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1. Syncope in hypertrophic cardiomyopathy (part I): An updated systematic review and meta-analysis

Author: Mascia, G, Crotti, L, Groppelli, A, Canepa, M, Merlo, A, Benenati, S, Di Donna, P, Della Bona, R, Soranna, D, Zambon, A, Porto, I, Olivotto, I, Parati, G, Brignole, M, Cecchi, F, Mascia G., Crotti L., Groppelli A., Canepa M., Merlo A. C., Benenati S., Di Donna P., Della Bona R., Soranna D., Zambon A., Porto I., Olivotto I., Parati G., Brignole M., Cecchi F., Mascia, G, Crotti, L, Groppelli, A, Canepa, M, Merlo, A, Benenati, S, Di Donna, P, Della Bona, R, Soranna, D, Zambon, A, Porto, I, Olivotto, I, Parati, G, Brignole, M, Cecchi, F, Mascia G., Crotti L., Groppelli A., Canepa M., Merlo A. C., Benenati S., Di Donna P., Della Bona R., Soranna D., Zambon A., Porto I., Olivotto I., Parati G., Brignole M., and Cecchi F.
Abstract: Aims: To describe the proportion of patients with syncope among those affected by hypertrophic cardiomyopathy (HCM) and the relevance of syncope as risk factor for sudden cardiac death and life-threatening arrhythmic events. Method and results: Systematic review of original articles that assessed syncope in HCM patients. Literature search of PubMed including all English publications from 1973 to 2021.We found 57 articles for a total of 21.791 patients; of these, 14 studies reported on arrhythmic events in the follow-up. Syncope was reported in 15.8% (3.452 of 21.791) patients. It was considered unexplained in 91% of cases. Life-threatening arrhythmic events occurred in 3.6% of non-syncopal patients and in 7.7% of syncopal patients during a mean follow-up of 5.6 years. A relative risk of 1.99 (95%CI 1.39 to 2.86) was estimated for syncope patients by the random effect model using Haldane continuity correction for 0 events. Conclusions: In the current practice, the cause of syncope remained unexplained in most patients affected by HCM. The management of patients seems mainly driven by risk stratification rather than identification of the aetiology of syncope. There is a need of precise instructions how to apply the recommendations of current guidelines to this disease, which tests are indicated and how to interpret their findings. The protocol was registered in Prospero (ID: 275963).
Published: 2022

2. Outcome and Morphofunctional Changes on Cardiac Magnetic Resonance in Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination

Author: Ammirati, E, Lupi, L, Palazzini, M, Ciabatti, M, Rossi, V, Gentile, P, Uribarri, A, Vecchio, C, Nassiacos, D, Cereda, A, Conca, C, Tumminello, G, Piriou, N, Lelarge, C, Pedrotti, P, Stucchi, M, Peretto, G, Galasso, M, Huang, F, Ianni, U, Procopio, A, Saponara, G, Cimaglia, P, Tomasoni, D, Moroni, F, Turco, A, Sala, S, Di Tano, G, Bollano, E, Moro, C, Abbate, A, Della Bona, R, Porto, I, Carugo, S, Campodonico, J, Pontone, G, Grosu, A, Bolognese, L, Salamanca, J, Diez-Villanueva, P, Ozieranski, K, Tyminska, A, Sardo Infirri, L, Bromage, D, Cannatà, A, Hong, K, Adamo, M, Quattrocchi, G, Foà, A, Potena, L, Garascia, A, Giannattasio, C, Adler, E, Sinagra, G, Ruschitzka, F, Camici, P, Metra, M, Pieroni, M, Ammirati, Enrico, Lupi, Laura, Palazzini, Matteo, Ciabatti, Michele, Rossi, Valentina A, Gentile, Piero, Uribarri, Aitor, Vecchio, Chiara R, Nassiacos, Daniele, Cereda, Alberto, Conca, Cristina, Tumminello, Gabriele, Piriou, Nicolas, Lelarge, Coline, Pedrotti, Patrizia, Stucchi, Miriam, Peretto, Giovanni, Galasso, Michele, Huang, Florent, Ianni, Umberto, Procopio, Antonio, Saponara, Gianluigi, Cimaglia, Paolo, Tomasoni, Daniela, Moroni, Francesco, Turco, Annalisa, Sala, Simone, Di Tano, Giuseppe, Bollano, Entela, Moro, Claudio, Abbate, Antonio, Della Bona, Roberta, Porto, Italo, Carugo, Stefano, Campodonico, Jeness, Pontone, Gianluca, Grosu, Aurelia, Bolognese, Leonardo, Salamanca, Jorge, Diez-Villanueva, Pablo, Ozieranski, Krzysztof, Tyminska, Agata, Sardo Infirri, Loren, Bromage, Daniel, Cannatà, Antonio, Hong, Kimberly N, Adamo, Marianna, Quattrocchi, Giuseppina, Foà, Alberto, Potena, Luciano, Garascia, Andrea, Giannattasio, Cristina, Adler, Eric D, Sinagra, Gianfranco, Ruschitzka, Frank, Camici, Paolo G, Metra, Marco, Pieroni, Maurizio, Ammirati, E, Lupi, L, Palazzini, M, Ciabatti, M, Rossi, V, Gentile, P, Uribarri, A, Vecchio, C, Nassiacos, D, Cereda, A, Conca, C, Tumminello, G, Piriou, N, Lelarge, C, Pedrotti, P, Stucchi, M, Peretto, G, Galasso, M, Huang, F, Ianni, U, Procopio, A, Saponara, G, Cimaglia, P, Tomasoni, D, Moroni, F, Turco, A, Sala, S, Di Tano, G, Bollano, E, Moro, C, Abbate, A, Della Bona, R, Porto, I, Carugo, S, Campodonico, J, Pontone, G, Grosu, A, Bolognese, L, Salamanca, J, Diez-Villanueva, P, Ozieranski, K, Tyminska, A, Sardo Infirri, L, Bromage, D, Cannatà, A, Hong, K, Adamo, M, Quattrocchi, G, Foà, A, Potena, L, Garascia, A, Giannattasio, C, Adler, E, Sinagra, G, Ruschitzka, F, Camici, P, Metra, M, Pieroni, M, Ammirati, Enrico, Lupi, Laura, Palazzini, Matteo, Ciabatti, Michele, Rossi, Valentina A, Gentile, Piero, Uribarri, Aitor, Vecchio, Chiara R, Nassiacos, Daniele, Cereda, Alberto, Conca, Cristina, Tumminello, Gabriele, Piriou, Nicolas, Lelarge, Coline, Pedrotti, Patrizia, Stucchi, Miriam, Peretto, Giovanni, Galasso, Michele, Huang, Florent, Ianni, Umberto, Procopio, Antonio, Saponara, Gianluigi, Cimaglia, Paolo, Tomasoni, Daniela, Moroni, Francesco, Turco, Annalisa, Sala, Simone, Di Tano, Giuseppe, Bollano, Entela, Moro, Claudio, Abbate, Antonio, Della Bona, Roberta, Porto, Italo, Carugo, Stefano, Campodonico, Jeness, Pontone, Gianluca, Grosu, Aurelia, Bolognese, Leonardo, Salamanca, Jorge, Diez-Villanueva, Pablo, Ozieranski, Krzysztof, Tyminska, Agata, Sardo Infirri, Loren, Bromage, Daniel, Cannatà, Antonio, Hong, Kimberly N, Adamo, Marianna, Quattrocchi, Giuseppina, Foà, Alberto, Potena, Luciano, Garascia, Andrea, Giannattasio, Cristina, Adler, Eric D, Sinagra, Gianfranco, Ruschitzka, Frank, Camici, Paolo G, Metra, Marco, and Pieroni, Maurizio
Published: 2023

3. Prevalence and prognostic value of cardiac troponin in elderly patients hospitalized for COVID-19

Author: de Marzo, V., Di Biagio, A., della Bona, R., Vena, A., Arboscello, E., Emirjona, H., Mora, S., Giacomini, M., da Rin, G., Pelosi, P., Bassetti, M., Ameri, P., Porto, I., Alessandrini, A., Camera, M., Delfino, E., de Maria, A., Dentone, C., Dodi, F., Ferrazin, A., Mazzarello, G., Mikulska, M., Nicolini, L., Toscanini, F., Giacobbe, D. R., Taramasso, L., Balletto, E., Portunato, F., Schenone, E., Rosseti, N., Baldi, F., Berruti, M., Briano, F., Dettori, S., Labate, L., Magnasco, L., Mirabella, M., Pincino, R., Russo, C., Sarteschi, G., Sepulcri, C., Tutino, S., Pontremoli, R., Beccati, V., Casciaro, S., Casu, M., Gavaudan, F., Ghinatti, M., Gualco, E., Leoncini, G., Pitto, P., Salam, K., Gratarola, A., Bixio, M., Amelia, A., Balestra, A., Ballarino, P., Bardi, N., Boccafogli, R., Caserza, F., Calzolari, E., Castelli, M., Cenni, E., Cortese, P., Cuttone, G., Feltrin, S., Giovinazzo, S., Giuntini, P., Nat-Ale, L., Orsi, D., Pastorino, M., Perazzo, T., Pescetelli, F., Schenone, F., Serra, M. G., Sottano, M., Brunetti, I., Loconte, M., Ball, L., Battaglini, D., Robba, C., Patroniti, N., Tallone, R., Amelotti, M., Majabo, M. J., Merlini, M., Perazzo, F., Ahamd, N., Barbera, P., Bovio, M., Cam-Podonico, P., Collida, A., Cutuli, O., Lomeo, A. -N., Fezza, F., Gentilucci, N., Hussein, N., Malvezzi, E., Mas-Sobrio, L., Motta, G., Pastorino, L., Pol-Licardo, N., Sartini, S., Vacca, P., Virga, V., Bezante, G. P., la Malfa, G., Valbusa, A., V. G., Ad, Bari-Sione, E., Bellotti, M., Teresita, A., Blanco, A., Grosso, M., Piroddi, M. G., Mosca-Telli, P., Caiti, M., Magnani, O., Sukkar, S., Cogorno, L., Gradaschi, R., Guiddo, E., Martino, E., Pisciotta, L., Cavagliere, B., Cristina, R., Francesca, F., Garibotto, G., Esposito, P., Passalacqua, G., Bagnasco, D., Braido, F., Riccio, A., Tagliabue, E., Gustavino, C., Ferraiolo, A., Giuffrida, S., Rosso, N., Morando, A., Papalia, R., Passerini, D., Tiberio, G., Orengo, G., Battaglini, A., Ruffoni, S., and Caglieris, S.
Subjects: Reseach Article
Abstract: BACKGROUND Increases in cardiac troponin (cTn) in coronavirus disease 2019 (COVID-19) have been associated with worse prognosis. Nonetheless, data about the significance of cTn in elderly subjects with COVID-19 are lacking. METHODS From a registry of consecutive patients with COVID-19 admitted to a hub hospital in Italy from 25/02/2020 to 03/07/2020, we selected those ≥ 60 year-old and with cTnI measured within three days from the molecular diagnosis of SARS-CoV-2 infection. When available, a second cTnI value within 48 h was also extracted. The relationship between increased cTnI and all-cause in-hospital mortality was evaluated by a Cox regression model and restricted cubic spline functions with three knots. RESULTS Of 343 included patients (median age: 75.0 (68.0−83.0) years, 34.7% men), 88 (25.7%) had cTnI above the upper-reference limit (0.046 µg/L). Patients with increased cTnI had more comorbidities, greater impaired respiratory exchange and higher inflammatory markers on admission than those with normal cTnI. Furthermore, they died more (73.9%vs. 37.3%, P < 0.001) over 15 (6−25) days of hospitalization. The association of elevated cTnI with mortality was confirmed by the adjusted Cox regression model (HR = 1.61, 95%CI: 1.06−2.52, P = 0.039) and was linear until 0.3 µg/L, with a subsequent plateau. Of 191 (55.7%) patients with a second cTnI measurement, 49 (25.7%) had an increasing trend, which was not associated with mortality (univariate HR = 1.39, 95%CI: 0.87−2.22, P = 0.265). CONCLUSIONS In elderly COVID-19 patients, an initial increase in cTn is common and predicts a higher risk of death. Serial cTn testing may not confer additional prognostic information.
Published: 2021

4. EURObservational Research Programme: the Chronic Ischaemic Cardiovascular Disease Registry: Pilot phase (CICD-PILOT)

Author: Komajda, Michel, Weidinger, Franz, Kerneis, Mathieu, Cosentino, Francesco, Cremonesi, Alberto, Ferrari, Roberto, Kownator, Serge, Steg, Philippe Gabriel, Tavazzi, Luigi, Valgimigli, Marco, Szwed, Hanna, Majda, Wojciech, Olivari, Zoran, Van Belle, Eric, Shlyakhto, Evgeny Vladimirovich, Mintale, Iveta, Slapikas, Rimvydas, Rittger, Harald, Mendes, Miguel, Tsioufis, Constantinos, Balanescu, Serban, Laroche, Cécile, Maggioni, Aldo Pietro, Komajda, Michel, Weidinger, Franz, Cosentino, Francesco, Cremonesi, Alberto, Ferrari, Roberto, Kownator, Serge, Maggioni, Aldo P., Steg, Gabriel, Tavazzi, Luigi, Valgimigli, Marco, Balanescu, Serban, Mendes, Miguel, Mintale, Iveta, Olivari, Zoran, Rittger, Harald, Shlyakhto, Evgeny V., Slapikas, Rimvydas, Szwed, Hanna, Van Belle, Éric, Laroche, Cécile, McNeill, Patti-Ann, Ferreira, Thierry, Vochelet, F., Tavildari, A., Silvestri, M., Maillard, L., Sevilla, J., Malaquin, D., Leborgne, L., Fournier, A., Jarry, G., Teiger, E., Marchant, B., Van Belle, E., Criquioche, A., Dupouy, P., Madiot, H., Lafitte, B., Belle, L., Cayla, G., Abouth-Benamara, S., Messas, E., Delarche, N., Bouvier, E., Couleru, J., Paparoni, F., Marchant, B., Bedossa, M., Lepage, Q., Le Bouquin, L., Auffret, V., Leurent, G., Boulmier, D., Le Breton, H., Vidal, C., Touet, M., Tron, C., Hemmerling, S., Flugel, P.-C., Beschorner, U., Noory, E., Strubin, J., Macharzina, R., Lindemann, C., Specht, T., Brantner, R., Zeller, T., Schwarzwalder, U., Hirschmann, S., Schonhardt, S., Slimack-Braun, S., Link, S., Hauk, M., Welslau, M., Henning, A., Menz, C., Buciuceanu, V., Rastan, A., Bschorr, R., Schmitt, C., Maas, C., Jacques, B., Bohme, T., Burgelin, K., Hoffmann, M., Pirzer, R., Brune, M., Braun, M., Stolte, D., Dietrich, A., Singh, A., Rittger, H., Schibgilla, V., Hopf, S., Fouridis, P., Fabiani, R., Jakob, A., Garlichs, C., Trautvetter, J., Schineis, N., Brugger, A., Bojanic, D., Matschke, C., Schmidt, A., Scheinert, D., Scheinert, S., Banning-Eichenseer, U., Stauffer, A., Straube, F., Hoffmann, E., Antoni, D., Rieber, J., Tomelden, J., Deichstetter, M., Landwehr, P., Reif, S., Kallikazaros, I., Tsioufis, C., Korkovili, M., Stamatelopoulos, K., Tsoumani, Z., Loizos, S., Kanakakis, I., Kampouridis, N., Simeonidis, D., Bougas, T., Chasapi, A., Alexopoulos, D., Xanthopoulou, I., Vogiatzi, X., Stavrou, K., Bampouri, T., Sicuro, M., Amato, G., Pisano, F., Casolati, D., Bare, C., Grotti, S., Angioli, P., Bolognese, L., Ducci, K., Porto, I., Falsini, G., Liisto, F., Manzi, R.C., Langiu, M., Lai, C., Lodolini, V., Biscaglia, S., Ferrari, R., Occhilupo, P., Tebaldi, M., Minarelli, M., Fileti, L., Campo, G., Sbarzaglia, P., Bonilla, N., Schiavina, G., dʼAlessandro, G., Borghesi, M., Cremonesi, A., Rota, I., Ghigliotti, G., Davi, F., Beccaria, F., Brunelli, C., Mussardo, M., Cisotta, F., Spagnolo, B., Liso, A., Dal Corso, L., Favretto, G., Borsatto, F., Benedetto, M., Cirrincione, G., Gandolfo, C., Caruso, M., Stabile, A., Lanteri, S., Riina, M., Lunetto, M.L., Vadala, G., Micari, A., Rossi, E., Griksteite, E., Cavallini, C., Longhi, S., Pasqualini, M., Negrelli, M., Pacchioni, E., Brunazzi, M.C., Marcomin, C., Neri, R., Cassin, M., Vendrametto, F., Macor, F., Nicolosi, G., Pavan, D., Piasentin, C., Roman-Pognuz, A., Taccheri, T., Calcagno, S., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Armato, A., Tarducci, R., Della Bona, R., Brandini, R., Rossi, P., Fronticelli, M., Casavecchia, M., Olivari, Z., Calzolari, D., Daniotti, A., Balcere, K., Stirna, V., Libins, A., Zabunova, M., Silina, E., Ozola, G., Rancane, G., Babarskiene, R., Viezelis, M., Petrauskaite, J., Rumbinaite, E., Stankala, S., Juszczyk, Z., Karwowska Polecka, W., Oleksza, A., Bialek, P., Klimczuk, A., Poplawski, A., Aksiucik, A., Musial, W., Swiecki, P., Marcinkiewicz-Siemion, M., Ptaszynska-Kopczynska, K., Prokop, J., Kubica, J., Janiszewska, E., Kopczynska, A., Tarnawska, M., Gruchala, M., Pajkowski, M., Raczak, G., Wojtowicz, D., Strozyk, A., Miekus, P., Szyman, M., Glaza, M., Roszko-Grycner, E., Szpajer, M., Wroblewska, M., Zadrozny, J., Muller, H., Puzio, E., Lesinski, D., Borowski, B., Kowalska, A., Wojtyniak, I., Krzewinska, J., Borej, G., Czaja, P., Janion, M., Zandecki, L., Kuczerowska, R., Bogacki, P., Kafara, M., Rola, A., Podolec, P., Waligora, M., Brozda, M., Skrzynska, M., Glowa, B., Gawor, Z., Dejak, P., Brylka, A., Banasiak, M., Simiera, M., Krecki, R., Ojrzanowski, M., Jankowski, L., Kupczynska, K., Kasprzak, J.D., Zapolski, T., Zarczuk, R., Lukasik, D., Wysokinski, A., Zalewska-Nowak, G., Tarnolicki, M., Major, M., Gorny, J., Krzyzanowski, W., Muzyk-Osikowicz, M., Boltryk, K., Grajek, S., Maczynski, M., Lesiak, M., Komosa, A., Drewnicki, A., Wolniewicz, L., Komorowska, E., Gmyrek, N., Kowalik, M., Kostka, M., Kaminski, L., Mikolowicz-Mosiadz, A., Mazur, R., Kosztowniak, M., Pajaczkowski, K., Duda, K., Kosno-Zak, J., Dworak-Podlewska, E., Burchard, E., Wrzosek, B., Gurba, S., Wozniak, P., Dabek, M., Kuzniar, J., Lyczywek, M., Szubielski, M., Gajewski, M., Wasiak, D., Oscik-Lukasiewicz, M., Kawka-Urbanek, T., Diks, F., Przywoska-Para, B., Drazkowicz-Gozdzik, B., Kornacewicz-Jach, Z., Kula, L., Goracy, J., Chlasta, J., Tomaniak, M., Opolski, G., Serafin, A., Pietrasik, A., Kosek, M., Jastrzebski, J., Witkowski, A., Pruszczyk, P., Roik, M., Kostrubiec, M., Irzyk, K., Wretowski, D., Labyk, A., Budaj, A., Maciejewski, P., Szwed, H., Majda, W., Chojecka, M., Mosur, M., Gajer-Blaszczyk, K., Bociaga, Z., Loboz-Rudnicka, M., Loboz-Grudzien, K., Jaroch, J., Rzyczkowska, B., Chelstowski, W., Lewandowska, A., Darocha, A., Skowron, W., Polonski, L., Maciol-Skurk, K., Madeira, S., Mendes, M., Brito, J., Santos, M., Leite, L., Vicente, J., Calisto, J., Faria, H., Jorge, E., Mendes, A., Santos, R., Pinto, P., Guedes, H., Placido, R., Correia, M.J., Cabrita, I., Rodrigues, C., Nunes Diogo, A., Magalhaes, A., Canas da Silva, A., Selas, M., Portugal, G., Viveiros Monteiro, A., Timoteo, A.T., Ribeiro, M., Espregueira Mendes, D., Rodrigues, R., Lopes, R., Ribeiro, V., Melao, F., Magalhaes, D., Silva, J., Ribeiro, V. Gama, Braga, P., Goncalves, M., de Morais, G. Pires, Melica, B., Rodrigues, A., Santos, L., Cojocaru, L., Mazilu, L., Suceveanu, A.I., Rusali, A., Parepa, I.R., Maxim, R., Matei, L., Ioanovici, S., Buzas, R., Mihaela Iuliana, M., Susan, M., Ionita, M., Coceala, L., Suceava, I., Ciobotaru, G., Lighezan, D., Nicolescu, C., Mukhametgatova, D., Baleeva, L., Galyavich, A., Gratsiansky, N.A., Erlikh, A., Kondratenko, V., Libis, R., Vezikova, N., Skopets, I., Marusenko, I., Lapshin, K., Yakovlev, A., Lokhovinina, N., Alugishvili, M., Panov, A., Abesadze, I., Salakhova, J., Kondrateva, I., and Duplyakov, D.
Published: 2016
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5. Brugada syndrome and syncope: a practical approach for diagnosis and treatment

Author: Mascia, G, Della Bona, R, Ameri, P, Canepa, M, Porto, I, Parati, G, Crotti, L, Brignole, M, Mascia, Giuseppe, Della Bona, Roberta, Ameri, Pietro, Canepa, Marco, Porto, Italo, Parati, Gianfranco, Crotti, Lia, Brignole, Michele, Mascia, G, Della Bona, R, Ameri, P, Canepa, M, Porto, I, Parati, G, Crotti, L, Brignole, M, Mascia, Giuseppe, Della Bona, Roberta, Ameri, Pietro, Canepa, Marco, Porto, Italo, Parati, Gianfranco, Crotti, Lia, and Brignole, Michele
Abstract: Syncope in patients with Brugada electrocardiogram pattern may represent a conundrum in the decision algorithm because incidental benign forms, especially neurally mediated syncope, are very frequent in this syndrome similarly to the general population. Arrhythmic syncope in Brugada syndrome typically results from a self-terminating sustained ventricular tachycardia or paroxysmal ventricular fibrillation, potentially leading to sudden cardiac death. Distinguishing syncope due to malignant arrhythmias from a benign form is often difficult unless an electrocardiogram is recorded during the episode. We performed a review of the existing literature and propose a practical approach for diagnosis and treatment of the patients with Brugada syndrome and syncope.
Published: 2021

6. Blood lactate predicts survival after percutaneous implantation of extracorporeal life support for refractory cardiac arrest or cardiogenic shock complicating acute coronary syndrome: insights from the CareGem registry

Author: Porto, I., Mattesini, A., D'Amario, D., Sorini Dini, C., Della Bona, R., Scicchitano, M., Vergallo, R., Martellini, A., Caporusso, S., Trani, C., Burzotta, F., Bruno, P., Di Mario, C., Crea, F., Valente, S., Massetti, M., Porto I. (ORCID:0000-0002-9854-5046), D'Amario D., Scicchitano M. (ORCID:0000-0002-9599-6642), Vergallo R., Trani C. (ORCID:0000-0001-9777-013X), Burzotta F. (ORCID:0000-0002-6569-9401), Bruno P. (ORCID:0000-0002-1075-5808), Di Mario C., Crea F. (ORCID:0000-0001-9404-8846), Valente S. (ORCID:0000-0003-4052-9200), Massetti M. (ORCID:0000-0002-7100-8478), Porto, I., Mattesini, A., D'Amario, D., Sorini Dini, C., Della Bona, R., Scicchitano, M., Vergallo, R., Martellini, A., Caporusso, S., Trani, C., Burzotta, F., Bruno, P., Di Mario, C., Crea, F., Valente, S., Massetti, M., Porto I. (ORCID:0000-0002-9854-5046), D'Amario D., Scicchitano M. (ORCID:0000-0002-9599-6642), Vergallo R., Trani C. (ORCID:0000-0001-9777-013X), Burzotta F. (ORCID:0000-0002-6569-9401), Bruno P. (ORCID:0000-0002-1075-5808), Di Mario C., Crea F. (ORCID:0000-0001-9404-8846), Valente S. (ORCID:0000-0003-4052-9200), and Massetti M. (ORCID:0000-0002-7100-8478)
Abstract: Refractory cardiogenic shock (RCS) or refractory cardiac arrest (RCA) complicating acute coronary syndrome (ACS) is associated with extremely high mortality rate. Veno-arterial extracorporeal life support (VA-ECLS) represents a valuable therapeutic option to stabilize patients’ condition before or at the time of emergency revascularization. We analyzed 29 consecutive patients with RCS or RCA complicating ACS, and implanted with VA-ECLS in two centers who have adopted a similar, structured approach to ECLS implantation. Data were collected from January 2010 to December 2015 and ECLS had to be percutaneously implanted either before (within 48 h) or at the time of attempted percutaneous coronary revascularization (PCI). We investigated in-hospital outcome and factors associated with survival. Twenty-one (72%) were implanted for RCA, whereas 8 (28%) were implanted on ECLS for RCS. All RCA were witnessed and no-flow time was shorter than 5 min in all cases but one. All patients underwent attempted emergency PCI, using radial access in ten cases (34.5%), whereas in three patients a subsequent CABG was performed. Overall, ten patients (34.5%) survived, nine of them with a good neurological outcome. Life threatening complications, including stroke (4 pts), leg ischemia (4 pts), intestinal ischemia (5 pts), and deep vein thrombosis 2 pts), occurred frequently, but were not associated with in-hospital death. Main cause of death was multi-organ failure. PCI variables did not predict survival. Survivors were younger, with shorter low-flow time, and with ECLS mainly implanted for RCS. At multivariate analysis, levels of lactate at ECLS implantation (OR 4.32, 95%CI 1.01–18.51, p = 0.049) emerged as the only variable that independently predicted survival. In patients with RCA or RCS complicating ACS who are percutaneously implanted with ECLS before or at the time of coronary revascularization, in hospital survival rate is higher than 30%. Level of lactate at ECLS im
Published: 2021

7. How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post-MI Study

Author: De Luca L., Colivicchi F., Meessen J., Uguccioni M., Piscione F., Bernabo P., Lardieri G., Granatelli A., Gabrielli D., Gulizia M. M., Silverio A., Benvenga R. M., Mascia F., Fusco A., Cicala S., Oltrona Visconti L., Marinoni B., Canosi U., Cirillo P., Trimarco B., Ziviello F., Grosseto D., Menozzi M., Mezzena D., Mauro C., Sasso A., Bellis A., Calabro P., Gragnano F., Cesaro A., Venturelli V., Porretta V., Borrelli N., Indolfi C., De Rosa S., Torella D., Morici N., Molfese M., Della Rovere F., Caiffa T., Moretto G., Grippo G., Di Vincenzo E., Lucisano L., Pennacchi M., Geraci G., Sanfilippo N., Ledda A., Di Lenarda A., Cherubini A., Russo G., Piemonte F., Di Donato A., Carraturo A., Villari B., Ciampi Q., Contaldi C., Pacher V., Corrada E., Cattani D., Nassiacos D., Meloni S., Barco B., Bonmassari R., Bertoldi A., Tedoldi F., Cannone M., Valenti G., Musci R. L., Caldarola P., Locuratolo N., Sublimi Saponetti L., Gentili L., Maiandi C., Caputo M., Capparuccia C. A., Tonella T., Massari F. M., Lupi A., Tessitori M., Montano M., Scaglione A., Torri A., Tortorella G., Navazio A., Cemin R., Latina L., Briguglia D., Marino R., Scalvini S., Zanelli E., Paganini V., Riboni G., Leiballi E., Della Mattia A., Imperadore F., Tespili M., Santangelo G., Parravicini U., Dellavesa P., Testa R., Venturini E., Feola M., Testa M., Crisci V., Tramontana M., Robiglio L., Varbella F., Meynet I., Galati A., Maddaluna A., Bilato C., Loddo I., Licciardello G., Cassaniti L., Scherillo M., Formigli D., Marullo L., Chianese L., Paolillo C., De Santis A. P. A., Brunetti N. D., Bottigliero D., Della Bona R., Giannico M. B., Tramarin R., Lucibello S., Perna G. P., Marini M., Colavita A. R., Raziliop A., Francese G. M., Mariani M., Collauto F., D'Urbano M., Naio R., Ando G., Saporito F., Assanelli E. M., Cabiati A., Crivaro A., Alberti S., Marchese I., Nejat T., Refice S., Raino R., Aiello A., Cristinziani G. R., Barilla F., Iorio R., Mascelli G., Tartaglione S. N., Di Chiara G., D'Andrea D., Antonicelli R., Malatesta G., Di Mario C., Mattesini A., Tramontana L., Conti S., Sommariva L., Celestini A., Amico F., Giubilato S., Amico A. F., De Filippis M., Pasini G. F., Triggiani M., Ferrara V., Cappetti S., Carugo S., Lucreziotti S., Persico M., Gizzi G., Cipolla T., Caronia A., Buia E., Pastori P., Scarpignato M., Biscottini E., Poletti F., Vimercati C., Pirola R., Barbieri E., Dugo C., De Cesare N., De Benedictis M. L., Ruggeri A., Campana C., Bonura S., Vigna C., Marchese N., Partesana N. G., Bandini P., Farinola G., Santoro D., Cassadonte F., Calabro F., Sansoni M., Abrignani M. G., Bonura F., Benvenuto M., Liso A., Passero T., Mori I., Pozzoni B., Prati F., Finocchiaro M. L., Tufano N., Miserrafiti B., Lacquaniti V., Del Piccolo F., Mohamad B., Spinnler M. T., Bovolo V., Rebulla E., Pieri M., Paloscia L., Di Clemente D., Mazzucco G., Micanti A., Peci P., Ornago O., Proietti F., Michisanti M., Reverzani A., Donatini A., Costa P., Russo S., Franceschini Grisolia E., Mario L., Di Palma F., Dell'Aquila F., Maestroni A., Caico S. I., De Caro G., Attianese L., Perotti S., Cotti Cometti V., Astengo D., Guerri E., Cianflone D., Maranta F., Esposito N., Malvezzi Caracciolo D'Aquino M., Caliendo L., Ricci C., Ceruso C. P., Lanteri S., Serdoz R., Bruno E., De Matteis C., Campagnuolo C., Ammirati M. A., Corrado V. M., Amado Eleas M. A., Fattore L., Ippoliti C., Turiano G., Piergentili C., Chiarella F., Capogrosso P., Perotti M., Di Marco S., Sibilio G., Di Lorenzo L., Aurelio A., Ramondo A. B., Zanna D., Cernetti C., Napolitano G., Negroni S., Alessandri N., Rigo F., Giusti F., Casu G., Vicentini A., Calculli G., Fera M. S., Lettica G. V., Vagheggini G., Piti A., Porfidia A., Di Leo A., Ravera A., Ciotta E., Sacca S., Silvestri O., Isidori S., Natali P., Anselmi M., Testa L., Antonelli A., Tavasci E., Furgi G., Lavorgna A., Gasparetto N., Bisceglia T., De Luca, L., Colivicchi, F., Meessen, J., Uguccioni, M., Piscione, F., Bernabo, P., Lardieri, G., Granatelli, A., Gabrielli, D., Gulizia, M. M., Silverio, A., Benvenga, R. M., Mascia, F., Fusco, A., Cicala, S., Oltrona Visconti, L., Marinoni, B., Canosi, U., Cirillo, P., Trimarco, B., Ziviello, F., Grosseto, D., Menozzi, M., Mezzena, D., Mauro, C., Sasso, A., Bellis, A., Calabro, P., Gragnano, F., Cesaro, A., Venturelli, V., Porretta, V., Borrelli, N., Indolfi, C., De Rosa, S., Torella, D., Morici, N., Molfese, M., Della Rovere, F., Caiffa, T., Moretto, G., Grippo, G., Di Vincenzo, E., Lucisano, L., Pennacchi, M., Geraci, G., Sanfilippo, N., Ledda, A., Di Lenarda, A., Cherubini, A., Russo, G., Piemonte, F., Di Donato, A., Carraturo, A., Villari, B., Ciampi, Q., Contaldi, C., Pacher, V., Corrada, E., Cattani, D., Nassiacos, D., Meloni, S., Barco, B., Bonmassari, R., Bertoldi, A., Tedoldi, F., Cannone, M., Valenti, G., Musci, R. L., Caldarola, P., Locuratolo, N., Sublimi Saponetti, L., Gentili, L., Maiandi, C., Caputo, M., Capparuccia, C. A., Tonella, T., Massari, F. M., Lupi, A., Tessitori, M., Montano, M., Scaglione, A., Torri, A., Tortorella, G., Navazio, A., Cemin, R., Latina, L., Briguglia, D., Marino, R., Scalvini, S., Zanelli, E., Paganini, V., Riboni, G., Leiballi, E., Della Mattia, A., Imperadore, F., Tespili, M., Santangelo, G., Parravicini, U., Dellavesa, P., Testa, R., Venturini, E., Feola, M., Testa, M., Crisci, V., Tramontana, M., Robiglio, L., Varbella, F., Meynet, I., Galati, A., Maddaluna, A., Bilato, C., Loddo, I., Licciardello, G., Cassaniti, L., Scherillo, M., Formigli, D., Marullo, L., Chianese, L., Paolillo, C., De Santis, A. P. A., Brunetti, N. D., Bottigliero, D., Della Bona, R., Giannico, M. B., Tramarin, R., Lucibello, S., Perna, G. P., Marini, M., Colavita, A. R., Francese, G. M., Mariani, M., Collauto, F., D'Urbano, M., Naio, R., Ando, G., Saporito, F., Assanelli, E. M., Cabiati, A., Crivaro, A., Alberti, S., Marchese, I., Nejat, T., Refice, S., Aiello, A., Cristinziani, G. R., Barilla, F., Iorio, R., Mascelli, G., Tartaglione, S. N., Di Chiara, G., D'Andrea, D., Antonicelli, R., Malatesta, G., Di Mario, C., Mattesini, A., Tramontana, L., Conti, S., Sommariva, L., Celestini, A., Amico, F., Giubilato, S., Amico, A. F., De Filippis, M., Pasini, G. F., Triggiani, M., Ferrara, V., Cappetti, S., Carugo, S., Lucreziotti, S., Persico, M., Gizzi, G., Cipolla, T., Caronia, A., Buia, E., Pastori, P., Scarpignato, M., Biscottini, E., Poletti, F., Vimercati, C., Pirola, R., Barbieri, E., Dugo, C., De Cesare, N., De Benedictis, M. L., Ruggeri, A., Campana, C., Bonura, S., Vigna, C., Marchese, N., Partesana, N. G., Bandini, P., Farinola, G., Santoro, D., Cassadonte, F., Calabro, F., Sansoni, M., Abrignani, M. G., Bonura, F., Benvenuto, M., Liso, A., Passero, T., Mori, I., Pozzoni, B., Prati, F., Finocchiaro, M. L., Tufano, N., Miserrafiti, B., Lacquaniti, V., Del Piccolo, F., Mohamad, B., Spinnler, M. T., Bovolo, V., Rebulla, E., Pieri, M., Paloscia, L., Di Clemente, D., Mazzucco, G., Micanti, A., Peci, P., Ornago, O., Proietti, F., Michisanti, M., Reverzani, A., Donatini, A., Costa, P., Russo, S., Franceschini Grisolia, E., Mario, L., Di Palma, F., Dell'Aquila, F., Maestroni, A., Caico, S. I., De Caro, G., Attianese, L., Perotti, S., Cotti Cometti, V., Astengo, D., Guerri, E., Cianflone, D., Maranta, F., Esposito, N., Malvezzi Caracciolo D'Aquino, M., Caliendo, L., Ricci, C., Ceruso, C. P., Lanteri, S., Serdoz, R., Bruno, E., De Matteis, C., Campagnuolo, C., Ammirati, M. A., Corrado, V. M., Amado Eleas, M. A., Fattore, L., Ippoliti, C., Turiano, G., Piergentili, C., Chiarella, F., Capogrosso, P., Perotti, M., Di Marco, S., Sibilio, G., Di Lorenzo, L., Aurelio, A., Ramondo, A. B., Zanna, D., Cernetti, C., Napolitano, G., Negroni, S., Alessandri, N., Rigo, F., Giusti, F., Casu, G., Vicentini, A., Calculli, G., Fera, M. S., Lettica, G. V., Vagheggini, G., Piti, A., Porfidia, A., Di Leo, A., Ravera, A., Ciotta, E., Sacca, S., Silvestri, O., Isidori, S., Natali, P., Anselmi, M., Testa, L., Antonelli, A., Tavasci, E., Furgi, G., Lavorgna, A., Gasparetto, N., Bisceglia, T., Raziliop, A., and Raino, R.
Subjects: Male, Multivariate analysis, Time Factors, medicine.medical_treatment, Myocardial Infarction, 030204 cardiovascular system & hematology, 0302 clinical medicine, Cardiologists, post‐MI, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Registries, intervention, risk, Dual Anti-Platelet Therapy, focused update, ticagrelor keywords plus:coronary-artery-disease, Atrial fibrillation, General Medicine, clopidogrel, dual antiplatelet therapy, percutaneous coronary intervention, post-mi, secondary prevention, dapt score, duration, management, Middle Aged, Clopidogrel, Treatment Outcome, Female, Cardiology and Cardiovascular Medicine, Ticagrelor, Human, medicine.drug, medicine.medical_specialty, animal structures, Time Factor, Clinical Investigations, Cardiologist, Drug Administration Schedule, Follow-Up Studie, ticagrelor, 03 medical and health sciences, Internal medicine, medicine, Humans, cardiovascular diseases, Aged, Aspirin, post-MI, Follow-Up Studies, Platelet Aggregation Inhibitors, Patient Selection, business.industry, Platelet Aggregation Inhibitor, Percutaneous coronary intervention, medicine.disease, Prospective Studie, Conventional PCI, Observational study, business
Abstract: Background Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1%) were on DAPT at the time of enrolment, and 450 (27.6%) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI.
Published: 2019

8. Blood lactate predicts survival after percutaneous implantation of extracorporeal life support for refractory cardiac arrest or cardiogenic shock complicating acute coronary syndrome: insights from the CareGem registry

Author: Porto, Italo, Mattesini, A., D'Amario, Domenico, Sorini Dini, C., Della Bona, R., Scicchitano, Bianca Maria, Vergallo, Rocco, Martellini, A., Caporusso, S., Trani, Carlo, Burzotta, Francesco, Bruno, Piergiorgio, Di Mario, Clara, Crea, Filippo, Valente, Salvatore, Massetti, Massimo, Porto I. (ORCID:0000-0002-9854-5046), D'Amario D., Scicchitano M. (ORCID:0000-0002-9599-6642), Vergallo R., Trani C. (ORCID:0000-0001-9777-013X), Burzotta F. (ORCID:0000-0002-6569-9401), Bruno P. (ORCID:0000-0002-1075-5808), Di Mario C., Crea F. (ORCID:0000-0001-9404-8846), Valente S. (ORCID:0000-0003-4052-9200), Massetti M. (ORCID:0000-0002-7100-8478), Porto, Italo, Mattesini, A., D'Amario, Domenico, Sorini Dini, C., Della Bona, R., Scicchitano, Bianca Maria, Vergallo, Rocco, Martellini, A., Caporusso, S., Trani, Carlo, Burzotta, Francesco, Bruno, Piergiorgio, Di Mario, Clara, Crea, Filippo, Valente, Salvatore, Massetti, Massimo, Porto I. (ORCID:0000-0002-9854-5046), D'Amario D., Scicchitano M. (ORCID:0000-0002-9599-6642), Vergallo R., Trani C. (ORCID:0000-0001-9777-013X), Burzotta F. (ORCID:0000-0002-6569-9401), Bruno P. (ORCID:0000-0002-1075-5808), Di Mario C., Crea F. (ORCID:0000-0001-9404-8846), Valente S. (ORCID:0000-0003-4052-9200), and Massetti M. (ORCID:0000-0002-7100-8478)
Abstract: Refractory cardiogenic shock (RCS) or refractory cardiac arrest (RCA) complicating acute coronary syndrome (ACS) is associated with extremely high mortality rate. Veno-arterial extracorporeal life support (VA-ECLS) represents a valuable therapeutic option to stabilize patients’ condition before or at the time of emergency revascularization. We analyzed 29 consecutive patients with RCS or RCA complicating ACS, and implanted with VA-ECLS in two centers who have adopted a similar, structured approach to ECLS implantation. Data were collected from January 2010 to December 2015 and ECLS had to be percutaneously implanted either before (within 48 h) or at the time of attempted percutaneous coronary revascularization (PCI). We investigated in-hospital outcome and factors associated with survival. Twenty-one (72%) were implanted for RCA, whereas 8 (28%) were implanted on ECLS for RCS. All RCA were witnessed and no-flow time was shorter than 5 min in all cases but one. All patients underwent attempted emergency PCI, using radial access in ten cases (34.5%), whereas in three patients a subsequent CABG was performed. Overall, ten patients (34.5%) survived, nine of them with a good neurological outcome. Life threatening complications, including stroke (4 pts), leg ischemia (4 pts), intestinal ischemia (5 pts), and deep vein thrombosis 2 pts), occurred frequently, but were not associated with in-hospital death. Main cause of death was multi-organ failure. PCI variables did not predict survival. Survivors were younger, with shorter low-flow time, and with ECLS mainly implanted for RCS. At multivariate analysis, levels of lactate at ECLS implantation (OR 4.32, 95%CI 1.01–18.51, p = 0.049) emerged as the only variable that independently predicted survival. In patients with RCA or RCS complicating ACS who are percutaneously implanted with ECLS before or at the time of coronary revascularization, in hospital survival rate is higher than 30%. Level of lactate at ECLS im
Published: 2020

9. Acute kidney injury after transcatheter aortic valve replacement: predictors and prognostic impact from a single, high-volume centre

Author: De Marzo, V, primary, Crimi, G, additional, Gil Ad, V, additional, Benenati, S, additional, Pescetelli, F, additional, Della Bona, R, additional, Balbi, M, additional, and Porto, I, additional
Published: 2020
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10. Reduced thromboxane production in morbidly obese subjects: another facet of the ‘obesity paradox’: O15B-5

Author: Cialdella, P, Graziani, F, Biasucci, L M, Giubilato, S, Liuzzo, G, Della Bona, R, Pulcinelli, F M, laconelli, A, Mingrone, G, and Crea, F
Published: 2010

11. Dropping aspirin in patients with atrial fibrillation undergoing percutaneous coronary intervention: A jump with a weak parachute?

Author: Galli, Mattia, Andreotti, Felicita, Savarese, G., D'Amario, D., Vergallo, Rocco, Della Bona, R., Calo, L., Porto, Italo, Crea, Filippo, Galli M., Andreotti F. (ORCID:0000-0002-1456-6430), Vergallo R., Porto I. (ORCID:0000-0002-9854-5046), Crea F. (ORCID:0000-0001-9404-8846), Galli, Mattia, Andreotti, Felicita, Savarese, G., D'Amario, D., Vergallo, Rocco, Della Bona, R., Calo, L., Porto, Italo, Crea, Filippo, Galli M., Andreotti F. (ORCID:0000-0002-1456-6430), Vergallo R., Porto I. (ORCID:0000-0002-9854-5046), and Crea F. (ORCID:0000-0001-9404-8846)
Abstract: N/A
Published: 2019

12. Early anticoagulation in the current management of NSTE-ACS: Evidence, guidelines, practice and perspectives

Author: Galli, Mattia, Porto, Italo, Andreotti, Felicita, D'Amario, D., Vergallo, Rocco, Della Bona, R., Crea, Filippo, Galli M., Porto I. (ORCID:0000-0002-9854-5046), Andreotti F. (ORCID:0000-0002-1456-6430), Vergallo R., Crea F. (ORCID:0000-0001-9404-8846), Galli, Mattia, Porto, Italo, Andreotti, Felicita, D'Amario, D., Vergallo, Rocco, Della Bona, R., Crea, Filippo, Galli M., Porto I. (ORCID:0000-0002-9854-5046), Andreotti F. (ORCID:0000-0002-1456-6430), Vergallo R., and Crea F. (ORCID:0000-0001-9404-8846)
Abstract: Anticoagulant therapy during the acute phase of non-ST elevation acute coronary syndromes (NSTE-ACS) is strongly recommended by current international guidelines. Evidence supporting the use of anticoagulant therapy in the early phase of NSTE-ACS however, is based on dated trials mostly performed in the nineties and recent randomised clinical trials (RCTs), performed during the last 15 years, clearly evidence a dichotomy in the investigation of antiplatelet and anticoagulant strategies. Many innovations have since occurred in the diagnosis and management of NSTE-ACS. Since a RCT evaluating the efficacy of anticoagulant therapy versus placebo in a contemporary setting of NSTE-ACS management is lacking, we provide a systematic review of 1) the randomised data for ATT in the early phase of NSTE-ACS; 2) modern international guidelines, and 3) contemporary clinical practice data. The results are analysed and potential treatment and research strategies are proposed. (c) 2018 Elsevier B.V. All rights reserved.
Published: 2019

13. Effects of bariatric surgery on cardiac remodeling: clinical and pathophysiologic implications

Author: Graziani, F., primary, Leone, A. M., additional, Cialdella, P., additional, Basile, E., additional, Della Bona, R., additional, Iaconelli, A., additional, Liuzzo, G., additional, Biasucci, L. M., additional, Mingrone, G., additional, and Crea, F., additional
Published: 2013
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14. Anti-inflammatory Treatment of Acute Coronary Syndromes

Author: Della Bona, R., primary, Liuzzo, G., additional, Pedicino, D., additional, and Crea, F., additional
Published: 2011
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15. Abstracts

Author: Barthelemy, O., primary, Silvain, J., additional, Brieger, D., additional, Bellemain-Appaix, A., additional, Cayla, G., additional, Beygui, F., additional, Lancar, R., additional, Collet, J. P., additional, Mercadier, A., additional, Montalescot, G., additional, Cha, K. S., additional, Nam, Y. H., additional, Kim, J. H., additional, Park, S. Y., additional, Park, T. H., additional, Kim, M. H., additional, Kim, Y. D., additional, Lee, H. C., additional, Ahn, M. S., additional, Hong, T. J., additional, Blanco, R., additional, Blanco, F., additional, Szarfer, J., additional, Garcia Escudero, A., additional, Gigena, G., additional, Gagliardi, J., additional, Rodriguez, A., additional, Sarmiento, R., additional, Affatatto, S., additional, Riccitelli, M., additional, Petris, A., additional, Datcu, M. D., additional, Pop, C., additional, Radoi, M., additional, Arsenescu-Georgescu, C., additional, Petrescu, I., additional, Petrescu, L., additional, Serban, L., additional, Nechita, E., additional, Tatu-Chitoiu, G., additional, Dorobantu, M., additional, Benedek, I., additional, Craiu, E., additional, Sinescu, C., additional, Ionescu, D. D., additional, Ginghina, C., additional, Minescu, B., additional, Izzo, A., additional, Mantovani, P., additional, Tomasi, L., additional, Dall'oglio, L., additional, Bonatti, S., additional, Rosiello, R., additional, Romano, M., additional, Agostini, F., additional, Zanini, R., additional, Zhao, Z. Y., additional, Wu, Y. J., additional, Li, J. J., additional, Yany, Y. J., additional, Qian, H. Y., additional, Tang, Y. D., additional, Timoteo, A. T., additional, Toste, A., additional, Lousinha, A., additional, Ramos, R., additional, Oliveira, J. A., additional, Ferreira, M. L., additional, Ferreira, R. C., additional, Cabades, C., additional, Diez Gil, J. L., additional, Aguar, P., additional, Sanmiguel, D., additional, Lopez-March, A., additional, Marmol, R., additional, Guerra, L., additional, Girbes, V., additional, Ferrando, J., additional, Rincon De Arellano, A., additional, Patricio, L., additional, Blondal, M., additional, Ainla, T., additional, Marandi, T., additional, Eha, J., additional, Oliveira, M. M., additional, Silva, M. N., additional, Cunha, P. S., additional, Feliciano, J., additional, Silva, S., additional, Kanovsky, J., additional, Kala, P., additional, Parenica, J., additional, Poloczek, M., additional, Prymusova, K., additional, Kubkova, L., additional, Spinar, J., additional, Olinic, D., additional, Homorodean, C., additional, Ober, M., additional, Olinic, M., additional, Andrioaia, C., additional, Condac, A., additional, Masmoudi, M., additional, Berdaoui, B., additional, Labidi, S., additional, Tapia Ballesteros, C., additional, Hernandez Luis, C., additional, Sandin, M. G., additional, Vegas, J. M., additional, Andion, R., additional, Martinez, N., additional, Gonzalez, I. A., additional, Alvarado, M., additional, Amat, I. J., additional, San Roman, J. A., additional, Garcia Gonzalez, M. J., additional, Arroyo Ucar, E., additional, Hernandez Garcia, C., additional, Dorta Martin, M., additional, Marrero Rodriguez, F., additional, Dragu, R., additional, Kapeliovich, M., additional, Hammerman, H., additional, Silva, D., additional, Cortez-Dias, N., additional, Jorge, C., additional, Silva Marques, J., additional, Carilho Ferreira, P., additional, Robalo Martins, S., additional, Almeida Ribeiro, M., additional, Calisto, C., additional, Fiuza, M., additional, Lopes, M. G., additional, Milicevic, P., additional, Panic, M., additional, Stankovic, I., additional, Milicevic, D., additional, Kalezic, T., additional, Kafedzic, S., additional, Ilic, I., additional, Cerovic, M., additional, Putnikovic, B., additional, Neskovic, A., additional, Rott, D., additional, Leibowitz, D., additional, Monhart, Z., additional, Reissigova, J., additional, Grunfeldova, H., additional, Jansky, P., additional, Valente, B., additional, Villanueva Benito, I., additional, Solla, I., additional, Paredes, E., additional, Diaz Castro, O., additional, Calvo, F., additional, Baz, J. A., additional, Iniguez, A., additional, Aleksova, A., additional, Gerloni, R., additional, Belfiore, R., additional, Carriere, C., additional, Barbati, G., additional, Fabris, E., additional, Possa, F., additional, Nait, D., additional, Milo, M., additional, Sinagra, G., additional, Marques, N., additional, Mimoso, J., additional, Gomes, V., additional, Agra Bermejo, R. M., additional, Emad Abu Assi, E. A. A., additional, Sergio Raposeiras Roubin, S. R. R., additional, Pilar Cabanas Grandio, P. C. G., additional, Carlos Pena Gil, C. P. G., additional, Jose Maria Garcia Acuna, J. M. G. A., additional, Jose Ramon Gonzalez Juanatey, J. R. G. J., additional, Daly, M. J., additional, Scott, P., additional, Owens, C. G., additional, Tomlin, A., additional, Smith, B., additional, Adgey, A. A. J., additional, Alvarez-Contreras, L. R., additional, Juarez, U., additional, Altamirano, A., additional, Arias, A., additional, Alvarez-San Gabriel, A., additional, Gonzalez-Pacheco, H., additional, Martinez-Sanchez, C., additional, Rahnavardi, M., additional, Keshtkar-Jahromi, M., additional, Vakili, H., additional, Gholamin, S., additional, Razavi, S. M., additional, Gilis-Januszewski, T., additional, Mellwig, K.- P., additional, Wiemer, M., additional, Gilis-Januszewski, J., additional, Peterschroeder, A., additional, Koerfer, J., additional, Horstkotte, D., additional, Vrsalovic, M., additional, Getaldic, B., additional, Vrkic, N., additional, Pintaric, H., additional, Khan, S., additional, Wasan, B., additional, Moretti, L., additional, Grossi, P., additional, Silenzi, S., additional, Testa, M., additional, Candelori, L., additional, Clementi, L. N., additional, Forlini, M., additional, Lando, L., additional, Pezzuoli, M. L., additional, Corradetti, P., additional, Leurent, G., additional, Pennec, P. Y., additional, Filippi, E., additional, Moquet, B., additional, Hacot, J. 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S., additional, Carvalho De Sousa, J., additional, Uthoff, H., additional, Thalhammer, C., additional, Potocki, M., additional, Reichlin, T., additional, Noveanu, M., additional, Aschwanden, M., additional, Staub, D., additional, Arenja, N., additional, Socrates, T., additional, Mueller, C., additional, Zhao, Y., additional, Wu, X., additional, Xue, Q., additional, Gao, L., additional, Lin, H., additional, Wang, S., additional, Watanabe, K., additional, Kawamura, A., additional, Seko, T., additional, Omura, A., additional, Sakabe, S., additional, Kasai, A., additional, Starodubova, A. V., additional, Storozhakov, G., additional, Kisliak, O., additional, Hautieva, F., additional, Tursheva, M., additional, Fedotova, N., additional, Di Maio, R. C., additional, Mclaughlin, J., additional, Allen, J. D., additional, Anderson, J. M. C., additional, Khaled Nagi, H., additional, Tayeh, O., additional, Farok, W., additional, Mousa, A., additional, Neuzil, P., additional, Skoda, J., additional, Petru, J., additional, Sediva, L., additional, Kralovec, S., additional, Holy, F., additional, Holdova, K., additional, Jehlicka, P., additional, Plasil, P., additional, Reddy, V. Y., additional, Alabakovska, S., additional, Labudovic, D., additional, Jovanova, S., additional, Tosheska, K., additional, Alabakovski, M., additional, Jeevaratnam, K., additional, Tee, S. P., additional, Zhang, Y., additional, Guzadhur, L., additional, Gurung, I. S., additional, Duehmke, R., additional, Grace, A. A., additional, Lei, M., additional, Huang, C. 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M., additional, Juarez-Prera, R., additional, Blanco-Palacios, G., additional, Lakhdar, R., additional, Drissa, M., additional, Jedaida, B., additional, Drissa, H., additional, Sampaio, F., additional, Hsin, H.- T., additional, Huang, J.- H., additional, Chiu, K.- M., additional, Chen, Z.- S., additional, Lin, P.- C., additional, Chen, L.- Y., additional, Chu, S.- H., additional, Efthimiadis, I., additional, Skendros, P., additional, Sarantopoulos, A., additional, Boura, P., additional, Van Der Laan, A. M., additional, Van Der Vleuten, P. A., additional, Klees, M., additional, Tijssen, J. G. P., additional, Backus, B. E., additional, Six, A. J., additional, Kelder, J. H., additional, Mosterd, A., additional, Mast, E. G., additional, Mast, T. P., additional, Braam, R., additional, Tio, R., additional, Veldkamp, R., additional, Doevendans, P. A., additional, Paarup Dridi, N., additional, Holmvang, L., additional, Engstroem, T., additional, Rekik, S., additional, Brunet, J., additional, Hager, F. X., additional, Bayet, G., additional, Meille, L., additional, Quatre, J. M., additional, Sainsous, J., additional, Chu, P.- H., additional, Tang, C.- H., additional, Pogosova, N., additional, Koltunov, I. E., additional, Sapunova, I. D., additional, Vigodin, V. A., additional, Uhliar, R., additional, Schmidt, A., additional, Brockmeyer, B., additional, Suzuki, A., additional, Eki, Y., additional, Higuchi, H., additional, Yukawa, A., additional, Yamauchi, R., additional, Sato, Y., additional, Endo, Y., additional, Salazar Mendigucha Garcia, J., additional, Homs Vila, S., additional, Cequier Fillat, A., additional, Andion Ogando, R., additional, Sandin Fuentes, M., additional, Vegas Valle, J. M., additional, Gonzalez Garcia, I. A., additional, Duro Aguado, I. A., additional, Palomino Doza, A. J., additional, Gomez Salvador, I., additional, San Roman Calvar, J. A., additional, Mamarasulov, T. M., additional, Todorovic, L., additional, Cherneva, Z. C. H., additional, Denchev, S. D., additional, Heltai, K., additional, Boytsov, A., additional, Nikulina, N. N., additional, Zanna, D., additional, Marangelli, V., additional, Caiati, C., additional, Picon Heras, R., additional, Loureiro, M. J., additional, Urazovskaya, I., additional, Vinogradova, D., additional, Vasilieva, E., additional, Shpektor, A., additional, Conti, E., additional, Musumeci, M. B., additional, Lauri, F. M., additional, Dito, E., additional, De Giusti, M., additional, Lallo, A., additional, Fusco, D., additional, Davoli, M., additional, Volpe, M., additional, Autore, C., additional, Gamra, H., additional, Dridi, Z., additional, Hassine, M., additional, Addad, F., additional, Gherissi, I., additional, Reda, A., additional, Mahjoub, M., additional, Bouraoui, S., additional, Abdennadher, M., additional, Betbout, F., additional, Mota, P. M. F. P., additional, Silva, J. D., additional, Jankovic Tomasevic, R., additional, Djordjevic, V., additional, Djordjevic Radojkovic, D., additional, Scafa Udriste, A., additional, Fruntelata, A., additional, Gainoiu, E., additional, Bogdan, S., additional, Zamfir, D., additional, Teodorescu, C., additional, Guran, M., additional, Constantinescu, D., additional, Konopka, A., additional, Banaszewski, M., additional, Wojtkowska, I., additional, Stepinska, J., additional, Vidergold, J. V., additional, Osipova, I. V., additional, Tavrovskaya, T. V., additional, Galkina, J. V., additional, Timofeev, A. V., additional, Vorobyov, R. I., additional, Vorobyova, E. N., additional, Matos, L., additional, Carvalho, A. C. C., additional, Oliveira, W., additional, Cintra, F., additional, Poyares, D., additional, Andersen, M., additional, Martins, R., additional, Tufik, S., additional, Ostadal, P., additional, Brada, J., additional, Horakova, S., additional, Mlcek, M., additional, Hrachovina, V., additional, Kittnar, O., additional, Gorudko, I. V., additional, Buko, I. V., additional, Cherenkevich, S. N., additional, Polonetsky, L. Z., additional, Plotkin, V. Y., additional, Timoshina, M. A., additional, Azanchevskaya, S. V., additional, Chromov-Borisov, N. N., additional, Vorlat, A., additional, Snoep, L., additional, Claeys, M. J., additional, Vrints, C. J., additional, Palazzuoli, A., additional, Caputo, M., additional, Quatrini, I., additional, Calabro, A., additional, Antonelli, G., additional, Campagna, M. S., additional, Franci, B., additional, Nuti, R., additional, Maisel, A., additional, Negrini, M., additional, Minora, T., additional, Marino, P., additional, Seregni, R., additional, Tavlueva, E., additional, Barbarash, O., additional, Barbarash, L., additional, Janota, T., additional, Kudlicka, J., additional, Malik, K., additional, Wichterle, D., additional, Hradec, J., additional, Body, R., additional, Carley, S. D., additional, Mcdowell, G., additional, Nuttall, M., additional, Wibberley, C., additional, France, M., additional, Cruickshank, J. K., additional, Mackway-Jones, K., additional, Leon, M., additional, Cozma, C., additional, Mitu, F., additional, Almeida, D. R., additional, Dias, C. B., additional, Burazor, I., additional, Burazor, M., additional, Krstic, M., additional, Lazovic, M., additional, Vukmanovic, M., additional, Djordjevic, J., additional, Radovanovic, Z., additional, Ilic, D., additional, Bosnjakovic, P., additional, Ferreira, A. C., additional, Mateus, P. S., additional, Fontes, P., additional, Teixeira, T., additional, Conte, G., additional, Menozzi, A., additional, Solinas, E., additional, Bolognesi, M. G., additional, Tadonio, I., additional, Mantovani, F., additional, Cattabiani, A., additional, Vignali, L., additional, Ardissino, D., additional, Tautu, O., additional, Alexandrescu, A., additional, Niculescu, R., additional, Jankovic, R., additional, Bozinovic, N., additional, Santos, C., additional, Costa, F., additional, Cardoso, G., additional, Correia, I., additional, Fountoulaki, K., additional, Kastellanos, S., additional, Voltirakis, E., additional, Kokotos, A., additional, Michalakeas, C., additional, Kontsas, K., additional, Hasioti, K., additional, Iliodromitis, E. T., additional, Sandin Fuentes, M. G., additional, Zatarain Nicolas, E., additional, Martinez Uruena, N., additional, Alvarado Montes De Oca, M., additional, Dytrych, V., additional, Kovarnik, T., additional, Smid, O., additional, Kral, A., additional, Aroutunov, A. G., additional, Intwala, S., additional, Jegere, I., additional, Shaalan, H. S. H., additional, Pagava, Z., additional, Agladze, R., additional, Shakarishvili, R., additional, Sharashidze, N., additional, Gujejiani, L., additional, Saatashvili, G., additional, Katova, T. Z., additional, Kostova, V., additional, Simova, Y., additional, Vukotic, S., additional, Rafajlovski, S., additional, Romanovic, R., additional, Antonijevic, N., additional, Gligic, B., additional, Hutyra, M., additional, Skala, T., additional, Horak, D., additional, Vindis, D., additional, Taborsky, M., additional, Contine, A., additional, Del Pinto, M., additional, Angeli, F., additional, Verdecchia, P., additional, Borgognoni, F., additional, Grikstaite, E., additional, Pantano, P., additional, Ambrosio, G., additional, Cavallini, C., additional, Bonanad, C., additional, Sanchis, J., additional, Bodi, V., additional, Nunez, J., additional, Bosch, X., additional, Heras, M., additional, Pellicer, M., additional, Llacer, A., additional, Adao, L., additional, Oliveira, M., additional, Goncalves, H., additional, Primo, J., additional, Gama, V., additional, Lombardi, C., additional, Metra, M., additional, Bugatti, S., additional, Pasotti, E., additional, Quinzani, F., additional, Adamo, M., additional, Villa, C., additional, Rovetta, R., additional, Manerba, A., additional, Mariani, M., additional, Dushpanova, A., additional, Baroni, M., additional, Cerone, E., additional, Nardelli, A., additional, Gianetti, J., additional, Berti, S., additional, Feliciano, F., additional, Soares, R., additional, Santos, S., additional, Kruger, A., additional, Vondrakova, D., additional, Herget, J., additional, Navarro, C., additional, Cromie, N. A., additional, Adgey, J. A. A., additional, Caeiro Pereira, D., additional, Braga, P., additional, Fontes Carvalho, R., additional, Rodrigues, A., additional, Goncalves, M., additional, Simoes, L., additional, and Borisov, K. V., additional
Published: 2010
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16. Cell survival: is not all about apoptosis: reply

Author: Biasucci, L. M., primary, Liuzzo, G., additional, Della Bona, R., additional, Leo, M., additional, Giubilato, S., additional, and Crea, F., additional
Published: 2009
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17. Delayed neutrophil apoptosis in patients with unstable angina: relation to C-reactive protein and recurrence of instability

Author: Biasucci, L. M., primary, Liuzzo, G., additional, Giubilato, S., additional, Della Bona, R., additional, Leo, M., additional, Pinnelli, M., additional, Severino, A., additional, Gabriele, M., additional, Brugaletta, S., additional, Piro, M., additional, and Crea, F., additional
Published: 2009
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18. Serum levels of γ-glutamyltransferase and progression of coronary atherosclerosis.

Author: Niccoli G, Della Bona R, Cosentino N, D'Amario D, Belloni F, Conti MG, Gustapane M, Fracassi F, Biasucci LM, Falcioni E, Antonazzo Panico R, Crea F, Niccoli, Giampaolo, Della Bona, Roberta, Cosentino, Nicola, D'Amario, Domenico, Belloni, Flavia, Conti, Maria G, Gustapane, Massimo, and Fracassi, Francesco
Published: 2013
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19. Prognostic biomarkers in ST-segment elevation myocardial infarction: a step toward personalized medicine or a tool in search of an application?

Author: Biasucci LM and Della Bona R
Published: 2011

20. Syncope in hypertrophic cardiomyopathy (part I): An updated systematic review and meta-analysis

Author: Giuseppe Mascia, Lia Crotti, Antonella Groppelli, Marco Canepa, Andrea Carlo Merlo, Stefano Benenati, Paolo Di Donna, Roberta Della Bona, Davide Soranna, Antonella Zambon, Italo Porto, Iacopo Olivotto, Gianfranco Parati, Michele Brignole, Franco Cecchi, Mascia, G, Crotti, L, Groppelli, A, Canepa, M, Merlo, A, Benenati, S, Di Donna, P, Della Bona, R, Soranna, D, Zambon, A, Porto, I, Olivotto, I, Parati, G, Brignole, M, and Cecchi, F
Subjects: Death, Sudden, Cardiac, Risk Factors, Sudden death, Humans, Lifethreatening arrhythmia, Cardiomyopathy, Hypertrophic, Diagnostic test, Cardiology and Cardiovascular Medicine, Risk Assessment, Syncope, Hypertrophic cardiomyopathy
Abstract: Aims: To describe the proportion of patients with syncope among those affected by hypertrophic cardiomyopathy (HCM) and the relevance of syncope as risk factor for sudden cardiac death and life-threatening arrhythmic events. Method and results: Systematic review of original articles that assessed syncope in HCM patients. Literature search of PubMed including all English publications from 1973 to 2021.We found 57 articles for a total of 21.791 patients; of these, 14 studies reported on arrhythmic events in the follow-up. Syncope was reported in 15.8% (3.452 of 21.791) patients. It was considered unexplained in 91% of cases. Life-threatening arrhythmic events occurred in 3.6% of non-syncopal patients and in 7.7% of syncopal patients during a mean follow-up of 5.6 years. A relative risk of 1.99 (95%CI 1.39 to 2.86) was estimated for syncope patients by the random effect model using Haldane continuity correction for 0 events. Conclusions: In the current practice, the cause of syncope remained unexplained in most patients affected by HCM. The management of patients seems mainly driven by risk stratification rather than identification of the aetiology of syncope. There is a need of precise instructions how to apply the recommendations of current guidelines to this disease, which tests are indicated and how to interpret their findings. The protocol was registered in Prospero (ID: 275963).
Published: 2022

21. Outcome and Morphofunctional Changes on Cardiac Magnetic Resonance in Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination

Author: Enrico Ammirati, Laura Lupi, Matteo Palazzini, Michele Ciabatti, Valentina A. Rossi, Piero Gentile, Aitor Uribarri, Chiara R. Vecchio, Daniele Nassiacos, Alberto Cereda, Cristina Conca, Gabriele Tumminello, Nicolas Piriou, Coline Lelarge, Patrizia Pedrotti, Miriam Stucchi, Giovanni Peretto, Michele Galasso, Florent Huang, Umberto Ianni, Antonio Procopio, Gianluigi Saponara, Paolo Cimaglia, Daniela Tomasoni, Francesco Moroni, Annalisa Turco, Simone Sala, Giuseppe Di Tano, Entela Bollano, Claudio Moro, Antonio Abbate, Roberta Della Bona, Italo Porto, Stefano Carugo, Jeness Campodonico, Gianluca Pontone, Aurelia Grosu, Leonardo Bolognese, Jorge Salamanca, Pablo Diez-Villanueva, Krzysztof Ozieranski, Agata Tyminska, Loren Sardo Infirri, Daniel Bromage, Antonio Cannatà, Kimberly N. Hong, Marianna Adamo, Giuseppina Quattrocchi, Alberto Foà, Luciano Potena, Andrea Garascia, Cristina Giannattasio, Eric D. Adler, Gianfranco Sinagra, Frank Ruschitzka, Paolo G. Camici, Marco Metra, Maurizio Pieroni, Ammirati, E, Lupi, L, Palazzini, M, Ciabatti, M, Rossi, V, Gentile, P, Uribarri, A, Vecchio, C, Nassiacos, D, Cereda, A, Conca, C, Tumminello, G, Piriou, N, Lelarge, C, Pedrotti, P, Stucchi, M, Peretto, G, Galasso, M, Huang, F, Ianni, U, Procopio, A, Saponara, G, Cimaglia, P, Tomasoni, D, Moroni, F, Turco, A, Sala, S, Di Tano, G, Bollano, E, Moro, C, Abbate, A, Della Bona, R, Porto, I, Carugo, S, Campodonico, J, Pontone, G, Grosu, A, Bolognese, L, Salamanca, J, Diez-Villanueva, P, Ozieranski, K, Tyminska, A, Sardo Infirri, L, Bromage, D, Cannatà, A, Hong, K, Adamo, M, Quattrocchi, G, Foà, A, Potena, L, Garascia, A, Giannattasio, C, Adler, E, Sinagra, G, Ruschitzka, F, Camici, P, Metra, M, and Pieroni, M
Subjects: myocarditi, COVID-19, COVID-19 vaccines, magnetic resonance spectroscopy, myocarditis, vaccination, Cardiology and Cardiovascular Medicine, COVID-19 vaccine
Published: 2023

22. Brugada syndrome and syncope: a practical approach for diagnosis and treatment

Author: Michele Brignole, Roberta Della Bona, Gianfranco Parati, Pietro Ameri, Lia Crotti, Giuseppe Mascia, Marco Canepa, Italo Porto, Mascia, G, Della Bona, R, Ameri, P, Canepa, M, Porto, I, Parati, G, Crotti, L, and Brignole, M
Subjects: medicine.medical_specialty, medicine.medical_treatment, Population, Brugada syndrome, Electrophysiologic study, Implantable cardioverter-defibrillator, Implantable loop recorder, Neurally mediated syncope, Sudden death, Syncope, Tilt testing, Ventricular fibrillation, Sudden cardiac death, Electrocardiography, Physiology (medical), Internal medicine, medicine, Humans, cardiovascular diseases, education, Vasovagal syncope, education.field_of_study, biology, business.industry, Syncope (genus), Arrhythmias, Cardiac, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, biology.organism_classification, medicine.disease, Defibrillators, Implantable, Death, Sudden, Cardiac, cardiovascular system, Cardiology, Tachycardia, Ventricular, Cardiology and Cardiovascular Medicine, business
Abstract: Syncope in patients with Brugada electrocardiogram pattern may represent a conundrum in the decision algorithm because incidental benign forms, especially neurally mediated syncope, are very frequent in this syndrome similarly to the general population. Arrhythmic syncope in Brugada syndrome typically results from a self-terminating sustained ventricular tachycardia or paroxysmal ventricular fibrillation, potentially leading to sudden cardiac death. Distinguishing syncope due to malignant arrhythmias from a benign form is often difficult unless an electrocardiogram is recorded during the episode. We performed a review of the existing literature and propose a practical approach for diagnosis and treatment of the patients with Brugada syndrome and syncope.
Published: 2021

23. Prognostic significance of electrophysiological study in drug-induced type-1 Brugada syndrome: a brief systematic review.

Author: Mascia G, Brugada J, Barca L, Benenati S, Della Bona R, Scarà A, Russo V, Arbelo E, Di Donna P, and Porto I
Subjects: Humans, Prognosis, Electrophysiologic Techniques, Cardiac, Risk Assessment, Electrocardiography, Risk Factors, Male, Female, Action Potentials drug effects, Predictive Value of Tests, Middle Aged, Brugada Syndrome physiopathology, Brugada Syndrome diagnosis, Brugada Syndrome chemically induced
Abstract: Background: Risk stratification in drug-induced type-1 Brugada syndrome (BrS) patients is challenging. The role of electrophysiological study (EPS) is debated as the majority of drug-induced type-1 BrS patients would not be studied according to the latest recommendations., Methods: A complete systematic literature search was performed to gauge the EPS role in this population. Three subgroups were defined: positive-EPS group, negative-EPS group, no-EPS group., Results: Among 1318 drug-induced type-1 BrS patients, no significant difference in the incidence rate of arrhythmic events was observed between groups (I2 = 45%, P for subgroup difference = 0.10) during a mean follow-up of 5.1 years, also considering symptomatic status., Conclusion: In long-term follow-up of drug-induced type-1 BrS patients, EPS does not seem to aid prognostic stratification., (Copyright © 2024 Italian Federation of Cardiology - I.F.C. All rights reserved.)
Published: 2024
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24. Takotsubo Syndrome and Gender Differences: Exploring Pathophysiological Mechanisms and Clinical Differences for a Personalized Approach in Patient Management.

Author: Giubilato S, Francese GM, Manes MT, Rossini R, Della Bona R, Gatto L, Di Monaco A, Zilio F, Gasparetto N, Sorini Dini C, Borrello F, Mannarini A, Scardovi AB, Pavan D, Amico F, Geraci G, Riccio C, Colivicchi F, Grimaldi M, Gulizia MM, and Oliva F
Abstract: Takotsubo syndrome (TTS), also known as the broken-heart syndrome, is a reversible condition typically observed in female patients presenting for acute coronary syndromes (ACS). Despite its increasing incidence, TTS often remains undiagnosed due to its overlap with ACS. The pathophysiology of TTS is complex and involves factors such as coronary vasospasm, microcirculatory dysfunction, increased catecholamine levels, and overactivity of the sympathetic nervous system. Diagnosing TTS requires a comprehensive approach, starting with clinical suspicion and progressing to both non-invasive and invasive multimodal tests guided by a specific diagnostic algorithm. Management of TTS should be personalized, considering potential complications, the presence or absence of coronary artery disease (CAD), diagnostic test results, and the patient's clinical course. The current data primarily derive from case series, retrospective analyses, prospective registries, and expert opinions. In recent years, there has been growing recognition of gender differences in the pathophysiology, presentation, and outcomes of TTS. This review provides an updated overview of gender disparities, highlighting the importance of tailored diagnostic and management strategies.
Published: 2024
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25. Provisional Circulatory Support with Extracorporeal Membrane Oxygenation during Ventricular Tachycardia Ablation in Intermediate Risk Patients: A Case Series.

Author: Mascia G, Barca L, Sartori P, Bianco D, Della Bona R, Di Donna P, and Porto I
Abstract: Background: Cardiogenic shock with acute hemodynamic decompensation may be one of the most serious risks in patients affected by ventricular tachycardia (VT). Its proper identification may have important implications in terms of pharmacological management, as might procedural planning in case of patients undergoing catheter ablation. Methods: We describe a case series of patients with provisional strategies for circulatory support in VT ablation, including the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) and vascular accesses in the electrophysiology lab but no initial ECMO activation due to an estimated intermediate pre-procedural risk from the case-series population. Results: In total, 10 patients (mean age 70 ± 11 years old, 9 males) with severe cardiomyopathy were admitted for incessant ventricular arrhythmia episodes, further diagnosis, and therapy planning; 1/10 patients (10%), documenting a PAINESD score of 14, underwent VA-ECMO cannulation due to electromechanical dissociation. All 10 patients were discharged alive. Conclusions: A pre-defined strategy before VT ablation is crucial. In our case series, the use of provisional circulatory support with VA-ECMO during incessant ablation of ventricular arrhythmia was a safe and winning alternative to upfront strategies.
Published: 2024
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26. Aspirin in Primary Prevention: Looking for Those Who Enjoy It.

Author: Della Bona R, Giubilato S, Palmieri M, Benenati S, Rossini R, Di Fusco SA, Novarese F, Mascia G, Gasparetto N, Di Monaco A, Gatto L, Zilio F, Sorini Dini C, Borrello F, Geraci G, Riccio C, De Luca L, Colivicchi F, Grimaldi M, Giulizia MM, Porto I, and Oliva FG
Abstract: Based on a wealth of evidence, aspirin is one of the cornerstones of secondary prevention of cardiovascular disease. However, despite several studies showing efficacy also in primary prevention, an unopposed excess risk of bleeding leading to a very thin safety margin is evident in subjects without a clear acute cardiovascular event. Overall, the variability in recommendations from different scientific societies for aspirin use in primary prevention is a classic example of failure of simple risk stratification models based on competing risks (atherothrombosis vs. bleeding), perceived to be opposed but intertwined at the pathophysiological level. Notably, cardiovascular risk is dynamic in nature and cannot be accurately captured by scores, which do not always consider risk enhancers. Furthermore, the widespread use of other potent medications in primary prevention, such as lipid-lowering and anti-hypertensive drugs, might be reducing the benefit of aspirin in recent trials. Some authors, drawing from specific pathophysiological data, have suggested that specific subgroups might benefit more from aspirin. This includes patients with diabetes and those with obesity; sex-based differences are considered as well. Moreover, molecular analysis of platelet reactivity has been proposed. A beneficial effect of aspirin has also been demonstrated for the prevention of cancer, especially colorectal. This review explores evidence and controversies concerning the use of aspirin in primary prevention, considering new perspectives in order to provide a comprehensive individualized approach.
Published: 2024
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27. Speckle-tracking echocardiography: state of art and its applications.

Author: Lotti R, DE Marzo V, Della Bona R, Porto I, and Rosa GM
Subjects: Humans, Ventricular Function, Left, Stroke Volume, Ventricular Remodeling, Echocardiography adverse effects, Echocardiography methods, Ventricular Dysfunction, Left diagnostic imaging, Myocardial Infarction diagnostic imaging, Cardiomyopathies
Abstract: Echocardiographic evaluation of left ventricular ejection fraction (LVEF) provides important information regarding both myocardial function and prognosis. This parameter presents various limitations and does not allow early detection of myocardial dysfunction. LVEF may be related to hemodynamic load, geometric assumptions, to image quality, and it does not reflect myocardial contractility. It has been hypothesized that speckle tracking echocardiography (STE) may allow overcoming such limits. STE through the measurement of strain and strain rate, which detect myocardial deformation, allows earlier identification of myocardial dysfunction in different settings both in presence of systolic and diastolic dysfunction, helps to predict left ventricular remodeling after acute myocardial infarction (AMI), and helps to decide the timing of surgery in asymptomatic severe valvular heart disease which is still a problematic issue. Increasingly interest regards the role of STE for the assessment of cardiomyopathies, myocarditis, and pulmonary hypertension. STE may be applied to the evaluation of systolic and diastolic dysfunction. STE is useful in all conditions in which cardiac dysfunction is not still overt, but a subclinical involvement is undoubtedly present such as in presence of cardiovascular risk factors and in cardio-oncology at earlier stages. It has been confirmed its role in predicting left ventricular remodeling after AMI which represents an important prognostic datum and in deciding the timing of surgery in asymptomatic valvular diseases. STE is an important tool to detect myocardial impairment even at earlier stages. 3DSTE and layer-specific strain represent promising fields of clinical application of STE.
Published: 2023
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28. Long-Term Outcomes of Transvenous Lead Extraction: A Comparison in Patients with or without Infection from the Italian Region with the Oldest Population.

Author: Barca L, Mascia G, Di Donna P, Sartori P, Bianco D, Della Bona R, Benenati S, Merlo AC, Buongiorno AL, Kaufman N, Vena A, Bassetti M, and Porto I
Abstract: Background: The gold standard for the treatment of cardiac implantable electronic devices (CIEDs)-related infection and lead malfunction is transvenous lead extraction (TLE). To date, the risk of mortality directly related to TLE procedures is relatively low, but data on post-procedural and long-term mortality are limited, even more in the aging population., Methods: Consecutive patients with CIEDs who underwent TLE were retrospectively studied. The primary outcome was the endpoint of death, considering independent predictors of long-term clinical outcomes in the TLE aging population comparing patients with and without infection., Results: One hundred nineteen patients (male 77%; median age 76 years) were included in the analysis. Eighty-two patients (69%) documented infection, and thirty-seven (31%) were extracted for a different reason. Infected patients were older (80 vs. 68 years, p -value > 0.001) with more implanted catheters ( p -value < 0.001). At the last follow-up (FU) available (median FU 4.1 years), mortality reached 37% of the patient population, showing a statistically significant difference between infected versus non-infected groups. At univariable analysis, age at TLE, atrial fibrillation, and anemia remained significant correlates of mortality; at multivariable analysis, only patients with anemia and atrial fibrillation have a 2.3-fold (HR 2.34; CI 1.16-4.75) and a 2.5-fold (HR 2.46; CI 1.33-4.54) increased rate of death, respectively., Conclusion: Our long-term data showed that aging patients who underwent TLE for CIED-related infection exhibit a high mortality risk during a long-term follow-up, potentially leading to a rapid and effective procedural approach in this patient population.
Published: 2023
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29. Outcome and Morphofunctional Changes on Cardiac Magnetic Resonance in Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination.

Author: Ammirati E, Lupi L, Palazzini M, Ciabatti M, Rossi VA, Gentile P, Uribarri A, Vecchio CR, Nassiacos D, Cereda A, Conca C, Tumminello G, Piriou N, Lelarge C, Pedrotti P, Stucchi M, Peretto G, Galasso M, Huang F, Ianni U, Procopio A, Saponara G, Cimaglia P, Tomasoni D, Moroni F, Turco A, Sala S, Di Tano G, Bollano E, Moro C, Abbate A, Della Bona R, Porto I, Carugo S, Campodonico J, Pontone G, Grosu A, Bolognese L, Salamanca J, Diez-Villanueva P, Ozieranski K, Tyminska A, Sardo Infirri L, Bromage D, Cannatà A, Hong KN, Adamo M, Quattrocchi G, Foà A, Potena L, Garascia A, Giannattasio C, Adler ED, Sinagra G, Ruschitzka F, Camici PG, Metra M, and Pieroni M
Subjects: Humans, Magnetic Resonance Spectroscopy, COVID-19 prevention & control, COVID-19 Vaccines adverse effects, Heart Failure, Myocarditis diagnostic imaging, Myocarditis etiology
Abstract: Competing Interests: Disclosures Dr Ammirati received a grant from the Italian Ministry of Health (GR-2019-12368506; principal investigator of the investigator-driven MYTHS trial [Myocarditis Therapy With Steroids]) and a grant from the Italian Ministry of Health and NextGenerationEU (PNRR-MAD-2022-12376225) and is a consultant for Kiniksa and Cytokinetics. Dr Metra reports personal fees from Actelion, Amgen, AstraZeneca, Abbott, Bayer, Servier, Edwards Therapeutics, Livanova, Vifor pharma, and WindTree Therapeutics, as a member of Trials’ Committees or for speeches at sponsored meetings in the last 3 years. Dr Ruschitzka has not received personal payments by pharmaceutical companies or device manufacturers in the past 3 years (remuneration for the time spent in activities, such as participation as a steering committee member of clinical trials and a member of the Pfizer Research Award selection committee in Switzerland, were made directly to the University of Zurich). The Department of Cardiology (University Hospital of Zurich/University of Zurich) reports research, educational, and/or travel grants from Abbott, Abiomed, Alexion, Amgen, AstraZeneca, At the Limits Ltd, Bayer, Berlin Heart, B. Braun, Biosense Webster, Biosensors Europe AG, Biotronik, Boehringer Ingelheim, Boston Scientific, Bracco, Bristol Myers Squibb, Cardinal Health Switzerland, Concept Medical, Corteria, CSL, Daiichi Sankyo, Diatools AG, Edwards Lifesciences, Guidant Europe NV (BS), Hamilton Health Sciences, IHF, Innosuisse, Johnson/Johnson, Kaneka Corporation, Kantar, Kiniksa, Labormedizinisches Zentrum, MedAlliance, Medical Education Global Solutions, Medtronic, MicroPort, MSD, Mundipharma Medical Company, Novartis, Novo Nordisk, Orion, Pfizer, Quintiles Switzerland Sarl, RecorMedical, Roche Diagnostics, Roche Pharma, Sahajanand IN, Sanofi, Sarstedt AG, Servier, SIS Medical, Sorin CRM SAS, SSS International Clinical Research, Stromal, Terumo Deutschland, Trama Solutions, V-Wave, Vascular Medical, Vifor, Wissens Plus, and ZOLL. These grants do not impact on Dr Ruschitzka’s personal remuneration. The other authors report no conflicts.
Published: 2023
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30. Syncope in hypertrophic cardiomyopathy (part I): An updated systematic review and meta-analysis.

Author: Mascia G, Crotti L, Groppelli A, Canepa M, Merlo AC, Benenati S, Di Donna P, Della Bona R, Soranna D, Zambon A, Porto I, Olivotto I, Parati G, Brignole M, and Cecchi F
Subjects: Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac etiology, Humans, Risk Assessment methods, Risk Factors, Syncope complications, Syncope diagnosis, Syncope epidemiology, Cardiomyopathy, Hypertrophic complications, Cardiomyopathy, Hypertrophic diagnosis, Cardiomyopathy, Hypertrophic epidemiology
Abstract: Aims: To describe the proportion of patients with syncope among those affected by hypertrophic cardiomyopathy (HCM) and the relevance of syncope as risk factor for sudden cardiac death and life-threatening arrhythmic events., Method and Results: Systematic review of original articles that assessed syncope in HCM patients. Literature search of PubMed including all English publications from 1973 to 2021.We found 57 articles for a total of 21.791 patients; of these, 14 studies reported on arrhythmic events in the follow-up. Syncope was reported in 15.8% (3.452 of 21.791) patients. It was considered unexplained in 91% of cases. Life-threatening arrhythmic events occurred in 3.6% of non-syncopal patients and in 7.7% of syncopal patients during a mean follow-up of 5.6 years. A relative risk of 1.99 (95%CI 1.39 to 2.86) was estimated for syncope patients by the random effect model using Haldane continuity correction for 0 events., Conclusions: In the current practice, the cause of syncope remained unexplained in most patients affected by HCM. The management of patients seems mainly driven by risk stratification rather than identification of the aetiology of syncope. There is a need of precise instructions how to apply the recommendations of current guidelines to this disease, which tests are indicated and how to interpret their findings. The protocol was registered in Prospero (ID: 275963)., (Copyright © 2022. Published by Elsevier B.V.)
Published: 2022
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31. Duration of dual antiplatelet therapy and subsequent monotherapy type in patients undergoing drug-eluting stent implantation: a network meta-analysis.

Author: Benenati S, Crimi G, Canale C, Pescetelli F, De Marzo V, Vergallo R, Galli M, Della Bona R, Canepa M, Ameri P, Crea F, and Porto I
Subjects: Bayes Theorem, Humans, Network Meta-Analysis, Platelet Aggregation Inhibitors adverse effects, Randomized Controlled Trials as Topic, Drug-Eluting Stents, Dual Anti-Platelet Therapy adverse effects, Dual Anti-Platelet Therapy methods, Duration of Therapy
Abstract: Aims: To compare the safety and efficacy of very short (≤3 months), short (6 months), standard (12 months), and extended (>12 months) dual antiplatelet therapy (DAPT), and of subsequent monotherapies, after coronary drug-eluting stent (DES) implantation., Methods and Results: Twenty-two randomized control trials (n = 110 059 patients/year) were selected and included in a Bayesian network meta-analysis. The primary efficacy endpoint (PEP) was a composite of cardiac death, myocardial infarction (MI), and stent thrombosis (ST), with each of the components of the PEP being a secondary efficacy endpoint. The primary safety endpoint was major bleeding rate. Compared to standard, we found a lower rate of MI [odds ratio (OR) 0.56, 95% confidence interval (CI) 0.44-0.77] in extended, a lower rate of major bleeding (OR 0.61, 95% CI 0.39-0.87) in very short, and a lower rate of any bleeding (OR 0.61, 95% CI 0.38-0.90) in short DAPT. All DAPT durations were comparable regarding the secondary efficacy endpoints. Very short DAPT followed by P2Y12 inhibition was the treatment of choice to reduce both major bleeding and MI. In the ACS subgroup, extended DAPT (as compared to standard) reduced PEP and ST rates (but not MIs)., Conclusion: The efficacy of short and very short is comparable with that of standard DAPT after DES implantation, whereas extended DAPT reduces MI rate. Very short DAPT is associated with lower haemorrhagic events and, followed by a P2Y12 inhibitor monotherapy, should be preferred in order to pursue a trade-off between major bleeding and ischaemic events., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)
Published: 2022
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32. Sport practice in hypertrophic cardiomyopathy: running to stand still?

Author: Mascia G, Olivotto I, Brugada J, Arbelo E, Di Donna P, Della Bona R, Canepa M, and Porto I
Subjects: Athletes, Death, Sudden, Cardiac, Exercise, Humans, Cardiomyopathy, Hypertrophic diagnosis, Cardiomyopathy, Hypertrophic epidemiology, Running
Abstract: During the last decades, the practice of sport and hypertrophic cardiomyopathy (HCM) were considered as incompatible, since evidence was not sufficient to gauge the risk associated to repeat and/or vigorous exercise across the spectrum of HCM. Additionally, it was acknowledged thatrisk stratification tools developed for HCM were not derived from athlete cohorts. Recent epidemiological studies focused on HCM both in the general population and in athletes, however, have de-emphasized the contribution of this condition to the risk of sport-associated sudden death, supporting the possibility of allowing the practice of some sports, even at professional level, for certain low-risk HCM categories. We hereby analyze the complex interaction of vigorous and continuative exercise with HCM, revising the available evidence for sports eligibility in HCM, the challenges and limitations of shared decision-making, as well as the potential harms and benefits of a highly personalised exercise schedule in subjects diagnosed with this complex disease., (Copyright © 2021 Elsevier B.V. All rights reserved.)
Published: 2021
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33. May standard basal echocardiogram allow to obtain predictors of asymptomatic cardiac dysfunction in alcoholics?

Author: Rosa GM, Scagliola R, Zoppoli G, Perna V, Buscaglia A, Berri A, Della Bona R, Porto I, Pellicano R, and Testino G
Subjects: Asymptomatic Diseases, Echocardiography, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Cardiomyopathy, Alcoholic diagnostic imaging
Abstract: Background: Long-lasting heavy alcohol intake has been progressively recognized as a leading cause of nonischemic dilated cardiomyopathy, involving 10% of all people who use alcohol. It is of huge importance to identify the earliest markers of this dysfunction and it is known that the newest echocardiographic techniques such as speckle tracking may allow to do it. In this study we investigated if standard basal echocardiogram features allow to obtain predictors of asymptomatic cardiac dysfunction in alcoholics., Methods: A population of 80 consecutive asymptomatic alcoholics was enrolled. None presented history, signs or symptoms of cardiovascular disease. All of them underwent a conventional transthoracic monobidimensional and doppler echocardiography., Results: Our cohort did not present echocardiographic findings of increased left ventricular sizes, mass or relative wall thickness. Hence, a significant rate of systolic dysfunction was not found. Furthermore, statistical analysis displayed an inverse relationship between alcohol consumption and systolic pulmonary arterial pressure as well as between alcohol abuse and left atrium enlargement. This may be explained by a potential vasodilator mechanism occurring in the earliest stages of alcohol intake. On the contrary, a positive correlation with the E/A ratio was found, and this might be ascribed to state of high cardiac output determined by alcohol abuse. There were modes sex-related differences., Conclusions: This study has demonstrated that standard echocardiography may allow to predict cardiac dysfunction in asymptomatic alcoholics, and sex-related differences may be identified in this regard. These data need to be confirmed by further studies involving larger population.
Published: 2021
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34. Impact of bioprosthetic valve type on peri-procedural myocardial injury and mortality after transcatheter aortic valve replacement.

Author: De Marzo V, Crimi G, Vercellino M, Benenati S, Pescetelli F, Della Bona R, Sarocchi M, Canepa M, Balbi M, and Porto I
Subjects: Aged, Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve surgery, Humans, Male, Treatment Outcome, Aortic Valve Stenosis surgery, Heart Injuries, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement adverse effects
Abstract: Peri-procedural myocardial injury (PPMI) is a common complication after transcatheter valve replacement (TAVR), often remaining clinically silent. The role of valve type on PPMI and the association between PPMI and mortality are still unclear. We sought to evaluate predictors and outcome of PPMI after TAVR, and the impact of self-expandable valve (SEV) vs. balloon-expandable valve (BEV) deployment on PPMI. Consecutive patients who underwent successful TAVR in a single-center from January 2014 to December 2019 were included. PPMI was defined according to a modified Valve Academic Research Consortium (VARC)-2 definition as a post-procedure elevation of troponin (with a peak value ≥ 15-times the upper-reference limit) < 72 h after TAVR. We included 596 patients, of whom 258 (43.3%) were men. Mean age was 83.4 ± 5.5 years. We deployed 368 (61.7%) BEV and 228 (38.3%) SEV. PPMI was observed in 471 (79.0%) patients. At multivariable analysis, SEV (OR 2.70, 95% CI 1.64-4.55, p < 0.001), creatinine clearance (OR 0.98, 95% CI 0.97-1.00, p = 0.011), and baseline ejection fraction (OR 1.05, 95% CI 1.02-1.07, p < 0.001) were independent predictors of PPMI; these findings were also confirmed using a propensity-weighted analysis. Thirty-day and 1-year all-cause mortality rates were 2.5% and 8.1%, respectively. No associations between PPMI and 30-day (p = 0.488) or 1-year (p = 0.139) all-cause mortality were found. Independent predictors of 30-day mortality were increasing EUROSCORE II (HR 1.16 per score point, 95% CI 1.08-1.19, p < 0.001) and life-threatening/major bleeding complications (HR 5.87, 95% CI 1.28-26.58, p = 0.019), whereas EUROSCORE II (HR 1.08, 95% CI 1.04-1.13, p = 0.031) and acute kidney injury (HR 2.59, 95% CI 1.20-5.35, p = 0.020) were related to 1-year mortality. PPMI is frequent after TAVR, but it does not affect 30-day or 1-year all-cause mortality. SEV implantation is associated with an increased frequency of PPMI., (© 2021. The Author(s).)
Published: 2021
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35. Iatrogenic aortic valve haematoma after emergency coronary angiography: location, location, location!

Author: De Marzo V, Della Bona R, Seitun S, Masoero G, and Porto I
Subjects: Aortic Valve diagnostic imaging, Aortic Valve surgery, Coronary Angiography adverse effects, Hematoma diagnostic imaging, Hematoma etiology, Humans, Iatrogenic Disease, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation
Published: 2021
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36. [Management of cardiogenic shock: a proposal for a shared protocol].

Author: Benenati S, Vercellino M, Avenoso D, Crimi G, Macchione A, Giachero C, Balbi M, Della Bona R, Gnecco G, Baronetto A, Ricci D, Buscaglia G, Palombo D, Gratarola A, Santini F, and Porto I
Subjects: Hemodynamics, Humans, Italy, Heart-Assist Devices, Shock, Cardiogenic therapy
Abstract: Cardiogenic shock (CS) is a complex and relatively rare disease. Whilst its mortality remains unacceptably high, a multidisciplinary approach based on pre-established and shared protocols may improve prognosis and ensure appropriate resource allocation. Comprehensive hemodynamic assessment and monitoring as well as tailored, goal-directed medical therapy are part of an optimal management. Moreover, mechanical support devices may be helpful as they sustain hemodynamics to a greater extent as compared to inotropes and vasopressors, while lacking their cardiotoxic effects. Therefore, they are increasingly used in CS patients. In 2019, a new protocol for the management of patients with CS was adopted at the Ospedale Policlinico San Martino (HSM) in Genoa, Italy. Following in the footsteps of similar international experiences, the HSM protocol aims at streamlining the management of these high-risk patients improving the cooperation among healthcare specialists, and also addressing the key issues of mechanical support device implantation and appropriate referral for palliative care.
Published: 2021
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37. BMI and acute kidney injury post transcatheter aortic valve replacement: unveiling the obesity paradox.

Author: De Marzo V, Crimi G, Benenati S, Buscaglia A, Pescetelli F, Vercellino M, Della Bona R, Sarocchi M, Canepa M, Ameri P, Balbi M, and Porto I
Subjects: Aged, 80 and over, Body Mass Index, Comorbidity, Female, Humans, Italy epidemiology, Male, Outcome and Process Assessment, Health Care, Prognosis, Risk Assessment, Risk Factors, Survival Analysis, Transcatheter Aortic Valve Replacement methods, Acute Kidney Injury diagnosis, Acute Kidney Injury etiology, Acute Kidney Injury mortality, Aortic Valve Stenosis epidemiology, Aortic Valve Stenosis surgery, Obesity epidemiology, Postoperative Complications diagnosis, Postoperative Complications mortality, Transcatheter Aortic Valve Replacement adverse effects
Abstract: Aims: Acute kidney injury (AKI) may complicate transcatheter aortic valve replacement (TAVR) leading to higher mortality. The relationship between AKI, obesity, and mortality, however, is controversial. We sought to investigate the impact of body habitus on the prognostic value of AKI in TAVR., Methods: Among the 645 patients who underwent successful TAVR in a single high-volume centre, we retrospectively evaluated the association between AKI-TAVR and 30-day, 6-month, and 1-year mortality, and whether this relationship was affected by BMI. AKI was defined according to the Valve Academic Research Consortium-2 criteria. Patients were categorized into three groups by BMI: low-to-normal weight (<25 kg/m2), overweight (25-30 kg/m2), obese (>30.0 kg/m2)., Results: Three-hundred and twenty-four (50.2%) patients were low-to-normal weight, 223 (34.6%) overweight, and 98 (15.2%) obese. AKI occurred in 141 (21.9%), similarly across BMI groups. Thirty-day, 6-month, and 1-year mortality rates were 2.2, 3.7, and 7.9%, without differences across BMI groups. Among patients who developed AKI-TAVR, 30-day (8.7 vs. 2.0 vs. 0.0%), 6-month (13.0 vs. 6.1 vs. 4.3%), and 1-year (20.3 vs. 12.2 vs. 4.3%) mortality showed a decreasing trend across increasing BMI categories (all P < 0.05); the same trend was not observed for patients without AKI-TAVR. In multivariate models, AKI was associated with 30-day [odds ratio (OR): 2.46, 95% confidence interval (CI): 1.70-8.67], 6-month (OR: 2.75, 95% CI: 1.32-7.59), and 1-year mortality (OR: 1.84, 95% CI: 1.22-3.71, all P < 0.05). The interaction between AKI and BMI, when added to the models, was consistently significant (all P < 0.05)., Conclusion: Higher BMI is associated with better survival in TAVR patients who develop AKI., (Copyright © 2021 Italian Federation of Cardiology - I.F.C. All rights reserved.)
Published: 2021
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38. Erratum for "Brugada syndrome and syncope: A systematic review" (Volume 31, Issue 12: 3334-3338).

Author: Mascia G, Della Bona R, Ameri P, Canepa M, Porto I, and Brignole M
Published: 2021
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39. Atrial fibrillation and Alzheimer's disease: A conundrum.

Author: Benenati S, Canale C, De Marzo V, Della Bona R, Rosa GM, and Porto I
Subjects: Alzheimer Disease physiopathology, Atherosclerosis physiopathology, Atrial Fibrillation physiopathology, Cardiovascular Diseases physiopathology, Cerebrovascular Circulation, Heart Disease Risk Factors, Humans, Intracranial Embolism physiopathology, Plaque, Amyloid physiopathology, Alzheimer Disease epidemiology, Atrial Fibrillation epidemiology, Cardiovascular Diseases epidemiology
Abstract: During ageing, the prevalence of Alzheimer's disease (AD) and of cardiovascular disease CVD) increases. Our aim is to investigate the relationship between AD and CVD and its risk factors, with a view to explaining the underlying mechanisms of this association. This review is based on the material obtained via MEDLINE (PubMed), Embase and Clinical Trials databases, from January 1980 until May 2019. The search term used was "Alzheimer's disease", combined with "cardiovascular disease", "hypertension", "dyslipidaemia", "diabetes mellitus", "atrial fibrillation", "coronary artery disease", "heart valve disease", "heart failure". Out of the 1328 papers initially retrieved, 431 duplicates and 216 records in languages other than English were removed; thus, only 98 papers were included in our research material. We have found that AD and CVD are frequently associated, while both of them, alone may be considered deleterious to health, the study of their combination constitutes a clinical challenge. Further research will help to clarify the real impact of CVD and its risk factors on AD, in order to better comprehend the effects of subclinical and clinical cardiovascular diseases on the brain. It may be hypothesized that there are various mechanisms underlying the association between AD and CVD, the main ones being: hypoperfusion and emboli, atherosclerosis, furthermore in both the heart and brain of AD patients, amyloid deposits may be present, thus causing damage to these organs. We need to clarify the real impact of these underlying hypothesized mechanisms and to investigate gender issues., (© 2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)
Published: 2021
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40. [Bileaflet mechanical valve dysfunction related to fibrous pannus: the role of cine-fluoroscopy].

Author: Troccolo A, De Marzo V, Della Bona R, Seitun S, Santini F, and Porto I
Subjects: Aged, Aortic Valve diagnostic imaging, Aortic Valve surgery, Female, Fluoroscopy, Humans, Pannus, Prosthesis Failure, Heart Valve Prosthesis adverse effects, Thrombosis
Abstract: We report the case of a 72-year-old female patient admitted for worsening heart failure. The patient had undergone aortic valve replacement with a mechanical prosthesis 28 years before and since then she had several acute heart failure episodes, with a progressive increase in transprosthetic gradients, without identifying a specific cause.We describe the diagnostic tools used to reach a diagnosis, with particular emphasis on the use of cine-fluoroscopy that allowed to make the decisively diagnosis of prosthetic valve dysfunction, subsequently confirmed by cardiac computed tomography (CT). By cine-fluoroscopy, a widespread, easy, low-cost, and safe tool (no need for medium contrast and low radiation dose), it is possible to precisely define the function of the valve leaflets and measure their opening and closing angles, comparing them to the specific reference angles. To make the correct diagnosis we also performed a cardiac CT demonstrating a sub-aortic fibrous pannus. However, although cardiac CT is highly accurate for the identification of valve leaflet neoformations and abnormalities and for the discrimination between thrombotic formations and fibrous pannus, it is burdened by high costs, use of contrast medium, and limited available dedicated devices.
Published: 2021
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41. Early infections after successful transcatheter aortic valve replacement are associated with increased short- and long-term mortality: A single-center study.

Author: De Marzo V, Dettori S, Nicolini LA, Crimi G, Vercellino M, Benenati S, Pescetelli F, Della Bona R, Sarocchi M, Mikulska M, Balbi M, Bassetti M, and Porto I
Subjects: Aged, Aged, 80 and over, Aortic Valve surgery, Female, Humans, Male, Risk Factors, Treatment Outcome, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement adverse effects
Abstract: Background: We reviewed frequency, microbiological pattern, predictors, and outcomes of early infections following transcatheter aortic valve replacement (TAVR)., Methods: Five hundred thirty-nine patients who underwent successful TAVR at a single, high-volume center between January 2014 and December 2019 were enrolled. We defined early infections as occurring within 30-day from TAVR., Results: Mean age was 83.5 ± 5.4 years; 230 (42.7%) patients were men. Median follow-up was 12.0 (5.7-18.3) months; 30-day and 1-year death rates were 8/539 (1.5%) and 30/539 (5.6%), respectively. Early infections occurred in 61/539 (11.3%) patients, of whom 2 had infections in two sites. Of the 63 infections, 10 were bloodstream infections (BSI), 5 urinary tract, 27 pulmonary (2 with sepsis), 6 access site infections, 1 enterocolitis, and 14 were clinically diagnosed (no specific site). We observed 31/63 (49.2%) microbiologically-documented infections: Gram+ bacteria were isolated in 12/31 (38.7%), Gram- in 17/31 (54.3%), both Gram+ and Gram- in 2/31 (6.5%); in thirty-two infections no specific pathogen could be isolated (clinically-documented infections). Early infections were more prevalent in patients who died within 30-day (8.2% vs. 0.6%, p < 0.001) or 1-year (14.8% vs. 4.4%, p < 0.001) from TAVR. At multivariable analysis, early infections were independently associated with 30-day (HR: 8.82, 95% CI: 1.11-19.83, p = 0.035) and 1-year mortality (HR: 2.10, 95%CI: 1.28-6.21, p = 0.041). The predictive value for 1-year mortality was maintained even restricting the analysis to documented infections only, or to more severe infections (BSI and pneumonia only) (all p < 0.05)., Conclusions: Early infections occur in 1/10th of TAVR and are associated with increased short- and long-term mortality. Whereas a causal relationship between early infections and the risk of death cannot be unequivocally proven, careful surveillance of infected patients may improve TAVR results., Competing Interests: Declaration of Competing Interest Prof. Porto in the last 2 years has received consultant or speaker fees from Biotronik, ABIOMED, Terumo, Philips, Sanofi, Amgen, Daiichi-Sankyo, Astra Zeneca, and Bayer, not related to this work. Prof. Basseti reports research grants and/or advisor/consultant and/or Speaker/chairman from Angelini, Astellas, Bayer, Biomerieux, Cidara, Cipla, Gilead, Menarini, MSD, Pfizer, Shionogi, Tetraphase, Nabriva, not related to this work . Giacobbe reports honoraria from Stepstone Pharma GmbH and unconditional grants from MSD Italia and Correvio Italia, not related to this work., (Copyright © 2021 Elsevier B.V. All rights reserved.)
Published: 2021
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42. Very short vs. long dual antiplatelet therapy after second generation drug-eluting stents in 35 785 patients undergoing percutaneous coronary interventions: a meta-analysis of randomized controlled trials.

Author: Benenati S, Galli M, De Marzo V, Pescetelli F, Toma M, Andreotti F, Della Bona R, Canepa M, Ameri P, Crea F, and Porto I
Subjects: Humans, Randomized Controlled Trials as Topic, Drug-Eluting Stents, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors adverse effects
Abstract: Aim: To provide an updated assessment of the efficacy-safety profile of very short (1 or 3 months) dual antiplatelet therapy (DAPT) compared with long (12 months) DAPT in patients undergoing percutaneous coronary interventions (PCIs)., Methods and Results: Seven randomized controlled trials (RCTs) comparing very short vs. long DAPT in 35 785 patients undergoing PCI were selected. The primary efficacy endpoint was major adverse cardiovascular events (MACE) and the primary safety endpoint trial-defined major bleeding through at least 1 year. Compared with longer duration, very short DAPT yielded comparable rates of MACE [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.84-1.03, P = 0.19], all-cause mortality (OR 0.92, 95% CI 0.80-1.06, P = 0.25), myocardial infarction (OR 1.01, 95% CI 0.88-1.15, P = 0.91), stroke (OR 1.04, 95% CI 0.72-1.50, P = 0.83), stent thrombosis (OR 1.05, 95% CI 0.80-1.37, P = 0.73), target vessel revascularization (OR 0.99, 95% CI 0.82-1.18, P = 0.89), and comparable net clinical benefit (OR 0.92, 95% CI 0.84-1.01, P = 0.08). Very short DAPT was associated with reduced rates of major bleeding (OR 0.61, 95% CI 0.40-0.94, P = 0.03) or any bleeding (OR 0.65, 95% CI 0.47-0.90, P = 0.009). Subgroup analyses showed consistent results for 1 vs. 3 month DAPT and for aspirin vs. P2Y12 inhibitor monotherapy following very short DAPT., Conclusions: Compared with long DAPT, very short DAPT did not increase the odds of ischaemic complications, while reducing the odds of major or any bleeding by over 30%., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)
Published: 2021
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43. Left Posterior Fascicular Block and Increased Risk of Sudden Cardiac Death in Young People.

Author: Calò L, Della Bona R, Martino A, Crescenzi C, Panattoni G, d'Amati G, Gaita F, Mango R, Sciarra L, and Laredo M
Subjects: Adolescent, Adult, Arrhythmogenic Right Ventricular Dysplasia diagnosis, Arrhythmogenic Right Ventricular Dysplasia genetics, Case-Control Studies, Electrocardiography, Female, Fibrosis, Heart Ventricles pathology, Humans, Male, Retrospective Studies, Young Adult, Bundle-Branch Block diagnosis, Death, Sudden, Cardiac prevention & control
Published: 2021
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44. Blood lactate predicts survival after percutaneous implantation of extracorporeal life support for refractory cardiac arrest or cardiogenic shock complicating acute coronary syndrome: insights from the CareGem registry.

Author: Porto I, Mattesini A, D'Amario D, Sorini Dini C, Della Bona R, Scicchitano M, Vergallo R, Martellini A, Caporusso S, Trani C, Burzotta F, Bruno P, Di Mario C, Crea F, Valente S, and Massetti M
Subjects: Acute Coronary Syndrome complications, Biomarkers blood, Female, Heart Arrest complications, Hospital Mortality, Humans, Italy, Male, Middle Aged, Postoperative Complications mortality, Predictive Value of Tests, Registries, Risk Factors, Shock, Cardiogenic complications, Survival Rate, Acute Coronary Syndrome mortality, Acute Coronary Syndrome therapy, Extracorporeal Membrane Oxygenation, Heart Arrest mortality, Heart Arrest therapy, Lactates blood, Shock, Cardiogenic mortality, Shock, Cardiogenic therapy
Abstract: Refractory cardiogenic shock (RCS) or refractory cardiac arrest (RCA) complicating acute coronary syndrome (ACS) is associated with extremely high mortality rate. Veno-arterial extracorporeal life support (VA-ECLS) represents a valuable therapeutic option to stabilize patients' condition before or at the time of emergency revascularization. We analyzed 29 consecutive patients with RCS or RCA complicating ACS, and implanted with VA-ECLS in two centers who have adopted a similar, structured approach to ECLS implantation. Data were collected from January 2010 to December 2015 and ECLS had to be percutaneously implanted either before (within 48 h) or at the time of attempted percutaneous coronary revascularization (PCI). We investigated in-hospital outcome and factors associated with survival. Twenty-one (72%) were implanted for RCA, whereas 8 (28%) were implanted on ECLS for RCS. All RCA were witnessed and no-flow time was shorter than 5 min in all cases but one. All patients underwent attempted emergency PCI, using radial access in ten cases (34.5%), whereas in three patients a subsequent CABG was performed. Overall, ten patients (34.5%) survived, nine of them with a good neurological outcome. Life threatening complications, including stroke (4 pts), leg ischemia (4 pts), intestinal ischemia (5 pts), and deep vein thrombosis 2 pts), occurred frequently, but were not associated with in-hospital death. Main cause of death was multi-organ failure. PCI variables did not predict survival. Survivors were younger, with shorter low-flow time, and with ECLS mainly implanted for RCS. At multivariate analysis, levels of lactate at ECLS implantation (OR 4.32, 95%CI 1.01-18.51, p = 0.049) emerged as the only variable that independently predicted survival. In patients with RCA or RCS complicating ACS who are percutaneously implanted with ECLS before or at the time of coronary revascularization, in hospital survival rate is higher than 30%. Level of lactate at ECLS implantation appears to be the most important factor to predict survival.
Published: 2021
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45. Interpretation of elevated high-sensitivity cardiac troponin I in elite soccer players previously infected by severe acute respiratory syndrome coronavirus 2.

Author: Mascia G, Pescetelli F, Baldari A, Gatto P, Seitun S, Sartori P, Pieroni M, Calò L, Della Bona R, and Porto I
Subjects: Biomarkers blood, COVID-19 diagnosis, COVID-19 epidemiology, Cohort Studies, Humans, Italy epidemiology, Retrospective Studies, Athletes, COVID-19 blood, SARS-CoV-2 isolation & purification, Soccer physiology, Troponin C blood
Abstract: Objectives: To clarify the meaning of elevated cardiac troponin in elite soccer athletes previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and screened for cardiovascular involvement in the wake of competitive sport resumption., Methods: We designed a retrospective cohort study with the collaboration of two Italian Serie A teams. Soccer players from both rosters (58 athletes) were systematically analysed. For every SARS-CoV-2 positive athlete, the Italian Soccer Federation protocol requested full blood tests including high-sensitivity cardiac troponin I (hs-cTnI), along with a complete cardiovascular examination. We extended the analysis to SARS-CoV-2 negative athletes., Results: A total of 13/58 players (22.4%) suffered from SARS-CoV-2infection: all had a negative cardiovascular examination and 2/13 (15%) showed increased hs-cTnI values (120.8 pg/ml and 72,6 pg/ml, respectively; upper reference level 39.2 pg/ml), which did not track with inflammatory biomarkers. Regarding the 45/58 (77.6%) non infected athletes, a slight increase in hs-cTnI was observed in 2 (4.5%) subjects (values: 61 pg/ml and 75 pg/ml respectively). All hs-cTnI positive athletes (4/58, 7%) underwent cardiac magnetic resonance (CMR), that excluded any cardiac injury., Conclusions: In our retrospective study, SARS-CoV-2 infection in elite soccer athletes was not associated to clinical or biomarkers abnormalities. Increased hs-cTnI was rare and not significantly associated with previous SARS-COV2 infection nor with pathological findings at CMR, albeit elevated hs-cTnI was numerically more prevalent in the infected group., Competing Interests: Declaration of Competing Interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2020 Elsevier B.V. All rights reserved.)
Published: 2021
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46. Systemic fibrinolysis for acute pulmonary embolism complicating acute respiratory distress syndrome in severe COVID-19: a case series.

Author: Della Bona R, Valbusa A, La Malfa G, Giacobbe DR, Ameri P, Patroniti N, Robba C, Gilad V, Insorsi A, Bassetti M, Pelosi P, and Porto I
Subjects: Acute Disease, Humans, Pulmonary Embolism diagnostic imaging, Retrospective Studies, COVID-19 complications, Fibrinolytic Agents therapeutic use, Pulmonary Embolism drug therapy, SARS-CoV-2, Tissue Plasminogen Activator therapeutic use
Published: 2021
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47. Coagulative Disorders in Critically Ill COVID-19 Patients with Acute Distress Respiratory Syndrome: A Critical Review.

Author: Robba C, Battaglini D, Ball L, Valbusa A, Porto I, Della Bona R, La Malfa G, Patroniti N, Brunetti I, Loconte M, Bassetti M, Giacobbe DR, Vena A, Silva CLM, Rocco PRM, and Pelosi P
Abstract: In critically ill patients with acute respiratory distress syndrome (ARDS) coronavirus disease 2019 (COVID-19), a high incidence of thromboembolic and hemorrhagic events is reported. COVID-19 may lead to impairment of the coagulation cascade, with an imbalance in platelet function and the regulatory mechanisms of coagulation and fibrinolysis. Clinical manifestations vary from a rise in laboratory markers and subclinical microthrombi to thromboembolic events, bleeding, and disseminated intravascular coagulation. After an inflammatory trigger, the mechanism for activation of the coagulation cascade in COVID-19 is the tissue factor pathway, which causes endotoxin and tumor necrosis factor-mediated production of interleukins and platelet activation. The consequent massive infiltration of activated platelets may be responsible for inflammatory infiltrates in the endothelial space, as well as thrombocytopenia. The variety of clinical presentations of the coagulopathy confronts the clinician with the difficult questions of whether and how to provide optimal supportive care. In addition to coagulation tests, advanced laboratory tests such as protein C, protein S, antithrombin, tissue factor pathway inhibitors, D-dimers, activated factor Xa, and quantification of specific coagulation factors can be useful, as can thromboelastography or thromboelastometry. Treatment should be tailored, focusing on the estimated risk of bleeding and thrombosis. The aim of this review is to explore the pathophysiology and clinical evidence of coagulation disorders in severe ARDS-related COVID-19 patients.
Published: 2021
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48. Delayed left subclavian artery pseudoaneurysm following transcatheter aortic valve implantation.

Author: Buscaglia A, Tini G, Balbi M, Rosa GM, Della Bona R, and Porto I
Subjects: Aortic Valve surgery, Humans, Subclavian Artery diagnostic imaging, Subclavian Artery surgery, Treatment Outcome, Aneurysm, False diagnostic imaging, Aneurysm, False etiology, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement adverse effects
Published: 2020
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49. Brugada syndrome and syncope: A systematic review.

Author: Mascia G, Della Bona R, Ameri P, Canepa M, Porto I, and Brignole M
Subjects: Arrhythmias, Cardiac diagnosis, Arrhythmias, Cardiac epidemiology, Arrhythmias, Cardiac therapy, Death, Sudden, Cardiac, Electrocardiography, Humans, Syncope diagnosis, Syncope epidemiology, Brugada Syndrome diagnosis, Brugada Syndrome therapy, Defibrillators, Implantable
Abstract: Introduction: Distinguishing syncope due to malignant arrhythmias from an incidental benign form in Brugada syndrome (BrS) is often difficult. Through systematic literature review, we evaluated the role of syncope in predicting subsequent malignant arrhythmias in BrS., Methods: A comprehensive literature search was performed on PubMed (MeSH search terms "Brugada syndrome" and "syncope"). Overall, 9 studies for a total of 1347 patients were included. Patients were stratified as affected by suspected arrhythmic syncope (SAS), undefined syncope (US) or neurally-mediated syncope (NMS)., Results: Overall, 15.7% of the 279 patients with SAS had malignant arrhythmic events during a mean follow-up of 67 months, corresponding to 2.8 events per 100/person year. At the same time, 7% of the 527 patients affected by US had malignant arrhythmias during a mean follow-up of 39 months, corresponding 2.2 events per 100/person year. Conversely, 0.7% of 541 patients with NMS had malignant arrhythmic events at follow-up, corresponding to 0.13 events per 100/person year (p = .0001 NMS versus SAS and US pooled)., Conclusion: In BrS population, the risk of arrhythmic events in the follow-up may be stratified according to the clinical evaluation. The "relatively" low predictive value of the clinical diagnosis of SAS warrants for a more accurate multi-parametric assessment, to restrict the number of candidates for implantable cardioverter-defibrillator therapy., (© 2020 Wiley Periodicals LLC.)
Published: 2020
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50. A Walking Thrombus.

Author: Monzo L, Silvetti E, Maresca L, Della Bona R, De Ruvo E, and Calò L
Published: 2020
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