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1. Right Ventricular Functional Reserve in Early-Stage Idiopathic Pulmonary Fibrosis

Author

Antonello D’Andrea, Anna Agnese Stanziola, Rajan Saggar, Rajeev Saggar, Simona Sperlongano, Marianna Conte, Michele D’Alto, Francesco Ferrara, Luna Gargani, Patrizio Lancellotti, Eduardo Bossone, Robert Naeije, William F. Armstrong, Theodore John Kolias, Luigi Caliendo, Rosangela Cocchia, Rodolfo Citro, Michele Bellino, Ilaria Radano, Antonio Cittadini, Paola Argiento, Andreina Carbone, Santo Dellegrottaglie, Nicola De Luca, Montuori Maria Grazia, Francesco Rozza, Valentina Russo, Giovanni Di Salvo, Stefano Ghio, Ekkerard Grunig, Alberto Marra, Marco Guazzi, Francesco Bandera, Valentina Labate, André La Gerche, Giuseppe Limongelli, Giuseppe Pacileo, Marina Verrengia, Jaroslaw D. Kasprzak, Karina Wierzbowska Drabik, Gabor Kovacs, Antonella Moreo, Francesca Casadei, Benedetta De Chiara, Ellen Ostenfeld, Francesco Pieri, Lorenza Pratali, Christine Selton-Suty, Olivier Huttin, Clément Venner, Walter Serra, Anna Stanziola, Maria Martino, Giovanna Caccavo, István Szabó, Albert Varga, Gergely Agoston, Darmien Voilliot, Olga Vriz, Domenico Galzerano, Marco Scalese, and Luca Carannante

Subjects
Pulmonary and Respiratory Medicine, Spirometry, medicine.medical_specialty, Speckle tracking echocardiography, Doppler echocardiography, Critical Care and Intensive Care Medicine, 03 medical and health sciences, Idiopathic pulmonary fibrosis, 0302 clinical medicine, Internal medicine, medicine, Stress Echocardiography, 030212 general & internal medicine, Pulmonary wedge pressure, medicine.diagnostic_test, business.industry, respiratory system, medicine.disease, Pulmonary hypertension, respiratory tract diseases, medicine.anatomical_structure, 030228 respiratory system, Vascular resistance, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Background The most important determinant of long-term survival in patients with idiopathic pulmonary fibrosis is the right ventricular (RV) adaptation to the increased pulmonary vascular resistance. Our aim was to explore RV contractile reserve during stress echocardiography in early-stage IPF. Methods Fifty early-stage patients with IPF and 50 healthy control patients underwent rest and stress echocardiography, including RV two-dimensional speckle tracking echocardiography. At peak exertion, blood gas analysis and spirometry were also assessed. Results At rest, RV diameters were mildly increased in IPF; however, although RV conventional systolic function indexes were similar between the IPF and control groups, RV global longitudinal strain and RV lateral wall longitudinal strain (LWLS) were significantly reduced in the IPF cohort. During physical exercise, patients with IPF showed a reduced exercise tolerance with lower maximal workload (P o 2; P Conclusions RV myocardial dysfunction is already present at rest in early-stage IPF and worsens during exertion as detected by two-dimensional speckle-tracking echocardiography. The RV altered contractile reserve appears to be related to reduced exercise tolerability and impaired pulmonary hemodynamic.

Published
2019
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2. Optimal left ventricular lead placement for cardiac resynchronization therapy in postmyocardial infarction patients

Author

Paola Chiariello, Anna Rago, Luigi Caliendo, Vincenzo Russo, Raffaele Chianese, Carmine Ciardiello, Francesco Solimene, Carmine Muto, Gerardo Nigro, Muto, Carmine, Solimene, Francesco, Russo, Vincenzo, Nigro, Gerardo, Rago, Anna, Chianese, Raffaele, Chiariello, Paola, Ciardiello, Carmine, and Caliendo, Luigi

Subjects
Male, medicine.medical_specialty, Time Factors, Ventricular lead, Heart Ventricles, medicine.medical_treatment, Population, Myocardial Infarction, Cardiac resynchronization therapy, Infarction, cardiac resynchronization therapy, 030204 cardiovascular system & hematology, Ventricular Function, Left, LV remodeling, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Cardiac Resynchronization Therapy Devices, Prospective Studies, 030212 general & internal medicine, Lead (electronics), education, Aged, Heart Failure, education.field_of_study, Ejection fraction, Ventricular Remodeling, business.industry, Stroke Volume, CRT responder, medicine.disease, ventricular mechanical activation, Treatment Outcome, Echocardiography, Heart failure, Cardiology, Molecular Medicine, Population study, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Aim: To evaluate at a 12-month follow-up, the clinical and echocardiographic outcomes in postmyocardial infarction (MI) heart failure patients who underwent cardiac resynchronization therapy (CRT) device implantation. Materials & methods: A total of 100 patients received a CRT device, and the study population was divided into three groups, according to the site of MI and left ventricular (LV) lead placed downstream of the ischemic area, as evaluated by echocardiography. Results: At the end of the 12-month follow-up, we reported a general improvement of LV ejection fraction from 28 ± 7% to 35 ± 9% (p

Published
2018

3. Zofenopril and Ramipril in Combination with Acetyl Salicylic Acid in Postmyocardial Infarction Patients with Left Ventricular Systolic Dysfunction: A Retrospective Analysis of the SMILE-4 Randomized, Double-Blind Study in Diabetic Patients

Author

BORGHI, CLAUDIO, AMBROSIONI, ETTORE, Omboni, Stefano, Novo, Salvatore, Vinereanu, Dragos, Ambrosio, Giuseppe, Dimitrios, Alexopolulus, Ioannis, Nanas, Marco, Agrusta, Antonio, Barsotti, Serena, Bergerone, Luigi, Caliendo, Pio, Caso, Antonio, Castello, Domenico, Cianflone, Tommaso, Cipolla, Gaetano, De Ferrari, Giuseppe, De Nittis, Livio, Dei Cas, Paolo, Di Pasquale, Rosario, Evola, Luciano, Fattore, Raffaele, Ferrante, Antonio, Fiscella, Achille, Gaspardone, Giuseppe, Ielasi, Niccoló, Marchionni, Giancarlo, Marenzi, Filippo, Marte, Federico, Miccoli, Patrizia, Noussan, Mario, Orlandi, Giancarlo, Piovaccari, Maurizio, Porcu, Patrizia, Presbitero, Antonio, Raviele, Emiliano, Renaldini, Jorge, Salerno Uriarte, Giovanni, Storti, Corrado, Tamburino, Pierfranco, Terrosu, Roberto, Testa, Rita, Trinchero, Bernardino, Tuccillo, Ludovico, Vasquez, Quinto, Villani Giovanni, Garcia, Alvés Mario, Aurora, Andrade, Silva, Cardoso, Ilidio, Moreira Joseà, Catalina, Arsenescu Georgescu, Mircea, Cinteza, Maria, Dorobantu, Dominic, Ionescu, Ioan, Manitiu, Florin, Ortan, Calin, Pop, Mariana, Radoi, Yuriy, Alexandrovich Vasyuk, Victor, Avenirovitch Kostenko, Yuriy, Borisovich Karpov, Vira, Iosifovna Tseluiko, Abram, Lvovich Syrkin, Boris, Mikhailovich Goloschekin, Evgeniy, Mikhaylovich Nifontov, Sergey, Nikolaevich Tereschenko, Natalia, Nikolaevna Burova, Konstantin, Nikolayevich Zrazhevsky, Grigory, Pavlovich Arutuynov, Valentin, Sergeevich Moiseev, Leonid, Victorovich Rudenko, Alexander, Yurievich Vishnevsky, Diaz, D. L. Y. De La Yera, Fernández, Romero, Cevat, Kirma, Kayikcioglu, Meral, Abdurrahman, Oğuzhan, Dilek, Ural Komsuoglu, Olena, Ankindinovna Koval, Alexan, Nikolaevich Parkhomenko, Igor, Petrovich Vakalyuk, Mykola, Tihonovich Vatutin, Valerii, Vladimirovich Batushkin, Borghi, Claudio, Omboni, Stefano, Novo, Salvatore, Vinereanu, Drago, Ambrosio, Giuseppe, Ambrosioni, Ettore, Dimitrios, Alexopolulu, Ioannis, Nana, Marco, Agrusta, Antonio, Barsotti, Serena, Bergerone, Luigi, Caliendo, Pio, Caso, Antonio, Castello, Domenico, Cianflone, Tommaso, Cipolla, Gaetano, De Ferrari, Giuseppe, De Nitti, Livio, Dei Ca, Paolo, Di Pasquale, Rosario, Evola, Luciano, Fattore, Raffaele, Ferrante, Antonio, Fiscella, Achille, Gaspardone, Giuseppe, Ielasi, Niccoló, Marchionni, Giancarlo, Marenzi, Filippo, Marte, Federico, Miccoli, Patrizia, Noussan, Mario, Orlandi, Giancarlo, Piovaccari, Maurizio, Porcu, Patrizia, Presbitero, Antonio, Raviele, Emiliano, Renaldini, Jorge, Salerno Uriarte, Giovanni, Storti, Corrado, Tamburino, Pierfranco, Terrosu, Roberto, Testa, Rita, Trinchero, Bernardino, Tuccillo, Ludovico, Vasquez, Quinto, Villani Giovanni, Garcia, Alvés Mario, Aurora, Andrade, Silva, Cardoso, Ilidio, Moreira Joseà, Catalina, Arsenescu Georgescu, Mircea, Cinteza, Maria, Dorobantu, Dominic, Ionescu, Ioan, Manitiu, Florin, Ortan, Calin, Pop, Mariana, Radoi, Yuriy, Alexandrovich Vasyuk, Victor, Avenirovitch Kostenko, Yuriy, Borisovich Karpov, Vira, Iosifovna Tseluiko, Abram, Lvovich Syrkin, Boris, Mikhailovich Goloschekin, Evgeniy, Mikhaylovich Nifontov, Sergey, Nikolaevich Tereschenko, Natalia, Nikolaevna Burova, Konstantin, Nikolayevich Zrazhevsky, Grigory, Pavlovich Arutuynov, Valentin, Sergeevich Moiseev, Leonid, Victorovich Rudenko, Alexander, Yurievich Vishnevsky, Diaz, D.L.Y.De La Yera, Fernández, Romero, Cevat, Kirma, Kayikcioglu, Meral, Abdurrahman, Oğuzhan, Dilek, Ural Komsuoglu, Olena, Ankindinovna Koval, Alexan, Nikolaevich Parkhomenko, Igor, Petrovich Vakalyuk, Mykola, Tihonovich Vatutin, Valerii, Vladimirovich Batushkin, on behalf of the SMILE-4 Working, Party, and Cianflone, Domenico

Subjects
Male, Captopril, Diabetic Cardiomyopathies, Myocardial Infarction, Infarction, Angiotensin-Converting Enzyme Inhibitors, 030204 cardiovascular system & hematology, chemistry.chemical_compound, Ventricular Dysfunction, Left, 0302 clinical medicine, Diabetes mellitus, Ramipril, Retrospective Studie, Cardiovascular Disease, Medicine, Pharmacology (medical), 030212 general & internal medicine, Myocardial infarction, Diabetic Cardiomyopathie, Randomized Controlled Trials as Topic, Aspirin, Left ventricular dysfunction, General Medicine, Acetyl salicylic acid, Acute myocardial infarction, Angiotensin-converting enzyme inhibitors, Zofenopril, Cardiology and Cardiovascular Medicine, Pharmacology, Middle Aged, Cardiovascular Diseases, Cardiology, Platelet aggregation inhibitor, Drug Therapy, Combination, Female, medicine.drug, Human, medicine.medical_specialty, Diabetes mellitu, Systole, 03 medical and health sciences, Internal medicine, Humans, Aged, Retrospective Studies, business.industry, Platelet Aggregation Inhibitor, Angiotensin-Converting Enzyme Inhibitor, medicine.disease, chemistry, Angiotensin-converting enzyme inhibitor, business, Mace, Platelet Aggregation Inhibitors
Abstract

Summary Objective In the SMILE-4 study, zofenopril + acetyl salicylic acid (ASA) was more effective than ramipril + ASA on 1-year prevention of major cardiovascular events (MACE) in patients with acute myocardial infarction complicated by left ventricular dysfunction. In this retrospective analysis, we evaluated drug efficacy in subgroups of patients, according to a history of diabetes mellitus. Methods The primary study endpoint was 1-year combined occurrence of death or hospitalization for cardiovascular causes. Diabetes was defined according to medical history (previous known diagnosis). Results A total of 562 of 693 (81.0%) patients were classified as nondiabetics and 131 (18.9%) as diabetics. The adjusted rate of MACE was lower under zofenopril than under ramipril in both nondiabetics [27.9% vs. 34.9% ramipril; odds ratio, OR and 95% confidence interval: 0.55 (0.35, 0.86)] and diabetics [30.9% vs. 41.3%; 0.56 (0.18, 1.73)], although the difference was statistically significant only for the nondiabetic group (P = 0.013). Zofenopril was superior to ramipril as regards to the primary study endpoint in the subgroup of 157 patients with uncontrolled blood glucose (≥126 mg/dL), regardless of a previous diagnosis of diabetes [0.31 (0.10, 0.90), P = 0.030]. Zofenopril significantly reduced the risk of hospitalization for cardiovascular causes in both nondiabetics [0.64 (0.43, 0.96), P = 0.030] and diabetics [0.38 (0.15, 0.95), P = 0.038], whereas it was not better than ramipril in terms of prevention of cardiovascular deaths. Conclusions This retrospective analysis of the SMILE-4 study confirmed the good efficacy of zofenopril plus ASA in the prevention of long-term MACE also in the subgroup of patients with diabetes mellitus.

Published
2016

4. Long-Term Clinical Outcomes After Bioresorbable Vascular Scaffold Implantation for the Treatment of Coronary In-Stent Restenosis: A Multicenter Italian Experience

Author

Eugenio Stabile, Akihito Tanaka, Azeem Latib, Antonio Colombo, Maurizio Tespili, Elisabetta Moscarella, Attilio Varricchio, Claudia Capozzolo, Luigi Caliendo, Sebastian Coscarelli, Francesco Granata, Alfonso Ielasi, Bernardo Cortese, Moscarella, Elisabetta, Ielasi, Alfonso, Granata, Francesco, Coscarelli, Sebastian, Stabile, Eugenio, Latib, Azeem, Cortese, Bernardo, Tespili, Maurizio, Tanaka, Akihito, Capozzolo, Claudia, Caliendo, Luigi, Colombo, Antonio, and Varricchio, Attilio

Subjects
Male, Registrie, Time Factors, medicine.medical_treatment, Myocardial Infarction, Coronary Artery Disease, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, 0302 clinical medicine, Restenosis, Risk Factors, Coronary Restenosi, Recurrence, Absorbable Implants, Drug-Eluting Stent, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Registries, Metal, Hazard ratio, Drug-Eluting Stents, Middle Aged, Treatment Outcome, Italy, Drug-eluting stent, Metals, Cardiology, Female, Stents, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Time Factor, Revascularization, Prosthesis Design, Coronary Restenosis, 03 medical and health sciences, Percutaneous Coronary Intervention, Absorbable Implant, Internal medicine, medicine, Humans, Proportional Hazards Models, Aged, business.industry, Risk Factor, Percutaneous coronary intervention, Stent, medicine.disease, Confidence interval, Surgery, Prospective Studie, Proportional Hazards Model, stent, business
Abstract

Background— Treatment of in-stent restenosis (ISR) is still challenging. In this setting, the use of bioresorbable vascular scaffold (BVS) seems attractive because it allows drug delivery combined with transient vessel scaffolding. We aimed to investigate the long-term results after BVS use in ISR lesions. Methods and Results— A prospective analysis was performed on all patients who underwent percutaneous coronary intervention with BVS implantation for ISR at 7 Italian Centers. Primary end point was the device-oriented composite end point (cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization) at the longest follow-up available. From April 2012 to June 2014, 116 patients (127 lesions) underwent percutaneous coronary intervention for ISR with BVS implantation. Among the ISR lesions, the majority were drug-eluting stent ISR (78, 61.6%), de novo ISR (92, 72.4%), and diffuse ISR (81, 63.8%). Procedural success was achieved for all (100%) patients. No in-hospital death, myocardial infarction, or revascularization occurred. At 15 months of follow-up, the incidence of the device-oriented composite end point estimated with the Kaplan–Meier method was 9.1%. No significant differences were reported between drug-eluting stent and bare-metal stent ISR groups in terms of device-oriented composite end point (10.9% versus 6.4%; hazard ratio, 1.7; 95% confidence interval, 0.5–6.5; P =0.425) and its singular components (cardiac death: 2.8% versus 2.0%, hazard ratio, 1.3; 95% confidence interval, 0.1–14.1, P =0.843; target vessel myocardial infarction: 1.5% versus 0%, P =0.421; ischemia-driven target lesion revascularization: 9.6% versus 4.4%, hazard ratio, 2.3; 95% confidence interval, 0.5–10.8, P =0.309). Conclusions— Our registry suggests that the use of BVS implantation for the treatment of complex drug-eluting stent and bare-metal stent ISR lesions might be associated with acceptable long-term clinical outcomes.

Published
2016

5. Zofenopril and ramipril and acetylsalicylic acid in postmyocardial infarction patients with left ventricular systolic dysfunction: a retrospective analysis in hypertensive patients of the SMILE-4 study

Author

Borghi, Claudio, Ambrosioni, Ettore, Omboni, Stefano, Cicero, Arrigo F. G., Bacchelli, Stefano, Esposti, Daniela D., Vinereanu, Dragos, Ambrosio, Giuseppe, Zava, Dario, SMILE-4 Working Party: Dimitrios Alexopolulus, Mario Garcia Alvés, Aurora Andrade, Marco Agrusta, Antonio Barsotti, Serena Bergerone, Luigi Caliendo, Pio Caso, Antonio Castello, Domenico Cianflone, Tommaso Cipolla, Gaetano De Ferrari, Giuseppe De Nittis, Livio Dei Cas, Paolo Di Pasquale, Rosario Evola, Luciano Fattore, Raffaele Ferrante, Antonio Fiscella, Achille Gaspardone, Giuseppe Ielasi, Niccol ‘o Marchionni, Giancarlo Marenzi, Filippo Marte, Federico Miccoli, Patrizia Noussan, Ioannis Nanas, Salvatore Novo, Mario Orlandi, Giancarlo Piovaccari, Maurizio Porcu, Patrizia Presbitero, Antonio Raviele, Emiliano Renaldini, Jorge Uriarte Salerno, Giovanni Storti, Corrado Tamburino, Pierfranco Terrosu, Roberto Testa, Rita Trinchero, Bernardino Tuccillo, Ludovico Vasquez, Giovanni Quinto Villani, Claudio, Borghi, Ettore, Ambrosioni, Stefano, Omboni, Arrigo F. G., Cicero, Stefano, Bacchelli, Daniela D., Esposti, Dragos, Vinereanu, Giuseppe, Ambrosio, Dario, Zava, Working Party: Dimitrios Alexopolulus, SMILE-4, Garcia Alvés, Mario, Andrade, Aurora, Agrusta, Marco, Barsotti, Antonio, Bergerone, Serena, Caliendo, Luigi, Caso, Pio, Castello, Antonio, Cianflone, Domenico, Cipolla, Tommaso, De Ferrari, Gaetano, De Nittis, Giuseppe, Dei Cas, Livio, Di Pasquale, Paolo, Evola, Rosario, Fattore, Luciano, Ferrante, Raffaele, Fiscella, Antonio, Gaspardone, Achille, Ielasi, Giuseppe, ‘o Marchionni, Niccol, Marenzi, Giancarlo, Marte, Filippo, Miccoli, Federico, Noussan, Patrizia, Nanas, Ioanni, Novo, Salvatore, Orlandi, Mario, Piovaccari, Giancarlo, Porcu, Maurizio, Presbitero, Patrizia, Raviele, Antonio, Renaldini, Emiliano, Uriarte Salerno, Jorge, Storti, Giovanni, Tamburino, Corrado, Terrosu, Pierfranco, Testa, Roberto, Trinchero, Rita, Tuccillo, Bernardino, Vasquez, Ludovico, Quinto Villani, Giovanni, Claudio Borghi, Ettore Ambrosioni, Stefano Omboni, Arrigo F.G. Cicero, Stefano Bacchelli, Daniela D. Esposti, Dragos Vinereanu, Giuseppe Ambrosio, Dario Zava, and on behalf of the SMILE-4 Working Party

Subjects
Male, Captopril, Physiology, Myocardial Infarction, Infarction, Blood Pressure, law.invention, chemistry.chemical_compound, Ventricular Dysfunction, Left, Randomized controlled trial, Ramipril, Retrospective Studie, law, Retrospective analysis, zofenopril, Myocardial infarction, Randomized Controlled Trials as Topic, left ventricular dysfunction, Middle Aged, humanities, Zofenopril, Europe, Antihypertensive Agent, angiotensin-converting enzyme inhibitor, Hypertension, Cardiology, Female, Cardiology and Cardiovascular Medicine, Human, medicine.drug, arterial hypertension, medicine.medical_specialty, acute myocardial infarction, Internal medicine, Internal Medicine, medicine, Humans, cardiovascular diseases, Risk factor, Antihypertensive Agents, Aged, Retrospective Studies, Aspirin, business.industry, Platelet Aggregation Inhibitor, Retrospective cohort study, acetylsalicylic acid, medicine.disease, chemistry, business, Platelet Aggregation Inhibitors
Abstract

BACKGROUND: Antecedent hypertension represents a risk factor for adverse outcomes in survivors of acute myocardial infarction (AMI). Prognosis of such patients might be greatly improved by drugs enhancing blood pressure control. In the present retrospective analysis of the randomized, double-blind, parallel-group, SMILE-4 study we compared the efficacy of zofenopril 60 mg and acetylsalicylic acid (ASA) 100 mg versus ramipril 10 mg and ASA in patients with AMI complicated by left ventricular dysfunction, classified according to a history of hypertension. METHODS: The primary study end-point was 1-year combined occurrence of death or hospitalization for cardiovascular causes. Hypertension was defined according to medical history and current blood pressure values at entry and could be determined in 682 of 716 patients of the intention-to-treat analysis. RESULTS: One hundred and fifty-seven patients (23%) were normotensives and 525 (77%) hypertensives. In the normotensive population the primary end-point occurred in 19 of 76 zofenopril-treated patients (25%) and in 23 of 81 ramipril-treated patients (28%) [odds ratio (95% confidence interval): 0.84 (0.41-1.71), P = 0.631]. In the hypertensive population, major cardiovascular outcomes were reported in 84 of 273 zofenopril-treated patients (31%) and in 99 of 252 ramipril-treated patients (39%), with a 31% significantly (P = 0.041) lower risk with zofenopril [0.69 (0.48-0.99)]. The superiority of zofenopril versus ramipril was particularly evident in patients with isolated systolic hypertension [n = 131, 0.48 (0.23-0.99), P = 0.045]. CONCLUSION: This retrospective analysis of the SMILE-4 study confirmed the good efficacy of zofenopril and ASA in the prevention of long-term cardiovascular outcomes also in the subgroup of patients with hypertension.

Published
2013

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