bluuebunny/crossref_metadata_2025_split huggingface dataset:
680 SINGLE-CENTER EXPERIENCE IN TRANSCATHETER MITRAL VALVE REPLACEMENT WITH THE TENDYNE MITRAL VALVE SYSTEM
Authors: Parlato Alessandro , Carapellucci Eliana , Mazzola Matteo , Vitale Carlo , Gentile Francesco , Spontoni Paolo , Giannini Cristina , Colli Andrea , De Carlo Marco , Petronio Anna Sonia 
Published: December 2022

Abstract

Background
Transcatheter mitral valve replacement (TMVR) with the Tendyne System is a therapeutic option for selected patients with severe symptomatic mitral regurgitation (MR) not eligible for either surgical intervention or transcatheter repair. To date, only a few studies have evaluated the short-term and mid-term outcomes of these patients in a real-life scenario.

Objectives
To describe the baseline features, and the short- and mid-term outcomes of patients undergoing TMVR with the Tendyne System at our Center.

Methods
Consecutive patients undergoing TMVR with the Tendyne System at our Center from November 2018 and August 2022 were enrolled. The baseline features of the study cohort were collected during the index hospitalization and patients were followed-up for the endpoints of all-cause death, residual MR, and prothesis dysfunction.

Results
Twenty-two patients (aged 75±6 years, 36% men) with moderate-to-severe or severe MR undergoing TMVR with the Tendyne System were recruited. Many patients were highly symptomatic (45% New York Heart Association [NYHA] functional class III or IV) and the etiology of MR was secondary or mixed in 18 (82%) cases. Prostheses were successfully implanted in all patients, with no peri-procedural residual MR (only two patients had a mild paravalvular leak). One patient died of sepsis during the index hospitalization. Out of 19 patients evaluated at a 30-day follow-up, 18 (95%) had no residual MR, 16 (84%) had an improved functional status (of at least one NYHA grade). Mid-term (&gt;6 months) follow-up was available for 15 patients, 4 of whom were dead (2 died of heart failure, one of sepsis, and one of intestinal ischemia). Among the 10 patients undergoing a mid-term follow-up echocardiography, 8 had no residual MR and 2 had only mild MR. Two valve-related adverse events (i.e., endocarditis) were registered during the follow-up.

Conclusions
TMVR with the Tendyne System appears to be a safe and promising technique for symptomatic patients affected by signficant MR and not suitable for other procedures. Since experience is still limited, more data including a longer follow-up is warranted to optimize patient selection and outcomes.
339 INTRAVENOUS CANGRELOR VERSUS ORAL TICAGRELOR IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION: A PROPENSITY SCORE-MATCHED ANALYSIS
Authors: Scalia Lorenzo , Sammartino Sofia , Greco Antonio , Mauro Maria Sara , Calderone Dario , Agnello Federica , Legnazzi Marco , Laudani Claudio , Capranzano Piera , Capodanno Davide , Tamburino Corrado 
Published: December 2022

Abstract

Background
In patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), potent oral inhibitors of the adenosine diphosphate (ADP)–activated platelet P2Y12 receptor (i.e., prasugrel, ticagrelor) are recommended in addition to acetylsalicylic acid, given as a loading dose as soon as possible, and followed by a maintenance dose. However, the onset of action of oral P2Y12 inhibitors is relatively slower in STEMI patients. In comparison with oral P2Y12 inhibitors, cangrelor has several pharmacokinetic advantages due to its intravenous route of administration, including platelet inhibition within minutes. There is no randomized study so far comparing cangrelor with ticagrelor. The aim of this study was to investigate the comparative effectiveness of intravenous cangrelor and ticagrelor pre-treatment in STEMI patients undergoing primary PCI.

Methods
We looked for patients with STEMI undergoing primary PCI at a single high-volume center who were naïve from oral P2Y12 inhibitors at presentation and who received cangrelor (in-lab) or ticagrelor pretreatment. The primary endpoint of the study was a composite of all-cause death, myocardial infarction (MI), definite or probable stent thrombosis and unplanned repeat revascularization within hospital discharge. Secondary outcomes were represented by individual components of the primary composite endpoint, cardiovascular death, non-cardiovascular death, and major bleeding within 72 hours from PCI. Propensity score matching was used to account for potential confounders.

Results
A total of 396 patients with STEMI (October 2019-March 2022) met the eligibility criteria and entered the analysis; of them, 186 (47%) received intravenous cangrelor. The ticagrelor loading dose was administered before invasive coronary angiography in 210 patients (53%). In the unadjusted analysis, no statistically significant difference between cangrelor and ticagrelor was observed with respect to the primary composite outcome (odds ratio [OR], 1.49, 95% CI, 0.79 to 2.82; P=0.22) and all the other secondary outcomes. Consistently, after propensity-score matching of 133 matched pairs of patients receiving cangrelor or ticagrelor, no significant differences emerged with respect to the primary outcome (OR, 1.12, 95% CI, 0.44 to 2.85; P=0.81) and all the other secondary outcomes.

Conclusion
In patients with STEMI undergoing primary who were naïve from oral P2Y12 inhibitors at presentation cangrelor and ticagrelor yielded similar results. Thanks to its pharmacologic characteristics, cangrelor could be especially useful in the acute setting.
88 INCIDENTAL DIAGNOSIS OF MASSIVE MOBILE LEFT VENTRICLE THROMBI FOLLOWING COVID-19 INFECTION IN A HEART FAILURE PATIENT
Authors: Maiolo Giulia , Mapelli Massimo , Celeste Fabrizio , Conte Edoardo , Palermo Pietro , Mancini Elisabetta , Agostoni Piergiuseppe 
Published: December 2022

Abstract
A 71-year-old woman, known to have a non-ischemic dilated cardiomyopathy with reduced ejection fraction (EF), and a previous transcatheter edge-to-edge mitral valve repair (MitraClip), was admitted after a routine echocardiogram showing new onset multiple, highly mobile, left ventricle (LV) masses. The patient, fully vaccinated against Sars-Cov-2, experienced a paucisymptomatic COVID-19 infection 1 month before, followed by a full recovery. A transthoracic echocardiogram performed 3 months before showed no LV masses. On admission she was completely asymptomatic with no clinical signs of heart failure or systemic embolization. A multimodality imaging evaluation (contrast ecocardiography, cardiac computed tomography, cardiac magnetic resonance) confirmed a severe dilation of the LV with severe EF reduction, and 3 mobile LV masses; the largest mass was adhered to the middle portion of the anterolateral wall (maximum diameter 49×15 mm). mm). A diagnostic endomyocardial biopsy and cardiac surgery were excluded due to prohibitive embolic/procedural risk and an anticoagulant treatment with warfarin was started with a progressive reduction of the masses’ dimension at transthoracic echocardiography. Thus, a diagnosis of exclusion of LV thrombosis was made. After 2-week a complete resolution of the masses was documented with no clinical or embolic events. Cardiovascular complications of the coronavirus disease have been documented both in the acute phase and in convalescence; one such complication is the formation of LV thrombus; the pro-thrombotic nature of COVID-19 infection is well known: the coagulation activation mechanism is currently uncler, but it might be correlated to excessive inflammation, COVID-induced hypoxia, direct cytopathic effects on the cardiac endothelial cells, immobilization. This case demonstrates how vulnerable patients, i.e. those with heart failure, may experience thrombotic complications following non-severe COVID-19 infection and despite having completed the vaccine course. Although currently unconfirmed by dedicated clinical trials, more assiduous echocardiographic monitoring could yield a benefit in selected patients; current guidelines do not support the use of anticoagulation prophylaxis for non-severe COVID.19, but further studies regarding anticoagulant prophylaxis for COVID-19 patients with chronic heart diseases, including DCM, are warranted.
528 OUTCOMES IN DIABETIC PATIENTS WITH ACUTE MYOCARDIAL INFARCTION TREATED WITH SGLT2-I: THE SGLT2-I AMI PROTECT REGISTRY
Authors: Paolisso Pasquale , Bergamaschi Luca , Gragnano Felice , Gallinoro Emanuele , Cesaro Arturo , Sardu Celestino , Mileva Niya , Foà Alberto , Armillotta Matteo , Sansonetti Angelo , Amicone Sara , Impellizzeri Andrea , Esposito Giuseppe , Morici Nuccia , Oreglia Jacopo Andrea , Casella Gianni , Mauro Ciro , Vassilev Dobrin , Galiè Nazzareno , Marfella Raffaele , Santulli Gaetano , Calabrò Paolo , Pizzi Carmine , Barbato Emanuele 
Published: December 2022

Abstract

Background
Sodium-glucose co-transporter 2 inhibitors (SGLT2-I) receive intense clinical interest in patients with and without type 2 diabetes mellitus (T2DM) for their pleiotropic beneficial effects.

Objectives
To investigate in-hospital and long-term prognosis in a cohort of T2DM patients presenting with acute myocardial infarction (AMI) treated with SGLT2-I versus other oral anti-diabetic (OAD) agents (non-SGLT2-I users).

Methods
In this multicenter international registry all consecutive diabetic AMI patients undergoing percutaneous coronary intervention (PCI) between 2018 and 2021 were enrolled and, based on the admission anti-diabetic therapy, divided into SGLT-I users versus non-SGLT2-I users. In-hospital outcomes included cardiovascular death, recurrent AMI, occurrence of arrhythmias, and contrast-induced acute kidney injury (CI-AKI). Long-term outcomes were cardiovascular mortality, recurrent AMI, heart failure (HF) hospitalization, and their composite (MACE).

Results
The study population consisted of 646 AMI patients (with or without ST-segment elevation): 111 SGLT2-I users and 535 non-SGLT-I users. The use of SGLT2-I was associated with a significantly lower in-hospital cardiovascular death, arrhythmic burden, and occurrence of CI-AKI (all p&lt;0.05). During a median follow-up of 24±13 months, cardiovascular mortality, HF hospitalization and the composite endpoint were lower for SGLT2-I users compared to non-SGLT2-I patients (p&lt;0.04 for all). After adjusting for confounding factors, the use of SGLT2-I was identified as independent predictor of HF hospitalization (HR=0.46; 95%CI:0.21-0.98; p=0.041) and MACE occurrence (HR=0.57; 95%CI:0.33-0.99; p=0.039).

Conclusions
In T2DM AMI patients, the use of SGLT2-I was associated with a lower risk of adverse cardiovascular outcomes during index hospitalization and long-term follow-up. Our findings provide new insights into the cardioprotective effects of SGLT2-I in the setting of AMI.
416 DESMOPLAKIN CARDIOMYOPATHY PRESENTING WITH CARDIAC ARREST IN A PATIENT WITH MYOCARDIAL NON-COMPACTION AND LEFT ACCESSORY PATHWAY
Authors: Ragnatela Ilaria , Santoro Francesco , Vitale Enrica , Cetera Rosa , Santacroce Rosa , Margaglione Maurizio , Brunetti Natale Daniele 
Published: December 2022

Abstract

Introduction
Desmoplakin is a human protein which plays a key role into desmosomes structure. Desmoplakin gene mutations can cause the so-called "desmoplakin cardiomyopathy", a form of arrhythmogenic cardiomyopathy. Its clinical history is characterized by severe ventricular arrhythmias, episodic myocardial injury and left ventricular systolic dysfunction associated with fibrosis.

Case Presentation
A 12-years-old male came to our inherited cardiomyopathy ambulatory for cardiological evaluation due to a previous history of cardiac arrest when he was infant (30 days newborn) and palpitation. Previous medical history included eczematous dermatitis and occasional hyperglycemia.
During cardiological evaluation EKG was unremarkable, echocardiography revealed myocardial noncompaction in apical and mid-ventricular regions of the left ventricle's infero-lateral wall (end systolic ratio 2:1) and evidence of direct blood flow into deep intertrabecular recesses by colour doppler.
Due to history of palpitation an EP study was performed that showed a lateral left-sided accessory pathway that was ablated during the same procedure.
A genetic molecular analysis with exome sequencing (NGS, next generation sequencing) was performed and revealed a heterozygous genetic variant in DSP (Desmoplakin) gene on chromosome 6 (c.4046 G&gt;A pSer1349Asn). Familiar screening revealed the same genetic variant in his father and his brother, both had no cardiological events.

Conclusion
Desmoplakin cardiomyopathy may have a severe clinical presentation with cardiac arrest. A multidisciplinary approach is suggested for a tailored management of these patients.
373 ADONHERS (AGED DONOR HEART RESCUE BY STRESS ECHO) PROTOCOL FOR HEART DONATION FROM MARGINAL DONOR HEARTS: MONOCENTRIC RETROSPECTIVE STUDY ON RECIPIENT'S SURVIVAL AFTER 10-YEAR FOLLOW-UP
Authors: Mandoli Giulia Elena , Barilli Maria , Ghionzoli Nicolò , Cameli Matteo 
Published: December 2022

Abstract

Backgorund
Amelioration of therapies and increased survival in heart failure (HF) is leading to a growing number of patients affected by advanced HF, with an overall 1-year prognosis ranging from 25 to 75%. The gold standard treatment for end stage HF is heart transplantation (Htx), but lack of organs donors remains an important limitation. Marginal hearts can potentially improve and be utilized after a re-evaluation by “aggressive” assessment of donor left ventricular function.

Purpose
In our study we analysed if recipients of marginal donor hearts, selected by dipyridamole stress echocardiography, had different outcome compared to recipients with acceptable donor hearts.

Methods
Data collected from 2006 and 2014 of patients who received orthotopic Htx from marginal heart donors (group 1) and were retrospectively analysed and compared with recipients of acceptable heart donors (group 2). Bedside standard echocardiography and dipyridamole stress echo was performed for the selection of marginal hearts &gt; 55 years old or &lt; 55 with comorbidities/mildly dysfunctional left ventricle. Clinical, laboratory and instrumental features of the two groups of recipients were evaluated and patients with homogenous baseline characteristics were selected to reduce biases among the two groups. Follow-up through routine heart transplant surveillance included visit, echocardiography, blood tests, serial endomyocardial biopsies and coronary angiography.

Results
Twenty-two recipients were included in the study. Mean donors age was 41 ± 23, 45 ± 29 years for group 1 vs 36 ± 12 for group 2. The average follow-up was 113 months. Age, cardiovascular risk and morpho-functional characteristics of the left ventricle were comparable between the two population (P&gt; 0.05). Left atrial size was significantly higher in marginal hearts (Optimal: p=0.007; Marginal: p=0.003). Acceptable recipients showed a higher impact of CAV (p= 0.019) together with more elevated values of cholesterol and triglycerides (p = 0.048 and p = 0.012 respectively). No differences concerning cellular or humoral rejection were found between the two groups. Four patients deceased, 3 had received a standard donor heart and 1 was from the marginal donor group, with and overall median time to death of 124 months.

Conclusions
Our small pilot study shows how the evaluation of marginal donor hearts with echo stress result to no affect recipients survival compared with controls of acceptable hearts. A well-controlled selection of marginal hearts could therefore improve the shortage of organs, reducing the long line of patients waiting for a heart.
469 SACUBITRIL/VALSARTAN REDUCES CARDIAC DECOMPENSATION IN HEART FAILURE WITH PRESERVED EJECTION FRACTION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Carbone Francesca , Basile Christian , Marzano Federica , Gargiulo Paola , Guarnaccia Teresa , Soriano Simona , Simeoli Luisa , Esposito Gennaro , Monaco Salvatore , Chieffo Antonio , Perrone-filardi Pasquale , Paolillo Stefania 
Published: December 2022

Abstract

Background
The impact of sacubitril-valsartan on heart failure patients with preserved ejection fraction (HFpEF) is uncertain. The purpose of this meta-analysis was to explore the clinical advantages and safety of sacubitril-valsartan in patients with HFpEF.

Methods
PubMed and Web of Science were searched without any restrictions from inception to 08 May 2022 to identify valuable articles. The studies that met the inclusion criteria were analyzed.

Results
Four trials, with a total of 7,008 patients were included. Compared with valsartan, sacubitril-valsartan significantly reduced the rate of HF decompensation and of the combined endpoint of HF decompensation and all-cause mortality. All-cause mortality, NYHA class improvement and rate of hyperkalemia were not significantly different between the two groups. Regarding safety, sacubitril-valsartan was more likely to increase the risk of hypotension.

Conclusion
This meta-analysis suggests that sacubitril-valsartan may be an effective strategy to reduce HF decompensation events in patients with HFpEF.
699 HYPERKALIEMIA, USE OF DRUGS TARGETING THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM AND MORTALITY IN PATIENTS FOLLOWED AT A TERTIARY CENTER
Authors: Bernardelli Alice , Mori Sara , Toma Matteo , Vecchiato Veronica , Bertero Edoardo , Semino Tommaso , De Pietro Gianni , Giovinazzo Stefano , Porto Italo , Canepa Marco , Ameri Pietro 
Published: December 2022

Abstract

Background
Hyperkalemia (HK) has been related to increased mortality in patients with heart failure (HF), at least in part because it leads to down-titration or interruption of renin angiotensin system inhibitors (RASi) and mineralocorticoid receptor antagonists (MRA).

Methods
We reviewed the records of the HF outpatients with ≥2 visits at our clinic between 2014 and 2021 and complete data on therapy, and identified those who had HK at any time after the first visit. The characteristics between these subjects and those without HK were compared by chi-square test, T-test, or Mann-Whitney test. The use of RASi, MRA and beta-blockers at multiple time points was examined by chi-square or Fisher exact test, and the mean dose for each drug class, expressed as percentage of the guideline-recommended dose, by Wilcoxon rank sum test. The trend of RASi dose over time in HK vs no-HK was assessed by two-way ordinal regression analysis, and the association of HK with all-cause death by Kaplan-Meier method and Cox regression analysis.

Results
110 of 690 patients (15.9%) had HK, with the mean potassium concentration being 5.6 mEq/L. Subjects with HK were older [73 (66-79) vs 68 (58-78) years, p&lt;0.001], had more often diabetes (42% vs 27%, p=0.002) and LVEF &lt;40% (77% vs 67%, p=0.03), and had higher creatinine [1.3 (1-1.8) vs 1.1 (0.9-1.3) mg/dL, p&lt;0.001], potassium [4.6 (4.2-5.2) vs 4.2 (3.9-4.5) mEq/L, p&lt;0.001], and NT-proBNP levels [6,480 (2,110-11,000) vs 2,900 (1,115-6,070)], p=0.003] than those without HK. The distribution of RASi, MRA, and beta-blocker was comparable between the two groups at baseline and during follow-up, with the exception of a transient reduction in an early phase (panel A). The mean dose of RASi did not vary significantly between groups and over time (group/timepoint interaction p=0.27; panel B). HK was not associated with all-cause death (panel C; hazard ratio 1.05, 95% confidence interval 0.72–1.52). A sensitivity analysis limited to patients with LVEF &lt;40% yielded similar results (not shown).

Conclusions
The negative impact of HK on RASi and MRA prescription and on prognosis may be mitigated in tertiary centers with expertise in HF treatment.
556 EFFECT OF SODIUM-GLUCOSE CO-TRANSPORTER-2 INHIBITION ON RIGHT VENTRICULAR FUNCTION IN HEART FAILURE WITH REDUCED EJECTION FRACTION
Authors: Bonvicini Eleonora , Portolan Leonardo , Urbani Giulia , Santino Jannello Elena Maria , Pizzini Jessica , Ciceri Luca , Benini Annachiara , Benfari Giovanni , Piccoli Anna , Ribichini Flavio Luciano 
Published: December 2022

Abstract

Background
Sodium-glucose-transporter (SGLT2)-inhibitors have modified heart failure's prognosis since they are able to reduce the combined risk of cardiovascular death or hospitalization for heart failure. Evidence is available about the contribute of these drugs to LV reverse remodeling. Instead, despite the right ventricular disfunction is often related to the left ventricular one, little is known about the effects of SGLT2-inhibitors on right ventricular function.

Methods
Between October 2021 and February 2022, we enrolled 43 consecutive patients affected by heart failure with reduced ejection fraction on optimal medical therapy including ARNI who initiated SGLT2i therapy. All patients referred to our Heart Failure Clinic and were included in our heart failure registry approved by the local ethical committee A transthoracic echocardiography was performed at the beginning of treatment and after 6 months, evaluating left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVi) and tricuspid annular plane systolic excursion (TAPSE). Right ventricular longitudinal strain (RVLS) was assessed in 27 patients, while 16 were excluded for poor acoustic window. Continuous variables are reported as median and interquartile range and compared with the Mann-Whitney U test as appropriate. Statistical analysis was performed with SPSS version 26 (IBM, Armonk, NY).

Results
Median age of the study population was 65,8 years [IQR 56,4-75,1]. Median LVEF was 30% [IQR 24-33]. No other medical or electrical therapies for heart failure were introduced during the study period in this population. There was a significant increase of LVEF (30 [24-33] vs 33 [26-40], p 0.001) and a trend toward decrease of LVEDVi (110 [77.5-127] vs 94.7 [67.7-114.6], p 0.084). Moreover, there were no variations of TAPSE (17.5 [16-20] vs 18 [14 to 19.7], p 0.375), while RVLS showed a significant improvement (-12.3% [-16.6 / -10.6] vs -16.9% [-20 / -11.7], p 0.007) (Figure).

Conclusions
These preliminary data, population on optimal medical therapy including ARNI confirm the role of SGLT2-i in left ventricular reverse remodeling. Of note, these medications seem to improve right ventricular function as well as the left one as demonstrated by the increase of RVLS, which seems to be more sensitive of conventional methods to assess right ventricular function. Larger studies are necessary to confirm the positive effects of SGLT2i on right ventricular function.