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FRANCESCO PASQUALE

DOTTORANDO DI ALTRA UNIVERSITA
Dipartimento di Ingegneria "Enzo Ferrari"


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Pubblicazioni

2019 - Long-Term Implications of Atrial Fibrillation in Patients With Degenerative Mitral Regurgitation [Articolo su rivista]
Grigioni, F.; Benfari, G.; Vanoverschelde, J. -L.; Tribouilloy, C.; Avierinos, J. -F.; Bursi, F.; Suri, R. M.; Guerra, F.; Pasquet, A.; Rusinaru, D.; Marcelli, E.; Theron, A.; Barbieri, A.; Michelena, H.; Lazam, S.; Szymanski, C.; Nkomo, V. T.; Capucci, A.; Thapa, P.; Enriquez-Sarano, M.; for the MIDA Investigators Clavel, M. A.; Maalouf, J.; Trojette, F.; Szymanski, C.; Touati, G.; Remadi, J. P.; Russo, A.; Biagini, E.; Pasquale, F.; Ferlito, M.; Rapezzi, C.; Savini, C.; Marinelli, G.; Pacini, D.; Gargiulo, G. D.; Di Bartolomeo, R.; Boulif, J.; de Meester, C.; El Khoury, G.; Gerber, B.; Noirhomme, P.; Vancraeynest, D.; Collard, F.; Habib, G.; Mantovani, F.; Lugli, R.; Modena, M. G.; Boriani, G.; Bacchi-Reggiani, L.
abstract

Background: Scientific guidelines consider atrial fibrillation (AF) complicating degenerative mitral regurgitation (DMR) a debated indication for surgery. Objectives: This study analyzed the prognostic/therapeutic implications of AF at DMR diagnosis and long-term. Methods: Patients were enrolled in the MIDA (Mitral Regurgitation International Database) registry, which reported the consecutive, multicenter, international experience with DMR due to flail leaflets echocardiographically diagnosed. Results: Among 2,425 patients (age 67 ± 13 years; 71% male, 67% asymptomatic, ejection fraction 64 ± 10%), 1,646 presented at diagnosis with sinus rhythm (SR), 317 with paroxysmal AD, and 462 with persistent AF. Underlying clinical/instrumental characteristics progressively worsened from SR to paroxysmal to persistent AF. During follow-up, paroxysmal and persistent AF were associated with excess mortality (10-year survival in SR and in paroxysmal and persistent AF was 74 ± 1%, 59 ± 3%, and 46 ± 2%, respectively; p < 0.0001), that persisted 20 years post-diagnosis and independently of all baseline characteristics (p values <0.0001). Surgery (n = 1,889, repair 88%) was associated with better survival versus medical management, regardless of all baseline characteristics and rhythm (adjusted hazard ratio: 0.26; 95% confidence interval: 0.23 to 0.30; p < 0.0001) but post-surgical outcome remained affected by AF (10-year post-surgical survival in SR and in paroxysmal and persistent AF was 82 ± 1%, 70 ± 4%, and 57 ± 3%, respectively; p < 0.0001). Conclusions: AF is a frequent occurrence at DMR diagnosis. Although AF is associated with older age and more severe presentation of DMR, it is independently associated with excess mortality long-term after diagnosis. Surgery is followed by improved survival in each cardiac rhythm subset, but persistence of excess risk is observed for each type of AF. Our study indicates that detection of AF, even paroxysmal, should trigger prompt consideration for surgery.


2013 - EURObservational Research Programme: Regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot) [Articolo su rivista]
Maggioni, A. P.; Dahlstrom, U.; Filippatos, G.; Chioncel, O.; Leiro, M. C.; Drozdz, J.; Fruhwald, F.; Gullestad, L.; Logeart, D.; Fabbri, G.; Urso, R.; Metra, M.; Parissis, J.; Persson, H.; Ponikowski, P.; Rauchhaus, M.; Voors, A. A.; Nielsen, O. W.; Zannad, F.; Tavazzi, L.; Alonso, A.; Ferrari, R.; Komajda, M.; Wood, D.; Manini, M.; Taylor, C.; Laroche, C.; Fiorucci, E.; Lucci, D.; Gonzini, L.; Auer, J.; Oberrauner, A.; Schumacher, M.; Ebner, C.; Hallas, A.; Espersen, G.; Gustafsson, F.; Mattsson, N.; Egstrup, K.; Aagaard, S.; Gohr, T.; Huld, K.; Knudsen, A.; Refsgaard, J.; Charniot, J.; Juillard, A.; Pon-Gabrielsen, P.; Douna, F.; Jondeau, G.; Jourdain, P.; Michel, L.; Hamm, C.; Lehinant, S.; Rieth, A.; Goeing, O.; Schultheiss, H. P.; Von-Schlippenbach, J.; Knollmann, R.; Neubuser, C.; Katus, H. A.; Taeger, T.; Zugck, C.; Fink, H.; Schulz, J.; Held, S.; Karmann, W.; Kreuzer, J.; Nitsche, K.; Winter, K.; Fahnrich, A.; Bruederlein, K.; Turan, C. H.; Berentelg, J.; Ittel, T.; Rubens, C.; Hanke, M.; Stoerk, S.; Chrysohoou, C.; Kaldara, E.; Karavidas, A.; Margari, R.; Matzaraki, V.; Nanas, J.; Pozios, I.; Psarogiannakopoulos, P.; Pyrgakis, V.; Stefanadis, C.; Terrovitis, J.; Trikas, A.; Xydonas, S.; Patrianakos, A.; Vardas, P.; Douras, A.; Nastas, J.; Ntertsas, K.; Tsaknakis, T.; Midi, P.; Pajes, G.; Moretti, L.; Partemi, M.; Barberini, F.; Branzi, A.; Gallelli, I.; Grigioni, F.; Ionico, T.; Pasquale, F.; Cas, L.; Delmagro, F.; Tanghetti, E.; Vaccari, A.; Mercuro, G.; Arcuri, G. M.; Marinacci, L.; Severini, D.; Cosmi, F.; Bosi, S.; Di Tano, G.; Pirelli, S.; Ferrari, R.; Fucili, A.; Minneci, C.; Santoro, G. M.; Correale, M.; Di Biase, M.; Buccolieri, M.; Mandorla, S.; Martinelli, S.; Barbiero, M.; Giordano, A.; Zanelli, E.; Agostoni, P.; Fiorentini, C.; Salvioni, E.; Leuzzi, C.; Modena, M. G.; Reggianini, L.; Cobelli, F.; Opasich, C.; Baldini, P.; Romei, M.; Pulitano, G.; Ruggeri, A.; Bologna, F.; Piovaccari, G.; Brasolin, B.; Fedele, F.; Merlo, M.; Sinagra, G.; Albanese, M. C.; Miani, D.; Linssen, G.; Rodijk, E.; Pinto, Y.; Van Donk, P.; Dunselman, P.; Lok, D.; Brouwers, F.; De Jong, R. M.; Boen, R.; Hole, T.; Rasmussen, L.; Christiansen, E. M.; Gjertsen, E.; Lyng, J.; German, M.; Hogalmen, G.; Skardal, R.; Apelland, T.; Borgen, M.; Forfang, E.; Baak, T.; Dickstein, K.; Olsen, I.; Stachurski, D.; Juszczyk, Z.; Stankala, S.; Gilewski, W.; Sinkiewicz, W.; Kasztelowicz, P.; Gabryel, J.; Kardaszewicz, P.; Lazorko-Piega, M.; Bellwon, J.; Mosakowska, K.; Rynkiewicz, A.; Olczyk, S.; Pagorek, M.; Bartlinski, R.; Borej, G.; Tarchalski, J.; Bartkowiak, R.; Sosnowska-Pasiarska, B.; Wozakowska-Kaplon, B.; Krzeminski, A.; Bury, K.; Grzegorzko, A.; Mirek-Bryniarska, E.; Nessler, J.; Zabojszcz, M.; Broncel, M.; Poliwczak, A.; Retwinski, A.; Soska, K.; Grajek, S.; Straburzynska-Migaj, E.; Kuzniar, J.; Rzeszuto, T.; Bednarczyk, G.; Ruszkowski, P.; Piasecka-Krysiak, E.; Zambrzycki, J.; Nowak, T.; Szelemej, R.; Balsam, P.; Folga, A.; Kaplon-Cieslicka, A.; Kowalewski, S.; Mamcarz, A.; Marchel, M.; Opolski, G.; Welnicki, M.; Jankowska, E.; Nowak, J.; Nowalany-Kozielska, E.; Rozentryt, P.; Zembala, M.; Kleinrok, A.; Prokop-Lewicka, G.; Kudlinska, B.; Radoi, M.; Macarie, C.; Vinereanu, D.; Capalneanu, R.; Giuca, A.; Ionescu, D. D.; Nechita, E.; Datcu, M.; Istrate, C.; Vladoianu, M.; Christodorescu, R.; Salguero, R.; Blanco, V. M.; Lavilla, M. A.; Comin-Colet, J.; Cantillo, D.; Bernal, J.; del Prado, J. M.; Pita, A.; Aguero, J.; Jimenez, J. F.; Calvo, F.; Gonzalez, R.; Molina, B.; Luengos, D.; Lostal, C.; Bonet, L.; Gonzalez, P.; Soriano, F.; Campos, M. J.; Karlstrom, P.; Nyrinder, I.; Olsson, B.; Pettersson, T.; Stenberg, A.; Lindmark, K.; Asserlund, B.
abstract

AimsThe ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.MethodsThe ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.ConclusionThe ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network. © 2013 The Author.