored, as increased tricuspid annular size was linked to higher TAPSE values, indicating a potential need for alternative measurements in assessing heart function.
Article Synopsis
- This study focused on how myocardial perfusion imaging (MPI) stress tests—specifically using stress cardiac magnetic resonance (sCMR) and single-photon emission computed tomography (SPECT-MPI)—affect the safety of high-risk patients undergoing non-cardiac surgery.
- It involved 1,590 patients with heart disease or significant cardiovascular risk factors, finding that those who underwent stress tests had fewer cardiac complications within 30 days post-surgery (1.2% vs. 3.4%).
- While both sCMR and SPECT-MPI reduced cardiac event rates equally, sCMR was shown to be more accurate for predicting the need for coronary artery revascularization.
Background: The presence of mitral annulus disjunction (MAD) has been considered a high-risk feature for sudden cardiac death based on selected study populations. We aimed to assess the prevalence of MAD in consecutive patients undergoing clinically indicated cardiovascular magnetic resonance (CMR), its association with ventricular arrhythmias, mitral valve prolapse (MVP), and other CMR features.
Methods: This single-center retrospective study included consecutive patients referred to CMR at our institution between June 2021 and November 2021.
An 81-year-old woman presented with acute pulmonary edema. Echocardiography revealed severe functional mitral regurgitation, the mechanism of which was unusual. An atypical bileaflet tethering caused by disharmonic annular remodeling, concomitant aortic dilatation, and reduced aorto-mitral angle without left ventricular dysfunction or dilatation was found.
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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.
Article Synopsis
- Percutaneous closure of a patent foramen ovale (PFO) is a common procedure aimed at preventing recurrent strokes and treating related syndromes in specific patients.
- While disc-based devices have been widely used for the past two decades, new suture-based devices are emerging as a promising option, although their long-term efficacy is not fully established.
- The review covers current evidence on suture-based closure devices, including their characteristics, evaluation methods, patient selection guidelines, procedural steps, potential complications, and future advancements in the field.
Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy.
Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website.
Article Synopsis
- - Cardiac magnetic resonance (CMR) is being used to better assess the risk of sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM).
- - A case study of a 24-year-old man with apical HCM showed that CMR revealed a high risk of SCD, which was initially underestimated through standard assessments.
- - The discussion emphasizes how CMR aids therapy decisions and highlights its advantages over traditional imaging techniques in evaluating SCD risk.
Objectives: To assess feasibility and safety of second-generation left atrial appendage closure (LAAC) Ultraseal device in patients with nonvalvular atrial fibrillation (NVAF).
Background: LAAC with first-generation Ultraseal device (Cardia, Eagan, Minnesota) has been shown to be a feasible therapeutic option in patients with NVAF. However, there is a paucity of data regarding the novel second-generation Ultraseal device.
Tricuspid valve disease represents a major health problem that affects a wide proportion of heart failure patients with a significant prognostic impact. In recent years an increasing number of minimally invasive and transcatheter treatments have been developed. The choice of the optimal transcatheter device therapy needs a careful patient selection and a dedicated anatomic assessment, mainly based on echocardiographic and computed tomography evaluation.
View Article and Find Full Text PDFIncreased sizes and dysfunction of the left atrium have been related to adverse outcomes. 3D-echocardiography is more accurate than 2D-echocardiography in estimating LA volumes and ejection fraction. However, the use of 3DE for LA analysis is limited by the absence of established reference values.
View Article and Find Full Text PDFIn-hospital prognostic role of coronary atherosclerotic burden in COVID-19 patients.
J Cardiovasc Med (Hagerstown)
November 2021
Aims: Currently, there are few available data regarding a possible role for subclinical atherosclerosis as a risk factor for mortality in Coronavirus Disease 19 (COVID-19) patients. We used coronary artery calcium (CAC) score derived from chest computed tomography (CT) scan to assess the in-hospital prognostic role of CAC in patients affected by COVID-19 pneumonia.
Methods: Electronic medical records of patients with confirmed diagnosis of COVID-19 were retrospectively reviewed.
During SARS-CoV-2 pandemic, several subjects were treated in our intensive care unit (ICU) because of acute respiratory failure following COVID-19 pneumonia. Most of them required mechanical ventilation and someone in prone position (PP) too, because of acute respiratory distress syndrome (ARDS). During PP, trans-esophageal echocardiography (TEE) is not always easy, mainly due to the forced position of the neck of the patient.
View Article and Find Full Text PDFInfective endocarditis (IE) affects patients at high clinical risk and may present as an acute and rapidly progressive, subacute or chronic infection. Transthoracic and transesophageal echocardiography represent the key diagnostic method in IE diagnosis. In particular, three-dimensional transesophageal echocardiography represents the imaging technique that allows to establish with adequate accuracy dimensions, shape, and localization of endocarditis vegetations.
View Article and Find Full Text PDFLeft ventricular apical masses constitute a rare finding. Imaging properties together with the clinical history of the patient usually allow an etiologic definition. We report a challenging case of an ambiguous left ventricular apical mass of uncertain nature till histological examination.
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