Roberto Valle - Academia.edu (original) (raw)

Papers by Roberto Valle

European Journal of Heart Failure Supplements, 2006

Aims: We examined the usefulness of BNP for screening for left ventricular (LV) diastolic dysfunc... more Aims: We examined the usefulness of BNP for screening for left ventricular (LV) diastolic dysfunction in a sample of type 2 diabetic patients, without structural heart disorder, who have never presented symptoms or signs of heart failure (HF). Methods and results: Seventy-six consecutive patients admitted to the Outpatient Diabetes Clinic were studied. Blood samples were analyzed using the Triage BNP fluorescence immunoassay (Biosite Diagnostics, La Jolla, CA, USA). Echocardiography examinations were performed, with no knowledge of the BNP value. A total of 39 patients out of 76 (51%) were diagnosed with LV diastolic dysfunction and 23 (30%) with LV hypertrophy. Of the patients with LV diastolic dysfunction, impaired relaxation and pseudonormal pattern accounted for 97 and 3% of the cases, respectively. BNP levels among subjects with LV diastolic dysfunction (26 G 22 pg/ml, n Z 39) were not significantly different from patients with normal LV function (24 G 23 pg/ml, n Z 37 pg/ml; ManneWhitney U-test, Z Z ÿ0.4, n.s.). Conclusions: Our data confirm alarmingly high prevalence of LV diastolic dysfunction in asymptomatic individuals with diabetes. Identification of patients with preclinical diabetic cardiomyopathy should be a research and clinical priority. BNP levels cannot be used to detect mild LV diastolic dysfunction in this subset of patients, which requires Doppler echocardiography to be detected.

European Journal of Heart Failure Supplements, 2008

Contributions To Nephrology, 2010

Bibliographic Indices. This publication is listed in bibliographic services, including Current Co... more Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents® and Index Medicus.

Riassunto. La popolazione italiana di Beccaccia di mate ammonta a 63 coppie, 40-42 delle quali so... more Riassunto. La popolazione italiana di Beccaccia di mate ammonta a 63 coppie, 40-42 delle quali sono presenti lungo le coste del Venero. Dal 1995 si sono avuti casi di nidificazione su barene o isole artificiali, costruite in laguna di Venezia ed in laguna di Porto Caleri (RO). Vengono presentati alcuni dati sulla biologia riproduttiva nel 1997. Lungo l'intero arco costiero del Mediterraneo, la specie è presente con circa 300 coppie, il 13% delle quali nidifica in lagune o delta del Venero. Vengono infine esposte brevi raccomandazioni per una gestione naturalistica dei siti artificiali di nidificazione.

Heart Failure Reviews, 2011

The pathophysiology of acute heart failure syndromes (AHFS), defined as a change or worsening in ... more The pathophysiology of acute heart failure syndromes (AHFS), defined as a change or worsening in heart failure symptoms and signs, is complex. The variety of adverse neurohormonal adaptations includes increased levels of plasma renin, aldosterone and angiotensin II, all responsible for cardio-renal dysfunction. In fact, such alterations result in an array of clinical changes that include abnormal haemodynamics, altered ventricular filling pressures, pathological neurohormonal responses, leading to fluid overload, congestion and ultimately heart failure symptoms. Clinical pictures can be various: in spite of a usual improvement in dyspnoea, little weight change and significant morbidity are generally observed during hospitalization. Short-term outcomes are characterized by a high 60-day re-hospitalization and high mortality rates; apparently, both can be predicted from pre-discharge characteristics. The most frequently used treatments for AHF care include diuretics, inotropic agents, and vasodilator/vasoactive agents; however, the final therapeutic strategy is often individualized. Diuretics are currently the most used agents, but resistance to diuretic therapy is common. In addition, several studies have demonstrated that aggressive diuresis can contribute to reduced renal function, and high doses of diuretics have been associated with increased morbidity and mortality. Many patients with AHFS also suffer from acute or from chronic renal dysfunction (cardio-renal syndromes type 1 and 2, respectively), which further complicate the outcomes and treatment strategies. A personalized patient evaluation of the combined heart and kidney functions is advised to implement the best possible multidisciplinary diagnostic and therapeutic approach.

European Journal of Internal Medicine, 2011

The prognostic value of B-type natriuretic peptide (BNP) for surgical outcome in patients with mi... more The prognostic value of B-type natriuretic peptide (BNP) for surgical outcome in patients with mitral regurgitation (MR) has not been studied. The purpose of this study was to determine the prognostic value of BNP in patients with chronic severe MR, undergoing mitral valve surgery.

... 205 Francesco Scarton, Massimo Semenzato, Roberto Valle ... In laguna di Venezia il Pellegrin... more ... 205 Francesco Scarton, Massimo Semenzato, Roberto Valle ... In laguna di Venezia il Pellegrino è saltuariamente presente in in-verno e durante le migrazioni, come riportato già nel secolo scorso da CONTARINI (1847) e successivamente da NINNI (1902). ...

American Journal of Medicine, 1993

Heart Failure Reviews, 2011

The study tests the hypothesis that in patients admitted with acutely decompensated heart failure... more The study tests the hypothesis that in patients admitted with acutely decompensated heart failure (ADHF), achievement of adequate body hydration status with intensive medical therapy, modulated by combined bioelectrical vectorial impedance analysis (BIVA) and B-type natriuretic peptide (BNP) measurement, may contribute to optimize the timing of patient’s discharge and to improve clinical outcomes. Three hundred patients admitted for ADHF underwent serial BIVA and BNP measurement. Therapy was titrated to reach a BNP value of <250 pg/ml, whenever possible. Patients were categorized as early responders (rapid BNP fall below 250 pg/ml); late responders (slow BNP fall below 250 pg/ml, after aggressive therapy); and non-responders (BNP persistently >250 pg/ml). Worsening of renal function (WRF) was evaluated during hospitalization. Death and rehospitalization were monitored with a 6-month follow-up. BNP value on discharge of ≤250 pg/ml led to a 25% event rate within 6 months (Group A: 17.4%; Group B: 21%, Chi2; n.s.), whereas a value >250 pg/ml (Group C) was associated with a far higher percentage (37%). At discharge, body hydration was 73.8 ± 3.2% in the total population and 73.2 ± 2.1, 73.5 ± 2.8, 74.1 ± 3.6% in the three groups, respectively. WRF was observed in 22.3% of the total. WRF occurred in 22% in Group A, 32% in Group B, and 20% in Group C (P = n.s.). Our study confirms the hypothesis that combined BNP/BIVA sequential measurements help to achieve adequate fluid balance status in patients with ADHF and can be used to drive a “tailored therapy,” allowing clinicians to identify high-risk patients and possibly to reduce the incidence of complications secondary to fluid management strategies.

Journal of The American College of Cardiology, 2011

Congestive Heart Failure, 2008

Journal of Cardiac Failure, 2009

Journal of Cardiac Failure, 2007

Lo scompenso cardiaco (SC) rappresenta una delle sfide più attuali e stringenti della pratica cli... more Lo scompenso cardiaco (SC) rappresenta una delle sfide più attuali e stringenti della pratica clinica cardiologica contempora-nea: è una malattia frequente, letale, econo-micamente onerosa per i sistemi sanitari1-3, e con un grado di mortalità simile a quello di molte forme di ...

Sebbene i trials sullo scompenso cardiaco mostrino un graduale calo della mortalità post-dimissio... more Sebbene i trials sullo scompenso cardiaco mostrino un graduale calo della mortalità post-dimissione [1], i dati provenienti dalle casistiche non selezionate rivelano che il 30-50% dei pazienti viene riammesso in ospedale per scompenso entro sei mesi dalla dimissione ed un ulteriore 20% decede nello stesso intervallo di tempo . Nonostante la disponibilità e la "intensa" applicazione delle linee guida lo scompenso cardiaco è ancora una condizione morbosa cronica caratterizzata dall'alternarsi di pe-La terapia guidata dal BNP consente l'ottimizzazione del timing di dimissione e la stratificazione del rischio a medio termine nel paziente ricoverato per scompenso cardiaco BNP-guided therapy optimizes the timing of discharge and the medium term risk stratification in patients admitted for congestive heart failure ABSTRACT: BNP-guided therapy optimizes the timing of discharge and the medium term risk stratification in patients admitted for congestive heart failure. R. Background: Congestive heart failure (HF) is one of the most important cause of hospitalizations and is associated with high cost. Despite a consistent body of data demonstrating the benefits of drug therapy in HF, persistently high rates of readmission, especially within six months of discharge, continue to be documented. Neurohormonal activation characterizes the disease; plasma brain natriuretic peptide (BNP), is correlated with the severity of left ventricular dysfunction and relates to outcome. Objective: The aim of the study was to evaluate if plasma levels of BNP would provide an index to guide drug treatment and to predict medium-term prognosis in HF patients (pts) after hospital discharge.

Sebbene lo scompenso cardiaco rappresenti attualmente una delle malattie di maggiore rilevanza so... more Sebbene lo scompenso cardiaco rappresenti attualmente una delle malattie di maggiore rilevanza sociale, a causa della sua frequenza, morbilità, mortalità ed assorbimento di risorse, la sua prevalenza non è ancora nota con precisione. Si stima che esso interessi una quota ingente della popolazione generale, ma mancano dati precisi . Per la popolazione italiana in particolare, tre studi hanno indagato la prevalenza nella popolazione generale, fornendo stime che variano da 7 a 20 casi per 1000 abitanti .

European Journal of Heart Failure Supplements, 2006

Aims: We examined the usefulness of BNP for screening for left ventricular (LV) diastolic dysfunc... more Aims: We examined the usefulness of BNP for screening for left ventricular (LV) diastolic dysfunction in a sample of type 2 diabetic patients, without structural heart disorder, who have never presented symptoms or signs of heart failure (HF). Methods and results: Seventy-six consecutive patients admitted to the Outpatient Diabetes Clinic were studied. Blood samples were analyzed using the Triage BNP fluorescence immunoassay (Biosite Diagnostics, La Jolla, CA, USA). Echocardiography examinations were performed, with no knowledge of the BNP value. A total of 39 patients out of 76 (51%) were diagnosed with LV diastolic dysfunction and 23 (30%) with LV hypertrophy. Of the patients with LV diastolic dysfunction, impaired relaxation and pseudonormal pattern accounted for 97 and 3% of the cases, respectively. BNP levels among subjects with LV diastolic dysfunction (26 G 22 pg/ml, n Z 39) were not significantly different from patients with normal LV function (24 G 23 pg/ml, n Z 37 pg/ml; ManneWhitney U-test, Z Z ÿ0.4, n.s.). Conclusions: Our data confirm alarmingly high prevalence of LV diastolic dysfunction in asymptomatic individuals with diabetes. Identification of patients with preclinical diabetic cardiomyopathy should be a research and clinical priority. BNP levels cannot be used to detect mild LV diastolic dysfunction in this subset of patients, which requires Doppler echocardiography to be detected.

European Journal of Heart Failure Supplements, 2008

Contributions To Nephrology, 2010

Bibliographic Indices. This publication is listed in bibliographic services, including Current Co... more Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents® and Index Medicus.

Riassunto. La popolazione italiana di Beccaccia di mate ammonta a 63 coppie, 40-42 delle quali so... more Riassunto. La popolazione italiana di Beccaccia di mate ammonta a 63 coppie, 40-42 delle quali sono presenti lungo le coste del Venero. Dal 1995 si sono avuti casi di nidificazione su barene o isole artificiali, costruite in laguna di Venezia ed in laguna di Porto Caleri (RO). Vengono presentati alcuni dati sulla biologia riproduttiva nel 1997. Lungo l'intero arco costiero del Mediterraneo, la specie è presente con circa 300 coppie, il 13% delle quali nidifica in lagune o delta del Venero. Vengono infine esposte brevi raccomandazioni per una gestione naturalistica dei siti artificiali di nidificazione.

Heart Failure Reviews, 2011

The pathophysiology of acute heart failure syndromes (AHFS), defined as a change or worsening in ... more The pathophysiology of acute heart failure syndromes (AHFS), defined as a change or worsening in heart failure symptoms and signs, is complex. The variety of adverse neurohormonal adaptations includes increased levels of plasma renin, aldosterone and angiotensin II, all responsible for cardio-renal dysfunction. In fact, such alterations result in an array of clinical changes that include abnormal haemodynamics, altered ventricular filling pressures, pathological neurohormonal responses, leading to fluid overload, congestion and ultimately heart failure symptoms. Clinical pictures can be various: in spite of a usual improvement in dyspnoea, little weight change and significant morbidity are generally observed during hospitalization. Short-term outcomes are characterized by a high 60-day re-hospitalization and high mortality rates; apparently, both can be predicted from pre-discharge characteristics. The most frequently used treatments for AHF care include diuretics, inotropic agents, and vasodilator/vasoactive agents; however, the final therapeutic strategy is often individualized. Diuretics are currently the most used agents, but resistance to diuretic therapy is common. In addition, several studies have demonstrated that aggressive diuresis can contribute to reduced renal function, and high doses of diuretics have been associated with increased morbidity and mortality. Many patients with AHFS also suffer from acute or from chronic renal dysfunction (cardio-renal syndromes type 1 and 2, respectively), which further complicate the outcomes and treatment strategies. A personalized patient evaluation of the combined heart and kidney functions is advised to implement the best possible multidisciplinary diagnostic and therapeutic approach.

European Journal of Internal Medicine, 2011

The prognostic value of B-type natriuretic peptide (BNP) for surgical outcome in patients with mi... more The prognostic value of B-type natriuretic peptide (BNP) for surgical outcome in patients with mitral regurgitation (MR) has not been studied. The purpose of this study was to determine the prognostic value of BNP in patients with chronic severe MR, undergoing mitral valve surgery.

... 205 Francesco Scarton, Massimo Semenzato, Roberto Valle ... In laguna di Venezia il Pellegrin... more ... 205 Francesco Scarton, Massimo Semenzato, Roberto Valle ... In laguna di Venezia il Pellegrino è saltuariamente presente in in-verno e durante le migrazioni, come riportato già nel secolo scorso da CONTARINI (1847) e successivamente da NINNI (1902). ...

American Journal of Medicine, 1993

Heart Failure Reviews, 2011

The study tests the hypothesis that in patients admitted with acutely decompensated heart failure... more The study tests the hypothesis that in patients admitted with acutely decompensated heart failure (ADHF), achievement of adequate body hydration status with intensive medical therapy, modulated by combined bioelectrical vectorial impedance analysis (BIVA) and B-type natriuretic peptide (BNP) measurement, may contribute to optimize the timing of patient’s discharge and to improve clinical outcomes. Three hundred patients admitted for ADHF underwent serial BIVA and BNP measurement. Therapy was titrated to reach a BNP value of <250 pg/ml, whenever possible. Patients were categorized as early responders (rapid BNP fall below 250 pg/ml); late responders (slow BNP fall below 250 pg/ml, after aggressive therapy); and non-responders (BNP persistently >250 pg/ml). Worsening of renal function (WRF) was evaluated during hospitalization. Death and rehospitalization were monitored with a 6-month follow-up. BNP value on discharge of ≤250 pg/ml led to a 25% event rate within 6 months (Group A: 17.4%; Group B: 21%, Chi2; n.s.), whereas a value >250 pg/ml (Group C) was associated with a far higher percentage (37%). At discharge, body hydration was 73.8 ± 3.2% in the total population and 73.2 ± 2.1, 73.5 ± 2.8, 74.1 ± 3.6% in the three groups, respectively. WRF was observed in 22.3% of the total. WRF occurred in 22% in Group A, 32% in Group B, and 20% in Group C (P = n.s.). Our study confirms the hypothesis that combined BNP/BIVA sequential measurements help to achieve adequate fluid balance status in patients with ADHF and can be used to drive a “tailored therapy,” allowing clinicians to identify high-risk patients and possibly to reduce the incidence of complications secondary to fluid management strategies.

Journal of The American College of Cardiology, 2011

Congestive Heart Failure, 2008

Journal of Cardiac Failure, 2009

Journal of Cardiac Failure, 2007

Lo scompenso cardiaco (SC) rappresenta una delle sfide più attuali e stringenti della pratica cli... more Lo scompenso cardiaco (SC) rappresenta una delle sfide più attuali e stringenti della pratica clinica cardiologica contempora-nea: è una malattia frequente, letale, econo-micamente onerosa per i sistemi sanitari1-3, e con un grado di mortalità simile a quello di molte forme di ...

Sebbene i trials sullo scompenso cardiaco mostrino un graduale calo della mortalità post-dimissio... more Sebbene i trials sullo scompenso cardiaco mostrino un graduale calo della mortalità post-dimissione [1], i dati provenienti dalle casistiche non selezionate rivelano che il 30-50% dei pazienti viene riammesso in ospedale per scompenso entro sei mesi dalla dimissione ed un ulteriore 20% decede nello stesso intervallo di tempo . Nonostante la disponibilità e la "intensa" applicazione delle linee guida lo scompenso cardiaco è ancora una condizione morbosa cronica caratterizzata dall'alternarsi di pe-La terapia guidata dal BNP consente l'ottimizzazione del timing di dimissione e la stratificazione del rischio a medio termine nel paziente ricoverato per scompenso cardiaco BNP-guided therapy optimizes the timing of discharge and the medium term risk stratification in patients admitted for congestive heart failure ABSTRACT: BNP-guided therapy optimizes the timing of discharge and the medium term risk stratification in patients admitted for congestive heart failure. R. Background: Congestive heart failure (HF) is one of the most important cause of hospitalizations and is associated with high cost. Despite a consistent body of data demonstrating the benefits of drug therapy in HF, persistently high rates of readmission, especially within six months of discharge, continue to be documented. Neurohormonal activation characterizes the disease; plasma brain natriuretic peptide (BNP), is correlated with the severity of left ventricular dysfunction and relates to outcome. Objective: The aim of the study was to evaluate if plasma levels of BNP would provide an index to guide drug treatment and to predict medium-term prognosis in HF patients (pts) after hospital discharge.

Sebbene lo scompenso cardiaco rappresenti attualmente una delle malattie di maggiore rilevanza so... more Sebbene lo scompenso cardiaco rappresenti attualmente una delle malattie di maggiore rilevanza sociale, a causa della sua frequenza, morbilità, mortalità ed assorbimento di risorse, la sua prevalenza non è ancora nota con precisione. Si stima che esso interessi una quota ingente della popolazione generale, ma mancano dati precisi . Per la popolazione italiana in particolare, tre studi hanno indagato la prevalenza nella popolazione generale, fornendo stime che variano da 7 a 20 casi per 1000 abitanti .