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35 results on '"Corra, U."'

2. Old and new equations for maximal heart rate prediction in patients with heart failure and reduced ejection fraction on beta-blockers treatment: results from the MECKI score data set

Author

Magri D., Piepoli M., Gallo G., Corra U., Metra M., Paolillo S., Filardi P. P., Maruotti A., Salvioni E., Mapelli M., Vignati C., Senni M., Limongelli G., Lagioia R., Scrutinio D., Emdin M., Passino C., Parati G., Sinagra G., Correale M., Badagliacca R., Sciomer S., Di Lenarda A., Agostoni P., Apostolo A., Palermo P., Contini M., Farina S., De Martino F., Mantegazza V., Bonomi A., Mattavelli I., Rocca M. D., Pezzuto B., Bandera F., Rovai S., Giordano A., Ricci R., Ferraironi A., Arcari L., Lombardi C., Carubelli V., Matassini M., Shkoza M., Malfatto G., Caravita S., Pacileo G., Cicoira M., Passantino A., Raimondo R., Confalonieri M., Zaffalon D., Carriere C., Ferraretti A., Bussotti M., Marchese G., Iorio A., Pastormerlo L., Gargiulo P., Halasz G., Capelli B., Villani G. Q., Oliva F., Santolamazza C., Re F., La Franca E., Herberg R., Magri, D., Piepoli, M., Gallo, G., Corra, U., Metra, M., Paolillo, S., Filardi, P. P., Maruotti, A., Salvioni, E., Mapelli, M., Vignati, C., Senni, M., Limongelli, G., Lagioia, R., Scrutinio, D., Emdin, M., Passino, C., Parati, G., Sinagra, G., Correale, M., Badagliacca, R., Sciomer, S., Di Lenarda, A., Agostoni, P., Apostolo, A., Palermo, P., Contini, M., Farina, S., De Martino, F., Mantegazza, V., Bonomi, A., Mattavelli, I., Rocca, M. D., Pezzuto, B., Bandera, F., Rovai, S., Giordano, A., Ricci, R., Ferraironi, A., Arcari, L., Lombardi, C., Carubelli, V., Matassini, M., Shkoza, M., Malfatto, G., Caravita, S., Pacileo, G., Cicoira, M., Passantino, A., Raimondo, R., Confalonieri, M., Zaffalon, D., Carriere, C., Ferraretti, A., Bussotti, M., Marchese, G., Iorio, A., Pastormerlo, L., Gargiulo, P., Halasz, G., Capelli, B., Villani, G. Q., Oliva, F., Santolamazza, C., Re, F., La Franca, E., and Herberg, R.

Subjects
MECKI score, cardiopulmonary exercise test, chronotropic incompetence, heart failure, maximal heart rate, kidney, Epidemiology, exercise test, Chronotropic incompetence, ventricular dysfunction, Heart failure, test, mecki score, adrenergic beta-antagonists, heart rate, humans, stroke volume, left, Ventricular Dysfunction, Left, Cardiology and Cardiovascular Medicine, Maximal heart rate, Cardiopulmonary exercise test
Abstract

Aims Predicting maximal heart rate (MHR) in heart failure with reduced ejection fraction (HFrEF) still remains a major concern. In such a context, the Keteyian equation is the only one derived in a HFrEF cohort on optimized β-blockers treatment. Therefore, using the Metabolic Exercise combined with Cardiac and Kidney Indexes (MECKI) data set, we looked for a possible MHR equation, for an external validation of Keteyien formula and, contextually, for accuracy of the historical MHR formulas and their relationship with the HR measured at the anaerobic threshold (AT). Methods and results Data from 3487 HFrEF outpatients on optimized β-blockers treatment from the MECKI data set were analyzed. Besides excluding all possible confounders, the new equation was derived by using HR data coming from maximal cardiopulmonary exercise test. The simplified derived equation was [109–(0.5*age) + (0.5*HR rest) + (0.2*LVEF)–(5 if haemoglobin Conclusion The derived equation to estimate the MHR in HFrEF patients, by accounting also for the systolic dysfunction degree and anaemia, improved slightly the Keteyian formula. Both formulas might be helpful in identifying the true maximal effort during an exercise test and the intensity domain during a rehabilitation programme.

Published
2022

3. Pick Your Threshold: A Comparison Among Different Methods of Anaerobic Threshold Evaluation in Heart Failure Prognostic Assessment

Author

Salvioni, E., Mapelli, M., Bonomi, A., Magri, D., Piepoli, M., Frigerio, M., Paolillo, S., Corra, U., Raimondo, R., Lagioia, R., Badagliacca, R., Filardi, P. P., Senni, M., Correale, M., Cicoira, M., Perna, E., Metra, M., Guazzi, M., Limongelli, G., Sinagra, G., Parati, G., Cattadori, G., Bandera, F., Bussotti, M., Re, F., Vignati, C., Lombardi, C., Scardovi, A. B., Sciomer, S., Passantino, A., Emdin, M., Passino, C., Santolamazza, C., Girola, D., Zaffalon, D., De Martino, F., Agostoni, P., Farina, S., Pezzuto, B., Apostolo, A., Palermo, P., Contini, M., Gugliandolo, P., Mattavelli, I., Della Rocca, M., Gallo, G., Moscucci, F., Iorio, A., Halasz, G., Capelli, B., Binno, S., Pacileo, G., Valente, F., Vastarella, R., Carriere, C., Mase, M., Cittar, M., Di Lenarda, A., Caravita, S., Vigano, E., Marchese, G., Ricci, R., Arcari, L., Scrutinio, D., Battaia, E., Moretti, M., Matassini, M. V., Shkoza, M., Herberg, R., Cittadini, A., Salzano, A., Marra, A., Lafranca, E., and Vitale, G.

Subjects
heart failure, prognosis, anaerobic threshold, cardiopulmonary exercise test
Published
2022

5. Exercise oscillatory ventilation and prognosis in heart failure patients with reduced and mid-range ejection fraction

Author

Rovai, S, Corra, U, Piepoli, M, Vignati, C, Salvioni, E, Bonomi, A, Mattavelli, I, Arcari, L, Scardovi, A, Perrone Filardi, P, Lagioia, R, Paolillo, S, Magri, D, Limongelli, G, Metra, M, Senni, M, Scrutinio, D, Raimondo, R, Emdin, M, Lombardi, C, Cattadori, G, Parati, G, Re, F, Cicoira, M, Villani, G, Mina, C, Correale, M, Frigerio, M, Perna, E, Mapelli, M, Magini, A, Clemenza, F, Bussotti, M, Battaia, E, Guazzi, M, Bandera, F, Badagliacca, R, Di Lenarda, A, Pacileo, G, Maggioni, A, Passino, C, Sciomer, S, Sinagra, G, Agostoni, P, Rovai S., Corra U., Piepoli M., Vignati C., Salvioni E., Bonomi A., Mattavelli I., Arcari L., Scardovi A. B., Perrone Filardi P., Lagioia R., Paolillo S., Magri D., Limongelli G., Metra M., Senni M., Scrutinio D., Raimondo R., Emdin M., Lombardi C., Cattadori G., Parati G., Re F., Cicoira M., Villani G. Q., Mina C., Correale M., Frigerio M., Perna E., Mapelli M., Magini A., Clemenza F., Bussotti M., Battaia E., Guazzi M., Bandera F., Badagliacca R., Di Lenarda A., Pacileo G., Maggioni A., Passino C., Sciomer S., Sinagra G., Agostoni P., Rovai, S, Corra, U, Piepoli, M, Vignati, C, Salvioni, E, Bonomi, A, Mattavelli, I, Arcari, L, Scardovi, A, Perrone Filardi, P, Lagioia, R, Paolillo, S, Magri, D, Limongelli, G, Metra, M, Senni, M, Scrutinio, D, Raimondo, R, Emdin, M, Lombardi, C, Cattadori, G, Parati, G, Re, F, Cicoira, M, Villani, G, Mina, C, Correale, M, Frigerio, M, Perna, E, Mapelli, M, Magini, A, Clemenza, F, Bussotti, M, Battaia, E, Guazzi, M, Bandera, F, Badagliacca, R, Di Lenarda, A, Pacileo, G, Maggioni, A, Passino, C, Sciomer, S, Sinagra, G, Agostoni, P, Rovai S., Corra U., Piepoli M., Vignati C., Salvioni E., Bonomi A., Mattavelli I., Arcari L., Scardovi A. B., Perrone Filardi P., Lagioia R., Paolillo S., Magri D., Limongelli G., Metra M., Senni M., Scrutinio D., Raimondo R., Emdin M., Lombardi C., Cattadori G., Parati G., Re F., Cicoira M., Villani G. Q., Mina C., Correale M., Frigerio M., Perna E., Mapelli M., Magini A., Clemenza F., Bussotti M., Battaia E., Guazzi M., Bandera F., Badagliacca R., Di Lenarda A., Pacileo G., Maggioni A., Passino C., Sciomer S., Sinagra G., and Agostoni P.

Abstract

Aims: Exercise oscillatory ventilation (EOV) is a pivotal cardiopulmonary exercise test parameter for the prognostic evaluation of patients with chronic heart failure (HF). It has been described in patients with HF with reduced ejection fraction (<40%, HFrEF) and with HF with preserved ejection fraction (>50%, HFpEF), but no data are available for patients with HF with mid-range ejection fraction (40–49%, HFmrEF). The aim of the study was to evaluate the prognostic role of EOV in HFmrEF patients. Methods and results: We analysed 1239 patients with HFmrEF and 4482 patients with HFrEF, enrolled in the MECKI score database, with a 2-year follow-up. The study endpoint was the composite of cardiovascular death, urgent heart transplant, and ventricular assist device implantation. We identified EOV in 968 cases (16% and 17% of cases in HFmrEF and HFrEF,. respectively). HFrEF EOV+ patients were significantly older, and their parameters suggested a more severe HF than HFrEF EOV− patients. A similar behaviour was found in HFmrEF EOV+ vs. EOV− patients. Kaplan–Meier analysis, irrespective of ejection fraction, showed that EOV is associated with a worse survival, and that patients with HFrEF and HFmrEF EOV+ had a significantly worse outcome than the EOV− of the same ejection fraction groups. EOV-associated survival differences in HFmrEF patients started after 18 months of follow-up. Conclusion: Exercise oscillatory ventilation has a similar prevalence and ominous prognostic value in both HFmrEF and HFrEF patients, indicating a group of patients in need of a more intensive follow-up and a more aggressive therapy. In HFmrEF, the survival curves between EOV+ and EOV− patients diverged only after 18 months.

Published
2019

7. Heart failure prognosis over time: how the prognostic role of oxygen consumption and ventilatory efficiency during exercise has changed in the last 20 years

Author

Paolillo, S., Veglia, F., Salvioni, E., Corra, U., Piepoli, M., Lagioia, R., Limongelli, G., Sinagra, G., Cattadori, G., Scardovi, A. B., Metra, M., Senni, M., Bonomi, A., Scrutinio, D., Raimondo, R., Emdin, M., Magri, D., Parati, G., Re, F., Cicoira, M., Mina, C., Correale, M., Frigerio, M., Bussotti, M., Battaia, E., Guazzi, M., Badagliacca, R., Di Lenarda, A., Maggioni, A., Passino, C., Sciomer, S., Pacileo, G., Mapelli, M., Vignati, C., Clemenza, F., Binno, S., Lombardi, C., Filardi, P. P., Agostoni, P., Apostolo, A., Palermo, P., Contini, M., Farina, S., Mantegazza, V., Spadafora, E., Lattarulo, M. S., Giordano, A., Mezzani, A., Ricci, R., Ferraironi, A., Carubelli, V., Pietrucci, F., Malfatto, G., Caravita, Sergio, Vigano, E., Valente, F., Vastarella, R., Gravino, R., Roselli, T., Buono, A., De Maria, R., Passantino, A., Santoro, D., Campanale, S., Caputo, D., Bertipaglia, D., Confalonieri, M., Gentile, P., Zambon, E., Morosin, M., Carriere, C., Ferraretti, A., Marchese, G., Iorio, A., Pastormerlo, L., Gargiulo, P., Villani, G. Q., Oliva, F., Perna, E., Paolillo, Stefania, Veglia, Fabrizio, Salvioni, Elisabetta, Corrà, Ugo, Piepoli, Massimo, Lagioia, Rocco, Limongelli, Giuseppe, Sinagra, Gianfranco, Cattadori, Gaia, Scardovi, Angela B., Metra, Marco, Senni, Michele, Bonomi, Alice, Scrutinio, Domenico, Raimondo, Rosa, Emdin, Michele, Magrì, Damiano, Parati, Gianfranco, Re, Federica, Cicoira, Mariantonietta, Minà, Chiara, Correale, Michele, Frigerio, Maria, Bussotti, Maurizio, Battaia, Elisa, Guazzi, Marco, Badagliacca, Roberto, Di Lenarda, Andrea, Maggioni, Aldo, Passino, Claudio, Sciomer, Susanna, Pacileo, Giuseppe, Mapelli, Massimo, Vignati, Carlo, Clemenza, Francesco, Binno, Simone, Lombardi, Carlo, Filardi, Pasquale Perrone, Agostoni, Piergiuseppe, Apostolo, Anna, Palermo, Pietro, Contini, Mauro, Farina, Stefania, Mantegazza, Valentina, Spadafora, Emanuele, Lattarulo, Maria Silvia, Giordano, Andrea, Mezzani, Alessandro, Ricci, Roberto, Ferraironi, Alessandro, Carubelli, Valentina, Pietrucci, Francesca, Malfatto, Gabriella, Caravita, Sergio, Viganò, Elena, Valente, Fabio, Vastarella, Rossella, Gravino, Rita, Roselli, Teo, Buono, Andrea, De Maria, Renata, Passantino, Andrea, Santoro, Daniela, Campanale, Saba, Caputo, Domenica, Bertipaglia, Donatella, Confalonieri, Marco, Gentile, Piero, Zambon, Elena, Morosin, Marco, Carriere, Cosimo, Ferraretti, Armando, Marchese, Giovanni, Iorio, Annamaria, Pastormerlo, Luigi, Gargiulo, Paola, Villani, Giovanni Quinto, Oliva, Fabrizio, Perna, Enrico, Paolillo, S, Veglia, F, Salvioni, E, Corrà, U, Piepoli, M, Lagioia, R, Limongelli, G, Sinagra, G, Cattadori, G, Scardovi, A, Metra, M, Senni, M, Bonomi, A, Scrutinio, D, Raimondo, R, Emdin, M, Magrì, D, Parati, G, Re, F, Cicoira, M, Minà, C, Correale, M, Frigerio, M, Bussotti, M, Battaia, E, Guazzi, M, Badagliacca, R, Di Lenarda, A, Maggioni, A, Passino, C, Sciomer, S, Pacileo, G, Mapelli, M, Vignati, C, Clemenza, F, Binno, S, Lombardi, C, Perrone Filardi, P, Agostoni, P, Apostolo, A, Palermo, P, Contini, M, Farina, S, Mantegazza, V, Spadafora, E, Lattarulo, M, Giordano, A, Mezzani, A, Ricci, R, Ferraironi, A, Carubelli, V, Pietrucci, F, Malfatto, G, Caravita, S, Vigano', E, Valente, F, Vastarella, R, Gravino, R, Roselli, T, Buono, A, De Maria, R, Passantino, A, Santoro, D, Campanale, S, Caputo, D, Bertipaglia, D, Confalonieri, M, Gentile, P, Zambon, E, Morosin, M, Carriere, C, Ferraretti, A, Marchese, G, Iorio, A, Pastormerlo, L, Gargiulo, P, Villani, G, Oliva, F, Perna, E, Paolillo, S., Veglia, F., Salvioni, E., Corra, U., Piepoli, M., Lagioia, R., Limongelli, G., Sinagra, G., Cattadori, G., Scardovi, A. B., Metra, M., Senni, M., Bonomi, A., Scrutinio, D., Raimondo, R., Emdin, M., Magri, D., Parati, G., Re, F., Cicoira, M., Mina, C., Correale, M., Frigerio, M., Bussotti, M., Battaia, E., Guazzi, M., Badagliacca, R., Di Lenarda, A., Maggioni, A., Passino, C., Sciomer, S., Pacileo, G., Mapelli, M., Vignati, C., Clemenza, F., Binno, S., Lombardi, C., Filardi, P. P., Agostoni, P., Apostolo, A., Palermo, P., Contini, M., Farina, S., Mantegazza, V., Spadafora, E., Lattarulo, M. S., Giordano, A., Mezzani, A., Ricci, R., Ferraironi, A., Carubelli, V., Pietrucci, F., Malfatto, G., Caravita, S., Vigano, E., Valente, F., Vastarella, R., Gravino, R., Roselli, T., Buono, A., De Maria, R., Passantino, A., Santoro, D., Campanale, S., Caputo, D., Bertipaglia, D., Confalonieri, M., Gentile, P., Zambon, E., Morosin, M., Carriere, C., Ferraretti, A., Marchese, G., Iorio, A., Pastormerlo, L., Gargiulo, P., Villani, G. Q., Oliva, F., and Perna, E.

Subjects
Male, Prognosi, Cardiopulmonary exercise test, Heart failure, Peak oxygen uptake, Prognosis, VE/VCO2 slope, cardiopulmonary exercise test, heart failure, peak oxygen uptake, prognosis, ve/vco, 2, slope, disease progression, exercise test, female, follow-up studies, humans, male, middle aged, oxygen consumption, pulmonary ventilation, roc curve, respiratory function tests, retrospective studies, forecasting, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Follow-Up Studie, VE/VCO, Oxygen Consumption, Cardiology and Cardiovascular Medicine, Retrospective Studie, Humans, Respiratory Function Test, Retrospective Studies, VE/VCO 2 slope, Middle Aged, Respiratory Function Tests, ROC Curve, Disease Progression, Exercise Test, Female, Pulmonary Ventilation, Human, Follow-Up Studies, Forecasting
Abstract

Aims: Exercise-derived parameters, specifically peak exercise oxygen uptake (peak VO 2 ) and minute ventilation/carbon dioxide relationship slope (VE/VCO 2 slope), have a pivotal prognostic value in heart failure (HF). It is unknown how the prognostic threshold of peak VO 2 and VE/VCO 2 slope has changed over the last 20 years in parallel with HF prognosis improvement. Methods and results: Data from 6083 HF patients (81% male, age 61 ± 13 years), enrolled in the MECKI score database between 1993 and 2015, were retrospectively analysed. By enrolment year, four groups were generated: group 1 1993–2000 (n = 440), group 2 2001–2005 (n = 1288), group 3 2006–2010 (n = 2368), and group 4 2011–2015 (n = 1987). We compared the 10-year survival of groups and analysed how the overall risk (cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation) changed over time according to peak VO 2 and VE/VCO 2 slope and to major clinical and therapeutic variables. At 10 years, a progressively higher survival from group 1 to group 3 was observed, with no further improvement afterwards. A 20% risk for peak VO 2 15 mL/min/kg (95% confidence interval 16–13), 9 (11–8), 4 (4–2) and 5 (7–4) was observed in group 1, 2, 3, and 4, respectively, while the VE/VCO 2 slope value for a 20% risk was 32 (37–29), 47 (51–43), 59 (64–55), and 57 (63–52), respectively. Conclusions: Heart failure prognosis improved over time up to 2010 in a HF population followed by experienced centres. The peak VO 2 and VE/VCO 2 slope cut-offs identifying a definite risk progressively decreased and increased over time, respectively. The prognostic threshold of peak VO 2 and VE/VCO 2 slope must be updated whenever HF prognosis improves.

Published
2019

8. 2016 European Guidelines on the Prevention of Cardiovascular Diseases in Clinical Practice Sixth Joint Task Force of the European Society of Cardiology and other Societies on the Prevention of Cardiovascular Diseases in Clinical Practice (consisting of representatives of 10 companies and invited experts) drafted with the extraordinary contribution of the European Association for Cardiovascular Prevention and Rehabilitation (EACPR)

Author

Piepoli M, Hoes A, Agewall S, Albus C, Brotons C, Catapano A, Cooney M, Corra U, Cosyns B, Deaton C, Graham I, Hall M, Hobbs F, Lochen M, Lollgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter D, Sattar N, Smulders Y, Tiberi M, van der Worp H, van Dis I, Verschuren W, Binno S, De Backer G, Roffi M, Aboyans V, Bachl N, Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M, Fitzsimons D, Franco O, Guenoun M, Jennings C, Jug B, Kirchhof P, Kotseva K, Lip G, Mach F, Mancia G, Bermudo F, Mezzani A, Niessner A, Ponikowski P, Rauch B, Ryden L, Stauder A, Turc G, Wiklund O, Windecker S, Zamorano J, Soc Europea Cardiologia, and Soc Prevenzione Malattie Cardiovas

Published
2017

10. Regular Wine Consumption in Chronic Heart Failure: Impact on Outcomes, Quality of Life, and Circulating Biomarkers

Author

Cosmi, Franco, Di Giulio, Paola, Masson, Serge, Finzi, Andrea, Marfisi, Rosa Maria, Cosmi, Deborah, Scarano, Marco, Tognoni, Gianni, Maggioni, Aldo P., Porcu, Maurizio, Boni, Silvana, Cutrupi, Giovanni, Tavazzi, Luigi, Latini, Roberto Tavazzi, L, Tognoni, G, Barlera, S, Franzosi, Mg, Latini, R, Lucci, D, Maggioni, Ap, Marchioli, R, Nicolosi, Gl, Porcu, M, Yusuf, S, Camerini, F, Cohn, Jn, Decarli, A, Pitt, B, Sleight, P, Poole-Wilson, Pa, Geraci, E, Scherillo, M, Fabbri, G, Bartolomei, B, Bertoli, D, Cobelli, F, Fresco, C, Ledda, A, Levantesi, G, Opasich, C, Rusconi, F, Sinagra, G, Turazza, F, Volpi, A, Ceseri, M, Alongi, G, Atzori, A, Bambi, F, Bastarolo, D, Bianchini, F, Cangioli, I, Canu, V, Caporusso, C, Cenni, G, Cintelli, L, Cocchio, M, Confente, A, Fenicia, E, Friso, G, Gianfriddo, M, Grilli, G, Lazzaro, B, Lonardo, G, Luise, A, Nota, R, Orlando, M, Petrolo, R, Pierattini, C, Pierota, V, Provenzani, A, Quartuccio, V, Ragno, A, Serio, C, Spolaor, A, Tafi, A, Tellaroli, E, Ghio, S, Ghizzardi, E, Masson, S, Crociati, L, Rovere, Mt, Corra, U, Di Giulio, P, Finzi, A, Gorini, M, Gonzini, L, Milani, V, Orsini, G, Bianchini, E, Cabiddu, S, Cipressa, L, Cipressa, Ml, Di Bitetto, G, Ferri, B, Galbiati, L, Lorimer, A, Pera, C, Priami, P, Rossi, Mg, Pasotti, E, Vaghi, F, Roncarolo, P, Zunino, Mt, Matta, F, Actis, E, Gaita, F, Azzaro, G, Zanetta, M, Paino, Am, Parravicini, U, Vegis, D, Conte, R, Ferraro, P, De Bernardi, A, Morelloni, S, Fagnani, M, Lucchina, Pg, Montagna, L, Bellone, E, Sappe, D, Ferraro, F, Delucchi, M, Reynaud, Sg, Dore, M, La, A, Massobrio, N, Bo, L, Trinchero, R, Imazio, M, Brocchi, G, Nejrotti, A, Rissone, L, Gabasio, S, Zocchi, C, Randazzo, S, Crenna, A, Giannuzzi, P, Bonanomi, E, Mezzani, A, De Marchi, M, Begliuomini, G, Gianonatti, Ca, Gavazzi, A, Grosu, A, Cas, Ld, Nodari, S, Garyfallidis, P, Bertoletti, A, Bonifazi, C, Arisi, S, Mascaro, F, Fraccarollo, M, Dell, S, Sfolcini, M, Bortolini, F, Raccagni, D, Turelli, A, Santarone, M, Miglierina, E, Sormani, L, Jemoli, R, Tettamanti, F, Pirelli, S, Bianchi, C, Verde, S, Mariani, M, Ziacchi, V, Ferrazza, A, Russo, A, Bortolotti, M, Pasini, Gf, Jones, Kn, Cuzzucrea, D, Gullace, G, Carbone, C, Granata, A, De, S, Del Rosso, G, Inserra, C, Renaldini, E, Zappa, C, Moretti, M, Zanini, R, Ferrari, M, Cei, A, Lissi, C, Dovico, E, Fiorentini, C, Palermo, P, Brusoni, B, Negrini, M, Heyman, J, Danzi, Gb, Frigerio, M, Beretta, L, Sachero, A, Casazza, F, Squadroni, L, Lombardi, F, Marano, L, Margonato, A, Fragasso, G, Febo, Oc, Aiolfi, E, Olmetti, F, Grieco, A, Antonazzo, V, Specchia, G, Mortara, A, Robustelli, F, Songini, Mg, Schweiger, C, Frisinghelli, A, Palvarini, M, Campana, C, Scelsi, L, Marsan, Na, Gualco, A, De Feo, S, Iannone, Ma, Diaco, T, Zaniboni, D, Milanesi, G, Nassiacos, D, Meloni, S, Giani, P, Nicoli, T, Malinverni, C, Gusmini, A, Pozzoni, L, Bisiani, G, Margaroli, P, Schizzarotto, A, Daverio, A, Morelli, E, Occhi, G, Partesana, N, Bandini, P, Rosella, Mg, Giustiniani, S, Cucchi, G, Pedretti, R, Raimondo, R, Vaninetti, R, Fedele, A, Ghezzi, I, Rezzonico, E, Salerno, Ja, Morandi, F, Salvucci, F, Valenti, C, Graziano, G, Romano, M, Cimminiello, C, Mangone, I, Lombardo, M, Quorso, P, Marinoni, G, Breghi, M, Erckert, M, Dienstl, A, Mirante, G, Stefenelli, C, Cioffi, G, Buczkowska, E, Bonanome, A, Bazzanini, F, Parissenti, L, Serafini, C, Catania, G, Tarantini, L, Rigatelli, G, Boni, S, Pasini, A, Masini, E, Zampiero, Aa, Zanchetta, M, Franceschetto, L, Delise, P, Marcon, C, Sacchetta, A, Borgese, L, Artusi, L, Casolino, P, Corbara, F, Banzato, A, Barbiero, M, Aldegheri, Mp, Bazzucco, R, Crivellenti, G, Raviele, A, Zanella, C, Pascotto, P, Sarto, P, Milan, S, Barbieri, E, Girardi, P, Dalla, W, Mule, Jd, Di Sipio ML, Cazzin, R, Milan, D, Zonzin, P, Carraro, M, Rossi, R, Carbonieri, E, Rossi, I, Stritoni, P, Meneghetti, P, Risica, G, Tenderini, Pl, Vassanelli, C, Zanolla, L, Perini, G, Brighetti, G, Chiozza, R, Giuliano, G, Baldin, Mg, Gortan, R, Cesanelli, R, Piazza, R, Mos, L, Vriz, O, Pavan, D, Pascottini, G, Alberti, E, Werren, M, Solinas, L, Longaro, F, Fioretti, P, Albanese, Mc, Miani, D, Gianrossi, R, Pende, A, Rubartelli, P, Magaia, O, Caruso, D, Faraguti, As, Magliani, L, Miccoli, F, Guglielmino, G, Cantarelli, A, Orlandi, S, Vallebona, A, Pozzati, A, Brega, G, Pancaldi, Lg, Vandelli, R, Urbinati, S, Poci, Mg, Zoli, M, Costa, Gm, Guiducci, U, Zobbi, G, Tartagni, F, Tisselli, A, Gentili, A, Pieri, P, Cagnetta, E, Bendinelli, S, Barbieri, A, Conti, R, Ferrari, R, Merlini, F, Fucili, A, Moruzzi, P, Buia, E, Galvani, M, Ferrini, D, Baggioni, G, Yiannacopulu, P, Canè, G, Bonfiglioli, A, Zandomeneghi, R, Brugioni, L, Giannini, A, Di, R, Giuliani, M, Rusconi, L, Del Corso, P, Piovaccari, G, Bologna, F, Venturi, P, Melandri, F, Bagni, E, Bolognese, L, Perticucci, R, Zuppiroli, A, Nannini, M, Consoli, N, Petrone, P, Pipitò, C, Colombi, L, Bernardi, D, Mariani, Pr, Testa, R, Mazzinghi, F, Cosmi, F, Cosmi, D, Zipoli, A, Cecchi, A, Castelli, G, Ciaccheri, M, Mori, F, Pieri, F, Valoti, P, Chiarantini, D, Santoro, Gm, Minneci, C, Marchi, F, Milli, M, Zambaldi, G, Geri, Aa, Cipriani, M, Alessandri, M, Severi, S, Stefanelli, S, Comella, A, Poddighe, R, Digiorgio, A, Carluccio, M, Berti, S, Rizza, A, Bonatti, V, Molendi, V, Brancato, A, D'Aprile, N, Giappichini, G, Del Vecchio, S, Mantini, G, De Tommasi, F, Meucci, G, Cordoni, M, Bechi, S, Barsotti, L, Baldini, P, Romei, M, Scopelliti, G, Lauri, G, Pestelli, F, Furiozzi, F, Cocchieri, M, Severini, D, Patriarchi, F, Chiocchi, P, Buccolieri, M, Martinelli, S, Wee, A, Angelici, F, Bernardinangeli, M, Proietti, G, Biscottini, B, Panciarola, R, Marinacci, L, Perna, Gp, Gabrielli, D, Moraca, A, Moretti, L, Partemi, L, Gregori, G, Amici, R, Patteri, G, Capone, P, Savini, E, Morgagni, Gl, Paccaloni, L, Pezzuoli, F, Carincola, S, Papi, S, De Crescentini, S, Gerardi, P, Midi, P, Gallenzi, E, Pajes, G, Mancone, C, Di, V, Di Gennaro, M, Calcagno, S, Toscano, S, Antonicoli, S, Carta, F, Giorgi, G, Comito, F, Daniele, E, Goretti, Sm, Ciarla, O, Gelfo, Pg, Acquaviva, A, Testa, D, Testa, G, Pagliaro, Fa, Russo, F, Vetta, F, Marchese, I, Di, G, D'Ambrosio, A, Leggio, F, Del Sindaco, D, Lacchè, A, Avallone, A, Risa, Mp, Azzolini, P, Baldo, E, Giovannini, E, Pulignano, G, Tondo, C, Picchio, E, Biffani, E, Tanzi, P, Pozzar, F, Farnetti, F, Azzarito, M, Santini, M, Varveri, A, Ferraiuolo, G, Valtorta, C, Gaspardone, A, Barbato, G, Ceci, V, Aspromonte, N, Bellocci, F, Colizzi, C, Fedele, F, Perez, Fi, Galati, A, Rossetti, A, Mainella, A, Ciuffetta, D, Matteucci, C, Busi, G, De, A, Farina, G, Granatelli, A, Leone, F, Frasca, F, Castellani, G, Massaro, G, Mastrogiuseppe, G, Vacri, A, De Sanctis, F, Cioli, M, Di Luzio, S, Napoletano, C, Piccioni, Ll, De Simone, G, Ottaviano, A, Mazza, V, Spedaliere, C, Staniscia, Td, Calgione, E, De Marco, G, Chiacchio, T, Di, T, Romanzi, S, Salvatore, G, Golino, P, Palermo, A, Mascia, F, Vetrano, A, Vinciguerra, A, Caliendo, L, Longobardi, R, De Caro, G, Di Nola, R, Piemonte, F, Prinzi, D, De Rosa, P, De, V, Riello, F, Capuano, V, Vecchio, G, Landi, M, Amato, S, Garofalo, M, D'Avino, M, Sensale, P, Maiolica, O, Santoro, R, Caso, P, Miceli, D, Maurea, N, Bianchi, U, Crispo, C, Chiariello, M, Filardi, Pp, Russo, L, Capuano, N, Ungaro, G, Vergara, G, Scafuro, F, D'Angelo, G, Campaniello, C, Bottiglieri, P, Volpe, A, Battista, R, De Risi, L, Cardillo, G, Sibilio, G, Marino, Ap, Silvestri, F, Predotti, P, Iervoglini, A, De Matteis, C, Sarnicola, P, Matarazzo, Mm, Baldi, S, Iuliano, V, Astarita, C, Cuccaro, P, Liguori, A, Liguori, G, Gregorio, G, Petraglia, L, Antonelli, G, Amodio, G, De Luca, I, Franchini, G, Lenti, Ml, Cavallari, D, D'Agostino, C, Scalera, G, Altamura, Cm, Russo, M, Mascolo, Ar, Pettinati, G, Ciricugno, Sa, Scrutinio, D, Passantino, A, Mastrangelo, D, Di Masi, A, De, R, Cannone, M, Dibiase, F, Pensato, M, Loliva, F, Trapani, F, Panettieri, I, Leone, L, Di, M, Carrone, M, Gallone, V, Cocco, F, Costantini, M, Tritto, C, Cavalieri, F, Stella, L, Magliari, F, Callerame, M, De Giorgi, A, Pellegrino, L, Correra, M, Portulano, V, Nisi, Gl, Grassi, G, Cristallo, E, De Laura, D, Salerno, C, Fanelli, R, Villella, M, Pede, S, Renna, A, De Lorenzi, E, Urso, L, Lenti, V, Peluso, A, Baldi, N, Polimeni, G, Palma, P, Lauletta, R, Tagliamonte, E, Cirillo, T, Centonze, G, D'Alessandro, B, Truncellito, L, Mecca, D, Petruzzi, Ma, Coviello, Ro, Lopizzo, A, Chiaffitelli, M, Barbuzzi, S, Gubelli, S, Germinario, G, Cosentino, N, Mingrone, A, Vico, R, Borrello, G, Mazza, Ml, Cimino, R, Galasso, D, Cassadonte, F, Talarico, U, Perticone, F, Cassano, S, Catapano, F, Calemme, S, Feraco, E, Cloro, C, Misuraca, G, Caporale, R, Vigna, L, Spagnuolo, V, De Rosa, F, Spadafora, G, Zampaglione, G, Russo, R, Schipani, Fa, Ferragina, Af, Stranieri, D, Musca, G, Carpino, C, Bencardino, P, Raimondo, F, Musacchio, D, Pulitano, G, Ruggeri, A, Provenzano, A, Salituri, S, Musolino, M, Calandruccio, S, Marrari, A, Tripodi, E, Scali, R, Anastasio, L, Arone, A, Aragona, P, Donnangelo, L, Comito, Mg, Bilotta, F, Vaccaro, I, Rametta, R, Ventura, V, Bonvegna, A, Alì, A, Cinnirella, C, Raineri, M, Pompeo, F, Ingurgio, Nc, Carini, V, Coco, R, Giunta, G, Leonardi, G, Randazzo, V, Di Blasi, V, Tamburino, C, Russo, G, Mangiameli, S, Cardillo, R, Castelli, D, Inserra, V, Arena, A, Gulizia, Mm, Raciti, S, Rapisarda, G, Romano, R, Prestifilippo, P, Braschi, Gb, Ledda, G, Terrazzino, R, De Caro, M, Scilabra, G, Graffagnino, B, Grassi, R, Scimone, Gf, Vasquez, L, Coppolino, C, Casale, A, Castelli, M, D'Urso, G, D'Antonio, E, Presti, Ll, Badalamenti, E, Conti, P, Sanfilippo, N, Cirrincione, V, Cinà, Mt, Cusimano, G, Taormina, A, Giuliano, P, Bajardi, A, Mandala, V, Canonico, A, Geraci, G, Sabella, Fp, Enia, F, Floresta, Am, Cascio, Il, Gumina, D, Cavallaro, A, Piccione, G, Ferrante, R, Blandino, M, Iudicello, Ms, Mossuti, E, Romano, G, Lombardo, L, Monastra, P, Di Vincenzo, D, Orru, P, Muscas, F, Giardina, G, Corda, M, Locci, G, Podda, A, Ledda, M, Siddi, P, Lai, C, Pili, G, Mercuro, G, Mureddu, G, Ganau, A, Meloni, G, Poddighe, G, Sanna, G., Cosmi, Franco, Di Giulio, Paola, Masson, Serge, Finzi, Andrea, Marfisi, Rosa Maria, Cosmi, Deborah, Scarano, Marco, Tognoni, Gianni, Maggioni, Aldo P, Porcu, Maurizio, Boni, Silvana, Cutrupi, Giovanni, Tavazzi, Luigi, Latini, Roberto, on behalf of the GISSI-HF, Investigator, Margonato, Alberto, DI GIULIO, Paola, Maggioni, Aldo P., GISSI HF, Investigator, and Sinagra, Gianfranco

Subjects
Male, Health Status, Left, Wine, Comorbidity, Ventricular Function, Left, Health Statu, Quality of life, Risk Factors, Surveys and Questionnaires, Prevalence, Ventricular Function, Surveys and Questionnaire, Depression (differential diagnoses), Depression, Medicine (all), Middle Aged, Prognosis, biological marker, Italy, Female, Risk assessment, Cardiology and Cardiovascular Medicine, biological markers, Human, Cardiac function curve, Vasculitis, medicine.medical_specialty, Vasculiti, Alcohol Drinking, Prognosi, Lower risk, Risk Assessment, Internal medicine, medicine, Humans, Protective Factor, Aged, Heart Failure, business.industry, Risk Factor, Stroke Volume, Biomarker, quality of life, wine, aged, alcohol drinking, biomarkers, chronic disease, comorbidity, depression, female, heart failure, humans, italy, male, middle aged, prevalence, prognosis, protective factors, risk assessment, risk factors, stroke volume, surveys and questionnaires, vasculitis, ventricular function, left, health status, cardiology and cardiovascular medicine, Biomarkers, Chronic Disease, Protective Factors, Quality of Life, medicine.disease, Clinical trial, Heart failure, Physical therapy, business
Abstract

Background— Moderate, regular alcohol consumption is generally associated with a lower risk of cardiovascular events but data in patients with chronic heart failure are scarce. We evaluated the relations between wine consumption, health status, circulating biomarkers, and clinical outcomes in a large Italian population of patients with chronic heart failure enrolled in a multicenter clinical trial. Methods and Results— A brief questionnaire on dietary habits was administered at baseline to 6973 patients enrolled in the Gruppo Italiano per lo Studio della Sopravvivenza nell’Insufficienza Cardiaca-Heart Failure (GISSI-HF) trial. The relations between wine consumption, fatal and nonfatal clinical end points, quality of life, symptoms of depression, and circulating biomarkers of cardiac function and inflammation (in subsets of patients) were evaluated with simple and multivariable-adjusted statistical models. Almost 56% of the patients reported drinking at least 1 glass of wine per day. After adjustment, clinical outcomes were not significantly different in the predefined 4 groups of wine consumption. However, patients with more frequent wine consumption had a significantly better perception of health status (Kansas City Cardiomyopathy Questionnaire score, adjusted P P =0.01), and lower plasma levels of biomarkers of vascular inflammation (osteoprotegerin and C-terminal proendothelin-1, adjusted P P =0.01) after adjusting for possible confounders. Conclusions— We show for the first time in a large cohort of patients with chronic heart failure that moderate wine consumption is associated with a better perceived and objective health status, lower prevalence of depression, and less vascular inflammation, but does not translate into more favorable clinical 4-year outcomes. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT0033633.

Published
2015

11. 2016 European Guidelines on cardiovascular disease prevention in clinical practice the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR)

Author

Piepoli, M, Hoes, A, Agewall, S, Albus, C, Brotons, C, Catapano, A, Cooney, M, Corra, U, Cosyns, B, Deaton, C, Graham, I, Hall, M, Richard Hobbs, F, Løchen, M, Lollgen, H, Marques-Vidal, P, Perk, J, Prescott, E, Redon, J, Richter, D, Sattar, N, Smulders, Y, Tiberi, M, Bart Van Der Worp, H, Van Dis, I, Monique Verschuren, W, De Backer, G, Roffi, M, Aboyans, V, Bachl, N, Bueno, H, Carerj, S, Cho, L, Cox, J, De Sutter, J, Egidi, G, Fisher, M, Fitzsimons, D, Franco, O, Guenoun, M, Jennings, C, Jug, B, Kirchhof, P, Kotseva, K, Lip, G, Mach, F, Mancia, G, Bermudo, F, Mezzani, A, Niessner, A, Ponikowski, P, Rauch, B, Ryden, L, Stauder, A, Turc, G, Wiklund, O, Windecker, S, Zamorano, J, Piepoli, Massimo F., Hoes, Arno W., Agewall, Stefan, Albus, Christian, Brotons, Carlos, Catapano, Alberico L., Cooney, Marie-Therese, Corra, Ugo, Cosyns, Bernard, Deaton, Christi, Graham, Ian, Hall, Michael Stephen, Richard Hobbs, F. D., Løchen, Maja-Lisa, Lollgen, Herbert, Marques-Vidal, Pedro, Perk, Joep, Prescott, Eva, Redon, Josep, Richter, Dimitrios J., Sattar, Naveed, Smulders, Yvo, Tiberi, Monica, Bart Van Der Worp, H., Van Dis, Ineke, Monique Verschuren, W. M., De Backer, Guy, Roffi, Marco, Aboyans, Victor, Bachl, Norbert, Bueno, Hector, Carerj, Scipione, Cho, Leslie, Cox, John, De Sutter, Johan, Egidi, Gunther, Fisher, Miles, Fitzsimons, Donna, Franco, Oscar H., Guenoun, Maxime, Jennings, Catriona, Jug, Borut, Kirchhof, Paulus, Kotseva, Kornelia, Lip, Gregory Y. H., MacH, Francois, Mancia, Giuseppe, Bermudo, Franz Martin, Mezzani, Alessandro, Niessner, Alexander, Ponikowski, Piotr, Rauch, Bernhard, Ryden, Lars, Stauder, Adrienne, Turc, Guillaume, Wiklund, Olov, Windecker, Stephan, Zamorano, Jose Luis, Piepoli, M, Hoes, A, Agewall, S, Albus, C, Brotons, C, Catapano, A, Cooney, M, Corra, U, Cosyns, B, Deaton, C, Graham, I, Hall, M, Richard Hobbs, F, Løchen, M, Lollgen, H, Marques-Vidal, P, Perk, J, Prescott, E, Redon, J, Richter, D, Sattar, N, Smulders, Y, Tiberi, M, Bart Van Der Worp, H, Van Dis, I, Monique Verschuren, W, De Backer, G, Roffi, M, Aboyans, V, Bachl, N, Bueno, H, Carerj, S, Cho, L, Cox, J, De Sutter, J, Egidi, G, Fisher, M, Fitzsimons, D, Franco, O, Guenoun, M, Jennings, C, Jug, B, Kirchhof, P, Kotseva, K, Lip, G, Mach, F, Mancia, G, Bermudo, F, Mezzani, A, Niessner, A, Ponikowski, P, Rauch, B, Ryden, L, Stauder, A, Turc, G, Wiklund, O, Windecker, S, Zamorano, J, Piepoli, Massimo F., Hoes, Arno W., Agewall, Stefan, Albus, Christian, Brotons, Carlos, Catapano, Alberico L., Cooney, Marie-Therese, Corra, Ugo, Cosyns, Bernard, Deaton, Christi, Graham, Ian, Hall, Michael Stephen, Richard Hobbs, F. D., Løchen, Maja-Lisa, Lollgen, Herbert, Marques-Vidal, Pedro, Perk, Joep, Prescott, Eva, Redon, Josep, Richter, Dimitrios J., Sattar, Naveed, Smulders, Yvo, Tiberi, Monica, Bart Van Der Worp, H., Van Dis, Ineke, Monique Verschuren, W. M., De Backer, Guy, Roffi, Marco, Aboyans, Victor, Bachl, Norbert, Bueno, Hector, Carerj, Scipione, Cho, Leslie, Cox, John, De Sutter, Johan, Egidi, Gunther, Fisher, Miles, Fitzsimons, Donna, Franco, Oscar H., Guenoun, Maxime, Jennings, Catriona, Jug, Borut, Kirchhof, Paulus, Kotseva, Kornelia, Lip, Gregory Y. H., MacH, Francois, Mancia, Giuseppe, Bermudo, Franz Martin, Mezzani, Alessandro, Niessner, Alexander, Ponikowski, Piotr, Rauch, Bernhard, Ryden, Lars, Stauder, Adrienne, Turc, Guillaume, Wiklund, Olov, Windecker, Stephan, and Zamorano, Jose Luis

Published
2016

12. Exercise oscillatory ventilation and prognosis in heart failure patients with reduced and mid‐range ejection fraction

Author

Michele Correale, Massimo F Piepoli, Domenico Scrutinio, Alice Bonomi, Mariantonietta Cicoira, Francesco Bandera, Luca Arcari, Rocco Lagioia, Giuseppe Pacileo, Maurizio Bussotti, M. Metra, Angela Beatrice Scardovi, Marco Guazzi, Giuseppe Limongelli, Massimo Mapelli, Federica Re, Giovanni Quinto Villani, Carlo Vignati, Susanna Sciomer, Claudio Passino, S. Paolillo, Aldo P. Maggioni, Michele Emdin, A. Di Lenarda, P. Perrone Filardi, Enrico Perna, Piergiuseppe Agostoni, Damiano Magrì, Roberto Badagliacca, Gaia Cattadori, Maria Frigerio, Roberto C. Raimondo, I. Mattavelli, Elisa Battaia, Chiara Minà, Francesco Clemenza, Michele Senni, Sara Rovai, Gianfranco Sinagra, Alessandra Magini, Gianfranco Parati, Carolina Lombardi, Elisabetta Salvioni, Ugo Corrà, Rovai, S., Corra, U., Piepoli, M., Vignati, C., Salvioni, E., Bonomi, A., Mattavelli, I., Arcari, L., Scardovi, A. B., Perrone Filardi, P., Lagioia, R., Paolillo, S., Magri, D., Limongelli, G., Metra, M., Senni, M., Scrutinio, D., Guarino, Raimondo, Emdin, M., Lombardi, C., Cattadori, G., Parati, G., Re, F., Cicoira, M., Villani, G. Q., Mina, C., Correale, M., Frigerio, M., Perna, E., Mapelli, M., Magini, A., Clemenza, F., Bussotti, M., Battaia, E., Guazzi, M., Bandera, F., Badagliacca, R., Di Lenarda, A., Pacileo, G., Maggioni, A., Passino, C., Sciomer, S., Sinagra, G., Agostoni, P., Raimondo, R., Rovai, S, Corra, U, Piepoli, M, Vignati, C, Salvioni, E, Bonomi, A, Mattavelli, I, Arcari, L, Scardovi, A, Perrone Filardi, P, Lagioia, R, Paolillo, S, Magri, D, Limongelli, G, Metra, M, Senni, M, Scrutinio, D, Raimondo, R, Emdin, M, Lombardi, C, Cattadori, G, Parati, G, Re, F, Cicoira, M, Villani, G, Mina, C, Correale, M, Frigerio, M, Perna, E, Mapelli, M, Magini, A, Clemenza, F, Bussotti, M, Battaia, E, Guazzi, M, Bandera, F, Badagliacca, R, Di Lenarda, A, Pacileo, G, Maggioni, A, Passino, C, Sciomer, S, Sinagra, G, and Agostoni, P

Subjects
Male, medicine.medical_specialty, Prognosi, medicine.medical_treatment, Left, 030204 cardiovascular system & hematology, Ventricular Function, Left, Exercise oscillatory ventilation, Cardiovascular death, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Cardiopulmonary exercise test, Prevalence, medicine, Ventricular Function, Humans, In patient, Registries, Heart failure with mid-range ejection fraction, Prognosis, Aged, Exercise Test, Female, Follow-Up Studies, Heart Failure, Italy, Middle Aged, Retrospective Studies, Stroke Volume, Survival Rate, Survival analysis, cardiopulmonary exercise test, exercise oscillatory ventilation, heart failure with mid-range ejection fraction, prognosis, Ejection fraction, Oscillatory ventilation, business.industry, medicine.disease, Ventricular assist device, Heart failure, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Aims: Exercise oscillatory ventilation (EOV) is a pivotal cardiopulmonary exercise test parameter for the prognostic evaluation of patients with chronic heart failure (HF). It has been described in patients with HF with reduced ejection fraction (50%, HFpEF), but no data are available for patients with HF with mid-range ejection fraction (40–49%, HFmrEF). The aim of the study was to evaluate the prognostic role of EOV in HFmrEF patients. Methods and results: We analysed 1239 patients with HFmrEF and 4482 patients with HFrEF, enrolled in the MECKI score database, with a 2-year follow-up. The study endpoint was the composite of cardiovascular death, urgent heart transplant, and ventricular assist device implantation. We identified EOV in 968 cases (16% and 17% of cases in HFmrEF and HFrEF,. respectively). HFrEF EOV+ patients were significantly older, and their parameters suggested a more severe HF than HFrEF EOV− patients. A similar behaviour was found in HFmrEF EOV+ vs. EOV− patients. Kaplan–Meier analysis, irrespective of ejection fraction, showed that EOV is associated with a worse survival, and that patients with HFrEF and HFmrEF EOV+ had a significantly worse outcome than the EOV− of the same ejection fraction groups. EOV-associated survival differences in HFmrEF patients started after 18 months of follow-up. Conclusion: Exercise oscillatory ventilation has a similar prevalence and ominous prognostic value in both HFmrEF and HFrEF patients, indicating a group of patients in need of a more intensive follow-up and a more aggressive therapy. In HFmrEF, the survival curves between EOV+ and EOV− patients diverged only after 18 months.

Published
2019
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13. Does moderate hyperkalemia influence survival in HF? Insights from the MECKI score data base

Author

Federica Toto, Elisabetta Salvioni, Damiano Magrì, Susanna Sciomer, Massimo Piepoli, Roberto Badagliacca, Arianna Galotta, Nikita Baracchini, Stefania Paolillo, Ugo Corrà, Rosa Raimondo, Rocco Lagioia, Pasquale Perrone Filardi, Annamaria Iorio, Michele Senni, Michele Correale, Mariantonietta Cicoira, Enrico Perna, Marco Metra, Marco Guazzi, Giuseppe Limongelli, Gianfranco Sinagra, Gianfranco Parati, Gaia Cattadori, Francesco Bandera, Maurizio Bussotti, Massimo Mapelli, Manlio Cipriani, Alice Bonomi, Gonçalo Cunha, Federica Re, Carlo Vignati, Andrea Garascia, Carlo Lombardi, Angela B. Scardovi, Andrea Passantino, Michele Emdin, Claudio Passino, Caterina Santolamazza, Davide Girola, Denise Zaffalon, Dario Vizza, Fabiana De Martino, Piergiuseppe Agostoni, Toto, Federica, Salvioni, Elisabetta, Magrì, Damiano, Sciomer, Susanna, Piepoli, Massimo, Badagliacca, Roberto, Galotta, Arianna, Baracchini, Nikita, Paolillo, Stefania, Corrà, Ugo, Raimondo, Rosa, Lagioia, Rocco, Filardi, Pasquale Perrone, Iorio, Annamaria, Senni, Michele, Correale, Michele, Cicoira, Mariantonietta, Perna, Enrico, Metra, Marco, Guazzi, Marco, Limongelli, Giuseppe, Sinagra, Gianfranco, Parati, Gianfranco, Cattadori, Gaia, Bandera, Francesco, Bussotti, Maurizio, Mapelli, Massimo, Cipriani, Manlio, Bonomi, Alice, Cunha, Gonçalo, Re, Federica, Vignati, Carlo, Garascia, Andrea, Lombardi, Carlo, Scardovi, Angela B, Passantino, Andrea, Emdin, Michele, Passino, Claudio, Santolamazza, Caterina, Girola, Davide, Zaffalon, Denise, Vizza, Dario, De Martino, Fabiana, Agostoni, Piergiuseppe, Toto, F., Salvioni, E., Magri, D., Sciomer, S., Piepoli, M., Badagliacca, R., Galotta, A., Baracchini, N., Paolillo, S., Corra, U., Raimondo, R., Lagioia, R., Filardi, P. P., Iorio, A., Senni, M., Correale, M., Cicoira, M., Perna, E., Metra, M., Guazzi, M., Limongelli, G., Sinagra, G., Parati, G., Cattadori, G., Bandera, F., Bussotti, M., Mapelli, M., Cipriani, M., Bonomi, A., Cunha, G., Re, F., Vignati, C., Garascia, A., Lombardi, C., Scardovi, A. B., Passantino, A., Emdin, M., Passino, C., Santolamazza, C., Girola, D., Zaffalon, D., Vizza, D., De Martino, F., and Agostoni, P.

Subjects
Renin angiotensin aldosterone system inhibitor, Prognosi, Heart failure, Hyperkalemia, Prognosis, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Cardiology and Cardiovascular Medicine
Abstract

Background: The prognostic role of moderate hyperkalemia in reduced ejection fraction (HFrEF) patients is still controversial. Despite this, it affects the use of renin–angiotensin–aldosterone system inhibitors (RAASi) with therapy down-titration or discontinuation. Objectives: Aim of the study was to assess the prognostic impact of moderate hyperkalemia in chronic HFrEF optimally treated patients. Methods and results: We retrospectively analyzed MECKI (Metabolic Exercise test data combined with Cardiac and Kidney Indexes) database, with median follow-up of 4.2 [IQR 1.9–7.5] years. Data on K+ levels were available in 7087 cases. Patients with K+ plasma level ≥ 5.6 mEq/L and < 4 mEq/L were excluded. Remaining patients were categorized into normal >4 and < 5 mEq/L (n = 4826, 68%) and moderately high ≥5.0 and ≤ 5.5 mEq/L (n = 496, 7%) K+. Then patients were matched by propensity score in 484 couplets of patients. MECKI score value was 7% [IQR 3.1–14.1%] and 7.3% [IQR 3.4–15%] (p = 0.678) in patients with normal and moderately high K+ values while cardiovascular mortality events at two years follow-up were 41 (4.2%) and 33 (3.4%) (p = 0.333) in each group respectively. Conclusions: Moderate hyperkalemia does not influence patients' outcome in a large cohort of ambulatory HFrEF patients.

Published
2023

14. Dose-dependent efficacy of β-blocker in patients with chronic heart failure and atrial fibrillation

Author

Michele Correale, Domenico Scrutinio, Stefania Paolillo, Gaia Cattadori, Marco Metra, Gianfranco Sinagra, Jeness Campodonico, Giuseppe Pacileo, Simone Binno, Massimo Mapelli, Angela Beatrice Scardovi, Marco Guazzi, Carlo Vignati, Susanna Sciomer, Massimo F Piepoli, Michele Emdin, Claudio Passino, Elisa Battaia, Pasquale Perrone Filardi, Andrea Di Lenarda, Piergiuseppe Agostoni, Carlo Lombardi, Fabrizio Veglia, Aldo P. Maggioni, Damiano Magrì, Giuseppe Limongelli, Chiara Minà, Federica Re, Elisabetta Salvioni, Maurizio Bussotti, Ugo Corrà, Francesco Clemenza, Michele Senni, Roberto Badagliacca, Rosa Raimondo, Rocco Lagioia, Alice Bonomi, Mariantonietta Cicoira, Maria Frigerio, Enrico Perna, Gianfranco Parati, Campodonico, Jene, Piepoli, Massimo, Clemenza, Francesco, Bonomi, Alice, Paolillo, Stefania, Salvioni, Elisabetta, Corrà, Ugo, Binno, Simone, Veglia, Fabrizio, Lagioia, Rocco, Sinagra, Gianfranco, Cattadori, Gaia, Scardovi, Angela B., Metra, Marco, Senni, Michele, Scrutinio, Domenico, Raimondo, Rosa, Emdin, Michele, Magrì, Damiano, Parati, Gianfranco, Re, Federica, Cicoira, Mariantonietta, Minà, Chiara, Limongelli, Giuseppe, Correale, Michele, Frigerio, Maria, Bussotti, Maurizio, Perna, Enrico, Battaia, Elisa, Guazzi, Marco, Badagliacca, Roberto, Di Lenarda, Andrea, Maggioni, Aldo, Passino, Claudio, Sciomer, Susanna, Pacileo, Giuseppe, Mapelli, Massimo, Vignati, Carlo, Lombardi, Carlo, Filardi, Pasquale Perrone, Agostoni, Piergiuseppe, Campodonico, J., Piepoli, M., Clemenza, F., Bonomi, A., Paolillo, S., Salvioni, E., Corra, U., Binno, S., Veglia, F., Lagioia, R., Sinagra, G., Cattadori, G., Scardovi, A. B., Metra, M., Senni, M., Scrutinio, D., Raimondo, R., Emdin, M., Magri, D., Parati, G., Re, F., Cicoira, M., Mina, C., Limongelli, G., Correale, M., Frigerio, M., Bussotti, M., Perna, E., Battaia, E., Guazzi, M., Badagliacca, R., Di Lenarda, A., Maggioni, A., Passino, C., Sciomer, S., Pacileo, G., Mapelli, M., Vignati, C., Lombardi, C., Filardi, P. P., Agostoni, P., Campodonico, J, Piepoli, M, Clemenza, F, Bonomi, A, Paolillo, S, Salvioni, E, Corrà, U, Binno, S, Veglia, F, Lagioia, R, Sinagra, G, Cattadori, G, Scardovi, A, Metra, M, Senni, M, Scrutinio, D, Raimondo, R, Emdin, M, Magrì, D, Parati, G, Re, F, Cicoira, M, Minà, C, Limongelli, G, Correale, M, Frigerio, M, Bussotti, M, Perna, E, Battaia, E, Guazzi, M, Badagliacca, R, Di Lenarda, A, Maggioni, A, Passino, C, Sciomer, S, Pacileo, G, Mapelli, M, Vignati, C, Lombardi, C, Filardi, P, and Agostoni, P

Subjects
Male, medicine.medical_specialty, Prognosi, medicine.medical_treatment, Cardiopulmonary exercise test, Prognosis, β-Blockers, Atrial fibrillation, Cardiology and Cardiovascular Medicine, Adrenergic beta-Antagonists, Dose dependence, heart failure, atrial fibrillation, prognosis, beta-blocker, cardiopulmonary exercise test, 030204 cardiovascular system & hematology, Follow-Up Studie, 03 medical and health sciences, 0302 clinical medicine, Retrospective Studie, Internal medicine, Atrial Fibrillation, medicine, Humans, In patient, 030212 general & internal medicine, Survival analysis, Aged, Retrospective Studies, Heart Failure, Entire population, Dose-Response Relationship, Drug, business.industry, Confounding, Adrenergic beta-Antagonist, Atrial fibrillation, Middle Aged, medicine.disease, Death, Treatment Outcome, Ventricular assist device, Heart failure, beta-blocker, Cardiology, β-Blockers, Female, business, Human, Follow-Up Studies
Abstract

The usefulness of β-blockers in heart failure (HF) patients with permanent atrial fibrillation (AF) has been questioned. Background: The usefulness of β-blockers in heart failure (HF) patients with permanent atrial fibrillation (AF) has been questioned. Methods and results: We analyzed data from HF patients (958 patients (801 males, 84%, age 67 ± 11 years)) with AF enrolled in the MECKI score database. We evaluated prognosis (composite of cardiovascular death, urgent heart transplant, or left ventricular assist device) of patients receiving β-blockers (n = 777, 81%) vs. those not treated with β-blockers (n = 181, 19%). We also analyzed the role β1-selectivity and the role of daily β-blocker dose. To account for different HF severity, Kaplan-Meier survival curves were normalized for relevant confounding factors and for treatment strategies. Dose was available in 629 patients. Median follow-up was 1312 (577–2304) days in the entire population, 1203 (614–2420) and 1325 (569–2300) days in patients not receiving and receiving β-blockers. 224 (23%, 54/1000 events/year), 163 (21%, 79/1000 events/year), and 61 (34%, 49/1000 events/year) events were recorded, respectively. At 10-year patients treated with β-blockers had a better outcome (HR 0.447, p < 0.01) with no effects as regards β1selective drugs (53%) vs. β1-β2 blockers (47%). Survival improved in parallel with β-blocker dose increase (HR 0.296, 0.496, 0.490 for the high, medium, and low dose vs. no β-blockers, p < 0.0001). Conclusion: HF patients with AF taking a β-blocker have a better outcome (with a survival improvement in parallel with daily dose but no differences as regards β1 selectivity) but this does not mean that β-blockers improve outcomes in these patients as we cannot control for all the potential confounders associated with β-blocker use.

Published
2018
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15. Corrigendum to 'Long-term prognostic role of diabetes mellitus and glycemic control in heart failure patients with reduced ejection fraction: Insights from the MECKI Score database' [Int J Cardiol. 2020 Oct 15; 317: 103–110. PMID: 32360652] (International Journal of Cardiology (2020) 317 (103–110), (S0167527320312663), (10.1016/j.ijcard.2020.04.079))

Author

Rosa Raimondo, P. Perrone Filardi, Enrico Perna, Rocco Lagioia, Piero Gentile, Alessandra Scoccia, Alice Bonomi, Elisabetta Salvioni, Paola Gugliandolo, Andrea Passantino, Piergiuseppe Agostoni, Chiara Minà, Ugo Corrà, Massimo F Piepoli, C. Cavaliere, Luca Arcari, Angela Beatrice Scardovi, Giuseppe Limongelli, Maria Frigerio, Maurizio Bussotti, Federica Re, Stefania Paolillo, Damiano Magrì, Roberto Badagliacca, Massimo Mapelli, Gaia Cattadori, Michele Correale, Gianfranco Sinagra, Nicola Cosentino, Carlo Vignati, Sergio Caravita, Rita Gravino, Paola Gargiulo, Gianfranco Parati, Francesco Clemenza, Paolillo, S., Salvioni, E., Perrone Filardi, P., Bonomi, A., Sinagra, G., Gentile, P., Gargiulo, P., Scoccia, A., Cosentino, N., Gugliandolo, P., Badagliacca, R., Lagioia, R., Correale, M., Frigerio, M., Perna, E., Piepoli, M., Re, F., Raimondo, R., Mina, C., Clemenza, F., Bussotti, M., Limongelli, G., Gravino, R., Passantino, A., Magri, D., Parati, G., Caravita, S., Scardovi, A. B., Arcari, L., Vignati, C., Mapelli, M., Cattadori, G., Cavaliere, C., Corra, U., and Agostoni, P.

Subjects
MECKI score database, medicine.medical_specialty, Ejection fraction, business.industry, MEDLINE, heart failure, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, medicine.disease, prognostic, diabetes mellitus, reduced ejection fraction, Term (time), Heart failure, Diabetes mellitus, Internal medicine, Cardiology, medicine, Cardiology and Cardiovascular Medicine, business, Glycemic
Abstract

The authors regret that the Author Dr. Bussotti Maurizio appears with the following affiliation: Unità Operativa Cardiologia Riabilitativa, Multimedica IRCCS, Milano, Italy. But that was a mistake, the right affiliation of Dr. Bussotti Maurizio is instead: Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy. The authors kindly ask you to correct this affiliation also with all abstracting partners as PubMed. The authors would like to apologise for any inconvenience caused. DOI of original article: .

Published
2021

16. Gender and age normalization and ventilation efficiency during exercise in heart failure with reduced ejection fraction

Author

Salvioni, E, Corrà, U, Piepoli, M, Rovai, S, Correale, M, Paolillo, S, Pasquali, M, Magrì, Damiano, Vitale, G, Fusini, L, Mapelli, M, Vignati, C, Lagioia, R, Raimondo, R, Sinagra, G, Boggio, F, Cangiano, L, Gallo, G, Magini, A, Contini, M, Palermo, P, Apostolo, A, Pezzuto, B, Bonomi, A, Scardovi, Ab, Filardi, Pp, Limongelli, G, Metra, M, Scrutinio, D, Emdin, M, Piccioli, L, Lombardi, C, Cattadori, G, Parati, G, Caravita, S, Re, F, Cicoira, M, Frigerio, M, Clemenza, F, Bussotti, M, Battaia, E, Guazzi, M, Bandera, F, Badagliacca, R, Di Lenarda, A, Pacileo, G, Passino, C, Sciomer, S, Ambrosio, G, Agostoni, P, MECKI score research, Group., Salvioni, E., Corra, U., Piepoli, M., Rovai, S., Correale, M., Paolillo, S., Pasquali, M., Magri, D., Vitale, G., Fusini, L., Mapelli, M., Vignati, C., Lagioia, R., Raimondo, R., Sinagra, G., Boggio, F., Cangiano, L., Gallo, G., Magini, A., Contini, M., Palermo, P., Apostolo, A., Pezzuto, B., Bonomi, A., Scardovi, A. B., Filardi, P. P., Limongelli, G., Metra, M., Scrutinio, D., Emdin, M., Piccioli, L., Lombardi, C., Cattadori, G., Parati, G., Caravita, S., Re, F., Cicoira, M., Frigerio, M., Clemenza, F., Bussotti, M., Battaia, E., Guazzi, M., Bandera, F., Badagliacca, R., Di Lenarda, A., Pacileo, G., Passino, C., Sciomer, S., Ambrosio, G., Agostoni, P., and Guarino, Raimondo

Subjects
Male, lcsh:Diseases of the circulatory (Cardiovascular) system, cardiopulmonary exercise test, heart failure, prognosis, ventilation efficiency, medicine.medical_treatment, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, 030204 cardiovascular system & hematology, Ventricular Function, Left, 0302 clinical medicine, Original Research Articles, Original Research Article, 030212 general & internal medicine, Lung, Aged, 80 and over, education.field_of_study, Ejection fraction, Age Factors, Middle Aged, Net reclassification improvement, Italy, Cardiology, Female, Cardiology and Cardiovascular Medicine, Cardiopulmonary exercise test, Prognosis, Ventilation efficiency, Heart failure, Adult, medicine.medical_specialty, Adolescent, Prognosi, Population, Age and gender, Young Adult, 03 medical and health sciences, Oxygen Consumption, Sex Factors, Internal medicine, Linear regression, medicine, Humans, education, Exercise, Aged, Retrospective Studies, Cardiovascular mortality, business.industry, Stroke Volume, medicine.disease, lcsh:RC666-701, Ventricular assist device, Exercise Test, Morbidity, business, human activities, Follow-Up Studies, Forecasting
Abstract

Aims Ventilation vs. carbon dioxide production (VE/VCO2) is among the strongest cardiopulmonary exercise testing prognostic parameters in heart failure (HF). It is usually reported as an absolute value. The current definition of normal VE/VCO2 slope values is inadequate, since it was built from small groups of subjects with a particularly limited number of women and elderly. We aimed to define VE/VCO2 slope prediction formulas in a sizable population and to test whether the prognostic power of VE/VCO2 slope in HF was different if expressed as a percentage of the predicted value or as an absolute value. Methods and results We calculated the linear regressions between age and VE/VCO2 slope in 1136 healthy subjects (68% male, age 44.9 ± 14.5, range 13–83 years). We then applied age‐adjusted and sex‐adjusted formulas to predict VE/VCO2 slope to HF patients included in the metabolic exercise test data combined with cardiac and kidney indexes score database, which counts 6112 patients (82% male, age 61.4 ± 12.8, left ventricular ejection fraction 33.2 ± 10.5%, peakVO2 14.8 ± 4.9, mL/min/kg, VE/VCO2 slope 32.7 ± 7.7) from 24 HF centres. Finally, we evaluated whether the use of absolute values vs. percentages of predicted VE/VCO2 affected HF prognosis prediction (composite of cardiovascular mortality + urgent transplant or left ventricular assist device). We did so in the entire cardiac and kidney indexes score population and separately in HF patients with severe (peakVO2 < 14 mL/min/kg, n = 2919, 61.1 events/1000 pts/year) or moderate (peakVO2 ≥ 14 mL/min/kg, n = 3183, 19.9 events/1000 pts/year) HF. In the healthy population, we obtained the following equations: female, VE/VCO2 = 0.052 × Age + 23.808 (r = 0.192); male, VE/VCO2 = 0.095 × Age + 20.227 (r = 0.371) (P = 0.007). We applied these formulas to calculate the percentages of predicted VE/VCO2 values. The 2‐year survival prognostic power of VE/VCO2 slope was strong, and it was similar if expressed as absolute value or as a percentage of predicted value (AUCs 0.686 and 0.690, respectively). In contrast, in severe HF patients, AUCs significantly differed between absolute values (0.637) and percentages of predicted values (0.650, P = 0.0026). Moreover, VE/VCO2 slope expressed as a percentage of predicted value allowed to reclassify 6.6% of peakVO2 < 14 mL/min/kg patients (net reclassification improvement = 0.066, P = 0.0015). Conclusions The percentage of predicted VE/VCO2 slope value strengthens the prognostic power of VE/VCO2 in severe HF patients, and it should be preferred over the absolute value for HF prognostication. Furthermore, the widespread use of VE/VCO2 slope expressed as percentage of predicted value can improve our ability to identify HF patients at high risk, which is a goal of utmost clinical relevance.

Published
2020

17. Choosing among β-blockers in heart failure patients according to β-receptors’ location and functions in the cardiopulmonary system

Author

Damiano Magrì, Mauro Contini, Stefania Paolillo, Susanna Sciomer, Piergiuseppe Agostoni, Pasquale Perrone Filardi, Gianfranco Sinagra, Roberto Badagliacca, Ugo Corrà, Sinagra, G., Corra, U., Contini, M., Magri, D., Paolillo, S., Perrone Filardi, P., Sciomer, S., Badagliacca, R., and Agostoni, P.

Subjects
Male, 0301 basic medicine, Nebivolol, 0302 clinical medicine, Quality of life, β-blocker, CID: 2585, 189562 [Nebivolol, CID], Lung, Metoprolol, CID: 441308, Carvedilol, CID: 2585, Sotalol, CID: 66245, Middle Aged, Prognosis, CID: 441308, CID: 2405, Bisoprolol, CID: 2405, Cardiopulmonary interaction, Heart failure, Nebivolol, CID: 189562, Sotalol, CID: 66245, β-receptor, Treatment Outcome, 030220 oncology & carcinogenesis, beta-blocker, Female, Algorithms, Signal Transduction, Metoprolol, medicine.medical_specialty, Prognosi, heart failure, beta-receptor, lung, prognosis, cardiopulmonary interaction, Adrenergic beta-Antagonists, Clinical Decision-Making, Context (language use), Respiratory physiology, Decision Support Techniques, 2585 [Carvedilol, CID], 03 medical and health sciences, CID: 189562, Receptors, Adrenergic, beta, medicine, Humans, Bisoprolol, In patient, Intensive care medicine, Aged, Cardiovascular mortality, Pharmacology, business.industry, Myocardium, 441308 [Metoprolol, CID], medicine.disease, β receptor, Clinical trial, 2405 [Bisoprolol, CID], 030104 developmental biology, Chronic Disease, 66245 [Sotalol, CID], Carvedilol, business
Abstract

Several large clinical trials showed a favorable effect of β-blocker treatment in patients with chronic heart failure (HF) as regards overall mortality, cardiovascular mortality, and hospitalizations. Indeed, the use of β-blockers is strongly recommended by current international guidelines, and it remains a cornerstone in the pharmacological treatment of HF. Although different types of β-blockers are currently approved for HF therapy, possible criteria to choose the best β-blocking agent according to HF patients’ characteristics and to β-receptors’ location and functions in the cardiopulmonary system are still lacking. In such a context, a growing body of literature shows remarkable differences between β-blocker types (β1-selective blockers versus β1-β2 blockers) with respect to alveolar-capillary gas diffusion and chemoreceptor response in HF patients, both factors able to impact on quality of life and, most likely, on prognosis. This review suggests an original algorithm for choosing among the currently available β-blocking agents based on the knowledge of cardiopulmonary pathophysiology. Particularly, starting from lung physiology and from some experimental models, it focuses on the mechanisms underlying lung mechanics, chemoreceptors, and alveolar-capillary unit impairment in HF. This paper also remarks the significant benefit deriving from the correct use of the different β-blockers in HF patients through a brief overview of the most important clinical trials.

Published
2020

18. Cardiovascular Death Risk in Recovered Mid-Range Ejection Fraction Heart Failure: Insights From Cardiopulmonary Exercise Test

Author

Magri', Damiano, Massimo, Piepol, Ugo, Corrà, Gallo, Giovanna, Maruotti, Antonello, Carlo, Vignati, Elisabetta, Salvioni, Massimo, Mapelli, Stefania, Paolillo, Pasquale Perrone Filardi, Davide, Girola, Metra, Marco, Angela, B Scardovi, Rocco, Lagioia, Giuseppe, Limongelli, Michele, Senni, Domenico, Scrutinio, Michele, Emdin, Claudio, Passino, Carlo, Lombardi, Gaia, Cattadori, Gianfranco, Parati, Mariantonietta, Cicoira, Michele, Correale, Maria, Frigerio, Francesco, Clemenza, Maurizio, Bussotti, Guazzi, Marco, Badagliacca, Roberto, Sciomer, Susanna, Andrea Di Lenarda, Aldo, Maggioni, Gianfranco, Sinagra, Volpe, Massimo, Piergiuseppe, Agostoni, MECKI score Research Group, Magri, D., Piepoli, M., Corra, U. G. O., Gallo, G., Maruotti, A., Vignati, C., Salvioni, E., Mapelli, M., Paolillo, S., PERRONE FILARDI, P., Girola, D., Metra, M., Scardovi, A. B., Lagioia, R., Limongelli, G., Senni, M., Scrutinio, D., Emdin, M., Passino, C., Lombardi, C., Cattadori, G. A. I. A., Parati, G., Cicoira, M., Correale, M., Frigerio, M., Clemenza, F., Bussotti, M., Guazzi, M., Badagliacca, R., Sciomer, S., DI LENARDA, A., Maggioni, A. L. D. O., Sinagra, G., Volpe, M., Agostoni, P., Magrì, D, Piepoli, M, Corrà, U, Gallo, G, Maruotti, A, Vignati, C, Salvioni, E, Mapelli, M, Paolillo, S, Perrone Filardi, P, Girola, D, Metra, M, Scardovi, A, Lagioia, R, Limongelli, G, Senni, M, Scrutinio, D, Emdin, M, Passino, C, Lombardi, C, Cattadori, G, Parati, G, Cicoira, M, Correale, M, Frigerio, M, Clemenza, F, Bussotti, M, Guazzi, M, Badagliacca, R, Sciomer, S, DI Lenarda, A, Maggioni, A, Sinagra, G, Volpe, M, and Agostoni, P

Subjects
medicine.medical_specialty, Multivariate analysis, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Heart failure, 030204 cardiovascular system & hematology, Cardiovascular death, heart failure, mecki score, cardiopulmonary exercise test, prognosis, 03 medical and health sciences, 0302 clinical medicine, MECKI score, Internal medicine, Cardiopulmonary exercise test, Cause of Death, medicine, Humans, 030212 general & internal medicine, Ejection fraction, End point, business.industry, VO2 max, Cardiopulmonary exercise testing, Stroke Volume, medicine.disease, Cardiology, Exercise Test, Cardiology and Cardiovascular Medicine, business, prognosi
Abstract

Background Heart failure with midrange ejection fraction (HFmrEF) represents a heterogeneous category where phenotype, as well as prognostic assessment, remains debated. The present study explores a specific HFmrEF subset, namely those who recovered from a reduced EF (rec-HFmrEF) and, particularly, it focuses on the possible additive prognostic role of cardiopulmonary exercise testing. Methods and Results We analyzed data from 4535 patients with HFrEF and 1176 patients with rec-HFmrEF from the Metabolic Exercise combined with Cardiac and Kidney Indexes database. The end point was cardiovascular death at 5 years. The median follow-up was 1343 days (25th–75th range 627–2403 days). Cardiovascular death occurred in 552 HFrEF and 61 rec-HFmrEF patients. The multivariate analysis confirmed an independent role of the MECKI score's variables in HFrEF (C-index = 0.744) whereas, in the rec-HFmrEF group, only age and peak oxygen uptake (pVO2) remained associated to the end point (C-index = 0.745). A peak oxygen uptake of ≤55% of predicted and a ventilatory efficiency of ≥31 resulted as the most accurate cut-off values in the outcome prediction. Conclusions: Present data support the cardiopulmonary exercise test and, particularly, the peak oxygen uptake, as a useful tool in the rec-HFmrEF prognostic assessment. A peak VO2 of ≤55% predicted and ventilatory efficiency of ≥31 might help to identify a high-risk rec-HFmrEF subgroup.

Published
2020

19. Long-term prognostic role of diabetes mellitus and glycemic control in heart failure patients with reduced ejection fraction: Insights from the MECKI Score database

Author

Stefania, Paolillo, Elisabetta, Salvioni, Pasquale, Perrone Filardi, Alice, Bonomi, Gianfranco, Sinagra, Piero, Gentile, Paola, Gargiulo, Alessandra, Scoccia, Nicola, Cosentino, Paola, Gugliandolo, Roberto, Badagliacca, Rocco, Lagioia, Michele, Correale, Maria, Frigerio, Enrico, Perna, Massimo, Piepoli, Federica, Re, Rosa, Raimondo, Chiara, Minà, Francesco, Clemenza, Maurizio, Bussotti, Giuseppe, Limongelli, Rita, Gravino, Andrea, Passantino, Damiano, Magrì, Gianfranco, Parati, Sergio, Caravita, Angela B, Scardovi, Luca, Arcari, Carlo, Vignati, Massimo, Mapelli, Gaia, Cattadori, Carlo, Cavaliere, Ugo, Corrà, Piergiuseppe, Agostoni, Paolillo, S, Salvioni, E, Perrone Filardi, P, Bonomi, A, Sinagra, G, Gentile, P, Gargiulo, P, Scoccia, A, Cosentino, N, Gugliandolo, P, Badagliacca, R, Lagioia, R, Correale, M, Frigerio, M, Perna, E, Piepoli, M, Re, F, Raimondo, R, Minà, C, Clemenza, F, Bussotti, M, Limongelli, G, Gravino, R, Passantino, A, Magrì, D, Parati, G, Caravita, S, Scardovi, Ab, Arcari, L, Vignati, C, Mapelli, M, Cattadori, G, Cavaliere, C, Corrà, U, Agostoni, P, Paolillo, S., Salvioni, E., Perrone Filardi, P., Bonomi, A., Sinagra, G., Gentile, P., Gargiulo, P., Scoccia, A., Cosentino, N., Gugliandolo, P., Badagliacca, R., Lagioia, R., Correale, M., Frigerio, M., Perna, E., Piepoli, M., Re, F., Raimondo, R., Mina, C., Clemenza, F., Bussotti, M., Limongelli, G., Gravino, R., Passantino, A., Magri, D., Parati, G., Caravita, S., Scardovi, A. B., Arcari, L., Vignati, C., Mapelli, M., Cattadori, G., Cavaliere, C., Corra, U., and Agostoni, P.

Subjects
Diabetes mellitu, Diabetes mellitus, Glycated hemoglobin, Humans, Stroke Volume, Heart failure, Prognosis, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Glycemic Control, diabetes mellitus, glycated hemoglobin, heart failure, prognosis, glycemic control, humans, kidney, stroke volume, Kidney
Abstract

Background: The prognostic role of diabetes mellitus (DM) in heart failure (HF) patients is undefined, since DM is outweighed by several DM-related variables when confounders are considered. We determined the prognostic role of DM, treatment, and glycemic control in a real-life HF population. Methods: 3927 HF patients included in the Metabolic Exercise Cardiac Kidney Index (MECKI) score database were evaluated with a median follow-up of 3.66 years (IQR 1.70–6.67). Data analysis considered survival between DM (n = 897) vs. non-DM (n = 3030) patients, and, in diabetics, between insulin (n = 304), oral antidiabetics (n = 479), and dietary only (n = 88) treatments. The role of glycemic control was evaluated grouping DM patients according to glycated hemoglobin (HbA1c): 8% (n = 149). All analyses were performed also adjusting for ejection fraction, renal function, hemoglobin, sodium, exercise peak oxygen uptake, and ventilation/carbon dioxide relationship slope. Study primary endpoint was the composite of cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation. Secondary endpoints were cardiovascular and all causes death. Results: For all endpoints, upon adjustment for confounders, DM status and insulin treatment or dietary regimen were not significantly associated with adverse long-term prognosis compared to non-DM and oral antidiabetic treated patients, respectively. A worse prognosis was observed in HbA1c >8% patients (Log-Rank p < 0.001), even after correction for confounding factors. All results were replicated by hazard ratio analysis. Conclusion: In HF patients, DM, insulin treatment and dietary regimen are not adverse outcome predictors. The only condition related to long-term prognosis, considering potential confounders, is poor glycemic control.

Published
2020

20. Increased serum uric acid level predicts poor prognosis in mildly severe chronic heart failure with reduced ejection fraction. An analysis from the MECKI score research group

Author

Angela Beatrice Scardovi, Michele Correale, Carlo Lombardi, Roberto Badagliacca, Francesco Doni, Gianfranco Sinagra, Giuseppe Limongelli, Federica Re, Piergiuseppe Agostoni, Elisabetta Salvioni, Francesco Clemenza, Stefania Paolillo, Ugo Corrà, Rocco La Gioia, Massimo Francesco Piepoli, Michele Emdin, Rosa Raimondo, Alice Bonomi, Mariantonietta Cicoira, Piepoli, M. F., Salvioni, E., Corra, U., Doni, F., Bonomi, A., La Gioia, R., Limongelli, G., Paolillo, S., Sinagra, G., Scardovi, A. B., Raimondo, R., Emdin, M., Re, F., Cicoira, M., Correale, M., Badagliacca, R., Clemenza, F., Lombardi, C., and Agostoni, P.

Subjects
Uric acid, prognosis, medicine.medical_specialty, Poor prognosis, Renal function, Heart failure, 030204 cardiovascular system & hematology, Nyha class, 03 medical and health sciences, Ventricular Dysfunction, Left, heart failure, prognosis, uric acid, 0302 clinical medicine, Kidney function, male, left, Internal medicine, middle aged, Internal Medicine, medicine, 030212 general & internal medicine, Hyperuricemia, Hemoglobin, humans, Cardiopulmonary exercise test, Kidney, Ejection fraction, business.industry, Increased serum uric acid, ventricular dysfunction, medicine.disease, aged, medicine.anatomical_structure, stroke volume, Cardiology, business, cardiopulmonary exercise test, hemoglobin, kidney function, uric acid, prognosis, ventricular dysfunction, left
Abstract

Background: Hyperuricemia prognostic impact on clinical outcomes in chronic heart failure (HF) patients has been investigated with inconclusive results. Objectives: Aim of the study was to evaluate the prognostic impact of serum uric acid (SUA) on long-term clinical outcomes in HF. Methods: An analysis of MECKI (Metabolic Exercise Cardiac Kidney Index) database, with median follow-up of 3.4 years. Results: Relation between SUA and all-cause/ cardiovascular (CV) deaths have been analysed in 4,577 patients (3,688 males, age 62.7 ± 12.9 years), with reduced ejection fraction HF (35 ± 11%), peakVO2 1151 ± 440 ml/min; NYHA class I-II (72.6%), III-IV (27.4%). SUA was associated with increased total and CV mortality (HR 1.120 and HR 1.128, respectively p < 0.0001), also after adjustment for peakVO2, VE/VCO2 slope, diuretic use and MECKI score. SUA was significantly associated with CV mortality only in NYHA class I-II (HR 1.17, p < 0.0001) while there was no association in class III-IV (HR 1.03, p = NS). No prognostic added values of SUA with respect to the MECKI score was observed at the ROC analysis. Conclusions: SUA is confirmed to be associated with increased mortality, but in less severe HF only. However SUA did not show additional prognostic power to the MECKI score

Published
2020

21. The metabolic exercise test data combined with Cardiac And Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study

Author

Corrà, Ugo, Agostoni, Piergiuseppe, Giordano, Andrea, Cattadori, Gaia, Battaia, Elisa, La Gioia, Rocco, Scardovi, Angela B., Emdin, Michele, Metra, Marco, Sinagra, Gianfranco, Limongelli, Giuseppe, Raimondo, Rosa, Federica, Re, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Magri', Damiano, Fiorentini, Cesare, Cicoira, Mariantonietta, Salvioni, Elisabetta, Giovannardi, Marta, Veglia, Fabrizio, Mezzani, Alessandro, Scrutinio, Domenico, Di Lenarda, Andrea, Ricci, Roberto, Apostolo, Anna, Iorio, Anna Maria, Paolillo, Stefania, Palermo, Pietro, Contini, Mauro, Vassanelli, Corrado, Passino, Claudio, Giannuzzi, Pantaleo, Piepoli, Massimo F., MECKI ScoreResearch Group, Other Members of the MECKI Score research Group, Antonioli, L., Segurini, C., Bertella, E., Farina, S., Bovis, F., Pietrucci, F., Malfatto, G., Roselli, T., Buono, A., Calabrò, R., De Maria, R., Santoro, D., Campanale, S., Caputo, D., Bertipaglia, D., Berton, E., Corrà, Ugo, Agostoni, Piergiuseppe, Giordano, Andrea, Cattadori, Gaia, Battaia, Elisa, La Gioia, Rocco, Scardovi, Angela B., Emdin, Michele, Metra, Marco, Sinagra, Gianfranco, Limongelli, Giuseppe, Raimondo, Rosa, Re, Federica, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Magrì, Damiano, Fiorentini, Cesare, Cicoira, Mariantonietta, Salvioni, Elisabetta, Giovannardi, Marta, Veglia, Fabrizio, Mezzani, Alessandro, Scrutinio, Domenico, DI LENARDA, Andrea, Ricci, Roberto, Apostolo, Anna, Iorio, Anna Maria, Paolillo, Stefania, Palermo, Pietro, Contini, Mauro, Vassanelli, Corrado, Passino, Claudio, Giannuzzi, Pantaleo, Piepoli, Massimo F., Corra, U., Agostoni, P., Giordano, A., Cattadori, G., Battaia, E., La Gioia, R., Scardovi, A. B., Emdin, M., Metra, M., Sinagra, G., Limongelli, G., Raimondo, R., Re, F., Guazzi, M., Belardinelli, R., Parati, G., Magri, D., Fiorentini, C., Cicoira, M., Salvioni, E., Giovannardi, M., Veglia, F., Mezzani, A., Scrutinio, D., Di Lenarda, A., Ricci, R., Apostolo, A., Iorio, A. M., Paolillo, S., Palermo, P., Contini, M., Vassanelli, C., Passino, C., Giannuzzi, P., Piepoli, M. F., Corrà, U, Agostoni, P, Giordano, A, Cattadori, G, Battaia, E, La Gioia, R, Scardovi, A, Emdin, M, Metra, M, Sinagra, G, Limongelli, G, Raimondo, R, Re, F, Guazzi, M, Belardinelli, R, Parati, G, Magrì, D, Fiorentini, C, Cicoira, M, Salvioni, E, Giovannardi, M, Veglia, F, Mezzani, A, Scrutinio, D, Di Lenarda, A, Ricci, R, Apostolo, A, Iorio, A, Paolillo, S, Palermo, P, Contini, M, Vassanelli, C, Passino, C, Giannuzzi, P, and Piepoli, M

Subjects
Male, medicine.medical_treatment, Predictive Value of Test, 030204 cardiovascular system & hematology, Kidney Function Tests, Severity of Illness Index, 0302 clinical medicine, score, 030212 general & internal medicine, Heart transplantation, education.field_of_study, Ejection fraction, Heart Function Test, Stroke volume, Middle Aged, Prognosis, Predictive value of tests, Heart Function Tests, Cardiology, Female, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Prognosi, Population, Renal function, Heart failure, Prognosis, score, Lower risk, Follow-Up Studie, 03 medical and health sciences, Oxygen Consumption, Predictive Value of Tests, Internal medicine, medicine, Humans, medicine (all), education, Aged, Kidney Function Test, business.industry, heart failure, prognosis, score, aged, exercise test, female, follow-up studies, heart function tests, heart transplantation, humans, kidney function tests, male, middle aged, oxygen consumption, predictive value of tests, prognosis, severity of illness index, stroke volume, cardiology and cardiovascular medicine, Stroke Volume, medicine.disease, Exercise Test, Follow-Up Studies, Heart Failure, Heart Transplantation, business
Abstract

Background The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is a prognostic model to identify heart failure (HF) patients at risk for cardiovascular mortality (CVM) and urgent heart transplantation (uHT) based on 6 routine clinical parameters: hemoglobin, sodium, kidney function by the Modification of Diet in Renal Disease (MDRD) equation, left ventricle ejection fraction (LVEF), percentage of predicted peak oxygen consumption (VO2) and VE/VCO2 slope. Objectives MECKI score must be generalizable to be considered useful: therefore, its performance was validated in a new sequence of HF patients. Methods Both the development (MECKI-D) and the validation (MECKI-V) cohorts were composed of consecutive HF patients with LVEF < 40% able to perform a symptom-limited cardiopulmonary exercise testing. The CVM or uHT rates were analyzed at one, two and three years in both cohorts: all patients with a censoring time shorter than the scheduled follow-up were excluded, while those with events occurring after 1, 2 and 3 years were considered as censored. Results MECKI-D and MECKI-V consisted of 2009 and 992 patients, respectively. MECKI-V patients had a higher LVEF, higher peak VO2 and lower VE/VCO2 slope, higher prescription of beta-blockers and device therapy: after the 3-year follow-up, CVM or uHT occurred in 206 (18%) MECKI-D and 44 (13%) MECKI-V patients (p < 0.000), respectively. MECKI-V AUC values at one, two and three years were 0.81 ± 0.04, 0.76 ± 0.04, and 0.80 ± 0.03, respectively, not significantly different from MECKI-D. Conclusions MECKI score preserves its predictive ability in a HF population at a lower risk.

Published
2016
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22. Anaerobic Threshold and Respiratory Compensation Point Identification During Cardiopulmonary Exercise Tests in Chronic Heart Failure

Author

Carlo Vignati, Susanna Sciomer, Marco Merlo, Simone Barbieri, Massimo Mapelli, Piergiuseppe Agostoni, Alice Bonomi, Gianfranco Sinagra, Elisabetta Salvioni, Francesca Maria Righini, Federica Moscucci, Cosimo Carriere, Massimo F Piepoli, Simone Binno, Ugo Corrà, Fabrizio Veglia, Carriere, C., Corra, U., Piepoli, M., Bonomi, A., Merlo, M., Barbieri, S., Salvioni, E., Binno, S., Mapelli, M., Righini, F., Sciomer, S., Vignati, C., Moscucci, F., Veglia, F., Sinagra, G., and Agostoni, P.

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Anaerobic Threshold, heart failure, Critical Care and Intensive Care Medicine, Respiratory compensation, Incremental exercise, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Internal medicine, Medicine, Humans, anaerobic threshold, exercise, prognosis, respiratory compensation point, 030212 general & internal medicine, Aged, Retrospective Studies, Heart Failure, Ejection fraction, Exercise Tolerance, business.industry, Hazard ratio, VO2 max, Stroke Volume, Middle Aged, medicine.disease, 030228 respiratory system, Heart failure, Chronic Disease, Cardiology, Exercise Test, Female, Cardiology and Cardiovascular Medicine, business, Anaerobic exercise, prognosi
Abstract

Background We evaluated the prognostic meaning of the simple presence or absence of identifiable anaerobic threshold (AT) and respiratory compensation point (RCP) at cardiopulmonary exercise tests (CPETs) performed with a maximal incremental exercise protocol. Methods In the present multicenter study, we retrospectively analyzed data in 1,995 patients with heart failure with reduced ejection fraction (HFrEF). All underwent clinical and laboratory evaluation, echocardiography, and maximal CPET at baseline. The analysis was performed according to absence of identified AT and RCP (group 1: n = 292; 15%), presence of AT but absence of identified RCP (group 2: n = 920; 46%), and presence of both AT and RCP (group 3: n = 783; 39%). The study end point was the composite of cardiovascular mortality, urgent heart transplant, and left ventricular assist device implantation. Results Median follow-up was 2.97 years (interquartile range, 1.50-5.35 years). Eighty-seven (30%), 169 (18%), and 111 (14%) events were observed in groups 1, 2, and 3, respectively (P = .025). Compared with results in group 3 (patients with the best survival), the likelihood of reaching the study end point increased 2.7 times when neither AT nor RCP were identified (hazard ratio, 2.74) and 1.4 times when only AT was identified (hazard ratio, 1.4). Moreover, adding the presence or absence of identified AT and RCP improved the prognostic power of peak oxygen uptake because a significant reclassification was obtained. Conclusions AT and RCP identification has a potential role in the prognostic stratification of HFrEF.

Published
2018

23. Multiparametric prognostic scores in chronic heart failure with reduced ejection fraction: a long-term comparison

Author

Agostoni, Piergiuseppe, Paolillo, Stefania, Mapelli, Massimo, Gentile, Piero, Salvioni, Elisabetta, Veglia, Fabrizio, Bonomi, Alice, Corrà , Ugo, Lagioia, Rocco, Limongelli, Giuseppe, Sinagra, Gianfranco, Cattadori, Gaia, Scardovi, Angela B., Metra, Marco, Carubelli, Valentina, Scrutinio, Domenico, Raimondo, Rosa, Emdin, Michele, Piepoli, Massimo, Magrì, Damiano, Parati, Gianfranco, Caravita, Sergio, Re, Federica, Cicoira, Mariantonietta, Minà , Chiara, Correale, Michele, Frigerio, Maria, Bussotti, Maurizio, Oliva, Fabrizio, Battaia, Elisa, Belardinelli, Romualdo, Mezzani, Alessandro, Pastormerlo, Luigi, Guazzi, Marco, Badagliacca, Roberto, Di Lenarda, Andrea, Passino, Claudio, Sciomer, Susanna, Zambon, Elena, Pacileo, Giuseppe, Ricci, Roberto, Apostolo, Anna, Palermo, Pietro, Contini, Mauro, Clemenza, Francesco, Marchese, Giovanni, Gargiulo, Paola, Binno, Simone, Lombardi, Carlo, Passantino, Andrea, Filardi, Pasquale Perrone, Agostoni, P, Paolillo, S, Mapelli, M, Gentile, P, Salvioni, E, Veglia, F, Bonomi, A, Corrà, U, Lagioia, R, Limongelli, G, Sinagra, G, Cattadori, G, Scardovi, A, Metra, M, Carubelli, V, Scrutinio, D, Raimondo, R, Emdin, M, Piepoli, M, Magrì, D, Parati, G, Caravita, S, Re, F, Cicoira, M, Minà, C, Correale, M, Frigerio, M, Bussotti, M, Oliva, F, Battaia, E, Belardinelli, R, Mezzani, A, Pastormerlo, L, Guazzi, M, Badagliacca, R, Di Lenarda, A, Passino, C, Sciomer, S, Zambon, E, Pacileo, G, Ricci, R, Apostolo, A, Palermo, P, Contini, M, Clemenza, F, Marchese, G, Gargiulo, P, Binno, S, Lombardi, C, Passantino, A, Filardi, P, Scardovi, Ab, CARAVITA DI TORITTO, Beniamino, Perrone Filardi, P., Agostoni, P., Paolillo, S., Mapelli, M., Gentile, P., Salvioni, E., Veglia, F., Bonomi, A., Corra, U., Lagioia, R., Limongelli, G., Sinagra, G., Cattadori, G., Scardovi, A. B., Metra, M., Carubelli, V., Scrutinio, D., Guarino, Raimondo, Emdin, M., Piepoli, M., Magri, D., Parati, G., Caravita, S., Re, F., Cicoira, M., Mina, C., Correale, M., Frigerio, M., Bussotti, M., Oliva, F., Battaia, E., Belardinelli, R., Mezzani, A., Pastormerlo, L., Guazzi, M., Badagliacca, R., Di Lenarda, A., Passino, C., Sciomer, S., Zambon, E., Pacileo, G., Ricci, R., Apostolo, A., Palermo, P., Contini, M., Clemenza, F., Marchese, G., Gargiulo, P., Binno, S., Lombardi, C., Passantino, A., Filardi, P. P., Agostoni, Piergiuseppe, Paolillo, Stefania, Mapelli, Massimo, Gentile, Piero, Salvioni, Elisabetta, Veglia, Fabrizio, Bonomi, Alice, Corrã , Ugo, Lagioia, Rocco, Limongelli, Giuseppe, Sinagra, Gianfranco, Cattadori, Gaia, Scardovi, Angela B., Metra, Marco, Carubelli, Valentina, Scrutinio, Domenico, Raimondo, Rosa, Emdin, Michele, Piepoli, Massimo, Magrã¬, Damiano, Parati, Gianfranco, Caravita, Sergio, Re, Federica, Cicoira, Mariantonietta, Minã , Chiara, Correale, Michele, Frigerio, Maria, Bussotti, Maurizio, Oliva, Fabrizio, Battaia, Elisa, Belardinelli, Romualdo, Mezzani, Alessandro, Pastormerlo, Luigi, Guazzi, Marco, Badagliacca, Roberto, Di Lenarda, Andrea, Passino, Claudio, Sciomer, Susanna, Zambon, Elena, Pacileo, Giuseppe, Ricci, Roberto, Apostolo, Anna, Palermo, Pietro, Contini, Mauro, Clemenza, Francesco, Marchese, Giovanni, Gargiulo, Paola, Binno, Simone, Lombardi, Carlo, Passantino, Andrea, and Filardi, Pasquale Perrone

Subjects
Male, Time Factors, Heart-Assist Device, Time Factor, Prognosi, Reproducibility of Result, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Heart failure, Risk Assessment, Follow-Up Studie, Oxygen Consumption, HFSS, Cause of Death, MECKI score, Prognosis, Risk score, SHFM, Exercise Test, Female, Follow-Up Studies, Heart Failure, Heart Transplantation, Heart-Assist Devices, Humans, Italy, Middle Aged, Morbidity, Prospective Studies, Reproducibility of Results, Stroke Volume, Survival Rate, Disease Management, heart failure, prognosis, heart failure, prognosis, risk score, cardiology and cardiovascular medicine, Prospective Studie, Human
Abstract

Aims: Risk stratification in heart failure (HF) is crucial for clinical and therapeutic management. A multiparametric approach is the best method to stratify prognosis. In 2012, the Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score was proposed to assess the risk of cardiovascular mortality and urgent heart transplantation. The aim of the present study was to compare the prognostic accuracy of MECKI score to that of HF Survival Score (HFSS) and Seattle HF Model (SHFM) in a large, multicentre cohort of HF patients with reduced ejection fraction. Methods and results: We collected data on 6112 HF patients and compared the prognostic accuracy of MECKI score, HFSS, and SHFM at 2- and 4-year follow-up for the combined endpoint of cardiovascular death, urgent cardiac transplantation, or ventricular assist device implantation. Patients were followed up for a median of 3.67 years, and 931 cardiovascular deaths, 160 urgent heart transplantations, and 12 ventricular assist device implantations were recorded. At 2-year follow-up, the prognostic accuracy of MECKI score was significantly superior [area under the curve (AUC) 0.781] to that of SHFM (AUC 0.739) and HFSS (AUC 0.723), and this relationship was also confirmed at 4 years (AUC 0.764, 0.725, and 0.720, respectively). Conclusion: In this cohort, the prognostic accuracy of the MECKI score was superior to that of HFSS and SHFM at 2- and 4-year follow-up in HF patients in stable clinical condition. The MECKI score may be useful to improve resource allocation and patient outcome, but prospective evaluation is needed.

Published
2018

24. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)

Author

Maxime Guenoun, Olov Wiklund, Christian Albus, Scipione Carerj, Carlos Brotons, Guillaume Turc, Paulus Kirchhof, Donna Fitzsimons, Borut Jug, Gregory Y.H. Lip, Marco Roffi, Alessandro Mezzani, Christi Deaton, Eva Prescott, Additional Contributor: Simone Binno, John Cox, Massimo Piepoli, Stefan Agewall, Bernard Cosyns, Michael Stephen Hall, W M Monique Verschuren, Giuseppe Mancia, Alexander Niessner, Pedro Marques-Vidal, Ugo Corrà, Monica Tiberi, Norbert Bachl, Herbert Löllgen, H. Bart van der Worp, Dimitrios J. Richter, Leslie Cho, Lars Rydén, Johan De Sutter, Arno W. Hoes, François Mach, Franz Martin Bermudo, Y.M. Smulders, Josep Redon, Maja-Lisa Løchen, F. D. Richard Hobbs, Alberico L. Catapano, Günther Egidi, Victor Aboyans, Piotr Ponikowski, Héctor Bueno, Ineke van Dis, Stephan Windecker, Ian D. Graham, Naveed Sattar, José Luis Zamorano, Joep Perk, Adrienne Stauder, Bernhard Rauch, Oscar H. Franco, Guy De Backer, Marie-Therese Cooney, Kornelia Kotseva, Miles Fisher, Catriona Jennings, Piepoli, M, Hoes, A, Agewall, S, Albus, C, Brotons, C, Catapano, A, Cooney, M, Corra, U, Cosyns, B, Deaton, C, Graham, I, Hall, M, Richard Hobbs, F, Løchen, M, Lollgen, H, Marques-Vidal, P, Perk, J, Prescott, E, Redon, J, Richter, D, Sattar, N, Smulders, Y, Tiberi, M, Bart Van Der Worp, H, Van Dis, I, Monique Verschuren, W, De Backer, G, Roffi, M, Aboyans, V, Bachl, N, Bueno, H, Carerj, S, Cho, L, Cox, J, De Sutter, J, Egidi, G, Fisher, M, Fitzsimons, D, Franco, O, Guenoun, M, Jennings, C, Jug, B, Kirchhof, P, Kotseva, K, Lip, G, Mach, F, Mancia, G, Bermudo, F, Mezzani, A, Niessner, A, Ponikowski, P, Rauch, B, Ryden, L, Stauder, A, Turc, G, Wiklund, O, Windecker, S, Zamorano, J, Clinical sciences, Cardio-vascular diseases, Vriendenkring VUB, Internal medicine, and ICaR - Circulation and metabolism

Subjects
Epidemiology, medicine.medical_treatment, Alternative medicine, physical activity, population, 030204 cardiovascular system & hematology, Guideline, Diabete, 0302 clinical medicine, prevention, Risk Factors, Cardiovascular Disease, Stakeholder, 030212 general & internal medicine, guidelines, 610 Medicine & health, stakeholder, Societies, Medical, Risk assessment, Advisory Committee, education.field_of_study, Rehabilitation, Cardiac Rehabilitation, diabetes, Diabetes, Smoking, Psychosocial factor, blood pressure, risk assessment, Lipid, Primary care, Clinical Practice, Europe, nutrition, Cardiovascular Diseases, Psychosocial factors, Blood pressure, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Population, Advisory Committees, Cardiology, Healthy lifestyle, Guidelines, risk management, smoking, rehabilitation, 03 medical and health sciences, primary care, Cardiovascular prevention, healthy lifestyle, lipid, medicine, Journal Article, Humans, Clinical settings, education, psychosocial factors, Nutrition, Physical activity, Prevention, Risk management, business.industry, Task force, Risk Factor, Clinical setting, Family medicine, Physical therapy, Disease prevention, business, clinical settings
Published
2016
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25. Sex Profile and Risk Assessment With Cardiopulmonary Exercise Testing in Heart Failure: Propensity Score Matching for Sex Selection Bias

Author

Domenico Scrutinio, Stefania Paolillo, Marco Metra, Cesare Fiorentini, Mariantonietta Cicoira, Michele Emdin, Corrado Vassanelli, Massimo F Piepoli, Angela Beatrice Scardovi, Alessandro Mezzani, Anna Maria Iorio, Marco Guazzi, Elisa Battaia, Rosa Raimondo, Andrea Di Lenarda, Pietro Palermo, Rocco La Gioia, Giuseppe Limongelli, Gianfranco Sinagra, Damiano Magrì, Federica Re, Piergiuseppe Agostoni, Andrea Giordano, Pantaleo Giannuzzi, Claudio Passino, Anna Apostolo, Elisabetta Salvioni, Gianfranco Parati, Fabrizio Veglia, Gaia Cattadori, Marta Giovannardi, Roberto Ricci, Mauro Contini, Ugo Corrà, Romualdo Belardinelli, Corrà, Ugo, Agostoni, Piergiuseppe, Giordano, Andrea, Cattadori, Gaia, Battaia, Elisa, La Gioia, Rocco, Scardovi, Angela B., Emdin, Michele, Metra, Marco, Sinagra, Gianfranco, Limongelli, Giuseppe, Raimondo, Rosa, Re, Federica, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Magrì, Damiano, Fiorentini, Cesare, Cicoira, Mariantonietta, Salvioni, Elisabetta, Giovannardi, Marta, Veglia, Fabrizio, Mezzani, Alessandro, Scrutinio, Domenico, DI LENARDA, Andrea, Ricci, Roberto, Apostolo, Anna, Iorio, Anna Maria, Paolillo, Stefania, Palermo, Pietro, Contini, Mauro, Vassanelli, Corrado, Passino, Claudio, Giannuzzi, Pantaleo, Piepoli, Massimo F., Corrà, U, Agostoni, P, Giordano, A, Cattadori, G, Battaia, E, La Gioia, R, Scardovi, A, Emdin, M, Metra, M, Sinagra, G, Limongelli, G, Raimondo, R, Re, F, Guazzi, M, Belardinelli, R, Parati, G, Magrì, D, Fiorentini, C, Cicoira, M, Salvioni, E, Giovannardi, M, Veglia, F, Mezzani, A, Scrutinio, D, Di Lenarda, A, Ricci, R, Apostolo, A, Iorio, A, Paolillo, S, Palermo, P, Contini, M, Vassanelli, C, Passino, C, Giannuzzi, P, Piepoli, M, Corra, U., Agostoni, P., Giordano, A., Cattadori, G., Battaia, E., La Gioia, R., Scardovi, A. B., Emdin, M., Metra, M., Sinagra, G., Limongelli, G., Raimondo, R., Re, F., Guazzi, M., Belardinelli, R., Parati, G., Magri, D., Fiorentini, C., Cicoira, M., Salvioni, E., Giovannardi, M., Veglia, F., Mezzani, A., Scrutinio, D., Di Lenarda, A., Ricci, R., Apostolo, A., Iorio, A. M., Paolillo, S., Palermo, P., Contini, M., Vassanelli, C., Passino, C., Giannuzzi, P., and Piepoli, M. F.

Subjects
Male, medicine.medical_specialty, Multivariate analysis, Databases, Factual, media_common.quotation_subject, Heart Failure, Cardiopulmonary exercise testing, Selection Bia, 030204 cardiovascular system & hematology, Risk Assessment, Ventricular Function, Left, Body Mass Index, Follow-Up Studie, 03 medical and health sciences, 0302 clinical medicine, Oxygen Consumption, Risk Factors, Internal medicine, medicine, Humans, 030212 general & internal medicine, cardiology and cardiovascular medicine, cardiopulmonary exercise test, sex selection, Propensity Score, Selection Bias, media_common, Aged, Selection bias, Heart Failure, Univariate analysis, business.industry, Risk Factor, Middle Aged, medicine.disease, Cardiopulmonary exercise testing, Italy, Heart failure, Propensity score matching, Cardiology, Physical therapy, Exercise Test, Population study, Female, business, Risk assessment, Cardiology and Cardiovascular Medicine, Body mass index, Follow-Up Studies, Human
Abstract

Background In heart failure (HF), women show better survival despite a comparatively low peak oxygen consumption ( V ˙ o 2 ): this raises doubt about the accuracy of risk assessment by cardiopulmonary exercise testing (CPET) in women. Accordingly, we aimed to check (1) whether the predictive role of well-known CPET risk indexes, ie, peak V ˙ o 2 and ventilatory response ( V ˙ e/ V ˙ co 2 slope), is sex independent and (2) if sex-related characteristics that impact outcome in HF should be considered as associations that may confound the effect of sex on survival. Methods The study population consisted of 2985 patients with HF, 498 (17%) of whom were women, from the multicentre Metabolic Exercise Test Data Combined with Cardiac and Kidney Indexes (MECKI): the end point was cardiovascular death within a 3-year period. Results During the follow-up, 305 (12%) men and 39 (8%) women ( P = 0.005) died, and female sex was linked to better survival on univariate analysis ( P = 0.008) and independent of peak V ˙ o 2 and V ˙ e/ V ˙ co 2 slope on multivariate analysis. According to propensity score matching for female sex to exclude a sex selection bias and sample discrepancy, 498 men were selected: the standardized percentage bias ranged from 20.8 ( P P = 0.667). After clinical profile harmonizing, female sex was predictive of HF at univariate analysis. Conclusions The low peak V ˙ o 2 and female association with better outcome in HF might be counterfeit: the female prognostic advantage is lost when sex-specific differences are correctly taken into account with propensity score matching, suggesting that for an effective and efficient HF model, adjustment must be made for sex-related characteristics.

Published
2016

26. Deceptive meaning of oxygen uptake measured at the anaerobic threshold in patients with systolic heart failure and atrial fibrillation

Author

Damiano, Magrì, Piergiuseppe, Agostoni, Ugo, Corrà, Claudio, Passino, Domenico, Scrutinio, Pasquale, Perrone-Filardi, Michele, Correale, Gaia, Cattadori, Marco, Metra, Davide, Girola, Massimo F, Piepoli, AnnaMaria, Iorio, Michele, Emdin, Rosa, Raimondo, Federica, Re, Mariantonietta, Cicoira, Romualdo, Belardinelli, Marco, Guazzi, Giuseppe, Limongelli, Francesco, Clemenza, Gianfranco, Parati, Maria, Frigerio, Matteo, Casenghi, Angela B, Scardovi, Alessandro, Ferraironi, Andrea, Di Lenarda, Maurizio, Bussotti, Anna, Apostolo, Stefania, Paolillo, Rocco, La Gioia, Paola, Gargiulo, Pietro, Palermo, Chiara, Minà, Stefania, Farina, Elisa, Battaia, Antonello, Maruotti, Giuseppe, Pacileo, Mauro, Contini, Fabrizio, Oliva, Roberto, Ricci, Gianfranco, Sinagra, Corrado, Vassanelli, Magrì, D, Agostoni, P, Corrà, U, Passino, C, Scrutinio, D, Perrone Filardi, P, Correale, M, Cattadori, G, Metra, M, Girola, D, Piepoli, M, Iorio, A, Emdin, M, Raimondo, R, Re, F, Cicoira, M, Belardinelli, R, Guazzi, M, Limongelli, G, Clemenza, F, Parati, G, Frigerio, M, Casenghi, M, Scardovi, A, Ferraironi, A, Di Lenarda, A, Bussotti, M, Apostolo, A, Paolillo, S, La Gioia, R, Gargiulo, P, Palermo, P, Minà, C, Farina, S, Battaia, E, Maruotti, A, Pacileo, G, Contini, M, Oliva, F, Ricci, R, Sinagra, G, Magrì, Damiano, Agostoni, Piergiuseppe, Corrà, Ugo, Passino, Claudio, Scrutinio, Domenico, Perrone Filardi, Pasquale, Correale, Michele, Cattadori, Gaia, Metra, Marco, Girola, Davide, Piepoli, Massimo F., Iorio, Annamaria, Emdin, Michele, Raimondo, Rosa, Re, Federica, Cicoira, Mariantonietta, Belardinelli, Romualdo, Guazzi, Marco, Limongelli, Giuseppe, Clemenza, Francesco, Parati, Gianfranco, Frigerio, Maria, Casenghi, Matteo, Scardovi, Angela B., Ferraironi, Alessandro, DI LENARDA, Andrea, Bussotti, Maurizio, Apostolo, Anna, Paolillo, Stefania, La Gioia, Rocco, Gargiulo, Paola, Palermo, Pietro, Minà, Chiara, Farina, Stefania, Battaia, Elisa, Maruotti, Antonello, Pacileo, Giuseppe, Contini, Mauro, Oliva, Fabrizio, Ricci, Roberto, Sinagra, Gianfranco, PERRONE FILARDI, Pasquale, Piepoli, Massimo F, Scardovi, Angela B, Di Lenarda, Andrea, Magri', D, Corra', U, PERRONE FILARDI, P, Correal, M, Piepoli, Mf, Iorio, Am, Raimonod, R, Cicoria, M, Scardovi, Ab, DI LENARDA, A, LA GIOIA, R, Mina', C, and Sinagra, G.

Subjects
Male, Time Factors, Digoxin, Anaerobic Threshold, Epidemiology, medicine.medical_treatment, Heart failure, anaerobic threshold, atrial fibrillation, exercise, prognosis, Predictive Value of Test, Kaplan-Meier Estimate, Risk Factors, Atrial Fibrillation, Sinus rhythm, Prospective Studies, Multivariate Analysi, Heart transplantation, Ejection fraction, Cardiology and Cardiovascular Medicine, Atrial fibrillation, Middle Aged, Prognosis, Italy, Area Under Curve, Cardiology, Female, Anaerobic exercise, prognosi, medicine.drug, Human, medicine.medical_specialty, Time Factor, Prognosi, Reproducibility of Result, Oxygen Consumption, Predictive Value of Tests, Internal medicine, Aged, Heart Failure, Systolic, Heart Transplantation, Humans, Multivariate Analysis, Proportional Hazards Models, ROC Curve, Reproducibility of Results, Exercise Test, medicine, business.industry, Risk Factor, medicine.disease, Transplantation, Prospective Studie, Proportional Hazards Model, business, Systolic
Abstract

Background: Oxygen uptake at the anaerobic threshold (VO 2 AT), a submaximal exercise-derived variable, independent of patients' motivation, is a marker of outcome in heart failure (HF). However, previous evidence of VO 2 AT values paradoxically higher in HF patients with permanent atrial fibrillation (AF) than in those with sinus rhythm (SR) raised uncertainties. Design: We tested the prognostic role of VO 2 AT in a large cohort of systolic HF patients, focusing on possible differences between SR and AF. Methods: Altogether 2976 HF patients (2578 with SR and 398 with AF) were prospectively followed. Besides a clinical examination, each patient underwent a maximal cardiopulmonary exercise test (CPET). Results: The follow-up was analysed for up to 1500 days. Cardiovascular death or urgent cardiac transplantation occurred in 303 patients (250 (9.6%) patients with SR and 53 (13.3%) patients with AF, p=0.023). In the entire population, multivariate analysis including peak oxygen uptake (VO 2 ) showed a prognostic capacity (C-index) similar to that obtained including VO 2 AT (0.76 vs 0.72). Also, left ventricular ejection fraction, ventilation vs carbon dioxide production slope, β-blocker and digoxin therapy proved to be significant prognostic indexes. The receiver-operating characteristic (ROC) curves analysis showed that the best predictive VO 2 AT cut-off for the SR group was 11.7 ml/kg/min, while it was 12.8 ml/kg/min for the AF group. Conclusions: VO 2 AT, a submaximal CPET-derived parameter, is reliable for long-term cardiovascular mortality prognostication in stable systolic HF. However, different VO 2 AT cut-off values between SR and AF HF patients should be adopted.

Published
2015

27. Exercise performance is a prognostic indicator in elderly patients with chronic heart failure: application of metabolic exercise cardiac kidney indexes score

Author

Valentina, Carubelli, Marco, Metra, Ugo, Corrà, Damiano, Magrì, Claudio, Passino, Carlo, Lombardi, Domenico, Scrutinio, Michele, Correale, Gaia, Cattadori, Massimo F, Piepoli, Elisabetta, Salvioni, Marta, Giovannardi, Rosa, Raimondo, Mariantonietta, Cicoira, Romualdo, Belardinelli, Marco, Guazzi, Giuseppe, Limongelli, Francesco, Clemenza, Gianfranco, Parati, Angela B, Scardovi, Andrea, Di Lenarda, Maurizio, Bussotti, Rocco, La Gioia, Piergiuseppe, Agostoni, Federica, Re, Carubelli, V., Metra, M., Corra, U., Magri, D., Passino, C., Lombardi, C., Scrutinio, D., Correale, M., Cattadori, G., Piepoli, M. F., Salvioni, E., Giovannardi, M., Raimondo, R., Cicoira, M., Belardinelli, R., Guazzi, M., Limongelli, G., Clemenza, F., Parati, G., Scardovi, A. B., Di Lenarda, A., Bussotti, M., La Gioia, R., Agostoni, P., Carubelli, V, Metra, M, Corrà, U, Magrì, D, Passino, C, Lombardi, C, Scrutinio, D, Correale, M, Cattadori, G, Piepoli, M, Salvioni, E, Giovannardi, M, Raimondo, R, Cicoira, M, Belardinelli, R, Guazzi, M, Limongelli, G, Clemenza, F, Parati, G, Scardovi, A, Di Lenarda, A, Bussotti, M, La Gioia, R, and Agostoni, P

Subjects
Databases, Factual, medicine.medical_treatment, Adrenergic beta-Antagonists, Adult, Age Factors, Aged, Chronic Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Oxygen, Sodium, Exercise Therapy, Heart Failure, Systolic, Kidney, Organ Dysfunction Scores, Stroke Volume, heart failure, Organ Dysfunction Score, middle aged, Clinical endpoint, Medicine, Age Factor, humans, sodium, Heart transplantation, education.field_of_study, Framingham Risk Score, Ejection fraction, exercise therapy, adult, General Medicine, follow-up studies, aged, cardiology and cardiovascular medicine, female, Quartile, Cardiology, cardiopulmonary exercise test, Human, medicine.medical_specialty, age factors, kidney, databases factual, Population, exercise performance, elderly, MECKI score, adrenergic beta-antagonists, chronic disease, male, oxygen, heart failure, systolic, organ dysfunction scores, stroke volume, Follow-Up Studie, Databases, Internal medicine, education, Factual, business.industry, Kidney metabolism, Adrenergic beta-Antagonist, Cardiopulmonary exercise test, Elderly, Exercise performance, Heart failure, Cardiology and Cardiovascular Medicine, medicine.disease, Exercise Performance, Prognostic Indicator, Chronic Heart Failure, systolic, business
Abstract

Background:In patients with chronic heart failure (HF) the Metabolic Exercise Cardiac Kidney Indexes (MECKI) score, is a predictor of cardiovascular death and urgent heart transplantation. We investigated the relationship between age, exercise tolerance and the prognostic value of the MECKI score.Methods and Results:We analyzed data from 3,794 patients with chronic systolic HF. The primary endpoint was a composite of cardiovascular death and urgent heart transplantation. Older patients had higher prevalence of comorbidities and lower exercise performance compared with younger subjects (peak V̇O2, 925 vs. 1,351 L/min; P#x003C;0.0001; V̇E/V̇CO2slope, 33.2 vs. 28.3; P>0.0001). The rate of the primary endpoint was 19% in the highest age quartile and 14% in the lowest quartile. At multivariable analysis, the independent predictors of the primary endpoint were left ventricular ejection fraction (LVEF), eGFR, peak V̇O2, serum Na+and the use of β-blockers in patients aged ≥70 years, and LVEF, eGFR and peak V̇O2in younger subjects. The MECKI risk score increased across age subgroups, but on receiver operating characteristic curve analysis its prognostic power was similar in both patients aged ≥70 and #x003C;70 years.Conclusions:Older patients with HF are a high-risk population with lower exercise performance. The MECKI score increased according to age and maintained its prognostic value also in older patients.

Published
2015

28. Renal function and peak exercise oxygen consumption in chronic heart failure with reduced left ventricular ejection fraction

Author

Scrutinio, Domenico, Agostoni, Piergiuseppe, Gesualdo, Loreto, Corra, Ugo, Mezzani, Alessandro, Piepoli, Massimo, Di Lenarda, Andrea, Iorio, Annamaria, Passino, Claudio, Magri, Damiano, Masarone, Daniele, Battaia, Elisa, Girola, Davide, Re, Federica, Cattadori, Gaia, Parati, Gianfranco, Sinagra, Gianfranco, Villani, Giovanni Quinto, LIMONGELLI, Giuseppe, Pacileo, Giuseppe, Guazzi, Marco, Metra, Marco, Frigerio, Maria, Cicoira, Mariantonietta, Miná, Chiara, Malfatto, Gabriella, Caravita, Sergio, Bussotti, Maurizio, Salvioni, Elisabetta, Veglia, Fabrizio, Correale, Michele, Scardovi, Angela B., Emdin, Michele, Giannuzzi, Pantaleo, Gargiulo, Paola, Giovannardi, Marta, Perrone Filardi, Pasquale, Raimondo, Rosa, Ricci, Roberto, Paolillo, Stefania, Farina, Stefania, Belardinelli, Romualdo, Passantino, Andrea, La Gioia, Rocco, Fiorentini, Cesare, Apostolo, Anna, Palermo, Pietro, Contini, Mauro, Bertella, Erika, Mantegazza, Valentina, Pietrucci, Francesca, Ferraironi, Aessandro, Casenghi, Matteo, Clemenza, Francesco, Roselli, Teo, Buono, Andrea, Santoro, Daniela, Campanale, Saba, Caputo, Domenica, Bertipaglia, Donatella, Vaninetti, Raffaella, Confalonieri, Marco, Zambon, Elena, Berton, Emanuela, Torregiani, Chiara, Cas, Livio Dei, Carubelli, Valentina, Binno, Simone, Marchese, Giovanni, Oliva, Fabrizio, Pastormerlo, Luigi, CALABRO', Raffaele, Scrutinio, Domenico, Agostoni, Piergiuseppe, Gesualdo, Loreto, Corra, Ugo, Mezzani, Alessandro, Piepoli, Massimo, Di Lenarda, Andrea, Iorio, Annamaria, Passino, Claudio, Magri, Damiano, Masarone, Daniele, Battaia, Elisa, Girola, Davide, Re, Federica, Cattadori, Gaia, Parati, Gianfranco, Sinagra, Gianfranco, Villani, Giovanni Quinto, Limongelli, Giuseppe, Pacileo, Giuseppe, Guazzi, Marco, Metra, Marco, Frigerio, Maria, Cicoira, Mariantonietta, Miná, Chiara, Malfatto, Gabriella, Caravita, Sergio, Bussotti, Maurizio, Salvioni, Elisabetta, Veglia, Fabrizio, Correale, Michele, Scardovi, Angela B., Emdin, Michele, Giannuzzi, Pantaleo, Gargiulo, Paola, Giovannardi, Marta, Perrone Filardi, Pasquale, Raimondo, Rosa, Ricci, Roberto, Paolillo, Stefania, Farina, Stefania, Belardinelli, Romualdo, Passantino, Andrea, La Gioia, Rocco, Fiorentini, Cesare, Apostolo, Anna, Palermo, Pietro, Contini, Mauro, Bertella, Erika, Mantegazza, Valentina, Pietrucci, Francesca, Ferraironi, Aessandro, Casenghi, Matteo, Clemenza, Francesco, Roselli, Teo, Buono, Andrea, Calabro', Raffaele, Santoro, Daniela, Campanale, Saba, Caputo, Domenica, Bertipaglia, Donatella, Vaninetti, Raffaella, Confalonieri, Marco, Zambon, Elena, Berton, Emanuela, Torregiani, Chiara, Cas, Livio Dei, Carubelli, Valentina, Binno, Simone, Marchese, Giovanni, Oliva, Fabrizio, Pastormerlo, Luigi, Corrà, Ugo, Lenarda, Andrea Di, Magrì, Damiano, Minà, Chiara, Scrutinio, D, Agostoni, P, Gesualdo, L, Corra, U, Mezzani, A, Piepoli, M, Di Lenarda, A, Iorio, A, Passino, C, Magri, D, Masarone, D, Battaia, E, Girola, D, Re, F, Cattadori, G, Parati, G, Sinagra, G, Villani, G, Limongelli, G, Pacileo, G, Guazzi, M, Metra, M, Frigerio, M, Cicoira, M, Miná, C, Malfatto, G, Caravita, S, Bussotti, M, Salvioni, E, Veglia, F, Correale, M, Scardovi, A, Emdin, M, Giannuzzi, P, Gargiulo, P, Giovannardi, M, Perrone Filardi, P, Raimondo, R, Ricci, R, Paolillo, S, Farina, S, Belardinelli, R, Passantino, A, La Gioia, R, Fiorentini, C, Apostolo, A, Palermo, P, Contini, M, Bertella, E, Mantegazza, V, Pietrucci, F, Ferraironi, A, Casenghi, M, Clemenza, F, Roselli, T, Buono, A, Calabrò, R, Santoro, D, Campanale, S, Caputo, D, Bertipaglia, D, Vaninetti, R, Confalonieri, M, Zambon, E, Berton, E, Torregiani, C, Cas, L, Carubelli, V, Binno, S, Marchese, G, Oliva, F, Pastormerlo, L, Scardovi, Angela B, and PERRONE FILARDI, Pasquale

Subjects
Adult, Male, medicine.medical_specialty, Kidney Disease, Aged, Chronic Disease, Female, Follow-Up Studies, Humans, Kidney Function Tests, Middle Aged, Exercise, Heart Failure, Kidney Diseases, Oxygen Consumption, Stroke Volume, Prognosi, medicine.medical_treatment, Renal function, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Heart failure, Follow-Up Studie, Peak exercise oxygen consumption, Prognosis, Cardiology and Cardiovascular Medicine, Internal medicine, medicine, Heart transplantation, Ejection fraction, Kidney Function Test, business.industry, Hazard ratio, Atrial fibrillation, General Medicine, Stroke volume, medicine.disease, heart failure, exercise capacity, renal function, exercise capacity, Cardiology, business, Kidney disease, Human
Abstract

Background: Chronic kidney disease is associated with sympathetic activation and muscle abnormalities, which may contribute to decreased exercise capacity. We investigated the correlation of renal function with peak exercise oxygen consumption (V˙O2) in heart failure (HF) patients. Methods and Results: We recruited 2,938 systolic HF patients who underwent clinical, laboratory, echocardiographic and cardiopulmonary exercise testing. The patients were stratified according to estimated glomerular filtration rate (eGFR). Mean follow-up was 3.7 years. The primary outcome was a composite of cardiovascular death and urgent heart transplantation at 3 years. On multivariable regression, eGFR was predictor of peakV˙O2 (P

Published
2015

29. Role of comorbidities in heart failure prognosis Part 2: Chronic kidney disease, elevated serum uric acid.

Author

Tedeschi A, Agostoni P, Pezzuto B, Corra' U, Scrutinio D, La Gioia R, Raimondo R, Passantino A, and Piepoli MF

Subjects
Biomarkers blood, Comorbidity, Heart Disease Risk Factors, Heart Failure blood, Heart Failure diagnosis, Heart Failure therapy, Humans, Hyperuricemia blood, Hyperuricemia diagnosis, Hyperuricemia therapy, Prognosis, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic therapy, Risk Assessment, Up-Regulation, Heart Failure epidemiology, Hyperuricemia epidemiology, Renal Insufficiency, Chronic epidemiology, Uric Acid blood
Abstract

Despite improvements in pharmacotherapy, morbidity and mortality rates in community-based populations with chronic heart failure still remain high. The increase in medical complexity among patients with heart failure may be reflected by an increase in concomitant non-cardiovascular comorbidities, which are recognized as independent prognostic factors in this population. Heart failure and chronic kidney disease share many risk factors, and often coexist. The presence of kidney failure is associated with incremented risk of cardiovascular and non-cardiovascular mortality in heart failure patients. Chronic kidney disease is also linked with underutilization of evidence-based heart failure therapy that may reduce morbidity and mortality. More targeted therapies would be important to improve the prognosis of patients with these diseases. In recent years, serum uric acid as a determinant of cardiovascular risk has gained interest. Epidemiological, experimental and clinical data show that patients with hyperuricaemia are at increased risk of cardiac, renal and vascular damage and cardiovascular events. Moreover, elevated serum uric acid predicts worse outcome in both acute and chronic heart failure. While studies have raised the possibility of preventing heart failure through the use of uric acid lowering agents, the literature is still inconclusive on whether the reduction in uric acid will result in a measurable clinical benefit. Available evidences suggest that chronic kidney disease and elevated uric acid could worsen heart failure patients' prognosis. The aim of this review is to analyse a possible utilization of these comorbidities in risk stratification and as a therapeutic target to get a prognostic improvement in heart failure patients.

Published
2020
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30. Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology.

Author

Piepoli MF, Abreu A, Albus C, Ambrosetti M, Brotons C, Catapano AL, Corra U, Cosyns B, Deaton C, Graham I, Hoes A, Lochen ML, Matrone B, Redon J, Sattar N, Smulders Y, and Tiberi M

Subjects
Cardiology economics, Cardiovascular Diseases diagnosis, Cardiovascular Diseases economics, Cardiovascular Diseases epidemiology, Consensus, Cost-Benefit Analysis, Health Care Costs, Heart Disease Risk Factors, Humans, Preventive Health Services economics, Prognosis, Protective Factors, Risk Assessment, Cardiology standards, Cardiovascular Diseases prevention & control, Preventive Health Services standards
Abstract

European guidelines on cardiovascular prevention in clinical practice were first published in 1994 and have been regularly updated, most recently in 2016, by the Sixth European Joint Task Force. Given the amount of new information that has become available since then, components from the task force and experts from the European Association of Preventive Cardiology of the European Society of Cardiology were invited to provide a summary and critical review of the most important new studies and evidence since the latest guidelines were published. The structure of the document follows that of the previous document and has six parts: Introduction (epidemiology and cost effectiveness); Cardiovascular risk; How to intervene at the population level; How to intervene at the individual level; Disease-specific interventions; and Settings: where to intervene? In fact, in keeping with the guidelines, greater emphasis has been put on a population-based approach and on disease-specific interventions, avoiding re-interpretation of information already and previously considered. Finally, the presence of several gaps in the knowledge is highlighted.

Published
2020
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31. The importance of return to work: How to achieve optimal reintegration in ACS patients.

Author

Reibis R, Salzwedel A, Abreu A, Corra U, Davos C, Doehner W, Doherty P, Frederix I, Hansen D, Christine Iliou M, Vigorito C, and Völler H

Subjects
Humans, Acute Coronary Syndrome rehabilitation, Cardiac Rehabilitation, Return to Work
Abstract

The vocational reintegration of patients after an acute coronary syndrome is a crucial step towards complete convalescence from the social as well as the individual point of view. Return to work rates are determined by medical parameters such as left ventricular function, residual ischaemia and heart rhythm stability, as well as by occupational requirement profile such as blue or white collar work, night shifts and the ability to commute (which is, in part, determined by physical fitness). Psychosocial factors including depression, self-perceived health situation and pre-existing cognitive impairment determine the reintegration rate to a significant extent. Patients at risk of poor vocational outcomes should be identified in the early period of rehabilitation to avoid a reintegration failure and to prevent socio-professional exclusion with adverse psychological and financial consequences. A comprehensive healthcare pathway of acute coronary syndrome patients is initiated by cardiac rehabilitation, which includes specific algorithms and assessment tools for risk stratification and occupational restitution. As the first in its kind, this review addresses determinants and legal aspects of reintegration of patients experiencing an acute coronary syndrome, and offers practical advice on reintegration strategies particularly for vulnerable patients. It presents different approaches and scientific findings in the European countries and serves as a recommendation for action.

Published
2019
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32. Main messages for primary care from the 2016 European Guidelines on cardiovascular disease prevention in clinical practice.

Author

Piepoli MF, Hoes AW, Brotons C, Hobbs RFD, and Corra U

Subjects
Age Factors, Europe, General Practitioners organization & administration, Health Personnel organization & administration, Humans, Physician's Role, Professional Role, Risk Factors, Cardiovascular Diseases prevention & control, Life Style, Practice Guidelines as Topic, Primary Health Care organization & administration
Abstract

In 2016, a new version of the European Guidelines on Cardiovascular Prevention was released, representing a partnership between the European Association for Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology (ESC) and nine European societies, including Wonca-Europe. The ESC guidelines underscore the importance of a lifetime approach to cardiovascular (CV) risk since both CV risk and prevention are dynamic and continuous as patients' age and/or accumulate co-morbidities. Healthy people of all ages should be encouraged to adopt a healthy lifestyle, as well as improved lifestyle and reduced risk factor levels are paramount in patients at increased risk of developing cardiovascular disease (CVD) and in those with established CVD. Healthcare professionals, and especially general practitioners, play an important role in helping patients achieve this and should set a personal example of healthy lifestyle behaviour. The ESC guidelines are based on 'to do' and 'not to do' messages. Of note, what remains uncertain is stated at the end of each dedicated chapter, confirming that guidelines are not absolute rules, and should be interpreted in the light of the healthcare worker's knowledge and experience, patient preferences and the local social, cultural and economic situation.

Published
2018
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33. European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS).

Author

Gorenek B, Pelliccia A, Benjamin EJ, Boriani G, Crijns HJ, Fogel RI, Van Gelder IC, Halle M, Kudaiberdieva G, Lane DA, Larsen TB, Lip GY, Løchen ML, Marín F, Niebauer J, Sanders P, Tokgozoglu L, Vos MA, Van Wagoner DR, Fauchier L, Savelieva I, Goette A, Agewall S, Chiang CE, Figueiredo M, Stiles M, Dickfeld T, Patton K, Piepoli M, Corra U, Marques-Vidal PM, Faggiano P, Schmid JP, and Abreu A

Subjects
Atrial Fibrillation diagnosis, Atrial Fibrillation epidemiology, Comorbidity, Consensus, Genetic Predisposition to Disease, Humans, Life Style, Risk Factors, Treatment Outcome, Atrial Fibrillation prevention & control, Cardiology standards, Preventive Health Services standards, Preventive Medicine standards, Risk Reduction Behavior
Published
2017
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34. Pre-participation cardiovascular evaluation for athletic participants to prevent sudden death: Position paper from the EHRA and the EACPR, branches of the ESC. Endorsed by APHRS, HRS, and SOLAECE.

Author

Mont L, Pelliccia A, Sharma S, Biffi A, Borjesson M, Brugada Terradellas J, Carré F, Guasch E, Heidbuchel H, La Gerche A, Lampert R, McKenna W, Papadakis M, Priori SG, Scanavacca M, Thompson P, Sticherling C, Viskin S, Wilson M, Corrado D, Lip GY, Gorenek B, Blomström Lundqvist C, Merkely B, Hindricks G, Hernández-Madrid A, Lane D, Boriani G, Narasimhan C, Marquez MF, Haines D, Mackall J, Manuel Marques-Vidal P, Corra U, Halle M, Tiberi M, Niebauer J, and Piepoli M

Subjects
Arrhythmias, Cardiac complications, Arrhythmias, Cardiac mortality, Consensus, Death, Sudden, Cardiac etiology, Humans, Predictive Value of Tests, Prognosis, Risk Assessment, Risk Factors, Arrhythmias, Cardiac diagnosis, Arrhythmias, Cardiac therapy, Athletes, Cardiac Imaging Techniques standards, Cardiology standards, Death, Sudden, Cardiac prevention & control, Electrocardiography standards, Evidence-Based Medicine standards
Published
2017
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35. Healthy lifestyle interventions to combat noncommunicable disease-a novel nonhierarchical connectivity model for key stakeholders: a policy statement from the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine.

Author

Arena R, Guazzi M, Lianov L, Whitsel L, Berra K, Lavie CJ, Kaminsky L, Williams M, Hivert MF, Cherie Franklin N, Myers J, Dengel D, Lloyd-Jones DM, Pinto FJ, Cosentino F, Halle M, Gielen S, Dendale P, Niebauer J, Pelliccia A, Giannuzzi P, Corra U, Piepoli MF, Guthrie G, Shurney D, Arena R, Berra K, Dengel D, Franklin NC, Hivert MF, Kaminsky L, Lavie CJ, Lloyd-Jones DM, Myers J, Whitsel L, Williams M, Corra U, Cosentino F, Dendale P, Giannuzzi P, Gielen S, Guazzi M, Halle M, Niebauer J, Pelliccia A, Piepoli MF, Pinto FJ, Guthrie G, Lianov L, and Shurney D

Abstract

Noncommunicable diseases (NCDs) have become the primary health concern for most countries around the world. Currently, more than 36 million people worldwide die from NCDs each year, accounting for 63% of annual global deaths; most are preventable. The global financial burden of NCDs is staggering, with an estimated 2010 global cost of $6.3 trillion (US dollars) that is projected to increase to $13 trillion by 2030. A number of NCDs share one or more common predisposing risk factors, all related to lifestyle to some degree: (1) cigarette smoking, (2) hypertension, (3) hyperglycemia, (4) dyslipidemia, (5) obesity, (6) physical inactivity, and (7) poor nutrition. In large part, prevention, control, or even reversal of the aforementioned modifiable risk factors are realized through leading a healthy lifestyle (HL). The challenge is how to initiate the global change, not toward increasing documentation of the scope of the problem but toward true action-creating, implementing, and sustaining HL initiatives that will result in positive, measurable changes in the previously defined poor health metrics. To achieve this task, a paradigm shift in how we approach NCD prevention and treatment is required. The goal of this American Heart Association/European Society of Cardiology/European Association for Cardiovascular Prevention and Rehabilitation/American College of Preventive Medicine policy statement is to define key stakeholders and highlight their connectivity with respect to HL initiatives. This policy encourages integrated action by all stakeholders to create the needed paradigm shift and achieve broad adoption of HL behaviors on a global scale., (© 2015 Mayo Foundation for Medical Education and Research, and the European Society of Cardiology. This article is being published concurrently in Mayo Clinic Proceedings [1]. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article. [1] Arena R, Guazzi M, Lianov L, Whitsel L, Berra K, Lavie CJ, Kaminsky L, Williams M, Hivert M-F, Franklin NC, Myers J, Dengel D, Lloyd-Jones DM, Pinto FJ, Cosentino F, Halle M, Gielen S, Dendale P, Niebauer J, Pelliccia A, Giannuzzi P, Corra U, Piepoli MF, Guthrie G, Shurney D. Healthy Lifestyle Interventions to Combat Noncommunicable Diseased - A Novel Nonhierarchical Connectivity Model for Key Stakeholders: A Policy Statement From the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine. Mayo Clinic Proceedings 2015; DOI: 10.1016/j.mayocp.2015.05.001 [In Press].)

Published
2015
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