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  1. Article ; Online: Syncope in a patient with acute pulmonary embolism and Brugada Type-2 ECG pattern: Brugada phenocopy or Brugada syndrome?

    Lippolis, Antonio / Buzzi, Maria Paola / Romano, Ilaria Jane / Facchini, Camilla / Gentile, Francesco

    Journal of electrocardiology

    2019  Volume 54, Page(s) 90–92

    Abstract: Brugada phenocopies are clinical entities characterized by electrocardiographic patterns that are identical to true Brugada syndrome, but are elicited by a number of clinical circumstances. ECG normalizes upon resolution of underlying condition, family ... ...

    Abstract Brugada phenocopies are clinical entities characterized by electrocardiographic patterns that are identical to true Brugada syndrome, but are elicited by a number of clinical circumstances. ECG normalizes upon resolution of underlying condition, family history of arrhythmic syncope or ventricular arrhythmias is strictly absent and provocative tests with sodium channel blockers have to be negative. We describe herein the case of type-2 ECG Brugada pattern in a patient with acute pulmonary embolism presenting with recurrent syncope but negative provocative test with sodium channel blockers. Transthoracic echocardiography and transcranial Doppler did not show atrial septal defect. In conclusion, to the best of our knowledge no other cases excluded atrial septal defect and paradoxical embolism as a possible cause of acute pulmonary embolism related Type-2 Brugada ECG pattern. Therefore in our case right ventricle transmural myocardial ischemia due to acute pulmonary embolism, mainly secondary to right ventricle stretch, could explain Brugada ECG pattern.
    MeSH term(s) Brugada Syndrome/diagnosis ; Brugada Syndrome/etiology ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Humans ; Male ; Middle Aged ; Phenotype ; Pulmonary Embolism/complications ; Pulmonary Embolism/diagnosis ; Syncope/diagnosis ; Syncope/etiology
    Language English
    Publishing date 2019-04-04
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 410286-1
    ISSN 1532-8430 ; 0022-0736
    ISSN (online) 1532-8430
    ISSN 0022-0736
    DOI 10.1016/j.jelectrocard.2019.04.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Lung ultrasound and transthoracic impedance for noninvasive evaluation of pulmonary congestion in heart failure.

    Facchini, Camilla / Malfatto, Gabriella / Giglio, Alessia / Facchini, Mario / Parati, Gianfranco / Branzi, Giovanna

    Journal of cardiovascular medicine (Hagerstown, Md.)

    2016  Volume 17, Issue 7, Page(s) 510–517

    Abstract: Background: In patients with heart failure, many indexes are available for noninvasive identification of pulmonary congestion: E/E' at echocardiography; plasma levels of brain natriuretic peptide (BNP) (pg/ml); number of B-lines at lung ultrasound; and ... ...

    Abstract Background: In patients with heart failure, many indexes are available for noninvasive identification of pulmonary congestion: E/E' at echocardiography; plasma levels of brain natriuretic peptide (BNP) (pg/ml); number of B-lines at lung ultrasound; and transthoracic conductance [thoracic fluid content (TFC)TT = 1/Ω] at impedance cardiography (ICG).
    Methods: We obtained 75 measures from 50 patients (72 ± 10 years, NYHA 2.4 ± 0.7, ejection fraction 31 ± 7%), 25 of them studied before and after intravenous diuretics, in whom we assessed the following: E/e' from Doppler echocardiogram; BNP plasma levels; presence and number of B-lines at lung ultrasound; and TFCTT from ICG. We determined the relationship among these indexes and their change with treatment, and compared B-lines and TFC for the diagnosis of pulmonary congestion. Finally, we considered the timing and the personnel required for performing and interpreting each test.
    Results: A mutual relationship was observed between all the variables. After clinical improvement, changes in each variable were of similar direction and magnitude. Congestion (estimated by chest radiograph) was present in 59% of the patients: TFC value and B-line number had the best sensitivity and specificity for its detection. BNP determination and ICG assessment were performed by a nurse (15 min), and echocardiography and lung ultrasound were performed by a cardiologist (15 min).
    Conclusion: The correlation between all indexes and their consensual change after improvement of the clinical status suggests that they all detect pulmonary congestion, and that using at least two indexes improves sensitivity and specificity. The choice among the methods may be determined by the patient characteristics or by the clinical setting.
    MeSH term(s) Aged ; Aged, 80 and over ; Cardiography, Impedance ; Echocardiography, Doppler ; Female ; Heart Failure/complications ; Humans ; Linear Models ; Lung/diagnostic imaging ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Pulmonary Edema/diagnostic imaging ; ROC Curve ; Sensitivity and Specificity
    Chemical Substances Natriuretic Peptide, Brain (114471-18-0)
    Language English
    Publishing date 2016-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2223461-5
    ISSN 1558-2035 ; 1558-2027
    ISSN (online) 1558-2035
    ISSN 1558-2027
    DOI 10.2459/JCM.0000000000000226
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: A brief period of intensive cardiac rehabilitation improves global longitudinal strain and diastolic function after a first uncomplicated myocardial infarction.

    Malfatto, Gabriella / Revera, Miriam / Branzi, Giovanna / Ciambellotti, Francesca / Giglio, Alessia / Blengino, Simonetta / Oldani, Matteo / Facchini, Camilla / Parati, Gianfranco / Facchini, Mario

    Acta cardiologica

    2017  Volume 72, Issue 3, Page(s) 284–291

    Abstract: Objectives In patients with abnormal left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI), cardiac rehabilitation with physical training prevents cardiac remodelling. To define the role of rehabilitation in the recovery of ... ...

    Abstract Objectives In patients with abnormal left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI), cardiac rehabilitation with physical training prevents cardiac remodelling. To define the role of rehabilitation in the recovery of ventricular function in less severe cases, we studied its effects on more refined indexes of left ventricular function in uncomplicated, low-risk patients. Methods and results Fifty-five patients underwent percutaneous coronary revascularization after uncomplicated first AMI. Thirty-four started cardiac rehabilitation with counselling and physical training; 21 patients did not train, followed a counselling program and were taken as controls. Echocardiography was performed at baseline, after rehabilitation or counselling program and at six months follow-up. We measured: global strain (GS%) with speckle tracking analysis, E/e' by tissue Doppler imaging (TDI), left ventricular elastance (K
    MeSH term(s) Diastole ; Echocardiography, Doppler ; Electrocardiography ; Exercise Test ; Exercise Therapy/methods ; Female ; Follow-Up Studies ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Recovery of Function ; ST Elevation Myocardial Infarction/physiopathology ; ST Elevation Myocardial Infarction/rehabilitation ; ST Elevation Myocardial Infarction/surgery ; Stroke Volume/physiology ; Treatment Outcome ; Ventricular Function, Left/physiology
    Language English
    Publishing date 2017-03-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 390197-x
    ISSN 0001-5385
    ISSN 0001-5385
    DOI 10.1080/00015385.2017.1305196
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  4. Article ; Online: G-CSF for Extensive STEMI.

    Achilli, Felice / Pontone, Gianluca / Bassetti, Beatrice / Squadroni, Lidia / Campodonico, Jeness / Corrada, Elena / Facchini, Camilla / Mircoli, Luca / Esposito, Giovanni / Scarpa, Daniele / Pidello, Stefano / Righetti, Stefano / Di Gennaro, Filiberto / Guglielmo, Marco / Muscogiuri, Giuseppe / Baggiano, Andrea / Limido, Alberto / Lenatti, Laura / Di Tano, Giuseppe /
    Malafronte, Cristina / Soffici, Federica / Ceseri, Martina / Maggiolini, Stefano / Colombo, Gualtiero I / Pompilio, Giulio

    Circulation research

    2019  Volume 125, Issue 3, Page(s) 295–306

    Abstract: Rationale: In the exploratory Phase II STEM-AMI (Stem Cells Mobilization in Acute Myocardial Infarction) trial, we reported that early administration of G-CSF (granulocyte colony-stimulating factor), in patients with anterior ST-segment-elevation ... ...

    Abstract Rationale: In the exploratory Phase II STEM-AMI (Stem Cells Mobilization in Acute Myocardial Infarction) trial, we reported that early administration of G-CSF (granulocyte colony-stimulating factor), in patients with anterior ST-segment-elevation myocardial infarction and left ventricular (LV) dysfunction after successful percutaneous coronary intervention, had the potential to significantly attenuate LV adverse remodeling in the long-term.
    Objective: The STEM-AMI OUTCOME CMR (Stem Cells Mobilization in Acute Myocardial Infarction Outcome Cardiac Magnetic Resonance) Substudy was adequately powered to evaluate, in a population showing LV ejection fraction ≤45% after percutaneous coronary intervention for extensive ST-segment-elevation myocardial infarction, the effects of early administration of G-CSF in terms of LV remodeling and function, infarct size assessed by late gadolinium enhancement, and myocardial strain.
    Methods and results: Within the Italian, multicenter, prospective, randomized, Phase III STEM-AMI OUTCOME trial, 161 ST-segment-elevation myocardial infarction patients were enrolled in the CMR Substudy and assigned to standard of care (SOC) plus G-CSF or SOC alone. In 119 patients (61 G-CSF and 58 SOC, respectively), CMR was available at baseline and 6-month follow-up. Paired imaging data were independently analyzed by 2 blinded experts in a core CMR lab. The 2 groups were similar for clinical characteristics, cardiovascular risk factors, and pharmacological treatment, except for a trend towards a larger infarct size and longer symptom-to-balloon time in G-CSF patients. ANCOVA showed that the improvement of LV ejection fraction from baseline to 6 months was 5.1% higher in G-CSF patients versus SOC (P=0.01); concurrently, there was a significant between-group difference of 6.7 mL/m
    Conclusions: Early administration of G-CSF exerted a beneficial effect on top of SOC in patients with LV dysfunction after extensive ST-segment-elevation myocardial infarction in terms of global systolic function, adverse remodeling, scar size, and myocardial strain.
    Clinical trial registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01969890.
    MeSH term(s) Aged ; Female ; Granulocyte Colony-Stimulating Factor/therapeutic use ; Heart Ventricles/drug effects ; Heart Ventricles/pathology ; Humans ; Male ; Middle Aged ; Myocardial Contraction/drug effects ; Organ Size ; Prospective Studies ; ST Elevation Myocardial Infarction/drug therapy ; ST Elevation Myocardial Infarction/pathology ; ST Elevation Myocardial Infarction/physiopathology ; Single-Blind Method ; Stroke Volume/drug effects ; Ventricular Remodeling/drug effects
    Chemical Substances Granulocyte Colony-Stimulating Factor (143011-72-7)
    Language English
    Publishing date 2019-05-29
    Publishing country United States
    Document type Clinical Trial, Phase III ; Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 80100-8
    ISSN 1524-4571 ; 0009-7330 ; 0931-6876
    ISSN (online) 1524-4571
    ISSN 0009-7330 ; 0931-6876
    DOI 10.1161/CIRCRESAHA.118.314617
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Transthoracic bioimpedance and brain natriuretic peptide levels accurately indicate additional diastolic dysfunction in patients with chronic advanced systolic heart failure.

    Malfatto, Gabriella / Branzi, Giovanna / Giglio, Alessia / Villani, Alessandra / Facchini, Camilla / Ciambellotti, Francesca / Facchini, Mario / Parati, Gianfranco

    European journal of heart failure

    2010  Volume 12, Issue 9, Page(s) 928–935

    Abstract: Aims: Diastolic dysfunction in patients with heart failure has prognostic relevance, possibly because of its relationship with worsening haemodynamic status. In the quest for simpler indexes of haemodynamic status in patients, brain natriuretic peptide ( ...

    Abstract Aims: Diastolic dysfunction in patients with heart failure has prognostic relevance, possibly because of its relationship with worsening haemodynamic status. In the quest for simpler indexes of haemodynamic status in patients, brain natriuretic peptide (BNP) levels have been proposed as a surrogate of diastolic function. To date, the value of combining BNP levels with non-invasive haemodynamic monitoring by transthoracic electric bioimpedance (TEB) for the prediction of diastolic function has not been evaluated.
    Methods and results: We compared left ventricular diastolic function measured by tissue Doppler imaging (TDI) with TEB results and BNP levels in 120 patients with chronic advanced systolic heart failure on optimal treatment (70 +/- 9 years, NYHA 2.4 +/- 0.8, ejection fraction 31 +/- 5%). Of the TEB variables measured, we only considered thoracic fluid content (TFC). To describe diastolic function, we used the TDI of the velocity of displacement of the mitral annulus (E') and the ratio E/E'. In all patients, E/E' was significantly related to TFC and to BNP levels (P < 0.001). Moreover, the combination of BNP > or = 350 pg/mL and TFC > or = 35/kOmega identified patients with diastolic dysfunction (defined as E/E' > or = 15) with high sensitivity and specificity (95 and 94%, respectively).
    Conclusion: The combination of transthoracic bioimpedance monitoring and BNP measurement accurately indicated the presence of diastolic dysfunction in most patients. These user-friendly and operator-independent tools may be useful as a screening assessment for diastolic dysfunction, and consequently abnormal central haemodynamic status, either in ambulatory patients or when an adequate echocardiographic evaluation is not readily available.
    MeSH term(s) Aged ; Biomarkers/blood ; Cardiography, Impedance/methods ; Diastole ; Disease Progression ; Echocardiography, Doppler, Color ; Electric Impedance ; Female ; Follow-Up Studies ; Heart Failure, Systolic/blood ; Heart Failure, Systolic/complications ; Heart Failure, Systolic/physiopathology ; Humans ; Male ; Myocardial Contraction/physiology ; Natriuretic Peptide, Brain/blood ; Reproducibility of Results ; Severity of Illness Index ; Ventricular Dysfunction, Left/blood ; Ventricular Dysfunction, Left/etiology ; Ventricular Dysfunction, Left/physiopathology
    Chemical Substances Biomarkers ; Natriuretic Peptide, Brain (114471-18-0)
    Language English
    Publishing date 2010-09
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 1483672-5
    ISSN 1879-0844 ; 1388-9842
    ISSN (online) 1879-0844
    ISSN 1388-9842
    DOI 10.1093/eurjhf/hfq089
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