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Novel cardiac magnetic resonance biomarkers: native T1 and extracellular volume myocardial mapping
This article describes technical challenges and clinical perspectives of these two novel CMR biomarkers: myocardial native T1 and ECV mapping. (Source: European Journal of Heart Failure Supplements)
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Cannao, P. M., Altabella, L., Petrini, M., Ali, M., Secchi, F., Sardanelli, F. Tags: Articles Source Type: research

Activities at Thoracic Aortic Research Center, IRCCS Policlinico San Donato
The Thoracic Aortic Research Center (TARC) of the IRCCS Policlinico San Donato (PSD) aims to promote research on thoracic aortic diseases, to disclose the scientific knowledge and clinical experience and to develop new scientific paths within the Hospital and the aortic community, in collaboration with other national and international centres. Thoracic Aortic Research Center collaborates with many centres in both Europe (e.g. University of Utrecht, the Netherlands) and the USA (e.g. University of Michigan). This has led to multiple highly regarded publications in respected cardiovascular journals and has led to several PhD...
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Trimarchi, S., Kamman, A., Lomazzi, C., Segreti, S., Cova, M., De Vincentiis, C., Frigiola, A., Menicanti, L., Marrocco-Trischitta, M. M., Grassi, V., Morganti, S., Conti, M., Auricchio, F., Rampoldi, V. Tags: Articles Source Type: research

Fractional flow reserve based on computed tomography: an overview
Computed tomography coronary angiography (CTCA) is a technique proved to provide high sensitivity and negative predictive value for the identification of anatomically significant coronary artery disease (CAD) when compared with invasive X-ray coronary angiography. While the CTCA limitation of a ionizing radiation dose delivered to patients is substantially overcome by recent technical innovations, a relevant limitation remains the only anatomical assessment of coronary stenoses in the absence of evaluation of their functional haemodynamic significance. This limitation is highly important for those stenosis graded as interm...
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Secchi, F., Ali, M., Faggiano, E., Cannao, P. M., Fedele, M., Tresoldi, S., Di Leo, G., Auricchio, F., Sardanelli, F. Tags: Articles Source Type: research

Point-of-care haemostasis and coagulation monitoring in cardiac surgery at IRCCS Policlinico San Donato
A rational management of perioperative and postoperative bleeding in modern cardiac surgery requires a thorough application of point-of-care (POC) monitoring in order to prevent and readily treat alterations of the haemostatic process. Preoperative platelet dysfunction, residual heparin after extracorporeal circulation, coagulation factors, and/or fibrinogen deficiency could be ruled out and specifically addressed with an appropriate treatment. Our approach includes preoperative platelet function testing of patients administered with thienopyridines or ticagrelor within 7–10 days before planned surgery and platelet f...
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Baryshnikova, E., Ranucci, M. Tags: Articles Source Type: research

New technologies in vascular surgery: San Donato's experience in the last decades
We report our experience in the last decades. (Source: European Journal of Heart Failure Supplements)
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Mazzaccaro, D., Occhiuto, M. T., Stegher, S., Righini, P., Malacrida, G., Nano, G. Tags: Articles Source Type: research

microRNAs in ischaemic cardiovascular diseases
microRNAs (miRNAs) are non-coding RNA molecules that modulate the stability and/or the translational efficiency of specific messenger RNAs. They have been shown to play a regulatory role in most biological processes and their expression is disrupted in many cardiovascular diseases. This review describes studies performed at Policlinico San Donato-IRCCS in cell cultures, animal models, and patients, showing a penetrant role of miRNAs in cell response to hypoxia and in ischaemic cardiovascular diseases. These experiments indicate miRNA as an emerging class of therapeutic targets. (Source: European Journal of Heart Failure Supplements)
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Greco, S., Zaccagnini, G., Voellenkle, C., Martelli, F. Tags: Articles Source Type: research

Multimodality cardiac imaging at IRCCS Policlinico San Donato: a new interdisciplinary vision
Multimodality imaging is the efficient integration of various methods of cardiovascular imaging to improve the ability to diagnose, guide therapy, or predict outcome. This approach implies both the availability of different technologies in a single unit and the presence of dedicated staff with cardiologic and radiologic background and certified competence in more than one imaging technique. Interaction with clinical practice and existence of research programmes and educational activities are pivotal for the success of this model. The aim of this paper is to describe the multimodality cardiac imaging programme recently star...
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Lombardi, M., Secchi, F., Pluchinotta, F. R., Castelvecchio, S., Montericcio, V., Camporeale, A., Bandera, F. Tags: Articles Source Type: research

Treatment of right ventricular outflow tract dysfunction: a multimodality approach
The right timing to replace the pulmonary valve in a patient with dysfunction of the right ventricular outflow tract is unknown. Both percutaneous pulmonary valve and surgical prosthesis are suitable options. In every patient, the right ventricle (RV) remodels and recovers differently after pulmonary replacement. Therefore, it is difficult to identify the best treatment option and to predict the long-term results. In the last few years, we focused our research on optimizing the characterization of these patients through advanced cardiovascular imaging in order to find possible variables, parameters, and reproducible measur...
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Pluchinotta, F. R., Bussadori, C., Butera, G., Piazza, L., Chessa, M., Saracino, A., Fernandez Sarabia, J., Giugno, L., Arcidiacono, C., Micheletti, A., Negura, D. G., Fesslova, V., Carminati, M. Tags: Articles Source Type: research

Rhinocerebral zygomycosis: an unusual dramatic presentation in a paediatric cardiac patient without risk factors
We describe a case of rhinocerebral mucormycosis presented in a paediatric patient after cardiac surgery correction of a complete atrioventricular canal defect. The rhinocerebral form of mucormycosis in our patient presented as an important epistaxis that needed immediate intubation due to blood inhalation. Furthermore, due to the worsening of pulmonary function, the patient also needed mechanical support with veno-arterial extracorporeal membrane oxygenation. The patient died as a consequence of a disseminated form of fungal infection. We describe our experience of this rare opportunistic infection and we think that early...
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Isgro, G., Carlucci, C., Giamberti, A., Frigiola, A., Ranucci, M. Tags: Articles Source Type: research

The care for adults with congenital heart disease: organization and function of a grown-up congenital heart disease unit
Thanks to the improvement of surgical and interventional cardiac procedures, the majority of children with congenital heart defects (CHD) can now be expected to reach adulthood. The number of adults with congenital heart disease (ACHD) will inevitably increase, and recent data affirm that in Europe, we are actually faced with an estimated patient population of 2.3 million. These patients, particularly the adults with moderate and highly complex CHD, can be very difficult to manage, and should be treated in few experienced and specialized ‘grown-up congenital heart disease’ (GUCH) units, concentrating resources,...
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Giamberti, A., Varrica, A., Pome, G., Micheletti, A., Negura, D., Ranucci, M., Carminati, M., Frigiola, A., Chessa, M. Tags: Articles Source Type: research

Surgical ventricular reconstruction for ischaemic heart failure: state of the art
Patients with ischaemic cardiomyopathy and left ventricular (LV) systolic dysfunction represent the highest-risk population with heart failure (HF). The cornerstone of treatment remains guideline-driven medical therapy, which is associated with significant improvement in survival and quality of life. The most commonly considered surgical interventions are coronary artery bypass graft surgery, at times combined with surgical ventricular reconstruction (SVR) and surgery for mitral valve regurgitation. Surgical ventricular reconstruction has been introduced as an optional therapeutic strategy aimed to reduce LV volumes throug...
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Castelvecchio, S., Garatti, A., Gagliardotto, P. V., Menicanti, L. Tags: Articles Source Type: research

A chemical approach to myocardial protection and regeneration
The possibility of generating induced pluripotent stem cells from mouse embryonic fibroblasts and human adult fibroblasts has introduced new perspectives for possible therapeutic strategies to repair damaged hearts. However, obtaining large numbers of adult stem cells is still an ongoing challenge, and the safety of genetic reprogramming with lenti- or retro-viruses has several drawbacks not easy to be addressed. Furthermore, the majority of adult stem cell-based clinical trials for heart regeneration have had generally poor and controversial results. Nonetheless, it is now clear that the injected cells activate the growth...
Source: European Journal of Heart Failure Supplements - April 28, 2016 Category: Cardiology Authors: Piccoli, M., Cirillo, F., Tettamanti, G., Anastasia, L. Tags: Articles Source Type: research

Once-daily rivaroxaban for long-term stroke prevention in patients with atrial fibrillation
Oral anticoagulation is the long-term standard of care for preventing stroke in patients with atrial fibrillation (AF). However, anticoagulation is associated with an increased risk of bleeding, such that its use should be based on the absolute risks of stroke and bleeding, and the relative benefit–risk profile of the individual patient. Non-vitamin K antagonist oral anticoagulants, including rivaroxaban, are alternatives to vitamin K antagonists such as warfarin in this setting, and are supported in treatment guidelines as the optimal choice for patients with AF at moderate to high risk of stroke. Rivaroxaban can be...
Source: European Journal of Heart Failure Supplements - April 20, 2016 Category: Cardiology Authors: Antoniou, S., Amara, W. Tags: Articles Source Type: research

Benefits of once-daily dosing with non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation
Atrial fibrillation (AF) is the most prevalent clinically relevant arrhythmia, affecting millions of individuals in Europe and the USA. Atrial fibrillation increases the risk of stroke; the long-term standard of care for prevention of AF-related stroke is anticoagulation. The use of anticoagulants should be based on the absolute risks of stroke and bleeding and the relative benefit–risk profile of the individual patient. Treatment options include vitamin K antagonists (VKAs) such as warfarin, whose use is long-established but associated with drawbacks, including regular coagulation monitoring requirements and many fo...
Source: European Journal of Heart Failure Supplements - April 20, 2016 Category: Cardiology Authors: Amara, W., Antoniou, S. Tags: Articles Source Type: research

Current practice in identifying and treating cardiovascular risk, with a focus on residual risk associated with atherogenic dyslipidaemia
A panel of European experts on lipids and cardiovascular disease discussed clinical approaches to managing cardiovascular risk in clinical practice, including residual cardiovascular risk associated with lipid abnormalities, such as atherogenic dyslipidaemia (AD). A simplified definition of AD was proposed to enhance understanding of this condition, its prevalence, and its impact on cardiovascular risk. Atherogenic dyslipidaemia can be defined by high fasting triglyceride levels (≥2.3 mmol/L) and low high-density lipoprotein cholesterol (HDL-c) levels (≤1.0 and ≤1.3 mmol/L in men and women, respectively) in statin...
Source: European Journal of Heart Failure Supplements - April 11, 2016 Category: Cardiology Authors: Ferrari, R., Aguiar, C., Alegria, E., Bonadonna, R. C., Cosentino, F., Elisaf, M., Farnier, M., Ferrieres, J., Filardi, P. P., Hancu, N., Kayikcioglu, M., Mello e Silva, A., Millan, J., Reiner, Z., Tokgozoglu, L., Valensi, P., Viigimaa, M., Vrablik, M., Z Tags: Article Source Type: research