Publications by authors named "Rodolfo Citro"

Background: Exercise transthoracic Doppler echocardiography (TTE) is considered suggestive of left ventricular (LV) diastolic dysfunction when the ratio of mitral Doppler E to tissue Doppler e' waves is >15 with or without a peak tricuspid regurgitation velocity (TRV) >3.4 m/s. However, these measurements may be affected by exercise intensity.

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Prevention of dementia represents a public health priority. Hypertension is a risk factor for mild cognitive impairment (MCI), a precursor to progressive dementia. A great effort is underway to develop accurate and sensitive tools to detect the MCI condition in hypertensive patients.

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Background: The impact of the COAPT results on clinical practice has not yet been investigated in large real-world cohort study. The aim of the study is to evaluate the potential impact of the COAPT trial by analyzing the temporal trends of baseline characteristics and outcome of secondary mitral regurgitation (SMR) patients undergoing MitraClip (MC) included in the GIOTTO registry.

Methods: The study population was divided into 2 groups, considering the enrolment before or after the COAPT publication.

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Background: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous entity including different phenotypes of near normal, normal, and supernormal left ventricular (LV) function. The aim of this study was to assess the value of resting LV elastance (also known as force) using transthoracic echocardiography to identify HFpEF phenotypes.

Methods: In a prospective, observational, multicenter study, 2,380 patients with HFpEF were recruited from July 2016 to May 2024.

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Background: Bicuspid aortic valve (BAV) is the most common congenital heart defect in adults, often leading to complications such as thoracic aortic aneurysms and aortic stenosis. While BAV is frequently associated with 22q11.2 deletion syndrome (22q11.

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  • This study investigates how right ventricular (RV) dysfunction affects the outcomes of patients with low-flow, low-gradient aortic stenosis (LFLG-AS) who are undergoing transcatheter aortic valve replacement (TAVR).
  • Utilizing data from two Italian centers, it was found that RV dysfunction is linked to a significantly increased risk of all-cause death and major cardiovascular events after one year.
  • The findings suggest that assessing RV dysfunction before TAVR can enhance the ability to predict patient prognosis.
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  • The study investigates the significance of cardiac troponin (cTn) levels in predicting mortality in patients with Takotsubo syndrome (TTS), analyzing data from the International Takotsubo Registry.
  • It identifies that a cTn increase greater than 28.8 times the upper reference limit signals clinically relevant myocardial injury, correlating with a higher risk of mortality over 5 years (adjusted HR 1.58).
  • The findings enhance understanding of patient risk profiles in TTS, emphasizing the need for increased monitoring and follow-up for those with significant troponin elevations.
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Hypercontractile phenotype (HP) of the left ventricle (LV) is an actionable therapeutic target in patients with chronic coronary syndromes (CCS) or heart failure (HF), but its clinical recognition remains difficult. To assess the clinical variables associated with the HP. In a prospective, observational, multicenter study, we recruited 5122 patients (age 65 ± 11 years, 2974 males, 58%) with CCS and/or HF with preserved ejection fraction (EF).

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Bicuspid aortic valve (BAV), the most common congenital heart defect, is a major cause of aortic valve disease requiring valve interventions and thoracic aortic aneurysms predisposing to acute aortic dissections. The spectrum of BAV ranges from early onset valve and aortic complications (EBAV) to sporadic late onset disease. Rare genomic copy number variants (CNVs) have previously been implicated in the development of BAV and thoracic aortic aneurysms.

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  • * Researchers analyzed whole-exome sequences from 215 families affected by EBAV, finding that 50% contained harmful gene variants related to BAV and related heart conditions.
  • * A total of 129 genetic variants were identified in 54 candidate genes associated with congenital heart issues, supporting the idea that specific rare genetic changes contribute to the severity of BAV.
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  • The study investigated changes in demographics, risk factors, clinical presentations, and outcomes of takotsubo syndrome (TTS) patients from 2004 to 2021, using data from the InterTAK registry.
  • Over the years, the proportion of male patients increased, and there was a rise in cases of midventricular TTS as well as significant growth in the incidence of physical triggers.
  • There was also a notable increase in 60-day mortality rates, although no significant change in 1-year mortality when excluding early deaths was observed, indicating a complex evolution of TTS and its management in recent years.
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Takotsubo syndrome (TTS) might exhibit particular chronobiological patterns in its onset, characterized by variations according to time of the day, day of the week, and month of the year. The aim of this study was to fully explore the temporal patterns (circadian, weekly and seasonal) in the onset of TTS. A systematic review and meta-analysis of literature were conducted for studies (2006-2024) reporting the temporal patterns (circadian, weekly and/or seasonal) in the onset of TTS.

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  • * Exercise pulmonary hypertension (PH) can be identified through exercise stress echocardiography (ESE) and is significant in predicting symptoms and mortality in HVD patients.
  • * This review seeks to summarize the prognostic importance of exercise PH in valvular diseases and explore its potential integration into the diagnostic and treatment protocols for HVD.*
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Background: Clinical outcomes of bicuspid aortic valve (BAV) patients with ascending aortic diameters ≥50 mm who are under surveillance are poorly defined.

Objectives: The purpose of this study was to assess clinical outcomes in BAV patients with ascending aorta ≥50 mm.

Methods: Multicenter retrospective cohort study of BAV adults with ascending aorta diameters ≥50 mm by transthoracic echocardiography (TTE).

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  • * A study reporting five cases of ApHCM showed signs of intramyocardial calcification through echocardiograms and MRI findings, which suggested endomyocardial fibrosis (EMF) – a condition involving scarring of the heart tissue that can lead to further complications.
  • * The analysis of patient histories indicated common inflammatory triggers, suggesting that these factors could contribute to small vessel disease and ischemic microvascular stress in conjunction with heart muscle thickening, ultimately resulting in fibrosis and calcification.
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  • - The study aimed to assess how the presence of raphe (a type of anatomical feature) in patients with bicuspid aortic valve (BAV) correlates with valve dysfunction, aortopathy, and the likelihood of needing aortic valve surgery.
  • - Researchers analyzed 695 BAV patients, finding that those with raphe experienced more moderate to severe aortic stenosis and a higher prevalence of aortopathy, particularly Type B, compared to those without raphe.
  • - The results indicated that having raphe significantly raises the odds of requiring aortic valve surgery within three years, highlighting the importance of monitoring patients with this anatomical feature.
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  • Bicuspid aortic valve (BAV) is the most common congenital heart defect in adults, but it can also lead to serious issues in children.
  • Adults with significant BAV complications before age 30 tend to have more severe symptoms, require more surgeries, and often have additional heart defects compared to those whose BAV issues arise after age 50.
  • This underscores the importance of early detection, ongoing monitoring, and focused treatment strategies for patients experiencing early complications from BAV.
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Bicuspid Aortic Valve (BAV) is the most common adult congenital heart lesion with an estimated population prevalence of 1%. We hypothesize that early onset complications of BAV (EBAV) are driven by specific impactful genetic variants. We analyzed whole exome sequences (WES) to identify rare coding variants that contribute to BAV disease in 215 EBAV families.

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  • The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to investigate stress echocardiography (SE) practices across Italy, collecting data from 228 laboratories in November 2022.
  • The survey revealed that out of 179 centers performing SE, most were located in northern Italy, and the study categorized them into low, moderate, and high volume of activity based on the number of SE examinations.
  • Key findings indicated differences in the use of stressors, with a tendency for high-volume centers to employ multiple stress techniques and incorporate advanced evaluations like coronary flow velocity reserve (CFVR) more frequently than low and moderate volume centers.
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Introduction: Bicuspid aortic valve (BAV) is the most common congenital heart disease with an increased risk of infective endocarditis (IE). Few data are available on isolated native BAV-IE. The aim of this study was to compare patients with tricuspid aortic valve (TAV) IE and BAV-IE in terms of characteristics, management and prognosis.

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