paolo ferrero - Academia.edu (original) (raw)

Papers by paolo ferrero

Research paper thumbnail of Oncogenesis in patients with congenital heart disease: A possible role of the neural crest

Annals of Pediatric Cardiology, 2022

Research paper thumbnail of Abstract 15083: Exercise Left Ventricular Ejection Fraction Predicts Long-term Brain Natriuretic Peptide Levels in Patients Undergoing Surgery for Severe Secondary Ischemic Mitral Regurgitation

Circulation, Nov 17, 2020

Background and Objective: Surgical treatment of severe secondary ischemic mitral regurgitation (I... more Background and Objective: Surgical treatment of severe secondary ischemic mitral regurgitation (IMR) may improve symptoms and functional capacity, however there are few data on its effect on long-on the evolution of heart failure. Time-course changes in brain natriuretic peptide (BNP) are a good marker of the heart failure status and outcomes. We investigated the association between the exercise stress echocardiographic (ESE) parameters and the changes in brain natriuretic peptide (BNP) following surgery for secondary IMR. Methods: We prospectively analyzed data on 50 patients (median age: 67, 61-64 y; EF: 35, 34-40%), undergoing mitral valve annuloplasty or replacement and coronary artery bypass graft (CABG). A valve annuloplasty with undersized ring was performed in 20 patients (40%) and a replacement in 30 (60%). A six minute walking test (6-MWT), BNP levels and ESE were performed at 1 year and at median follow-up (FU) of 6 years (4-7). Results: BNP level was: 388 (329-441) pg/ml before surgery, 175 (142-743) pg/ml at 1 y, and 123 (100-979) pg/ml at last FU (p=0.2). The relative changes of BNP from baseline to last FU significantly correlated with exercise tricuspid annulus plane systolic excursion (TAPSE) at last FU (r= -0.7, p<0.001), with preoperative and FU exercise LVEF, respectively ( r=-0.7 p= 0.01) (r=-0.93, p<0.001).On multivariable analysis, preoperative exercise EF was strongly and independently associated with independent BNP levels at last FU and with the changes in BNP from baseline to last FU. Conclusions: Despite surgical treatment of severe secondary IMR, BNP levels progressively increased over time in nearly 50% of the patients. Lower preoperative and 1-year FU exercise-stress EF was associated with increased levels of BNP during FU..

Research paper thumbnail of Catheter closure of a patent vertical vein after repair of an unusual total anomalous variant of pulmonary venous drainage

Annals of Pediatric Cardiology, 2021

Total anomalous pulmonary venous drainage (TAPVD) encompasses a wide spectrum of anatomical varia... more Total anomalous pulmonary venous drainage (TAPVD) encompasses a wide spectrum of anatomical variants. The infradiaphragmatic type is almost always obstructive owing to the interposition of intrahepatic resistances; since almost invariable, the vertical vein inserts on the portal venous system. On correction of this variant, the vertical vein might not be ligated to avoid postoperative pulmonary hypertension. We hereby describe an unusual case of infradiaphragmatic TAPVD, with a vertical vein connected to ductus venosus. Since vertical vein was not ligated, it realized an unrestrictive pathway between the left atrium and the suprahepatic veins which resulted in persistent chylous peritoneal drainage. The patient successfully underwent catheter occlusion of the vertical vein which led to complete resolution of the clinical picture.

Research paper thumbnail of Arrhythmic outcomes in consecutive patients undergoing both surgical and percutaneous atrial septal defect closure

Research paper thumbnail of First case reported of COVID-19 infection in an adult patient with Ellis-van Creveld Syndrome

Progress in Pediatric Cardiology, Dec 1, 2022

Ellis-van Creveld syndrome (EVC) is a rare autosomal recessive disorder, the features of the synd... more Ellis-van Creveld syndrome (EVC) is a rare autosomal recessive disorder, the features of the syndrome are: chondral and ectodermal dysplasia characterized by short ribs, polydactyly, growth retardation resulting in dwarfism, teeth and craniofacial abnormalities and heart defects (mostly endocardial cushions and atrial septal defects). We describe the first case reported of COVID-19 infection in a 24-years-old girl, diagnosed with EVC syndrome. The patient suffered only from a mild illness, she remained stable with normal saturation without need of neither respiratory support nor specific therapy and she was rapidly discharged. This case appraises the pathophysiological interplay between different specific prognostic variable in a syndromic patient with congenital heart disease and COVID-19. In patients with congenital heart disease, comorbidities related to syndromic picture may affect the clinical course of COVID-19 infection regardless of the anatomic complexity.

Research paper thumbnail of Radiofrequency Catheter Ablation of Atrial Fibrillation in Athletes Referred for Disabling Symptoms Preventing Usual Training Schedule and Sport Competition

Journal of Cardiovascular Electrophysiology, Jul 8, 2008

Research paper thumbnail of Balloon-Expandable Valve Implantation in a Systemic Tricuspid Valve With Annular Calcification Using 3D CT Overlay

Jacc-cardiovascular Interventions, Nov 1, 2022

Research paper thumbnail of Myocarditis in the pediatric population: CMR image appraisal of myocardial inflammation

International Journal of Cardiology, Apr 1, 2021

Research paper thumbnail of Reversible acute Fontan circulation failure secondary to retrogradely conducted junctional rhythm: clinical echocardiographic correlation

Journal of congenital cardiology, Apr 15, 2021

Background: Sequential atrioventricular activation plays a critical role in the physiology of Fon... more Background: Sequential atrioventricular activation plays a critical role in the physiology of Fontan circulation. Although bradycardia is usually well tolerated, retrogradely conducted junctional rhythm may acutely increase atrial pressure impairing cardiac output. Echocardiographic evaluation can reveal clues of this hemodynamic condition. The clinical impact of arrhythmic disturbance on the follow up of patients who had undergone total cavopulmonary connection is well recognized but the role of, transient periods of retrogradely conducted junctional rhythm on the immediate post-operative course is less defined. Case presentation: We describe two cases of acute Fontan circulatory failure due to postoperative retrogradely conducted junctional escape rhythm despite an adequate heart rate and circadian variation. The patients rapidly improved after atrial pacing, allowing discharge with a minimal dose of diuretic. Conclusion: In the absence of any hemodynamic target, hearth rhythm should be systematically checked after TCPC irrespective of adequacy of heart rate. Likewise, efficiency of temporary atrial pacing should be granted and surgeons should have a low threshold for epicardial lead implantation.

Research paper thumbnail of Letter by Ferrero and Chessa Regarding Article, “Long-Term Follow-Up of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator: The DAI-T4F Nationwide Registry”

Research paper thumbnail of Myocardial infarction in a child with multiple coronary aneurysms and neurofibromatosis type 1

Cardiology in The Young, Aug 11, 2020

Vascular involvement in neurofibromatosis type 1 has been described, although coronary artery dis... more Vascular involvement in neurofibromatosis type 1 has been described, although coronary artery disease is rare. Data about clinical presentation and natural history are anecdotal. This is the first case of myocardial infarction due to coronary aneurysms in a 13-year-old boy with neurofibromatosis type 1. We discuss pathophysiology, diagnostic images, and therapeutic management of this rare association.

Research paper thumbnail of Abstract 20606: Persistent Low Oxygen Saturation During Sleep Predicts Impaired Pulmonary Vascular Response to Exercise in Patients With Sleep Disordered Breathing

Introduction: Sleep disordered breathing (SDB) is common among patients with cardiovascular disea... more Introduction: Sleep disordered breathing (SDB) is common among patients with cardiovascular disease, but its impact on physiologic responses to exercise remains unclear. Hypothesis: We sought to determine the functional significance of SDB and low nocturnal oxygen saturation (SaO2) on hemodynamic responses to exercise. Methods: We investigated subjects who underwent invasive cardiopulmonary exercise tests (iCPET) to evaluate dyspnea of unclear etiology who had evidence of SDB defined as an apnea hypopnea index (AHI) > 5 events/hour during a formal sleep study done within 3 years of the iCPET. Mean pulmonary artery pressure (mPAP) and mean wedge pressure (mPW) were indexed to cardiac output (CO) during exercise, with a mPAP-CO slope > 3 mmHg·min·L(-1) and a mPW-CO slope > 2 mmHg·min·L(-1) indicating an abnormal pulmonary vascular (PV) response to exercise. Results: A total of 120 patients (mean±SD age 58.2 ± 12.6 years, body mass index 31.6 ± 7.5) with SDB (mean AHI 18.9 ± 21.3) and reduced SaO2 during the sleep study (minimal SaO2: 83± 7%, percentage of sleep-time with SaO2 Conclusions: The magnitude and duration of reduced SaO2 during sleep is related to degree of impairment in exercise capacity and pulmonary hemodynamic responses to exercise among patients with dyspnea on exertion. Persistent low nocturnal SaO2 correlates better than AHI with impaired PV response to exercise.

Research paper thumbnail of Abstract 19125: Athletes With Repolarization Abnormalities During Exercise Stress Test Have a Lower Global Longitudinal Strain Compared to Hypertensive Patients With the Same Degree of Septal Thickness

Circulation, Nov 25, 2014

Introduction: Athletes may have electrocardiographic (ECG) repolarization abnormalities during st... more Introduction: Athletes may have electrocardiographic (ECG) repolarization abnormalities during stress test suggestive for ischemia in the absence of ischemic coronary artery disease. These alterations can be related to a certain degree of septal hypertrophy often associated to intensive training. Global longitudinal strain (GLS) by speckle tracking is a novel technique able to detect segmental alterations in myocardial contractility even in presence of a preserved ventricular function. Hypothesis: GLS might be altered in athletes with ECG repolarization abnormalities at the stress test compared to hypertensive patients with the same degree of septal hypertrophy. Methods: 735 consecutive subjects (mean age 53±12.5 yrs) were enrolled. At the screening stress test, 23 (19 M, 4 F) were found to have ECG repolarization abnormalities suggestive for ischemia in the presence of normal coronary vessels at the multi-slice computed tomography. They were compared to a control group of 10 hypertensive patients (9 M, 1...

Research paper thumbnail of Global Longitudinal Strain in master athletes and in hypertensive patients with the same degree of septal thickness

Scandinavian Journal of Medicine & Science in Sports, Oct 17, 2016

Two-dimensional strain analysis of the global and regional myocardial function for the differenti... more Two-dimensional strain analysis of the global and regional myocardial function for the differentiation of pathologic and physiologic left ventricular hypertrophy: a study in athletes and in patients with hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 2011: 27: 91-100.

Research paper thumbnail of Overview of Long-Term Outcome in Adults with Systemic Right Ventricle and Transposition of the Great Arteries: A Review

Diagnostics

The population of patients with a systemic right ventricle (sRV) in biventricular circulation inc... more The population of patients with a systemic right ventricle (sRV) in biventricular circulation includes those who have undergone an atrial switch operation for destro-transposition of the great arteries (d-TGA) and those with congenitally corrected transposition of the great arteries (ccTGA). Despite the life expectancy of these patients is significantly increased, the long-term prognosis remains suboptimal due to late complications such as heart failure, arrhythmias, and premature death. These patients, therefore, need a close follow-up to early identify predictive factors of adverse outcomes and to implement all preventive therapeutic strategies. This review analyzes the late complications of adult patients with an sRV and TGA and clarifies which are risk factors for adverse prognosis and which are the therapeutic strategies that improve the long-term outcomes. For prognostic purposes, it is necessary to monitor sRV size and function, the tricuspid valve regurgitation, the function...

Research paper thumbnail of Patterns of myocardial involvement in children during COVID-19 pandemic: Early experience from northern Italy

Annals of Pediatric Cardiology, 2020

There is limited information about coronavirus disease 2019 (COVID-19) in the pediatric populatio... more There is limited information about coronavirus disease 2019 (COVID-19) in the pediatric population. Preliminary data suggest a not insignificant prevalence of cardiac involvement. Here, we report our early experience with COVID-19 in the pediatric population. These patients display exceptionally high levels of acute-phase reactants. The clinical syndrome in these patients is somewhat similar to Kawasaki disease with or without myocardial involvement. In some cases, the presentation mimics typical myocarditis. Severe myocardial involvement is associated with transient electrocardiographic and echocardiographic abnormalities. These findings may be due to the cardiotropic nature of the virus or may be the result of an immunologic response to the infection.

Research paper thumbnail of Long-term effects of physical training on cardiopulmonary exercise parameters in young patients with congenital heart diseases

Cardiology in the Young

Introduction: Physical activity is recognised as an important intervention in patients with CHD. ... more Introduction: Physical activity is recognised as an important intervention in patients with CHD. However, more data on the actual magnitude of physical training impact on functional capacity in this group of patients are still warranted. We aim to assess effort tolerance in a contemporary cohort of patients with congenital heart disease, regularly following a training programme, in comparison with a matched control group. Methods: Patients with CHD followed at the sports medicine department, who had undergone cardiopulmonary exercise test between 2011 and 2019, were included. Variables recorded were maximum workload, absolute and indexed maximum oxygen consumption, maximum heart rate, absolute and indexed maximum O2 pulse, ventilatory equivalent of CO2 and oxygen consumption/Work. Trend of cardiopulmonary parameters was analysed over time. Maximal workload, maximum oxygen consumption and ventilatory equivalent of CO2 were compared with a control group of patients with a more sedenta...

Research paper thumbnail of Acute myocarditis as first presentation of severe ulcerative colitis in a young man. Multidisciplinary management and long-term follow-up

Journal of Cardiology Cases, 2022

Research paper thumbnail of Early Diagnosis of Acute Myocarditis in the ED: Proposal of a New ECG-Based Protocol

Diagnostics, 2022

The diagnosis of acute myocarditis (AM) is based on a multi-parametric assessment including clini... more The diagnosis of acute myocarditis (AM) is based on a multi-parametric assessment including clinical presentation, ECG, imaging and biomarkers. Fragmented QRS (fQRS) might be an additional diagnostic sign in patients with proven AM. The main objective of this study was to assess the diagnostic yield of fQRS in patients with suspected AM presenting to the emergency department (ED). Patients admitted between January 2016 and March 2021 with a proven diagnosis of AM, according to clinical, cardiac magnetic resonance (CMR) and/or histologic criteria, were included in the analysis. In total, 51 patients were analyzed (41 men, 78%), with a median age of 36 (29–45) years. Thirty-three (65%) patients had prodromal flu-like symptoms. Patients presented to the ED mostly complaining of chest pain (68%) and palpitations (21%). Seven (14%) patients experienced cardiac arrest, one of whom died. At presentation, 40 patients (78%) displayed fQRS, and 10 (20%) presented ventricular arrhythmias. All ...

Research paper thumbnail of Abstract 15321: Impact of Exercise Right Ventricular Performance on Functional Capacity in Patients Undergoing Mitral Valve Surgery for Chronic Ischemic Mitral Regurgitation: A Longitudinal Study

Circulation, 2017

Introduction: Data on the exercise hemodynamic performance of the right ventricle (RV) in patient... more Introduction: Data on the exercise hemodynamic performance of the right ventricle (RV) in patients undergoing mitral valve surgery (MVS) for chronic ischemic mitral regurgitation (CIMR) are sparse....

Research paper thumbnail of Oncogenesis in patients with congenital heart disease: A possible role of the neural crest

Annals of Pediatric Cardiology, 2022

Research paper thumbnail of Abstract 15083: Exercise Left Ventricular Ejection Fraction Predicts Long-term Brain Natriuretic Peptide Levels in Patients Undergoing Surgery for Severe Secondary Ischemic Mitral Regurgitation

Circulation, Nov 17, 2020

Background and Objective: Surgical treatment of severe secondary ischemic mitral regurgitation (I... more Background and Objective: Surgical treatment of severe secondary ischemic mitral regurgitation (IMR) may improve symptoms and functional capacity, however there are few data on its effect on long-on the evolution of heart failure. Time-course changes in brain natriuretic peptide (BNP) are a good marker of the heart failure status and outcomes. We investigated the association between the exercise stress echocardiographic (ESE) parameters and the changes in brain natriuretic peptide (BNP) following surgery for secondary IMR. Methods: We prospectively analyzed data on 50 patients (median age: 67, 61-64 y; EF: 35, 34-40%), undergoing mitral valve annuloplasty or replacement and coronary artery bypass graft (CABG). A valve annuloplasty with undersized ring was performed in 20 patients (40%) and a replacement in 30 (60%). A six minute walking test (6-MWT), BNP levels and ESE were performed at 1 year and at median follow-up (FU) of 6 years (4-7). Results: BNP level was: 388 (329-441) pg/ml before surgery, 175 (142-743) pg/ml at 1 y, and 123 (100-979) pg/ml at last FU (p=0.2). The relative changes of BNP from baseline to last FU significantly correlated with exercise tricuspid annulus plane systolic excursion (TAPSE) at last FU (r= -0.7, p<0.001), with preoperative and FU exercise LVEF, respectively ( r=-0.7 p= 0.01) (r=-0.93, p<0.001).On multivariable analysis, preoperative exercise EF was strongly and independently associated with independent BNP levels at last FU and with the changes in BNP from baseline to last FU. Conclusions: Despite surgical treatment of severe secondary IMR, BNP levels progressively increased over time in nearly 50% of the patients. Lower preoperative and 1-year FU exercise-stress EF was associated with increased levels of BNP during FU..

Research paper thumbnail of Catheter closure of a patent vertical vein after repair of an unusual total anomalous variant of pulmonary venous drainage

Annals of Pediatric Cardiology, 2021

Total anomalous pulmonary venous drainage (TAPVD) encompasses a wide spectrum of anatomical varia... more Total anomalous pulmonary venous drainage (TAPVD) encompasses a wide spectrum of anatomical variants. The infradiaphragmatic type is almost always obstructive owing to the interposition of intrahepatic resistances; since almost invariable, the vertical vein inserts on the portal venous system. On correction of this variant, the vertical vein might not be ligated to avoid postoperative pulmonary hypertension. We hereby describe an unusual case of infradiaphragmatic TAPVD, with a vertical vein connected to ductus venosus. Since vertical vein was not ligated, it realized an unrestrictive pathway between the left atrium and the suprahepatic veins which resulted in persistent chylous peritoneal drainage. The patient successfully underwent catheter occlusion of the vertical vein which led to complete resolution of the clinical picture.

Research paper thumbnail of Arrhythmic outcomes in consecutive patients undergoing both surgical and percutaneous atrial septal defect closure

Research paper thumbnail of First case reported of COVID-19 infection in an adult patient with Ellis-van Creveld Syndrome

Progress in Pediatric Cardiology, Dec 1, 2022

Ellis-van Creveld syndrome (EVC) is a rare autosomal recessive disorder, the features of the synd... more Ellis-van Creveld syndrome (EVC) is a rare autosomal recessive disorder, the features of the syndrome are: chondral and ectodermal dysplasia characterized by short ribs, polydactyly, growth retardation resulting in dwarfism, teeth and craniofacial abnormalities and heart defects (mostly endocardial cushions and atrial septal defects). We describe the first case reported of COVID-19 infection in a 24-years-old girl, diagnosed with EVC syndrome. The patient suffered only from a mild illness, she remained stable with normal saturation without need of neither respiratory support nor specific therapy and she was rapidly discharged. This case appraises the pathophysiological interplay between different specific prognostic variable in a syndromic patient with congenital heart disease and COVID-19. In patients with congenital heart disease, comorbidities related to syndromic picture may affect the clinical course of COVID-19 infection regardless of the anatomic complexity.

Research paper thumbnail of Radiofrequency Catheter Ablation of Atrial Fibrillation in Athletes Referred for Disabling Symptoms Preventing Usual Training Schedule and Sport Competition

Journal of Cardiovascular Electrophysiology, Jul 8, 2008

Research paper thumbnail of Balloon-Expandable Valve Implantation in a Systemic Tricuspid Valve With Annular Calcification Using 3D CT Overlay

Jacc-cardiovascular Interventions, Nov 1, 2022

Research paper thumbnail of Myocarditis in the pediatric population: CMR image appraisal of myocardial inflammation

International Journal of Cardiology, Apr 1, 2021

Research paper thumbnail of Reversible acute Fontan circulation failure secondary to retrogradely conducted junctional rhythm: clinical echocardiographic correlation

Journal of congenital cardiology, Apr 15, 2021

Background: Sequential atrioventricular activation plays a critical role in the physiology of Fon... more Background: Sequential atrioventricular activation plays a critical role in the physiology of Fontan circulation. Although bradycardia is usually well tolerated, retrogradely conducted junctional rhythm may acutely increase atrial pressure impairing cardiac output. Echocardiographic evaluation can reveal clues of this hemodynamic condition. The clinical impact of arrhythmic disturbance on the follow up of patients who had undergone total cavopulmonary connection is well recognized but the role of, transient periods of retrogradely conducted junctional rhythm on the immediate post-operative course is less defined. Case presentation: We describe two cases of acute Fontan circulatory failure due to postoperative retrogradely conducted junctional escape rhythm despite an adequate heart rate and circadian variation. The patients rapidly improved after atrial pacing, allowing discharge with a minimal dose of diuretic. Conclusion: In the absence of any hemodynamic target, hearth rhythm should be systematically checked after TCPC irrespective of adequacy of heart rate. Likewise, efficiency of temporary atrial pacing should be granted and surgeons should have a low threshold for epicardial lead implantation.

Research paper thumbnail of Letter by Ferrero and Chessa Regarding Article, “Long-Term Follow-Up of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator: The DAI-T4F Nationwide Registry”

Research paper thumbnail of Myocardial infarction in a child with multiple coronary aneurysms and neurofibromatosis type 1

Cardiology in The Young, Aug 11, 2020

Vascular involvement in neurofibromatosis type 1 has been described, although coronary artery dis... more Vascular involvement in neurofibromatosis type 1 has been described, although coronary artery disease is rare. Data about clinical presentation and natural history are anecdotal. This is the first case of myocardial infarction due to coronary aneurysms in a 13-year-old boy with neurofibromatosis type 1. We discuss pathophysiology, diagnostic images, and therapeutic management of this rare association.

Research paper thumbnail of Abstract 20606: Persistent Low Oxygen Saturation During Sleep Predicts Impaired Pulmonary Vascular Response to Exercise in Patients With Sleep Disordered Breathing

Introduction: Sleep disordered breathing (SDB) is common among patients with cardiovascular disea... more Introduction: Sleep disordered breathing (SDB) is common among patients with cardiovascular disease, but its impact on physiologic responses to exercise remains unclear. Hypothesis: We sought to determine the functional significance of SDB and low nocturnal oxygen saturation (SaO2) on hemodynamic responses to exercise. Methods: We investigated subjects who underwent invasive cardiopulmonary exercise tests (iCPET) to evaluate dyspnea of unclear etiology who had evidence of SDB defined as an apnea hypopnea index (AHI) > 5 events/hour during a formal sleep study done within 3 years of the iCPET. Mean pulmonary artery pressure (mPAP) and mean wedge pressure (mPW) were indexed to cardiac output (CO) during exercise, with a mPAP-CO slope > 3 mmHg·min·L(-1) and a mPW-CO slope > 2 mmHg·min·L(-1) indicating an abnormal pulmonary vascular (PV) response to exercise. Results: A total of 120 patients (mean±SD age 58.2 ± 12.6 years, body mass index 31.6 ± 7.5) with SDB (mean AHI 18.9 ± 21.3) and reduced SaO2 during the sleep study (minimal SaO2: 83± 7%, percentage of sleep-time with SaO2 Conclusions: The magnitude and duration of reduced SaO2 during sleep is related to degree of impairment in exercise capacity and pulmonary hemodynamic responses to exercise among patients with dyspnea on exertion. Persistent low nocturnal SaO2 correlates better than AHI with impaired PV response to exercise.

Research paper thumbnail of Abstract 19125: Athletes With Repolarization Abnormalities During Exercise Stress Test Have a Lower Global Longitudinal Strain Compared to Hypertensive Patients With the Same Degree of Septal Thickness

Circulation, Nov 25, 2014

Introduction: Athletes may have electrocardiographic (ECG) repolarization abnormalities during st... more Introduction: Athletes may have electrocardiographic (ECG) repolarization abnormalities during stress test suggestive for ischemia in the absence of ischemic coronary artery disease. These alterations can be related to a certain degree of septal hypertrophy often associated to intensive training. Global longitudinal strain (GLS) by speckle tracking is a novel technique able to detect segmental alterations in myocardial contractility even in presence of a preserved ventricular function. Hypothesis: GLS might be altered in athletes with ECG repolarization abnormalities at the stress test compared to hypertensive patients with the same degree of septal hypertrophy. Methods: 735 consecutive subjects (mean age 53±12.5 yrs) were enrolled. At the screening stress test, 23 (19 M, 4 F) were found to have ECG repolarization abnormalities suggestive for ischemia in the presence of normal coronary vessels at the multi-slice computed tomography. They were compared to a control group of 10 hypertensive patients (9 M, 1...

Research paper thumbnail of Global Longitudinal Strain in master athletes and in hypertensive patients with the same degree of septal thickness

Scandinavian Journal of Medicine & Science in Sports, Oct 17, 2016

Two-dimensional strain analysis of the global and regional myocardial function for the differenti... more Two-dimensional strain analysis of the global and regional myocardial function for the differentiation of pathologic and physiologic left ventricular hypertrophy: a study in athletes and in patients with hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 2011: 27: 91-100.

Research paper thumbnail of Overview of Long-Term Outcome in Adults with Systemic Right Ventricle and Transposition of the Great Arteries: A Review

Diagnostics

The population of patients with a systemic right ventricle (sRV) in biventricular circulation inc... more The population of patients with a systemic right ventricle (sRV) in biventricular circulation includes those who have undergone an atrial switch operation for destro-transposition of the great arteries (d-TGA) and those with congenitally corrected transposition of the great arteries (ccTGA). Despite the life expectancy of these patients is significantly increased, the long-term prognosis remains suboptimal due to late complications such as heart failure, arrhythmias, and premature death. These patients, therefore, need a close follow-up to early identify predictive factors of adverse outcomes and to implement all preventive therapeutic strategies. This review analyzes the late complications of adult patients with an sRV and TGA and clarifies which are risk factors for adverse prognosis and which are the therapeutic strategies that improve the long-term outcomes. For prognostic purposes, it is necessary to monitor sRV size and function, the tricuspid valve regurgitation, the function...

Research paper thumbnail of Patterns of myocardial involvement in children during COVID-19 pandemic: Early experience from northern Italy

Annals of Pediatric Cardiology, 2020

There is limited information about coronavirus disease 2019 (COVID-19) in the pediatric populatio... more There is limited information about coronavirus disease 2019 (COVID-19) in the pediatric population. Preliminary data suggest a not insignificant prevalence of cardiac involvement. Here, we report our early experience with COVID-19 in the pediatric population. These patients display exceptionally high levels of acute-phase reactants. The clinical syndrome in these patients is somewhat similar to Kawasaki disease with or without myocardial involvement. In some cases, the presentation mimics typical myocarditis. Severe myocardial involvement is associated with transient electrocardiographic and echocardiographic abnormalities. These findings may be due to the cardiotropic nature of the virus or may be the result of an immunologic response to the infection.

Research paper thumbnail of Long-term effects of physical training on cardiopulmonary exercise parameters in young patients with congenital heart diseases

Cardiology in the Young

Introduction: Physical activity is recognised as an important intervention in patients with CHD. ... more Introduction: Physical activity is recognised as an important intervention in patients with CHD. However, more data on the actual magnitude of physical training impact on functional capacity in this group of patients are still warranted. We aim to assess effort tolerance in a contemporary cohort of patients with congenital heart disease, regularly following a training programme, in comparison with a matched control group. Methods: Patients with CHD followed at the sports medicine department, who had undergone cardiopulmonary exercise test between 2011 and 2019, were included. Variables recorded were maximum workload, absolute and indexed maximum oxygen consumption, maximum heart rate, absolute and indexed maximum O2 pulse, ventilatory equivalent of CO2 and oxygen consumption/Work. Trend of cardiopulmonary parameters was analysed over time. Maximal workload, maximum oxygen consumption and ventilatory equivalent of CO2 were compared with a control group of patients with a more sedenta...

Research paper thumbnail of Acute myocarditis as first presentation of severe ulcerative colitis in a young man. Multidisciplinary management and long-term follow-up

Journal of Cardiology Cases, 2022

Research paper thumbnail of Early Diagnosis of Acute Myocarditis in the ED: Proposal of a New ECG-Based Protocol

Diagnostics, 2022

The diagnosis of acute myocarditis (AM) is based on a multi-parametric assessment including clini... more The diagnosis of acute myocarditis (AM) is based on a multi-parametric assessment including clinical presentation, ECG, imaging and biomarkers. Fragmented QRS (fQRS) might be an additional diagnostic sign in patients with proven AM. The main objective of this study was to assess the diagnostic yield of fQRS in patients with suspected AM presenting to the emergency department (ED). Patients admitted between January 2016 and March 2021 with a proven diagnosis of AM, according to clinical, cardiac magnetic resonance (CMR) and/or histologic criteria, were included in the analysis. In total, 51 patients were analyzed (41 men, 78%), with a median age of 36 (29–45) years. Thirty-three (65%) patients had prodromal flu-like symptoms. Patients presented to the ED mostly complaining of chest pain (68%) and palpitations (21%). Seven (14%) patients experienced cardiac arrest, one of whom died. At presentation, 40 patients (78%) displayed fQRS, and 10 (20%) presented ventricular arrhythmias. All ...

Research paper thumbnail of Abstract 15321: Impact of Exercise Right Ventricular Performance on Functional Capacity in Patients Undergoing Mitral Valve Surgery for Chronic Ischemic Mitral Regurgitation: A Longitudinal Study

Circulation, 2017

Introduction: Data on the exercise hemodynamic performance of the right ventricle (RV) in patient... more Introduction: Data on the exercise hemodynamic performance of the right ventricle (RV) in patients undergoing mitral valve surgery (MVS) for chronic ischemic mitral regurgitation (CIMR) are sparse....