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1. Serum Uric Acid, Hypertriglyceridemia, and Carotid Plaques: A Sub-Analysis of the URic Acid Right for Heart Health (URRAH) Study

Author

Agabiti Rosei, Claudia, primary, Paini, Anna, additional, Buso, Giacomo, additional, Maloberti, Alessandro, additional, Giannattasio, Cristina, additional, Salvetti, Massimo, additional, Casiglia, Edoardo, additional, Tikhonoff, Valerie, additional, Angeli, Fabio, additional, Barbagallo, Carlo Maria, additional, Bombelli, Michele, additional, Cappelli, Federica, additional, Cianci, Rosario, additional, Ciccarelli, Michele, additional, Cicero, Arrigo Francesco Giuseppe, additional, Cirillo, Massimo, additional, Cirillo, Pietro, additional, Dell’Oro, Raffaella, additional, D’Elia, Lanfranco, additional, Desideri, Giovambattista, additional, Ferri, Claudio, additional, Galletti, Ferruccio, additional, Gesualdo, Loreto, additional, Grassi, Guido, additional, Iaccarino, Guido, additional, Lippa, Luciano, additional, Mallamaci, Francesca, additional, Masi, Stefano, additional, Masulli, Maria, additional, Mazza, Alberto, additional, Mengozzi, Alessandro, additional, Nazzaro, Pietro, additional, Palatini, Paolo, additional, Parati, Gianfranco, additional, Pontremoli, Roberto, additional, Quarti-Trevano, Fosca, additional, Rattazzi, Marcello, additional, Reboldi, Gianpaolo, additional, Rivasi, Giulia, additional, Russo, Elisa, additional, Tocci, Giuliano, additional, Ungar, Andrea, additional, Verdecchia, Paolo, additional, Viazzi, Francesca, additional, Volpe, Massimo, additional, Virdis, Agostino, additional, Muiesan, Maria Lorenza, additional, and Borghi, Claudio, additional

Published
2024
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2. Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) Project

Author

D’Elia, Lanfranco, primary, Masulli, Maria, additional, Cirillo, Pietro, additional, Virdis, Agostino, additional, Casiglia, Edoardo, additional, Tikhonoff, Valerie, additional, Angeli, Fabio, additional, Barbagallo, Carlo Maria, additional, Bombelli, Michele, additional, Cappelli, Federica, additional, Cianci, Rosario, additional, Ciccarelli, Michele, additional, Cicero, Arrigo F. G., additional, Cirillo, Massimo, additional, Dell’Oro, Raffaella, additional, Desideri, Giovambattista, additional, Ferri, Claudio, additional, Gesualdo, Loreto, additional, Giannattasio, Cristina, additional, Grassi, Guido, additional, Iaccarino, Guido, additional, Lippa, Luciano, additional, Mallamaci, Francesca, additional, Maloberti, Alessandro, additional, Masi, Stefano, additional, Mazza, Alberto, additional, Mengozzi, Alessandro, additional, Muiesan, Maria Lorenza, additional, Nazzaro, Pietro, additional, Palatini, Paolo, additional, Parati, Gianfranco, additional, Pontremoli, Roberto, additional, Quarti-Trevano, Fosca, additional, Rattazzi, Marcello, additional, Reboldi, Gianpaolo, additional, Rivasi, Giulia, additional, Russo, Elisa, additional, Salvetti, Massimo, additional, Tocci, Giuliano, additional, Ungar, Andrea, additional, Verdecchia, Paolo, additional, Viazzi, Francesca, additional, Volpe, Massimo, additional, Borghi, Claudio, additional, and Galletti, Ferruccio, additional

Published
2024
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3. Heart Failure with Preserved Ejection Fraction: How to Deal with This Chameleon

Author

Lucà, Fabiana, primary, Oliva, Fabrizio, additional, Abrignani, Maurizio Giuseppe, additional, Di Fusco, Stefania Angela, additional, Gori, Mauro, additional, Giubilato, Simona, additional, Ceravolo, Roberto, additional, Temporelli, Pier Luigi, additional, Cornara, Stefano, additional, Rao, Carmelo Massimiliano, additional, Caretta, Giorgio, additional, Pozzi, Andrea, additional, Binaghi, Giulio, additional, Maloberti, Alessandro, additional, Di Nora, Concetta, additional, Di Matteo, Irene, additional, Pilleri, Anna, additional, Gelsomino, Sandro, additional, Riccio, Carmine, additional, Grimaldi, Massimo, additional, Colivicchi, Furio, additional, and Gulizia, Michele Massimo, additional

Published
2024
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4. Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios

Author

Lucà, Fabiana, primary, Oliva, Fabrizio, additional, Abrignani, Maurizio Giuseppe, additional, Di Fusco, Stefania Angela, additional, Parrini, Iris, additional, Canale, Maria Laura, additional, Giubilato, Simona, additional, Cornara, Stefano, additional, Nesti, Martina, additional, Rao, Carmelo Massimiliano, additional, Pozzi, Andrea, additional, Binaghi, Giulio, additional, Maloberti, Alessandro, additional, Ceravolo, Roberto, additional, Bisceglia, Irma, additional, Rossini, Roberta, additional, Temporelli, Pier Luigi, additional, Amico, Antonio Francesco, additional, Calvanese, Raimondo, additional, Gelsomino, Sandro, additional, Riccio, Carmine, additional, Grimaldi, Massimo, additional, Colivicchi, Furio, additional, and Gulizia, Michele Massimo, additional

Published
2023
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6. Serum Uric Acid Predicts All-Cause and Cardiovascular Mortality Independently of Hypertriglyceridemia in Cardiometabolic Patients without Established CV Disease: A Sub-Analysis of the URic acid Right for heArt Health (URRAH) Study

Author

Mengozzi, Alessandro, primary, Pugliese, Nicola Riccardo, additional, Desideri, Giovambattista, additional, Masi, Stefano, additional, Angeli, Fabio, additional, Barbagallo, Carlo Maria, additional, Bombelli, Michele, additional, Cappelli, Federica, additional, Casiglia, Edoardo, additional, Cianci, Rosario, additional, Ciccarelli, Michele, additional, Cicero, Arrigo F. G., additional, Cirillo, Massimo, additional, Cirillo, Pietro, additional, Dell’Oro, Raffaella, additional, D’Elia, Lanfranco, additional, Ferri, Claudio, additional, Galletti, Ferruccio, additional, Gesualdo, Loreto, additional, Giannattasio, Cristina, additional, Grassi, Guido, additional, Iaccarino, Guido, additional, Lippa, Luciano, additional, Mallamaci, Francesca, additional, Maloberti, Alessandro, additional, Masulli, Maria, additional, Mazza, Alberto, additional, Muiesan, Maria Lorenza, additional, Nazzaro, Pietro, additional, Palatini, Paolo, additional, Parati, Gianfranco, additional, Pontremoli, Roberto, additional, Quarti-Trevano, Fosca, additional, Rattazzi, Marcello, additional, Reboldi, Gianpaolo, additional, Rivasi, Giulia, additional, Russo, Elisa, additional, Salvetti, Massimo, additional, Tikhonoff, Valerie, additional, Tocci, Giuliano, additional, Ungar, Andrea, additional, Verdecchia, Paolo, additional, Viazzi, Francesca, additional, Volpe, Massimo, additional, Borghi, Claudio, additional, and Virdis, Agostino, additional

Published
2023
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7. Lipoprotein(a): Cardiovascular Disease, Aortic Stenosis and New Therapeutic Option

Author

Maloberti, Alessandro, primary, Fabbri, Saverio, additional, Colombo, Valentina, additional, Gualini, Elena, additional, Monticelli, Massimiliano, additional, Daus, Francesca, additional, Busti, Andrea, additional, Galasso, Michele, additional, De Censi, Lorenzo, additional, Algeri, Michela, additional, Merlini, Piera Angelica, additional, and Giannattasio, Cristina, additional

Published
2022
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8. Endothelial Dysfunction in Patients with Advanced Heart Failure Treated with Levosimendan Periodic Infusion Compared with Optimal Medical Therapy: A Pilot Study

Author

Maloberti, Alessandro, primary, Sun, Jinwei, additional, Zannoni, Jessica, additional, Occhi, Lucia, additional, Bassi, Ilaria, additional, Fabbri, Saverio, additional, Colombo, Valentina, additional, Gualini, Elena, additional, Algeri, Michela, additional, Varrenti, Marisa, additional, Masciocco, Gabriella, additional, Perna, Enrico, additional, Oliva, Fabrizio, additional, Cipriani, Manlio, additional, Frigerio, Maria, additional, and Giannattasio, Cristina, additional

Published
2022
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9. Incident Atrial Fibrillation and In-Hospital Mortality in SARS-CoV-2 Patients

Author

Maloberti, Alessandro, primary, Giannattasio, Cristina, additional, Rebora, Paola, additional, Occhino, Giuseppe, additional, Ughi, Nicola, additional, Biolcati, Marco, additional, Gualini, Elena, additional, Rizzi, Jacopo Giulio, additional, Algeri, Michela, additional, Giani, Valentina, additional, Rossetti, Claudio, additional, Epis, Oscar Massimiliano, additional, Molon, Giulio, additional, Beltrame, Anna, additional, Bonfanti, Paolo, additional, Valsecchi, Maria Grazia, additional, and Genovesi, Simonetta, additional

Published
2022
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10. Incident Atrial Fibrillation and In-Hospital Mortality in SARS-CoV-2 Patients

Author

Maloberti, A, Giannattasio, C, Rebora, P, Occhino, G, Ughi, N, Biolcati, M, Gualini, E, Rizzi, J, Algeri, M, Giani, V, Rossetti, C, Epis, O, Molon, G, Beltrame, A, Bonfanti, P, Valsecchi, M, Genovesi, S, Maloberti, Alessandro, Giannattasio, Cristina, Rebora, Paola, Occhino, Giuseppe, Ughi, Nicola, Biolcati, Marco, Gualini, Elena, Rizzi, Jacopo Giulio, Algeri, Michela, Giani, Valentina, Rossetti, Claudio, Epis, Oscar Massimiliano, Molon, Giulio, Beltrame, Anna, Bonfanti, Paolo, Valsecchi, Maria Grazia, Genovesi, Simonetta, Maloberti, A, Giannattasio, C, Rebora, P, Occhino, G, Ughi, N, Biolcati, M, Gualini, E, Rizzi, J, Algeri, M, Giani, V, Rossetti, C, Epis, O, Molon, G, Beltrame, A, Bonfanti, P, Valsecchi, M, Genovesi, S, Maloberti, Alessandro, Giannattasio, Cristina, Rebora, Paola, Occhino, Giuseppe, Ughi, Nicola, Biolcati, Marco, Gualini, Elena, Rizzi, Jacopo Giulio, Algeri, Michela, Giani, Valentina, Rossetti, Claudio, Epis, Oscar Massimiliano, Molon, Giulio, Beltrame, Anna, Bonfanti, Paolo, Valsecchi, Maria Grazia, and Genovesi, Simonetta

Abstract

Background: Among the different cardiovascular (CV) manifestations of the coronavirus disease 2019 (COVID-19), arrhythmia and atrial fibrillation (AF) in particular have recently received special attention. The aims of our study were to estimate the incidence of AF in patients hospitalized for COVID-19, and to evaluate its role as a possible predictor of in-hospital all-cause mortality. (2) Methods: We enrolled 3435 people with SARS-CoV2 infection admitted to three hospitals in Northern Italy from February 2020 to May 2021. We collected data on their clinical history, laboratory tests, pharmacological treatment and intensive care unit (ICU) admission. Incident AF and all-cause in-hospital mortality were considered as outcomes. (3) Results: 145 (4.2%) patients developed AF during hospitalization, with a median time since admission of 3 days (I-III quartile: 0, 12). Patients with incident AF were admitted more frequently to the ICU (39.3 vs. 12.4%, p < 0.001), and more frequently died (37.2 vs. 16.9%, p < 0.001). In the Cox regression model, the significant determinants of incident AF were age (HR: 1.041; 95% CI: 1.022, 1.060 per year), a history of AF (HR: 2.720; 95% CI: 1.508, 4.907), lymphocyte count (HR: 0.584; 95% CI: 0.384, 0.888 per 103/µL), estimated glomerular filtration rate (eGFR, HR: 0.988; 95% CI: 0.980, 0.996 per mL/min) and ICU admission (HR: 5.311; 95% CI: 3.397, 8.302). Incident AF was a predictor of all-cause mortality (HR: 1.405; 95% CI: 1.027, 1.992) along with age (HR: 1.057; 95% CI: 1.047, 1.067), male gender (HR: 1.315; 95% CI: 1.064; 1.626), dementia (HR: 1.373; 95% CI: 1.045, 1.803), lower platelet (HR: 0.997; 95% CI: 0.996, 0.998 per 103/µL) and lymphocyte counts (HR: 0.843; 95% CI: 0.725, 0.982 per 103/µL), C-Reactive protein values (HR: 1.004; 95% CI: 1.003, 1.005 per mg/L), eGFR (HR: 0.990; 95% CI: 0.986, 0.994 per mL/min), and ICU admission (HR: 1.759; 95% CI: 1.292, 2.395). (4) Conclusions: Incident AF is a common complication in C

Published
2022

11. Endothelial Dysfunction in Patients with Advanced Heart Failure Treated with Levosimendan Periodic Infusion Compared with Optimal Medical Therapy: A Pilot Study

Author

Maloberti, A, Sun, J, Zannoni, J, Occhi, L, Bassi, I, Fabbri, S, Colombo, V, Gualini, E, Algeri, M, Varrenti, M, Masciocco, G, Perna, E, Oliva, F, Cipriani, M, Frigerio, M, Giannattasio, C, Maloberti, Alessandro, Sun, Jinwei, Zannoni, Jessica, Occhi, Lucia, Bassi, Ilaria, Fabbri, Saverio, Colombo, Valentina, Gualini, Elena, Algeri, Michela, Varrenti, Marisa, Masciocco, Gabriella, Perna, Enrico, Oliva, Fabrizio, Cipriani, Manlio, Frigerio, Maria, Giannattasio, Cristina, Maloberti, A, Sun, J, Zannoni, J, Occhi, L, Bassi, I, Fabbri, S, Colombo, V, Gualini, E, Algeri, M, Varrenti, M, Masciocco, G, Perna, E, Oliva, F, Cipriani, M, Frigerio, M, Giannattasio, C, Maloberti, Alessandro, Sun, Jinwei, Zannoni, Jessica, Occhi, Lucia, Bassi, Ilaria, Fabbri, Saverio, Colombo, Valentina, Gualini, Elena, Algeri, Michela, Varrenti, Marisa, Masciocco, Gabriella, Perna, Enrico, Oliva, Fabrizio, Cipriani, Manlio, Frigerio, Maria, and Giannattasio, Cristina

Abstract

Endothelial dysfunction (ED) is frequently found in patients with heart failure (HF). Among several pharmacological agents reported to improve endothelial function, levosimendan seems to be a promising one, even though, to date, only two previously published studies have evaluated its effects on ED in these patients. The aim of our pilot study was to further investigate the role of periodic levosimendan infusion on endothelial function in patients affected by advanced HF. In this cross-sectional study, three different groups were enrolled: 20 patients with advanced HF treated with periodic levosimendan (LEVO), 20 patients with HF on optimal medical therapy (OMT), and 20 healthy subjects (control group). ED was evaluated through flow-mediated dilation (FMD) at the level of the brachial artery. The three groups presented similar ages with significant differences in gender distribution, systolic blood pressure, and chronic kidney disease (eGFR < 30 mL/min). In HF patients, ischaemic aetiology was more prevalent in the LEVO group than in the OMT group (60 vs. 40%, p < 0.001). The New York Heart Association (NYHA) functional class was worse in the LEVO group, as well as in NT-proBNP (5636.7 ± 6164.6 ng/dL and 1243.7 ± 1487.2 ng/dL, in the LEVO and OMT groups, respectively, p = 0.005). The FMD was significantly higher in the healthy control group compared to that of the OMT group (15.7 ± 6.4 vs. 9.1 ± 6.0%, p = 0.007) while it showed an intermediate value in LEVO patients (12.4 ± 7.1%) (ANOVA p = 0.010). In conclusion, levosimendan therapy seems to ameliorate endothelial dysfunction related to heart failure. Longitudinal studies in patients on periodic therapy are needed in order to confirm the long-term effects of levosimendan on ED.

Published
2022

12. Differences in Diagnosis and Management of Hypertensive Urgencies and Emergencies According to Italian Doctors from Different Departments Who Deal With Acute Increase in Blood Pressure—Data from Gear (Gestione Dell’emergenza e Urgenza in ARea Critica) Study

Author

Saladini, Francesca, primary, Mancusi, Costantino, additional, Bertacchini, Fabio, additional, Spannella, Francesco, additional, Maloberti, Alessandro, additional, Giavarini, Alessandra, additional, Rosticci, Martina, additional, Bruno, Rosa Maria, additional, Pucci, Giacomo, additional, Grassi, Davide, additional, Pengo, Martino, additional, and Muiesan, Maria Lorenza, additional

Published
2022
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14. The Role of Uric Acid in Acute and Chronic Coronary Syndromes

Author

Maloberti, Alessandro, primary, Biolcati, Marco, additional, Ruzzenenti, Giacomo, additional, Giani, Valentina, additional, Leidi, Filippo, additional, Monticelli, Massimiliano, additional, Algeri, Michela, additional, Scarpellini, Sara, additional, Nava, Stefano, additional, Soriano, Francesco, additional, Oreglia, Jacopo, additional, Sacco, Alice, additional, Morici, Nuccia, additional, Oliva, Fabrizio, additional, Piani, Federica, additional, Borghi, Claudio, additional, and Giannattasio, Cristina, additional

Published
2021
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15. Atrial Fibrillation and Clinical Outcomes in a Cohort of Hospitalized Patients with Sars-Cov-2 Infection and Chronic Kidney Disease

Author

Genovesi, Simonetta, primary, Rebora, Paola, additional, Occhino, Giuseppe, additional, Rossi, Emanuela, additional, Maloberti, Alessandro, additional, Belli, Michele, additional, Bonfanti, Paolo, additional, Giannattasio, Cristina, additional, Rossetti, Claudio, additional, Epis, Oscar Massimiliano, additional, Ughi, Nicola, additional, and Valsecchi, Maria Grazia, additional

Published
2021
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16. Protein Intake and Physical Activity in Newly Diagnosed Patients with Acute Coronary Syndrome: A 5-Year Longitudinal Study

Author

Greco, A, Brugnera, A, Adorni, R, D'Addario, M, Fattirolli, F, Franzelli, C, Giannattasio, C, Maloberti, A, Zanatta, F, Steca, P, Greco, Andrea, Brugnera, Agostino, Adorni, Roberta, D'Addario, Marco, Fattirolli, Francesco, Franzelli, Cristina, Giannattasio, Cristina, Maloberti, Alessandro, Zanatta, Francesco, Steca, Patrizia, Greco, A, Brugnera, A, Adorni, R, D'Addario, M, Fattirolli, F, Franzelli, C, Giannattasio, C, Maloberti, A, Zanatta, F, Steca, P, Greco, Andrea, Brugnera, Agostino, Adorni, Roberta, D'Addario, Marco, Fattirolli, Francesco, Franzelli, Cristina, Giannattasio, Cristina, Maloberti, Alessandro, Zanatta, Francesco, and Steca, Patrizia

Abstract

Cardiovascular disease is one of the most common causes of hospitalization and is associated with high morbidity and mortality rates. Among the most important modifiable and well-known risk factors are an unhealthy diet and sedentary lifestyle. Nevertheless, adherence to healthy lifestyle regimes is poor. The present study examined longitudinal trajectories (pre-event, 6-, 12-, 24-, 36-, and 60-month follow-ups) of protein intake (fish, legumes, red/processed meat) and physical activity in 275 newly-diagnosed patients with acute coronary syndrome. Hierarchical Generalized Linear Models were performed, controlling for demographic and clinical variables, the season in which each assessment was made, and the presence of anxiety and depressive symptoms. Significant changes in protein intake and physical activity were found from pre-event to the six-month follow-up, suggesting the adoption of healthier behaviors. However, soon after the six-month follow-up, patients experienced significant declines in their healthy behaviors. Both physical activity and red/processed meat intake were modulated by the season in which the assessments took place and by anxiety symptoms over time. The negative long-term trajectory of healthy behaviors suggests that tailored interventions are needed that sustain patients' capabilities to self-regulate their behaviors over time and consider patient preference in function of season.

Published
2021

18. Differences in Diagnosis and Management of Hypertensive Urgencies and Emergencies According to Italian Doctors from Different Departments Who Deal With Acute Increase in Blood Pressure—Data from Gear (Gestione Dell’emergenza e Urgenza in ARea Critica) Study

Author

Francesca Saladini, Costantino Mancusi, Fabio Bertacchini, Francesco Spannella, Alessandro Maloberti, Alessandra Giavarini, Martina Rosticci, Rosa Maria Bruno, Giacomo Pucci, Davide Grassi, Martino Pengo, Maria Lorenza Muiesan, Saladini, Francesca, Mancusi, Costantino, Bertacchini, Fabio, Spannella, Francesco, Maloberti, Alessandro, Giavarini, Alessandra, Rosticci, Martina, Maria Bruno, Rosa, Pucci, Giacomo, Grassi, Davide, Pengo, Martino, Muiesan, MARIA LORENZA, Saladini, F, Mancusi, C, Bertacchini, F, Spannella, F, Maloberti, A, Giavarini, A, Rosticci, M, Bruno, R, Pucci, G, Grassi, D, Pengo, M, and Muiesan, M

Subjects
hypertensive emergency, treatment, hypertensive urgency, blood pressure, General Medicine
Abstract

Background: Diagnosis and treatment of hypertension emergency (HE) and urgency (HU) may vary according to the physicians involved and the setting of the treatment. The aim of this study was to investigate differences in management of HE and HU according to the work setting of the physicians. Methods: The young investigators of the Italian Society of Hypertension developed a 23-item questionnaire spread by email invitation to the members of Italian Scientific societies involved in the field of emergency medicine and hypertension. Results: Six-hundred and sixty-five questionnaires were collected. No differences emerged for the correct definitions of HE and HU or for the investigation of possible drugs that may be responsible for an acute increase in BP. The techniques used to assess BP values (p < 0.004) and the sizes of cuffs available were different according to the setting. Cardiologists more frequently defined epistaxis (55.2% p = 0.012) and conjunctival hemorrhages (70.7%, p < 0.0001) as possible presentation of HE, and rarely considered dyspnea (67.2% p = 0.014) or chest pain (72.4%, p = 0.001). Intensive care (IC) unit doctors were more familiar with lung ultrasound (50% p = 0.004). With regard to therapy, cardiologists reported the lowest prescription of i.v. labetalol (39.6%, p = 0.003) and the highest of s.l. nifedipine (43.1% p < 0.001). After discharge, almost all categories of physicians required home BP assessment or referral to a general practitioner, whereas hypertensive center evaluation or ambulatory BP monitoring were less frequently suggested. Conclusion: Management and treatment of HE and HU may be different according to the doctor’s specialty. Educational initiatives should be done to standardize treatment protocols and to improve medical knowledge.

Published
2022
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19. Anderson-Fabry Disease: An Overview of Current Diagnosis, Arrhythmic Risk Stratification, and Therapeutic Strategies.

Author

Tognola C, Ruzzenenti G, Maloberti A, Varrenti M, Mazzone P, Giannattasio C, and Guarracini F

Abstract

Anderson-Fabry disease (AFD) is a rare X-linked lysosomal storage disorder characterized by the accumulation of globotriaosylceramide, leading to multi-organ involvement and significant morbidity. Cardiovascular manifestations, particularly arrhythmias, are common and pose a considerable risk to affected individuals. This overview examines current approaches to arrhythmic risk stratification in AFD, focusing on the identification, assessment, and management of cardiac arrhythmias associated with the disease. We explore advancements in diagnostic techniques, including echocardiography, cardiac MRI, and ambulatory ECG monitoring, to enhance the detection of arrhythmogenic substrate. Furthermore, we discuss the role of genetic and biochemical markers in predicting arrhythmic risk and the implications for personalized treatment strategies. Current therapeutic interventions, including enzyme replacement therapy and antiarrhythmic medications, are reviewed in the context of their efficacy and limitations. Finally, we highlight ongoing research and future directions with the aim of improving arrhythmic risk assessment and management in AFD. This overview underscores the need for a multidisciplinary approach to optimize care and outcomes for patients with AFD.

Published
2025
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20. Arrhythmic Risk Stratification in Cardiac Amyloidosis: A Review of the Current Literature.

Author

Bonvicini E, Preda A, Tognola C, Falco R, Gidiucci R, Leo G, Vargiu S, Varrenti M, Gigli L, Baroni M, Carbonaro M, Colombo G, Maloberti A, Giannattasio C, Mazzone P, and Guarracini F

Abstract

Cardiac amyloidosis is the most frequent infiltrative disease caused by the deposition of misfolded proteins in the cardiac tissue, leading to heart failure, brady- and tachyarrhythmia and death. Conduction disorders, atrial fibrillation (AF) and ventricular arrhythmia (VA) significantly impact patient outcomes and demand recognition. However, several issues remain unresolved regarding early diagnosis and optimal management. Extreme bradycardia is the most common cause of arrhythmic death, while fast and sustained VAs can be found even in the early phases of the disease. Risk stratification and the prevention of sudden cardiac death are therefore to be considered in these patients, although the time for defibrillator implantation is still a subject of debate. Moreover, atrial impairment due to amyloid fibrils is associated with an increased risk of AF resistant to antiarrhythmic therapy, as well as recurrent thromboembolic events despite adequate anticoagulation. In the last few years, the aging of the population and progressive improvements in imaging methods have led to increases in the diagnosis of cardiac amyloidosis. Novel therapies have been developed to improve patients' functional status, quality of life and mortality, without data regarding their effect on arrhythmia prevention. In this review, we consider the latest evidence regarding the arrhythmic risk stratification of cardiac amyloidosis, as well as the available therapeutic strategies.

Published
2024
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21. Risk of Cardiovascular Events in Metabolically Healthy Overweight or Obese Adults: Role of LDL-Cholesterol in the Stratification of Risk.

Author

Palatini P, Virdis A, Masi S, Mengozzi A, Casiglia E, Tikhonoff V, Cicero AFG, Ungar A, Parati G, Rivasi G, Salvetti M, Barbagallo CM, Bombelli M, Dell'Oro R, Bruno B, Lippa L, D'Elia L, Masulli M, Verdecchia P, Reboldi G, Angeli F, Cianci R, Mallamaci F, Cirillo M, Rattazzi M, Cirillo P, Gesualdo L, Russo E, Mazza A, Giannattasio C, Maloberti A, Volpe M, Tocci G, Iaccarino G, Nazzaro P, Galletti F, Ferri C, Desideri G, Viazzi F, Pontremoli R, Muiesan ML, Grassi G, and Borghi C

Abstract

The objective of this study was to investigate the longitudinal association of metabolically healthy overweight/obese adults with major adverse cardiovascular events (MACE) and the effect of LDL-cholesterol levels on this association. This study was conducted with 15,904 participants from the URRAH study grouped according to BMI and metabolic status. Healthy metabolic status was identified with and without including LDL-cholesterol. The risk of MACE during 11.8 years of follow-up was evaluated with multivariable Cox regressions. Among the participants aged <70 years, high BMI was associated with an increased risk of MACE, whereas among the older subjects it was associated with lower risk. Compared to the group with normal weight/healthy metabolic status, the metabolically healthy participants aged <70 years who were overweight/obese had an increased risk of MACE with an adjusted hazard ratio of 3.81 (95% CI, 1.34-10.85, p = 0.012). However, when LDL-cholesterol < 130 mg/dL was included in the definition of healthy metabolic status, no increase in risk was found in the overweight/obese adults compared to the normal weight individuals (hazard ratio 0.70 (0.07-6.71, p = 0.75). The present data show that the risk of MACE is increased in metabolically healthy overweight/obese individuals identified according to standard criteria. However, when LDL-cholesterol is included in the definition, metabolically healthy individuals who are overweight/obese have no increase in risk.

Published
2024
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22. Heart Rate in Patients with SARS-CoV-2 Infection: Prevalence of High Values at Discharge and Relationship with Disease Severity.

Author

Maloberti A, Ughi N, Bernasconi DP, Rebora P, Cartella I, Grasso E, Lenoci D, Del Gaudio F, Algeri M, Scarpellini S, Perna E, Verde A, Santolamazza C, Vicari F, Frigerio M, Alberti A, Valsecchi MG, Rossetti C, Epis OM, Giannattasio C, and On The Behalf Of The Niguarda Covid-Working Group

Abstract

The most common arrhythmia associated with COronaVIrus-related Disease (COVID) infection is sinus tachycardia. It is not known if high Heart Rate (HR) in COVID is simply a marker of higher systemic response to sepsis or if its persistence could be related to a long-term autonomic dysfunction. The aim of our work is to assess the prevalence of elevated HR at discharge in patients hospitalized for COVID-19 and to evaluate the variables associated with it. We enrolled 697 cases of SARS-CoV2 infection admitted in our hospital after February 21 and discharged within 23 July 2020. We collected data on clinical history, vital signs, laboratory tests and pharmacological treatment. Severe disease was defined as the need for Intensive Care Unit (ICU) admission and/or mechanical ventilation. Median age was 59 years (first-third quartile 49, 74), and male was the prevalent gender (60.1%). 84.6% of the subjects showed a SARS-CoV-2 related pneumonia, and 13.2% resulted in a severe disease. Mean HR at admission was 90 ± 18 bpm with a mean decrease of 10 bpm to discharge. Only 5.5% of subjects presented HR > 100 bpm at discharge. Significant predictors of discharge HR at multiple linear model were admission HR (mean increase = β = 0.17 per bpm, 95% CI 0.11; 0.22, p < 0.001), haemoglobin (β = -0.64 per g/dL, 95% CI -1.19; -0.09, p = 0.023) and severe disease (β = 8.42, 95% CI 5.39; 11.45, p < 0.001). High HR at discharge in COVID-19 patients is not such a frequent consequence, but when it occurs it seems strongly related to a severe course of the disease.

Published
2021
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