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  • 1
    Online Resource
    Online Resource
    Prognostic value of right ventricular longitudinal strain in patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge mitral valve repair
    Oxford University Press (OUP) ; 2023
    In:  European Heart Journal - Cardiovascular Imaging ( 2023-05-17)
    Details
    In: European Heart Journal - Cardiovascular Imaging, Oxford University Press (OUP), ( 2023-05-17)
    Abstract: To evaluate the prognostic impact of pre-procedural right ventricular longitudinal strain (RVLS) in patients with secondary mitral regurgitation (SMR) undergoing transcatheter edge-to-edge repair (TEER) in comparison with conventional echocardiographic parameters of RV function. Methods and results This is a retrospective study including 142 patients with SMR undergoing TEER at two Italian centres. At 1-year follow-up 45 patients reached the composite endpoint of all-cause death or heart failure hospitalization. The best cut-off value of RV free-wall longitudinal strain (RVFWLS) to predict outcome was −18% [sensitivity 72%, specificity of 71%, area under curve (AUC) 0.78, P & lt; 0.001], whereas the best cut-off value of RV global longitudinal strain (RVGLS) was −15% (sensitivity 56%, specificity 76%, AUC 0.69, P & lt; 0.001). Prognostic performance was suboptimal for tricuspid annular plane systolic excursion, Doppler tissue imaging-derived tricuspid lateral annular systolic velocity and fractional area change (FAC). Cumulative survival free from events was lower in patients with RVFWLS ≥ −18% vs. RVFWLS & lt; −18% (44.0% vs. 85.4%; & lt; 0.001) as well as in patients with RVGLS ≥ −15% vs. RVGLS & lt; −15% (54.9% vs. 81.7%; P & lt; 0.001). At multivariable analysis FAC, RVGLS and RVFWLS were independent predictors of events. The identified cut-off of RVFWLS and RVGLS both resulted independently associated with outcomes. Conclusion RVLS is a useful and reliable tool to identify patients with SMR undergoing TEER at high risk of mortality and HF hospitalization, on top of other clinical and echocardiographic parameters, with RVFWLS offering the best prognostic performance.
    Type of Medium: Online Resource
    ISSN: 2047-2404 , 2047-2412
    URL: Article
    DOI: 10.1093/ehjci/jead103
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 2
    Online Resource
    Online Resource
    Coronary artery disease: novel insights in a long-standing disease
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Journal of Cardiovascular Medicine Vol. 24, No. 7 ( 2023-07), p. 396-399
    Details
    In: Journal of Cardiovascular Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 24, No. 7 ( 2023-07), p. 396-399
    Type of Medium: Online Resource
    ISSN: 1558-2027 , 1558-2035
    URL: Article
    DOI: 10.2459/JCM.0000000000001481
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
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  • 3
    Online Resource
    Online Resource
    Prevalence and prognostic significance of malnutrition in patients with secondary mitral regurgitation undergoing transcatheter edge‐to‐edge repair
    Wiley ; 2024
    In:  Catheterization and Cardiovascular Interventions
    Details
    In: Catheterization and Cardiovascular Interventions, Wiley
    Abstract: Malnutrition is associated with poor prognosis in several cardiovascular diseases; however, its role in patients with secondary mitral regurgitation (SMR) is poorly known. Aims To evaluate the impact of nutritional status, assessed using different scores, on clinical outcomes in patients with SMR undergoing transcatheter edge‐to‐edge repair (TEER) in a real‐world setting. Methods A total of 658 patients with SMR and complete nutritional data were identified from the MIVNUT registry. Nutritional status has been assessed using controlling nutritional status index (CONUT), prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI) scores. Outcomes of interest were all‐cause mortality and all‐cause mortality or heart failure (HF) hospitalization. Results Any malnutrition grade was observed in 79.4%, 16.7%, and 47.9% of patients by using CONUT, PNI, and GNRI, respectively, while moderate to severe malnutrition was noted in 24.7%, 16.7%, and 25.6% of patients, respectively. At a median follow‐up of 2.2 years, 212 patients (32.2%) died. Moderate‐severe malnutrition was associated with a higher rate of all‐cause mortality (HR: 2.46 [95% CI: 1.69−3.58], HR: 2.18 [95% CI: 1.46−3.26] , HR: 1.97 [95% CI: 1.41−2.74] for CONUT, PNI, and GNRI scores, respectively). The combined secondary endpoint of all‐cause mortality and HF rehospitalization occurred in 306 patients (46.5%). Patients with moderate‐severe malnutrition had a higher risk of the composite endpoint (HR: 1.56 [95% CI: 1.20−2.28] , HR: 1.55 [95% CI: 1.01−2.19], HR: 1.36 [95% CI: 1.02−1.80] for CONUT, PNI, and GNRI scores, respectively). After adjustment for multiple confounders, moderate‐severe malnutrition remained independently associated with clinical outcomes. Conclusions Moderate‐severe malnutrition was common in patients with SMR undergoing TEER. It was independently associated with poor prognosis regardless of the different scores used.
    Type of Medium: Online Resource
    ISSN: 1522-1946 , 1522-726X
    URL: Article
    DOI: 10.1002/ccd.31079
    Language: English
    Publisher: Wiley
    Publication Date: 2024
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  • 4
    Online Resource
    Online Resource
    566 Transthyretin and light-chain cardiac amyloidosis: clinical characteristics, echocardiographic findings, and outcomes of a large cohort of patients in Northern Italy
    Oxford University Press (OUP) ; 2021
    In:  European Heart Journal Supplements Vol. 23, No. Supplement_G ( 2021-12-08)
    Details
    In: European Heart Journal Supplements, Oxford University Press (OUP), Vol. 23, No. Supplement_G ( 2021-12-08)
    Abstract: To describe the characteristics of a cohort of patients with cardiac amyloidosis (CA) and to compare the two most common phenotypes of CA, transthyretin (ATTR) and immunoglobulin light-chain (AL). Methods and results One-hundred and eighty patients [n = 115 (64%) men, 74 ± 11 years] were retrospectively included from January 2013 to April 2021 in a single centre in Northern Italy. The majority [n = 102 (57%)] had ATTR-CA, whereas 78 patients (43%) had AL-CA. ATTR-CA patients were older (79 ± 7 vs. 66 ± 10 years, P  & lt; 0.001) and with higher prevalence of cardiovascular comorbidities, compared to those with AL-CA. ATTR-CA patients had higher N-terminal pro-B-type natriuretic peptide (Nt-proBNP) and troponin levels, and lower haemoglobin and estimated glomerular filtration rate. Echocardiographic findings suggested a more advanced stage of the disease in the ATTR-CA subgroup [left ventricular ejection fraction (LVEF), 51 ± 10% vs. 60 ± 9%; global longitudinal strain (GLS), −11 ± 3% vs. −13 ± 4%; peak systolic wall motion velocity, 4.9 ± 1.7 vs. 6.4 ± 1.9; left ventricular mass index (LVMI) 316 ± 133 g/m2 vs. 157 ± 72 g/m2; left atrium volume index (LAVI) 48 ± 17 ml vs. 40 ± 16 ml; right ventricular diameter 31 ± 9 mm vs. 22 ± 5 mm; tricuspidal annular plane systolic excursion (TAPSE) 17 ± 5 vs. 19 ± 5; all P  & lt; 0.05). During a median follow-up of 15 (6–31) months, 68 (38%) patients died. All-cause death occurred in 31% vs. 46% patients with ATTR- and AL-CA, respectively. AL-CA was an independent predictor of mortality (adjusted hazard ratio 2.62, 95% confidence interval 1.55–4.43; P  & lt; 0.001). Other independent predictors of mortality were age, systolic blood pressure, Nt-proBNP, troponin and GLS. When cardiovascular (CV) death was considered, there was no significant difference between the two phenotypes (log rank P = 0.384). Conclusions Despite ATTR-CA patients showed worse baseline characteristics, suggesting a more advanced disease at presentation, AL-CA phenotype was associated with a higher risk of all-cause death. Of note, CV mortality was comparable between the two groups.
    Type of Medium: Online Resource
    ISSN: 1520-765X , 1554-2815
    URL: Article
    DOI: 10.1093/eurheartj/suab142.055
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2141255-8
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