ORCID Profile
0000-0002-8456-609X
Current Organisations
European Society Of Cardiology
,
European Society of Cardiovascular Prevention and Rehabilitation
,
Società Italiana di Cardiologia
,
IRCCS Policlinico San Donato
,
Università degli Studi di Milano
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Publications
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Publisher: Wiley
Date: 20-05-2016
DOI: 10.1002/EJHF.592
The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis
Publisher: Oxford University Press (OUP)
Date: 06-08-2011
Abstract: A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF). We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using in idual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation) hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.
The Right Heart International Network (RIGHT-NET)
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.HFC.2018.03.010
Abstract: The Right Heart International Network is a multicenter international study aiming to prospectively collect exercise Doppler echocardiography tests of the right heart pulmonary circulation unit (RHPCU) in large cohorts of healthy subjects, elite athletes, and in iduals at risk of or with overt pulmonary hypertension. It is going to provide standardization of exercise stress echocardiography of RHPCU and explore the full physiopathologic response.
Relationship of serum sodium concentration to mortality in a wide spectrum of heart failure patients with preserved and with reduced ejection fraction: an individual patient data meta‐analysis†
Publisher: Wiley
Date: 10-2012
Abstract: Hyponatraemia has been associated with reduced survival in patients with heart failure and reduced ejection fraction (HF-REF). The relationship between serum sodium and outcome is unclear in heart failure with preserved (≥ 50%) ejection fraction (HF-PEF). Therefore, we used a large in idual patient data meta-analysis to study the risk of death associated with hyponatraemia in HF-REF and in HF-PEF. This analysis included 14 766 patients from 22 studies that recruited patients without ejection fraction inclusion criterion at baseline and reported death from any cause. Cox proportional analysis was undertaken for hyponatraemia (sodium <135 mmol/L), adjusted for variables of clinical relevance, and stratified by study. The endpoint was death from any cause at 3 years. Patients with hyponatraemia (n = 1618) and patients with normal serum sodium had similar characteristics as regards to age, gender, and ischaemic aetiology. However, patients with hyponatraemia had higher New York Heart Association class and lower blood pressure. At follow-up, there were 335 deaths among 1618 patients with hyponatraemia (21%) and 2128 deaths among 13 148 patients with normal serum sodium (16%). The risk of death appeared to increase linearly with serum sodium levels <140 mmol/L. Hyponatraemia was identified in 1199 HF-REF patients (11%) and 419 HF-PEF patients (11%). Hyponatraemia was independently predictive of death in both HF-REF [adjusted hazard ratio (HR) 1.69, 95% confidence interval (CI) 1.50-1.91] and HF-PEF (adjusted HR 1.40, 95% CI 1.10-1.79, P for interaction 0.20). Hyponatraemia is a powerful determinant of mortality in patients with HF regardless of ejection fraction. Further work is needed to determine if correction of hyponatraemia translates into clinical benefit.
Right Ventricular Functional Reserve in Early-Stage Idiopathic Pulmonary Fibrosis
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.CHEST.2018.11.015
Abstract: The most important determinant of long-term survival in patients with idiopathic pulmonary fibrosis is the right ventricular (RV) adaptation to the increased pulmonary vascular resistance. Our aim was to explore RV contractile reserve during stress echocardiography in early-stage IPF. Fifty early-stage patients with IPF and 50 healthy control patients underwent rest and stress echocardiography, including RV two-dimensional speckle tracking echocardiography. At peak exertion, blood gas analysis and spirometry were also assessed. At rest, RV diameters were mildly increased in IPF however, although RV conventional systolic function indexes were similar between the IPF and control groups, RV global longitudinal strain and RV lateral wall longitudinal strain (LWLS) were significantly reduced in the IPF cohort. During physical exercise, patients with IPF showed a reduced exercise tolerance with lower maximal workload (P < .01), level of oxygen saturation (P < .001), and peak heart rate (P < .01). Systolic and diastolic BP values were similar in both groups. Systolic pulmonary artery pressure (PAPs) increase (ΔPAPs) during exertion was higher in IPF vs healthy subjects (P < .0001) RV LWLS increase (ΔRV LWLS) during exercise was lower in patients with IPF vs control patients (P < .00001). By multivariable analysis, RV LWLS at rest and ΔRV LWLS were directly related to peak exertion capacity, PAPs, and blood oxygen saturation level (Spo RV myocardial dysfunction is already present at rest in early-stage IPF and worsens during exertion as detected by two-dimensional speckle-tracking echocardiography. The RV altered contractile reserve appears to be related to reduced exercise tolerability and impaired pulmonary hemodynamic.
Prognostic significance of anaemia in patients with heart failure with preserved and reduced ejection fraction: results from the MAGGIC individual patient data meta-analysis
Publisher: Oxford University Press (OUP)
Date: 14-05-2015
DOI: 10.1093/QJMED/HCV087
Related Organisations
European Society Of Cardiovascular Prevention And Rehabilitation
Location: Italy
Boston University School Of Medicine
Location: United States of America
Tufts University School Of Medicine
Location: United States of America
Università Degli Studi Di Milano Facoltà Di Medicina E Chirurgia
Location: Italy
Related Funding Activities
No related grants have been discovered for Marco Guazzi.