1
|
Guerra F, Pimpini L, Flori M, Contadini D, Stronati G, Gioacchini F, Massara M, Gennaro F, Antonicelli R, Busacca P, Luzi M, Dello Russo A, Marchese P. Sacubitril/valsartan reduces atrial fibrillation and supraventricular arrhythmias in patients with HFrEF and remote monitoring: preliminary data from the SAVE THE RHYTHM. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0926] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sacubitril/valsartan, the first combined angiotensin receptor-neprilysin inhibitor, has demonstrated a significant benefit compared to angiotensin inhibitor in decreasing ventricular arrhythmias and appropriate implantable cardioverter defibrillator (ICD) shocks in patients with heart failure with reduced ejection fraction (HFrEF). At present, there is no study which evaluates the effect of sacubitril/valsartan on the supraventricular arrhythmic burden in HFrEF patients with an ICD or cardiac resynchronisation therapy-defibrillator (CRT-D) and remote monitoring.
Purpose
To evaluate the effect of sacubitril/valsartan on the supraventricular arrhythmic burden in HFrEF patients with an ICD or CRTD and remote monitoring.
Methods
The SAVETHERHYTHM ((SAacubitril Valsartan rEal-world registry evaluating THE arRHYTHMia burden in HFrEF patients with implantable cardioverter defibrillator) is a multicentre, observational, prospective registry enrolling all patients with HFrEF, ICD or CRT-D actively followed through remote monitoring and starting treatment with sacubitril/valsartan. All patients are followed-up for at least one year after sacubitril/valsartan start. The primary endpoint is the mean number of sustained atrial tachycardia or atrial fibrillation (AT/AF) episodes per month. Secondary endpoints include the total burden of AT/AF (defined as the percentage of time in AT/AF per day), the mean number of premature ventricular contractions (PVC) per hour and the percentage of biventricular pacing per day (in patients with CRT-D). All primary and secondary endpoints are collected through remote monitoring.
Results
At the time of the first ad interim analysis, 60 patients (85.2% male, age 69±10 years) were consecutively enrolled. After treatment with sacubitril/valsartan, patients with at least one episode of AT/AF per month decreased from 32.8% to 21.3% (p=0.015). A significant decrease in number of AT/AF episodes (from 4.3 to 1.2 per year), in AT/AF burden (from 12% to 9%) and in number of PVC (from 83 to 74 per hour) were seen in patients with a previous diagnosis of paroxysmal or persistent AF (n=15; all p<0.05). Patients with permanent AF (n=7) experienced no benefits from sacubitril/valsartan therapy in terms of arrhythmic burden reduction. Patients with no previous history of AF (n=38) showed a decrease in number of AT/AF episodes (from 2.0 to 0.8 per year) and in number of PVC (from 77 to 49 per hour, all p<0.05). No new diagnosis of clinical AF was made after starting treatment with sacubitrl/valsartan, and patients with subclinical AT/AF episodes decreased from 8% to 3%.
Conclusions
Preliminary data suggest that therapy with sacubitril/valsartan could decrease arrhythmic burden in patients with non-permanent AF and reduce subclinical AT/AF episodes in patients with no history of AF. No positive effect has been noted in patients with permanent AF.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- F Guerra
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - L Pimpini
- National Institute of Hospital and Care for Elderly (INRCA), Department of Cardiology, Ancona, Italy
| | - M Flori
- Ospedale della Misericordia, Department of Cardiology, Urbino, Italy
| | - D Contadini
- General Hospital, Department of Cardiology, Macerata, Italy
| | - G Stronati
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - F Gioacchini
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - M.F Massara
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - F Gennaro
- Cardiology ASUR-AV5 Mazzoni Hospital, Department of Cardiology, Ascoli Piceno, Italy
| | - R Antonicelli
- National Institute of Hospital and Care for Elderly (INRCA), Department of Cardiology, Ancona, Italy
| | - P Busacca
- Ospedale della Misericordia, Department of Cardiology, Urbino, Italy
| | - M Luzi
- General Hospital, Department of Cardiology, Macerata, Italy
| | - A Dello Russo
- Marche Polytechnic University of Ancona, Cardiology and Arrhythmology Clinic, Ancona, Italy
| | - P Marchese
- Cardiology ASUR-AV5 Mazzoni Hospital, Department of Cardiology, Ascoli Piceno, Italy
| |
Collapse
|
2
|
Simonelli M, Massara M, Persico P, Capucetti A, Lorenzi E, Lugli E, Dipasquale A, Nibali M, Rossi M, Bello L, Locati M, Bonecchi R. P04.86 Correlation between activated infiltrating neutrophils and MGMT methylation in patients with diffuse malignant gliomas (MGs). Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Simonelli
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
- Humanitas University, Pieve Emanuele (MI), Italy
| | - M Massara
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
- Università degli Studi di Milano, Milano, Italy
| | - P Persico
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
| | - A Capucetti
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
| | - E Lorenzi
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
| | - E Lugli
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
| | - A Dipasquale
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
| | - M Nibali
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
| | - M Rossi
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
| | - L Bello
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
| | - M Locati
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
- Università degli Studi di Milano, Milano, Italy
| | - R Bonecchi
- Humanitas Clinical and Research Center, Rozzano (MI), Italy
- Humanitas University, Pieve Emanuele (MI), Italy
| |
Collapse
|
3
|
Barillà D, Massara M, Volpe A, Versace P, Volpe P. Re: ‘How Should I Treat a Patient with a Tandem Carotid Artery Atherosclerotic Stenosis Involving the Internal Carotid Artery and the Innominate/Proximal Common Carotid Artery?’. Eur J Vasc Endovasc Surg 2016; 51:313-4. [DOI: 10.1016/j.ejvs.2015.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 10/10/2015] [Indexed: 11/30/2022]
|
4
|
Mazzini L, Ferrero I, Luparello V, Rustichelli D, Gunetti M, Mareschi K, Testa L, Stecco A, Tarletti R, Miglioretti M, Fava E, Nasuelli N, Cisari C, Massara M, Vercelli R, Oggioni GD, Carriero A, Cantello R, Monaco F, Fagioli F. Mesenchymal stem cell transplantation in amyotrophic lateral sclerosis: A Phase I clinical trial. Exp Neurol 2009; 223:229-37. [PMID: 19682989 DOI: 10.1016/j.expneurol.2009.08.007] [Citation(s) in RCA: 294] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 07/31/2009] [Accepted: 08/02/2009] [Indexed: 01/01/2023]
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a devastating incurable disease. Stem-cell-based therapies represent a new possible strategy for ALS clinical research. The objectives of this Phase 1 clinical study were to assess the feasibility and toxicity of mesenchymal stem cell transplantation and to test the impact of a cell therapy in ALS patients. The trial was approved and monitored by the National Institute of Health and by the Ethics Committees of all participating Institutions. Autologous MSCs were isolated from bone marrow, expanded in vitro and analyzed according to GMP conditions. Expanded MSCs were suspended in the autologous cerebrospinal fluid (CSF) and directly transplanted into the spinal cord at a high thoracic level with a surgical procedure. Ten ALS patients were enrolled and regularly monitored before and after transplantation by clinical, psychological, neuroradiological and neurophysiological assessments. There was no immediate or delayed transplant-related toxicity. Clinical, laboratory, and radiographic evaluations of the patients showed no serious transplant-related adverse events. Magnetic resonance images (MRI) showed no structural changes (including tumor formation) in either the brain or the spinal cord. However the lack of post mortem material prevents any definitive conclusion about the vitality of the MSCs after transplantation. In conclusion, this study confirms that MSC transplantation into the spinal cord of ALS patients is safe and that MSCs might have a clinical use for future ALS cell based clinical trials.
Collapse
Affiliation(s)
- L Mazzini
- Department of Neurology Eastern Piedmont University, Maggiore della Carità Hospital, 28100 Novara, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Bogliani G, Massara M. Optimal prey size for chicks of two species of single-prey loaders. ETHOL ECOL EVOL 1990. [DOI: 10.1080/08927014.1990.9525426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|