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Spitaleri G, Brugaletta S, Potena L, Mirabet S, González-Costello J, Zucchetti O, Masetti M, Asmarats L, Gual M, Nardi E, Di Girolamo D, Campo G, Farrero M. Role of Quantitative Flow Ratio in Predicting Future Cardiac Allograft Vasculopathy in Heart Transplant Recipients. Circ Cardiovasc Interv 2022; 15:e011656. [PMID: 35580200 DOI: 10.1161/circinterventions.121.011656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Coronary angiography is the gold standard for cardiac allograft vasculopathy (CAV) diagnosis, but it usually detects the disease at an advanced stage. We investigated the role of quantitative flow ratio (QFR), a noninvasive tool to identify potentially flow-limiting lesions, in predicting CAV development in heart transplant recipients. METHODS Consecutive heart transplant recipients with no evidence of angiographic CAV at baseline coronary angiography were retrospectively included between January 2010 and December 2015, and QFR computation was performed. The relationship between vessel QFR and the occurrence of angiographic vessel-related CAV (≥50% stenosis) was assessed. RESULTS One hundred forty-three patients were included and QFR computation was feasible in 241 vessels. The median value of QFR at baseline coronary angiography was 0.98 (interquartile range, 0.94-1.00). During a median follow-up of 6.0 years (interquartile range, 4.6-7.8 years), vessel-related CAV occurred in 25 (10.4%) vessels. Receiver-operating characteristic curve analysis identified a QFR best cutoff of ≤0.95 (area under the curve, 0.81 [95% CI, 0.71-0.90]; P<0.001). QFR≤0.95 was associated with an increased risk of vessel-related CAV (adjusted hazard ratio, 20.87 [95% CI, 5.35-81.43]; P<0.001). In an exploratory analysis, QFR≤0.95 in at least 2 vessels was associated with higher incidence of cardiovascular death or late graft dysfunction (71.4% in recipients with 2-3 vessels affected versus 5.1% in recipients with 0-1 vessels affected, P<0.001). CONCLUSIONS In a cohort of heart transplant recipients, QFR computation at baseline coronary angiography may be a safe and reliable tool to predict vessel-related CAV and clinical outcomes at long-term follow-up.
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Affiliation(s)
- Giosafat Spitaleri
- Heart Failure Clinic and Cardiology Service, University Hospital Germans Trias i Pujol, Badalona, Spain (G.S.).,Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain (G.S., S.B., M.F.)
| | - Salvatore Brugaletta
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain (G.S., S.B., M.F.)
| | - Luciano Potena
- Heart Failure and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy (L.P., M.M.)
| | - Sonia Mirabet
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIB-SantPau, CIBERCV, Universidad Autónoma de Barcelona, Spain (S.M., L.A.)
| | - José González-Costello
- Advanced Heart Failure and Heart Transplant Unit, Heart Disease Institute, Bellvitge University Hospital, Bellvitge Biomedical Research Institute, Barcelona, Spain (J.G.-C., M.G.)
| | - Ottavio Zucchetti
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy (O.Z., G.C.)
| | - Marco Masetti
- Heart Failure and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy (L.P., M.M.)
| | - Lluis Asmarats
- Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIB-SantPau, CIBERCV, Universidad Autónoma de Barcelona, Spain (S.M., L.A.)
| | - Miquel Gual
- Advanced Heart Failure and Heart Transplant Unit, Heart Disease Institute, Bellvitge University Hospital, Bellvitge Biomedical Research Institute, Barcelona, Spain (J.G.-C., M.G.)
| | - Elena Nardi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy (E.N.)
| | - Domenico Di Girolamo
- Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.)
| | - Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy (O.Z., G.C.).,Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (G.C.)
| | - Marta Farrero
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain (G.S., S.B., M.F.)
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Biscaglia S, Uretsky BF, Tebaldi M, Erriquez A, Brugaletta S, Cerrato E, Quadri G, Spitaleri G, Colaiori I, Di Girolamo D, Scoccia A, Zucchetti O, D'Aniello E, Manfrini M, Pavasini R, Barbato E, Campo G. Angio-Based Fractional Flow Reserve, Functional Pattern of Coronary Artery Disease, and Prediction of Percutaneous Coronary Intervention Result: a Proof-of-Concept Study. Cardiovasc Drugs Ther 2021; 36:645-653. [PMID: 33830399 PMCID: PMC9270302 DOI: 10.1007/s10557-021-07162-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2021] [Indexed: 10/26/2022]
Abstract
PURPOSE Wire-based coronary physiology pullback performed before percutaneous coronary intervention (PCI) discriminates coronary artery disease (CAD) distribution and extent, and is able to predict functional PCI result. No research investigated if quantitative flow ratio (QFR)-based physiology assessment is able to provide similar information. METHODS In 111 patients (120 vessels) treated with PCI, QFR was measured both before and after PCI. Pre-PCI QFR trace was used to discriminate functional patterns of CAD (focal, serial lesions, diffuse disease, combination). Functional CAD patterns were identified analyzing changes in the QFR virtual pullback trace (qualitative method) or after computation of the QFR virtual pullback index (QVPindex) (quantitative method). QVPindex calculation was based on the maximal QFR drop over 20 mm and the length of epicardial coronary segment with QFR most relevant drop. Then, the ability of the different functional patterns of CAD to predict post-PCI QFR value was tested. RESULTS By qualitative method, 51 (43%), 20 (17%), 15 (12%), and 34 (28%) vessels were classified as focal, serial focal lesions, diffuse disease, and combination, respectively. QVPindex values >0.71 and ≤0.51 predicted focal and diffuse patterns, respectively. Suboptimal PCI result (post-PCI QFR value ≤0.89) was present in 22 (18%) vessels. Its occurrence differed across functional patterns of CAD (focal 8% vs. serial lesions 15% vs. diffuse disease 33% vs. combination 29%, p=0.03). Similarly, QVPindex was correlated with post-PCI QFR value (r=0.62, 95% CI 0.50-0.72). CONCLUSION Our results suggest that functional patterns of CAD based on pre-PCI QFR trace can predict the functional outcome after PCI. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov , number NCT02811796. Date of registration: June 23, 2016.
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Affiliation(s)
- Simone Biscaglia
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy.
| | | | - Matteo Tebaldi
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy
| | - Andrea Erriquez
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy
| | - Salvatore Brugaletta
- University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Enrico Cerrato
- San Luigi Gonzaga University Hospital, Orbassano and Infermi Hospital, Rivoli, Turin, Italy
| | - Giorgio Quadri
- San Luigi Gonzaga University Hospital, Orbassano and Infermi Hospital, Rivoli, Turin, Italy
| | - Giosafat Spitaleri
- University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Iginio Colaiori
- Interventional Cardiology Unit, S. Maria Nuova Hospital, Reggio Emilia, Italy
| | | | - Alessandra Scoccia
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy
| | - Ottavio Zucchetti
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy
| | - Emanuele D'Aniello
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy
| | - Marco Manfrini
- GVM Care & Research, Maria Cecilia Hospital, Cotignola, RA, Italy
| | - Rita Pavasini
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy
| | - Emanuele Barbato
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.,Cardiovascular Research Center, OLV Hospital, Aalst, Belgium
| | - Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, 44124, Cona, FE, Italy.,GVM Care & Research, Maria Cecilia Hospital, Cotignola, RA, Italy
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3
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Biscaglia S, Tebaldi M, Brugaletta S, Cerrato E, Erriquez A, Passarini G, Ielasi A, Spitaleri G, Di Girolamo D, Mezzapelle G, Geraci S, Manfrini M, Pavasini R, Barbato E, Campo G. Prognostic Value of QFR Measured Immediately After Successful Stent Implantation. JACC Cardiovasc Interv 2019; 12:2079-2088. [DOI: 10.1016/j.jcin.2019.06.003] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/16/2019] [Accepted: 06/04/2019] [Indexed: 12/12/2022]
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Cesaro A, Moscarella E, Gragnano F, Perrotta R, Diana V, Pariggiano I, Concilio C, Alfieri A, Cesaro F, Mercone G, Falato S, Esposito A, Di Girolamo D, Limongelli G, Calabrò P. Transradial access versus transfemoral access: a comparison of outcomes and efficacy in reducing hemorrhagic events. Expert Rev Cardiovasc Ther 2019; 17:435-447. [PMID: 31213156 DOI: 10.1080/14779072.2019.1627873] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Introduction: The radial artery is currently the most widely used access site for PCI procedures both acute and stable patient settings. Thanks to advantages in pharmacological therapy as well as in interventional devices, the rate of ischemic complications following PCI has significantly decreased. Nevertheless, this has been counterbalanced by an increased risk of periprocedural and late bleeding event, that can occur both at access and non-access sites. Choice of access site for PCI is of paramount importance to reduce the risk of access-related bleeding events. Areas covered: The aim of this review is to provide an overview of the actual available evidence comparing the transradial versus transfemoral approach to reduce hemorrhagic events. The most robust evidence comes from large randomized trials, partly also from observational registries, which compared the transradial and transfemoral approach. Expert opinion: Results show that radial access has proved to be decisive in reducing the incidence of hemorrhagic events. Furthermore, it showed a significant reduction in mortality and AKI compared to transfemoral access. However, increased experience in the use of the radial approach has led to less practice in the use of the femoral approach, which may be useful in cases of emergency, complications or inability to use the radial artery.
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Affiliation(s)
- Arturo Cesaro
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy.,b Department of Translational Medical Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Elisabetta Moscarella
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy.,b Department of Translational Medical Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Felice Gragnano
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy.,b Department of Translational Medical Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Rocco Perrotta
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy
| | - Vincenzo Diana
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy.,b Department of Translational Medical Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Ivana Pariggiano
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy.,b Department of Translational Medical Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Claudia Concilio
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy.,b Department of Translational Medical Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Alfonso Alfieri
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy
| | - Francesco Cesaro
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy
| | - Giuseppe Mercone
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy
| | - Sergio Falato
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy.,b Department of Translational Medical Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Augusto Esposito
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy.,b Department of Translational Medical Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Domenico Di Girolamo
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy
| | - Giuseppe Limongelli
- b Department of Translational Medical Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Paolo Calabrò
- a Division of Clinical Cardiology , A.O.R.N. "Sant'Anna e San Sebastiano" , Caserta , Italy.,b Department of Translational Medical Sciences , University of Campania "Luigi Vanvitelli" , Naples , Italy
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5
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Spitaleri G, Tebaldi M, Biscaglia S, Westra J, Brugaletta S, Erriquez A, Passarini G, Brieda A, Leone AM, Picchi A, Ielasi A, Girolamo DD, Trani C, Ferrari R, Reiber JHC, Valgimigli M, Sabatè M, Campo G. Quantitative Flow Ratio Identifies Nonculprit Coronary Lesions Requiring Revascularization in Patients With ST-Segment-Elevation Myocardial Infarction and Multivessel Disease. Circ Cardiovasc Interv 2019; 11:e006023. [PMID: 29449325 DOI: 10.1161/circinterventions.117.006023] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/26/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND The nonculprit lesion (NCL) management in ST-segment-elevation myocardial infarction patients with multivessel disease is debated. We sought to assess whether quantitative flow ratio (QFR), a noninvasive tool to identify potentially flow-limiting lesions, may be reliable in this scenario. METHODS AND RESULTS The present proof-of-concept study is based on a 3-step process: (1) identification of the QFR reproducibility in NCLs assessment (cohort A, n=31); (2) prospective validation of QFR diagnostic accuracy in respect to fractional flow reserve (cohort B, n=45); and (3) investigation of long-term clinical outcomes of NCLs stratified according to QFR (cohort C, n=110). A blinded core laboratory computed QFR values for all NCLs. Cohort A showed a good correlation and agreement between QFR values at index (acute) and at staged (subacute, 3-4 days later) procedures (r=0.98; 95% confidence interval, 0.96-0.99; mean difference, 0.004 [-0.027 to 0.34]). The inter-rater agreement was κ=0.9. In cohort B, fractional flow reserve and QFR identified 16 (33%) and 17 (35%) NCLs potentially flow limiting. Sensitivity, specificity, negative, and positive predictive values were 88%, 97%, 94%, and 94%. The area under the receiver operating characteristics curve was 0.96 (95% confidence interval, 0.89-0.99). Finally, in cohort C, we identified 110 ST-segment-elevation myocardial infarction patients where at least 1 NCL was left untreated. Patients with NCLs showing a QFR value ≤0.80 were at higher risk of adverse events (hazard ratio, 2.3; 95% confidence interval, 1.2-4.5; P=0.01). CONCLUSIONS In a limited and selected study population, our study showed that QFR computation may be a safe and reliable tool to guide coronary revascularization of NCLs in ST-segment-elevation myocardial infarction patients.
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Affiliation(s)
- Giosafat Spitaleri
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Matteo Tebaldi
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Simone Biscaglia
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Jelmer Westra
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Salvatore Brugaletta
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Andrea Erriquez
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Giulia Passarini
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Alessandro Brieda
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Antonio Maria Leone
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Andrea Picchi
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Alfonso Ielasi
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Domenico Di Girolamo
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Carlo Trani
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Roberto Ferrari
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Johan H C Reiber
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Marco Valgimigli
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Manel Sabatè
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.)
| | - Gianluca Campo
- From the Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona (FE), Italy (G.S., M.T., S.B., A.E., G.P., A.B., R.F., G.C.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.W.); University Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (S.B., M.S.); Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy (A.M.L., C.T.); Division of Cardiology, Misericordia Hospital, Grosseto, Italy (A.P.); Bolognini Hospital, Seriate (BG), Italy (A.I.); Cardiologia Interventistica, A.O. Sant'Anna e San Sebastiano, Caserta, Italy (D.D.G.); Maria Cecilia Hospital, GVM Care and Research, E.S: Health Science Foundation, Cotignola, Italy (R.F., G.C.); Department of Radiology, Leiden University Medical Center, the Netherlands (J.H.C.R.); and University Hospital of Bern, Inselspital, Switzerland (M.V.).
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Cesaro A, Gragnano F, Di Girolamo D, Moscarella E, Diana V, Pariggiano I, Alfieri A, Perrotta R, Golino P, Cesaro F, Mercone G, Campo G, Calabrò P. Functional assessment of coronary stenosis: an overview of available techniques. Is quantitative flow ratio a step to the future? Expert Rev Cardiovasc Ther 2018; 16:951-962. [DOI: 10.1080/14779072.2018.1540303] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Arturo Cesaro
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Felice Gragnano
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Domenico Di Girolamo
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Elisabetta Moscarella
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Vincenzo Diana
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ivana Pariggiano
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Alfonso Alfieri
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Rocco Perrotta
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Pasquale Golino
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Francesco Cesaro
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Giuseppe Mercone
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
| | - Paolo Calabrò
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
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7
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Tarantini G, Esposito G, Musumeci G, Fraccaro C, Franzone A, Castiglioni B, La Manna A, Limbruno U, Marchese A, Mauro C, Rigattieri S, Tarantino F, Gandolfo C, Santoro G, Violini R, Airoldi F, Albiero R, Balbi M, Baralis G, Bartorelli AL, Bedogni F, Benassi A, Berni A, Bonzani G, Bortone AS, Braito G, Briguori C, Brscic E, Calabrò P, Calchera I, Cappelli Bigazzi M, Caprioglio F, Castriota F, Cernetti C, Cicala C, Cioffi P, Colombo A, Colombo V, Contegiacomo G, Cremonesi A, D'Amico M, De Benedictis M, De Leo A, Di Biasi M, Di Girolamo D, Di Lorenzo E, Di Mario C, Dominici M, Ettori F, Ferrario M, Fioranelli M, Fischetti D, Gabrielli G, Giordano A, Giudice P, Greco C, Indolfi C, Leonzi O, Lettieri C, Loi B, Maddestra N, Marchionni N, Marrozzini C, Medda M, Missiroli B, My L, Oreglia JA, Palmieri C, Pantaleo P, Paparoni SR, Parodi G, Petronio AS, Piatti L, Piccaluga E, Pierli C, Perkan A, Pitì A, Poli A, Ramondo AB, Reale MA, Reimers B, Ribichini FL, Rosso R, Saccà S, Sacra C, Santarelli A, Sardella G, Satullo G, Scalise F, Siviglia M, Spedicato L, Stabile A, Tamburino C, Tesorio TNM, Tolaro S, Tomai F, Trani C, Valenti R, Valsecchi O, Valva G, Varbella F, Vigna C, Vignali L, Berti S. [Updated SICI-GISE position paper on institutional and operator requirements for transcatheter aortic valve implantation]. G Ital Cardiol (Rome) 2018; 19:519-529. [PMID: 30087514 DOI: 10.1714/2951.29672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Transcatheter aortic valve implantation (TAVI) has revolutionized the management of patients with symptomatic severe aortic stenosis and has become the standard of care for inoperable patients and the preferred therapy for those at increased surgical risk with peculiar clinical and anatomic features. Technology advances, growing experience and accumulating data prompted the update of the 2011 Italian Society of Interventional Cardiology (SICI-GISE) position paper on institutional and operator requirements to perform TAVI. The main objective of this document is to provide a guidance to assess the potential of institutions and operators to initiate and maintain an efficient TAVI program.
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Affiliation(s)
| | | | | | - Chiara Fraccaro
- A.O. Policlinico Universitario di Padova, Centro Gallucci, Padova
| | | | | | - Alessio La Manna
- Cardiologia Centro Alte Specialità e Trapianti, Ospedale Gaspare Rodolico, Catania
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ciro Indolfi
- Policlinico Universitario Mater Domini, Catanzaro
| | | | | | | | | | | | - Cinzia Marrozzini
- A.O. Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna
| | | | | | - Luigi My
- Casa di Cura Villa Verde, Taranto
| | | | | | | | | | | | | | | | | | | | - Andrea Perkan
- Azienda Sanitaria Universitaria Integrata di Trieste, Ospedale di Cattinara, Trieste
| | | | | | | | | | | | | | | | | | - Cosimo Sacra
- Università Cattolica del Sacro Cuore, Campobasso
| | | | | | | | | | | | | | | | - Corrado Tamburino
- Cardiologia Centro Alte Specialità e Trapianti, Ospedale Gaspare Rodolico, Catania
| | | | | | | | - Carlo Trani
- Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Roma
| | | | | | | | | | - Carlo Vigna
- Ospedale Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo (FG)
| | | | - Sergio Berti
- Ospedale del Cuore, Fondazione CNR Toscana G. Monasterio, Pisa
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Westra J, Andersen BK, Campo G, Matsuo H, Koltowski L, Eftekhari A, Liu T, Di Serafino L, Di Girolamo D, Escaned J, Nef H, Naber C, Barbierato M, Tu S, Neghabat O, Madsen M, Tebaldi M, Tanigaki T, Kochman J, Somi S, Esposito G, Mercone G, Mejia-Renteria H, Ronco F, Bøtker HE, Wijns W, Christiansen EH, Holm NR. Diagnostic Performance of In-Procedure Angiography-Derived Quantitative Flow Reserve Compared to Pressure-Derived Fractional Flow Reserve: The FAVOR II Europe-Japan Study. J Am Heart Assoc 2018; 7:JAHA.118.009603. [PMID: 29980523 PMCID: PMC6064860 DOI: 10.1161/jaha.118.009603] [Citation(s) in RCA: 215] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Quantitative flow ratio (QFR) is a novel modality for physiological lesion assessment based on 3‐dimensional vessel reconstructions and contrast flow velocity estimates. We evaluated the value of online QFR during routine invasive coronary angiography for procedural feasibility, diagnostic performance, and agreement with pressure‐wire–derived fractional flow reserve (FFR) as a gold standard in an international multicenter study. Methods and Results FAVOR II E‐J (Functional Assessment by Various Flow Reconstructions II Europe‐Japan) was a prospective, observational, investigator‐initiated study. Patients with stable angina pectoris were enrolled in 11 international centers. FFR and online QFR computation were performed in all eligible lesions. An independent core lab performed 2‐dimensional quantitative coronary angiography (2D‐QCA) analysis of all lesions assessed with QFR and FFR. The primary comparison was sensitivity and specificity of QFR compared with 2D‐QCA using FFR as a reference standard. A total of 329 patients were enrolled. Paired assessment of FFR, QFR, and 2D‐QCA was available for 317 lesions. Mean FFR, QFR, and percent diameter stenosis were 0.83±0.09, 0.82±10, and 45±10%, respectively. FFR was ≤0.80 in 104 (33%) lesions. Sensitivity and specificity by QFR was significantly higher than by 2D‐QCA (sensitivity, 86.5% (78.4–92.4) versus 44.2% (34.5–54.3); P<0.001; specificity, 86.9% (81.6–91.1) versus 76.5% (70.3–82.0); P=0.002). Area under the receiver curve was significantly higher for QFR compared with 2D‐QCA (area under the receiver curve, 0.92 [0.89–0.96] versus 0.64 [0.57–0.70]; P<0.001). Median time to QFR was significantly lower than median time to FFR (time to QFR, 5.0 minutes [interquartile range, –6.1] versus time to FFR, 7.0 minutes [interquartile range, 5.0–10.0]; P<0.001). Conclusions Online computation of QFR in the catheterization laboratory is clinically feasible and is superior to angiographic assessment for evaluation of intermediary coronary artery stenosis using FFR as a reference standard. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02959814.
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Affiliation(s)
- Jelmer Westra
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | | | - Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy.,Maria Cecilia Hospital, GVM Care and Research, Cotignola (RA), Italy
| | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu City, Japan
| | - Lukasz Koltowski
- Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Ashkan Eftekhari
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | - Tommy Liu
- Department of Cardiology, Hagaziekenhuis, The Hague, The Netherlands
| | - Luigi Di Serafino
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Javier Escaned
- Hospital Clinico San Carlos IDISSC, Complutense University, Madrid, Spain
| | - Holger Nef
- Department of Cardiology and Angiology, University of Giessen, Giessen, Germany
| | | | - Marco Barbierato
- Emodinamica Aziendale AULSS 3 Serenissima, Ospedale Dell'Angelo, Mestre, Italy
| | - Shengxian Tu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Omeed Neghabat
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | - Morten Madsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Skejby, Denmark
| | - Matteo Tebaldi
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy
| | - Toru Tanigaki
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu City, Japan
| | - Janusz Kochman
- Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Samer Somi
- Department of Cardiology, Hagaziekenhuis, The Hague, The Netherlands
| | - Giovanni Esposito
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | | | - Federico Ronco
- Emodinamica Aziendale AULSS 3 Serenissima, Ospedale Dell'Angelo, Mestre, Italy
| | - Hans Erik Bøtker
- Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
| | - William Wijns
- The Lambe Institute for Translational Medicine and Curam, National University of Ireland Galway, Galway, Ireland
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Attisano T, Silverio A, Di Lorenzo E, Tesorio T, Di Girolamo D, Golino P, Giordano A, Valva G, Esposito G, Cappelli Bigazzi M, Briguori C, Monteforte I, Dialetto G, Rubino P, Vigorito F, Giudice P, Mauro C. [SICI-GISE commuNity CAmpania survey doNna TAVI (INCANTA): perioperative and short-term outcome of transcatheter aortic valve implantation in women]. G Ital Cardiol (Rome) 2017; 18:27S-32S. [PMID: 28652630 DOI: 10.1714/2718.27732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Nowadays the prognostic role of gender as a relevant factor after transcatheter aortic valve implantation (TAVI) is still unfair, since available data in the literature are few and uneven. The aim of this survey was to collect acute and 30-day safety and efficacy clinical data in high- and intermediate-risk women, who underwent TAVI with new-generation devices, in the Campania Region. METHODS All medium and high-volume TAVI centers in Campania have been invited to fulfill an online, ad-hoc questionnaire, collecting pre-, peri- and post-procedural data concerning female patients, treated between January and December 2016. RESULTS 331 women (representing the 61% of the overall population treated; mean age 83 ± 7 years) underwent TAVI in the participating Campania centers. Age >80 years (72%), high surgical risk score (63%) and frailty (55%) were found to be the top three reasons for the TAVI choice. Overall, 95% of the procedures were performed by transfemoral approach with local anesthesia; the remaining 5% (16 cases) were conducted via transapical (14, 4%) and transaortic (2, 1%) accesses, under general anesthesia. Edwards Sapien 3 (Edwards Lifesciences, Irvine, CA, USA) and Medtronic Evolut R (Medtronic Inc., Minneapolis, MN, USA) were the most frequently implanted valves (146, 44% and 132, 43%, respectively). The questioned Centers reported a mean length of hospital stay of 5.5 ± 1.1 days, 1.6 ± 0.37 of which in a cardiac care unit. The most prevalent in-hospital complication was pacemaker implantation (15%), followed by life-threatening vascular complications (3%). The 30-day VARC-2 composite endpoint occurred in 7% of cases, all-cause death in 4%, and stroke in 1%. CONCLUSIONS This survey, the first representative of women undergoing TAVI in Campania, appears to confirm the good safety and efficacy profile of this procedure, also in the high- and intermediate-risk settings, probably favored by a prevalent use of new-generation devices and a low rate prevalence of significant patient comorbidities.
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Affiliation(s)
- Tiziana Attisano
- Cardiologia Interventistica, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Angelo Silverio
- Cardiologia Interventistica, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | | | - Tullio Tesorio
- Servizio di Emodinamica, Casa di Cura Montevergine, Mercogliano (AV)
| | | | - Paolo Golino
- Cattedra di Cardiologia, Seconda Università degli Studi, Napoli e A.O. San Sebastiano, Caserta
| | - Arturo Giordano
- Reparto di Interventistica Cardiovascolare, Clinica Pineta Grande, Castelvolturno (CE)
| | - Giuseppe Valva
- Laboratorio di Emodinamica, Casa di Cura San Michele, Maddaloni (CE)
| | - Giovanni Esposito
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi "Federico II", Napoli
| | | | - Carlo Briguori
- Laboratorio di Cardiologia Interventistica, Clinica Mediterranea, Napoli
| | | | | | - Paolo Rubino
- Emodinamica-UTIC, Presidio Ospedaliero IOS Pomigliano d'Arco, Napoli
| | - Francesco Vigorito
- Cardiologia Interventistica, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Pietro Giudice
- Cardiologia Interventistica, A.O.U. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Ciro Mauro
- Dipartimento Cardiovascolare, AORN A. Cardarelli, Napoli
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Ciccarelli G, Barbato E, Golino M, Cimmino G, Bartunek J, Di Serafino L, Di Girolamo D, De Bruyne B, Wijns W, Golino P. Prognostic Factors in Patients With Stemi Undergoing Primary PCI in the Clopidogrel Era: Role of Dual Antiplatelet Therapy at Admission and the Smoking Paradox on Long-Term Outcome. J Interv Cardiol 2016; 30:5-15. [PMID: 27925310 DOI: 10.1111/joic.12360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Several clinical and laboratory variables have an impact on the prognosis of STEMI patients undergoing PPCI; however, little is known about the role of ongoing DAPT at the time of the event and the smoking status as prognostic factors affecting the outcome of these patients. METHODS AND RESULTS Seven-hundred and thirteen consecutive STEMI patients undergoing PPCI, admitted to the S. Anna and S. Sebastiano Hospital (Caserta, Italy) and to the OLV Clinic (Aalst, Belgium), between March 2009 and December 2011, were retrospectively enrolled. Rescue PCI was the only exclusion criterion. Primary end-point was the combination of death for all causes, re-infarction, stroke, and target lesion revascularization (TLR). Patients already on DAPT at admission (26.4%) showed a significant increase in the event rate at univariate analysis (HR 2.34, CI 1.62-3.75, P < 0.05), while current smokers (56.5%) had a lower event rate, as compared to non-smokers (HR 0.67, CI 0.46-0.96, P < 0.05). In smoking patients already on DAPT at admission, a lower event rate was observed than in non-smoking patients on DAPT. Although, patients already on DAPT had a higher-risk profile (renal impairment, ongoing statin treatment, ST resolution <50%, and Killip class >1 were more frequently present than in patients not on DAPT), Cox regression analysis confirmed that both DAPT (HR 1.74, 95%CI 1.20-2.53, P < 0.01) and smoking status (HR 0.69, 95%CI 0.48-1.00, P < 0.05) retained their statistical significance, as they and were significantly associated with a worse and a better outcome, respectively, underlying their role as independent prognostic factors. CONCLUSIONS Not being a current smoker and ongoing DAPT at admission, in patients with STEMI undergoing PPCI, represent independent negative prognostic value.
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Affiliation(s)
- Giovanni Ciccarelli
- Department of Cardio-Thoracic Sciences, Section of Cardiology, Second University of Naples, Naples, Italy.,Cardiovascular Center, OLV Clinic, Aalst, Belgium
| | - Emanuele Barbato
- Cardiovascular Center, OLV Clinic, Aalst, Belgium.,Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy
| | - Marco Golino
- Department of Cardio-Thoracic Sciences, Section of Cardiology, Second University of Naples, Naples, Italy
| | - Giovanni Cimmino
- Department of Cardio-Thoracic Sciences, Section of Cardiology, Second University of Naples, Naples, Italy
| | | | - Luigi Di Serafino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy
| | | | | | | | - Paolo Golino
- Department of Cardio-Thoracic Sciences, Section of Cardiology, Second University of Naples, Naples, Italy
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Biondi-Zoccai G, Romagnoli E, Castagno D, Sheiban I, De Servi S, Tamburino C, Colombo A, Burzotta F, Presbitero P, Bolognese L, Paloscia L, Rubino P, Sardella G, Briguori C, Niccoli L, Franco G, Di Girolamo D, Piatti L, Greco C, Petronio AS, Loi B, Benassi A, Patti A, Gaspardone A, Frati G, Sangiorgi G. Simplifying clinical risk prediction for percutaneous coronary intervention of bifurcation lesions: the case for the ACEF (age, creatinine, ejection fraction) score. EUROINTERVENTION 2013; 8:359-67. [PMID: 22584142 DOI: 10.4244/eijv8i3a55] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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: 02/05/2023]
Abstract
AIMS We aimed to appraise the predictive accuracy of a novel and user-friendly risk score, the ACEF (age, creatinine, ejection fraction), in patients undergoing PCI for coronary bifurcations. METHODS AND RESULTS A multicentre, retrospective study was conducted enrolling consecutive patients undergoing bifurcation PCI between January 2002 and December 2006 in 22 Italian centres. Patients with complete data to enable computation of the ACEF score were divided into three groups according to tertiles of ACEF score. The primary endpoint was 30-day mortality. The discrimination of the ACEF score as a continuous variable was also appraised with area under the curve (AUC) of the receiver-operating characteristic. A total of 3,535 patients were included: 1,119 in the lowest tertile of ACEF score, 1,190 in the mid tertile, and 1,153 in the highest tertile. Increased ACEF score was associated with significantly different rates of 30-day mortality (0.1% in the lowest tertile vs. 0.5% in the mid tertile and 3.0% in the highest tertile, p<0.001), with similar differences in myocardial infarction (0.3% vs. 0.7% and 1.8%, p<0.001) and major adverse cardiac events (MACE, 0.5% vs. 1.2% and 4.3%, p<0.001). After an average follow-up of 24.4±15.1 months, increased ACEF score was still associated with a higher rate of all-cause death (1.3% vs. 2.4% and 11.0%, p<0.001), cardiac death (0.9% vs. 1.4% and 7.2%, p<0.001), myocardial infarction (3.4% vs. 2.7% and 5.7%, p<0.001), MACE (13.6% vs. 15.9% and 22.3%, p<0.001), and stent thrombosis (2.3% vs. 1.8% and 5.0%, p<0.001). Discrimination of ACEF score was satisfactory for 30-day mortality (AUC=0.82 [0.77-0.87], p<0.001), 30-day MACE (AUC=0.73 [0.67-0.78], p<0.001), long-term mortality (AUC=0.77 [0.74-0.81], p<0.001), and moderate for long-term MACE (AUC=0.60 [0.57-0.62], p<0.001). CONCLUSIONS The simple and extremely user-friendly ACEF score can accurately identify patients undergoing PCI for coronary bifurcation lesions at high risk of early fatal or non-fatal complications, as well as long-term fatality.
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Affiliation(s)
- Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, Latina, Italy.
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Roversi S, Biondi-Zoccai G, Romagnoli E, Sheiban I, De Servi S, Tamburino C, Colombo A, Burzotta F, Presbitero P, Bolognese L, Paloscia L, Rubino P, Sardella G, Briguori C, Niccoli L, Franco G, Di Girolamo D, Piatti L, Greco C, Petronio S, Loi B, Lioy E, Benassi A, Patti A, Gaspardone A, Capodanno D, Modena MG, Sangiorgi G. Early and long-term outlook of percutaneous coronary intervention for bifurcation lesions in young patients. Int J Cardiol 2012; 167:2995-9. [PMID: 22995415 DOI: 10.1016/j.ijcard.2012.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 09/02/2012] [Indexed: 02/08/2023]
Abstract
BACKGROUND Coronary artery disease is most common in older patients, but may occur in younger subjects. The outlook of young patients after percutaneous coronary intervention (PCI) of challenging lesion subsets such as coronary bifurcations, is not established. We thus aimed to appraise the early and long-term results of PCI for bifurcations in young patients. METHODS A multicenter, retrospective study was conducted enrolling consecutive patients undergoing bifurcation PCI between 2002 and 2006 in 22 Italian centers. Patients were divided in 2 groups: age ≤ 45 years, and age > 45 years. The primary end-point was long-term rate of major adverse cardiac events (MACE). RESULTS 4,314 patients were included: 195 (4.5%) in the younger group, and 4119 (95.5%) in the older group. 30-day outcomes did not show significant differences in MACE rates, with 1.0% in the ≤ 45 years group and 2.1% in the >45 years group (p=0.439), with death in 0.5% and 1.2% (p=0.388). At long-term follow-up (24.4 ± 15.1 months), younger patients showed similar rates of MACE, (12.8% vs. 16.6%, p=0.161), myocardial infarction (3.1% vs. 3.7%, p=0.633), target lesion revascularization (11.3% vs. 12.5%, p=0.627), or stent thrombosis (1.5% vs. 2.8%, p=0.294), despite an increased risk of death in older patients (1.0% vs. 5.0%, p=0.012). Even at extensive multivariable analysis, younger patients still faced a similar risk of MACE (HR=0.78 [0.48-1.27], p=0.318). CONCLUSIONS Despite their low age, young patients undergoing PCI for bifurcation face a significant risk of early and late non-fatal adverse events. Thus, they should not be denied careful medical management and follow-up.
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Affiliation(s)
- Sara Roversi
- University of Modena and Reggio Emilia, Modena, Italy.
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Biondi-Zoccai G, Sheiban I, Romagnoli E, De Servi S, Tamburino C, Colombo A, Burzotta F, Presbitero P, Bolognese L, Paloscia L, Rubino P, Sardella G, Briguori C, Niccoli L, Franco G, Di Girolamo D, Piatti L, Greco C, Capodanno D, Sangiorgi G. Is intravascular ultrasound beneficial for percutaneous coronary intervention of bifurcation lesions? Evidence from a 4,314-patient registry. Clin Res Cardiol 2011; 100:1021-8. [PMID: 21701872 DOI: 10.1007/s00392-011-0336-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 06/09/2011] [Indexed: 02/05/2023]
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Capodanno D, Tamburino C, Sangiorgi GM, Romagnoli E, Colombo A, Burzotta F, Gasparini GL, Bolognese L, Paloscia L, Rubino P, Sardella G, Briguori C, Ettori F, Franco G, Di Girolamo D, Sheiban I, Piatti L, Greco C, Petronio AS, Loi B, Lyoi E, Benassi A, Patti A, Gaspardone A, De Servi S. Impact of drug-eluting stents and diabetes mellitus in patients with coronary bifurcation lesions: a survey from the Italian Society of Invasive Cardiology. Circ Cardiovasc Interv 2011; 4:72-9. [PMID: 21205940 DOI: 10.1161/circinterventions.110.959460] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND We investigated the long-term impact of different stent types and diabetes mellitus (DM) in patients undergoing percutaneous coronary intervention (PCI) of bifurcation lesions, based on a large multicenter survey endorsed by the Italian Society of Invasive Cardiology. METHODS AND RESULTS Relative benefits of drug eluting stent (DES) over bare metal stent (BMS) in patients with (n=1049) and without (n=3020) DM were analyzed with extensive multivariable adjustment. At 3 years, stenting with DES was associated with lower adjusted risk of major adverse cardiac events (MACE, adjusted hazard ratio [HR] 0.27, 95% confidence interval [CI] 0.15 to 0.49, P<0.001), cardiac death, and target lesion revascularization in DM patients but failed to demonstrate any significant benefit in patients without DM. CONCLUSIONS In a large observational registry with admitted potential for selection bias and residual confounding, DES in DM patients with coronary bifurcation lesions were associated with improved outcomes in terms of MACE, cardiac death, and repeat revascularization at long-term follow up. These figures were not replicated in non-DM subjects.
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Affiliation(s)
- Davide Capodanno
- Cardiology Department, Ferrarotto Hospital, University of Catania, via Citelli 6, Catania, Italy.
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