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1. Long‐term outcomes of phenoclusters in preclinical heart failure with preserved and mildly reduced ejection fraction.

Author

Fazzini, Luca, Ghirardi, Arianna, Limonta, Raul, Calabrese, Alice, D'Elia, Emilia, Canova, Paolo, Fontana, Alessandra, Grosu, Aurelia, Iacovoni, Attilio, Ferrari, Paola, De Maria, Renata, Gavazzi, Antonello, Montisci, Roberta, Senni, Michele, and Gori, Mauro

Subjects
CONGESTIVE heart failure, HEART failure, LEFT heart atrium, GLOMERULAR filtration rate, CARDIOVASCULAR diseases
Abstract

Aims: The identification of subjects at higher risk for incident heart failure (HF) with preserved ejection fraction (EF) suitable for more intensive preventive programmes remains challenging. We applied phenomapping to the DAVID‐Berg population, comprising subjects with preclinical HF, aiming to refine HF risk stratification. Methods: The DAVID‐Berg study prospectively enrolled 596 asymptomatic outpatients with EF > 40% with hypertension, diabetes mellitus or known cardiovascular disease. In this cohort, we performed an unsupervised cluster analysis on 591 patients, including clinical, laboratory, electrocardiographic and echocardiographic parameters. We tested the association between each cluster and a composite outcome of HF/death. Results: The median age was 70 years, 55.5% were males and the median EF was 61.0%. Phenomapping provided three different clusters. Subjects in Cluster 3 were the oldest and had the highest prevalence of atrial fibrillation, the lowest estimated glomerular filtration rate (eGFR), the highest N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and the largest left atrium. During a median follow‐up of 5.7 years, 13.4% of subjects experienced HF/death events (N = 79). Compared with Clusters 1 and 2, Cluster 3 had the worst prognosis (log‐rank test: Cluster 3 vs. 1 P < 0.001; Cluster 3 vs. 2 P = 0.008). Cluster 3 was associated with a risk of HF/death 2.5 times higher than Cluster 1 [adjusted hazard ratio (HR) = 2.46, 95% confidence interval (CI) 1.24–4.90]. Conclusions: Based on phenomapping, older patients with lower kidney function and worse diastolic function might represent a subset of preclinical HF with EF > 40% who deserve more efforts to prevent clinical HF. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Coronary calcium score as a predictor of outcomes in the hypertensive Covid-19 population: results from the Italian (S) Core-Covid-19 Registry

Author

Cereda, Alberto, Toselli, Marco, Palmisano, Anna, Vignale, Davide, Khokhar, Arif, Campo, Gianluca, Bertini, Matteo, Loffi, Marco, Andreini, Daniele, Pontone, Gianluca, Patelli, Gianluigi, Sangiorgi, Giuseppe Massimo, Tumminello, Gabriele, Elia, Mariarosa, Iacovoni, Attilio, Carugo, Stefano, Rapezzi, Claudio, Colombo, Antonio, Giannini, Francesco, and Esposito, Antonio

Published
2022
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4. Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients

Author

Giannini, Francesco, Toselli, Marco, Palmisano, Anna, Cereda, Alberto, Vignale, Davide, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Manfrini, Marco, Khokhar, Arif, Sticchi, Alessandro, Biagi, Andrea, Turchio, Piergiorgio, Tacchetti, Carlo, Landoni, Giovanni, Boccia, Edda, Campo, Gianluca, Scoccia, Alessandra, Ponticelli, Francesco, Danzi, Gian Battista, Loffi, Marco, Muri, Margherita, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Ippolito, Davide, Bellani, Giacomo, Franzesi, Camillo Talei, Patelli, Gianluigi, Besana, Francesca, Costa, Claudia, Vignali, Luigi, Benatti, Giorgio, Sverzellati, Nicola, Scarnecchia, Elisa, Lombardo, Francesco Paolo, Anastasio, Fabio, Iannaccone, Mario, Vaudano, Paolo Giacomo, Pacielli, Alberto, Baffoni, Lucio, Gardi, Iljia, Cesini, Elisabetta, Sperandio, Massimiliano, Micossi, Chiara, De Carlini, Caterina Chiara, Spreafico, Cristiano, Maggiolini, Stefano, Bonaffini, Pietro Andrea, Iacovoni, Attilio, Sironi, Sandro, Senni, Michele, Fominskiy, Evgeny, De Cobelli, Francesco, Maggioni, Aldo Pietro, Rapezzi, Claudio, Ferrari, Roberto, Colombo, Antonio, and Esposito, Antonio

Published
2021
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6. COVID-19 in Heart Transplant Recipients: A Multicenter Analysis of the Northern Italian Outbreak

Author

Bottio, Tomaso, Bagozzi, Lorenzo, Fiocco, Alessandro, Nadali, Matteo, Caraffa, Raphael, Bifulco, Olimpia, Ponzoni, Matteo, Lombardi, Carlo Maria, Metra, Marco, Russo, Claudio Francesco, Frigerio, Maria, Masciocco, Gabriella, Potena, Luciano, Loforte, Antonio, Pacini, Davide, Faggian, Giuseppe, Onorati, Francesco, Sponga, Sandro, Livi, Ugolino, Iacovoni, Attilio, Terzi, Amedeo, Senni, Michele, Rinaldi, Mauro, Boffini, Massimo, Marro, Matteo, Jorgji, Vjola, Carrozzini, Massimiliano, and Gerosa, Gino

Published
2021
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7. The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): fourth Paediatric EUROMACS (Paedi-EUROMACS) report.

Author

Rohde, Sofie, Puyvelde, Joeri van, Veen, Kevin M, Schweiger, Martin, Biermann, Daniel, Amodeo, Antonio, Martens, Thomas, Damman, Kevin, Gollmann-Tepeköylü, Can, Hulman, Michael, Iacovoni, Attilio, Krämer, Ulrike S, Loforte, Antonio, Napoleone, Carlo Pace, Nemec, Petr, Netuka, Ivan, Özbaran, Mustafa, Polo, Luz, Pya, Yuriy, and Ramjankhan, Faiz

Subjects
ARTIFICIAL blood circulation, PULSATILE flow, STROKE, PROPORTIONAL hazards models, CONGENITAL heart disease
Abstract

OBJECTIVES The use of ventricular assist devices (VADs) in children is increasing. However, absolute numbers in individual centres and countries remain small. Collaborative efforts such as the Paedi-European Registry for Patients with Mechanical Circulatory Support (EUROMACS) are therefore essential for combining international experience with paediatric VADs. Our goal was to present the results from the fourth Paedi-EUROMACS report. METHODS All paediatric (<19 years) patients from the EUROMACS database supported by a VAD were included. Patients were stratified into a congenital heart disease (CHD) group and a group with a non-congenital aetiology. End points included mortality, a transplant and recovery. Cox proportional hazard models were used to explore associated factors for mortality, cerebrovascular accident and pump thrombosis. RESULTS A total of 590 primary implants were included. The congenital group was significantly younger (2.5 vs 8.0 years, respectively, P  < 0.001) and was more commonly supported by a pulsatile flow device (73.5% vs 59.9%, P  < 0.001). Mortality was significantly higher in the congenital group (30.8% vs 20.4%, P  = 0.009) than in the non-congenital group. However, in multivariable analyses, CHD was not significantly associated with mortality [hazard ratio (HR) 1.285; confidence interval (CI) 0.8111–2.036, P  = 0.740]. Pump thrombosis was the most frequently reported adverse event (377 events in 132 patients; 0.925 events per patient-year) and was significantly associated with body surface area (HR 0.524, CI 0.333–0.823, P  = 0.005), CHD (HR 1.641, CI 1.054–2.555, P  = 0.028) and pulsatile flow support (HR 2.345, CI 1.406–3.910, P  = 0.001) in multivariable analyses. CONCLUSIONS This fourth Paedi-EUROMACS report highlights the increasing use of paediatric VADs. The patient populations with congenital and non-congenital aetiologies exhibit distinct characteristics and clinical outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Corrigendum: Five-Year Outcome After Continuous Flow LVAD With Full-Magnetic (HeartMate 3) Versus Hybrid Levitation System (HeartWare): A Propensity-Score Matched Study From an All-Comers Multicentre Registry

Author

Francica, Alessandra, primary, Loforte, Antonio, additional, Attisani, Matteo, additional, Maiani, Massimo, additional, Iacovoni, Attilio, additional, Nisi, Teodora, additional, Comisso, Marina, additional, Terzi, Amedeo, additional, De Bonis, Michele, additional, Vendramin, Igor, additional, Boffini, Massimo, additional, Musumeci, Francesco, additional, Luciani, Giovanni Battista, additional, Rinaldi, Mauro, additional, Pacini, Davide, additional, and Onorati, Francesco, additional

Published
2023
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11. Five-Year Outcome After Continuous Flow LVAD With Full-Magnetic (HeartMate 3) Versus Hybrid Levitation System (HeartWare): A Propensity-Score Matched Study From an All-Comers Multicentre Registry

Author

Francica, Alessandra, primary, Loforte, Antonio, additional, Attisani, Matteo, additional, Maiani, Massimo, additional, Iacovoni, Attilio, additional, Nisi, Teodora, additional, Comisso, Marina, additional, Terzi, Amedeo, additional, De Bonis, Michele, additional, Vendramin, Igor, additional, Boffini, Massimo, additional, Musumeci, Francesco, additional, Luciani, Giovanni Battista, additional, Rinaldi, Mauro, additional, Pacini, Davide, additional, and Onorati, Francesco, additional

Published
2023
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12. Acute necrotizing eosinophilic myocarditis presenting with cardiogenic shock after mRNA booster dose for COVID-19: Case report and review of literature

Author

Abete, Raffaele, Valastro, Pietro, Iacovoni, Attilio, Vittori, Claudia, Arbustini, Eloisa, Pellicioli, Federica, Schiavo, Alessandra, Grazioli, Lorenzo Stephan Cesare, Lorini, Ferdinando Luca, and Senni, Michele

Subjects
Case Report, Cardiology and Cardiovascular Medicine
Abstract

Eosinophilic myocarditis is a rare subtype of myocarditis characterized by myocardial eosinophilic infiltration, and it is potentially lethal if untreated. In its severest form, acute eosinophilic necrotizing myocarditis may lead to cardiac dysfunction and cardiogenic shock. Several cases have been reported after coronavirus disease 2019 (COVID-19) vaccination, but the pathophysiology is still unclear. We describe a case of acute necrotizing eosinophilic myocarditis complicated by cardiogenic shock in a 33-year-old man after booster dose of mRNA COVID-19 vaccine. The patient was diagnosed with endomyocardial biopsy, successfully treated with steroids, and discharged on Day 20 after admission in stable condition. In short term follow-up, he was asymptomatic with normal left and right ventricular ejection fraction. LEARNING OBJECTIVES: Eosinophilic myocarditis (EM) still has a high morbidity and mortality, so it is crucial to promptly diagnose it and treat as appropriate. Endomyocardial biopsy is the gold standard for the diagnosis of EM. This case highlights the diagnostic work-up, differential diagnosis of hypereosinophilia, and the management of this life-threatening condition.

Published
2023

14. Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) scientific statement on the simplification of the drug regimen for secondary cardiovascular prevention

Author

De Luca, Leonardo, Di Fusco, Stefania Angela, Iannopollo, Gianmarco, Mistrulli, Raffaella, Rizzello, Vittoria, Aimo, Alberto, Navazio, Alessandro, Bilato, Claudio, Corda, Marco, Di Marco, Massimo, Geraci, Giovanna, Iacovoni, Attilio, Milli, Massimo, Pascale, Vittorio, Riccio, Carmine, Scicchitano, Pietro, Tizzani, Emanuele, Gabrielli, Domenico, Grimaldi, Massimo, Colivicchi, Furio, and Oliva, Fabrizio

Abstract

The issue of suboptimal drug regimen adherence in secondary cardiovascular prevention presents a significant barrier to improving patient outcomes. To address this, the utilization of drug combinations, specifically single pill combinations (SPCs) and polypills, was proposed as a strategy to simplify treatment regimens. This approach aims to enhance treatment accessibility, affordability, and adherence, thereby reducing healthcare costs and improving patient health. The document is an Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) scientific statement on simplifying drug regimens for secondary cardiovascular prevention. It discusses the underuse of treatments despite available, effective, and accessible options, highlighting a significant gap in secondary prevention across different socio-economic statuses and countries. The statement explores barriers to implementing evidence-based treatments, including patient, healthcare provider, and system-related challenges. The paper also reviews international guidelines, the role of SPCs and polypills in clinical practice, and their economic impact, advocating for their use in secondary prevention to improve patient outcomes and adherence.

Published
2024
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15. Italian Association of Hospital Cardiologists position paper—obesity in adults: a clinical primer

Author

Di Fusco, Stefania Angela, Mocini, Edoardo, Gori, Mauro, Iacoviello, Massimo, Bilato, Claudio, Corda, Marco, De Luca, Leonardo, Di Marco, Massimo, Geraci, Giovanna, Iacovoni, Attilio, Milli, Massimo, Navazio, Alessandro, Pascale, Vittorio, Riccio, Carmine, Scicchitano, Pietro, Tizzani, Emanuele, Gabrielli, Domenico, Grimaldi, Massimo, Colivicchi, Furio, and Oliva, Fabrizio

Abstract

Obesity is a chronic and relapsing disease characterized by the interaction between individual predispositions and an obesogenic environment. Recent advances in understanding the mechanisms of energetic homoeostasis paved the way to more effective therapeutic approaches compared with traditional treatments. Since obesity is a complex disease, it necessitates a multi-disciplinary approach whose implementation remains challenging. Nonetheless, emerging pharmacological interventions appear promising. Currently, therapeutic success is discreet in the short term but often fails to maintain long-term weight loss due to a high likelihood of weight regain. Cardiologists play a key role in managing patients with obesity, yet often lack familiarity with its comprehensive management. The aim of this document is to summarize knowledge to consolidate essential knowledge for clinicians to effectively treat patients living with obesity. The paper emphasizes the pivotal role of a strong patient–clinician relationship in navigating successful treatment. We analyse the criteria commonly used to diagnose obesity and point out the strengths and limitations of different criteria. Furthermore, we discuss the role of obesiologists and the contributions of cardiologists. In addition, we detail key components of effective therapeutic strategies, including educational aspects and pharmacological options.

Published
2024
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18. P2X7R mutation disrupts the NLRP3-mediated Th program and predicts poor cardiac allograft outcomes

Author

D'Addio, Francesca, Vergani, Andrea, Potena, Luciano, Maestroni, Anna, Usuelli, Vera, Nasr, Moufida Ben, Bassi, Roberto, Tezza, Sara, Dellepiane, Sergio, Essawy, Basset El, Iascone, Maria, Iacovoni, Attilio, Borgese, Laura, Liu, Kaifeng, Visner, Gary, Dhe-Paganon, Sirano, Corradi, Domenico, Abdi, Reza, Starling, Randall C., Folli, Franco, Zuccotti, Gian Vincenzo, Sayegh, Mohamed H., Heeger, Peter S., Chandraker, Anil, Grigioni, Francesco, and Fiorina, Paolo

Subjects
Heart transplantation -- Usage -- Complications and side effects, Gene mutation -- Research, Cardiac patients -- Health aspects, Transcription factors -- Analysis, T cells -- Research, Health care industry
Abstract

Purinergic receptor-7 (P2X7R) signaling controls Th17 and Th1 generation/differentiation, while NOD-like receptor P3 (NLRP3) acts as a Th2 transcriptional factor. Here, we demonstrated the existence of a P2X7R/NLRP3 pathway in T cells that is dysregulated by a P2X7R intracellular region loss-of-function mutation, leading to NLRP3 displacement and to excessive Th17 generation due to abrogation of the NLRP3-mediated Th2 program. This ultimately resulted in poor outcomes in cardiac-transplanted patients carrying the mutant allele, who showed abnormal Th17 generation. Transient NLRP3 silencing in nonmutant T cells or overexpression in mutant T cells normalized the Th profile. Interestingly, IL-17 blockade reduced Th17 skewing of human T cells in vitro and abrogated the severe allograft vasculopathy and abnormal Th17 generation observed in preclinical models in which P2X7R was genetically deleted. This P2X7R intracellular region mutation thus impaired the modulatory effects of P2X7R on NLRP3 expression and function in T cells and led to NLRP3 dysregulation and Th17 skewing, delineating a high-risk group of cardiac-transplanted patients who may benefit from personalized therapy., Introduction Purinergic receptor-7 (P2X7R), primarily expressed on lymphocytes, senses adenosine 5'-triphosphate (ATP) (1) released extracellularly during cell damage (2, 3) and has been shown to regulate T cell activation (4-6). [...]

Published
2018
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26. Significance of Sarcomere Gene Mutations Analysis in the End-Stage Phase of Hypertrophic Cardiomyopathy

Author

Biagini, Elena, Olivotto, Iacopo, Iascone, Maria, Parodi, Maria I., Girolami, Francesca, Frisso, Giulia, Autore, Camillo, Limongelli, Giuseppe, Cecconi, Massimiliano, Maron, Barry J., Maron, Martin S., Rosmini, Stefania, Formisano, Francesco, Musumeci, Beatrice, Cecchi, Franco, Iacovoni, Attilio, Haas, Tammy S., Bacchi Reggiani, Maria L., Ferrazzi, Paolo, Salvatore, Francesco, Spirito, Paolo, and Rapezzi, Claudio

Published
2014
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28. The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): third Paediatric (Paedi-EUROMACS) report

Author

de By, Theo M M H, primary, Schweiger, Martin, additional, Hussain, Hina, additional, Amodeo, Antonio, additional, Martens, Thomas, additional, Bogers, Ad J J C, additional, Damman, Kevin, additional, Gollmnan-Tepeköylü, Can, additional, Hulman, Michael, additional, Iacovoni, Attilio, additional, Krämer, Ulrike, additional, Loforte, Antonio, additional, Napoleone, Carlo Pace, additional, Němec, Petr, additional, Netuka, Ivan, additional, Özbaran, Mustafa, additional, Polo, Luz, additional, Pya, Yuri, additional, Ramjankhan, Faiz, additional, Sandica, Eugen, additional, Sliwka, Joanna, additional, Stiller, Brigitte, additional, Kadner, Alexander, additional, Franceschini, Alessio, additional, Thiruchelvam, Timothy, additional, Zimpfer, Daniel, additional, Meyns, Bart, additional, Berger, Felix, additional, and Miera, Oliver, additional

Published
2022
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29. Does the distance between residency and implanting center affect the outcome of patients supported by left ventricular assist devices? A multicenter Italian study on radial mechanically assisted circulatory support ( MIRAMACS ) analysis

Author

Lechiancole, Andrea, primary, Loforte, Antonio, additional, Scandroglio, Mara, additional, Comisso, Marina, additional, Iacovoni, Attilio, additional, Maiani, Massimo, additional, Gliozzi, Gregorio, additional, De Bonis, Michele, additional, Musumeci, Francesco, additional, Terzi, Amedeo, additional, Pacini, Davide, additional, and Livi, Ugolino, additional

Published
2022
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30. [ANMCO Position paper: Care pathway for advanced heart failure patients candidate for heart transplantation/ventricular assist device]

Author

Iacoviello, Massimo, Cipriani, Manlio, Valente, Serafina, Marini, Marco, Ammirati, Enrico, Benvenuto, Manuela, Cassaniti, Leonarda Rosaria, De Maria, Renata, Gori, Mauro, Municinò, Annamaria, Navazio, Alessandro, Amodeo, Vincenzo, Aspromonte, Nadia, Barili, Fabio, Casolo, Giancarlo, Clemenza, Francesco, Di Eusanio, Marco, Di Lenarda, Andrea, Di Tano, Giuseppe, Domenicucci, Stefano, Faggian, Giuseppe, Francese, Giuseppina Maura, Frongillo, Doriana, Gilardi, Rossella, Iacovoni, Attilio, Imazio, Massimo, Livi, Ugolino, Maiello, Ciro, Milano, Aldo, Mondino, Michele, Moreo, Antonella Maurizia, Mortara, Andrea, Murrone, Adriano, Palmieri, Vittorio, Pelenghi, Stefano, Pini, Daniela, Pistono, Massimo, Porcu, Maurizio, Potena, Luciano, Rinaldi, Mauro, Romanò, Massimo, Roncon, Loris, Rossini, Roberta, Russo, Claudio Francesco, Scotto di Uccio, Fortunato, Urbinati, Stefano, Zecchin, Massimo, Caldarola, Pasquale, Oliveti, Alessandra, Frigerio, Maria, Musumeci, Francesco, Gulizia, Michele Massimo, Oliva, Fabrizio, Gabrielli, Domenico, and Colivicchi, Furio

Subjects
Heart Failure, Cardiotonic Agents, Advanced heart failure, Heart transplantation, Ventricular assist device, Critical Pathways, Humans, Palliative Care, Heart Transplantation, Heart-Assist Devices
Abstract

Heart failure is a complex clinical syndrome with a severe prognosis, despite therapeutic progress. The management of the advanced stages of the syndrome is particularly complex in patients who are referred to palliative care as well as in those who are candidates for cardiac replacement therapy. For the latter group, a prompt recognition of the transition to the advanced stage as well as an early referral to the centers for cardiac replacement therapy are essential elements to ensure that patients follow the most appropriate diagnostic-therapeutic pathway. The aim of this document is to focus on the main diagnostic and therapeutic aspects related to the advanced stages of heart failure and, in particular, on the management of patients who are candidates for cardiac replacement therapy.

Published
2022

31. The European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery: third report

Author

de By, Theo M. M. H., Schoenrath, Felix, Veen, Kevin M., Mohacsi, Paul, Stein, Julia, Alkhamees, Khalid M. M., Anastasiadis, Kyriakos, Berhnardt, Alexander, Beyersdorf, Friedhelm, Caliskan, Kadir, Reineke, David, Damman, Kevin, Fiane, Arnt, Gkouziouta, Angeliki, Gollmann-Tepekoeylue, Can, Finn, Gustafsson, Hulman, Michal, Iacovoni, Attilio, Loforte, Antonio, Merkely, Bela, Musumeci, Francesco, Nemec, Petr, Netuka, Ivan, Ozbaran, Mustafa, Potapov, Evgenij, Pya, Yuri, Rabago, Gregorio, Ramjankhan, Faiz, Reichenspurner, Hermann, Saeed, Diyar, Sandoval, Elena, Stockman, Bernard, Vanderheyden, Marc, Tops, Laurens, Wahlers, Thorsten, Zembala, Michael, Zimpfer, Daniel, Carrel, Thierry, Gummert, Jan, Meyns, Bart, de By, Theo M. M. H., Schoenrath, Felix, Veen, Kevin M., Mohacsi, Paul, Stein, Julia, Alkhamees, Khalid M. M., Anastasiadis, Kyriakos, Berhnardt, Alexander, Beyersdorf, Friedhelm, Caliskan, Kadir, Reineke, David, Damman, Kevin, Fiane, Arnt, Gkouziouta, Angeliki, Gollmann-Tepekoeylue, Can, Finn, Gustafsson, Hulman, Michal, Iacovoni, Attilio, Loforte, Antonio, Merkely, Bela, Musumeci, Francesco, Nemec, Petr, Netuka, Ivan, Ozbaran, Mustafa, Potapov, Evgenij, Pya, Yuri, Rabago, Gregorio, Ramjankhan, Faiz, Reichenspurner, Hermann, Saeed, Diyar, Sandoval, Elena, Stockman, Bernard, Vanderheyden, Marc, Tops, Laurens, Wahlers, Thorsten, Zembala, Michael, Zimpfer, Daniel, Carrel, Thierry, Gummert, Jan, and Meyns, Bart

Abstract

OBJECTIVES In the third report of the European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery, outcomes of patients receiving mechanical circulatory support are reviewed in relation to implant era. METHODS Procedures in adult patients (January 2011-June 2020) were included. Patients from centres with <60% follow-ups completed were excluded. Outcomes were stratified into 3 eras (2011-2013, 2014-2017 and 2018-2020). Adverse event rates (AERs) were calculated and stratified into early phase (<3 months) and late phase (>3 months). Risk factors for death were explored using univariable Cox regression with a stepwise time-varying hazard ratio (3 months). RESULTS In total, 4834 procedures in 4486 individual patients (72 hospitals) were included, with a median follow-up of 1.1 (interquartile range: 0.3-2.6) years. The annual number of implants (range: 346-600) did not significantly change (P = 0.41). Both Interagency Registry for Mechanically Assisted Circulatory Support class (classes 4-7: 23, 25 and 33%; P < 0.001) and in-hospital deaths (18.5, 17.2 and 11.2; P < 0.001) decreased significantly between eras. Overall, mortality, transplants and the probability of weaning were 55, 25 and 2% at 5 years after the implant, respectively. Major infections were mainly noted early after the implant occurred (AER(3 months): 0.45). Bilirubin and creatinine levels were significant risk factors in the early phase but not in the late phase after the implant. CONCLUSIONS In its 10 years of existence, EUROMACS has become a point of reference enabling benchmarking and outcome monitoring. Patient characteristics and outcomes changed between implant eras. In addition, both occurrence of outcomes and risk factor weights are time dependent. As a registry of the European Association for Cardio-Thoracic Surgery, the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) offers a robust repository of clinica

Published
2022

32. The European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery:third report

Author

De By, Theo M. M. H., Schoenrath, Felix, Veen, Kevin M., Mohacsi, Paul, Stein, Julia, Alkhamees, Khalid M. M., Anastasiadis, Kyriakos, Berhnardt, Alexander, Beyersdorf, Friedhelm, Caliskan, Kadir, Reineke, David, Damman, Kevin, Fiane, Arnt, Gkouziouta, Angeliki, Gollmann-Tepeköylü, Can, Gustafsson, Finn, Hulman, Michal, Iacovoni, Attilio, Loforte, Antonio, Merkely, Bela, Musumeci, Francesco, Němec, Petr, Netuka, Ivan, Özbaran, Mustafa, Potapov, Evgenij, Pya, Yuri, Rábago, Gregorio, Ramjankhan, Faiz, Reichenspurner, Hermann, Saeed, Diyar, Sandoval, Elena, Stockman, Bernard, Vanderheyden, Marc, Tops, Laurens, Wahlers, Thorsten, Zembala, Michael, Zimpfer, Daniel, Carrel, Thierry, Gummert, Jan, Meyns, Bart, De By, Theo M. M. H., Schoenrath, Felix, Veen, Kevin M., Mohacsi, Paul, Stein, Julia, Alkhamees, Khalid M. M., Anastasiadis, Kyriakos, Berhnardt, Alexander, Beyersdorf, Friedhelm, Caliskan, Kadir, Reineke, David, Damman, Kevin, Fiane, Arnt, Gkouziouta, Angeliki, Gollmann-Tepeköylü, Can, Gustafsson, Finn, Hulman, Michal, Iacovoni, Attilio, Loforte, Antonio, Merkely, Bela, Musumeci, Francesco, Němec, Petr, Netuka, Ivan, Özbaran, Mustafa, Potapov, Evgenij, Pya, Yuri, Rábago, Gregorio, Ramjankhan, Faiz, Reichenspurner, Hermann, Saeed, Diyar, Sandoval, Elena, Stockman, Bernard, Vanderheyden, Marc, Tops, Laurens, Wahlers, Thorsten, Zembala, Michael, Zimpfer, Daniel, Carrel, Thierry, Gummert, Jan, and Meyns, Bart

Abstract

OBJECTIVES: In the third report of the European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery, outcomes of patients receiving mechanical circulatory support are reviewed in relation to implant era. METHODS: Procedures in adult patients (January 2011-June 2020) were included. Patients from centres with <60% follow-ups completed were excluded. Outcomes were stratified into 3 eras (2011-2013, 2014-2017 and 2018-2020). Adverse event rates (AERs) were calculated and stratified into early phase (<3 months) and late phase (>3 months). Risk factors for death were explored using univariable Cox regression with a stepwise time-varying hazard ratio (<3 vs >3 months). RESULTS: In total, 4834 procedures in 4486 individual patients (72 hospitals) were included, with a median follow-up of 1.1 (interquartile range: 0.3-2.6) years. The annual number of implants (range: 346-600) did not significantly change (P = 0.41). Both Interagency Registry for Mechanically Assisted Circulatory Support class (classes 4-7: 23, 25 and 33%; P < 0.001) and in-hospital deaths (18.5, 17.2 and 11.2; P < 0.001) decreased significantly between eras. Overall, mortality, transplants and the probability of weaning were 55, 25 and 2% at 5 years after the implant, respectively. Major infections were mainly noted early after the implant occurred (AER<3 months: 1.44 vs AER>3 months: 0.45). Bilirubin and creatinine levels were significant risk factors in the early phase but not in the late phase after the implant. CONCLUSIONS: In its 10 years of existence, EUROMACS has become a point of reference enabling benchmarking and outcome monitoring. Patient characteristics and outcomes changed between implant eras. In addition, both occurrence of outcomes and risk factor weights are time dependent.

Published
2022

33. The European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery: third report

Author

CTC, Circulatory Health, de By, Theo M M H, Schoenrath, Felix, Veen, Kevin M, Mohacsi, Paul, Stein, Julia, Alkhamees, Khalid M M, Anastasiadis, Kyriakos, Berhnardt, Alexander, Beyersdorf, Friedhelm, Caliskan, Kadir, Reineke, David, Damman, Kevin, Fiane, Arnt, Gkouziouta, Angeliki, Gollmann-Tepeköylü, Can, Gustafsson, Finn, Hulman, Michal, Iacovoni, Attilio, Loforte, Antonio, Merkely, Bela, Musumeci, Francesco, Němec, Petr, Netuka, Ivan, Özbaran, Mustafa, Potapov, Evgenij, Pya, Yuri, Rábago, Gregorio, Ramjankhan, Faiz, Reichenspurner, Hermann, Saeed, Diyar, Sandoval, Elena, Stockman, Bernard, Vanderheyden, Marc, Tops, Laurens, Wahlers, Thorsten, Zembala, Michael, Zimpfer, Daniel, Carrel, Thierry, Gummert, Jan, Meyns, Bart, CTC, Circulatory Health, de By, Theo M M H, Schoenrath, Felix, Veen, Kevin M, Mohacsi, Paul, Stein, Julia, Alkhamees, Khalid M M, Anastasiadis, Kyriakos, Berhnardt, Alexander, Beyersdorf, Friedhelm, Caliskan, Kadir, Reineke, David, Damman, Kevin, Fiane, Arnt, Gkouziouta, Angeliki, Gollmann-Tepeköylü, Can, Gustafsson, Finn, Hulman, Michal, Iacovoni, Attilio, Loforte, Antonio, Merkely, Bela, Musumeci, Francesco, Němec, Petr, Netuka, Ivan, Özbaran, Mustafa, Potapov, Evgenij, Pya, Yuri, Rábago, Gregorio, Ramjankhan, Faiz, Reichenspurner, Hermann, Saeed, Diyar, Sandoval, Elena, Stockman, Bernard, Vanderheyden, Marc, Tops, Laurens, Wahlers, Thorsten, Zembala, Michael, Zimpfer, Daniel, Carrel, Thierry, Gummert, Jan, and Meyns, Bart

Published
2022

34. The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): third Paediatric (Paedi-EUROMACS) report

Author

CTC, Circulatory Health, de By, Theo M M H, Schweiger, Martin, Hussain, Hina, Amodeo, Antonio, Martens, Thomas, Bogers, Ad J J C, Damman, Kevin, Gollmann-Tepeköylü, Can, Hulman, Michael, Iacovoni, Attilio, Krämer, Ulrike, Loforte, Antonio, Napoleone, Carlo Pace, Němec, Petr, Netuka, Ivan, Özbaran, Mustafa, Polo, Luz, Pya, Yuri, Ramjankhan, Faiz, Sandica, Eugen, Sliwka, Joanna, Stiller, Brigitte, Kadner, Alexander, Franceschini, Alessio, Thiruchelvam, Timothy, Zimpfer, Daniel, Meyns, Bart, Berger, Felix, Miera, Oliver, CTC, Circulatory Health, de By, Theo M M H, Schweiger, Martin, Hussain, Hina, Amodeo, Antonio, Martens, Thomas, Bogers, Ad J J C, Damman, Kevin, Gollmann-Tepeköylü, Can, Hulman, Michael, Iacovoni, Attilio, Krämer, Ulrike, Loforte, Antonio, Napoleone, Carlo Pace, Němec, Petr, Netuka, Ivan, Özbaran, Mustafa, Polo, Luz, Pya, Yuri, Ramjankhan, Faiz, Sandica, Eugen, Sliwka, Joanna, Stiller, Brigitte, Kadner, Alexander, Franceschini, Alessio, Thiruchelvam, Timothy, Zimpfer, Daniel, Meyns, Bart, Berger, Felix, and Miera, Oliver

Published
2022

40. The European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery: third report

Author

de By, Theo M M H, primary, Schoenrath, Felix, additional, Veen, Kevin M, additional, Mohacsi, Paul, additional, Stein, Julia, additional, Alkhamees, Khalid M M, additional, Anastasiadis, Kyriakos, additional, Berhnardt, Alexander, additional, Beyersdorf, Friedhelm, additional, Caliskan, Kadir, additional, Reineke, David, additional, Damman, Kevin, additional, Fiane, Arnt, additional, Gkouziouta, Angeliki, additional, Gollmann-Tepeköylü, Can, additional, Gustafsson, Finn, additional, Hulman, Michal, additional, Iacovoni, Attilio, additional, Loforte, Antonio, additional, Merkely, Bela, additional, Musumeci, Francesco, additional, Němec, Petr, additional, Netuka, Ivan, additional, Özbaran, Mustafa, additional, Potapov, Evgenij, additional, Pya, Yuri, additional, Rábago, Gregorio, additional, Ramjankhan, Faiz, additional, Reichenspurner, Hermann, additional, Saeed, Diyar, additional, Sandoval, Elena, additional, Stockman, Bernard, additional, Vanderheyden, Marc, additional, Tops, Laurens, additional, Wahlers, Thorsten, additional, Zembala, Michael, additional, Zimpfer, Daniel, additional, Carrel, Thierry, additional, Gummert, Jan, additional, and Meyns, Bart, additional

Published
2022
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43. Coronary calcium score as a predictor of outcomes in the hypertensive Covid-19 population: results from the Italian (S) Core-Covid-19 Registry

Author

Cereda, Alberto, primary, Toselli, Marco, additional, Palmisano, Anna, additional, Vignale, Davide, additional, Khokhar, Arif, additional, Campo, Gianluca, additional, Bertini, Matteo, additional, Loffi, Marco, additional, Andreini, Daniele, additional, Pontone, Gianluca, additional, Patelli, Gianluigi, additional, Sangiorgi, Giuseppe Massimo, additional, Tumminello, Gabriele, additional, Elia, Mariarosa, additional, Iacovoni, Attilio, additional, Carugo, Stefano, additional, Rapezzi, Claudio, additional, Colombo, Antonio, additional, Giannini, Francesco, additional, and Esposito, Antonio, additional

Published
2021
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46. Impact of surgical ventricular reconstruction on sphericity index in patients with ischaemic cardiomyopathy: follow-up from the STICH trial

Author

Choi, Jin-Oh, Daly, Richard C., Lin, Grace, Lahr, Brian D., Wiste, Heather J., Beaver, Thomas M., Iacovoni, Attilio, Malinowski, Marcin, Friedrich, Ivar, Rouleau, Jean L., Favaloro, Roberto R., Sopko, George, Lang, Irene M., White, Harvey D., Milano, Carmelo A., Jones, Robert H., Lee, Kerry L., Velazquez, Eric J., and Oh, Jae K.

Published
2015
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48. Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients

Author

Giannini, F, Toselli, M, Palmisano, A, Cereda, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Manfrini, M, Khokhar, A, Sticchi, A, Biagi, A, Turchio, P, Tacchetti, C, Landoni, G, Boccia, E, Campo, G, Scoccia, A, Ponticelli, F, Danzi, G, Loffi, M, Muri, M, Pontone, G, Andreini, D, Mancini, E, Casella, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Franzesi, C, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Sverzellati, N, Scarnecchia, E, Lombardo, F, Anastasio, F, Iannaccone, M, Vaudano, P, Pacielli, A, Baffoni, L, Gardi, I, Cesini, E, Sperandio, M, Micossi, C, De Carlini, C, Spreafico, C, Maggiolini, S, Bonaffini, P, Iacovoni, A, Sironi, S, Senni, M, Fominskiy, E, De Cobelli, F, Maggioni, A, Rapezzi, C, Ferrari, R, Colombo, A, Esposito, A, Giannini, Francesco, Toselli, Marco, Palmisano, Anna, Cereda, Alberto, Vignale, Davide, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Manfrini, Marco, Khokhar, Arif, Sticchi, Alessandro, Biagi, Andrea, Turchio, Piergiorgio, Tacchetti, Carlo, Landoni, Giovanni, Boccia, Edda, Campo, Gianluca, Scoccia, Alessandra, Ponticelli, Francesco, Danzi, Gian Battista, Loffi, Marco, Muri, Margherita, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Ippolito, Davide, Bellani, Giacomo, Franzesi, Camillo Talei, Patelli, Gianluigi, Besana, Francesca, Costa, Claudia, Vignali, Luigi, Benatti, Giorgio, Sverzellati, Nicola, Scarnecchia, Elisa, Lombardo, Francesco Paolo, Anastasio, Fabio, Iannaccone, Mario, Vaudano, Paolo Giacomo, Pacielli, Alberto, Baffoni, Lucio, Gardi, Iljia, Cesini, Elisabetta, Sperandio, Massimiliano, Micossi, Chiara, De Carlini, Caterina Chiara, Spreafico, Cristiano, Maggiolini, Stefano, Bonaffini, Pietro Andrea, Iacovoni, Attilio, Sironi, Sandro, Senni, Michele, Fominskiy, Evgeny, De Cobelli, Francesco, Maggioni, Aldo Pietro, Rapezzi, Claudio, Ferrari, Roberto, Colombo, Antonio, Esposito, Antonio, Giannini, F, Toselli, M, Palmisano, A, Cereda, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Manfrini, M, Khokhar, A, Sticchi, A, Biagi, A, Turchio, P, Tacchetti, C, Landoni, G, Boccia, E, Campo, G, Scoccia, A, Ponticelli, F, Danzi, G, Loffi, M, Muri, M, Pontone, G, Andreini, D, Mancini, E, Casella, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Franzesi, C, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Sverzellati, N, Scarnecchia, E, Lombardo, F, Anastasio, F, Iannaccone, M, Vaudano, P, Pacielli, A, Baffoni, L, Gardi, I, Cesini, E, Sperandio, M, Micossi, C, De Carlini, C, Spreafico, C, Maggiolini, S, Bonaffini, P, Iacovoni, A, Sironi, S, Senni, M, Fominskiy, E, De Cobelli, F, Maggioni, A, Rapezzi, C, Ferrari, R, Colombo, A, Esposito, A, Giannini, Francesco, Toselli, Marco, Palmisano, Anna, Cereda, Alberto, Vignale, Davide, Leone, Riccardo, Nicoletti, Valeria, Gnasso, Chiara, Monello, Alberto, Manfrini, Marco, Khokhar, Arif, Sticchi, Alessandro, Biagi, Andrea, Turchio, Piergiorgio, Tacchetti, Carlo, Landoni, Giovanni, Boccia, Edda, Campo, Gianluca, Scoccia, Alessandra, Ponticelli, Francesco, Danzi, Gian Battista, Loffi, Marco, Muri, Margherita, Pontone, Gianluca, Andreini, Daniele, Mancini, Elisabetta Maria, Casella, Gianni, Iannopollo, Gianmarco, Nannini, Tommaso, Ippolito, Davide, Bellani, Giacomo, Franzesi, Camillo Talei, Patelli, Gianluigi, Besana, Francesca, Costa, Claudia, Vignali, Luigi, Benatti, Giorgio, Sverzellati, Nicola, Scarnecchia, Elisa, Lombardo, Francesco Paolo, Anastasio, Fabio, Iannaccone, Mario, Vaudano, Paolo Giacomo, Pacielli, Alberto, Baffoni, Lucio, Gardi, Iljia, Cesini, Elisabetta, Sperandio, Massimiliano, Micossi, Chiara, De Carlini, Caterina Chiara, Spreafico, Cristiano, Maggiolini, Stefano, Bonaffini, Pietro Andrea, Iacovoni, Attilio, Sironi, Sandro, Senni, Michele, Fominskiy, Evgeny, De Cobelli, Francesco, Maggioni, Aldo Pietro, Rapezzi, Claudio, Ferrari, Roberto, Colombo, Antonio, and Esposito, Antonio

Abstract

Background: Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated. Objectives: The aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients. Methods: 1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients’ outcomes. Results: Non-survivors compared to survivors had higher coronary artery [Agatston (467.76 ​± ​570.92 vs 206.80 ​± ​424.13 ​mm2, p ​< ​0.001); Volume (487.79 ​± ​565.34 vs 207.77 ​± ​406.81, p ​< ​0.001)], aortic valve [Volume (322.45 ​± ​390.90 vs 98.27 ​± ​250.74 mm2, p ​< ​0.001; Agatston 337.38 ​± ​414.97 vs 111.70 ​± ​282.15, p ​< ​0.001)] and thoracic aorta [Volume (3786.71 ​± ​4225.57 vs 1487.63 ​± ​2973.19 mm2, p ​< ​0.001); Agatston (4688.82 ​± ​5363.72 vs 1834.90 ​± ​3761.25, p ​< ​0.001)] calcium values. Coronary artery calcium (HR 1.308; 95% CI, 1.046–1.637, p ​= ​0.019) and total thoracic calcium (HR 1.975; 95% CI, 1.200–3.251, p ​= ​0.007) resulted to be independent predictors of in-hospital mortality. Conclusion: Coronary, aortic valve and thoracic aortic calcium assessment on admission non-gated CT permits to stratify the COVID-19 patients in-hospital mortality risk.

Published
2021

50. European Registry for Patients with Mechanical Circulatory Support (EUROMACS): third Paediatric (Paedi-EUROMACS) report.

Author

By, Theo M M H de, Schweiger, Martin, Hussain, Hina, Amodeo, Antonio, Martens, Thomas, Bogers, Ad J J C, Damman, Kevin, Gollmann-Tepeköylü, Can, Hulman, Michael, Iacovoni, Attilio, Krämer, Ulrike, Loforte, Antonio, Napoleone, Carlo Pace, Němec, Petr, Netuka, Ivan, Özbaran, Mustafa, Polo, Luz, Pya, Yuri, Ramjankhan, Faiz, and Sandica, Eugen

Subjects
ARTIFICIAL blood circulation, HEART assist devices, MEDICAL registries, CHILD patients, PEDIATRICS, CONGENITAL heart disease
Abstract

OBJECTIVES A third paediatric report has been generated from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). The purpose of EUROMACS, which is operated by the European Association for Cardio-Thoracic Surgery, is to gather data related to durable mechanical circulatory support for scientific purposes and to publish reports with respect to the course of mechanical circulatory support therapy. Since the first report issued, efforts to increase compliance and participation have been extended. Additionally, the data provided the opportunity to analyse patients of younger age and lower weight. METHODS Participating hospitals contributed pre-, peri- and long-term postoperative data on mechanical circulatory support implants to the registry. Data for all implants in paediatric patients (<19 years of age) performed from 1 January 2000 to 31 December 2020 were analysed. This report includes updates of patient characteristics, implant frequency, outcome (including mortality rates, transplants and recovery rates) as well as adverse events including neurological dysfunction, device malfunction, major infection and bleeding. RESULTS Twenty-five hospitals contributed 537 registered implants in 480 patients. The most frequent aetiology of heart failure was any form of cardiomyopathy (59%), followed by congenital heart disease and myocarditis (15% and 14%, respectively). Competing outcomes analysis revealed that a total of 86% survived to transplant or recovery or are ongoing; at the 2-year follow-up examination, 21.9% died while on support. At 12 months, 45.1% received transplants, 7.5% were weaned from their device and 20.8% died. The 3-month adverse events rate was 1.59 per patient-year for device malfunction including pump exchange, 0.7 for major bleeding, 0.78 for major infection and 0.71 for neurological events. CONCLUSIONS The overall survival rate was 79.2% at 12 months following ventricular assist device implant. The comparison of survival rates of the early and later eras shows no significant difference. A focus on specific subgroups showed that survival was less in patients of younger age (<1 year of age; P = 0.01) and lower weight (<20 kg; P = 0.015). Transplant rates at 6 months continue to be low (33.2%). [ABSTRACT FROM AUTHOR]

Published
2022
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