Publications by authors named "Valentina Carubelli"
Prognostic role of tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio in patients hospitalized for acute heart failure.
J Cardiovasc Med (Hagerstown)
August 2023
Article Synopsis
- The study investigates the significance of TAPSE/PASP measurements in predicting outcomes for patients hospitalized with acute heart failure (AHF).
- It found that lower TAPSE/PASP values were associated with more severe patient conditions and a higher risk of adverse outcomes, including death or hospitalization due to heart failure.
- The research concludes that TAPSE/PASP is a valuable prognostic tool for assessing risks in AHF patients upon admission.
Background: Several risk factors have been identified to predict worse outcomes in patients affected by SARS-CoV-2 infection. Machine learning algorithms represent a novel approach to identifying a prediction model with a good discriminatory capacity to be easily used in clinical practice. The aim of this study was to obtain a risk score for in-hospital mortality in patients with coronavirus disease infection (COVID-19) based on a limited number of features collected at hospital admission.
View Article and Find Full Text PDFAim: We investigated the prognostic significance of serum potassium abnormalities at discharge in patients hospitalized for acute heart failure (AHF).
Methods And Results: In a retrospective analysis, we included 926 patients hospitalized for AHF, stratified by serum potassium levels at discharge as hypokalaemia (<3.5 mEq/L), normokalaemia (3.
Introduction: The role of sex compared to comorbidities and other prognostic variables in patients with coronavirus disease (COVID-19) is unclear.
Methods: This is a retrospective observational study on patients with COVID-19 infection, referred to 13 cardiology units. The primary objective was to assess the difference in risk of death between the sexes.
Article Synopsis
- * A total of 341 patients were analyzed, with findings indicating that patients with elevated levels of both NPs and troponin had a significantly higher risk of death, even when adjusted for other health factors.
- * The results suggest that NPs can help identify patients at risk of poor outcomes, even in those with normal troponin levels, highlighting their potential as a useful biomarker in COVID-19 prognosis.
Heart failure (HF) is characterized by frequent hospital admissions due to acute decompensation and shortened life span with a progressive clinical course leading to an advanced stage where traditional therapies become ineffective. Due to aging of the population and improved therapies, only a small of proportion of patients with advanced HF are candidates for surgical treatments, such as mechanical circulatory support or heart transplantation. In most cases, prompt identification and management of congestion is paramount to improving symptoms and quality of life and avoiding progression to severe multiorgan dysfunction and death.
View Article and Find Full Text PDFPurpose Of Review: The nitric oxide (NO)-soluble guanylate cyclase (sGC)-cyclic guanosine monophosphate (cGMP) pathway plays an important role in the regulation of cardiovascular function, and it is disrupted in heart failure (HF), resulting in decreased protection against myocardial injury. Impaired NO-sGC-cGMP signaling in HF is secondary to reduced NO bioavailability and altered redox state of sGC, which becomes less responsive to NO. The sGC activator cinaciguat increases cGMP levels by direct NO-independent activation of sGC and may be particularly effective in conditions of increased oxidative stress and endothelial dysfunction, and therefore reduced NO levels, at the expense of a greater risk of hypotension.
View Article and Find Full Text PDFArticle Synopsis
- The study focused on hospitalized COVID-19 patients to evaluate the impact of a history of atrial fibrillation (AF) on their clinical outcomes.
- Among the 696 patients, those with a history of AF had significantly higher mortality rates (38.7% vs 20.8%) and faced more in-hospital complications like new-onset AF and acute heart failure.
- Even after adjusting for other serious health factors, the presence of AF remained a critical risk factor for worse outcomes in these patients.
Aims: Myocardial injury (MI) in coronavirus disease-19 (COVID-19) is quite prevalent at admission and affects prognosis. Little is known about troponin trajectories and their prognostic role. We aimed to describe the early in-hospital evolution of MI and its prognostic impact.
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- Glucocorticoid therapy has been found effective in reducing mortality in hospitalized COVID-19 patients, based on a study of 706 patients from the Cardio-COVID-Italy registry.
- The study showed that patients treated with glucocorticoids had a significantly lower risk of in-hospital mortality (adjusted HR 0.44) compared to those who weren't treated, especially those with specific clinical conditions.
- The benefits of glucocorticoids were particularly noticeable in patients with poor respiratory function (lower PaO/FiO ratio and oxygen saturation) and higher levels of systemic inflammation (higher CRP levels).
Aims: We sought to analyse quality of life (QoL) measures derived from two questionnaires widely used in clinical trials, the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQoL 5 dimensions (EQ-5D), and to compare their prognostic value in men and women with heart failure and reduced ejection fraction (HFrEF).
Methods And Results: From the BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF) we compared KCCQ and EQ-5D at baseline and after 9 months in 1276 men and 373 women with new-onset or worsening symptoms of HFrEF, who were sub-optimally treated and in whom there was an anticipated up-titration of guideline-derived medical therapies. Women had significantly worse baseline QoL (median) as compared with men, both when assessed with KCCQ overall score (KCCQ-OS, 44 vs.
Aims: Treatment with angiotensin converting enzyme inhibitor (ACEi)/angiotensin II receptors blockers (ARBs) and beta-blockers is frequently suboptimal at discharge in patients hospitalized for acute heart failure (AHF). We investigated the prognostic significance of medical treatment at discharge and its changes during hospitalization.
Methods And Results: In a retrospective analysis, we included 623 patients hospitalized for AHF with reduced left ventricular ejection fraction (<40%).
Aims: This study aimed to assess the utility of contemporary clinical risk scores and explore the ability of two biomarkers [growth differentiation factor-15 (GDF-15) and soluble ST2 (sST2)] to improve risk prediction in elderly patients with cardiogenic shock.
Methods And Results: Patients (n = 219) from the multicentre CardShock study were grouped according to age (elderly ≥75 years and younger). Characteristics, management, and outcome between the groups were compared.
Aims: To assess the prognostic value of a history of heart failure (HF) in patients with coronavirus disease 2019 (COVID-19).
Methods And Results: We enrolled 692 consecutive patients admitted for COVID-19 in 13 Italian cardiology centres between 1 March and 9 April 2020. Mean age was 67.
Article Synopsis
- The study investigated pulmonary embolism (PE) in COVID-19 patients across 13 Cardiology Units in Italy, finding that 7.5% of 689 patients developed PE during their stay.
- Patients with PE were generally younger, had a higher BMI, and more severe respiratory issues, and had significantly higher D-dimer levels compared to those without PE.
- A linear relationship between D-dimer concentrations and the incidence of PE was identified, indicating the need for further research into the implications of bleeding events and the role of D-dimer in this patient population.
Article Synopsis
- Myocardial injury in COVID-19 patients, indicated by elevated troponin levels, correlates with higher mortality rates, especially in older and sicker populations in Europe and the US.
- A multicenter study in Italy involved 614 hospitalized COVID-19 patients and found that 45.3% had elevated troponin levels.
- Patients with elevated troponin were older and had higher rates of comorbidities like hypertension and heart disease, leading to a significant increase in their in-hospital mortality risk.
Background: Inflammatory responses play an important role in the pathophysiology of cardiogenic shock (CS). The aim of this study was to investigate the kinetics of procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) in CS and to assess their relation to clinical presentation, other biochemical variables, and prognosis.
Methods: Levels of PCT, CRP and IL-6 were analyzed in serial plasma samples (0-120h) from 183 patients in the CardShock study.
Aims: Acute heart failure (AHF) leads to a drastic increase in mortality and rehospitalization. The aim of the study was to identify prognostic variables in a real-life population of AHF patients admitted to the emergency department with acute shortness of breath.
Methods And Results: We evaluated potential predictors of mortality in 728 consecutive patients admitted to the emergency department with AHF.
Background: Geographical differences may impact the treatment of heart failure (HF) and the results of clinical trials. We have investigated the differences between geographical areas across Europe in the BIOSTAT-CHF program.
Methods: Patients with worsening HF enrolled in BIOSTAT-CHF were subdivided, according to the European geographical areas, into those from Northern countries (The Netherlands, Norway, Sweden, UK), Central countries (Germany, Poland, Serbia, Slovenia), and Mediterranean countries (France, Greece, Italy).
Aim: Istaroxime is a first-in-class agent which acts through inhibition of the sarcolemmal Na /K pump and activation of the SERCA2a pump. This study assessed the effects of a 24 h infusion of istaroxime in patients hospitalised for acute heart failure (AHF).
Methods And Results: We included patients hospitalised for AHF with left ventricular ejection fraction ≤40% and E/e' > 10.
Resting heart rate (HR) is considered a powerful predictor of mortality both in healthy subjects and in cardiovascular (CV) patients, including those affected by heart failure (HF). Its reduction below 70 bpm is the treatment target in chronic HF with reduced ejection fraction (HFrEF) when sinus rhythm is present. In acute HF (AHF) HR is usually elevated but its role as risk marker is still unknown.
View Article and Find Full Text PDFIntroduction: Cardiogenic shock complicating acute myocardial infarction has a very high mortality. Our present study focuses on serial measurement of lactate during admission due to cardiogenic shock and the prognostic effect of lactate and a relative change in lactate in patients after admission and the institution of intensive care treatment.
Methods And Results: This is a secondary analysis of the CardShock study.
Background: Cardiogenic shock (CS) is the most life-threatening manifestation of acute heart failure. Its complexity and high in-hospital mortality may justify the need for invasive monitoring with a pulmonary artery catheter (PAC).
Methods: Patients with CS included in the CardShock Study, an observational, prospective, multicenter, European registry, were analyzed, aiming to describe the real-world use of PAC, evaluate its impact on 30-day mortality, and the ability of different hemodynamic parameters to predict outcomes.
Background: There is controversy about the outcome of patients with acute myocarditis (AM), and data are lacking on how patients admitted with suspected AM are managed. We report characteristics, in-hospital management, and long-term outcome of patients with AM based on a retrospective multicenter registry from 19 Italian hospitals.
Methods: A total of 684 patients with suspected AM and recent onset of symptoms (<30 days) were screened between May 2001 and February 2017.
Aim: Heart rate (HR) is an important prognostic factor in patients affected by chronic heart failure (CHF); ivabradine has been demonstrated to significantly reduce nonfatal myocardial infarction and hospitalization rate for acute heart failure and to improve left ventricular (LV) reverse remodeling, quality of life, exercise capacity, and arterial elastance (Ea) in these patients. We aimed at evaluating the short-term effects of ivabradine on ventricular-arterial coupling (VAC), aortic stiffness, and endothelial function in stable patients with CHF.
Methods: We evaluated 30 consecutive CHF patients (LVEF≤ 35%, NYHA class II) with sinus rhythm and HR ≥ 70 bpm on optimized pharmacological therapy.