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Browsing by Author "Cortigiani, Lauro"

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  • Prognostic value of reduced heart rate reserve during exercise in hypertrophic cardiomyopathy
    Publication . Ciampi, Quirino; Olivotto, Iacopo; Peteiro, Jesus; D’Alfonso, Maria; Mori, Fabio; Tassetti, Luigi; Milazzo, Alessandra; Monserrat, Lorenzo; Fernandez, Xusto; Pálinkás, Attila; Pálinkás, Eszter; Sepp, Róbert; Re, Federica; Cortigiani, Lauro; Tesic, Milorad; Djordjevic-Dikic, Ana; Beleslin, Branko; Losi, Mariangela; Canciello, Grazia; Betocchi, Sandro; Lopes, Luis; Cruz, Ines; Cotrim, Carlos; Torres, Marco; Bellagamba, Clarissa; Van De Heyning, Caroline; Varga, Albert; Ágoston, Gergely; Villari, Bruno; Lorenzoni, Valentina; Carpeggiani, Clara; Picano, Eugenio
    Background: Sympathetic dysfunction can be evaluated by heart rate reserve (HRR) with exercise test. Objectives: To determine the value of HRR in predicting outcome of patients with hypertrophic cardiomyopathy (HCM). Methods: We enrolled 917 HCM patients (age = 49 +/- 15 years, 516 men) assessed with exercise stress echocardiography (ESE) in 11 centres. ESE modality was semi-supine bicycle in 51 patients (6%), upright bicycle in 476 (52%), and treadmill in 390 (42%). During ESE, we assessed left ventricular outflow tract obstruction (LVOTO), stress-induced new regional wall motion abnormalities (RWMA), and HRR (peak/rest heart rate, HR). By selection, all patients completed the follow-up. Mortality was the predetermined outcome measure Results: During ESE, RWMA occurred in 22 patients (2.4%) and LVOTO (>= 50 mmHg) in 281 (30.4%). HRR was 1.90 +/- 0.40 (lowest quartile <= 1.61, highest quartile > 2.13). Higher resting heart rate (odds ratio 1.027, 95% CI: 1.018-1.036, p < 0.001), older age (odds ratio 1.021, 95% CI: 1.009-1.033, p < 0.001), lower exercise tolerance (mets, odds ratio 0.761, 95% CI: 0.708-0.817, p < 0.001) and resting LVOTO (odds ratio 1.504, 95% CI: 1.043-2.170, p = 0.029) predicted a reduced HRR. During a median follow-up of 89 months (interquartile range: 36-145 months), 90 all-cause deaths occurred. At multivariable analysis, lowest quartile HRR (Hazard ratio 2.354, 95% CI 1.116-4.968 p = 0.025) and RWMA (Hazard ratio 3.279, 95% CI 1.441-7.461 p = 0.004) independently predicted death, in addition to age (Hazard ratio 1.064, 95% CI 1.043-1.085 p < 0.001) and maximal wall thickness (Hazard ratio 1.081, 95% CI 1.037-1.128, p < 0.001). Conclusions: A blunted HRR during ESE predicts survival independently of RWMA in HCM patients.
    2021Journal article Open access Show more
  • Quality control of B-lines analysis in stress Echo 2020
    Publication . Scali, Maria C.; Ciampi, Quirino; Picano, Eugenio; Bossone, Eduardo; Ferrara, Francesco; Citro, Rodolfo; Colonna, Paolo; Costantino, Marco F.; Cortigiani, Lauro; Andrea, Antonello D.; Severino, Sergio; Dodi, Claudio; Gaibazzi, Nicola; Galderisi, Maurizio; Barbieri, Andrea; Monte, Ines; Mori, Fabio; Reisenhofer, Barbara; Re, Federica; Rigo, Fausto; Trambaiolo, Paolo; Amor, Miguel; Lowenstein, Jorge; Merlo, Pablo M.; Daros, Clarissa B.; de Castro e Silva Pretto, José L.; Miglioranza, Marcelo H.; Torres, Marco A. R.; de Azevedo Bellagamba, Clarissa C.; Chaves, Daniel Q.; Simova, Iana; Varga, Albert; Čelutkienė, Jelena; Kasprzak, Jaroslaw D.; Wierzbowska-Drabik, Karina; Lipiec, Piotr; Weiner-Mik, Paulina; Szymczyk, Eva; Wdowiak-Okrojek, Katarzyna; Djordjevic-Dikic, Ana; Dekleva, Milica; Stankovic, Ivan; Neskovic, Aleksandar N.; Zagatina, Angela; Di Salvo, Giovanni; Perez, Julio E.; Camarozano, Ana C.; Corciu, Anca I.; Boshchenko, Alla; Lattanzi, Fabio; Cotrim, Carlos; Fazendas, Paula; Haberka, Maciej; Sobkowic, Bozena; Kosmala, Wojciech; Witkowski, Tomasz; Gosciniak, Piotr; Salustri, Alessandro; Rodriguez-Zanella, Hugo; Leal, Luis I. M.; Nikolic, Alexandra; Gligorova, Suzana; Urluescu, Madalina-Loredana; Fiorino, Maria; Novo, Giuseppina; Preradovic-Kovacevic, Tamara; Ostojic, Miodrag; Beleslin, Branko; Villari, Bruno; De Nes, Michele; Paterni, Marco; Carpeggiani, Clara
    Background The effectiveness trial “Stress echo (SE) 2020” evaluates novel applications of SE in and beyond coronary artery disease. The core protocol also includes 4-site simplified scan of B-lines by lung ultrasound, useful to assess pulmonary congestion. Purpose To provide web-based upstream quality control and harmonization of B-lines reading criteria. Methods 60 readers (all previously accredited for regional wall motion, 53 B-lines naive) from 52 centers of 16 countries of SE 2020 network read a set of 20 lung ultrasound video-clips selected by the Pisa lab serving as reference standard, after taking an obligatory web-based learning 2-h module ( http://se2020.altervista.org ). Each test clip was scored for B-lines from 0 (black lung, A-lines, no B-lines) to 10 (white lung, coalescing B-lines). The diagnostic gold standard was the concordant assessment of two experienced readers of the Pisa lab. The answer of the reader was considered correct if concordant with reference standard reading ±1 (for instance, reference standard reading of 5 B-lines; correct answer 4, 5, or 6). The a priori determined pass threshold was 18/20 (≥ 90%) with R value (intra-class correlation coefficient) between reference standard and recruiting center) > 0.90. Inter-observer agreement was assessed with intra-class correlation coefficient statistics. Results All 60 readers were successfully accredited: 26 (43%) on first, 24 (40%) on second, and 10 (17%) on third attempt. The average diagnostic accuracy of the 60 accredited readers was 95%, with R value of 0.95 compared to reference standard reading. The 53 B-lines naive scored similarly to the 7 B-lines expert on first attempt (90 versus 95%, p = NS). Compared to the step-1 of quality control for regional wall motion abnormalities, the mean reading time per attempt was shorter (17 ± 3 vs 29 ± 12 min, p < .01), the first attempt success rate was higher (43 vs 28%, p < 0.01), and the drop-out of readers smaller (0 vs 28%, p < .01). Conclusions Web-based learning is highly effective for teaching and harmonizing B-lines reading. Echocardiographers without previous experience with B-lines learn quickly.
    2018-09-25Journal article Open access Show more
  • Stress Echo 2030: the novel ABCDE-(FGLPR) protocol to define the future of imaging
    Publication . Picano, Eugenio; Ciampi, Quirino; Cortigiani, Lauro; Arruda-Olson, Adelaide M.; Borguezan-Daros, Clarissa; de Castro e Silva Pretto, José Luis; Cocchia, Rosangela; Bossone, Eduardo; Merli, Elisa; Kane, Garvan C.; Varga, Albert; Agoston, Gergely; Scali, Maria Chiara; Morrone, Doralisa; Simova, Iana; Samardjieva, Martina; Boshchenko, Alla; Ryabova, Tamara; Vrublevsky, Alexander; Palinkas, Attila; Palinkas, Eszter D.; Sepp, Robert; Torres, Marco A. R.; Villarraga, Hector R.; Preradović, Tamara Kovačević; Citro, Rodolfo; Amor, Miguel; Mosto, Hugo; Salamè, Michael; Leeson, Paul; Mangia, Cristina; Gaibazzi, Nicola; Tuttolomondo, Domenico; Prota, Costantina; Peteiro, Jesus; Van De Heyning, Caroline M.; D’Andrea, Antonello; Rigo, Fausto; Nikolic, Aleksandra; Ostojic, Miodrag; Lowenstein, Jorge; Arbucci, Rosina; Haber, Diego M. Lowenstein; Merlo, Pablo M.; Wierzbowska-Drabik, Karina; Kasprzak, Jaroslaw D.; Haberka, Maciej; Camarozano, Ana Cristina; Ratanasit, Nithima; Mori, Fabio; D’Alfonso, Maria Grazia; Tassetti, Luigi; Milazzo, Alessandra; Olivotto, Iacopo; Marchi, Alberto; Rodriguez-Zanella, Hugo; Zagatina, Angela; Padang, Ratnasari; Dekleva, Milica; Djordievic-Dikic, Ana; Boskovic, Nikola; Tesic, Milorad; Giga, Vojislav; Beleslin, Branko; Di Salvo, Giovanni; Lorenzoni, Valentina; Cameli, Matteo; Mandoli, Giulia Elena; Bombardini, Tonino; Caso, Pio; Celutkiene, Jelena; Barbieri, Andrea; Benfari, Giovanni; Bartolacelli, Ylenia; Malagoli, Alessandro; Bursi, Francesca; Mantovani, Francesca; Villari, Bruno; Russo, Antonello; De Nes, Michele; Carpeggiani, Clara; Monte, Ines; Re, Federica; Cotrim, Carlos; Bilardo, Giuseppe; Saad, Ariel K.; Karuzas, Arnas; Matuliauskas, Dovydas; Colonna, Paolo; Antonini-Canterin, Francesco; Pepi, Mauro; Pellikka, Patricia A.; The Stress Echo 2030 Study Group of the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI)
    With stress echo (SE) 2020 study, a new standard of practice in stress imaging was developed and disseminated: the ABCDE protocol for functional testing within and beyond CAD. ABCDE protocol was the fruit of SE 2020, and is the seed of SE 2030, which is articulated in 12 projects: 1-SE in coronary artery disease (SECAD); 2-SE in diastolic heart failure (SEDIA); 3-SE in hypertrophic cardiomyopathy (SEHCA); 4-SE post-chest radiotherapy and chemotherapy (SERA); 5-Artificial intelligence SE evaluation (AI-SEE); 6-Environmental stress echocardiography and air pollution (ESTER); 7-SE in repaired Tetralogy of Fallot (SETOF); 8-SE in post-COVID-19 (SECOV); 9: Recovery by stress echo of conventionally unfit donor good hearts (RESURGE); 10-SE for mitral ischemic regurgitation (SEMIR); 11-SE in valvular heart disease (SEVA); 12-SE for coronary vasospasm (SESPASM). The study aims to recruit in the next 5 years (2021–2025) ≥10,000 patients followed for ≥5 years (up to 2030) from ≥20 quality-controlled laboratories from ≥10 countries. In this COVID-19 era of sustainable health care delivery, SE2030 will provide the evidence to finally recommend SE as the optimal and versatile imaging modality for functional testing anywhere, any time, and in any patient.
    2021-08-17Journal article Open access Show more