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1. Symptomatic post COVID patients have impaired alveolar capillary membrane function and high VE/VCO2

Author

Agostoni, Piergiuseppe, Mapelli, Massimo, Salvioni, Elisabetta, Mattavelli, Irene, Banfi, Cristina, Bonomi, Alice, Biondi, Maria Luisa, Rovai, Sara, Tamborini, Gloria, Muratori, Manuela, Ghulam Ali, Sarah, Ghilardi, Stefania, De Martino, Fabiana, Vignati, Carlo, Palermo, Pietro, Gugliandolo, Paola, Elia, Davide, Moscucci, Federica, Cassandro, Roberto, Andreini, Daniele, Mancini, Elisabetta, and Harari, Sergio

Published
2024
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4. The importance of re-evaluating the risk score in heart failure patients: An analysis from the Metabolic Exercise Cardiac Kidney Indexes (MECKI) score database

Author

Pezzuto, Beatrice, Piepoli, Massimo, Galotta, Arianna, Sciomer, Susanna, Zaffalon, Denise, Filomena, Domenico, Vignati, Carlo, Contini, Mauro, Alimento, Marina, Baracchini, Nikita, Apostolo, Anna, Palermo, Pietro, Mapelli, Massimo, Salvioni, Elisabetta, Carriere, Cosimo, Merlo, Marco, Papa, Silvia, Campodonico, Jeness, Badagliacca, Roberto, Sinagra, Gianfranco, and Agostoni, Piergiuseppe

Published
2023
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5. Pick Your Threshold: A Comparison Among Different Methods of Anaerobic Threshold Evaluation in Heart Failure Prognostic Assessment

Author

Farina, Stefania, Pezzuto, Beatrice, Apostolo, Anna, Palermo, Pietro, Contini, Mauro, Gugliandolo, Paola, Mattavelli, Irene, Della Rocca, Michele, Gallo, Giovanna, Moscucci, Federica, Iorio, Anita, Halasz, Geza, Capelli, Bruno, Binno, Simone, Pacileo, Giuseppe, Valente, Fabio, Vastarella, Rossella, Zaffalon, Denise, Carriere, Cosimo, Masè, Marco, Cittar, Marco, Di Lenarda, Andrea, Caravita, Sergio, Viganò, Elena, Marchese, Giovanni, Ricci, Roberto, Arcari, Luca, Scrutinio, Domenico, Battaia, Elisa, Moretti, Michele, Matassini, Maria Vittoria, Shkoza, Matilda, Herberg, Roland, Cittadini, Antonio, Salzano, Andrea, Marra, Alberto, Lafranca, Eluisa, Vitale, Giuseppe, Salvioni, Elisabetta, Mapelli, Massimo, Bonomi, Alice, Magrì, Damiano, Piepoli, Massimo, Frigerio, Maria, Paolillo, Stefania, Corrà, Ugo, Raimondo, Rosa, Lagioia, Rocco, Badagliacca, Roberto, Filardi, Pasquale Perrone, Senni, Michele, Correale, Michele, Cicoira, Mariantonietta, Perna, Enrico, Metra, Marco, Guazzi, Marco, Limongelli, Giuseppe, Sinagra, Gianfranco, Parati, Gianfranco, Cattadori, Gaia, Bandera, Francesco, Bussotti, Maurizio, Re, Federica, Vignati, Carlo, Lombardi, Carlo, Scardovi, Angela B., Sciomer, Susanna, Passantino, Andrea, Emdin, Michele, Passino, Claudio, Santolamazza, Caterina, Girola, Davide, De Martino, Fabiana, and Agostoni, Piergiuseppe

Published
2022
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6. Activities of daily living in heart failure patients and healthy subjects: when the cardiopulmonary assessment goes beyond traditional exercise test protocols

Author

Mapelli, Massimo, primary, Salvioni, Elisabetta, additional, Mattavelli, Irene, additional, Gugliandolo, Paola, additional, Bonomi, Alice, additional, Palermo, Pietro, additional, Rossi, Maddalena, additional, Stolfo, Davide, additional, Gustafsson, Finn, additional, Piepoli, Massimo, additional, and Agostoni, Piergiuseppe, additional

Published
2023
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9. Heart failure and anemia: Effects on prognostic variables

Author

Cattadori, Gaia, Agostoni, Piergiuseppe, Corrà, Ugo, Sinagra, Gianfranco, Veglia, Fabrizio, Salvioni, Elisabetta, Bonomi, Alice, La Gioia, Rocco, Scardovi, Angela B., Ferraironi, Alessandro, Emdin, Michele, Metra, Marco, Di Lenarda, Andrea, Limongelli, Giuseppe, Raimondo, Rosa, Re, Federica, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Caravita, Sergio, Magrì, Damiano, Lombardi, Carlo, Frigerio, Maria, Oliva, Fabrizio, Girola, Davide, Mezzani, Alessandro, Farina, Stefania, Mapelli, Massimo, Scrutinio, Domenico, Pacileo, Giuseppe, Apostolo, Anna, Iorio, AnnaMaria, Paolillo, Stefania, Filardi, Pasquale Perrone, Gargiulo, Paola, Bussotti, Maurizio, Marchese, Giovanni, Correale, Michele, Badagliacca, Roberto, Sciomer, Susanna, Palermo, Pietro, Contini, Mauro, Giannuzzi, Pantaleo, Battaia, Elisa, Cicoira, Mariantonietta, Clemenza, Francesco, Minà, Chiara, Binno, Simone, Passino, Claudio, and Piepoli, Massimo F.

Published
2017
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10. Sex Profile and Risk Assessment With Cardiopulmonary Exercise Testing in Heart Failure: Propensity Score Matching for Sex Selection Bias

Author

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

Published
2016
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11. The metabolic exercise test data combined with Cardiac And Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study

Author

Corrà, Ugo, Agostoni, Piergiuseppe, Giordano, Andrea, Cattadori, Gaia, Battaia, Elisa, La Gioia, Rocco, Scardovi, Angela B., Emdin, Michele, Metra, Marco, Sinagra, Gianfranco, Limongelli, Giuseppe, Raimondo, Rosa, Re, Federica, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Magrì, Damiano, Fiorentini, Cesare, Cicoira, Mariantonietta, Salvioni, Elisabetta, Giovannardi, Marta, Veglia, Fabrizio, Mezzani, Alessandro, Scrutinio, Domenico, Di Lenarda, Andrea, Ricci, Roberto, Apostolo, Anna, Iorio, Anna Maria, Paolillo, Stefania, Palermo, Pietro, Contini, Mauro, Vassanelli, Corrado, Passino, Claudio, Giannuzzi, Pantaleo, Piepoli, Massimo F., Antonioli, Laura, Segurini, Chiara, Bertella, Erica, Farina, Stefania, Bovis, Francesca, Pietrucci, Francesca, Malfatto, Gabriella, Roselli, Teo, Buono, Andrea, Calabrò, Raffaele, De Maria, Renata, Santoro, Daniela, Campanale, Saba, Caputo, Domenica, Bertipaglia, Donatella, and Berton, Emanuela

Published
2016
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12. Activities of daily living in heart failure patients and healthy subjects:when the cardiopulmonary assessment goes beyond traditional exercise test protocols

Author

Mapelli, Massimo, Salvioni, Elisabetta, Mattavelli, Irene, Gugliandolo, Paola, Bonomi, Alice, Palermo, Pietro, Rossi, Maddalena, Stolfo, Davide, Gustafsson, Finn, Piepoli, Massimo, Agostoni, Piergiuseppe, Mapelli, Massimo, Salvioni, Elisabetta, Mattavelli, Irene, Gugliandolo, Paola, Bonomi, Alice, Palermo, Pietro, Rossi, Maddalena, Stolfo, Davide, Gustafsson, Finn, Piepoli, Massimo, and Agostoni, Piergiuseppe

Abstract

Heart failure (HF) patients traditionally report dyspnoea as their main symptom. Although the cardiopulmonary exercise test (CPET) and 6 min walking test are the standardized tools in assessing functional capacity, neither cycle ergometers nor treadmill maximal efforts do fully represent the actual HF patients’ everyday activities [activities of daily living (ADLs)] (i.e. climbing the stairs). New-generation portable metabolimeters allow the clinician to measure task-related oxygen intake (VO2) in different scenarios and exercise protocols. In the last years, we have made considerable progress in understanding the ventilatory and metabolic behaviours of HF patients and healthy subjects during tasks aimed to reproduce ADLs. In this paper, we describe the most recent findings in the field, with special attention to the relationship between the metabolic variables obtained during ADLs and CPET parameters (i.e. peak VO2), demonstrating, for example, how exercises traditionally thought to be undemanding, such as a walk, instead represent supramaximal efforts, particularly for subjects with advanced HF and/or artificial heart (left ventricular assist devices) wearers., Heart failure (HF) patients traditionally report dyspnoea as their main symptom. Although the cardiopulmonary exercise test (CPET) and 6 min walking test are the standardized tools in assessing functional capacity, neither cycle ergometers nor treadmill maximal efforts do fully represent the actual HF patients' everyday activities [activities of daily living (ADLs)] (i.e. climbing the stairs). New-generation portable metabolimeters allow the clinician to measure task-related oxygen intake (VO2) in different scenarios and exercise protocols. In the last years, we have made considerable progress in understanding the ventilatory and metabolic behaviours of HF patients and healthy subjects during tasks aimed to reproduce ADLs. In this paper, we describe the most recent findings in the field, with special attention to the relationship between the metabolic variables obtained during ADLs and CPET parameters (i.e. peak VO2), demonstrating, for example, how exercises traditionally thought to be undemanding, such as a walk, instead represent supramaximal efforts, particularly for subjects with advanced HF and/or artificial heart (left ventricular assist devices) wearers. Lay summary This article summarizes the most recent evidence on the cardiometabolic behaviours of a full spectrum of heart failure (HF) patients of different severity during their daily life activities (i.e. walking, making a bed, and taking the stairs). Heart failure patients experience symptoms (mostly dyspnoea) during daily activities that sometimes represent maximal or supramaximal exercises for them, particularly for the most severe patients. Measuring metabolic parameters (O2 intake, ventilation, and CO2 production) through appropriate devices during these activities provides a better understanding of the pathophysiological mechanisms underlying HF patients' symptoms and their adaptation. This can lead to the detection of new parameters that can become novel patient-centred prognostic markers or the

Published
2023

13. Symptomatic post COVID patients have impaired alveolar capillary membrane function and high VE/VCO2.

Author

Agostoni, Piergiuseppe, Mapelli, Massimo, Salvioni, Elisabetta, Mattavelli, Irene, Banfi, Cristina, Bonomi, Alice, Biondi, Maria Luisa, Rovai, Sara, Tamborini, Gloria, Muratori, Manuela, Ghulam Ali, Sarah, Ghilardi, Stefania, De Martino, Fabiana, Vignati, Carlo, Palermo, Pietro, Gugliandolo, Paola, Elia, Davide, Moscucci, Federica, Cassandro, Roberto, and Andreini, Daniele

Abstract

Background: Post COVID-19 syndrome is characterized by several cardiorespiratory symptoms but the origin of patients’ reported symptomatology is still unclear. Methods: Consecutive post COVID-19 patients were included. Patients underwent full clinical evaluation, symptoms dedicated questionnaires, blood tests, echocardiography, thoracic computer tomography (CT), spirometry including alveolar capillary membrane diffusion (DM) and capillary volume (Vcap) assessment by combined carbon dioxide and nitric oxide lung diffusion (DLCO/DLNO) and cardiopulmonary exercise test. We measured surfactant derive protein B (immature form) as blood marker of alveolar cell function. Results: We evaluated 204 consecutive post COVID-19 patients (56.5 ± 14.5 years, 89 females) 171 ± 85 days after the end of acute COVID-19 infection. We measured: forced expiratory volume (FEV1) 99 ± 17%pred, FVC 99 ± 17%pred, DLCO 82 ± 19%, DM 47.6 ± 14.8 mL/min/mmHg, Vcap 59 ± 17 mL, residual parenchymal damage at CT 7.2 ± 3.2% of lung tissue, peakVO2 84 ± 18%pred, VE/VCO2 slope 112 [102–123]%pred. Major reported symptoms were: dyspnea 45% of cases, tiredness 60% and fatigability 77%. Low FEV1, Vcap and high VE/VCO2 slope were associated with persistence of dyspnea. Tiredness was associated with high VE/VCO2 slope and low PeakVO2 and FEV1 while fatigability with high VE/VCO2 slope. SPB was fivefold higher in post COVID-19 than in normal subjects, but not associated to any of the referred symptoms. SPB was negatively associated to Vcap. Conclusions: In patients with post COVID-19, cardiorespiratory symptoms are linked to VE/VCO2 slope. In these patients the alveolar cells are dysregulated as shown by the very high SPB. The Vcap is low likely due to post COVID-19 pulmonary endothelial/vasculature damage but DLCO is only minimally impaired being DM preserved. [ABSTRACT FROM AUTHOR]

Published
2024
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14. 356 DAPAGLIFLOZIN USE IN HEART FAILURE WITH REDUCED EJECTION FRACTION PATIENTS: A SINGLE CENTRE COMPARISON BETWEEN REAL-LIFE AND DAPA-HF DATA

Author

Capovilla, Teresa Maria, primary, Mapelli, Massimo, additional, Mattavelli, Irene, additional, Salvioni, Elisabetta, additional, Marongiu, Alessandro, additional, Maranzano, Gaspare, additional, Vignati, Carlo, additional, Palermo, Pietro, additional, Sinagra, Gianfranco, additional, and Agostoni, Piergiuseppe, additional

Published
2022
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18. Heart failure patients with improved ejection fraction: Insights from the MECKI score database.

Author

Agostoni, Piergiuseppe, Pluchinotta, Francesca Romana, Salvioni, Elisabetta, Mapelli, Massimo, Galotta, Arianna, Bonomi, Alice, Magrì, Damiano, Perna, Enrico, Paolillo, Stefania, Corrà, Ugo, Raimondo, Rosa, Lagioia, Rocco, Badagliacca, Roberto, Perrone Filardi, Pasquale, Apostolo, Anna, Senni, Michele, Iorio, Annamaria, Correale, Michele, Campodonico, Jeness, and Palermo, Pietro

Subjects
VENTRICULAR ejection fraction, HEART failure, HEART failure patients, DATABASES, HEART assist devices, HEART transplantation, CARDIOVASCULAR disease related mortality
Abstract

Aims: Improvement of left ventricular ejection fraction is a major goal of heart failure (HF) treatment. However, data on clinical characteristics, exercise performance and prognosis in HF patients who improved ejection fraction (HFimpEF) are scarce. The study aimed to determine whether HFimpEF patients have a distinct clinical phenotype, biology and prognosis than HF patients with persistently reduced ejection fraction (pHFrEF). Methods and results: A total of 7948 patients enrolled in the Metabolic Exercise Cardiac Kidney Indexes (MECKI) score database were evaluated (median follow‐up of 1490 days). We analysed clinical, laboratory, electrocardiographic, echocardiographic, exercise, and survival data from HFimpEF (n = 1504) and pHFrEF (n = 6017) patients. The primary endpoint of the study was the composite of cardiovascular death, left ventricular assist device implantation, and urgent heart transplantation. HFimpEF patients had lower HF severity: left ventricular ejection fraction 44.0 [41.0–47.0] versus 29.7 [24.1–34.5]%, B‐type natriuretic peptide 122 [65–296] versus 373 [152–888] pg/ml, haemoglobin 13.5 [12.2–14.6] versus 13.7 [12.5–14.7] g/dl, renal function by the Modification of Diet in Renal Disease equation 72.0 [56.7–89.3] versus 70.4 [54.5–85.3] ml/min, peak oxygen uptake 62.2 [50.7–74.1] versus 52.6 [41.8–64.3]% predicted, minute ventilation‐to‐carbon dioxide output slope 30.0 [26.9–34.4] versus 32.1 [28.0–38.0] in HFimpEF and pHFrEF, respectively (p < 0.001 for all). Cardiovascular mortality rates were 26.6 and 46.9 per 1000 person‐years for HFimpEF and pHFrEF, respectively (p < 0.001). Kaplan–Meier analysis showed that HFimpEF had better a long‐term prognosis compared with pHFrEF patients. After adjustment for variables differentiating HFimpEF from pHFrEF, except echocardiographic parameters, the Kaplan–Meier curves showed the same prognosis. Conclusions: Heart failure with improved ejection fraction represents a peculiar group of HF patients whose clinical, laboratory, electrocardiographic, echocardiographic, and exercise characteristics parallel the recovery of systolic function. Nonetheless, these patients remain at risk for adverse outcome. [ABSTRACT FROM AUTHOR]

Published
2023
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20. Pick Your Threshold

Author

Salvioni, Elisabetta, primary, Mapelli, Massimo, additional, Bonomi, Alice, additional, Magrì, Damiano, additional, Piepoli, Massimo, additional, Frigerio, Maria, additional, Paolillo, Stefania, additional, Corrà, Ugo, additional, Raimondo, Rosa, additional, Lagioia, Rocco, additional, Badagliacca, Roberto, additional, Filardi, Pasquale Perrone, additional, Senni, Michele, additional, Correale, Michele, additional, Cicoira, Mariantonietta, additional, Perna, Enrico, additional, Metra, Marco, additional, Guazzi, Marco, additional, Limongelli, Giuseppe, additional, Sinagra, Gianfranco, additional, Parati, Gianfranco, additional, Cattadori, Gaia, additional, Bandera, Francesco, additional, Bussotti, Maurizio, additional, Re, Federica, additional, Vignati, Carlo, additional, Lombardi, Carlo, additional, Scardovi, Angela B., additional, Sciomer, Susanna, additional, Passantino, Andrea, additional, Emdin, Michele, additional, Passino, Claudio, additional, Santolamazza, Caterina, additional, Girola, Davide, additional, Zaffalon, Denise, additional, De Martino, Fabiana, additional, Agostoni, Piergiuseppe, additional, Farina, Stefania, additional, Pezzuto, Beatrice, additional, Apostolo, Anna, additional, Palermo, Pietro, additional, Contini, Mauro, additional, Gugliandolo, Paola, additional, Mattavelli, Irene, additional, Della Rocca, Michele, additional, Gallo, Giovanna, additional, Moscucci, Federica, additional, Iorio, Anita, additional, Halasz, Geza, additional, Capelli, Bruno, additional, Binno, Simone, additional, Pacileo, Giuseppe, additional, Valente, Fabio, additional, Vastarella, Rossella, additional, Carriere, Cosimo, additional, Masè, Marco, additional, Cittar, Marco, additional, Di Lenarda, Andrea, additional, Caravita, Sergio, additional, Viganò, Elena, additional, Marchese, Giovanni, additional, Ricci, Roberto, additional, Arcari, Luca, additional, Scrutinio, Domenico, additional, Battaia, Elisa, additional, Moretti, Michele, additional, Matassini, Maria Vittoria, additional, Shkoza, Matilda, additional, Herberg, Roland, additional, Cittadini, Antonio, additional, Salzano, Andrea, additional, Marra, Alberto, additional, Lafranca, Eluisa, additional, and Vitale, Giuseppe, additional

Published
2022
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22. Metabolic exercise test data combined with cardiac and kidney indexes, the MECKI score: A multiparametric approach to heart failure prognosis

Author

Agostoni, Piergiuseppe, Corrà, Ugo, Cattadori, Gaia, Veglia, Fabrizio, La Gioia, Rocco, Scardovi, Angela B., Emdin, Michele, Metra, Marco, Sinagra, Gianfranco, Limongelli, Giuseppe, Raimondo, Rossella, Re, Federica, Guazzi, Marco, Belardinelli, Romualdo, Parati, Gianfranco, Magrì, Damiano, Fiorentini, Cesare, Mezzani, Alessandro, Salvioni, Elisabetta, Scrutinio, Domenico, Ricci, Renato, Bettari, Luca, Di Lenarda, Andrea, Pastormerlo, Luigi E., Pacileo, Giuseppe, Vaninetti, Raffaella, Apostolo, Anna, Iorio, AnnaMaria, Paolillo, Stefania, Palermo, Pietro, Contini, Mauro, Confalonieri, Marco, Giannuzzi, Pantaleo, Passantino, Andrea, Cas, Livio Dei, Piepoli, Massimo F., and Passino, Claudio

Published
2013
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23. Mediterranean diet impact on cardiovascular diseases: a narrative review

Author

Mattioli, Anna V., Palmiero, Pasquale, Manfrini, Olivia, Puddu, Paolo E., Nodari, Savina, Dei Cas, Alessandra, Mercuro, Giuseppe, Scrutinio, Domenico, Palermo, Pietro, Sciomer, Susanna, Di Francesco, Simona, Novo, Giuseppina, Novo, Salvatore, Pedretti, Roberto F.E., Zito, Annapaola, Parati, Gianfranco, Pedrinelli, Roberto, Farinetti, Alberto, Maiello, Maria, Moscucci, Federica, Tenaglia, Raffaele L., Sucato, Vincenzo, Triggiani, Marco, Cugusi, Lucia, Scicchitano, Pietro, Saba, Pier S., and Ciccone, Marco M.

Published
2017
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29. Deceptive meaning of oxygen uptake measured at the anaerobic threshold in patients with systolic heart failure and atrial fibrillation

Author

Magrì, Damiano, Agostoni, Piergiuseppe, Corrà, Ugo, Passino, Claudio, Scrutinio, Domenico, Perrone-Filardi, Pasquale, Correale, Michele, Cattadori, Gaia, Metra, Marco, Girola, Davide, Piepoli, Massimo F, Iorio, AnnaMaria, Emdin, Michele, Raimondo, Rosa, Re, Federica, Cicoira, Mariantonietta, Belardinelli, Romualdo, Guazzi, Marco, Limongelli, Giuseppe, Clemenza, Francesco, Parati, Gianfranco, Frigerio, Maria, Casenghi, Matteo, Scardovi, Angela B, Ferraironi, Alessandro, Di Lenarda, Andrea, Bussotti, Maurizio, Apostolo, Anna, Paolillo, Stefania, La Gioia, Rocco, Gargiulo, Paola, Palermo, Pietro, Minà, Chiara, Farina, Stefania, Battaia, Elisa, Maruotti, Antonello, Pacileo, Giuseppe, Contini, Mauro, Oliva, Fabrizio, Ricci, Roberto, and Sinagra, Gianfranco

Published
2015
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32. “You can leave your mask on”: effects on cardiopulmonary parameters of different airway protective masks at rest and during maximal exercise

Author

Mapelli, Massimo, primary, Salvioni, Elisabetta, additional, De Martino, Fabiana, additional, Mattavelli, Irene, additional, Gugliandolo, Paola, additional, Vignati, Carlo, additional, Farina, Stefania, additional, Palermo, Pietro, additional, Campodonico, Jeness, additional, Maragna, Riccardo, additional, Lo Russo, Gerardo, additional, Bonomi, Alice, additional, Sciomer, Susanna, additional, and Agostoni, Piergiuseppe, additional

Published
2021
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35. Minute ventilation/carbon dioxide production in chronic heart failure

Author

Agostoni, Piergiuseppe, primary, Sciomer, Susanna, additional, Palermo, Pietro, additional, Contini, Mauro, additional, Pezzuto, Beatrice, additional, Farina, Stefania, additional, Magini, Alessandra, additional, De Martino, Fabiana, additional, Magrì, Damiano, additional, Paolillo, Stefania, additional, Cattadori, Gaia, additional, Vignati, Carlo, additional, Mapelli, Massimo, additional, Apostolo, Anna, additional, and Salvioni, Elisabetta, additional

Published
2021
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36. The MECKI score initiative: Development and state of the art

Author

Salvioni, Elisabetta, primary, Bonomi, Alice, additional, Re, Federica, additional, Mapelli, Massimo, additional, Mattavelli, Irene, additional, Vitale, Giuseppe, additional, Sarullo, Filippo M, additional, Palermo, Pietro, additional, Veglia, Fabrizio, additional, and Agostoni, Piergiuseppe, additional

Published
2020
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37. Cardiac patient care during a pandemic: how to reorganise a heart failure unit at the time of COVID-19

Author

Agostoni, Piergiuseppe, primary, Mapelli, Massimo, additional, Conte, Edoardo, additional, Baggiano, Andrea, additional, Assanelli, Emilio, additional, Apostolo, Anna, additional, Alimento, Marina, additional, Berna, Giovanni, additional, Guglielmo, Marco, additional, Muratori, Manuela, additional, Susini, Francesca, additional, Palermo, Pietro, additional, Pezzuto, Beatrice, additional, Salvioni, Elisabetta, additional, Sudati, Anna, additional, Vignati, Carlo, additional, and Merlino, Luca, additional

Published
2020
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43. Mineralocorticoid receptor antagonists for heart failure: a real-life observational study

Author

Bruno, Noemi, Sinagra, Gianfranco, Paolillo, Stefania, Bonomi, Alice, Corrà, Ugo, Piepoli, Massimo, Veglia, Fabrizio, Salvioni, Elisabetta, Lagioia, Rocco, Metra, Marco, Limongelli, Giuseppe, Cattadori, Gaia, Scardovi, Angela B, Carubelli, Valentina, Scrutino, Domenico, Badagliacca, Roberto, Guazzi, Marco, Raimondo, Rosa, Gentile, Piero, Magrì, Damiano, Correale, Michele, Parati, Gianfranco, Re, Federica, Cicoira, Mariantonietta, Frigerio, Maria, Bussotti, Maurizio, Vignati, Carlo, Oliva, Fabrizio, Mezzani, Alessandro, Vergaro, Giuseppe, Di Lenarda, Andrea, Passino, Claudio, Sciomer, Susanna, Pacileo, Giuseppe, Ricci, Roberto, Contini, Mauro, Apostolo, Anna, Palermo, Pietro, Mapelli, Massimo, Carriere, Cosimo, Clemenza, Francesco, Binno, Simone, Belardinelli, Romualdo, Lombardi, Carlo, Perrone Filardi, Pasquale, Emdin, Michele, Agostoni, Piergiuseppe, Bruno, N, Sinagra, G, Paolillo, S, Bonomi, A, Corrà, U, Piepoli, M, Veglia, F, Salvioni, E, Lagioia, R, Metra, M, Limongelli, G, Cattadori, G, Scardovi, A, Carubelli, V, Scrutino, D, Badagliacca, R, Guazzi, M, Raimondo, R, Gentile, P, Magrì, D, Correale, M, Parati, G, Re, F, Cicoira, M, Frigerio, M, Bussotti, M, Vignati, C, Oliva, F, Mezzani, A, Vergaro, G, Di Lenarda, A, Passino, C, Sciomer, S, Pacileo, G, Ricci, R, Contini, M, Apostolo, A, Palermo, P, Mapelli, M, Carriere, C, Clemenza, F, Binno, S, Belardinelli, R, Lombardi, C, Perrone Filardi, P, Emdin, M, Agostoni, P, Scardovi, Ab, Agostoni, P., Bruno, Noemi, Sinagra, Gianfranco, Paolillo, Stefania, Bonomi, Alice, Corrà, Ugo, Piepoli, Massimo, Veglia, Fabrizio, Salvioni, Elisabetta, Lagioia, Rocco, Metra, Marco, Limongelli, Giuseppe, Cattadori, Gaia, Scardovi, Angela B, Carubelli, Valentina, Scrutino, Domenico, Badagliacca, Roberto, Guazzi, Marco, Raimondo, Rosa, Gentile, Piero, Magrì, Damiano, Correale, Michele, Parati, Gianfranco, Re, Federica, Cicoira, Mariantonietta, Frigerio, Maria, Bussotti, Maurizio, Vignati, Carlo, Oliva, Fabrizio, Mezzani, Alessandro, Vergaro, Giuseppe, Di Lenarda, Andrea, Passino, Claudio, Sciomer, Susanna, Pacileo, Giuseppe, Ricci, Roberto, Contini, Mauro, Apostolo, Anna, Palermo, Pietro, Mapelli, Massimo, Carriere, Cosimo, Clemenza, Francesco, Binno, Simone, Belardinelli, Romualdo, Lombardi, Carlo, Perrone Filardi, Pasquale, Emdin, Michele, and Agostoni, Piergiuseppe

Subjects
Male, Heart failure, Hyperkalaemia, Mineralocorticoid receptor antagonists, Worsening renal function, Mineralocorticoid receptor antagonist, Stroke Volume, Middle Aged, Ventricular Function, Left, Cardiology and Cardiovascular Medicine, Treatment Outcome, Original Research Articles, cardiovascular system, Humans, Female, mineralocorticoid receptor antagonists, heart failure, worsening renal function, hyperkalaemia, cardiovascular diseases, Original Research Article, Prospective Studies, Propensity Score, Follow-Up Studies, Forecasting
Abstract

Aims Mineralocorticoid receptor antagonists (MRAs) have been demonstrated to improve outcomes in reduced ejection fraction heart failure (HFrEF) patients. However, MRAs added to conventional treatment may lead to worsening of renal function and hyperkalaemia. We investigated, in a population‐based analysis, the long‐term effects of MRA treatment in HFrEF patients. Methods and results We analysed data of 6046 patients included in the Metabolic Exercise Cardiac Kidney Index score dataset. Analysis was performed in patients treated (n = 3163) and not treated (n = 2883) with MRA. The study endpoint was a composite of cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation. Ten years' survival was analysed through Kaplan–Meier, compared by log‐rank test and propensity score matching. At 10 years' follow‐up, the MRA‐untreated group had a significantly lower number of events than the MRA‐treated group (P

Published
2018

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

Author

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

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

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

Published
2018

47. When should cardiovascular prevention begin? The importance of antenatal, perinatal and primordial prevention

Author

D’Ascenzi, Flavio, primary, Sciaccaluga, Carlotta, additional, Cameli, Matteo, additional, Cecere, Annagrazia, additional, Ciccone, Marco M, additional, Di Francesco, Simona, additional, Ganau, Antonello, additional, Imbalzano, Egidio, additional, Liga, Riccardo, additional, Palermo, Pietro, additional, Palmiero, Pasquale, additional, Parati, Gianfranco, additional, Pedrinelli, Roberto, additional, Scicchitano, Piero, additional, Zito, Annapaola, additional, and Mattioli, Anna V, additional

Published
2019
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48. Prognostic role of beta-blocker selectivity and dosage regimens in heart failure patients. Insights from the MECKI score database

Author

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

Subjects
Male, equivalent dose, heart failure, prognosis, β-blocker selectivity, β-blockers, Time Factors, Prognosi, Adrenergic beta-Antagonists, Carbazoles, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Heart failure, β-Blocker, β-Blocker, Ventricular Function, Left, β-Blocker selectivity, Propanolamines, Heart Rate, Humans, Prospective Studies, Equivalent dose, Prognosis, β-Blocker selectivity, β-Blockers, Cardiology and Cardiovascular Medicine, β-Blockers, Dose-Response Relationship, Drug, Stroke Volume, Middle Aged, Treatment Outcome, Echocardiography, Carvedilol, Female, Follow-Up Studies
Abstract

Aims: The use of β-blockers represents a milestone in the treatment of heart failure with reduced ejection fraction (HFrEF). Few studies have compared β-blockers in HFrEF, and there is little data on the effects of different doses. The present study aimed to investigate in a large database of HFrEF patients (MECKI score database) the association of β-blocker treatment with a composite outcome of cardiovascular death, urgent heart transplantation or left ventricular assist device implantation, addressing the role of β-selectivity and dosage regimens. Methods and results: In 5242 HFrEF patients, we investigated the role of: (i) β-blocker treatment vs. non-β-blocker treatment, (ii) β1-/β2-receptor-blockers vs. β1-selective blockers, and (iii) daily β-blocker dose. Patients were followed for 3.58 years, and 1101 events (18.3%) were observed; 4435 patients (86.8%) were on β-blockers, while 807 (13.2%) were not. At 5 years, β-blocker-patients showed a better outcome than non-β-blocker-subjects [hazard ratio (HR) 0.48, P < 0.0001], while also considering potential confounders. A comparable prognosis was observed at 5 years in the β1-/β2-receptor-blocker (n = 2219) vs. β1-selective group (n = 2216) (HR 0.95, P = ns). A better prognosis was observed in high-dose (>2 5 mg carvedilol equivalent daily dose, n = 1005) patients than in both medium dose (12.5–25 mg, n = 1431) and low dose (

Published
2017

50. Mineralocorticoid receptor antagonists for heart failure: a real-life observational study

Author

Bruno, N, Sinagra, G, Paolillo, S, Bonomi, A, Corrà, U, Piepoli, M, Veglia, F, Salvioni, E, Lagioia, R, Metra, M, Limongelli, G, Cattadori, G, Scardovi, A, Carubelli, V, Scrutino, D, Badagliacca, R, Guazzi, M, Raimondo, R, Gentile, P, Magrì, D, Correale, M, Parati, G, Re, F, Cicoira, M, Frigerio, M, Bussotti, M, Vignati, C, Oliva, F, Mezzani, A, Vergaro, G, Di Lenarda, A, Passino, C, Sciomer, S, Pacileo, G, Ricci, R, Contini, M, Apostolo, A, Palermo, P, Mapelli, M, Carriere, C, Clemenza, F, Binno, S, Belardinelli, R, Lombardi, C, Perrone Filardi, P, Emdin, M, Agostoni, P, Bruno, Noemi, Sinagra, Gianfranco, Paolillo, Stefania, Bonomi, Alice, Corrà, Ugo, Piepoli, Massimo, Veglia, Fabrizio, Salvioni, Elisabetta, Lagioia, Rocco, Metra, Marco, Limongelli, Giuseppe, Cattadori, Gaia, Scardovi, Angela B, Carubelli, Valentina, Scrutino, Domenico, Badagliacca, Roberto, Guazzi, Marco, Raimondo, Rosa, Gentile, Piero, Magrì, Damiano, Correale, Michele, Parati, Gianfranco, Re, Federica, Cicoira, Mariantonietta, Frigerio, Maria, Bussotti, Maurizio, Vignati, Carlo, Oliva, Fabrizio, Mezzani, Alessandro, Vergaro, Giuseppe, Di Lenarda, Andrea, Passino, Claudio, Sciomer, Susanna, Pacileo, Giuseppe, Ricci, Roberto, Contini, Mauro, Apostolo, Anna, Palermo, Pietro, Mapelli, Massimo, Carriere, Cosimo, Clemenza, Francesco, Binno, Simone, Belardinelli, Romualdo, Lombardi, Carlo, Perrone Filardi, Pasquale, Emdin, Michele, Agostoni, Piergiuseppe, Bruno, N, Sinagra, G, Paolillo, S, Bonomi, A, Corrà, U, Piepoli, M, Veglia, F, Salvioni, E, Lagioia, R, Metra, M, Limongelli, G, Cattadori, G, Scardovi, A, Carubelli, V, Scrutino, D, Badagliacca, R, Guazzi, M, Raimondo, R, Gentile, P, Magrì, D, Correale, M, Parati, G, Re, F, Cicoira, M, Frigerio, M, Bussotti, M, Vignati, C, Oliva, F, Mezzani, A, Vergaro, G, Di Lenarda, A, Passino, C, Sciomer, S, Pacileo, G, Ricci, R, Contini, M, Apostolo, A, Palermo, P, Mapelli, M, Carriere, C, Clemenza, F, Binno, S, Belardinelli, R, Lombardi, C, Perrone Filardi, P, Emdin, M, Agostoni, P, Bruno, Noemi, Sinagra, Gianfranco, Paolillo, Stefania, Bonomi, Alice, Corrà, Ugo, Piepoli, Massimo, Veglia, Fabrizio, Salvioni, Elisabetta, Lagioia, Rocco, Metra, Marco, Limongelli, Giuseppe, Cattadori, Gaia, Scardovi, Angela B, Carubelli, Valentina, Scrutino, Domenico, Badagliacca, Roberto, Guazzi, Marco, Raimondo, Rosa, Gentile, Piero, Magrì, Damiano, Correale, Michele, Parati, Gianfranco, Re, Federica, Cicoira, Mariantonietta, Frigerio, Maria, Bussotti, Maurizio, Vignati, Carlo, Oliva, Fabrizio, Mezzani, Alessandro, Vergaro, Giuseppe, Di Lenarda, Andrea, Passino, Claudio, Sciomer, Susanna, Pacileo, Giuseppe, Ricci, Roberto, Contini, Mauro, Apostolo, Anna, Palermo, Pietro, Mapelli, Massimo, Carriere, Cosimo, Clemenza, Francesco, Binno, Simone, Belardinelli, Romualdo, Lombardi, Carlo, Perrone Filardi, Pasquale, Emdin, Michele, and Agostoni, Piergiuseppe

Abstract

AIMS: Mineralocorticoid receptor antagonists (MRAs) have been demonstrated to improve outcomes in reduced ejection fraction heart failure (HFrEF) patients. However, MRAs added to conventional treatment may lead to worsening of renal function and hyperkalaemia. We investigated, in a population-based analysis, the long-term effects of MRA treatment in HFrEF patients. METHODS AND RESULTS: We analysed data of 6046 patients included in the Metabolic Exercise Cardiac Kidney Index score dataset. Analysis was performed in patients treated (n = 3163) and not treated (n = 2883) with MRA. The study endpoint was a composite of cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation. Ten years' survival was analysed through Kaplan-Meier, compared by log-rank test and propensity score matching. At 10 years' follow-up, the MRA-untreated group had a significantly lower number of events than the MRA-treated group (P < 0.001). MRA-treated patients had more severe heart failure (higher New York Heart Association class and lower left ventricular ejection fraction, kidney function, and peak VO2 ). At a propensity-score-matching analysis performed on 1587 patients, MRA-treated and MRA-untreated patients showed similar study endpoint values. CONCLUSIONS: In conclusion, MRA treatment does not affect the composite of cardiovascular death, urgent heart transplantation or left ventricular assist device implantation in a real-life setting. A meticulous patient follow-up, as performed in trials, is likely needed to match the positive MRA-related benefits observed in clinical trials

Published
2018

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