Publications by authors named "Andrea Attanasio"

Background And Aims: Despite the advancements in the treatment of patients with heart failure with reduced ejection fraction (HFrEF), clinical inertia regarding the prescription of the four classes of guidelines-directed medical therapies (GDMT) remains prevalent. This study aims to assess how adherence and time of prescription to GDMT in HFrEF impact mortality. Additionally, it seeks to evaluate sex differences in prescription, and outcome.

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: The cardiovascular effects of SARS-CoV-2, including autonomic dysregulation, are becoming increasingly recognized, even following mild infections. However, long-term electrocardiographic (ECG) changes remain poorly characterized. : We conducted a prospective study of 151 unvaccinated healthcare workers with RT-PCR-confirmed mild to moderate SARS-CoV-2 infection.

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Despite advances in cancer treatments with significant improvement in patient outcomes, chemotherapy, targeted molecular therapies and radiotherapy may cause a range of cardiovascular complications, such as cancer therapy-related cardiac dysfunction (CTRCD), which represents a broad spectrum of possible presentation and aetiological link with the broad scope of various cancer therapies, including chemotherapy, targeted agents, immunotherapies, and radiation therapy, aiming at reducing the associated morbidity and mortality. However, practical guidelines on the primary prevention of CTRCD in high-risk patients, a key element in improving prognosis, are lacking in cancer patients and related evidence remains inconclusive. This Clinical Consensus Statement, authored by experts from the Heart Failure Association (HFA) and the European Association of Preventive Cardiology (EAPC) of the European Society of Cardiology (ESC), and the ESC Council of Cardio-Oncology, aims to discuss the definition and epidemiology of CTRCD, the implicated factors for risk stratification, and the appropriate early diagnostic pathways, while focusing on lifestyle modifications, and pharmacological interventions to reduce the incidence of CTRCD.

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Aims: Anomalous Aortic Origin of Coronary Arteries (AAOCA) is associated with myocardial ischaemia and sudden cardiac death, particularly in young athletes. Although inducible myocardial ischaemia investigation is generally recommended, there is no clear indication of the most appropriate stress test, as the ECG exercise stress test presents low diagnostic accuracy. Dobutamine-stress cardiac magnetic resonance (dsCMR) has been proposed as a promising diagnostic tool, but its application has been limited to paediatric populations.

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Background: For the time being, tafamidis is the only approved treatment for wild-type transthyretin cardiac amyloidosis. However, benefits on all-cause death only emerge after ≈18 months. The current available staging systems are unable to specifically discriminate patients at high risk of death within 18 months from diagnosis, and the selection of patients who are expected to benefit from tafamidis is left to the clinical judgment of treating physicians, being often based primarily (and sometimes only) on age.

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Background: Cardiovascular magnetic resonance (CMR) is the gold-standard to estimate right ventricular (RV) volumes, which are key for clinical management of patients with repaired tetralogy of Fallot (rTOF). Semi-automated threshold-based methods (SAT) have been proposed for CMR post-processing as alternatives to fully manual standard tracing. We investigated the impact of SAT on RV analysis using different thresholds in rTOF patients.

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Article Synopsis
  • The HF syndrome involves an imbalance in the autonomic nervous system, leading to an increase in sympathetic activity and various cardiac changes that result in chronotropic incompetence (CI), or the inability to raise heart rate with activity.
  • CI is linked to decreased exercise capacity and poorer health outcomes, and the definition of CI can vary, complicating its assessment.
  • While β-blockers can lower peak heart rate, they improve prognosis in heart failure, and strategies like rate-adapting pacing are being explored to address the reduced heart rate response during exercise.
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  • Fabry Disease cardiomyopathy (FDc) and sarcomeric hypertrophic cardiomyopathy (HCM) show similar hypertrophic heart features, particularly anomalies of the mitral valve apparatus (AMVA), which were assessed in this study for better diagnosis and understanding of disease progression.
  • The study involved 80 Fabry patients and 40 HCM patients, utilizing cardiovascular magnetic resonance (CMR) imaging to measure various AMVA and compare groups with similar levels of left ventricular hypertrophy.
  • Results indicated that Fabry patients exhibited greater hypertrophy of papillary muscles compared to HCM patients, alongside significant anomalies like apical displacement, supporting the idea that AMVA may serve as early indicators in Fabry disease. *
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cardiomyopathy is a rare genetic disorder that manifests early in life with an autosomal dominant inheritance pattern. It harbors left ventricular hypertrophy (LVH), ventricular pre-excitation and progressively worsening conduction system defects. Its estimated prevalence among patients with LVH ranges from 0.

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Background: Early identification of immunoglobulin light-chain amyloidosis (AL) is crucial due to its rapid progression. Monoclonal light-chain (M-LC) testing is the first step in the diagnostic workup for patients with suspected cardiac amyloidosis (CA). We aimed to determine whether the time interval between the first CA suspicion and M-LC testing can be related to AL amyloidosis survival outcomes.

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Article Synopsis
  • Daratumumab-based treatments are considered the new standard therapy for newly diagnosed AL amyloidosis patients, supported by findings from the ANDROMEDA study.
  • A prospective observational study involving 88 newly diagnosed patients explored daratumumab's efficacy and safety, revealing a low rate of serious side effects (16%) and a high overall hematologic response rate of 75%.
  • The study found that daratumumab was effective in advanced cases, with similar rates of hematologic and organ responses between patients with more severe disease stages and those with less severe stages.
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